MiniMed Relies on Insulin Pumps for Cash Infusion : Medicine: Firm’s only revenue-generating product, buoyed by a 1993 study, is slowly establishing itself among diabetics and doctors.
Insulin infusion pumps are a lifeline for the diabetics who use them, and also for the only company in this country that makes them, MiniMed Inc. of Sylmar.
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MiniMed’s only revenue-producing product, the infusion pump, is a pager-sized device worn hooked to the abdomen, day and night. The pumps allow diabetics to forgo daily injections of insulin.
It’s hard to conceive of a more difficult product to develop and market: The pumps must be virtually flawless because their users’ health depends on their reliability. But their sales are complicated by their cost--about $4,000 per pump--doctors’ skepticism, and the reluctance of diabetics themselves to change their lifestyles.
Only one other company, Disetronic Medical Systems A. G. of Switzerland, makes external insulin infusion pumps. But acceptance of the pumps has come slowly. Only a few thousand diabetics are pump users now.
MiniMed, which has been selling the insulin pump since 1985, has long had trouble making money, in part due to large amounts spent on research into new systems of diabetes treatment.
Granted, MiniMed’s annual sales have almost tripled to $36.3 million in 1994 from $12.5 million in 1990, but in 1994, MiniMed lost $900,000, compared to a loss of $1.6 million in 1993. However, in the second quarter ending June 30 of this year, the company reported a profit of $101,000.
Last month, bolstered by a health study that concluded the pumps can offer a substantial reduction in health risks for diabetics, the company raised $29.5 million in its first public stock offering. The move is expected to stabilize its finances.
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MiniMed’s insulin pump aims to revolutionize treatment of Type 1 diabetes, a dangerous metabolism disorder affecting an estimated 700,000 nationwide, said Peter Rule, MiniMed’s chief operating officer and president.
The company has also been encouraged by growing medical support for its diabetic pump.
Doctors often used to instruct insulin-dependent diabetics to inject themselves with insulin only twice a day.
But a National Institutes of Health study published in September, 1993, in the New England Journal of Medicine found that tight control of blood sugars such as that achieved by very frequent injections of insulin--say four times a day--or infusion pumps can delay and slow progression of several of the most serious long-term complications of diabetes, such as blindness.
This was a watershed finding for the treatment of diabetes and for MiniMed, which provided the pumps used in the study. “It was a landmark study,” said Dr. David Kayne, insulin pump director at the diabetes care center at Encino/Tarzana Regional Medical Center.
Physicians had long speculated that a continuous flow of the hormone insulin is healthier than injections of longer-acting insulin.
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MiniMed’s insulin pumps are connected to the body by a slender, flexible tube that is attached to a needle inserted under the skin of the abdomen. The wearer can clip the pump on a belt. Worn this way, it looks almost exactly like a pager. A recent feature added by MiniMed allows the wearer to temporarily detach the device, to take a shower, for example, leaving only a few inches of tube hanging from the skin.
The pump continuously feeds insulin into the body, although the flow rate must be set by the diabetic, who regularly monitors blood sugars to determine the desired setting. The pump allows more spontaneity in eating habits and freedom from injections, Rule said.
But wearers must be vigilant in checking their blood sugar in case the flow of shorter-acting insulin used in the pumps needs to be adjusted to match sometimes unpredictable changes in blood sugar levels, said Susan Strele, a nurse who manages MiniMed’s clinical pump therapy department, where workers staff a 24-hour hot line for pump users.
The pump is also seen by some as having “social drawbacks,” said Len Cohen, who has Type 1 diabetes, works for a diabetes education center and lives in Woodland Hills. Cohen said injections were easy to get used to. “I feel like if I can get away with four injections a day I would rather do that,” said Cohen, 39. “That way, you just take a shot and have it over with. The pump you have to carry around.”
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Cohen, though, quickly added that he may soon switch to an infusion pump anyway because he is convinced by the newly revealed health considerations. “I guess as you get older, your priorities straighten out. So what if people know you are wearing an insulin pump? As long as you feel healthy.”
Physicians, too, are becoming more interested in the pumps since the institutes’ study. But “you have to carefully pick your patients,” said Dr. Joshua Rokaw, a Van Nuys physician, who emphasized that it is only appropriate for diabetes patients who have proven that they regularly check their blood sugar levels.
Dr. Bagher Sheikholislam, a Sacramento physician, agreed: “I think use [of the pump] will increase. But I don’t think most, or at least not all, patients with diabetes are going to receive it.”
