Competition in the CGM Market


I see no reason to scream, It seems impolite.

I do not wish to dismiss your past experiences with Medtronic, I just wished to point out that there is bias in both directions. You have made your position on Medtronic perfectly clear many times in the past. @Rphil2 equally states his bias, he post a disclaimer each time he post about Medtronic. I find his integrity quite refreshing, he receives no compensation from Medtronic, he does what he does because he believes in their products and has used them for years, he does what he does to help others.


Medtronic used to be a great company with helpful representatives and customer support. They are the most difficult company to work with now and phone wait times, ability to get help from the right/any person is nearly impossible now. Nobody knows what anyone else is doing in the company and keep moving you on to someone else and never getting anyone who can help. Now that they are no longer having the 530 available, I need to find a new pump company. The 600 series pumps are way too large and I loved being able to easily hide and hardly notice having the 530 pump. I thought with pumps, as we moved on, they would get smaller…not bigger and bulkier and less user friendly.
I hope I can keep my 530 pump going strong and don’t require any assistance with Medtronic in the future…they are extremely frustrating.


I was a Dexcom user for years and will continue to recommend it as a literal “life saver.” In the last 6 months I have switched to Medtronic 469g because of some other goals. I have been pleased with the integrated CGM and have lower A1C than ever in my life with T1D. But I would still recommend Dexcom too. Both technologies are important. I get concerned when I see a competition brewing about product. I feel there are too few options on the market for T1D. It is not a one size fits all thing. We need options. In fact, I was incensed when United Healthcare went exclusively Medtronic. (I am still sure there is an anti-trust issue in that.) I want to see more technology on the market and more varied uses cleared by FDA (rather than having to resort to off label use). I want to CMS and independent insurers approving more options for coverage for patients - particularly for the elderly dependent on CMS whims for what devices and therapies are covered. I really could care less about who is leading the market as long as I know there is a large and varied market to lead.


I don’t recognize this pump model. Is this a typo?


^^^ This x 10million. Problem is, all of the players in the D space are doing their utmost to eliminate alternative tech and pharma, particularly in the T1 realm. It’s just a tight space to operate in. Medtronic’s success has been due in significant part to exercising their market dominance with insurance providers and Medicare, ensuring that anywhere coverers are being forced to narrow down to a single source, it’s going to be them. As patients we need more competition, not less, but as corporations they’re pushing in the opposite direction. How many innovative pump makers have failed over the last ten years, out of how many total? It’s just a really hard space for a newcomer to get started in, and for others to maintain a profit margin in, due to the relatively small size of the whole. This article is a year old, so already a bit overtaken by events, but still a useful take on the general situation:

[…] let’s acknowledge the realities of the insulin pump market – a market that I have consistently stated is not large enough nor growing fast enough to support all the companies that play in this sandbox.


Article is a little out of date as Tandem position has completed flipped and their future looks much brighter (financially and product roadmap) than in 2017.

Also I think they have a very loyal Dexcom customers base that will only help better position them in the market. I for one will move to Tandem from Medtronic primarily because of the Dexcom integration. Time will tell on Basal IQ and Control IQ, but they seem very promising.


When I started with Minimed pump, it was directly from Minimed. Dealing with Minimed was always great. Then medtronics bought Minimed, and in the beginning things were still pretty good. But in my opinion, declined over the years under Medtronics.


@Donna_H and @DrBB,
Let me just clarify to make sure that I understand your perspective. I always felt like we, as diabetics, had a much larger variety of devices and medical tech to choose from than other chronic illness groups. That alleviated some of my concerns.

But, what your saying is that insurers narrow down the number of devices from which you can select from? Aren’t treatment options supposed to be up to the doctors discretion? The insurance co isn’t supposed to be able to dictate which treatments you can have. Are you saying that they do that directly, or kinda indirectly through buying up other companies and things? You believe that this is why Medtronic has such a large market share? I have always wondered why so many people just coincidentally happened to all use Medtronic pump.


I got my minimed when it was the only option. Many endo practices learned that first, and refused to support other pumps, claiming they they didn’t have bandwidth to support them all. Medtronics was able to provide more of their own resources to the doctors and CDEs.

Over time, as newer options were gaining sales, then more endos supported them. I remember seeing websites for endo offices that stated they only supported Medtronics.


I see. I do recall when they were the only game in town. I live in a Medtronic town. They are a large employer here with a heavy presence, so I always assumed their relationships within healthcare here resulted in such a large market share. I didn’t realize that was true nationally until this year. Do you think most insulin pump users on this forum use Medtronic pumps? We should do a poll to see how we compare to the broader diabetics population. Does Medtronic have such a large market share overseas?


yeah, I remember that!


When I first joined this forum, I would guess more were medtronic. But this is where I first learned that other pumps were even available. Once I was using pump, there was no reason for me to want or know about others. Over time, I think the percent of medtronic users (on this site) has dropped. Although maybe an increase when 670 was introduced.

I first found this site when starting medtronic Sof-sensor CGMS. So thanks to struggle with getting it to work, I found others using dexcom, and switched soon after.


As I noted, yes, but I think as a general picture of why the market is so hard to break into it’s still useful.


My experience too mm. I’m back on Medtronic tho, a 522, with Dexcom and Looping with the DIYs. Wow, it’s an amazing change. Still bolus for meals but basal adjusts to the cgm. Just gotta remember that when my cgm is a day old it isn’t as accurate…Hope you are well. Kim


I just wanted to point out the landscape for Tandem is completely different today than in 2017. I agree, completing against Medtronic is difficult and quite the challenge. Heck when I started pumping 10 years ago I didn’t even consider another pump.


I started pumping about six years ago, through Joslin. They have a great process there, where they have reps from all the companies come (quite a few more of them then!) and you go around to each one and they explain their features etc. All the reps were pumpers themselves and you could ask anything you wanted, Once you decided, Joslin had you train on that pump with one of the manufacturer’s trainers as well as one from Joslin. Great experience. I didn’t know anything about Medtronic, or their market dominance or anything at the time, but I ended up going with them. I was interested in some of the others for various features, but it just seemed like the best one all around. Not to say I haven’t had my complaints about them—I actually switched to the Assante Snap a few years ago only to have the company crater about 3 months into my experience with 'em. But none of these things are perfect that’s for sure.


Medtronic over billed me then lied to me for a solid year

They are the essence of pure evil

Enlight sensors were the biggest scam in all of medical history - this would include all the turn of the century scams


They actually asked me to prove documentation they had sent to me.
If you think about it long enough you cannot even do that if you had a time machine.


Tony, Medtronic tried to falsely bill me for a pump ($500) that I was told by a sales rep on the last day of the year (some years ago) that I could get a new pump AND KEEP THE OLD ONE. He was trying to improve his quarterly sales figures; hence he told me what I wanted to hear, but he wasn’t (apparently) authorized to tell me I could keep the old pump. About 5 years later I get a surprise bill in the mail. After not getting the billing department to admit the error, I finally contacted the CEO’s office. After a few days they decided that their tactic of cheating me wasn’t going to work. Basically, I told them if you want the $500, get it from the salesperson.


Go Eagles!!! Yeah !!! Fly Eagles Fly


I also get tired of repetitive questions from Dexcom Support. After I answered several with “Same as I always tell you, - - - -” I was advised that user and technical issues are reported to the FDA and they had to repeat the questions.