[Weekly Preview] What’s Behind the Supply and Demand Mismatch in Blood Sugar Monitoring? (AI Translation)
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文｜财新周刊 崔笑天 蒋模婷
By Caixin Weekly's Cui Xiaotian, Jiang Moting
一个如同硬币、小而薄的传感器，经由胶布固定在上臂，胶布下是刺入皮肤的微针，可以连续佩戴14天，其间洗澡、运动都不成问题。在手机中，实时呈现血糖的数值与趋势曲线，能直观看到吃下某种食物之后，血糖如何波动。连续血糖监测系统（CGM，Continuous Glucose Monitoring）正在给越来越多的年轻人带来新奇体验。
A small and thin sensor, akin to a coin, is affixed to the upper arm using adhesive tape. Beneath the tape, a microneedle penetrates the skin, allowing continuous wear for 14 days, during which bathing and exercise pose no issues. On a smartphone, real-time blood glucose values and trend curves are displayed, providing a clear view of blood sugar fluctuations after consuming certain foods. Continuous Glucose Monitoring (CGM) systems are offering a novel experience to a growing number of young people.
今年7月，在北京国贸上班的年轻白领欧琳（化名）在地铁口看到一张CGM的巨幅广告，之前她在社交平台也常常刷到糖尿病前期的科普帖。由于家人有糖尿病史，她觉得近来身体疲劳，CGM又宣传无痛监测血糖，马上下单订购了一款。
In July this year, a young professional in Beijing's Central Business District, pseudonymously known as Ou Lin, noticed a massive CGM advertisement at the subway entrance. She had also frequently come across educational posts about pre-diabetes on social media. With a family history of diabetes and recent fatigue, CGM’s painless blood sugar monitoring pitch prompted her to quickly place an order.
收到货后，欧琳轻松将其佩戴在上臂。“当时只有一个触觉，有一块硬币大小的东西碰到了你胳膊，那会儿胶布连带着传感器的针就已经植入你的胳膊了，没有任何的痛感。”
After receiving the product, Oulin easily placed it on her upper arm. "At that time, it just felt like a tactile sensation, as if a coin-sized object was touching your arm. Then, the adhesive tape along with the sensor needle was already embedded into your arm, with absolutely no pain."
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- Continuous Glucose Monitoring (CGM) systems enable users to monitor blood glucose trends without finger pricks, aiding diabetes management, though price wars in China have drastically reduced costs and profit margins, creating market challenges.
- The industry faces difficulties in product differentiation and market penetration, particularly in hospitals, where traditional monitoring methods are still preferred, despite CGM's capabilities.
- Some regions in China allow partial insurance reimbursement for CGM, enhancing accessibility, but broader adoption may require technology improvements and greater clinical evidence to convince medical professionals and systems.
Continuous Glucose Monitoring (CGM) technology is transforming blood glucose monitoring, especially for people with diabetes. A small, coin-sized sensor attaches to the arm and provides real-time blood glucose readings on a smartphone without the need for traditional finger pricks. Initially used for Type 1 diabetes patients in hospital settings, CGMs are now entering the consumer market, appealing to young, health-conscious individuals without diabetes. [para. 1]
The entry into the personal consumer domain sparked interest due to CGMs' ability to provide comprehensive glucose trends over time, rather than just point measurements like traditional glucometers. The device records fluctuations in glucose levels continuously during a 14-day wear period, while remaining unaffected by activities such as bathing or exercising. Beijing's professional, Ou Lin, found CGM useful to understand how different foods affected her blood glucose levels, providing insights that challenged conventional dietary wisdom. [para. 2][para. 3]
Though initially lauded as a promising market in China due to its large diabetic population, the CGM industry is now embroiled in a price war. Since the introduction of CGMs to China, prices have plummeted by nearly five times, straining manufacturers' finances. This price cut has strained the profitability of CGMs, posing a challenge for companies relying on low prices to attract consumers. [para. 4][para. 5]
While type 2 diabetes patients are targeted, CGMs have more significant clinical benefits for type 1 diabetes patients requiring insulin therapy. Studies suggest that for them, CGMs delay the onset of complications and increase life expectancy. However, the use of CGM among healthy individuals is debated, as critics argue without proper evidence, the anxiety induced over minor fluctuations in blood glucose may be unwarranted. [para. 5][para. 6][para. 7]
Still, the market for CGMs among non-diabetics grows as society increasingly focuses on health and wellness. Silicon-based companies cater to this by promoting CGM for weight loss management, providing real-time feedback on dietary impacts. However, retention rates for such users remain low, as the perceived novelty wears off. [para. 8]
Despite potential benefits, CGMs face challenges breaking into hospital markets in China. Domestic brands are pressured to slash prices, limiting their ability to penetrate in-hospital markets, which require meeting clinical standards and achieving widespread medical endorsement. High demand from consumer markets also diverts focus from developing necessary hospital networks. [para. 9][para. 10]
Currently, CGMs face an uphill battle entering clinical guidelines within hospitals, which offer a growing stable market crucial for sustained industry growth. Recognition in clinical guidelines is essential as it emphasizes device precision and stability over affordability. However, financial incentives like medical insurance reimbursement could drive adoption. As foreign markets exhibit higher adoption rates due to insurance involvement, similar policy shifts in China might boost CGM uptake. [para. 11]
The convergence of accurate clinical insights and consumer appeal positions CGMs as transformative tools in diabetes management and beyond. Experts believe an increased focus on rigorous clinical validation, coupled with health management integration and insurance support, could unlock the potential of CGMs further, raising its efficiency in healthcare settings while fostering market viability. [para. 12]
- Medtronic
美敦力 - Medtronic is a key player in the CGM (Continuous Glucose Monitoring) market. Initially, it focused on in-hospital bedside glucose monitoring in China and got approval for its CGM product in 2020. Unlike many other brands that are deeply involved in the consumer market, Medtronic remains concentrated on the hospital market in China, continuing its long-standing commitment to in-hospital patient care.
- Abbott
雅培 - Abbott is highlighted in the article for its Freestyle Libre CGM series, which leads global sales and reached a revenue of $5.3 billion in 2023. The company's market share in China is approximately 57%, competing closely with domestic brands like SiBionics. Despite price wars in the market, Abbott maintains its product at premium pricing, with its new generation Freestyle Libre priced at 499 RMB in China.
- Yuwell
鱼跃医疗 - Yuwell, a company involved in the Chinese CGM market, acquired shares in Kailitet Medical, becoming its controlling shareholder. Kailitet Medical is one of the companies that obtained China's Class III medical device registration certificate for CGM products between 2017 and 2020.
- Meiqi Medical
美奇医疗 - Meiqi Medical, a company involved in the CGM market, was among the first wave of domestic brands obtaining China's medical device registration for CGM products between 2017 and 2020. The company followed international brands like Medtronic in introducing bedside blood glucose monitoring solutions in China prior to the CGM trend, aiming primarily at the inpatient market. However, details on its current market position and performance remain unspecified.
- Sannomedicare
圣美迪诺 - Sannomedicare is a domestic or joint venture brand in the Chinese Continuous Glucose Monitoring (CGM) market. The article mentions that its CGM products have been approved in China and that it is part of the competitive domestic CGM landscape. However, specific sales performance or market position details for Sannomedicare are not disclosed in the provided text.
- Yiyu Technology
移宇科技 - Yiyu Technology is one of the domestic brands that have obtained regulatory approval for their CGM products in China between 2017 and 2020. However, they are facing significant challenges in mass production, with some not yet reaching the market or only having a brief presence. The difficulty in achieving stable mass production is acknowledged within the industry, requiring significant effort to overcome.
- Princeton Medical
普林斯顿医疗 - Princeton Medical is one of the companies that have obtained the certificate for their continuous glucose monitoring (CGM) products in China between 2017 and 2020. However, the article suggests that many enterprises, possibly including Princeton Medical, are struggling with mass production challenges, with no extensive details on their current market status or success.
- Jiunuo Medical
九诺医疗 - Jiunuo Medical obtained the registration certificate for its CGM product in China between 2017 and 2020. However, the company struggled with large-scale production, resulting in its market appearance being short-lived. Some industry insiders acknowledge the difficulty in achieving mass production, which is often more challenging than the initial development of the CGM product itself.
- Silicon Biosensor
硅基仿生 - Silicon Biosensor claims to have a significant share in China's CGM market, rivaling Abbott with a 30% market share as of 2023. They focus on both medical and consumer markets and have managed to overcome production challenges, achieving an annual production capacity of over 6 million units. The company has explored extending CGM use beyond diabetes management into areas like weight loss.
- Welltec Medical
微泰医疗 - Welltec Medical is one of the domestic brands that launched CGM products in China. It finished core technology development and obtained China's Class III medical device registration between 2017 and 2020. Welltec Medical focuses on the Chinese market and is known for its efforts to navigate challenges such as production scaling and market competition, although specific sales data haven't been made public.
- Sinocare
三诺医疗 - Sinocare has introduced its CGM product in March 2023. It is considered to have the second-highest market share among domestic brands in China, following SiBionics. Despite the competitive landscape and price wars, Sinocare is one of the companies striving to break through in the CGM market.
- Dexcom
德康医疗 - Dexcom is an American company that introduced the first mature Continuous Glucose Monitoring (CGM) product approved by the FDA in 2006. Although successful in the U.S. market, Dexcom has chosen not to enter the Chinese market, preferring to focus on deepening its presence in the U.S. instead.
- Calypso Medical
凯立特医疗 - Calypso Medical is not mentioned in the provided article content. The content primarily discusses the rise and challenges of Continuous Glucose Monitoring (CGM) systems in China, including various companies involved in the CGM market, but there is no reference to Calypso Medical.
- Otek Technology
欧态科技 - Otek Technology, established in late 2023 and fully owned by Beijing DeepNeurupes AI Technology Co., offers CGM products at aggressive prices, around 90 yuan each. This low pricing strategy aims to disrupt the market but is seen as unsustainable and focused on capturing market share through negative gross margin competition. The founding team consists of "post-90s" graduates from elite universities like Oxford and Cambridge, backed by significant investment.
- 2016：
- The first CGM entered China with a unit price set at 450 yuan.
- 2017：
- Players began flocking to the domestic CGM market in China.
- 2017 to 2020：
- Kindly Medical, Meiqi Medical, Saintmed, Medtrum Technologies, and Princeton Medical received China's Class III medical device registration certificates for CGM products.
- 2020：
- Medtronic's CGM product was approved in China.
- 2021：
- A significant burst of activity with launches of several domestic CGM products including by Yuwell Medical, Juno Medical, SiBionics, and Weitai Medical.
- 2022：
- Silicon-based Bionics commercialized its CGM products and claimed to rival Abbott in terms of market share in China.
- March 2023：
- Sinocare launched its CGM product.
- 2023：
- Silicon-based Dynamic CGM's market share neared 30%. Abbott held approximately 57%.
- By 2023：
- Silicon-based Bionics' market share neared 30%, while Abbott held approximately 57%.
- January 2024：
- Abbott's Chief Executive Officer Robert Ford stated that Shunganc became the most successful medical technology product in history in terms of revenue.
- As of 2024：
- Silicon-based Bionics claimed that their market share had caught up with Abbott, estimating stabilization around a 40% market share for each.
- By July 2024：
- A young professional, Ou Lin, noticed a CGM advertisement and placed an order.
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