Thursday, March 18, 2010

Calibra Finesse - Elegant and Easy to use

Recently Abi Basu, the Marketing VP at Calibra Medical gave me a detailed run through of their recently approved Finesse Insulin Patch-Pen. I'd been waiting to learn more about it since the FDA announcement on January 20th, because Calibra Medical doesn't have a web site.

In a nutshell the Finesse is a simple to use and elegant insulin dispensing device. It doesn't contain any electronics, so it takes almost no time to learn how to use it. And the Calibra Medical folks have really thought about design and usability carefully in the Finesse.

The design itself is slim enough that it should be invisible under most clothing. It contains a reservoir that holds 200 units of insulin.

To dispense insulin you simply squeeze the two small buttons on both sides of the Finesse, the unit clicks with each press so you can count the number of units delivered. There's an interlocking mechanism, so both buttons must be pressed before any insulin is bolused, this is designed to avoid accidental dispensing of insulin. It's a bolus-only device, so users will still need shots of long-acting insulin.

You fill the Finesse reservoir with a supplied syringe, they've got a window on the back to see any bubbles - you click the buttons several times to get rid of these. Priming the internal tubing takes about 8 units of insulin and then whatever is needed to fill the 6 or 9 mm cannula.

Depending on the Finesse model, each press will bolus 1 unit or 2 units of insulin. They hope to develop a model that will bolus 5 units per press, but that's in the future.

When designing the Finesse, Calibra Medical looked at some unmet needs in the diabetes space. They found that one major barrier to better blood glucose control is the need to carry syringes and insulin, or pens, at all times. The Finesse can be worn for 2-3 days and ensures that you'll always have the needed insulin with you. Currently Calibra estimates that only 6% of insulin users are on pumps, leaving a whopping 94% of folks with diabetes who might benefit from their product.

They've tested it under extreme cold conditions ("Minnesota-like") and determined that the dispensing mechanism continues to work well. The buttons lock when the reservoir is empty or the cannula is occluded. Currently there's no way to determine how close to empty you might be, they're hoping to have a window in a future version. They're also planning a pediatric version that dispenses 0.5 units with each click.

Calibra has developed a simple sticker system to remind you when you've been wearing the Finesse for 2-3 days. This was in response to the FDA's concern that people wouldn't know when to change it. Each box of 10 Finesse patch pumps comes with a sheet of stickers to remind you which day to change it on, and whether to do this in the morning or evening. And they've made sure that those stickers don't come off, once they're in place.

I was on a conference call with Ellen Ullman of Kids R Pumping and she asked about teenagers and the 200 unit limitation, because some teenagers might go through that much insulin in less than 3 days. (They eat a lot!) Here's the neat thing, you can load another Finesse and put it on but not start using it until the first is empty, so you already have a replacement ready to go.

Calibra Medical has talked with most of the major insurance companies and believe that they'll get coverage for this almost immediately and it won't be counted as durable medical equipment. Costs will be 'more expensive' than an insulin pen, they'll probably have a Tier 3 copay.

The gauge of the Finesse inserter needle for the cannula is 27 gauge, which is on the chunky side. But Calibra Medical claims that the design is such that it's almost painless.

Calibra Medical didn't give a definite date when the Finesse patch-pen would be available, they're currently finalizing some design and supply issues.

Why no website? Abi Basu points out that if they had a website (it appears they currently own the domain CalibraMedical.com) most of his time would have been spent responding to inquiries and demands from potential customers.

My opinion? Calibra Medical has addressed a real need in the marketplace. Their patch-pen is really easy to use, extremely discreet and ensures that the wearer always has insulin for boluses with them. It's one less thing to carry around. The design is as elegant as it can be, and it's something that will probably have an off-label use for Symlin and other drugs. I'm looking forward to trying one out!

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9 Comments:

At March 20, 2010 7:12 PM , Blogger Michelle said...

I agree. I can see this filling a real need. :)

 
At March 20, 2010 9:07 PM , Blogger Melissa said...

At first I wasn't sure how this would work, but now I can see a need for it. This will be great for people who are bolusing often, but don't want to switch to a full pump experience.

I never had a problem with taking the one long-acting shot; it was the frequent bolusing that took all my energy. This way people can dial in boluses (for both food and correction!) easily, making it much more likely to stay in range.

It's great hearing about all the new devices and technology out there. Thanks Bernard!

 
At March 20, 2010 10:02 PM , Blogger Scott said...

Bernard, Thanks for the heads up, this indeed sounds like an interesting device and might also be a bridge to full pumping for those who are on the fence. Even more important, the price may make it more available to many who lack adequate insurance coverage to afford a pump/pod. Looks very interesting!

 
At March 20, 2010 11:11 PM , Blogger Jonah said...

I would be extremely uncomfortable with one click= one unit. I need to look at the syringe or pen and see: this is how much I'm going to inject, now it's down to zero and I injected it all.
If I can't tell if you got each unit in, I would be very uncomfortable using such a device.

 
At March 21, 2010 7:48 AM , Blogger Bernard said...

Jonah

The FDA requires that devices like this be very accurate. So if you press the handle, you'll get one unit (or 2 if you're wearing the other model). FDA also asked Calibra to do testing to ensure that folks didn't lose count of their button presses. Calibra wouldn't tell users what they were doing. They had two people in the room with a user. One would count the clicks while the other tried to distract them. so they'd lose count. Sometimes they would have the phone ring and carry on a phone conversation while the user was dosing. They found that 99% of the time, folks counted right. They gave an extra click in 0.5% of the time.

This isn't go to be for everyone. But I do think a lot of folks will look at it. One way it's more usable than a pump is that you'd don't have to change your dosing approach. So once you've learned how to fill the Finesse and press the buttons, you're ready to go.

 
At March 21, 2010 9:18 PM , Blogger Anne said...

I would consider such a device if I weren't using a pump except that the increments are too large. Kids aren't the only ones who need smaller increments. I guess it might do okay to replace injections, but doesn't match the precision available on a pump.

 
At March 22, 2010 10:52 PM , Blogger si_si_ay said...

As someone who has found himself out and about w/o insulin way to many times to count, this is something that I would find very handy. While I know someday I will get a pump, my control issues are not such right now that I really want to shoulder that cost. But 200 unites for 2-3 days? 200 units would last me at least 10 days, usually more. Would I have to replace it every 2-3 days anyway?

 
At April 03, 2010 2:45 PM , Blogger katerina said...

It sounds very interesting can you please tell us the exact size of it? The only thing I didn't like is the 27 gause too thick for me. Thanks for the info

 
At April 11, 2010 2:09 AM , Blogger Scott K. Johnson said...

Very interesting!

Should I be proud that Minnesota is mentioned for extreme cold weather testing (WHY do I still LIVE here?)?

The idea of using something like this for Symlin is really intriguing. I would do that in a heartbeat.

Please keep us posted on updates you hear about.

 

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