Let’s call it what it is

Back in the day Momma Kliff, someone as we all know isn’t one to mince words, used to tell us don’t be afraid to call out bullshit when you see it. Others may try and sugarcoat things or put lipstick on a pig but when you strip away all the crap bullshit is just that bullshit.

We thought of Mom today when heard that UnitedHealthcare has deemed the Tandem t:slim insulin pump as “not medically necessary.” Keep in mind that this is the same UnitedHealthcare which has an exclusive deal with Medtronic. So, it makes perfect sense that the 670G is medically necessary and the t:slim is not, PLEASE.

We often remark that the business of diabetes sometimes interferes with the treatment of diabetes. This is one of those times. Let’s be clear here we are not accusing Medtronic with influencing United’s decision. Let’s just say what we always say THIS IS ABOUT MONEY AND IF YOU WANT A FRIEND IN THIS BUSINESS GET A FRIKIN DOG.

As we noted just this morning many things have changed for Tandem in a positive way. The company is no longer on deaths door. Their new Basal IQ pump is out, and they have an exciting pipeline of new products coming. What hasn’t changed are the competitive dynamics of the insulin pump market. (And not to digress here but Lilly wants to be in this market why?)

Let’s be very clear here crystal clear – we are in no way blaming Medtronic of anything and quite honestly this is exactly what the company should be doing. Medtronic is the big dog in the yard and this dog isn’t afraid to bite. They know they may not have the best toy in the toy chest, but they also know that having the best toy doesn’t matter all that much if no one will pay for it.

This my friends is the reality of the insulin pump market, a market not for those with weak knees or queasy stomachs. As Momma Kliff used to say if you’re going to play in this game you need to bring a heavy bat. Or as Gordon Gecko said in Wall Street “If you want to piss in the tall wheat with the big dogs the key is your capital reserves.”

Tandem may now be financially secure but this security does not buy them the one thing they need most, finding a profitable strategy for taking share away from Medtronic. This problem is not unique to Tandem and is faced by each and every insulin pump company. (Again, not to digress but Lilly and heaven knows how many others want to be in this market why?)

What’s laughable about United’s decision is not just bullshit it’s hypocritical. How the hell can they deem one insulin pump medically necessary and another not medically necessary. Folks as we have said forever all insulin pumps do basically the same thing the same way. Yes, the 670G is hybrid closed loop system but so what. Does United seriously believe that the t:slim or any other insulin pump for that matter sucks. That a patient not using a Medtronic system will suffer. PLEASE.

Tonight, at sundown Jews around the world will begin to atone for their sins. The folks at United just committed a big one with this hypocritical decision and should repent.