Devices & Diagnostics

New Abbott diabetes deal is a “missed opportunity” for DexCom

Abbott struck a deal with Bigfoot Medical by which the latter will use Abbott's glucose sensing technology to develop an artificial pancreas and not that of DexCom, the CGM market leader.

By Arundhati Parmar on July 13, 2017

DexCom is the unrivaled king of the CGM market especially as it relates to various artificial pancreas development efforts.

A new deal between Abbott and startup Bigfoot Medical may be the beginnings of future competition for the San Diego CGM maker.

Abbott Laboratories announced Thursday that it is teaming up with Milpitas, California-based Bigfoot to develop diabetes management systems that would integrate Abbott’s FreeStyle Libre glucose sensing technology with Bigfoot’s insulin delivery solutions in the United States. Terms of the deal weren’t disclosed

Essentially, Bigfoot will leverage Abbott’s glucose sensing technology to come up with what the two companies are billing as the “first-ever personalized, user-friendly systems intended to optimize insulin delivery without the need for fingerstick calibration of a glucose sensor.”

The artificial pancreas — the technically more accurate definition is the closed-loop insulin delivery system — is the Holy Grail in diabetes with its promise of automated insulin delivery that removes the need for human input and regular finger prick tests for proper calibration of the sensor. It also reduces the threat night-time

Several artificial pancreas developments are underway, notably the one being developed by Medtronic using its own algorithms. But Bigfoot may be standing a step apart from them and others.

“We feel Bigfoot is a leader in the development of automated pancreases with significant algorithm development complete and ways to integrate cell phones such that the FDA is comfortable with their use in the closed-loop system,” wrote Sean Lavin, an analyst with BTIG, an investment bank, in a research note after the announcement on Thursday.

Here’s more from Lavin that shows that Bigfoot ultimately chose the Abbott CGM technology over that of Dexcom, perhaps loosening the latter’s vice-like grip on the fate of the artificial pancreas in the future. (slightly edited)

In the past, we have commented that DexCom has an arms-dealer type business model as the only source of CGM for the multiple artificial pancreas initiatives by the various pump companies. All the work being done on closing the loop, other than by Medtronic essentially required DexCom CGM. With this partnership, it might be the case that DexCom’s grip on the CGM market may fade over time. Bigfoot Biomedical originally used DexCom, but has chosen Abbott. We believe this decision was made on both Abbott’s worldwide scale and likely financial negotiations with both options.

For DexCom, we view this as a missed opportunity, but the company still has multiple shots with other pump systems. DexCom is being used for Insulet, Tandem, Animas (by J&J), Cellnovo, Beta Bionics, and remains the market leader of standalone CGM.

A DexCom executive didn’t specifically address the comment about “missed opportunity, but through a representative made the following statement.

“Dexcom remains the CGM partner of choice for the vast majority of insulin delivery products currently in the market or in development. Using our best-in-class accuracy, we are focused on our current collaborations to bring great CGM-enabled systems to patients in need,” said Rick Doubleday, Chief Commercial Officer at Dexcom.

Meanwhile, Bigfoot has two means of delivering insulin in an automated fashion — injected as in through a pen, and through a pump. The devices incorporate using smartphones and Internet of Things technology to keep a diabetes patient’s insulin levels at optimal levels.

The company expects to launch a pivotal trial using the Libre technology from Abbott next year.

Photo: Nicol??s Mero??o, Getty Images