Dive Brief:

• Continuous glucose monitor (CGM) patients are projected to jump by 38% and 29% in 2021 and 2022, respectively, as new patients continue to flock to diabetes tech, according to a survey of endocrinologists and nurse practitioners from SVB Leerink. The projected growth rate is above SVB Leerink's previous projections for both years.
• Top players Abbott Laboratories and Dexcom are expected to benefit the most from the growing market over the next two years, while Medtronic is expected to lose share of the Type 1 market by 2022. However, the analysts wrote that higher-than-expected adoption over the next two years is a positive for all three.
• CGM adoption is projected to grow among both Type 1 diabetes patients and Type 2 patients, fueled by an increase for both insulin intensive and non-insulin intensive patients with Type 2 diabetes.

Dive Insight:

The broader diabetes tech market has been gaining momentum over the last several years, but use has accelerated during the coronavirus pandemic. Remote patient monitoring, telehealth and wearables, like CGMs or insulin pumps, have all benefited as patients stay home.

While companies across the healthcare space struggled throughout last year, Dexcom brought in about $1.3 billion of gross profit, a $349 million increase compared to 2019. Meanwhile, sales for Abbott's FreeStyle Libre system grew year over year by 43% in 2020.

The growth in CGM use ripples throughout the entire diabetes tech market. Shacey Petrovic, CEO for insulin pump maker Insulet, during a recent earnings call tied the use of insulin pumps among new patients to the future success of CGMs.

A similar survey from SVB Leerink of the insulin pump market projected double-digit growth for the insulin pump usage. 

SVB Leerink's survey suggests that the CGM market could meet the growth potential touted by Wall Street analysts over the next several years.

SVB Leerink projects that the current Type 1 market is about 45% penetrated. Market penetration is projected to eventually peak at about 74%, according to the survey. The analysts noted the respondents' peak penetration forecast of 74% is slightly lower than Dexcom's 80% projection and well below SVB Leerink's projection that the market will be completely penetrated.

Survey respondents expect market penetration to peak at about 55% for Type 2 insulin intensive patients and 30% for non-insulin intensive patients. The survey suggests that the Type 2 market is projected to make some of the largest gains in the diabetes space in the coming year as both patient groups are less penetrated than the Type 1  population.

The Type 2 population has been held up by analysts and diabetes tech companies, particularly Dexcom, as the future growth driver. SVB Leerink analysts wrote that the Type 2 non-intensive populations could "be a meaningful source of upside for the entire market" because the "opportunity is large, under-penetrated, and growing."

However, experts have questioned if CGMs are an effective treatment for patients that do not require insulin injections.

SVB Leerink commissioned MEDACorp for the survey of 101 endocrinologists and nurse practitioners, representing 124,847 diabetes patients. The group is a global network of healthcare professionals and part of SVB Leerink.

Dexcom stands to benefit the most from the next several years of growth among Type 1 patients, slightly growing its lead in that market. Meanwhile, Abbott's market share is projected to remain flat and Medtronic is projected to lose about four percentage points of market share by 2022.

Dexcom is also projected to grow market share among both insulin intensive and non-insulin intensive Type 2 patient populations by 2022, while Abbott's share is projected to decline. However, Abbott is expected to maintain its substantial lead in those markets.

Both Dexcom and Abbott have been fighting over a leadership spot in the broader diabetes tech market, with Dexcom recently targeting pharmacies and lowering prices to better compete with Abbott.

The competition could heat up soon as both look to release next-generation products. Dexcom plans to release the G7 CGM system at the end of 2021, and Abbott received a CE mark for FreeStyle Libre 3 in September and is currently developing a fourth version of the product.