Diabetes tech saw a growing presence at the J.P. Morgan Healthcare Conference this week, from Dexcom's G7 partner Verily, newly public Livongo to Eli Lilly-backed Companion Medical touting their products to investors.
Absent was Tandem, which announced Wednesday it launched its Control-IQ insulin dosing algorithm in the U.S. CEO John Sheridan noted the company began processing Control-IQ orders earlier in January.
The automated insulin dosing software gained De Novo clearance last month as the first algorithm to pair with interoperable diabetes management devices. It uses continuous glucose monitor readings from Dexcom's G6 to adjust insulin delivery from its pump.
The availability of Control-IQ gives Tandem a head start over Omnipod maker Insulet, which highlighted at JPM its plans to launch Horizon, its own Dexcom-integrated automated insulin delivery system, in the second half of 2020 with a pediatric indication from the outset. Tandem's algorithm is currently authorized by FDA in patients 14 years of age and older, whereas Insulet's pivotal trial includes patients between ages 6 and 70.
Insulet thinks an edge in the pediatric diabetes market will help it hit $1 billion in annual revenue by 2021. Others are more focused on adults with Type 2.
Elsewhere, timed around Livongo's JPM debut as a public company, the employer-focused diabetes management platform announced it will give users the ability to integrate data from Dexcom’s G6 CGM.
The move may make Livongo's diabetes management platform more attractive to Dexcom loyalists. Livongo said over a year ago it would enable data integration from Abbott’s FreeStyle Libre Pro, the physician-applied version of the CGM.
The partnership comes as Dexcom is prioritizing expansion in the Type 2 population on intensive insulin therapy, only 15% of which it believes currently uses CGM to manage the condition, compared to about 40% in the Type 1 market. In addition to Livongo, that expansion will see the company lean on partnerships with Welldoc, Onduo, Intermountain Healthcare and UnitedHealthcare.
Dexcom this week predicted revenue between $1.725 billion and $1.775 billion in 2020. Achieving that target will require extra emphasis on growing its patient base, given projections that more patients will be starting therapy outside the U.S., via Medicare, or through pharmacy access, as opposed to commercial and other types of coverage. The net effect of this shift will cause average revenue per patient to fall, CEO Kevin Sayer told investors at JPM.
While Dexcom expects G6 to remain a prominent, and in some countries its flagship, product for the foreseeable future, the company does plan to begin rolling out its next CGM by year's end, a product co-developed with Google venture Verily called G7.
STAT News reported Thursday that some details about G7 that Verily CEO Andy Conrad publicized in its first JPM presentation were not OK'ed by Dexcom, namely the inclusion of an accelerometer for real-time tracking of how exercise affects a person with diabetes.
Meanwhile, medical device giant Medtronic is playing catch-up in the space.
Medtronic teased at JPM it will present data next month in Madrid on its next big diabetes bet, the 780G advanced hybrid closed loop system, at the International Conference on Advanced Technology & Treatments for Diabetes.
"We've got some work to do" in diabetes, said outgoing CEO Omar Ishrak. Although Medtronic brought the first artificial pancreas to the market in 2016 (670G), the company's diabetes unit has lost U.S. share on growing competition in both the CGM and insulin pump sides of its business.
Medtronic said it's already filed 780G for CE marking and an FDA submission is forthcoming. It ultimately expects to present U.S. pivotal trial results at the American Diabetes Association conference in June.
Big players aren't deterring cash flow to smaller, private players, however. Virta Health, whose platform is aimed at Type 2 diabetes patients and works with an at-risk payment model, announced a $93 million Series C. Bigfoot Biomedical also announced that Abbott led a $45 million raise of initial Series C funding, building on the two companies' longstanding partnership to develop FreeStyle Libre-compatible insulin delivery devices. And smart insulin pen maker Companion said it received $27.5 million in debt financing from K2 HealthVentures.