Interesting Choices

Here at Diabetic Investor we follow several different information sources to kept abreast of what’s going on in this wacky world of ours. Towards the end of the year we see lots of lists and one in particular caught our attention. Per a post on the Medical Device and Diagnostic Industry web site;

“The people have spoken. Beta Bionics has been named medtech company of the year. Nearly 44% of MD+DI readers participating in a special poll voted for the Boston, MA-based company, which is developing an artificial intelligence-powered bionic pancreas, called the iLet, to help manage type 1 diabetes. Beta Bionics pulled ahead of other competitors like Boston Scientific, which was MD+DI Editor’s Choice for medtech company of the year.”

Besides Beta Bionics grabbing the top spot second place went to Senseonics and Dexcom finished third in the voting. Yep when it comes to MedTech in 2018 it’s a diabetes trifecta. Now we don’t want to rain on anyone’s parade but after the champagne is gone and the hangover sets in it will be time to get back to reality. Yes, we know this sucks, but it is what it is.

The reality is of those three companies only Dexcom and Senseonics have products in the marketplace and while Beta Bionics with their iLet has an interesting idea we are sorry to say it is not a commercially viable idea. Which to us proves once again that everyone loves the toys in the toy chest but few bother to care whether the toy can be commercially viable.

Even with their unique corporate structure, Beta Bionics is a Massachusetts public benefit corporation and certified as a B Corporation®. Being commercially viable matters for several reasons the most obvious being running an insulin pump company requires lots of capital. This capital isn’t just needed to develop the toy but to sell and support the toy. Anyone who doesn’t believe this is important just ask any Animas patient.

The we won’t wait movement got a real boost the other day when the Helmsley Charitable Trust gave Tidepool $6 million to help develop their Loop system. Tidepool is also unusual as they are a non-profit that gives away their IP for free. Like so many in this movement the goal is to what we like to call mix and match. Develop a closed loop system where the patient choses which insulin pump and CGM system they use. Theoretically this means a patient could choose a Dexcom CGM and a Medtronic pump and the software will do all the heavy lifting.

While we have some concerns when it comes to customer support one thing is certain this movement is becoming one big pain in the ass for all the pump companies particularly Medtronic. Insulet to their credit has accepted the inevitable and is working with Tidepool so that a patient’s smartphone can control the OmniPod system. We suspect it won’t be long before Tandem also finds a way to work with Tidepool.

Medtronic with their huge installed user base has the most at stake here. Should Tidepool and others in the we won’t wait movement gain traction billions of dollars are at stake. The company is already facing several critical issues and cannot afford to see anyone seriously wound the goose that lays all those golden eggs. They can ill-afford to see patients choosing a Dexcom CGM which works with a Medtronic pump as their future revenues are dependent upon sensor revenues.

Nor can they afford users selecting a Tidepool supported system over the 670G. As we noted with the Control IQ coming from Tandem Medtronic will no longer have the coolest toy in the toy box, patients will a hybrid closed loop system that works with the best CGM sensor on the planet.

Even with the concerns we have overall, we see this movement benefiting the entire insulin pump market if for no other reason it will push them to do better. Not just developing better more patient friendly systems but better technologies to support the patient. Let’s be honest about this no matter what Medtronic says publicly their customer support is horrendous. It’s unacceptable that any patient should have to wait hours on hold or get put into voicemail hell.

Now we understand with their huge base of patient’s customer support isn’t easy. However, Medtronic has been loath to embrace new technologies for support and worse has placed an undue burden on their support personal. Customer support personal cost money and with the company focused on profits over patients they have been slow to hire more support personal. Let’s be clear here we are not blaming their support staff they are not the problem. The problem is there aren’t enough of them.

What’s surprising here is technology whether it’s live chat’s, FaceTime or texting require little investment and can produce dramatic improvements in customer support. Anyone who’s dealt with Amazon or Apple understands what we are talking about. The fact is most patients prefer these types of support and are very comfortable with them. Yes, there are times when the patient needs a human involved but the majority of support issues can be handled more efficiently using technology.

The fact is Medtronic has a huge problem on their hands while everyone else is adapting to 21st Century they are caught in the dark ages. Their pumps still look like pagers when everyone else is moving towards an iPhone like look complete with touchscreens. While everyone else has systems that seamlessly send data to a smartphone none of the Medtronic pumps has this connectivity. The fact is Medtronic’s technology is long in the tooth and in desperate need of a makeover, a makeover which will cost them a pretty penny.

This is why Medtronic is doing whatever they can to protect their installed base as they cannot afford mass defections. They are losing the battle when it comes to new pump starts and as their experience with Animas patients indicate even when this patient has to pay out of pocket, they would rather have an advanced system that works with the Dexcom sensor then a FREE system from Medtronic.

We have long stated that in order for any Medtronic competitor to be truly successful they must find a profitable way to take share away from the company they must find a way to convert existing Medtronic patients to their system. The ultimate irony here it could a non-profit like Tidepool who’s giving away their technology that is the Luke Skywalker strong with the Force that destroys the Death Star, brings an end to the Evil Empire and restores peace to the galaxy.