Novo Nordisk Enters Smart Insulin Market and the War with Eli Lilly is On

Another Batch of Smart Insulin Pens to Hit the Market

Will this be the next battleground between Eli Lilly and Novo Nordisk?

Novo Nordisk Announces Two New Smart Inhalers

At the beginning of October, Novo Nordisk announced the plans to create two new connected insulin pens, the NovoPen 6 and the NovoPen Echo Plus. Their aim is to bring these pens to market in 1st or 2nd quarter of 2019. Novo Nordisk already has partnerships with IBM and Glooko for diabetes care, but also is partnering with Roche (who is also heavily invested in the diabetes digital health space) and Dexcom (with their new CGM devices on market).

These will be Novo Nordisk first smart insulin pens, and with Eli Lilly already underway, it’s no surprise they want to come out swinging with firm partnerships to enter and reclaim a market that is sure to explode in the near future. Essentially, any pharma company with a product (e.g., inhaler, injectable) that is not being enabled with IOT is bound to lose out to competitors. Now, to recap who makes what insulin product:

Eli Lilly Insulin Products Include

• Lantus/Glargine (and Basaglar)

• Humolog/Lispro and mixes

• Humulin - R, N, and mixes

Novo Nordisk Insulin Products Include

• Tresiba/Insulin degludec

• Levemir/insulin determir

• Novolog/insulin aspart and mixes

• Novolin R and mixes

Taking into consideration the crossover in different classes of insulin between the two companies, and recent new insulin products coming to market from each, it comes as no surprise that digital health has turned into the next battleground. This is reinforced by comments from the PR:

"Our non-exclusive partnership strategy allows us to integrate with the various digital platforms that people are already using to help manage their diabetes," said Camilla Sylvest, executive vice president of Commercial Strategy & Corporate Affairs at Novo Nordisk. "We firmly believe that this will help more people realise the full benefit of our innovative medicines and begin to ease the mental burden of diabetes treatment for those individuals."

In addition, it seems likely that the CGM market is rapidly growing, especially with products like the Freestyle Libre arriving on the scene, and backed up by Dexcom comments:

"We believe that a fully connected ecosystem represents a significant opportunity to improve the lives of people on multiple daily injections," said Steve Pacelli, executive vice president of Strategy & Corporate Development at Dexcom.

But, this news is only one part of the recent digital health news surrounding Novo Nordisk that is interesting this month…

Novo Nordisk Signs up as Flex Digital Health Customer

Just this week, Flex Digital Health announced that it was partnering with Novo Nordisk to develop digital health solutions for patients with diabetes. Novo Nordisk will sign onto the BrightInsight platform to create such solutions.

Now, Flex is a company in many different industries, with Digital Health being just one area. Their expertise focuses on their ‘Sketch-to-Scale Solutions’ that helps companies build products and platforms integrating internet services. With digital health primarily focused on such an interconnected world, it comes as no surprise that Flex is involved.

The PR had some interesting quotes, including one that stood out to me:

"Traditional methods of managing diabetes have not kept pace with a world moving at digital speed," said Kal Patel, M.D. and SVP of Digital Health at Flex. “BrightInsight securely unlocks real-world data and actionable insights, enabling pharma and medtech companies to develop advanced regulated digital health solutions that enable automated clinical decisions and better engagement between clinicians and people with diabetes.”

Now, the bottom line is this: Novo Nordisk is entering the digital health space hard with smart insulin pens and it needs someone to help bridge the gap between data collection and analytics, and that is where Flex comes in. It will be interesting to see if Flex BrightInsight will be the missing link to help Novo Nordisk provide better clinical care and communication between providers and patients.

Some of My Thoughts

• Eli Lilly is a bit ahead of Novo Nordisk in this space, but it seems that Novo Nordisk is going all in with many of these partnerships. I would say that Novo Nordisk saw the writing on the wall and has been planning this maneuver, and wants to come come out swinging instead of just incremental additions that some pharma companies have been doing. I think the partnership with Flex is key here, as the data management and analytics they provide may be the one way to get ahead in the market.

• Smart Devices such as smart pen caps and adaptors (that I have covered under my Medication Adherence Page) have a lot to consider. The most obvious move by many of these companies would have been a B2B model whereby pharma would pick them up to be used with their products and then covered by payers instead of a B2C model that most have been relying on. But, it seems that many pharma companies are now looking to get into just manufacturing their own devices internally. This may be a warning sign to other companies or start-ups looking to enter this space.

• I don’t see smart connected devices taking off for a bit. One of the biggest issues will be to demonstrate efficacy and reduction of cost expenditures by payers. I think demonstrating reduced hypoglycemic events and hospital visits is key here, as we know insulin is in the top 5 for ADR in the US. Efficacy and reduction of A1c and reaching goals would also be a great selling point. The only thing is the studies are going to take time, and Medicaid I think will be one of the hardest markets to get into, just because most don’t even cover insulin pens easier and Medicare may be a challenge as well. Nonetheless, this is a multimillion dollar market at the end of the day, so I expect amazing things here soon.

I welcome your thoughts as always!