Memorandum
Novo Nordisk smart pens now delayed to launch in “2020”; Novo Nordisk adds third CGM partner, in addition to Abbott and Dexcom; Medtronic’s first smart pen partner
This morning, Novo Nordisk and Medtronic jointly announced a partnership to share data from Novo Nordisk’s smart pens – NovoPen 6, NovoPen Echo Plus, and a disposable pen attachment – with Medtronic CGMs. According to the announcement, Novo Nordisk’s smart pens will now launch “starting in 2020,” at least a one-year delay from the original plan to launch in “early 2019”. It was at EASD one year ago that Novo Nordisk first announced a CE Mark for the durable pens, and we’re glad to see them inching closer to market. Medtronic will update its Guardian Connect CGM app (already targeted at MDI users) to pull in Novo Nordisk insulin data. From our view, it’s just fine that the timing has changed – we want to see Novo Nordisk get this product as tuned as possible.
This announcement came on the same day as fellow CGM and insulin giants Abbott and Sanofi launched an almost identical partnership, with broader timing to launch “in the next few years.” Lilly is currently partnered with Dexcom CGM for its smart pen data, a device that is currently under FDA review (as of 1Q19). Companion Medical and Dexcom have already integrated CGM and insulin injection data, and we hope to see this become standard-of-care for all CGM users – seeing both glucose and insulin data streams together is critical for the full therapeutic context.
Novo Nordisk continues to take a prudent partnership approach to connected care, now publicly working with all three major CGM manufacturers (Abbott, Dexcom, and now Medtronic), along with Glooko and Roche. At this stage, we’d guess Novo Nordisk will provide the insulin pen data to enable partners to build decision support. Both Novo Nordisk and Lilly seem to be ahead of Sanofi in the connected pen landscape, with Sanofi’s offerings a “few years” away, though it’s always hard to tell.
Medtronic now has its first smart pen partner in Novo Nordisk, an important move to add value its relatively new standalone CGM offering. Back at Medtronic’s 2018 Analyst Day, the hope was to launch insulin dose capture and advanced food logging by April 2020. The company now has the pieces in place with today’s announcement and its acquisition of food app Nutrino in November 2018 – we have spend time with founder Dr. Yanon Hadad and found him quite compelling. Medtronic also has an active partnership with IBM Watson via its Sugar.IQ app, which added hypoglycemia warnings (up to four hours in advance) in January and has ambitious plans to add “basic” CGM-based insulin dosing guidance, a predictive trace, and some insulin dose advising by April 2020. From a competitive standpoint, Medtronic’s CGM offerings still lag behind those of Abbott and Dexcom (e.g., wear-time, factory calibration), though Medtronic has always been strong on data analytics and was first-to-market with insulin automation for pumps. Dexcom has a strong set of existing insulin partners and its acquisition of TypeZero in 2018 may prove critical for driving into MDI decision support.
We’re glad to see the partnership momentum to combine CGM and insulin data, ultimately towards automated titration and delivery as standard of care. While automated insulin delivery via pumps has a lot of commercial momentum especially as AID will be the killer app for pumps, the vast majority of insulin users globally remain on injections and pens – with no passive data capture on how much insulin they are taking. These smart pen/CGM data partnerships will be key for advancing outcomes!
Close Concerns Questions
Q: What is the status of Novo Nordisk’s connected pens and titration apps? What caused the delay in launch timing? Where will they launch first? When is regulatory submission expected in the US? When will we see the disposable pen attachment for capturing doses?
Q: How much will Novo Nordisk invest in connectivity and titration vs. molecule innovation? How much near-term upside is there on the smart pen and connectivity fronts – On outcomes? On HCP hassle? On new business models? On revenue and profit?
Q: What are Medtronic’s plans to build out its own insulin dose decision support software? How much will other partners be a part of this? How will Medtronic’s MDI/CGM offerings compare to Dexcom and Abbott?
Q: Will Medtronic and Novo Nordisk work together in sales, marketing, or other aspects of connected pen and CGM?
Q: Are there plans for Medtronic to integrate with other smart pen partners? Other data partners (e.g., meal logging apps, heart rate trackers)?
--by Albert Cai, Adam Brown, and Kelly Close