April 05, 2021

Diabetes Devices - Smart Insulin Pens Considered Bridge to Insulin Pumps

ABT, DXCM, MDT
By Beth Gilbert
U.S. endocrinology practitioners believe smart insulin pens may facilitate, rather than compete with, insulin pump adoption by helping patients become comfortable with using technology to manage their diabetes.

During the past year, several companies in the diabetes market, including Medtronic PLC, have increased investment in smart insulin pens, which are reusable insulin delivery pens that work with continuous glucose monitors (CGMs) and/or smartphones to assist in calculating insulin doses. Smart insulin pens are particularly helpful for patients who require multiple daily doses of insulin by lessening the burden of calculating insulin doses, which raises the question of whether pens are likely to undercut demand for insulin pumps from Tandem Diabetes Care Inc., Insulet Corp. and Medtronic itself.

Seven sources interviewed for OTR Global’s March 16 Insulin Pumps report who commented on smart insulin pen technology believe smart pens do not pose a risk to insulin pumps because the pens, unlike pumps, do not automatically inject insulin. Rather, sources believe smart pens could facilitate insulin pump adoption as patients become more comfortable with using technology to manage their diabetes. “[Pens] could be a stepping stone. Patients who are injecting insulin but are not ready for an insulin pump could eventually graduate from a smart pen to a pump,” an endocrinologist said. Another said, “Smart pens are a great bridge to pump therapy, but I do not think they threaten the pump market.” A third endocrinologist said, “I don’t place smart pens in the same category as pumps. I do not think they will prevent many pump starts and may actually inspire a few patients to move toward a pump.”

In 2020, Medtronic acquired Companion Medical Inc., manufacturer of the Bluetooth-enabled, reusable InPen (FDA approved in 2016), which works with short-acting insulin and connects with an app to track data and provide insulin dosing recommendations. “InPen has refillable cartridges and has a phone app calculator, which is great for determining insulin doses,” a CDE said. The InPen integrates with Dexcom Inc.’s popular G6 CGM as well as Medtronic’s own Guardian Sensor 3. Another smart insulin pen, Eli Lilly and Co.’s Humalog Tempo Pen, also integrates with Dexcom’s G6. The insulin pen market is likely to further expand as Bigfoot Biomedical Inc. seeks FDA approval for two smart insulin pens, including one for long-acting insulin and the other for short-acting insulin, both of which will be compatible with Abbott Laboratories’ FreeStyle Libre CGM. In addition, Novo Nordisk A/S is expected to file this year for FDA approval of its NovoPen Echo Plus, which was originally planned for a 2020 launch but was delayed by the pandemic.

Additional Quotes:
“Smart insulin pens can be helpful for calculating insulin dosing based on carbohydrate intake. The patient can test their blood sugar levels and get the results on their smartphone or other reader. The [patient] inputs the number of carbohydrates they are going to eat and their blood sugar levels into an app with an insulin dose calculator, which then provides a dose recommendation. I can also download their pen to get all the data.” CDE

“I think most patients who are interested in a pump will still choose a pump over the pens.” CDE

“I have heard a little noise about smart pens, but they’re not something I’m excited about so far. I do a lot of research about new technologies and drugs, and I get excited to start new things but this isn’t getting me excited.” Endocrinologist