It begins

Earlier this morning we noted that one of things we wanted to see was just how many Tyler’s we’ll see at the show. In a move that should shock no one shortly after we posted news came that Dexcom and Companion Medical are teaming up for their version of Tyler. Per a press release;

“Dexcom and Companion Medical are working together to develop a seamless data transfer of both insulin and glucose information. This collaboration enables both companies to offer advanced features and algorithms to improve in-the-moment decisions for those managing their diabetes with multiple daily injections. Advanced decision support requires multiple inputs, including current glucose, glucose trend, carbohydrate intake, accurate insulin dosing and insulin-on-board.”

This is just reinforcement of our belief that not only will Tyler make a huge impact in the insulin delivery area but is also becoming a serious threat to the future growth in the insulin pump market. Several studies have noted that it really does not matter how the insulin is delivered, pump, pen or syringe. What really matters is that the insulin using patient has accurate dosing information. Again we hate to be redundant but given the cost disparity between a pump and a Tyler payors are likely to embrace Tyler with both arms.

Of all the current insulin pump companies Insulet is in the best position to deal with Tyler now that the OmniPod has become a pharmacy benefit. This is another reason we believe both Tandem and Medtronic should do two things;

1. Develop a Tyler of their own

2. Switch to a monthly subscription model

Ironically the only insulin pump company that has both a pump and Tyler is Bigfoot only problem being neither system is currently on the market or anywhere near being on the market for that matter. Bigfoot does have the monthly subscription model but with nothing to sell that really doesn’t matter all that much.

Not to be left out in the cold Novo Nordisk, Lilly and Sanofi all are working their versions of Tyler. Of the three Lilly seems best positioned as they are working within existing infrastructure and patient preference with a disposable Tyler. Novo on the other hand has gone the open system route allowing their connected pen to connect with multiple CGM’s and apps. Sanofi, an investor in Common Sensing is indirectly connected with Dexcom through OnDuo the Google/Sanofi partnership. Suffice it to say the three big insulin companies have a lot at stake here and Sanofi should have the edge as they are the only one who has a biosimilar short-acting but in typical Sanofi fashion they are turning gold into sand.

With more biosimilar short-acting insulin’s on the way there is nothing to prevent a company from providing an Austin, Tyler’s brother, and provide everything the insulin using patient needs to manage their diabetes.

There was a time when we believed Medtronic would have a Tyler but things are so screwed up in Northridge their lucky to still have an insulin pump franchise to worry about. Tandem could leap frog Medtronic do a Tyler deal and use Tyler to capture patients who can later to be converted to pump therapy. Tandem like just about everyone else in the Tyler space with the notable exception of Bigfoot works with Dexcom.

At the end of the day when it comes to Tyler performance will not matter as much as patient access. This is one reason we see the insulin companies having an edge as they are using Tyler to protect their insulin franchises and likely will give away their connected pen. Yes the InPen™ from Companion is reimbursed but Momma Kliff told us that free is always better. Could Dexcom give away the InPen we suppose so but that would destroy any chance at making money. Dexcom is in this to sell more sensors and has plenty of Tyler/Pump partners that will help this happen.

We have long thought that Companion would be wise to add a connected pen cap to their portfolio as that would make a more attractive model and fit into the current insulin pen infrastructure as disposable pens own 90% of the pen market.

No matter who hooks up with whom one thing is certain Tyler will have a major impact on the future of not just the insulin delivery market but the insulin market too. We’re off and running.