Full article reprinted from Start Up - August/September 2009
It's the end of a dynasty in the traditional market for self blood glucose testing--the test strips and hand-held monitors that patients have been using as the mainstay of their diabetes management. The four major companies, once differentiated players in a high growth market, have cut R&D and marketing budgets in the face of increasing commoditization. But a new era in continuous glucose monitoring has begun, and that sector is poised to grow in coming years, according to "US Markets for Diabetes Management Products," a report published in May 2009 by the Medtech Insight division of Elsevier Business Intelligence. Read more...
Opportunity for Start-Ups in Continuous Glucose Monitoring
Full article reprinted from Start Up - August/September 2009
It's the end of a dynasty in the traditional market for self blood glucose testing--the test strips and hand-held monitors that patients have been using as the mainstay of their diabetes management. The four major companies, Johnson & Johnson's LifeScan Inc., Abbott Laboratories Inc., Roche, and Bayer AG's Bayer HealthCare AG, once differentiated players in a high growth market, have cut R&D and marketing budgets in the face of increasing commoditization. One of the most telling signs of that commoditization: giant retailer WalMart ("Save Money. Live Better.") already sells its own brand of meters and test strips, ReliOn, which sells for less than half the cost of competitors, and is heading toward a "one price fits all" strategy.
But a new era in continuous glucose monitoring has begun, according to Chris O'Donnell, SVP and president of the diabetes business unit at Medtronic Inc., speaking at Medtronic's Analyst Day in June 2009. Today, Medtronic holds 90% of the continuous glucose monitoring (CGM) market (in which DexCom Inc. and Abbott also operate) with just over $100 million in sales. That's only a tiny fraction of a blood glucose monitoring market worth almost $3 billion in 2008 and forecast to grow to approximately $4 billion by 2013, according to "US Markets for Diabetes Management Products," a report published in May 2009 by the Medtech Insight division of Elsevier Business Intelligence. For now, lack of reimbursement has stalled penetration of CGM products, but O'Donnell says that Medtronic is betting on its future. At the investor presentation, he said "Ten years from now, you will think of us as a CGM company rather than a pump company," just before he revealed two new developments in Medtronic's CGM business.
First, he announced that Medtronic has launched in the UK the first ever diabetes management system to use a "semi-closed loop for glucose management and insulin delivery." The MiniMed Paradigm Veo system was launched in June 2009 and combines glucose monitoring and insulin delivery in a system that prevents episodes of hypoglycemia by suspending insulin delivery, if warranted by glucose readings.
At its analyst day, Medtronic also revealed that it had acquired Danish start-up PreciSense AS to gain a potentially new platform for continuous glucose monitoring that is a departure from the conventional glucose oxidase measurements upon which most blood glucose monitors are based today. PreciSense uses fluorescence resonance energy transfer, which emits light and returns captured fluorescence. It's an early-stage, high risk opportunity, says O'Donnell, but potentially transforming because it has breakthrough capabilities in terms of accuracy, ease-of-use, and longevity, with potential durability in the range of weeks vs. the days of today's conventional sensors.O'Donnell says Medtronic looked at every CGM company in development before settling on PreciSense. Among the small companies targeting continuous glucose monitoring is OrSense Ltd., which is selling its non-invasive CGM under a CE mark. The OrSense NBM-200G uses occlusion spectroscopy to measure analytes in blood from a finger cuff. The Medtech Insight report also mentions Echo Therapeutics Inc., which has a needle-free wireless device called the Symphony transdermal CGM system. Symphony uses ultrasonic permeation technology to create reversible channels in the skin. Echo is in clinical trials and hopes to file a PMA within 24 months. There's also Sensors for Medicine and Science Inc., which has a miniature CGM the size of a small cold capsule that is implanted under the skin to measure fluorescent reporter molecules in interstitial fluid. SMSI is aiming for the ultimate ease-of-use with an implant designed to function continuously for six to 12 months. Its device is at the preclinical stage. Mellitor, a seed stage start-up in the Meytag Hi-Tec incubator in Israel, is also working on an implantable sensor. Sentek Group Inc. is developing a non-invasive, low-cost test that utilizes crystalline colloidal array technology (licensed from the University of Pittsburgh). Finally, Swiss company Solianis Monitoring AG is working on a multisensing CGM system that addresses variables such as body temperature, microcirculation, perspiration and the thickness of different skin layers in order to provide more accurate measurements of glucose levels measured by impedance spectroscopy. Solianis aims to be on the market in Europe in 2010. This is but a small number of a large group of companies with development efforts in continuous glucose monitoring, whose future markets look more and more assured.
- Mary Stuart
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