The insulin pump market - France (2024)

1.2 The global market

The global insulin pump market is estimated at US$*.** billion in ****, and is expected to continue growing over the next few years at a CAGR of *.*%, reaching US$*.* billion in ****.

Insulin pump market size World, **** - ****, in billions of USD Source: GandViewResearch (***) : projection

Global market growth drivers include the rising number of people with diabetes, the increase in obesity and overweight, technological developments, and the growing adoption of insulin pumps by patients in both developed and emerging countries[***].

IDF (***) published a report in **** with key figures on diabetes worldwide. As the **** and **** reports have not yet been published, we will use the **** data to gain a better understanding of this market.

Over the past two decades, the number of people with diabetes has risen steadily, from *** million in **** to *** million in ****, a considerable increase of ***% over the period. In ****, compared with ****, the number of diabetics has risen by **% (***).

Number of diabetics worldwide World, **** - ****, in millions Source: ****

And this trend is set to continue, as DiabetesAtlas forecasts that the number of diabetics will reach *** million in **** and *** million in ****.

This increase will be particularly strong in Africa (***) and North America will experience more moderate growth.

to date, Asia-Pacific has the highest ...

1.3 Growth in the French market

The following graph shows the evolution of diabetes-related healthcare expenditure in France. This figure includes all diabetes-related expenses in France. It includes, for example, all the costs of insulin therapy, visits to healthcare professionals and equipment, as well as all the resources devoted to prevention, nutrition and so on. It also includes all public and private expenditure. Although the scope of this expenditure goes beyond the insulin pump market alone, these figures do underlinethe buoyant context in which the insulin pump market is evolving. Indeed, the diabetes-related market in France, which was stable between **** and ****, has been very dynamic since **** (***). Diabetes-related healthcare expenditure in France France, **** - ****, in USD billion Source : DiabetesAtlas The European insulin pump market, expected to reach over $*.* billion in ****, is being driven by a sharp rise in the number of diabetics in the region. In ****, there were around ** million diabetics in Europe, and this figure is expected to rise to ** million by ****. [***] AlongsideGermany and the UK, France is one of Europe's biggest consumers of insulin pumps. In fact, the French insulin pump market is expected to grow at a CAGR of +*.**% over the period ****-****. [***]

2.1 The profile of diabetes patients

The number of diabetics under care is trending upwards in France, rising from *.* million in **** to * million in ****, an increase of **% in just * years. However, by ****, the number of people in care would have fallen by ***,***, before rising again by ***,*** in ****, to around *.* million.

People treated for diabetes in **** (***) France, **** - ****, in millions of people Source: ****

However, in ****, according to the European Center for the Study of Diabetes (***), nearly * million French people are unaware that they have diabetes and have not been diagnosed.

What's more, between **** and ****, the average annual growth rate (***) in the number of people treated for diabetes was *.**%. The gross annual change in prevalence between **** and **** is *.** points. [***]

There are * main types of diabetes[***]:

type * diabetes, due to a lack of insulin secretion by the pancreas; type * diabetes, due to poor utilization of insulin by the body's cells. It develops very gradually, insidiously over many years.

Type * diabetes is the most widespread(***). Type * diabetes accounts for *% of cases. The remaining *% are rarer types of diabetes, such as MODY, LADA or secondary diabetes resulting from certain illnesses or medications. Breakdown of the proportion of diabetics by type France, ****, in % Source: Federation of Diabetics Men (***).

Breakdown of the proportion of ...

2.2 Obesity and overweight as risk factors

Obesity and diabetes are two closely related diseases. In fact, according to the Pasteur Institute in Lille, obesity is the leading risk factor for diabetes, and **% of obese people also suffer from diabetes. The increase in obesity and overweight is the main reason for the sharp rise in the number of diabetics worldwide.

In ****, Oxoda, in conjunction with several partners, carried out a new edition ofthe "Obépi-Roche study", a national epidemiological survey on overweight and obesity for the Ligue contre l'Obésité. It gathers data from **** to ****, but has not been updated since. However, Le Monde confirms that obesity will continue to affect more and more French people in ****, while overweight will stabilize.

In France, between **** and ****, the proportion of the population who were overweight or obese rose by *%, from **.*% to **.*%. However, the proportion of overweight and obese people will not change between **** and ****. In detail, the proportion of overweight people has changed little over the period (***) and multiplied by * for people with massive obesity. [***]

Trends in obesity and overweight in the French population France, **** - ****, in Source: ****

The following map and table show the prevalence of obesity by region. Overall,the northern part of France is more affected by ...

2.3 Insulin pump users among diabetics

Of the *,***,*** diabetic patients who were treated in ****, (***).

According to Has-Santé, the population of French patients using external insulin pumps stood at **,*** in ****. This would mean that only *% of diabetics would be using this device. According to lvlmedical, however, *% of diabetics will be using an insulin pump. by way of comparison, this proportion rises to **% among American diabetics.

According to Sécurité Sociale, **,*** French people used an insulin pump in ****. So, in * years, the number of diabetics using an insulin pump would have almost multiplied by * (***) underlining a trend that is the growing use of insulin pumps. What's more, since summer ****, three new insulin pump models have entered the market and benefit from ***% reimbursement by the Assurance Maladie[***] :

the Minimed™ ***G insulin pump - Medtronic, the Omnipod DASH ™- Insulet insulin pump, the t :slim X* insulin pump - Tandem.

This initiative is therefore in line with the trend of increasing use of insulin pumps.

Two types of pump can be distinguished:[***]

pumps with tubing (***) Patch: Pod and remote control.

In ****, **% of patients will use a "patch" pump, since **,*** pump users use pumps without external tubing. Pumps with tubing thus represented **,*** users, or **% of pumps. [***]

What's more, Insulin pumps are mainly ...

3.1 The central role of health insurance and reimbursements

The French Assurance Maladie plays a central role in the insulin pump market, as it does for many drugs, treatments and medical equipment. As diabetes is classified as a long-term condition (***), costs are ***% covered by the French health insurance system, whether for diabetes-related care or for complications: ocular, vascular, renal or neurological complications, hypertension, resulting from diabetes. [***]

The reimbursements granted each year for French healthcare considerably broaden access to certain equipment or devices that can be costly, as is the case for insulin pumps (***)

Of the *** billion euros of social security expenditure in ****, *,*** million euros, or *.*% of social security expenditure, is allocated to diabetes care. expenditure therefore rose by **.*% between **** and ****, from *,*** million to *,*** million euros.

Expenditure reimbursed by Assurance Maladie for diabetes France, ****, in millions of euros Source: ****

Of this expenditure, in ****, *,*** million euros will be for outpatient care(***).

Breakdown of diabetes-related expenditure France, ****, in Source: ****

Average annual reimbursed expenditure per diabetic patient is estimated at *,*** euros per person in ****. This figure has not changed since ****. So, although total expenditure due to diabetes rose between **** and **** as a result of the increase in the number of diabetics, expenditure per patient remained the same.

Moreover, on average, this equates to a ...

3.2 The main players in the diabetes treatments market

The global market for anti-diabetic treatments is not very fragmented, and is dominated by a handful of large international groups. Evaluate Pharma provides annual reports on the global pharmaceutical market, but only the **** report focuses on the anti-diabetic market.

In ****, the top ** groups accounted for over **% of total market value, including Novo Nordisk (***). In particular, the report stated that the Novo Nordisk group's strong presence should continue to grow by ****, to reach over **% market share in anti-diabetics worldwide.

Market share of diabetes treatments World, ****, in Source: ****

Market share of diabetes treatments World, ****, in Source: ****

3.3 Leading insulin pump manufacturers

The French insulin pump market is highly fragmented and dominated by a handful of industry giants .

Medtronic

Sales of the Medtronic group's Diabetes division have grown steadily in recent years, from $*.** billion in **** to $*.** billion in ****. A world leader in medical technologies, the group has a very strong presence in the insulin pump segment, with highly specialized expertise (***).

However, the Group has announced that it will cease production of this internally implanted pump in ****, as it is not sufficiently profitable according to the Group, and concerns very few patients in France (***). This announcement has caused considerable concern among patients. [***]

The main Medtronic model on the French market is the MiniMed ***G.

Sales of Medtronic's diabetes division World, **** - **** * Source: ****

Roche

In ****, sales for the Diabetes Division of the Roche pharmaceutical group reached *.*** billion euros (***). Roche Diabetes Care France recorded sales of ***.* million euros in ****. The Diabetes division is represented by the Accu-Chek brand, created in **** when Roche acquired the insulin therapy/self-monitoring of blood glucose division of Boehringer Mannheim. [***]

Although the Roche group is number * in insulin pumps in France, it is under intense competitive pressure from specialist players such as Medtronic and Abbott. The group is therefore seeking to revive ...

4.1 Insulin pump typology

Insulin pumps are medical devices used in the treatment of diabetes (***). Compared with multi-injection therapy, the insulin pump enables patients to maintain a freer, more flexible lifestyle, with greater flexibility in mealtimes, as well as better monitoring of blood glucose levels, and therefore a lower risk of complications.

The insulin pump delivers precise doses of insulin continuously, at a rate programmed by the user. The insulin pump is equipped with an infusion device (***). [***]

The main models available in France and their characteristics

Source: ****

Overview of market prices

According to NHC, insulin pumps are reimbursed up to a maximum of €*,*** incl. VAT. There is also the option of renting. In this case, the pump costs around €*.** (***) are reimbursed up to €**.** per replacement.

According to the Diabète Infos website, the complete Medtronic MiniMed® ***G system, which includes a pump, Enlite sensors and a Guardian * Link transmitter, generates an annual cost of €*,*** incl. VAT, fully reimbursed by Social Security.

By way of comparison, the Diabetes.co. uk website references the purchase price of the main insulin pumps in the UK. These range from £**** to £****, or €**** to €****. The same site tells us that consumables cost between £**** and £**** a year, or between €**** and €****.

4.2 Product innovation on the market

Digital technology in diabetes treatment

Manufacturers in the insulin therapy market are increasingly investing in the connected objects segment to meet consumer expectations. For example, Abbott and Sanofi, as well as Medtronic and Novo Nordisk, have signed alliances in **** to advance in the connected pen segment.

In particular, Abbott has launched the Free Style Libre device on the French market, enabling continuous blood glucose measurement using a subcutaneous sensor whose data can then be retrieved and read on smartphones. For Abbott, the aim of the partnership with Sanofi is to be able to take advantage of Sanofi's other platforms and cloud data, to move towards interoperability. [***]

Patch" or "pod" insulin pumps

This new type of pump is smaller and lighter. They also have a practical advantage in that they can be stuck to the skin, with the insulin reservoir directly connected to the catheter, a small cannula inserted under the skin.the insulin reservoir is directly connected to the catheter, a small cannula inserted under the skin, thus doing away with the sixty-centimeter tubing usually found on other models. [***]. Two patch/pod models are currently available: La Cellnovo and My Life Omnipod.

Closed-loop pumps

For insulin pumps, the "closed-loop" system consists ...

5.1 Supervision of insulin pump therapy

Prescriptions[***]

Insulin pumps are reimbursed by the French national health insurance scheme (***) for type * and type * diabetes which cannot be controlledby insulin therapy using multiple subcutaneous injections of insulin.

The initial prescription for an external insulin pump (***) must be made in an initiating center. This prescription is valid for a maximum of * months. Renewal of this prescription, also for * months, is carried out bya doctor specializing inendocrinology and metabolism,or by a doctor qualified in diabetology and nutrition, working in consultation with thewith the initiating center. Next, are-evaluation of the appropriateness of continuing treatment must be carried out by a physician specializing in endrinology and metabolismevery year in an initiatinginitiating center.

The prescription must specifythe make and model of the pump, as well asmake and model of consumables, and the number required per month.

In addition, any prescription for a pump change must be madebe made at an initiating center. According to the registration decree , this change cannot take place before * years have elapsed. However, the social security organization may cover the cost of renewal before the expiry of this period, on the advice ofthe medical advisor.

Patient and provider training

Theorder of June **, **** frames the terms and conditions for reimbursement ...

6. Segmentation

• Medtronic
• Cellnovo
• Roche Diabetes Care (Roche Groupe)
• Insulet
• Ypsomed Group
• ISIS diabète (Isis Médical)
• Physidia
• Nova Medical Center
• Medtrum
• Apex Wellell
• Open APS
• Eli Lilly
• TreeFrog Therapeutics
• Boydsense
• Diabeloop