When it rains …..

When it rains …..

Well it seems as if the flood gates have opened and the wackiness in the diabetes device sector continues. Besides the news that Roche has received FDA approval for their combo system word now comes that Johnson and Johnson (NYSE:JNJ), who already owns LifeScan and Animas, have acquired another diabetes device company. According to a communication from the company; “On Friday, July 13, LifeScan, acquired Calibra Medical, Inc. of Redwood City, CA.  Calibra Medical is the developer of a unique, wearable three-day insulin patch designed to offer a convenient and discrete mealtime insulin dosing option for people with diabetes who take multiple daily injections (MDI) of insulin.  While not yet available, this new insulin patch is intended to make it easier for patients to adhere to their prescribed mealtime insulin therapy and help them achieve and maintain good diabetes control.”

It’s important to note that the Calibra system is not anything like a conventional insulin pump as it has no electronics. Perhaps the best way to think of this system is to think OmniPod without the electronics. Diabetic Investor has been aware of Calibra for some time as well several other companies who are working on the exact same concept.  While there is nothing wrong with the system itself we question exactly who would use this product and why they would use it.

As the company notes the patch is targeted at patients who follow multiple daily injection (MDI) therapy and the theory is wearing a patch is more patient friendly as the patient does not have to inject themselves multiple times each day. They simply put on the patch, one stick, and then click on the patch when they need short-acting insulin. After three days the patch is thrown away and a new one goes onto the patient.

This all sounds good in theory until one considers that the majority of patients following MDI already have several patient options for following their therapy regimen. As everyone knows for insulin patients not using an insulin pump there are basically two delivery systems available; syringe or pen. While syringes are still very popular, insulin pens have grown in popularity over the years and it would not be an overstatement to say they are now the preferred delivery system for non-pumpers. This is especially true with the newer, smaller needles that are now available for insulin pens. As Diabetic Investor has noted many times while insulin injections are never pleasant, pens and improved needle technology have made these injections nearly painless.

We also question whether or not the Calibra system truly is more patient friendly, while it is true the system does eliminate injections, which is never a bad thing, getting the correct amount of insulin dosed isn’t that easy. If our memory is correct, and these days that’s not always a given, the Calibra system delivered a pre-set amount of insulin with each click. Our question has always been what happens when the patient needs an odd amount of insulin. For example if each click delivers two units of insulin, what happens when the patient needs an odd number of units? Even if the system has been changed to deliver both even and odd amounts, is it really easier to click on the patch multiple times or simply dial out the exact dose on a pen and then inject. To Diabetic Investor it is more important to deliver the correct amount of insulin rather than go over or under that amount. Or put another way, dosing accuracy trumps less “sticks”.

Considering all the options a patient has for insulin delivery and the importance of accurate dosing, Diabetic Investor isn’t convinced there are more than a handful of patients who would use this type of system. Put simply, at best this is niche product at worst a waste of money. But this is the wacky world of diabetes devices where anything can and as this deal proves, does happen.