Historically, the medical device industry has been a highly proprietary industry, characterized for a long time by the development of specialized, patented technologies that were closely guarded by developers. Here, you won't find an App Store where APIs are distributed to developers to create tools from the underlying technologies.
In a surprising development, in at least one sector of the medtech world — diabetes — enemies are becoming friends.
This month, medical device giant Abbott announced a partnership with four of the industry's largest insulin-pump makers — Medtronic, Insulet, Tandem Diabetes Care and Ypsomed — to integrate their automated insulin delivery systems into its FreeStyle Libre continuous glucose monitor (CGM). Abbott's biggest CGM rival, Dexcom, has been pursuing a similar integration effort for the past decade. Its CGMs are compatible with Insulet, Tandem and Beta Bionics automated insulin delivery systems.
The companies involved in these alliances say they are proud to offer consumers more choices and accelerate the pace of innovation in the diabetes space. Consultants and industry experts say the alliances are a smart move to stay relevant in the rapidly evolving diabetes care space.
And, of course, there's the profit motive. Until this week, automated insulin delivery systems had only been approved to treat type 1 diabetes. On Monday, the FDA announced that it had approved Insulet's Omnipod insulin pump as the first automated delivery system approved to treat people with type 2 diabetes, immediately allowing diabetes device makers to target a new, and much larger, patient population.
Following this news, experts say partnerships between CGM and insulin pump makers are likely to continue and expand.
Enemies become friends
Abbott began working with insulin pump makers about five years ago. The first collaboration began in 2020, when Abbott announced plans to integrate its FreeStyle Libre technology into automated insulin delivery systems made by Insulet and Tandem for people with type 1 diabetes.
The company subsequently integrated the Freestyle Libre device into its Ypsomed automated insulin delivery system in 2022. Abbott's latest diabetes device collaboration, a new partnership with Medtronic, was announced less than two weeks ago.
Abbott's FreeStyle Libre devices contain a small sensor that is attached to the skin, typically on the underside of the upper arm. These devices are designed to measure blood glucose levels as a patient goes about their daily life and send that data to a reader or smartphone app. By adding automated insulin dosing technology, the system can automatically adjust insulin doses to keep a user's blood glucose levels within range.
“Every day we hear from doctors and people with diabetes about how technology like the FreeStyle Libre system has made managing their diabetes easier. But a continuous glucose monitor is only one piece of the puzzle, which is where the power of partnerships comes in. That's why we're working with others in the industry to deliver new, integrated solutions aimed at making diabetes care as easy and accessible as possible,” Chris Scoggins, senior vice president, Abbott Diabetes Care, said in a statement to MedCity News.
Partnering with industry will result in more coordinated care, greater patient choice and improved health outcomes, “a win-win for everyone,” he added.
Abbott's industry partners appear to see this collaboration in a similar light.
Medtronic Diabetes President Que Dallara emphasized that the company's partnership with Abbott will expand access to its automated insulin delivery system, as Abbott owns the most popular CGM on the market. Abbott's Freestyle Libre product is used by more than six million people with type 1 or type 2 diabetes.
She added that the collaboration will provide more options for people with diabetes and is a “win-win all around.”
Eric Benjamin, chief product and customer experience officer at Insulet, another leader in the diabetes device space, says the company wants to give users of its Omnipod automated insulin delivery system the freedom to choose any leading continuous glucose monitor, which is why Insulet has integrated its system with glucose monitoring devices from Abbott and Dexcom, as Tandem has also done.
“Collaborations like this foster and accelerate innovation for our customers, leading to more inclusive and effective technologies that improve the lives of people with diabetes,” Benjamin said.
Dexcom, another major player in the world of continuous glucose monitoring, teamed up with Insulet in 2015 to form the first automated insulin dosing partnership, followed by integrations with Tandem and Beta Bionics in the following years.
Outperform the competition
By pursuing partnerships with automated insulin delivery companies, Abbott and Dexcom are seeking to solidify their position as leading CGM providers and remain significant market players in the diabetes space, said Aaron DeGagné, senior healthcare analyst at PitchBook.
“These partnerships will give patients easier access to best-in-class glucose monitor and insulin pump combinations and further strengthen market share for the leading vendors,” he declared.
The fact that medical device companies are partnering is further evidence of the growing consumerization of healthcare, especially in the area of diabetes, Degagné added. Many patients “have strong brand preferences, bolstered by the introduction of new features and highly effective marketing campaigns,” he explained.
To DeGagné, Medtronic's choice to partner with Abbott this month was likely influenced in part by the fact that Abbott was already partnering with another insulin-pump vendor and could have lost market share by not participating, he said.
“While it's unlikely that Medtronic will capture a significant share of the CGM space with its devices, it isn't giving up on the market entirely given the large growth opportunity it sees in the future,” DeGagné said.
He also noted that these partnerships will enable the largest vendors to maintain strong distribution and access to patients in the face of competition from next-generation integrated CGM and insulin pump technologies that could hit the market in the coming years.
Sean Meara, CEO of virtual primary care provider HealthTap, echoed DeGagné's comments.
“This unusual alliance between normally competitive healthcare providers signals concerns that incumbents could be disintermediated by new entrants and models that interact directly with patients and decide what care they receive,” Mehra said.
Large incumbents like Abbott and Dexcom are using their trusted brands and established customer bases to “leapfrog newer competitors,” he explained.
Mehra believes that to remain competitive, these incumbents will need to sell comprehensive bundled products that include telehealth and digital care management tools, meaning CGM makers could see further partnership growth over the next decade.
“An ecosystem of new partnerships will form between medical device and durable medical equipment companies and telehealth provider groups to build and maintain deeper, more direct relationships with consumers than potential competitors,” he declared.
Improved patient health
Sheila Shah, managing director and digital healthcare leader at LEK Consulting, said the country's deepening diabetes crisis is another reason why medical device companies are flocking together to innovate.
Approximately 1.2 million Americans are diagnosed with diabetes each year, and in 2022 the disease cost the country $413 billion in medical expenses and lost wages.
“I think what's behind this collaboration is the recognition that diabetes management requires a multifaceted approach, and that no single device, drug or lifestyle choice is going to be a silver bullet,” Shah said.
Integrating one company's blood glucose monitoring technology with another's automated insulin delivery system can help patients manage their diabetes better by taking the strain, guesswork and worry out of taking insulin. This collaboration can improve patients' health outcomes while reducing the burden of constant decision-making, Shah noted.
Beth Mosier, director of West Monroe's healthcare M&A group, agreed with Shah, saying these partnerships aim to create a more seamless continuum of care for people with diabetes.
“Integrating continuous glucose monitoring with automated insulin dosing and maintenance will enable people to spend less time thinking about diabetes and more time living their daily lives. Whether and how these types of partnerships continue to develop will depend on the impact they can demonstrate on key metrics like adherence to treatment plans and patient health,” Mosier noted.
The FDA's decision on Monday presents diabetes device manufacturers with an opportunity to improve treatment outcomes by using dual CGM insulin pump devices with an entirely new patient population.
Now that the first insulin pump has been approved for use in people with type 2 diabetes, these partnerships will allow us to serve a broader patient population: According to CDC data, 90-95% of the 38 million people with diabetes nationwide have type 2 diabetes.
Photo: mediaphotos, Getty Images
