Tag Archives: diabetes economics

Market forces in the insulin pump space.

It’s no secret that the number of people diagnosed with diabetes is growing, here in the United States and elsewhere. Yet, with the end of the Snap insulin pump last Friday, insulin pump options just got smaller. Does that mean we’ll start to see less innovation in pumping? Less options to upgrade? Possibly a higher cost?

I fear the answer may be Yes.

It’s all tied to a little thing I don’t like to call supply and demand. But I guess I have to.

There are roughly 300,000 insulin pumpers in the USA, give or take 50,000, depending on who you get your data from. As of this time last week, there were six insulin pump options available. That’s about 50,000 pumpers per maker, though obviously, some companies have more market share than others. Today, there are five pumps available to People With Diabetes in this country. If we divide the math evenly, that’s immediately 10,000 more users per pump.

Of course, if you’re a maker of one of these (still available) pumps, you might want to make a deal with previous Snap users to get them under your umbrella before another company does. That’s also supply and demand. So Insulet, makers of the OmniPod, and Animas, makers of the Vibe, are offering deals for Snap pumpers to move to their respective offerings.

Once this transition is complete (I’m guessing in about four months or so), the offers will probably end. At that point, who knows? Well, we do know this: With fewer competitors, pump makers will be less inclined to compete for our business. They will all see a spike in their revenue as a result of Asante’s demise, and they will all believe they have the best pump on the market. So if they don’t want to offer an upgrade pathway for existing users (as Tandem’s t:slim has declined to do recently), they won’t. Especially if you’ve still got some time under warranty left.

And what about price? The retail cost of an insulin pump has been right around $5,000 to $6,500 per unit for some years now. We know that the cost of everything goes up at some point, but that’s especially troubling when it comes to our diabetes, which costs a great deal of my disposable income already, even though I have good insurance coverage. The thought of having to pay even more for something I rely on so heavily is scary indeed. If I finally decide on a new pump in six months, will I have to pay a higher price?

Will I be paying a higher price for what is essentially the same pump? I’m thrilled that Medtronic has their threshold suspend technology, and I’ve seen and heard lots of positive news about the Vibe, but… the pumps themselves, on the outside, appear to be pretty much the same pumps as the previous generation from these companies. At this point, manufacturing these for a number of years (remember, only the software is different) should make the cost to the manufacturer far less than it was at the beginning of their run. But will it still be the same cost? Without any significant innovation other than software, which should also get less expensive over time?

I wish I had we had the chance to try out every pump on the market. Then I’d we’d be able to decide for ourselves if there is something special about a pump that is worth paying the same, or an extra, price for. Or something about a pump that makes it not worth paying the same, or an extra, price for.

Not that we’d be allowed to do that.

More choice, at least steady improvement, and a chance to upgrade for a fair price. Is that all we get, if we’re lucky? How about more innovation, more choices, and less cost as a product gets older? They even do that with mobile phones, for heaven’s sake. Is someone saying we’re not as worthy of innovation, choice, and affordability as the average cell phone user?

That’s the message I’m hearing, and I fear we may not be at the end of this cycle yet.

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