Merck’s Glass beads
---Dr. Martin Luther King, Jr.
Back in the year 1626 an enterprising fellow named Peter Minuit made one of the greater real-estate deals in history, and for that act has been variously painted as either a genius or a rouge of the highest order.
Yeah, he’s the dude that bought Manhattan Island from the Natives.
For what it is worth, and totally off subject, this transaction is not what it first appears. I’d been taught in grade school that he got the real-estate for some glass beads worth a few bucks at most (those silly savages). Later, I often read that it was $24 in trade goods. Newer research has shown that, due to a historical translation error, the value was $37.98. Of course, a buck went a lot further in those days. In today’s dollars we’re looking at something like $1,500.
Even at that bargain rate, I still couldn’t afford to buy Manhattan.
But I digress. Did the Natives get swindled? Probably not. They didn’t get just some glass beads. They got the 1600’s equivalent of i-Phones and Dell computers. The trade goods included iron kettles and axe heads, hoes, and metal awls. Some historians have called this history’s first high-technology transfer.
And the money? Well, 384 years later Manhattan is worth something like 8 trillion bucks. Not too bad for a swamp between a couple of rivers. But before you flame me in comments, consider the brilliant compound interest analysis by Jeffrey Strain. He crunched the numbers and said (paraphrasing, of course), “well, what if the money had been cash? And what if the Natives had just parked it in a savings account?” Yeah, I know, no such thing at that time. Still, it is interesting to note that the Natives would be trillions ahead in the deal given the power of compound interest out-stripping the power of the rising value of real-estate.
So why are we talking about this? Because Merck just bought the future of the entire 116-billion-dollar-per-year diabetes business for a paltry 500 million bucks. This move makes the purchase of Manhattan for fifteen hundred bucks look like a bad deal by comparison.
I want you to remember the name Dr. Todd C. Zion. He’s the Dr. Frederick Banting of the future. As part of his doctoral thesis in chemical engineering from M.I.T., he developed something he calls SmartInsulin™.
I call it THE game changer.
So what the fuck is SmartInsulin™, you ask? Well, quoting from his company’s website, it’s “a layered, biocompatible and biodegradable polymer-therapeutic that is bound to an engineered glucose-binding molecule. Insulin is released from SmartInsulin only when the therapeutic is unbound by the presence of a specific glucose concentration.”
Don’t panic, I’ll translate that to English in a moment.
Oh, never mind. I’ll do it right now. SmartInsulin is the ultimate NPH. Remember NPH? In the pre-Lantus and pre-Levemir days it was the closest thing we had to long-acting insulin. It was an insulin suspension. In other words, bubble-wrapped insulin. Once injected, the bubble-wrap dissolved a bit at a time, releasing the insulin to do its thing. Both Lantus and Levemir are higher-tech, improved versions of the concept.
But SmartInsulin raises the bar. Instead of just dissolving at a set rate, the bubble-wrap is glucose sensitive. In effect, it’s insulin that only works when your blood sugar is high. And it stops working when your blood sugar is normal.
In short, SmartInsulin is a bio-chemical artificial pancreas. No pump needed. No CGM needed. No complicated algorithms. No gear at all. It’s an elegantly simple, self regulating system. As billed, it would be a once a day shot. The insulin stays nice and cozy and warm in its polymer blanket until your blood sugar begins to rise. Then the polymer dissolves, releasing some insulin. Which lowers you sugar again. Then the polymer stops dissolving.
Who knows? The next stage might be once a week shots. Or once a month.
Blood sugar automatically controlled. No matter what you eat. No matter how you move. It’ll be a therapy indistinguishable from a cure, except for the monthly payment to stay healthy.
And what will they charge? Pretty much as fucking much as they want. And this time insurance will pay. Because it will be all they have to pay. No more gear. No more durable medical supplies.
No more expensive complications.
If it works, they won’t even have to pay for eye exams any more, as there will be no risk of damage from high blood sugar.
In a Press Release over at PharmaTimes Online and SmartPlanet, Merck’s head of diabetes and obesity a research, Nancy Thornberry, is quoted as saying "if this investigational technology is ultimately approved for use with patients, it could provide an important new therapy [which] holds the potential to significantly impact the treatment of this disease." And reading between the lines, as she wipes the drool from her chin, I could have sworn I heard her add “plus it will make us and our shareholders sticking fucking rich!”
I realized the significance of SmartInsulin when I first read about it a few years ago. I just figured that if it worked, it would never see the light of day. Too many people had too much to lose. And actually, this is where Merck will come to our rescue. You see, of all the big players, Merck really doesn’t have much going on the diabetes arena. Right now all they have is the DDP-4 Inhibitor class med Januvia, which will be generic by the time SmartInsulin is ready for market. They haven’t got a product line to sell for the plague of the 21st century. They have nothing to lose and everything to gain by getting their mitts on a game-changing med.
If SmartInsulin gets approved, what does Merck get for their 500 million? Instant access to 30 million customers overnight. And if the CDC is right in their projections, fully one third of the US population could be Merck customers by 2050.
SmartInsulin will destroy the diabetes industry. All the other companies will go down in flames, their CEO’s will be running hot dog carts on Wall Street or pan-handling in Times Square.
If SmartInsulin lives up to its promise, there will be no need for other medications for our blood sugar.
There will be no need for meters. Or strips. Or lances.
There will be no need for CGMs.
Or diabetes educators.
In short, SmartInsulin will be a de facto cure, but one with a perfect pharma edge. With their product we’ll live normal, healthy lives. Without it we’ll die. It’ll be the final evolution of insulin, probably just in time for the 100th Anniversary of its discovery. If it works, there will be no motivation, no incentive, for a real cure. We’ll forever be medicine addicts. Trapped like vampires.
It’s slavery, I think. Still… I would use it in a heartbeat.
If I were you, I’d sell the rest of your diabetes portfolio and buy Merck stock.