How far we’ve come and how far we still must go

How far we’ve come and how far we still must go

Back in the day when Diabetic Investor first began publishing we predicted that one day patients and physicians would prefer insulin pen delivery systems over syringe delivery. Back then and still today insulin pens is the preferred delivery method in Europe and Asia with pens delivery making up almost 80% of the market. The undisputed leader in insulin pen technology has long been Novo Nordisk (NYSE:NVO) and it’s no accident that Novo’s assent to the top spot in the insulin market is in part due to their excellent delivery systems.

The importance of pen delivery became even more apparent when Lilly (NYSE:LLY) completely redesigned their insulin pens offering three different models. Next Sanofi-Aventis (NYSE:SNY) revamped their insulin pen for use with Lantus. Pen delivery is also used with Amylin’s (NASDAQ:AMLN) Byetta and is the likely delivery system for Novo’s liraglutide. Amylin and Lilly also announced they are working on a new pen delivery system for Byetta LAR, the once weekly version of Byetta.

Given the highly competitive nature of the insulin market it should come as no surprise that insulin pens will be the next battle ground to gain market share. While all the insulin companies would disagree when it comes to short acting insulin there really isn’t that much different between short acting insulin’s. Realizing this Novo, Lilly and Sanofi have embarked on an aggressive campaign to prove that their particular pen is better than the competition.

Yesterday Novo issued a press release entitled “New study directly comparing insulin delivery devices shows that Next Generation FlexPen® has a significantly lower injection force than SoloStar® and KwikPen®.” According to the release; “New data published this week in Expert Opinion Pharmacotherapy has revealed that Next Generation FlexPen®, Novo Nordisk’s prefilled insulin delivery device, has a significantly lower injection force than two other devices, SoloStar® and KwikPen®.1,2,3 Previous studies show that people with diabetes prefer a lower injection force.4,5” 

This is not the first nor will it the last study we see on insulin pens and people should get used to hearing some terms like injection force. Diabetic Investor is somewhat amused by these studies as like short-acting insulin’s there isn’t much difference between insulin pens. The fact is insulin pens are more patient friendly than syringe delivery and it’s not surprising that pen use continues to increase in the United States. 

While Novo, Lilly and Sanofi will continue trying to prove that their pen is the best and the most patient friendly, there’s a more important point here. Just as the BGM and insulin pump market have become increasingly competitive the insulin market is following this same path. With no major performance advantage between the various short-acting insulin’s the players are looking elsewhere for any advantage no matter how slight to promote their particular insulin. 

Given this situation everyone should become familiar with a whole new vocabulary. Expect to see terms like injection force, plunger velocity and injection speed in upcoming studies as companies seek any advantage possible to gain market share. The differences will be slight but that won’t matter one bit as insulin companies will surly tout any advantage possible in this very competitive market. 

One might think the insulin companies would have learned that technological advancements don’t necessarily translate into increased sales. All one has to do is look at the BGM market where technological advances have done little to increase usage. Moving down this path is also a slippery slope as technological advancements are quickly copied and become ubiquitous. If insulin companies were truly interested in increasing sales it might just be a good idea to educate patients and physicians on the benefits of insulin therapy. But as we’ve seen with the BGM market where there’s lots of talk about education, real action is rare. 

Diabetic Investor would like to think that one day everyone will wake up and smell the coffee. That all of these companies would realize that education does more than just improve patient outcomes. Sadly this is not the case as everyone lives in this fantasy world believing that somehow advanced technology will improve sales. Numerous studies have shown that educated patients are more compliant with their therapy regimens and therefore refill their prescriptions more frequently than patients who are non-compliant. Bottom line is education equals greater sales and that is a win-win scenario. 

It may seem like common sense but when it comes to the diabetes market common sense does not seem to apply even to the companies who would benefit. Go figure.