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Beta Bionics Does the Work to Reduce Insulin Pump Burden · Vanguards of Healthcare by Bloomberg Intelligence

• 0:20
  Speaker 1: Welcome to another episode of the Vanguards of Healthcare series.
• 0:23
  Speaker 1: My name is Matt Hendrickson, the medical technology analyst at
• 0:26
  Speaker 1: Bloomberg Intelligence, which is the in house equity research platform
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  Speaker 1: of Bloomberg LP. We are pleased to have with us
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  Speaker 1: today Sean Saint, CEO of Beta Bionics, a medical device
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  Speaker 1: company that is a key leader in the expansion of
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  Speaker 1: automated insulin delivery systems or AIDS for short, the next
• 0:43
  Speaker 1: generation of insulin pumps to help diabetic patients keep track
• 0:47
  Speaker 1: of the glucose levels. You can dive deeper into the
• 0:49
  Speaker 1: financials by typing in b b NX equity go on
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  Speaker 1: your Bloomberg terminal. Sean, thank you for joining us today.
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  Speaker 2: Thanks for having us Matt and Sean.
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  Speaker 1: You know you started the role of Beta BIONICX CEO
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  Speaker 1: a few years ago, but you've had a long history
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  Speaker 1: in the diabetes space and a personal level as well.
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  Speaker 1: So why don't we start with for the listeners a
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  Speaker 1: story of your path that got you to the CEO
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  Speaker 1: rule today.
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  Speaker 3: Ooh yeah, long and long and winding road. Actually, Matt,
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  Speaker 3: I got involved in diabetes gosh it over twenty years ago.
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  Speaker 3: Now with a little company may have heard of called Dexcom.
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  Speaker 3: Obviously they're not a little company anymore, but at the
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  Speaker 3: time they really were. You know, we didn't have real
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  Speaker 3: time continuous glucose monitoring at that stage, and looking back
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  Speaker 3: on it twenty two years later, we didn't know. We
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  Speaker 3: had no idea what it was ultimately going to become.
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  Speaker 3: But yeah, I spent about five years there. Later moved
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  Speaker 3: on to Tandem Diabetes Care, designing insulin pumps, and it
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  Speaker 3: was oddly a Tandem that I got diagnosed with type
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  Speaker 3: one diabetes. Myself had been in the industry almost a
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  Speaker 3: decade at that stage, and to have that happened to
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  Speaker 3: me as the director of advanced Technologies at an insulin
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  Speaker 3: pump company was pretty ironic, but you know, it did
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  Speaker 3: set me up for my future beyond that. At that point,
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  Speaker 3: I would say, there's two things that happened. The first
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  Speaker 3: is that I met our founder from Beta Bionics at
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  Speaker 3: Domiano at Ada, and I walked up to him afterwards.
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  Speaker 3: I'd heard him talk about this crazy idea of bi
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  Speaker 3: hormonal and still in delivery insulain in GLUCAGND delivery and
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  Speaker 3: I was just amazed, and I asked him how I
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  Speaker 3: could help and that started our collaboration back in that's
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  Speaker 3: twenty ten, and then a few years later I left
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  Speaker 3: Tandem to go found Companion Medical, which was the opposite
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  Speaker 3: way of doing the same thing, which was we wanted
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  Speaker 3: to make a smart pen, this smart an insulin pen,
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  Speaker 3: which was just another way of bringing better technologies to
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  Speaker 3: more people with diabetes who'd really been left out in
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  Speaker 3: the cold by the pump technologies that existed at that time.
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  Speaker 3: And then years later to get the opportunity to come
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  Speaker 3: sit in this seat was just lightning striking for me.
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  Speaker 1: Yeah, quite a career. And you know what caught my
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  Speaker 1: attention is you were diagnosed with I mean, was this
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  Speaker 1: type one or type two diabetes? You were diagnosed in
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  Speaker 1: your in your adult years?
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  Speaker 3: Yeah, definitely type one. You know, something we used to
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  Speaker 3: call juvenile onset diabetes. Don't call it that anymore because
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  Speaker 3: we've realized that, you know, people can get it at
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  Speaker 3: any time.
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  Speaker 2: For me, I was thirty five.
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  Speaker 3: My wife might argue that I'm still juvenile, but be
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  Speaker 3: that as it may, we don't call it that anymore.
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  Speaker 1: Yeah, I tell you, I feel like my wife's on
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  Speaker 1: the same boat there. But it's interesting though, because it
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  Speaker 1: just makes you think that you know, you have this.
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  Speaker 1: You know, we'll dive deeper into kind of the market
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  Speaker 1: opportunities and the patient pools that can benefit from these
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  Speaker 1: you know, aids, but just the fact that it's just
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  Speaker 1: you know, when we go into that knowing that the
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  Speaker 1: type one opportunity, the patients that can be benefit from this,
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  Speaker 1: it's not a static numbers. It's in the ever evolving number,
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  Speaker 1: which is I always find interesting with the you know,
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  Speaker 1: how how the disease progresses with some of these patients.
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  Speaker 3: Yeah, well, the type one you know, you're on insulin
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  Speaker 3: right out of the gate. Question about that Type two diabetes,
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  Speaker 3: on the other hand, you definitely do progress, you know,
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  Speaker 3: from diet and exercise, et cetera, to oral medications and
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  Speaker 3: eventually to basil insulin and maybe intensive insulin therapy where
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  Speaker 3: you really are a candidate for something like the islet
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  Speaker 3: Type two of course being a much larger total population
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  Speaker 3: than type one, but in terms of intensive insulin therapy,
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  Speaker 3: type one type two about the same size.
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  Speaker 2: Give or take.
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  Speaker 3: And then there's additional segmentation that we talk about in
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  Speaker 3: terms of who's seen these patients and the desires of
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  Speaker 3: these patients, et cetera. But it is really designed to
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  Speaker 3: increase the penetration of insulin pumps across all those who
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  Speaker 3: need them.
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  Speaker 1: Yeah, and let's maybe take a step back about how
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  Speaker 1: insulin used to be delivered to these patients, you know,
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  Speaker 1: because as you said, it's been a twenty plus year
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  Speaker 1: journey for you know, the technology that's now in the market.
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  Speaker 1: But I guess through the for these patients who need insulin,
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  Speaker 1: what were the steps that they had beforehand? And then
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  Speaker 1: it kind of has it has progressed to now what
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  Speaker 1: we're calling, you know, the AIDS.
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  Speaker 3: Wow, that's a it's a far reaching question. Let's start
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  Speaker 3: the beginning and say that people would type one diabetes
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  Speaker 3: and certainly type two is similar and the way it's treated,
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  Speaker 3: the you know, physiologies a little different. But let's talk
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  Speaker 3: about type one for a second. Your body stops producing insulin,
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  Speaker 3: you know, obviously it's usually done in the pancreas. There's
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  Speaker 3: various cells in the pancreas that an infector killed off.
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  Speaker 3: It's an autoimmune disease, and you need to replace that insulin.
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  Speaker 3: You need to do it on a daily basis or
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  Speaker 3: you're going to be a big trouble. So Historically, patients
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  Speaker 3: have had to take insulin multiple times a day, either
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  Speaker 3: through as we call multiple daily injections shots, or through
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  Speaker 3: an insulin pump. Now, of course we've been doing shots
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  Speaker 3: since nineteen twenty one. I think insulin was first formulated. Pumps,
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  Speaker 3: of course, are more recent. They came about in the eighties.
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  Speaker 3: And the reason for pumps at that time is that
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  Speaker 3: insulin itself was really not great. It took a long
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  Speaker 3: time to act, it was not flat, and the way
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  Speaker 3: it acted on your blood sugar. And what we realized
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  Speaker 3: is that if you give a little bit of these
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  Speaker 3: some comparatively poor insulins every five minutes, it flattens out
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  Speaker 3: their response and makes them nice and predictable. And that
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  Speaker 3: was the original benefit of an insulin pump. Again, in
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  Speaker 3: the eighties, you get into the two thousands that we've
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  Speaker 3: got better insulince that are really flat by their very nature.
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  Speaker 3: And interestingly, during the two thousands, we struggled as an
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  Speaker 3: industry to see if there was a clinical benefit of
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  Speaker 3: insulin pumping. Fundamentally, the trials at that time were not
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  Speaker 3: really showing that you could do just as well with
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  Speaker 3: multiple daily injections as you could with an insulin pump.
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  Speaker 3: What was beginning to be a benefit at that time
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  Speaker 3: was CGM, continuous glucose monitoring That really became a patient
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  Speaker 3: centric tool in two thousand and six with Dexcom, and
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  Speaker 3: that was the first time that a patient could really
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  Speaker 3: react to their blood sugar in quite a bit more
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  Speaker 3: rapid way, rather than three to five to ten blood
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  Speaker 3: sugar measurements a day on every five minutes for two
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  Speaker 3: hundred and eighty eight points per day. What that led to, though,
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  Speaker 3: was the combination of continuous glucose monitoring and insulin pumps,
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  Speaker 3: which allowed us to put algorithms on top of that
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  Speaker 3: to close the loop and respond to your blood sugar
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  Speaker 3: in real time. And that was the advent of automated
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  Speaker 3: insulin delivery technologies that really started in the early twenty
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  Speaker 3: tens and done nothing but gotten better to where we
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  Speaker 3: are today. And of course beta bonyx represents the most
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  Speaker 3: recent and the highest level of automation.
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  Speaker 2: Of what that is.
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  Speaker 1: Yeah, and you know, it's interesting from your perspective, it
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  Speaker 1: sounds like it wasn't the smooth delivery of insulin every
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  Speaker 1: five minutes that was the game factory. It was when
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  Speaker 1: was the right time to deliver the insulin in the
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  Speaker 1: first place.
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  Speaker 3: From my perspective, yes, I mean all those things are
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  Speaker 3: important innovations, but the idea that we can respond to
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  Speaker 3: your blood sugar in real time by increasing the insulin
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  Speaker 3: when you start to get high without you even knowing
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  Speaker 3: it's happening, by decreasing insulan when your bloodchiger starts to
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  Speaker 3: get low automatically without you necessarily even though it's happening.
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  Speaker 3: That's really starting to take the burden off of the user.
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  Speaker 3: And diabetes is a twenty four to seven unpaid job
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  Speaker 3: that you can't quit and you can't.
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  Speaker 2: Call in sick to.
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  Speaker 3: So the real goal, what I think all of the
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  Speaker 3: companies are trying to accomplish, is to reduce the burden
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  Speaker 3: of living with type one. We've taken different tax in
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  Speaker 3: order to get there, but that ultimately is the end
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  Speaker 3: of the day, what we're really trying to do. Better
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  Speaker 3: outcomes are fantastic, but better user experience of living with
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  Speaker 3: this disease is I think a goal that we don't
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  Speaker 3: want to forget about.
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  Speaker 1: Yeah, and maybe that's give you we can jump into
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  Speaker 1: the islet pump. How is that designed to kind of
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  Speaker 1: you know, have that dual mandate of one accuracy and
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  Speaker 1: being able to deliver the right insulin at the right time,
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  Speaker 1: but also that ease of use factor.
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  Speaker 3: Yeah, So I'd say there are two concepts that we
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  Speaker 3: want to keep in mind in order to understand that question.
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  Speaker 3: The first is the way the user experiences the pump, right,
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  Speaker 3: the sorts of interactions they need to have with it.
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  Speaker 3: How often they need to announce a meal. Do they
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  Speaker 3: need to call their carb count their carbohydrates that they're eating.
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  Speaker 3: Do they need to deliver correction bulses of insulin? Do
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  Speaker 3: they need to extend their bulses of insulin? All these
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  Speaker 3: complicated concepts that with a traditional automated insulin delivery system
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  Speaker 3: they need to do, and Beta bionics is designed to
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  Speaker 3: eliminate most of those things. We ask you to tell
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  Speaker 3: us that you're eating, but we don't require the account carbs,
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  Speaker 3: we don't require that you ever give a correction bullus
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  Speaker 3: any of those other things I stated not necessary with
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  Speaker 3: the islets. So we're reducing the burden and the engagement
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  Speaker 3: required to really get a great outcome with our product.
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  Speaker 3: And then sort of orthogonal to that is the burden
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  Speaker 3: on the healthcare provider traditional automated insulin delivery systems require
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  Speaker 3: that the physician get an idea of who you are,
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  Speaker 3: and they're going to start with your weight. They're going
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  Speaker 3: to not guess, but rule a thumb, your insulin sensitivity,
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  Speaker 3: carb factor, and all these variables that we have with
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  Speaker 3: how your body works, and they're going to enter those
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  Speaker 3: into the pump. Our product starts with your weight, and again,
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  Speaker 3: because these are rules of thumb, we can use that
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  Speaker 3: weight and then we learn and adapt to you automatically.
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  Speaker 3: So rather than going back to your doctor every three
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  Speaker 3: months to have them read your glucose charts and try
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  Speaker 3: and guess it how your variables are different than what's
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  Speaker 3: currently programmed into the pump, we're going to do that
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  Speaker 3: on our own, usually within a few days. It just
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  Speaker 3: removes the burden of the healthcare provider and really ensures
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  Speaker 3: that that pump worked perfectly for you the whole time,
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  Speaker 3: which also is an interesting benefit opening up the technology
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  Speaker 3: to healthcare providers that don't necessarily have the skill sets
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  Speaker 3: to manage an insulin pump, and of course i'm talking
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  Speaker 3: about primary care physicians here to manage. Frankly, most of
• 10:49
  Speaker 3: the patients with both type one as well as type
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  Speaker 3: two diabetes.
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  Speaker 1: Interesting, And you know, I was about to ask, well,
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  Speaker 1: you know, kind of diving a little bit deeper into
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  Speaker 1: that carb counting because that is an important input for
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  Speaker 1: some of these other pumps. I was going to ask
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  Speaker 1: how your algorithm is able to avoid requiring those carb
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  Speaker 1: counting But it sounds like it takes, you know, it's
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  Speaker 1: a few days of learning the patient's behavior. So is
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  Speaker 1: it kind of a you know, your algorithm is being
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  Speaker 1: able to use kind of that big data machine learning
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  Speaker 1: capabilities to be able to maybe the same thing as
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  Speaker 1: we're talking about, understanding the patient and the impact of
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  Speaker 1: the carbs before the patient even realizes it.
• 11:31
  Speaker 3: Yeah, great question. So there's a couple layers to that one.
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  Speaker 3: And let me start with the fact that what our
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  Speaker 3: algorithm asks you to do is announce that you're eating
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  Speaker 3: a usual meal, a meal that's less than usual or
• 11:42
  Speaker 3: more than usual. And what does that mean?
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  Speaker 2: What is a usual meal? I don't know.
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  Speaker 3: You tell me, it means usual for you. And that's
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  Speaker 3: what the product is going to learn. Why can we
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  Speaker 3: do that with a smaller number of buckets three buckets
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  Speaker 3: rather than you know, if you're counting carbs, you can
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  Speaker 3: enter any and the reason is, frankly, that people are
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  Speaker 3: really bad at carb counting. And that's not a criticism.
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  Speaker 3: I'm horrible at it. Nutritionness are horrible at it. It's
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  Speaker 3: extremely hard to look at a plate of see pasta
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  Speaker 3: or potatoes or bread or whatever it is and know
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  Speaker 3: how many carbohydrates are in that. But we're really good
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  Speaker 3: at relativistic measurements and saying, you know what, that's a
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  Speaker 3: lot of carbs for me. So it turns out we've
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  Speaker 3: done studies on this, I mean the industry and not
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  Speaker 3: Pata Bionyx that when people estimate their actual carbohydrates, it's
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  Speaker 3: a pretty poor estimate. So the reality is they're already
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  Speaker 3: sort of all over the place and the estimates they
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  Speaker 3: give by just quantitizing it into the small medium in
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  Speaker 3: large buckets, it works out as simple as that. But
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  Speaker 3: what we do need to do, and this is a
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  Speaker 3: little different, Ordinarily, it's the healthcare provider's job to say, Okay,
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  Speaker 3: you know, this person is estimating that plate of food
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  Speaker 3: at forty grams of carbs, and I can turn their
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  Speaker 3: carb factor. It's called to a just how much insulin
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  Speaker 3: they get when they estimate forty grams and you get
• 13:04
  Speaker 3: into a situation where in fact the user may be
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  Speaker 3: misestimating their carbs, and then the pump is misset to
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  Speaker 3: account for their misestimation. In the case of islet, we're
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  Speaker 3: going to say this is what they usually, this is
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  Speaker 3: how much insulin they're getting for what they consider to
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  Speaker 3: be a usual meal, and we learn that and we
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  Speaker 3: can set it that way. So we just again take
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  Speaker 3: the responsibility of learning carb counting, which is really tough,
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  Speaker 3: off the user's plate, and the responsibility of learning how
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  Speaker 3: the users learned it off the physician's plate. Again, learning
• 13:37
  Speaker 3: and adapting to you. That's an extra level of automation
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  Speaker 3: that traditional pumps don't provide.
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  Speaker 1: Yeah, and so I mean we're focused on carb counting.
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  Speaker 1: Is that kind of the kind of benefit ease of
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  Speaker 1: use that the patients get? Are are there other ones
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  Speaker 1: as well that are worthwhile to note?
• 13:55
  Speaker 3: So with diabetes we talk about the concept of and
• 13:58
  Speaker 3: of one, everybody's and of one, And what it really
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  Speaker 3: means is that you have to ask that question to
• 14:03
  Speaker 3: each a pretty individual person who uses the islet.
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  Speaker 2: But I'll answer for myself.
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  Speaker 3: For me, counting carbs is a skill that even as
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  Speaker 3: bad as that as it at it as I am.
• 14:15
  Speaker 3: I have at some level, so that one for me
• 14:17
  Speaker 3: is fine for me. A much larger benefit is the
• 14:20
  Speaker 3: concept of not really needed to do anything else. Traditionally,
• 14:25
  Speaker 3: with automated insulin delivery systems, you're going to eat, you're
• 14:29
  Speaker 3: going to monitor your blood sugar. Two three hours later,
• 14:31
  Speaker 3: you look at it. You're a little high. That's very typical,
• 14:34
  Speaker 3: and you're going to need to deliver additional insulin. We
• 14:36
  Speaker 3: call that correction insulin. We tell the pump to do it.
• 14:39
  Speaker 3: It gives you the insulin.
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  Speaker 2: In the case of the islet.
• 14:42
  Speaker 3: Not only do you not need to do that, but
• 14:43
  Speaker 3: in fact, you cannot do that, And the reason is
• 14:46
  Speaker 3: that we've done it for you. We've looked at your
• 14:48
  Speaker 3: blood sugar, we've reacted to it. There's nothing to do.
• 14:52
  Speaker 3: We've also combed through our real world evidence data and
• 14:56
  Speaker 3: found that there's a large cross section of our users
• 14:59
  Speaker 3: who choose not to announce meals at all, and the
• 15:02
  Speaker 3: outcomes with that has been also quite quite impressive. I've
• 15:06
  Speaker 3: tried it myself and that's the way I tend to
• 15:08
  Speaker 3: use the product these days, generally, as I call very
• 15:11
  Speaker 3: few meals. So the point of the product has always
• 15:15
  Speaker 3: been to reduce the burden of living with T one
• 15:17
  Speaker 3: and it really does that for me.
• 15:19
  Speaker 1: Yeah, I have a question, how do the engineers at
• 15:23
  Speaker 1: bea Bionics enjoy or maybe not so much enjoy the
• 15:28
  Speaker 1: fact that you're a user as well and you can
• 15:31
  Speaker 1: give some first person inputs on the device.
• 15:35
  Speaker 3: I think more than not so much enjoy the fact
• 15:38
  Speaker 3: is probably accurate. But what I will say is that,
• 15:42
  Speaker 3: you know, I'm so proud of our team here because
• 15:44
  Speaker 3: they do understand what it is that we're trying to do.
• 15:48
  Speaker 3: We're not trying to make the best technology possible. We're
• 15:51
  Speaker 3: trying to improve the user experience. And everybody gets that.
• 15:55
  Speaker 3: I think they got it when they came here, they
• 15:56
  Speaker 3: got it when they interviewed, and they get it when
• 15:58
  Speaker 3: I evangelize it every day. So you know, you look
• 16:02
  Speaker 3: at our chief product officer, Mike Menzinger. I swear that
• 16:05
  Speaker 3: guy's qualified to be my endochronologist. And obviously he's an engineer.
• 16:09
  Speaker 3: I mean he gets how these things are used, and
• 16:11
  Speaker 3: you know, right down to every engineer here really makes
• 16:13
  Speaker 3: it their business to understand that. So I hope it's
• 16:17
  Speaker 3: it's been nothing but a positive. We can all be
• 16:19
  Speaker 3: advocates for the user experience.
• 16:21
  Speaker 1: Oh yeah, and so then you know, kind of leading
• 16:24
  Speaker 1: up to the launch itself. A few years ago, the
• 16:29
  Speaker 1: randomized Pivotal trial data came out. What was some of
• 16:32
  Speaker 1: the highlights of that data that kind of pointed to
• 16:35
  Speaker 1: these benefits that we've been discussing.
• 16:37
  Speaker 3: Yeah, so I'll probably hit our randomized clin contril as
• 16:42
  Speaker 3: well as some our real world evidence here. Fundamentally, we
• 16:46
  Speaker 3: ran a trial where we had people come to us
• 16:48
  Speaker 3: at a somewhat higher ANC. Achemoglobe and A and C is
• 16:51
  Speaker 3: a measure of your average blood sugar over the last
• 16:54
  Speaker 3: ninety days and it's sort of the gold standard measurement
• 16:56
  Speaker 3: of how you're doing with your diabetes and eighty eight
• 17:00
  Speaker 3: goals seven point zero. Average in the country I think
• 17:04
  Speaker 3: is about eight point three, so we're not quite there yet.
• 17:07
  Speaker 3: And the higher your A and C is, the more complications,
• 17:10
  Speaker 3: of course, that you have because of your diabetes. And
• 17:14
  Speaker 3: the current best belief we have with it with diabetes
• 17:17
  Speaker 3: is that if you keep your AE C under control,
• 17:18
  Speaker 3: you eliminate those complications of diabetes. So it's hugely important.
• 17:23
  Speaker 3: It's everything we're here to do. Our trials started with
• 17:26
  Speaker 3: people with somewhat higher A and c's and that was
• 17:29
  Speaker 3: very much important to us because those are the people
• 17:32
  Speaker 3: who historically have had a very hard time getting their
• 17:35
  Speaker 3: A and C under control. There are certain users with
• 17:39
  Speaker 3: diabetes who honestly, they're going to do great regardless of
• 17:42
  Speaker 3: what you give them. You give them pens, they do great,
• 17:44
  Speaker 3: a pump they do great. AD they do great because
• 17:47
  Speaker 3: they're highly engaged in the management of their disease. And
• 17:51
  Speaker 3: then there's others who, for whatever reason, they're not bad people,
• 17:54
  Speaker 3: they're just busy or distracted or whatever it is, and
• 17:57
  Speaker 3: they put less time and effort into managing the disease
• 18:00
  Speaker 3: and they.
• 18:00
  Speaker 2: Have less success.
• 18:02
  Speaker 3: So the high point of our trials that we were
• 18:05
  Speaker 3: able to get people from a comparatively higher A one
• 18:07
  Speaker 3: C down near goal as compared to some of the
• 18:11
  Speaker 3: other ones that have been run in the past. And yes,
• 18:14
  Speaker 3: we've looked with our real world data at engagement and
• 18:19
  Speaker 3: it's really correlated the way you'd think. What we found
• 18:21
  Speaker 3: is that when you come to us with a higher
• 18:23
  Speaker 3: A one C, in fact, you tend to do less
• 18:27
  Speaker 3: on the islet, and when you come to us with
• 18:28
  Speaker 3: the lower A and C, you tend to do more
• 18:30
  Speaker 3: on the islet. Shocker that people who previously had better
• 18:34
  Speaker 3: control are actually really engaged in their diabetes and willing
• 18:38
  Speaker 3: to do more. But the upshot of this is that
• 18:41
  Speaker 3: after they use the islet for a while, they're all
• 18:44
  Speaker 3: doing great. You know, we tend to bring people to
• 18:46
  Speaker 3: an A and C in the sevens, you know, very
• 18:48
  Speaker 3: near goal as an average, and this is exactly what
• 18:53
  Speaker 3: those higher A and C people have failed to have before.
• 18:56
  Speaker 3: So that that was our goal as a company, not
• 18:58
  Speaker 3: to take the great control people them under slightly better control,
• 19:01
  Speaker 3: but to bring you know, the option of good control
• 19:05
  Speaker 3: to people who've really never had it prior.
• 19:07
  Speaker 1: Yeah, well it kind of sounds like you know, those
• 19:10
  Speaker 1: set it and forget it type of functions. Is that's
• 19:13
  Speaker 1: the most beneficial for those who didn't really try to
• 19:16
  Speaker 1: care about carb county in the first place.
• 19:19
  Speaker 3: Well carb counting or you know, the willingness to go
• 19:22
  Speaker 3: in and give a you know, multiple correction boluses, et cetera.
• 19:25
  Speaker 3: It's interesting with diabetes, every intervention that I can think of,
• 19:30
  Speaker 3: we've studied all of them, of course, and they all
• 19:32
  Speaker 3: have the same upshot, which is the more you engage
• 19:35
  Speaker 3: with that particular technology, the better you do until the
• 19:39
  Speaker 3: islet in. Our data from meta Bionics suggests that the
• 19:43
  Speaker 3: outcomes are largely independent of engagement, and that's incredible, right,
• 19:47
  Speaker 3: It's yes, it's both the user experience and improvement for
• 19:50
  Speaker 3: those who don't want to engage, and it's the option
• 19:53
  Speaker 3: of a good outcome for those who for whatever reason
• 19:56
  Speaker 3: aren't able to engage, which is a huge cross section
• 19:59
  Speaker 3: of the country unfortunately.
• 20:01
  Speaker 1: Yeah, and you know, moving them into the actual launch itself,
• 20:06
  Speaker 1: you're up to nearly if I'm correct, if I'm wrong,
• 20:08
  Speaker 1: thirty thousand is let users. How has that launch been
• 20:12
  Speaker 1: to get to that accelerated of a patient base? And
• 20:16
  Speaker 1: then you know the other thing too, just kind of
• 20:17
  Speaker 1: thrown in there, and maybe you know, I'm answering my
• 20:20
  Speaker 1: own question here is the transition into using the pharmacy
• 20:26
  Speaker 1: channel is something that you guys have highlighted a lot about,
• 20:30
  Speaker 1: and so maybe we can just start there and you know,
• 20:33
  Speaker 1: the different different channels that these patients can get these
• 20:37
  Speaker 1: durable insulin pumps, and why pitching into the pharmacy channel
• 20:43
  Speaker 1: has been a benefit for you know, it seems like
• 20:45
  Speaker 1: for you, the patients and the papers.
• 20:47
  Speaker 2: Yeah.
• 20:47
  Speaker 3: Absolutely, Let me quickly take a step back and hit
• 20:51
  Speaker 3: what I call the four questions. These are the four
• 20:54
  Speaker 3: things people care about when they get their insulin pump.
• 20:58
  Speaker 3: You know, we talk about the algorithm. We've been talking
• 20:59
  Speaker 3: about that for a while. Clearly we believe we have
• 21:03
  Speaker 3: algorithm advantages in our products. So you've got to get
• 21:05
  Speaker 3: that right form factor right. There's durable pumps, there's patch pumps.
• 21:10
  Speaker 3: You know, there's people prefer one or the other of
• 21:12
  Speaker 3: those for different people, so we want to make sure
• 21:14
  Speaker 3: we provide options there. A third is the CGM that
• 21:17
  Speaker 3: they work with. People tend to be very passionate about
• 21:19
  Speaker 3: their CGM, so we really want to make sure that
• 21:21
  Speaker 3: we work with whatever CGM you're passionate about. We've worked
• 21:24
  Speaker 3: hard to do that. And then the last is channel.
• 21:27
  Speaker 3: Channel means DM, it means pharmacy, And why does that matter?
• 21:31
  Speaker 3: It matters because the pharmacy channel tends to be more
• 21:35
  Speaker 3: inexpensive for the user, it tends to be easier for
• 21:38
  Speaker 3: them and the doctor, and it tends to not lock
• 21:41
  Speaker 3: them into a four year commitment, so if they don't
• 21:44
  Speaker 3: like whatever it is that they're getting, they can move
• 21:46
  Speaker 3: away from it. There's lots of benefits to the pharmacy
• 21:50
  Speaker 3: benefit channel that we've been able to access with what's
• 21:53
  Speaker 3: historically been a dmy product. But how are we able
• 21:56
  Speaker 3: to do that? Frankly, it's simply the pay as you
• 22:00
  Speaker 3: go model.
• 22:01
  Speaker 2: What does that mean? Though?
• 22:03
  Speaker 3: It means we don't receive a big upfront payment when
• 22:05
  Speaker 3: we sell an islet in the pharmacy channel. We are
• 22:09
  Speaker 3: willing to share the risk with the insurance provider and
• 22:11
  Speaker 3: maybe even transfer the risk to us that people are
• 22:14
  Speaker 3: going to.
• 22:14
  Speaker 2: Like our product.
• 22:17
  Speaker 3: If we sell a pump to somebody in the pharmacy
• 22:20
  Speaker 3: channel and a month later they don't like it, you know,
• 22:22
  Speaker 3: we're going to lose out on that patient. But that's
• 22:25
  Speaker 3: okay because we believe in our product and we think
• 22:28
  Speaker 3: that's not going to happen very often.
• 22:30
  Speaker 1: Well, you know, it's interesting about the pay as you
• 22:32
  Speaker 1: go model, but it sounds like.
• 22:36
  Speaker 2: You know you're willing to.
• 22:40
  Speaker 1: I mean, there's the opportunity cost of some of that
• 22:42
  Speaker 1: upfront revenue for you know, further payouts down the road.
• 22:47
  Speaker 1: What makes you feel comfortable about that model?
• 22:49
  Speaker 2: Yeah, that's a great question. You know a couple things.
• 22:52
  Speaker 3: The first is that look, I mean if a user
• 22:56
  Speaker 3: a tricks or you know, stops using our product after
• 22:59
  Speaker 3: a month or two months or three months because they
• 23:01
  Speaker 3: don't like it, they would have stopped in the DM
• 23:03
  Speaker 3: channel too. I mean, we certainly don't want people using
• 23:05
  Speaker 3: our products solely because they're forced to by their insurance
• 23:08
  Speaker 3: company or they were to return to it within a
• 23:11
  Speaker 3: ninety day warranty period. So we would have been dead anyway.
• 23:15
  Speaker 3: So we always have believed in our product. We have
• 23:18
  Speaker 3: to believe in our product, and for that reason, we're
• 23:20
  Speaker 3: willing to take, you know, to formally transfer the risk
• 23:24
  Speaker 3: and effect to us with the pay as you go model.
• 23:27
  Speaker 3: And it's one of the great reasons that the providers
• 23:30
  Speaker 3: like it, and excuse me, the payers like it as well,
• 23:32
  Speaker 3: because you know, with this, they don't have to police
• 23:35
  Speaker 3: what system they're on. They don't have to worry about
• 23:38
  Speaker 3: you know, okay bottom a system six months ago and
• 23:41
  Speaker 3: now they say they don't like it and they want
• 23:42
  Speaker 3: another one, and they're trying to get a medical justification
• 23:45
  Speaker 3: for it. You know, there's all these things that just
• 23:47
  Speaker 3: go away when we all agree on a pay as
• 23:50
  Speaker 3: you go model. So you know, it takes us about
• 23:53
  Speaker 3: a year give or take to sort of pay back
• 23:55
  Speaker 3: that up front payment but again that's our risk we're
• 23:58
  Speaker 3: willing to take because we believe in our Yeah.
• 24:01
  Speaker 1: And then for the payers themselves, I mean for them,
• 24:05
  Speaker 1: they see some benefit of that as well, because there's
• 24:08
  Speaker 1: I mean, maybe how would I want to put this,
• 24:12
  Speaker 1: there's some there's less risk involved of having to pay
• 24:17
  Speaker 1: that upfront payment, right, yeah, And so like that, when
• 24:19
  Speaker 1: you see that three thousand dollars payment and then they switch,
• 24:23
  Speaker 1: the payers are eating that cost, right.
• 24:25
  Speaker 2: They're eating that cost.
• 24:26
  Speaker 3: And what's important to remember is, I don't remember the
• 24:29
  Speaker 3: exact number, but the average person stays on an insurance plan,
• 24:33
  Speaker 3: I don't know, a year or eighteen months or something
• 24:35
  Speaker 3: like that. So you know, you get somebody six months
• 24:38
  Speaker 3: into being on your plan and then they get an
• 24:40
  Speaker 3: insulin pump, and then a year later they're gone. They
• 24:42
  Speaker 3: wrote that big upfront check for somebody who's only on
• 24:44
  Speaker 3: their plan for a year or less than a year,
• 24:47
  Speaker 3: and then they go to another plan. Now that other
• 24:49
  Speaker 3: plan might try and get the idea that they already
• 24:52
  Speaker 3: have a pump and not buy them another one. That's
• 24:54
  Speaker 3: a bunch of you know, of work and effect. Or
• 24:58
  Speaker 3: they can just continue paying for the page A model
• 25:01
  Speaker 3: and not worry about it.
• 25:02
  Speaker 2: It's just easier for everybody.
• 25:04
  Speaker 1: Yeah, very interesting. And then you know, kind of then
• 25:07
  Speaker 1: going back to the patients that benefit from this. I mean,
• 25:10
  Speaker 1: we talked about in the with the Pivotal trial, how
• 25:14
  Speaker 1: sicker patients benefited from it as much as kind of
• 25:17
  Speaker 1: the you know, patients that are you know, more into
• 25:20
  Speaker 1: the treatment beforehand. But you know, we also talked about
• 25:23
  Speaker 1: the Type one and the Type two market. You know,
• 25:26
  Speaker 1: we talked about you know, roughly the same size, but
• 25:30
  Speaker 1: different access points for those patients. The other interesting thing
• 25:36
  Speaker 1: that I've taken from this is that while technically the
• 25:41
  Speaker 1: islet doesn't have a label for the Type two, during
• 25:44
  Speaker 1: your earning calls, you're highlighting how these primary care physicians
• 25:48
  Speaker 1: are still prescribing it to those patients, and you're mentioning
• 25:52
  Speaker 1: a significant amount of patients, almost up to thirty percent
• 25:55
  Speaker 1: if I remember correctly, that of your new patients are
• 25:58
  Speaker 1: actually Type two. So one winded way of asking about.
• 26:02
  Speaker 2: How is those you know, how are those.
• 26:05
  Speaker 1: Approaches different be for the Type one patients and the
• 26:07
  Speaker 1: Type two patients.
• 26:09
  Speaker 3: Yeah, from and I believe we said over twenty five
• 26:11
  Speaker 3: percent are we believe our Type two patients from our perspective,
• 26:17
  Speaker 3: they're really not because when considering that we don't have
• 26:19
  Speaker 3: an indication for type two diabetes, we don't sell to
• 26:22
  Speaker 3: type two diabetes in any way. We don't talk about
• 26:24
  Speaker 3: type two, we don't push it in that regard. But
• 26:27
  Speaker 3: what we do do is show up in the healthcare
• 26:30
  Speaker 3: provider's office and explain what the islet is and show
• 26:33
  Speaker 3: them the clinical data and show them the product. And
• 26:36
  Speaker 3: it's always been this way. A healthcare provider can choose
• 26:38
  Speaker 3: to write a product for any person that they want,
• 26:41
  Speaker 3: and it turns out that that's how ours gets used.
• 26:45
  Speaker 3: This is really not that different from some of the
• 26:47
  Speaker 3: other pumps. I think we broadly have enough information now
• 26:50
  Speaker 3: to say that AID generally seems to work in type
• 26:52
  Speaker 3: two as well as it doesn't type one, although again
• 26:54
  Speaker 3: there have been studies on some of the products and
• 26:56
  Speaker 3: not others, and not ours in fact, so still you know,
• 27:00
  Speaker 3: building that communication standpoint. Type two diabetes is interesting though,
• 27:05
  Speaker 3: because so many more of them are being managed by
• 27:08
  Speaker 3: primary care physicians something like eighty five percent or being
• 27:10
  Speaker 3: seen by primary care, whereas on the type one side
• 27:13
  Speaker 3: it's more like, you know, fifty to sixty percent or
• 27:16
  Speaker 3: being seen by primary care physicians. So we really need
• 27:19
  Speaker 3: to make sure that we make a product that's applicable
• 27:22
  Speaker 3: for a particular user but also for a particular healthcare
• 27:26
  Speaker 3: provider on the type one or the type two side.
• 27:28
  Speaker 1: Yeah, and you know it's interesting too, because I mean,
• 27:32
  Speaker 1: I believe you guys are considering a type two label. Yeah,
• 27:37
  Speaker 1: I can see the benefits and the you know, one
• 27:39
  Speaker 1: way or the other. On one hand, you're already reaching
• 27:41
  Speaker 1: out to the or not you, but the doctors are already
• 27:44
  Speaker 1: reaching out to those type two patients. So you're kind
• 27:47
  Speaker 1: of already getting that growth. But if you have an
• 27:49
  Speaker 1: official label, I could see that growth growing even exponentially more.
• 27:54
  Speaker 1: But I guess one of the questions I have is
• 27:56
  Speaker 1: do you need a separate clinical trial to show that
• 28:00
  Speaker 1: benefit for the type two patients?
• 28:02
  Speaker 2: Yeah?
• 28:05
  Speaker 3: Right now, the standard of care, if you will, or
• 28:07
  Speaker 3: the you know standard with the agency is that you
• 28:09
  Speaker 3: do need a clinical trial. Whether or not that will
• 28:11
  Speaker 3: remain that way or will always be that way, we
• 28:13
  Speaker 3: don't know, but right now that is the expectation. Yes,
• 28:19
  Speaker 3: we have plans to do this to seek the indication.
• 28:23
  Speaker 3: I do want to set expectations, though in my view,
• 28:26
  Speaker 3: I don't think it really will accelerate when we got
• 28:28
  Speaker 3: when we get the if we were to have maybe
• 28:31
  Speaker 3: we should say it that way, the type two indication.
• 28:34
  Speaker 3: I just you know, I've talked to a heck of
• 28:36
  Speaker 3: a lot of healthcare providers and they do understand the
• 28:39
  Speaker 3: tools that they use and where that they where they
• 28:41
  Speaker 3: can be well utilized. So my expectation is not that
• 28:46
  Speaker 3: it would expand massively. But I can always be proved
• 28:49
  Speaker 3: wrong regardless. It's the right thing to do to pursue that,
• 28:53
  Speaker 3: So we'll do it for that reason.
• 28:54
  Speaker 2: Yeah.
• 28:55
  Speaker 1: And hey, if that if we're talking about that, you know,
• 28:58
  Speaker 1: being proved wrong, is that growth delrates further. I mean,
• 29:01
  Speaker 1: that's a good reason.
• 29:02
  Speaker 2: I'm happy to be wrong in that way.
• 29:03
  Speaker 1: Yeah, But you know, let's talk about some of the
• 29:06
  Speaker 1: other developments then, because you know, you know, we've talked
• 29:10
  Speaker 1: a lot about the islet for the first you know,
• 29:12
  Speaker 1: twenty five thirty minutes here, but we also were talking
• 29:17
  Speaker 1: earlier about how there's different form factors and there's the
• 29:19
  Speaker 1: you know, there's a traditional pump, there's you know, but
• 29:22
  Speaker 1: there's also the on the bodywear, what are your developments
• 29:26
  Speaker 1: for and on the body wear for those patients that
• 29:29
  Speaker 1: prefer that kind of more discrete fit. Yeah.
• 29:33
  Speaker 3: So first of all, let me say the islet today
• 29:35
  Speaker 3: is really two things. It's the physical pump itself, which
• 29:38
  Speaker 3: is a durable component, and it's the algorithm that goes
• 29:41
  Speaker 3: on that pump. So in our MINT program, which is
• 29:44
  Speaker 3: our our patch pump program and development, we're switching out
• 29:47
  Speaker 3: the hardware while maintaining the algorithm. So all the user
• 29:50
  Speaker 3: experience stuff that we've talked about in terms of you know,
• 29:53
  Speaker 3: carb counting and no setup or weight based set up
• 29:56
  Speaker 3: and learning and adaptation, all those things stay with our
• 29:58
  Speaker 3: MINT program, a form factor that you can wear on
• 30:01
  Speaker 3: your body. We have chosen a two part reusable architecture.
• 30:05
  Speaker 3: One's disposal ones reusable, and there's a lot of good
• 30:08
  Speaker 3: reasons for that. We believe that's the right way to go.
• 30:11
  Speaker 3: And I'll specifically state for the user experience, and I
• 30:15
  Speaker 3: hope that everything Beta Bionics does today and ever is
• 30:18
  Speaker 3: all about, you know, is in service of a better
• 30:21
  Speaker 3: user experience. With a two part architecture, what we're able
• 30:25
  Speaker 3: to do is number one, eliminate any kind of recharging
• 30:29
  Speaker 3: or any of that with the product, because you get
• 30:31
  Speaker 3: fresh batteries every time. We eliminate any interaction with the
• 30:36
  Speaker 3: phone required when we're changing the product, because when you
• 30:40
  Speaker 3: separate the two components and put them back together again,
• 30:43
  Speaker 3: you know, it already knows that that's happening because connecting
• 30:46
  Speaker 3: and disconnecting to the batteries, you're eliminating any bluetooth pairing
• 30:50
  Speaker 3: that has to happen because the reusable component is already
• 30:53
  Speaker 3: paired to that phone. That eliminates a step, and of
• 30:56
  Speaker 3: course it does cost the goods advantages as well, but
• 30:59
  Speaker 3: that's not the prime reason that we do it.
• 31:01
  Speaker 2: We do it for user experience reasons.
• 31:02
  Speaker 1: Now, that's one of those things as we talked earlier about,
• 31:05
  Speaker 1: you know, taking a few days for kind of the
• 31:07
  Speaker 1: algorithm to learn the specific patient. Is that reusable portion
• 31:12
  Speaker 1: able to kind of keep that data more and be
• 31:15
  Speaker 1: able to able to you know, benefit from that machine
• 31:20
  Speaker 1: learning in an easier way than kind of maybe a
• 31:23
  Speaker 1: fully disposable patch pump.
• 31:26
  Speaker 3: Certainly it does, and maybe I guess is the answer. Yeah,
• 31:30
  Speaker 3: it's a great point. Are the reasonable component is going
• 31:33
  Speaker 3: to continue. It remembers previous you know, sessions if you will,
• 31:38
  Speaker 3: so it continues, just evolves, gets better and better and
• 31:40
  Speaker 3: better over every day. Doesn't take any longer to adapt
• 31:44
  Speaker 3: than the islet did. It'll be the same algorithm based experience.
• 31:48
  Speaker 3: And there are multiple ways to design patch pump experiences.
• 31:52
  Speaker 3: Some that it's patch specific, some that it's not. I
• 31:55
  Speaker 3: really can't comment into what what our you know, others
• 31:58
  Speaker 3: have done, but yeah, that's that's an op.
• 32:00
  Speaker 2: Yeah.
• 32:01
  Speaker 1: And so the other thing too is because you're using
• 32:03
  Speaker 1: the same algorithm that kind of you don't need to
• 32:08
  Speaker 1: do you need to have a new trial to support
• 32:12
  Speaker 1: the durable on the body wear pump or is it
• 32:16
  Speaker 1: Are you able to go to the FDA and say, look,
• 32:18
  Speaker 1: we already have the algorithm, we have this new pump
• 32:21
  Speaker 1: that it checks off the boxes compared to some of
• 32:25
  Speaker 1: the other on the body whereas that are in the market,
• 32:28
  Speaker 1: we don't need to have that new clinical trial.
• 32:31
  Speaker 2: That's a great question. You know.
• 32:32
  Speaker 3: The agency did us this huge favor a number of
• 32:35
  Speaker 3: years ago when they came up with the concepts of ICGM,
• 32:38
  Speaker 3: which are the requirements that a CGM has to meet
• 32:40
  Speaker 3: to be part of an AID system. IAGC which is
• 32:44
  Speaker 3: the algorithm, and ACE which is the pump itself that
• 32:47
  Speaker 3: stands for Alternate controller enabled Insulin pump and What it
• 32:51
  Speaker 3: means is that you're right. There is no trial on
• 32:53
  Speaker 3: the pump itself. The trial is on the algorithm, and
• 32:56
  Speaker 3: of course there is a trial on the CGM side
• 32:57
  Speaker 3: as well. But we can do benchtop ten on the
• 33:00
  Speaker 3: physical pump, get it approved as an ACE, and then
• 33:03
  Speaker 3: pair it with our i AGC algorithm and our ICGM partners,
• 33:07
  Speaker 3: and then you have all three of those together an
• 33:09
  Speaker 3: AID system. And sorry for the TLAs, which of course
• 33:12
  Speaker 3: is three letter acronym.
• 33:14
  Speaker 1: We had a lot of applebets super right now going on.
• 33:16
  Speaker 2: But yeah, yeah, we should sorry about that.
• 33:18
  Speaker 1: No worries, all right, So but then so and then
• 33:21
  Speaker 1: so what is then the potential timeline to get me
• 33:23
  Speaker 1: into the market.
• 33:25
  Speaker 3: Yeah, our public statement so that we intend to have
• 33:27
  Speaker 3: an unconstrained launch by the end of twenty twenty seven,
• 33:31
  Speaker 3: meaning if you want one, you can get it by
• 33:32
  Speaker 3: that time.
• 33:33
  Speaker 1: Okay, all right, that's good to know, and we'll mark
• 33:35
  Speaker 1: that on the calendar. So next time we you know,
• 33:38
  Speaker 1: probably have you next year. You know, we'll get a
• 33:40
  Speaker 1: good update on how things are going.
• 33:42
  Speaker 2: I look forward to that.
• 33:43
  Speaker 1: Yeah, and so you know the other thing, you know,
• 33:45
  Speaker 1: kind of longer term project we got you have and
• 33:48
  Speaker 1: it kind of goes back to the beginning of Beta
• 33:49
  Speaker 1: Bionics and you know, hearing the story from Ed about
• 33:53
  Speaker 1: you know, his reasons for starting, you know, the company
• 33:57
  Speaker 1: because you know, making sure take care of his children
• 34:01
  Speaker 1: who were suffering.
• 34:01
  Speaker 2: From the disease.
• 34:03
  Speaker 1: It always started as a dual hormone company. And so
• 34:07
  Speaker 1: now we're kind of getting to that, you know, potentially
• 34:09
  Speaker 1: that full circle of getting back to a dual hormone
• 34:13
  Speaker 1: for the listeners who are kind of new to that,
• 34:16
  Speaker 1: and you're you know, thinking about, oh, it's just insulin delivery.
• 34:19
  Speaker 1: What is the second dual hormone and why is that
• 34:22
  Speaker 1: important potentially for the patients.
• 34:25
  Speaker 3: Yeah, but you're absolutely right. Bi hormonal was the original
• 34:28
  Speaker 3: founding concept of beta bionics, and it's the concept of
• 34:31
  Speaker 3: using insulin to bring your blood sugar down and glucagon
• 34:34
  Speaker 3: to bring it back up again. So that's the gas
• 34:36
  Speaker 3: and the brakes of driving your car. You know, you
• 34:38
  Speaker 3: can drive a car without brakes, but it's a heck
• 34:40
  Speaker 3: of a lot easier with them. So glucagon is the
• 34:42
  Speaker 3: breaks and it eliminates the need for people to really
• 34:45
  Speaker 3: manage lows, which is something that everybody with diabetes deals
• 34:49
  Speaker 3: with every single day, and that is an important distinction
• 34:53
  Speaker 3: we have. There's been some lack of clarity on this
• 34:56
  Speaker 3: in the past. Some people think that we're providing a
• 34:58
  Speaker 3: rescue dose of glucagon, which is how it's delivered today,
• 35:01
  Speaker 3: and if you have a severe low BAM, we give
• 35:03
  Speaker 3: you a whole bunch of glucagon, And nothing could be
• 35:05
  Speaker 3: farther from the truth. The intent is that we give
• 35:07
  Speaker 3: you a little bit of insulin, a little bit of
• 35:10
  Speaker 3: glucagon to really keep your blood sugar as close to
• 35:12
  Speaker 3: stable as we possibly can, rather than a rescue dose
• 35:15
  Speaker 3: of glukugon, which is something very different. And you know,
• 35:20
  Speaker 3: the company was originally founded on this concept of bi hormonal. Interestingly,
• 35:26
  Speaker 3: when ED started working on it back in about two
• 35:28
  Speaker 3: thousand and three, CGM didn't even exist and the concept
• 35:33
  Speaker 3: of automated insulin delivery really didn't exist. So ED was,
• 35:37
  Speaker 3: you know, a very early pioneer in stating, you know,
• 35:40
  Speaker 3: what the AID world was ultimately going to be and
• 35:43
  Speaker 3: looking into the future. What happened was that over the
• 35:47
  Speaker 3: years of developing this product, two things happened. The first
• 35:50
  Speaker 3: is that we didn't originally have a glucagon candidate that
• 35:53
  Speaker 3: we felt could be progressed into.
• 35:57
  Speaker 2: You know, could be.
• 35:58
  Speaker 3: Successful in this product. And the second is that we
• 36:01
  Speaker 3: did clinical trials on an insulent only version of our system,
• 36:04
  Speaker 3: found out how amazingly it worked, and really felt that
• 36:07
  Speaker 3: we couldn't withhold that from the market. So for that reason,
• 36:10
  Speaker 3: we chose to release the insulent only candidate. But now
• 36:14
  Speaker 3: the world's completely different. We have licensed a glucagon candidate
• 36:18
  Speaker 3: that's shelf stable, pumpable human glucagon, and we now feel
• 36:22
  Speaker 3: that very for the very first time, we're in charge
• 36:25
  Speaker 3: of getting this promonal system out of the market where
• 36:28
  Speaker 3: we sort of have all the pieces that we need now.
• 36:31
  Speaker 1: Yeah, interesting because then it sounds like from also from
• 36:34
  Speaker 1: a business component, getting that insulin only pump out there
• 36:37
  Speaker 1: allows you to now be able to generate the revenue
• 36:41
  Speaker 1: and the potential cash flow to help finance that initial
• 36:44
  Speaker 1: project that was going on.
• 36:46
  Speaker 2: Yeah.
• 36:47
  Speaker 3: Absolutely, I mean, you know, we're not profitable company yet,
• 36:50
  Speaker 3: but revenue does always help, and certainly access some public
• 36:53
  Speaker 3: markets helps as well. And it does allow us to
• 36:57
  Speaker 3: really validate the idea of beta bionyx, because I don't
• 37:00
  Speaker 3: care if we're talking about insulin only or by hormonal
• 37:03
  Speaker 3: they're both designed to do the same thing, which is
• 37:05
  Speaker 3: reduced the burden of living with type one and you
• 37:07
  Speaker 3: know one takes over insulin delivery, that's our current product
• 37:10
  Speaker 3: with islet one takes over diabetes management almost entirely, which
• 37:16
  Speaker 3: with bio hormonal, and that's really the beauty of that product.
• 37:20
  Speaker 3: And I'll reiterate you know, we talked about this earlier.
• 37:22
  Speaker 3: Obviously we're proud of the outcomes that bio hormonal is
• 37:25
  Speaker 3: going to we believe is going to produce and what
• 37:28
  Speaker 3: has what it has produced in early clinical trials. But
• 37:30
  Speaker 3: it's not really about that, right, It's about helping you
• 37:33
  Speaker 3: forget the fact that you have type one diabetes or
• 37:35
  Speaker 3: I should say diabetes at all eventually.
• 37:38
  Speaker 2: Yeah, and then you know.
• 37:40
  Speaker 1: Just kind of closing out here, I mean as putting
• 37:43
  Speaker 1: your kind of CEO, how do you have a lot
• 37:44
  Speaker 1: of different projects You've got you know, a lot of
• 37:46
  Speaker 1: different you know, and we've talked about you know, not
• 37:48
  Speaker 1: almost we're almost at the state of gain to profitability
• 37:52
  Speaker 1: for you know, but for you know, for a very
• 37:54
  Speaker 1: new I p O company. How do you make those
• 37:59
  Speaker 1: decisions about out you know, accelerating growth or accelerating investments
• 38:03
  Speaker 1: in one area or in one project versus you know,
• 38:08
  Speaker 1: being focused on that kind of you know, profitability trajectory
• 38:13
  Speaker 1: and you know cash burned type of management.
• 38:15
  Speaker 3: Wow, that's the keys of the castle, right, there, isn't it.
• 38:19
  Speaker 3: You've got a lot of competing priorities, no question about that.
• 38:22
  Speaker 3: But what I think is similar across all of those
• 38:26
  Speaker 3: is that companies tend to waste a lot of money,
• 38:29
  Speaker 3: and we just refuse to do that. You know, we
• 38:31
  Speaker 3: want to be good stewards of our investors trust in us,
• 38:34
  Speaker 3: good stewards of their money, and make sure that we
• 38:36
  Speaker 3: don't waste that trust. Now that at times can be
• 38:43
  Speaker 3: you know, are we thinking about short term or long
• 38:45
  Speaker 3: term outcomes?
• 38:46
  Speaker 2: Right?
• 38:47
  Speaker 3: We are making investments today on mint on by hormonal.
• 38:51
  Speaker 3: Those investments at some level obviously increase the spend of
• 38:54
  Speaker 3: the company today, but they are the right things to
• 38:56
  Speaker 3: be doing for both the population people with diabetes as
• 39:01
  Speaker 3: well as the long term health debta bionics.
• 39:03
  Speaker 2: Right, we see a world where we disrupt ourselves, right.
• 39:06
  Speaker 3: We're not waiting for somebody else to come along and
• 39:09
  Speaker 3: come up with a better product than we have. We
• 39:11
  Speaker 3: are going to always intend to be the company that
• 39:15
  Speaker 3: supplants the current product that we're selling with our next
• 39:17
  Speaker 3: version or disrupt ourselves. And to do that, you've got
• 39:19
  Speaker 3: to be making investments. And so we think we're making
• 39:23
  Speaker 3: the right investments, and we're doing them at an efficient
• 39:26
  Speaker 3: level so we don't go crazy.
• 39:29
  Speaker 2: Yeah.
• 39:29
  Speaker 1: Well, I look forward to following this story over the
• 39:32
  Speaker 1: next few years. Sean, thanks for joining us today. Appreciate it.
• 39:36
  Speaker 2: Thanks so much. Matt really enjoyed it.
• 39:37
  Speaker 1: And I'd like to thank our listeners for tuning in.
• 39:41
  Speaker 1: We hope you enjoin us for a few future episodes,
• 39:43
  Speaker 1: and if you want to stay up to date, please
• 39:45
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• 39:48
  Speaker 1: Take care US bases, US bases