Just how many insulin delivery devices do we need?

Just how many insulin delivery devices do we need?

This morning privately held CeQur announced they have closed a $27 million Series B financing round. According to a company issued press release; “CeQur SA, a company focused on the development and commercialization of simple insulin delivery devices, announced the closing of a $27 million dollar Series B financing. The financing was led by two new private investors with the participation of all current shareholders, and will support manufacturing scale up for the CeQur PaQ® simple insulin delivery device, which received CE Mark approval in November 2012.”

This news comes after Johnson and Johnson (NYSE:JNJ), the owners of insulin pump maker Animas back in July announced they were acquiring privately held Calibra Medical makers of the Finesse insulin delivery device. And let’s not forget about the recently approved V-Go® system from Valeritas. What all these systems have in common is they are basically insulin pumps without the electronics or think the OmniPod patch pump from Insulet (NASDAQ:PODD) without the personal diabetes manager (PDM).

Nearly every maker of these “dumb” pumps claims their system is better than patients injecting insulin and not nearly as complex as true insulin pumps. The basic theory is that patients will embrace these systems as they will only inject themselves once every three days rather than multiple times per day. Additionally they claim patients will be more compliant with their insulin therapy as they won’t have to worry about carrying around an insulin pen or syringe and vial. Finally they believe since the systems are worn discreetly patients will not suffer from the embarrassment of daily injections.

What none of these companies mention is that while some of their claims hold pieces of the truth they are omitting several notable obstacles to their systems. Yes it is true patients would only need to inject themselves once every three days their systems are designed to deliver predetermined amounts of insulin with each push of a button. Just by way of example for the V-Go one button push delivers 2 units of insulin which is great if the patient requires an even amount of insulin units. Now perhaps there patients who only need insulin dosed in even amounts but we suspect in the real world that there are times when a patient requires 7, 9 or 11 units of insulin.

Diabetic Investor would also argue that injecting just once every three days this is not necessarily better than injecting multiple times per day. The implication here is that the injection is a painful event which is why patients are not always compliant with their insulin therapy. While this may have been true years ago it is no longer true today. Needle technology has progressed to the point where it is actually more painful to have a patient test their glucose levels than take an insulin injection.

We would further argue that patients would be better off using an insulin pen than these “dumb” pumps. Not only are insulin pens the simplest devices available they offer the patient a greater degree of flexibility.  Rather than force the patient into possibly under or over dosing their insulin a patient has the flexibility to dose the exact amount of insulin they need.  Keep in mind that unlike real insulin pumps these “dumb” pumps don’t come with bolus calculators that provide a real insulin pump patient with a recommended amount of insulin to be dosed. Basically a patient using one of these “dumb” pumps would be forced to do their own bolus calculation and then if that calculation comes up with an odd number of insulin units the patient would be forced to choose whether to under dose their insulin and risk hyperglycemia or over dose and risk hypoglycemia. A patient using an insulin pen combined with one of the many bolus calculator apps available stands a better chance at better diabetes management than one using a “dumb” pump.

The real question Diabetic Investor keeps asking about these “dumb” pumps is where they fit or put another way are they truly better than what is already on the market. Considering how these systems work it would be inaccurate to state they are easier to use than an insulin pen or provide for better overall diabetes management than real insulin pumps.  Given the current set of insulin delivery options it’s hard to see any of these “dumb” pumps gaining much traction in the marketplace.