The forgotten millions

The forgotten millions

One of the oddities of this wacky world is the bias towards Type 1 patients. Perhaps we should clarify that remark as there is defiantly a bias towards insulin using patients. Although non-insulin patients outnumber insulin patients by a wide margin it continues to amaze Diabetic Investor how many companies have basically given up on trying to penetrate this huge market. Just to prove our point go out and do some simple research.

Look at the all the way cool apps and whiz bang devices that are being worked on. Are any of these way cool whiz bang devices or apps targeted at non-insulin using patients? Do any of these way cool whiz bang cloud enabled devices and apps all of which are jumping on the interconnected diabetes management (IDM) bandwagon targeting this huge market? Or are they merely paying lip service to these patients with their real target being insulin using patients?

Not that we blame everyone for chasing insulin using patients as these patients due to the fact they use insulin tend to be more engaged with their diabetes than a non-insulin using patient. As a group they use more test strips then non-insulin patients. As a group they are more proactive than non-insulin patients. However, it is also true in terms of sheer numbers this group is not large enough no is it  growing fast enough to support all the companies chasing these patients. (If that sounds familiar it should as that statement does not just apply to the insulin pump market.)

One just might that think that there would be one or two companies out there who see the size of this market, see that no one else is targeting it and say let’s give it a go. To these brave companies it might make sense to get a small percentage of huge market then to fight for a small share of smaller market.

Look at it this way right now there are 5 insulin pump companies, more if you include companies who do not play in the US market. Most estimates peg the total number of insulin pump patients worldwide at slightly under a million. Medtronic (NYSE: MDT) the global leader owns about 70% of the market which basically means their competition must fight for the remaining 30% of the market. Now this would be fine if the total insulin pump market was growing at double digit rates but it’s hardly growing at all. Yep, so it makes perfect sense that even more companies want to enter this market.

This is exactly what’s happening in the IDM space. Even though non-insulin patients vastly outnumber insulin using patients all these companies are targeting the same market. Do these patients not need help managing their diabetes? Are they immune from the many complications associated with poorly controlled diabetes? Just because they take pills or use a GLP-1 to manage their diabetes, does this mean they aren’t concerned about their diabetes? Are employers who spend a fortune on their employees with diabetes only concerned about those which use insulin?

This is not the first time Diabetic Investor has covered this subject as we definitely see this bias every day and not just from companies in this market. Go out and read almost any diabetes related blog, many of which are written by people with diabetes some of whom that actually know what they are doing. Yes, even these educated bloggers with diabetes are biased against non-insulin using patients. It’s almost as if these non-insulin patients do not have diabetes, that they are somehow unworthy. That they really don’t have diabetes. Yes, we will go as far and say there are a more than a fair number of insulin snobs out there.

Well folks we hate to break the news but even patients who don’t use insulin to manage their diabetes are worthy. They may not have the same issues or concerns as an insulin using patients, but like every patient with diabetes they will pay a heavy price if they do not control their diabetes. The harsh reality is complications don’t discriminate between insulin and non-insulin using patients, complications impact ALL patients with diabetes.

What’s even worse here is not what the bloggers are doing as for the most part they are doing a great job. What’s worse here is that companies are missing a huge opportunity. Seriously can anyone name a market that has millions of customers, a market that continues to grow that’s being avoided as if it these people have the plague. The reality is for the most part these companies are either stupid, lazy or both. Now this behavior is to be expected from the larger players who just can’t think out of the box. The fact is these larger players are so entrenched in the past they aren’t capable or equipped to see what they are missing.

But we are shocked, yes shocked that some of these newer more entrepreneurial companies aren’t stepping up to the plate. Have these so-called innovators become so obsessed with being acquired that they aren’t willing to be daring.  Is this not what entrepreneurs do?

Listen we know that the non-insulin patients are a different bred than insulin using patients. We also know that this is a much tougher group to engage. We never claimed this would be an easy task, far from it. However, given the sheer size of this market even a small success would translate into huge riches.

Just in case anyone doesn’t believe this market is worth the effort take a look at the history of Apple, yes Apple. Although it seems implausible today there was a time when the company was on the brink of extinction. Microsoft was ruling the world and anyone who used an Apple product was considered some sort of freak or something.  Yet thanks to the legendary Steve Jobs Apple dared to be different, they knew there was a large untapped market for innovative, well-designed, customer friendly products. They didn’t see the obstacles; they saw the opportunity.

Diabetic Investor is beginning to wonder if anyone is up to the challenge, someone willing to go against conventional wisdom, someone who will dare to go boldly where no one has gone before.