Insulin pumps offer several prominent benefits over other insulin delivery methods. Insulin pumps can reduce the need for insulin injections and can also deliver doses with a precision unmatched by other options. Allowing users to set up pre-determined delivery schedules can be helpful for preventing hyperglycemic events should users forget to administer insulin or for helping parents manage their child's glucose levels. So why are insulin pumps so rarely used today, as compared to other insulin delivery methods?
The primary reason is the cost. Insulin pumps are extremely expensive, with a single unit worth several thousand dollars due to the range of sensors required to ensure precise insulin delivery. This does not even account for the disposable equipment required: a traditional insulin infusion pump needs catheters, batteries, adhesives, and several other components that need to be replaced regularly, further adding to the costs. In the face of more affordable insulin delivery options, insulin pumps have struggled to justify their price. This has seen less-than-stellar volume uptake for insulin pumps, with a study finding a pump uptake rate of only 6.2% among adults with diabetes in the UK in 2021.
However, this could all be set to change due to two key developments in the industry: the development of more affordable patch pumps and the gradual move towards fully automated diabetes management in the form of full closed-loop and artificial pancreas systems, which have caused rising interest in the previously largely stagnant insulin pump industry. The IDTechEx report, "Diabetes Management Technologies 2022-2032: Markets, Players, and Forecasts", details the insulin pump market and its interactions with the wider diabetes management device industry.
Patch pumps: More affordable, more convenient
Traditional insulin pumps can be priced between US$2000-US$8000 per unit, with further supplies requiring around US$1000-US$2000 per year. While the long lifetimes of these pumps (of 4 - 8 years) do translate to a reduced annual price, the fact remains that this high upfront cost is a major barrier to customers. Despite their ability to mitigate risks of hyperglycemia, this high cost also discourages reimbursement policies outside specific patient groups. Encouraging patient uptake would require pump developments to either offer patients with significant improvements to their quality of life or to notably reduce unit cost.
This latter approach is taken by patch pumps, wherein all the required components are encapsulated in a single disposable unit. Patch pumps are typically deployed as a single disposable pod and can be controlled using a connected transmitter device. Patch pumps are much more affordable than traditional insulin pumps, with each pump being priced between US$20-US$50. However, patch pumps also have a much shorter lifetime than infusion pumps, with each pump typically lasting between 1-5 days.
The patch pump industry has grown rapidly over the last few years, and growth is expected to continue over the next 10 years. The low unit cost is believed to be a particularly attractive characteristic to consumers; each pod is sufficiently affordable even without reimbursement support.
Insulin pump revenue by type. Source: IDTechEx - "Diabetes Management Technologies 2022-2032: Markets, Players, and Forecasts"
Despite their lower unit costs, patch pumps may not necessarily lower patient expenses as compared to traditional infusion pumps: the need for constant replacement of patch pumps may actually result in higher annual costs, depending on pump model and usage. Despite this, consumers have continued to show significant interest in these patch pump options.
Automating diabetes management: Full closed-loop systems
The goal of the diabetes management industry has long been to automate the process of managing diabetes completely. Perhaps the most promising method for achieving this thus far has been the development of closed-loop systems.
In a closed-loop system, an insulin delivery device is paired with a glucose monitoring device. This allows blood glucose to be measured and used by software to inform insulin dosing autonomously, without requiring patient intervention. Insulin pumps are the ideal insulin delivery system for such a system, as they are already able to deliver insulin autonomously (albeit in small doses and often according to pre-set schedules) and only require suitable algorithms to be developed for autonomous insulin delivery to be carried out.
The recent rise to the prominence of continuous glucose monitors (CGMs) has brought closed loop into the spotlight. CGMs can act as the requisite glucose monitoring component for closed-loop insulin delivery; these devices can collect and deliver blood glucose data frequently and remotely to mobile data, a feat unachievable by previous test strip methods. CGMs have continued to develop over the years, with accuracies now approaching that of test strips. The interest in developing closed-loop systems has sparked a flurry of partnerships between the insulin pump and CGM manufacturers, with CGM leader Dexcom having partnered with a host of insulin pump manufacturers such as Insulet and Tandem Diabetes Care. Today, Medtronic leads the pack with their 780G system: this "advanced hybrid closed-loop" system allows Medtronic pumps to receive data from connected Medtronic CGMs and modulate their insulin delivery autonomously. However, insulin delivery amounts are restricted, and human input is required for larger insulin doses; the requirement of human approval classes this as a "hybrid" rather than a "full" closed-loop system.
Commercialization of full closed-loop systems is expected to drive the insulin pump industry significantly; in addition to the greater convenience and peace of mind these systems can offer, the improved patient outcomes will likely encourage further reimbursement policies. However, reaching full closed-loop is difficult: any mistakes of the system can potentially lead to death, and so the progress towards full closed-loop is slow in no small part due to stringent regulatory policy requirements. Regardless, promising advancements in hybrid closed-loop automation demonstrated by the insulin pump industry over the last few years are causes for optimism.
These developments promise major changes in the insulin pump industry over the coming years, and the highly interconnected nature of the diabetes management device market will thus result in significant "knock-on" effects on various other markets across the entire industry. The IDTechEx report, "Diabetes Management Technologies 2022-2032: Markets, Players, and Forecasts", discusses the outlook of the insulin pump industry and its effects on the wider ecosystem in detail, summarizing our findings in 10-year market forecasts.
For more information on this report, please visit www.IDTechEx.com/Diabetes or for the full portfolio of Healthcare research available from IDTechEx please visit www.IDTechEx.com/Research/Healthcare