Happy Birthday Tyler

While many may not realize it today is a very special day as today on World Diabetes Day Tyler turns 2 years old. Now for those new to Diabetic Investor Tyler, besides being a scrappy two-year-old who’s cute as a dickens, is our term for a connected insulin pen/CGM/app insulin delivery system. The big difference between the real Tyler and the system Tyler is that the real Tyler is growing up and making a name for himself, unlike the system Tyler who continues to languish in development.

Frankly we’re aren’t surprised the real Tyler is making his way in the world, and damn that kid better grow up to a Bears fan, nor unfortunately are we surprised the system Tyler isn’t on the market yet. All three insulin companies, Lilly, Novo Nordisk and Sanofi have a connected insulin pen. All three have way cool whiz bang apps that can collect data from the pen plus the Dexcom CGM. It’s also likely whenever the Libre2 gets here all three of these apps will also collect data from it as well.

The closet we are to the system Tyler being here is the partnership between Companion Medical and Dexcom. Remember besides having a great CGM sensor Dexcom also owns the TypeZero insulin dosing algorithm, also one of the best. This is one reason we believe Dexcom could leapfrog all the insulin companies who continue to fumble about with their Tyler’s and grab this market by horns. With the coming of a biosimilar short-acting insulin, Dexcom could gobble up Companion, find an insulin partner and use Tyler to sell more sensors.

We still believe the insulin companies could dominate this market given their scale, relationships with payors and the fact that Tyler would protect their insulin franchises from further commodization. However as effective as Tyler would be at protecting these franchises all three of the insulin companies are excuse the expression taking their sweet time getting Tyler onto the market.

About the only people who are happy that the system Tyler isn’t here yet are the insulin pump companies. As we have stated previously Tyler is the biggest threat to continued growth in the insulin pump market. The system Tyler will provide payors with insulin pump like outcomes at a much cheaper price point. And while much has changed in the last two years one thing that hasn’t changed when it comes to all the toys in the toy chest payors care about one thing and one thing only, money.

Insulet with their pay as you go model is about the only insulin pump that has somewhat insulated themselves from the impact Tyler will have. Tandem is at risk as well but given how the Control IQ will stomp all over the 670G it is Medtronic, who needs another problem as much as Chicago needs more cold weather, who is the most at risk when Tyler arrives. Even so we continue to believe all the insulin pump companies strictly from a defensive perspective should add a Tyler to their suite of offerings.

This would be pretty easy as besides Companion, there are a gazillion connected pen companies who would do a major hippie hippie if any of the pump companies came along and wanted to do a deal. There are also a gazillion more Dexcom wannabes who would be equally delighted to do a deal. The fact is insulin pump companies are already built to sell and support a Tyler, something the insulin companies no matter what they think are not.

This is another reason we believe Dexcom pull the trigger and launch a Tyler. They have the best CGM on the planet, the have one of the best if not the best insulin dosing algorithm and besides their partnership with Companion they could also buy one of the many connected pen cap covers which work with the very popular disposable insulin pens. Frankly we have never understood why Companion, who has the only real connected pen hasn’t gone out and gotten a connected cap cover.

Like the insulin pump companies Dexcom already has the infrastructure in place to sell and support a Tyler. If nothing else should they begin to head down this path it might just light a fire under the butts of the insulin companies to get their Tyler’s on the market. Frankly Dexcom will win either way as their sensor will work with them anyway.

One company noticeably absent from this conversation is Bigfoot, you may remember them as they were supposed to have the coolest connected cap cover ever. Guess that for all the bluster all the bravado all the talk there is no there there.

Anyway Happy Birthday Tyler, hope Mom and Dad are ready for the terrible twos.