Dive Brief:

• A survey of health providers from SVB Leerink projects insulin pump adoption to outpace previous estimates, with a shift in market position among players like Medtronic, Insulet and Tandem Diabetes Care.
• Patient adoption is projected to grow by about 21% in 2021 and 17% in 2022, up from SVB Leerink's previous estimates of mid-teens growth for both years. The analysts said the findings mesh with industry commentary and recent financial reports.
• The survey also projects strong near-term growth among patients with Type 2 diabetes, a large underpenetrated market that both insulin pump and continuous glucose monitor (CGM) makers are targeting to drive future growth for their companies.

Dive Insight:

The diabetes tech market, which includes both insulin pumps and CGMs, has caught the eye of Wall Street as patients flock towards wearables and virtual care, a trend accelerated by the coronavirus pandemic.

Pump makers like Insulet and Tandem have reported strong results for 2020, and both companies expect that momentum to continue throughout this year. Meanwhile, Medtronic has a renewed focus on diabetes tech. Whether due to upcoming product launches, underpenetrated patient populations, or both, all three companies say that there is still lots of potential for the insulin pump market.

And SVB Leerink's survey seems to confirm the potential of both an underpenetrated and growing market.

Adoption among patients with Type 1 diabetes is projected to grow from 51% in 2021 to 62% in 2024, according to the survey. Ultimately, the survey projects the Type 1 patient adoption to peak at about 71%.

SVB Leerink commissioned MEDACorp to conduct 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. 

While Type 2 patients are the oft-touted strategic move for diabetes tech, SVB Leerink's survey suggests only so much room to grow, at least for insulin pumps.

Adoption among insulin-intensive Type 2 patients is projected to grow from 17% in 2021 to 23% in 2024, according to the survey. Adoption is projected to eventually peak at 29%, less than half of the projected peak for Type 1 patients.

Still, the analysts valued a roughly 30% penetrated Type 2 market at $2 billion.

While the survey suggests 17% current market penetration among insulin-intensive Type 2 patients, the analysts estimate that the overall market penetration is actually closer to about 4%, leaving a lot more growth ahead for the industry. 

The survey may have a bias towards early adopters as respondents came from medical clinics, the analysts noted.

As patient adoption increases, so too will the competition.

Insulet and Tandem are already taking on giants like Medtronic, which is placing more focus on the diabetes market and has more resources to throw behind that focus.

Tandem is ahead in terms of technology as the first FDA-cleared algorithm for use with a fully interoperable, automated insulin dosing system. However, analysts expect Insulet to compete for top spot in the market with the launch of their new Omnipod 5 insulin pump, also a closed-loop system scheduled to hit the market in the first half of 2021.

Analysts have been high on Omnipod 5 as it will be a more discreet wearable patch pump and come in at a lower cost than Tandem's. J.P. Morgan called the release of the Omnipod 5 one of medtech's most important launches in 2021.

SVB Leerink's survey suggests a similar view of Omnipod 5's potential impact among healthcare professionals, projecting Tandem to gain about three percentage points of market share by 2022.

"This survey also points to relatively meaningful market share shifts as new products come to market, notably in favor of [Insulet], primarily at the expense of [Medtronic], with [Tandem] market share basically stable over the next few years," the analysts wrote.

While Medtronic will still be the market leader by 2022, SVB Leerink analysts project that Medtronic will lose about eight percentage points of market share by that time, with Tandem and Insulet closing in.