Happy Holidays, everyone! 'Tis the season for cocktail parties, and roundups of the closing year, no? I was feeling a little overwhelmed about attempting "the roundup" this year, so I decided to ask you all to get involved. To me, it seems that if 2007 is remembered for anything, it will be as the birth year of Health 2.0, the rise of Social Media and its conjunction with health and healthcare offerings on the web. For diabetes in particular, product design took the spotlight for the first time, while a few drugs were spectacular failures.
LET'S WRITE THIS ONE TOGETHER...
Below are my personal observations about what was Big in Diabetes for 2007. I'm thinking that many of you out there in the Diabetes Community have your own take on what was big in diabetes this year. So how about you share your comments on launches, happenings, treatments, trends, bloopers & outtakes -- you name it -- below? I'll continue to update this post with your feedback until we hit 2008. What say?
Making Pharma History.
2007 was a watershed year. At a $2.8 billion loss, Exubera made its mark as one of the most expensive flops in the history of the pharmaceutical industry. Pfizer spent about $370 million this year on promotion alone, financing everything from CDE and doctor training, to prime-time TV spots. Lesson learned: Before you invest billions in a product that will benefit very few people, you'd better do your homework and talk to your customers first!
Avandia came in at a close second, making history as one of the most controversial and potentially harmful blockbuster drugs ever pushed through the system. It's had an enormous ripple effect, even to the point of potentially contributing to a slow-down in pharma innovation, some observers say.
Byetta continued to take the diabetes world by storm this year, especially with the introduction of its new long-acting release (LAR) version that's showing unparalleled A1c results in patients. "LAR continues to look like a $3 billion-plus seller in our minds as no other diabetes medication -- now or on the horizon -- comes close to lowering A1c as effectively combined with the weight loss profile, which likely gets better in longer-term studies," states Jim Reddoch, an analyst with the high-profile firm Friedman, Billings, Ramsey & Co.
Meanwhile, Merck's Januvia may take the prize as the most talked-about oral diabetes drug of the year, with both experts and patients duking it out over its relative effectiveness and safety. Hundreds of visitors find their way here to DiabetesMine.com each day by searching the Web for the term "Januvia" (!)
Pushing the Envelope.
Despite some grumblings to the contrary, innovation in diabetes R&D made some great strides this year. A number of studies proved the positive effects of new ultrafast insulins -- including Biodel's Viaject and Sanofi's Apidra. Microneedle patches for insulin delivery, from companies like Ingenta, also showed very promising results in studies this year.
For Type 1's in particular, 2007 was all about "the steady growth and implementation" of continuous glucose monitors. As part of the JDRF's Artificial Pancreas project, Yale researchers have successfully tested an artificial pancreas made by Medtronic in a small group of teens with type 1 disease, according to US News & World Report. Still, some prominent diabetes physicians think the CGM market is "growing too slowly and reimbursement denials are criminal." Amen. Despite the establishment of official HCPCS codes (insurance codes) for CGM, coverage by your health plan is far from guaranteed.
"The (CGM) systems are far from perfect, but they have saved countless individuals from severe lows and dangerous highs, and gave us all a valuable tool in the quest for glycemic stability," CDE and author Gary Scheiner remarks to me.
One area where we really pushed the envelope this year was product design. I am proud to report that my "Open Letter to Steve Jobs," calling on the gurus of consumer design to help update medical product design, echoed off the walls. Before long, the issue was appearing in BusinessWeek and the UK Guardian and BrandWeek, and one design firm in particular decided to take action to get the industry's creative juices flowing. We, the Patient Community, were finally able to speak out loud and clear on how important product design is in devices that we wear and live with 24/7.
Piercing the Public Consciousness.
Many believe that 2007 was "watershed" for diabetes for this reason alone: "Diabetes is becoming part of the national debate and people are beginning to realize that we have a serious problem and things have to change."
Certainly Mike Huckabee's candidacy (like him or not), and national awareness campaigns like the Know Your A1c campaign from the Diabetes Care Coalition have helped to sear diabetes into the American consciousness. The UN Resolution on "Uniting for Diabetes," along with the 2007 World Diabetes Day events, lighting up iconic landmarks around the globe, captured media attention everywhere to help "bring the world together around diabetes care." Now it remains to be seen what the Powers That Be will do about it in 2008.
Social Media: Taking Flight.
As noted, 2007 marks the take-off of Health 2.0, where Web 2.0 interactive internet functionality meets health and healthcare. Suddenly, patients who use the web to learn about and/or manage their health are taking center stage.
Health on the Net is so hot, in fact, that VC (venture capitalist) money is flowing almost like back in the old days of the Internet bubble -- but with better business plans behind the sites this time, presumably. For a sampling, see these 38 new health web sites. Specifically for diabetes, just a few of the new online tools include:
What's really changing the landscape, of course, are new Social Media sites for patients -- blogs, wikis, podcasts, and full-featured networks such as TuDiabetes that give people a place to congregate and share their knowledge and concerns. These sites give the patient community a collective voice they never could have dreamed of before. And our collective voice is making waves. Witness the call for improved product design, mentioned above, and also the hypoglycemia case of Mr. Universe, Doug Burns. An outraged patient community spoke out, and the trumped-up charges were suddenly dropped. Lesson learned: Social media on the Net really CAN make a difference in "real life."
Here At Home.
As you all know, I became an insulin pumper this year. And never-say-never, but I am feeling like I'll never to go back to injections if can avoid it. Insulet's OmniPod really has succeeded in "making diabetes a smaller part of life" for me. Of course, it's not perfect, as I am not perfect. Managing diabetes remains a $#%@! frustrating challenge, thus I continue to write :)
In fact, I penned my 30th Straight Up column for dLife this month. I also a spent a good part of 2007 researching the field of Diabetes Education, and what can be done to remedy the crisis it is facing. I learned a ton -- and made a few people mad along the way -- but "blowing the whistle" was never a popular job.
DiabetesMine.com hit the Top 10 in the World's Best Blogs in Health & Medicine on the Healthcare 100 Index. We started an online newsletter service so readers can follow the site directly from their own inboxes if they so desire. I even hosted the first-ever T-shirt giveaway contest, and had a little fun with a new category called Monday Madness. Share yours ;)
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Now it's your turn...
*** UPDATE 12/25 ***
Thank you, everyone, for your excellent input on the highlights of 2007. To summarize briefly, not to be missed this year:
* The Photo Projects: Diabetes Made Visible, Manny's Word in the Hand contest, and the Diabetes365 Project started by Beth, all bringing life with diabetes "to life" on the web, with about 1,500 pictures posted on the latter to date.
* On the CGM front, duly noted that Dexcom, the first continuous monitor to gain FDA approval, now has its 2nd generation product on the market, and the 3rd generation rendition is already in clinical trials.
* Offline, several leadings CDE's brought my attention to the increased recognition of the importance of
a patient-centered approach to diabetes care by the Powers That Be. "This is evidenced by the
articles in Diabetes Forecast, the development of the Conversation Maps teaching system by the American Diabetes Association, the new Standards for Diabetes Self-Management Education published by the ADA and AADE," educator Martha Funnell writes to me. In any case, we've turned the spotlight on improving diabetes education across the board.
* Keep your eyes peeled for Scott S's year-end roundup, including what he considers important steps toward a cure -- "Teva's Diapep 277 drug, Eli Lilly's deal with MacroGenics, Inc. to commercialize teplizumab, a humanized anti-CD3 monoclonal antibody, and other potential next generation anti-CD3 molecules for use in the treatment of autoimmune diseases, including Type 1 diabetes."
Got more to add? Feel free to post your input below.