Eli Lilly, one of the makers of insulin, is entering the insulin delivery devices business. A serious competitor for Medtronic, Insulet and Tandem?? Maybe, but is this good? How will the smaller existing pump companies survive with this additional competition??
https://www.wsj.com/articles/eli-lilly-bets-big-on-insulin-delivery-devices-1511269200?mod=e2tw
Yes of course it’s good. Competition makes things better.
More pump options is better than fewer.
This could be a problem for us older T1D’s. It is difficult to get Medicare to cover newer devices. Competition may make things better, but then Medicare may not cover the better things. The Dexcom G5 is the only CGM they will cover.
But it is also difficult to get coverage for a device that does not exist! Even if not everyone can get coverage, having it available increases market competition, increases choices, and forces other companies to keep striving to meet customer desires.
I can’t read WSJ articles, but I found another link that talked about this being for a product using Dexcom CGM to develop an automated insulin delivery (“artificial pancreas”) presumably similar to the Minimed 670G. It may take time before Medicare will cover it (do they currently cover the 670G?) but if it is successful they presumably will cover it eventually. The links I found didn’t spell out a timeframe for release. I think there will be lots of these released in coming years, which I think is definitely a good thing.
Totally. Choices are good. Fair & healthy competition is good.
In this case, it kinda sounds like Lilly may be moving in a slightly different direction that truly would be increasing the choices available.
The following article is about a year old but obviously these things take years to get to market so it still sounds quite relevant to me. The focus (at least in this article) seems to be more in insulin PENS as opposed to pumps.
I had a talk with the Companion Medical CEO mentioned in the article - Sean Saint - a while ago in March. They received approval this year to release, but it still hasn’t come out yet.
I just emailed him to ask about availability. Will let you know what he says.
Here is the entire article:
"CAMBRIDGE, Mass.—Eli Lilly & Co., one of the biggest makers of insulin, has been planning a risky new business venture: making the high-tech devices that deliver insulin to diabetes patients.
In a research laboratory Lilly opened here in 2015, scientists have been developing a wearable, automated insulin-delivery device designed to reduce the decision-making and guesswork of conventional insulin injections. They are also developing a “smart pen” injection device that can wirelessly transmit dosing information to a patient’s phone, to ensure proper dosing.
Lilly’s previously undisclosed projects, for which the company has enlisted several design and device-firm partners, including the inventor of the Segway scooter, is an unusual example of diversification at a time when much of the drug industry is moving in the opposite direction—shedding nondrug businesses to focus on pharmaceuticals.
Indianapolis-based Lilly, the first company to mass produce insulin in 1923, faces competitive pressures including the expected arrival of lower-cost copies of its top-selling insulin, Humalog. And it sees growth in the market for advanced insulin-delivery devices.
Enrique Conterno, head of Lilly’s diabetes business, said he believed Lilly’s insulin business would become “obsolete” if the company remained largely an insulin provider without delivery systems.
“Do we want to be just an insulin provider that just goes into a system, or do we want to be the integrator of the system?” he said at the Cambridge lab this month. “To me, it’s clear where the business is going.” Lilly’s insulin products currently generate about 20% of the company’s total revenue.
Still, the projects are a risky bet because Lilly will compete with medical-device heavyweights like Medtronic PLC, which received U.S. marketing approval for an automated insulin-delivery device last year.
Medtronic’s product is the only one of its kind on the market, but other companies including Roche Holding AG, Insulet Corp. and Tandem Diabetes Care Inc. are developing automated pump systems, too.
Danielle Antalffy, an analyst with Leerink Partners, said competition in the diabetes-device field is fierce, with several companies racing to develop insulin-delivery systems that advance toward a so-called “artificial pancreas,” or a device that would completely remove patient decision-making from insulin delivery.
‘Do we want to be just an insulin provider that just goes into a system, or do we want to be the integrator of the system?’
—Enrique Conterno, head of Lilly’s diabetes business
Lilly has been introducing new drugs for diabetes and other diseases such as cancer and psoriasis in recent years to try to offset a wave ofsales-eroding patent expirations for former top-selling drugs. While results have improved since 2014, Lilly faces more challenges ahead including expected generic competition for erectile-dysfunction drug Cialis next year. Its stock price has risen 8.5% in the past 12 months, less than rivals such as Novo Nordisk A/S and Sanofi SA and below the 11% gain in the NYSE Arca Pharmaceutical index.
Mr. Conterno declined to specify how much Lilly is spending on its device program, but said “it’s a major effort.” Lilly expects it will take about two to three years to get the devices to market, if they succeed in patient studies and pass muster with regulators. The company expects to begin clinical trials in December. Lilly declined to discuss its pricing plans.
The company has outside help with the project. Deka Research and Development Corp., the R&D firm led by Dean Kamen, inventor of the Segway scooter, is designing the pump for Lilly’s product. Lilly has also tapped Dexcom Inc. to supply devices that attach to a patient’s skin to monitor blood-glucose levels continuously.
And last year, Lilly acquired a privately held Montreal startup, Class AP, to gain software algorithm technology that will make decisions about how much insulin to inject, and when. Lilly hasn’t previously disclosed these deals. The companies declined to disclose financial terms.
About 30 million Americans have diabetes, according to the Centers for Disease Control and Prevention. Keeping blood sugar in a healthy range can help prevent immediate risks such as passing out, and reduce long-term complications such as vision loss and kidney disease.
Lilly’s Cambridge lab occupies two floors of a new six-story building on the edge of Massachusetts Institute of Technology’s campus. Lilly has hired about 40 people for the lab including mechanical engineers, material scientists and industrial designers.
Deka’s Mr. Kamen, who was visiting Lilly’s lab on a recent afternoon, reached into his shirt pocket and pulled out a prototype of the pump—a white disk about the size of a shoe-polish tin. The disk carries a 3-day supply of insulin and is attached to a tube that delivers the drug into the abdomen. A patient could carry the disk in a pocket, he said.
The current version of the Dexcom glucose monitor is about 1 ½ inches long and can adhere to the abdomen or upper buttocks, with a small wire that pierces the skin to sense glucose levels. Patients will be able to control the system using an app on their phones, Lilly said.
Write to Peter Loftus at peter.loftus@wsj.com"
Perhaps related? No point in funding a competitor.
“Beta Bionics also received $5 million from the pharmaceutical company, Eli Lilly.”
EDIT: Follow-up to my mention of Beta Bionics:
When will the iLet be commercially available in the United States?
We are working as quickly as possible to bring the iLet to market. Our insulin-only pivotal trial is anticipated to begin in the second half of 2018, and we hope to receive FDA approval of the insulin-only configuration of the iLet by the end of 2019. We anticipate that our bihormonal pivotal trial will begin in late 2018 or early 2019 with potential FDA approval 12 to 24 months after approval of the insulin-only configuration of the iLet.
Apparently they have approval to start the trial.
https://beyondtype1.org/new-ilet-bionic-pancreas-system-begins-clinical-trial-testing/
They’ll use Fiasp as the insulin in the adult trial; I don’t know what kind of glucagon.
According to the article, the system will completely surf. There’s no basal schedule, no carb entry, no carb ratio or correction factor. It just blindly surfs the CGM. Hope it works…
Wait a minute…
No bolus?!?!?
OMG, these people are seriously deluded about Fiasp.
Fiasp is the first fast-acting insulin that does not have a pre-meal dosing recommendation, and becomes active in the blood in just 2.5 minutes, approximately.
Sure, 2.5 minutes if you inject it in a vein.
No bolus? So you wait 20 minutes for your CGM to figure out you ate and then it injects, without knowing how much you ate?
Yeah, that will work great. 
So - I am a big fan of the “AndroidAPS” type systems because they can be customized and turned on/off.
I love my CGM, but I find when I exercise it just drops to “LOW” and stays there not matter what my BG is. Here is an example from last night. I was doing construction work in my back yard (a lot of heavy lifting and walking).
The RED squares are my BG meter readings and the red line is my estimation of my BG based on how I felt. The red dots are the CGM reading “LOW” which I definitely was not.
Had I been using an APS system, it would have either shut the basal off and pumped me full of glucagon. As you can see I didn’t need any - BTW - I had some Cheezies (20g of carb worth) (well sort of what @eric suggests at the end of exercise) as some fast acting carbs and the rest of the night was a completely flat line with no mysterious drops.
For those who don’t know what cheezies are - they are a health food that combines a fast acting carb with some protien…
What would happen if your pump waited on your CGM to start rising from a meal before you ever got insulin for the meal?
Am I the only one who thinks that’s nuts?
Maybe the person who wrote the article did not really fully understand it and described it incorrectly. I just think that can’t be right.
Well… it is kind of like driving… if you are driving in a straight line at 60 mph (100 km/h) and want to make a right turn (eat a meal), you turn your right turn signal on (test BG), being to slow down (prebolus) and make the turn (eat your carbs) - now you are going in the right direction.
If you make the right turn (eat carbs) with no preparation - you probably will spin out and crash into something (high blood sugar).
That’s what I’m thinking.
This pump sounds curious! We will see.
Here is a little more info on the iLet. This sounds a little more reasonable than not entering anything for a meal.
The bionic pancreas technology they continue to test in clinical trials, now integrated into a device they call the iLet (a nod to pancreatic islets, clusters of cells that include insulin-making beta cells and glucagon-making alpha cells), gives users the option of administering extra insulin before meals, though there’s no need to estimate how many grams of carbohydrates they’ll eat. Instead, the iLet interface allows users to check off the type of meal—breakfast, lunch or dinner—and whether it will be small, typical or larger than usual. The system’s algorithm adapts to what the user means by each designation and administers enough insulin to keep blood sugar in a healthy range. Moreover, if a user skips the premeal boost—as young people often do, Damiano says—blood sugar will rise, but only briefly, as the machine quickly detects the change in glucose levels and responds with a series of algorithm-selected doses of insulin.
That’s the point: to take the most unpredictable variable—the patient—out of the equation while also achieving reliable control of blood sugar.
WHAT??? Are they saying I am unpredictable? 
Apparently there is a big market for pumps that treat us all like incompetent boobs. See 670G.
That is exactly what I was thinking.
