What this could be

What this could be

First before we get into the gist of today’s post we need to issue somewhat of a correction. Yesterday in our post “Tyler is growing up” we stated that Bigfoot had yet to submit their connected cap covers to the FDA. According to the Bigfoot CEO Jeff Brewer this is inaccurate as the 510k was submitted last month. So we stand corrected and wish Bigfoot good luck at the FDA. As we have said before we’re not sure how a patient knowing that they just injected their insulin will help all that much but hey the company had to get something to the FDA after all this time and all the money invested.

Now onto a more detailed analysis of Medtronic’s acquisition of Companion and how this might play out. As we noted yesterday if played correctly this could be a very strategic acquisition for Medtronic. Adding a Tyler to their insulin pump portfolio helps accomplish the most important goal, capturing insulin using patients no matter how they deliver their insulin. Patients who would also have the option of purchasing the Medtronic CGM although as we noted it’s likely the Medtronic Tyler will work with any CGM system that doesn’t have AID issues.

Yet it’s quite possible that Medtronic has much bigger plans, plans which would place them in direct competition with Lilly, Novo Nordisk and Sanofi. The three major insulin companies all of whom are also developing a Tyler of their own. Lilly has also gone one step further and has an insulin pump in development.

Think of what would happen if Medtronic begins selling insulin delivery systems that include everything the insulin patient needs including the insulin. It’s well known that Medtronic has reached out to companies in China regarding the possibility of manufacturing biosimilar insulins. Insulin’s which could be configured for the Companion pen. Additionally the short-acting insulin could also be configured for their insulin pumps as well. Novo Nordisk already has developed a pre-filled insulin cartridge that works with the Ypsomed pump.

Given that the Companion InPen is a durable pen Medtronic could really make things interesting if they also added a connected cap cover for pre-filled disposable insulin pens. Considering that the majority of multiple daily injection (MDI) patients use disposable pens the addition of connected cap covers would broaden their ability to capture even more insulin using patients. Medtronic could easily add connected cap covers by acquiring a company like Common Sensing.

Remember the goal here is to capture insulin using patients no matter how they delivery their insulin.

All of this is made possible by a couple of factors;

1. Insulin has become a commodity.

2. It’s just a matter of time before we have multiple short-acting biosimilars just as we have multiple long-acting biosimilars now.

3. While the major insulin companies would beg to differ payors really could care less which insulin a patient uses they care about money.

4. There may be some pushback from physicians however any pushback would be offset by payors who would likely give the biosimilar preferred formulary status. Simply put while the physician might prefer an insulin from the major insulin companies they might not have much of a choice.

5. Lilly, Novo Nordisk and Sanofi continue to move at glacial speed getting their version of Tyler to market.

Right now the door is wide open for any company that has the vision to get Tyler into the hands of patients. This could be the hidden driver in Medtronic’s decision to acquire Companion. Companion could be just the first step in this process allowing them to get a jump on Lilly, Novo and Sanofi.

Ironically Medtronic’s own failure with their insulin pump franchise could forever alter the insulin landscape. The dominos are lining up all that’s needed is someone with the tenacity to knock over that first domino. Could it be that it’s Medtronic who will knock over that first domino which then sets off a chain reaction of events which will forever alter the insulin landscape?

Listen this being the wacky world of diabetes anything is possible. So sit tight folks think this ride is about to get much more interesting.