Just where does this fit in

Just where does this fit in

With all the rumors circulating about who will buy which insulin pump company and what the future looks like for the insulin pump market in general, not much has been written on the many companies developing non-mechanical insulin patches. The general premise behind these patches is similar to the premise behind some of the new drugs under development that require less frequent administration. Simply put the developers of these patches seem to believe that patients will embrace one needle stick over a three day period rather multiple needle sticks each day.


These patches come in many shapes and sizes and have many of the same characteristics of a true insulin pump. They are worn for three days, hold up to 200 units of insulin and deliver insulin in pre-determined units. Some even have injection ports that allow a patient using who also uses long-acting insulin such as Lantus, to inject their Lantus through the patch. But most of all what these patches have in common is they are very cheap to manufacture and support.


What Diabetic Investor fails to understand is just where these devices fit in.  While insulin pens are gaining popularity, syringes still dominate when it comes to insulin delivery. For all the benefits of insulin pump therapy it remains the therapy option of last resort for the majority of insulin using patients. And for all the over-hyped talk about the supposed fear of injection, the reality is it’s more painful for a patient to monitor their glucose levels than it is to inject insulin.


Still it’s easy to understand why these devices peak curiosity. While injections may not be that painful anyone who’s followed multiple daily injection (MDI) therapy will tell you there no walk in the park either and given the choice most patients would prefer fewer injections per day. However, it is also true that patients following MDI therapy are just one step away from insulin pump therapy. Like insulin pump patients they must understand carb counting, insulin duration of action, insulin to carb ratio, etc. Also like insulin pump patients they monitor their glucose levels frequently and understand the importance of this information.


So the question remains; given the choice between moving to insulin pump therapy or using a patch delivery system why would the MDI patient choose the patch over the pump? It seems to Diabetic Investor the patch companies are banking on the cost of patch therapy versus insulin pump therapy. It’s not outside the realm of possibility that one day glucose monitors will also come equipped with bolus calculators that are a now standard on insulin pumps. With such a feature the insulin patch would have almost all of the capabilities of an insulin pump which would leave the main difference between the two delivery systems being that insulin pumps deliver continuously while the patient will have greater control of insulin delivery using the patch, just as they have now with insulin pens or syringes.


Considering that insulin pump therapy costs nearly $8,000 to initiate and another $2,000 plus per year in supplies, an inexpensive insulin patch could find traction with insurers looking to contain costs. Another benefit of a patch would be lower support costs.  While no delivery system operates 100% of the time, common sense says that there would far fewer malfunctions with the patch than with an insulin pump. Diabetic Investor can also see physicians recommending an insulin patch as a method to transition a MDI patient to insulin pump therapy.


Even patients who are not following MDI therapy may benefit from a patch delivery system as studies have shown that patients sometimes skip injections. With a discrete patch attached to their body it would be difficult for the patient to skip taking their insulin. This is one reason the OmniPod has gained traction in the marketplace as it is perhaps the most discrete insulin delivery system available. As Diabetic Investor has written in the past no one should underestimate the “vanity factor” when it comes to insulin delivery. This is the reason so many patients who inject insulin do so in private as they prefer the whole world not know they are diabetic or taking insulin.


Given the growing importance of cost containment and emerging technology the possibility exists that an insulin patch may find a place in the already crowded insulin delivery marketplace. Diabetic Investor does not see an insulin patch as an ideal solution however given the growing use of insulin therapy it would be foolish to rule this delivery system out. After all this is the wacky world of diabetes devices and if we’ve learned anything at all over the past few years anything is possible.