Startup aims to upend diabetes care with matchstick implant

Growing market

The diabetes market has grown accordingly. Novo Nordisk reaped $2.39 billion in sales of its GLP-1 injection Victoza in 2014. Merck & Co.'s diabetes pill Januvia is its top seller, accounting for $3.93 billion in 2014.

Unlike an insulin pump, which is carried on a belt or in a pocket and delivers insulin through a catheter inserted under the skin, Intarcia's device is designed to be implanted entirely, in a simple procedure that takes less than a minute. The company aims for the device to be implantable by a nurse or physician's assistant, not requiring a doctor.

The pump is often implanted in the stomach area, where there's ample skin, though it can go elsewhere, such as the upper arm. Once it's under the skin, the patient doesn't need to take any action. The pump must be removed after six months to a year and replaced with a new one.

"I think it's going to be very quickly taken up, and the cost is reasonable," said Robert Henry, a professor of medicine at the University of California at San Diego who ran a final-stage trial for Intarcia.

Product life

The pump's duration — whether it lasts six months or a year — will be a key factor, the diabetes association's Ratner said. When an old pump is taken out, the new one needs to be placed in a new location because of scar tissue formed in the old site, he said. More frequent applications would mean the need for more implantation sites on a patient's body.

Intarcia's Graves, on the other hand, said the pump should be able to be reapplied for multiple years to the same location. So far in trials, the device has been used for up to two years in patients, with new pumps reimplanted in the same location, he said.

Ratner said he's waiting to see the results of a trial pitting Intarcia's pump against Merck's Januvia, an oral drug with a different mechanism. Those results are coming in September. Intarcia may also face additional competition if Novo Nordisk's oral version of a GLP-1 is approved.

Graves says he wants to show that his pump can beat any class of diabetes treatment. Besides Januvia, Intarcia is planning a study that will compare the pump to three classes of drugs.

His ambitions don't end there. Studies have shown that GLP-1 shots may be able to delay the onset of diabetes. The CDC estimates about 86 million people in the U.S. are pre-diabetic.

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"We're not just trying to change the treatment market," he said. "At the end of the day, I want to show we can use it, once a year, to prevent and delay onset of diabetes."

—With assistance from Michelle Fay Cortez in Minneapolis.