Memorandum

First Senseonics Eversense CGMs inserted in US following FDA approval; first payer coverage with Horizon BCBS New Jersey – August 7, 2018

This morning, Senseonics announced the start of the Eversense CGM’s US commercialization, with “first shipment, first users, and first policy coverage.” Shipments began as expected in late July, and less than six weeks following FDA approval in early June, trained clinics and physicians have inserted their first patients with the 90-day implantable CGM.

Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ), which covers nearly four total million lives, is the first commercial payer to cover Eversense as part of its Medical Policy. It’s not clear to us how initial coverage will segment: using existing CGM codes, via the newly-created implantable CGM insertion/removal codes, or as a bundle (reimbursing physician time + Eversense supplies). Outside of BCBSNJ, Senseonics will presumably work on a case-by-case basis to get individual patients covered using existing CGM reimbursement policies and pricing.

Senseonics is also hailing this week as “Freedom Week,” to “help patients mark the day they were freed from the weekly and biweekly self-insertions required by traditional CGM systems.” This marketing seems aimed at former/existing CGM users frustrated with insertions – is this where Senseonics will focus initially? Will the marketing differ for CGM naïve users? We aren’t sure that this is necessary since so many people without CGM need CGM more than folks with insertions need to be without insertions – also, insertions just aren’t an issue anymore for the vast majority of patients on Dexcom and Abbott, far different from years ago! We do note however that implants may well be very appealing to some due to lower perceived hassle factor for some patients.

We expect a moderate ramp for Eversense in the US, and would be cautious about broader expectations, especially since HCP insertion is the gating factor to scale. As of the writing of this piece, the company’s US Facebook page has ~400 likes, while 335 people are following the company’s US Twitter feed. One Facebook user did exclaim: “Insertion done yesterday. So quick, easy and painless. Excited to be sharing in this huge advancement!”

We expect to hear many more details on the US rollout, financials, international adoption, the US regulatory pipeline (iCGM? Non-adjunctive? Calibration reduction?), and more on tomorrow’s 2Q18 financial update (1:30 PM PT).

 

-- by Brian Levine, Adam Brown, and Kelly Close