Disclosures, you're not going to go to the website anyway, but it's here if you feel really compelled. Massive thank you to Steven and Sean for coming along from Beta Bionics and agreeing to this. I really appreciate having you guys.
Thanks, Patrick.
Great to be here.
Yeah, it's been a good conference. We're looking forward to the time here.
Yeah, good energy. Let's just dive into it, right? Why don't we, maybe two minutes just to level set people. I think probably almost everybody in this room is aware of pumps and how that market works, but maybe just from your perspective, what really distinguishes, you know, Beta Bionics relative to the pump competitors?
Yeah, absolutely. We all know Beta Bionics is an automated insulin delivery pump. We don't like to call it an insulin pump. We like to call it the Bionic Pancreas to differentiate it. Why the difference? It is the most automated version of an insulin delivery system ever. We've all been adding these user simplicity functions, like trying to reduce boluses and whatnot, and we've done that completely. We've also added the concept of moving from a static to an adaptive algorithm, which removes the need for the healthcare provider to set up and manage the pump, which means it can be done by, for example, a primary care physician. We have data on that.
We generally believe that the insulin pump industry has, this is not a criticism, by the way, more of a statement of fact, has sort of failed at improving outcomes with diabetes, not on the patient basis, but on the population basis. The evidence I'll cite for that is that the average A1C in the country is not really falling, right? We know that we can take those patients and improve their A1C massively. We do that by providing a product that's not absolutely fantastic for one person, but broadly applicable to everybody, which means work with CGMs that they like, meaning provide a form factor that they prefer, meaning give them an algorithm that they can utilize successfully, and lastly, provide it to them in a channel that they can get it, namely pharmacy if they can't afford the DME channel, etc.
By doing all of those things, we do think that we're in a position to meaningfully improve population health, meaning lower A1C of the population, at least with type 1 diabetes over time. That's what we're up to.
Love it. I mean, loaded question to start with, but starting with type 1, what, 40% pump penetration in the U.S., you could argue that's still pretty low, frankly, given who wants to be doing multiple daily injections and trying to manage everything. What do you think is that's been holding it, not holding it back, it's been going well, but we're still less than half of patients, do you think is the gap?
To me, there's really only one answer to that question. I mean, there's a lot of on-the-margin answers, but the big one is primary care. If you take that 40% number and you look at, you know, 45% of patients are managed by primary care providers. If you ask them, 80% of their patient cohort are on AID pumps. What is 80% times 45%, is what, 36% or something like that? There you go. That's pump penetration, meaning it's not being used by primary care providers. Why? Because by and large, they don't know how to do it because they're complicated to set up and manage. That's the direct thing that we've added with Beta Bionics. I do think it's important to note that the patients are not any different, right? The same patient goes to an endocrinologist, goes to a primary.
It's more a factor of where you live, et cetera, than who you are. Therefore, that 80% plus penetration in the endocrinologist space really ought to apply perfectly provided in the primary care space. We do need to provide a product that can be well utilized by those patients with that provider, and we think we've done that. We do have clinical trial data showing that outcomes with our product with primary care providers are identical to those with endocrinologists. That's unprecedented, but we've done it, illustrating that you really don't need to set up and manage the pump the way a traditional endocrinologist does.
Do you think the primary care physicians don't trust their patients or don't trust themselves?
That's a really interesting question. I've never heard it phrased that way. Themselves would be my guess. Managing diabetes is not particularly complicated, but it's also not easy. It's not something that they do on a daily basis. We have protocols on how to manage type 1 with MDI, things like the Bergen-Stahl protocol you can look up, which tells you exactly how to do it based on fasting blood glucoses and waking blood sugars, et cetera. They work to some extent as long as they're followed. They require every two-day titration. They're just not followed enough. I think it does come down to that. They just don't know how to set up and manage the pump.
Yeah, the CGM, like speaking to Sean's point, and Sean, feel free to add to this. CGMs figured out what Sean was alluding to a moment ago there with primary care and making a system easier to prescribe far earlier than pumps did. In 2015, CGMs before 2015, before Dexcom created a sensor that didn't require calibration, they would compare one another using metrics like accuracy, so the MARD, and metrics that patients turned out probably didn't care about. Once they launched, once we made the devices easier, not we, but once the industry made CGMs easier to use, that was a huge unlocking mechanism that now type 1 penetration for CGMs is north of 80%. I don't actually know that number. It's probably closer to 90% now.
I think that the key takeaway there, as it relates to primary care and insulin pumping, is that insulin pumps before the iLet have been comparing themselves with one another on metrics that, frankly, I'm not sure the patients ultimately really care that much about. Yes, time in range and A1C matters, but really, patients want to understand how this device fits into their life and how it makes their life easier. That's the unlocking mechanism for diabetes devices. We're the first company that, just like any great innovation, has changed the metrics from, again, just caring about A1C and time in range to how does this thing get any easier to use. We're the only pump positioned to do that, and hence why we've had a lot of success.
It's a great point, Steven. You know, if you look back, every single innovation, every single intervention in diabetes has always had one thing in common, and that's the more you engage with it, the better your outcome, always. Whether it's BG checks per day, CGM checks per day, injections per day, boluses per day, I don't care. The more engagement, better outcome until the iLet. We have data showing that our outcomes are independent of engagement. That's absolutely a first. It's absolutely innovative. It really puts a point on what Steven's talking about. You want easier, then you got to get a product that actually doesn't need you to engage with it all that much.
Could there be a subset within type 1s? Because there's some, unlike yourself, there's some who developed very, very young, and they've been doing MDI an incredibly long time, and maybe now they're relatively older. There's a trust that you're giving up to an algorithm, and there might be good clinical data, things like that, but is there a subset that they just kind of need to age out of the pool, which is another way to die out? Is that a subset that's just going to be really difficult to convert, or just they need proof?
You know, with diabetes, it's very hard to talk about the patient profile because there's a gazillion of them. It's absolutely a spectrum from this to that, and maybe it's even on three dimensions. There's always going to be that. We know people like that. What I think we are seeing is that there are people who don't necessarily trust it, but there's nobody who really likes it, meaning there's nobody who just gets up in the morning raring to go saying, "Today, I get to manage my diabetes." It's not fun, right? Over time, as we build trust in what our algorithm does and how it works, you will convert people like that. You won't convert everybody, but you will convert a number of them. We don't have to, right?
If we go back to my argument from earlier, roughly 80% of patients, at least who have attended an endocrinologist, have accepted the fact that pumps are a better way to go. That's growing over time, even in the endocrinology space. If we do the exact same thing in the primary space, and that's not the only place we're going, of course, there's a long way to run before we start to run into what's clearly that, I don't know, late adopter, laggards, I guess they call them.
primary care physician discussion, you go in, you're just like, "Look, you don't really need to carb count here." How do you communicate? Because they don't want to see trials, I'm guessing.
Yeah, no, you know, primary care physicians are definitely different. I want to be clear that we're at the very infancy of penetration to the primary care market at this point. The reason is that what I don't think works is just showing up with, you know, doubling of your sales force and calling on every primary care doctor in existence and explaining why iLet is better. It's not going to have any success at all doing that. I mentioned the protocols earlier. You know, when a new type 1 comes into a primary care's office, they pull out the piece of paper and say, "Okay, start them on 0.5 units per kilogram per day." It says it right here. That protocol needs to say write iLet. In order to do that, it's not a one-to-one with the healthcare provider. It's going to be with the clinic.
It's going to be with the ADA, things like that, the larger bodies. We're generating the data now that shows that we should be that. The work to actually get that done is, you know, still to some extent coming. I do think that the iLet is in a unique position to be able to do that. What I don't think is going to be useful is to protocolize exactly how one reviews a spaghetti chart, which is our modal day glucose chart over time, and say, "Okay, based on this kind of trend, you think you're seeing, here's the change to the carb factor," for example. You just don't need to do any of that with our product. It's a pretty unique greenfield opportunity for us. It'll take a little longer than converting a single doctor. When you convert, for example, a healthcare system, the whole thing comes.
A lot of people I speak to, when they hear about the algorithm and iLet, jump to the conclusion that it's even better suited for type 2 because the stereotypes that exist around type 2 patients and their management of their condition versus type 1. Is that stereotype less true than people think that it is? How do you view the type 2 opportunity overall?
We don't have an indication in type 2. I think we'd be a little careful on saying what is and isn't true. We don't know. I understand the stereotype. I can understand why somebody might say that about our algorithm. Certainly, you know, over 25% of our users are coming to us with type 2. There's something that's clearly resonating there. It's important to state that we don't push it in type 2. That's just what's happening in the market. I don't know if I could go into all that much more detail on that.
Yeah, what I can say about the type 2 market is that that particular segment of the market is growing in its insulin pump adoption at an unprecedented level. I think you won't find an analyst model out there that predicted the uptick that we would have seen in type 2 insulin pumping in the first half of the year. We don't really see that stopping. Again, we can't be advertising or marketing what the product, how the product's doing on type 2 because we don't have the indication.
I think people always feel type 2 are slow to engage with their health. I think people just assumed that, to your point, the curve was very aggressive.
It is really Beta Bionics and, you know, our tube pump competitor that are driving that. I would illustrate that when you look at our clinical data, we have quite a bit of data in the very high A1C segment. These are people with A1Cs of 14 to 17 when they came to us. They end up with a GMI, I think, in that group of 7.7, if I'm remembering correctly. That is just an astounding difference. I am not familiar with another intervention that's ever been able to take somebody from 14 to 17 on 7.7. Whatever kind of diabetes you have at 14 to 17, that is a disengaged population. Clearly, whatever we're doing is able to have some level of success without that engagement because the patient didn't change when we handed them the iLet. I think that's a point on what you're saying.
I also realized I just misspoke. I meant to say our Tubeless pump competitor, and I'll start the reasons for the growth in type 2. I said tuned, but I'm just saying the name, Tubeless. Sorry, go ahead.
Yeah, I mean, that is also one of those things. Even within type 1, you know, if I could stop carb counting, isn't that just better? Is this one feeler thing that I have to do, or do you find that there's a subset of people who just, they're so habitually prone to doing it that there's a control thing there or something?
There is a segment of people that will continue to carb count in their head and then convert that to a usual meal. You don't need to do that. Turns out, I do it at some level. I'm looking at it. I see it in carbs. I'm really bad at that. Everybody else is too. We know that. That's the reason the usual works. It's because, you know, somebody might say 40 or 50 or 60 or 70. That's all kind of usual. They're not getting that right exactly. That happens at some level. What's really interesting, though, is that I think this even surprised us at some level. We didn't appreciate the number of our users that were going to not touch it at all. Forget about carb counting. Just don't even call a meal.
I think we share this data at ADA where, and check me on this, something like 15% or 16% of our users call less than one meal per day. Of that group, it's one every three days on average, which we would define as largely fully closed loop mode. They're going from roughly an A1C of 9.4 to a GMI of 7.4. 7.4 in a fully closed loop mode. It's unbelievable. We don't have an indication for that, but that's what's happening in the real world.
Yeah, super interesting. On the topic of form factor, you guys obviously are going for a multi-form factor approach. Ultimately, how do you think, I know you're agnostic between them long term, how do you think it ends up as an overall market?
Yeah, in terms of split between variable.
were waiting for that, weren't you?
That's our mid-product right there, the TubeLiss version that Steven alluded to earlier. What do we think the ultimate split between the two is? Hard to say. I think today you guys probably know those numbers even better than we do. We can look at Omnipod's new starts versus everybody else's added up, and there you have it. There are probably additional drivers that move that over time. What I would say is if you want to fulfill our goal of being able to move the entire population health, then you really have to provide both. I don't see a world where either form factor is just the absolute dominant form factor and nobody wants the other one. There's good reasons to want both, so we should offer both. We feel strongly about that. This is it right here, probably a size you're sort of familiar with. Yeah, we're pretty proud of the sucker.
Do you want to walk through some of the features that I don't know how familiar people are?
Yeah, sure. You know, again, it should sound reasonably familiar. It's a 200-unit insulin capacity. The size is as you're familiar with. We have made one design decision that's a little different or atypical, and it's this right here. It's a two-part durable disposable product. That was done for very good reasons. It's done for user experience reasons. This is a durable product. It's paired to your phone all the time. I'll get to the importance of that. This is a disposable. This is what, you know, more of what you're familiar with. Fill this up every three days. The user experience of this, you're wearing it, right? You take it off, take this off, discard this part. You didn't have to go into your phone and stop a sensor session or a pump session, right? Because you pulled this apart. There you go. That's all it costs you.
Take a new one out, fill it up. You no longer have to wait for your phone to pair with it because this is already paired. Another step you've eliminated. Still haven't gone into your phone. Put these together. That took me all of one second. That just started the thing up, primed it. Still haven't gone into your phone. Put that on yourself, pull out the safety lock and hit the button. You're done. You still haven't gone into your phone. That is differentiated from some other experiences you may be familiar with in that we've done away with the need to interact with the phone in any way. The cannula insertion experience is a little bit different, which we feel will have some advantages as well. Time will tell on that one.
In short, the experience generally is the same, but with a few fewer steps and hopefully less discomfort.
What about the unit economics relative to doing it that way rather than chucking everything?
Yeah, at any level of scale, meaning a couple of years after we launched this thing commercially, the design decisions that we've chosen with the durable component lasting two years and then the disposable having all the inexpensive components will have the gross margins at above the level of the tubeless pump competitor. Very advantaged on gross margin, assuming the same price point, which we don't expect to be a problem. In this durable, we have a PCB, a processor, memory, radio, speaker, motor, gear train, very, very expensive components, right? Things you don't throw away every three days so you can avoid it. In this guy, we have a couple of injection molded plastic components, two batteries, and the patch that fits in your body. Comparatively inexpensive components that you don't mind throwing away every three days. That's why it's comparatively easy to do what Steven just explained.
I remember chatting with you guys about this in, I think it was ADA 2024. It's part of the bigger picture thing. You moved pretty quickly on that CGM integration, you ended up moving faster than some of your peers. You still have that kind of speedy, small company energy. How important do you think that is for how you've been competitively? How do you keep that? Some of your peers are a little more bureaucratic.
It's central to what we are as a company and how we'll be successful. I don't think anybody should ever lose that. If you lose it before you're successful, good luck. It can be natural in the long run, but we'll sure fight it as long as we possibly can. Both Steven and I are engaged in the business on a daily basis. The exception fact over here, we're still trying to keep up with things in between our meetings upstairs. We try, for example, we don't have the word committee at Beta Bionics. It's just not a thing. You need a decision, boom, come to me and you'll have it or make it and we'll back you on it. We move very quickly because of the way we trust our employees and the way when people are uncomfortable, we'll help them out.
That's not in and of itself going to mean much today. I think the proof's in the pudding, frankly. CGM is a great example. We were absolutely at the forefront of every one of the integrations that we did. Interesting side note to this architecture here. This guy, again, is a durable. It's analogous to the iLet in that it's paired with your phone. Let's just say we were to launch a new CGM with this. You would go to your phone and hit update, and we would update the software on this, and you have it the next day, right? That's a major competitive advantage compared to a situation where you might have to build your entire inventory that's in the field with said new software. We can over-the-air update this one. Continue advantages like that.
Yeah, I like that question, by the way, about you. I think that we do these, like, we're new to being a public company. Sean and I heard, like, Sean and I used to, we're new to operating a public company. I'm kind of surprised at times, not disappointed, but surprised that we do, like, conferences and various meetings with investors, and very little time actually gets spent on talking about the management philosophy of the business and the way work actually gets done. I think that's a really core advantage to our company. I think there can be starkly different capabilities and paces of innovation from one company to the next. We have a lot of things that really work well for us in that regard, and we're proud of it. I don't expect it'll stop, especially not as well. Sean and I are managing the company together.
One of the key things, and not to gas Sean up too much here, but actually having an engineer-led company really does matter. Sean's very close to this mid-project. Everyone in our company shows up, unless you're in the remote sales team, you show up to the office every day. That innovation is happening like a couple hundred feet from Sean's desk. The people, the team members that are involved in it, we've removed every decision cycle down to giving the right people the right authority. If there's a decision that needs to be made, Sean makes it. I think that's a part of the philosophy that just kind of maybe speaks to the timelines and the execution that you alluded to. Thanks for the compliment. There's more I could say, but anyways, we're definitely proud of it.
I appreciate that. I wanted to say one thing. I'm not always right, right? Not by a long shot. Far better to make that damn decision, find out that you're wrong, and make a different one than to obsess over it for months on end and not make any decision at all. Hopefully you didn't hear some egomania about Sean's always right, because that ain't the case at all. I can be wrong really fast.
There's a funny story recently of a decision I saw Sean make, and it was the name of the product, which is called Mint. Mint is, I think, a great name. You guys, if you don't like it, don't tell me, but I think it's an awesome name. It stands for mini insulin therapy. It seems like people really like it. That product, how it got, how decisions like this typically get made in my corporate past life is that someone puts together a deck of a bunch of names, like using hiring a consulting firm, which probably comes up with some really good ideas and the rationale as to why. There's a committee of people. Everyone wants to be involved in it because it's so crucial of a decision. At least that's what you're led to believe.
Ultimately, it gets made over a period of time, and you ask the employees what they think.
You forgot about the market research.
Market research, which is crucial. In Mint's case, there were three names that would hit Sean's desk. I was there kind of standing by the door, not even sitting down. Sean looked at them. Somebody said, "Yeah, I kind of like Mint." Sean's like, "I like it too. Let's go with that." That's how you move fast.
It's better to move fast than be wrong or right.
I guess the point is, if you can belabor all you want, it's a pretty good name.
Yeah, it's kind of fresh.
What I feel like I remember from that meeting is it wasn't even really a naming meeting. It was more like a naming concept meeting. We were like, "For example, here's some." I was like, "I like that one. Let's just be done. Forget it. Let's just not name the product. It's fine.
Yeah.
Speaking of that, maybe moving on. We've gone on and on about the company.
I think I found nice names. I think they did it like that.
Oh, really?
Mine did it a little bit as well. Same deal.
I borrowed it from Shoe Dog.
There you go. Good book. GLP-1s. 2023 callback, going very retro, but I feel like we're kind of done with the panic and hysteria associated with that. How do you think about the combo with a product like iLet, particularly because you're already pretty good about getting people's A1C into the right place, and it's just another tool to kind of get them there within the type 2 community, which I know you don't have a label for, et cetera, but how do you think it fits into the infrastructure?
Yeah, I mean, I think, look, it's a phenomenal class of drug, no question about that. Newsflash, it's not getting type 1s off insulin. That's certainly true. In the type 2 space, while it may prevent certain people from purchasing insulin, it's also not getting your people who are on intensive insulin therapy, which is our target market, back off either. I think it can and does make it a little bit easier to control people, but it's not going to fundamentally change the market. I'll remind everybody too that it's expensive. It's really expensive. It's more expensive than insulin therapy. I don't think we've seen a major impact to this market. I mean, the pump industry has outgrown its history here in the face of GLP-1s.
Asked and answered as far as I'm concerned, but that's not to say that I don't believe in them or think they're a great class of drug. They are.
The grapefruit yoga and disruptive NLI, I think, seems to be the main vibe. The other one that's been a little bit more topical currently is obviously competitive bidding. Actually, of the areas of reform that I was more interested in was the shift to more of a rental model, which you guys are already going in that direction. My interpretation when I saw that was like, okay, the stated aim is to get people to be able to churn their system faster so that they can get access to your innovation faster. A, is that a good or a bad thing from your perspective? B, does that increase the speed of the innovation cycle because now you don't have to wait every four years or a magistrate or a junior?
It's a very good thing. It's especially good if you believe in your products and you believe that you develop those products faster than anybody else, meaning you always have a technological lead, which we do. Everybody has asked us in one form or another, geez, moving to a pay-as-you-go model, doesn't that transfer the risk to you? If you don't get paid up front, you might not get the full payment over time. Sort of. Our perspective is that if you get that payment up front and then they don't like your product and they attrit in one way or the other, then you're dead anyway, right? Four years from now, they're sure not going to be getting a new product. They're sure not telling their doctor that they love it, and the doctor's not writing them for their other patients.
If you believe in your product and you believe people are liking it, then pay-as-you-go model ought to be something you really, you know, there's a benefit to you, especially since you can also pull them from other people earlier. We do believe that. We think patient choice is a great thing, and we believe in our product. The first time you tell me that we want to, the first time I tell you I want to pivot to a big upfront payment, it's probably when I lost confidence in the product.
Yeah, I mean, do you think like the end, we don't know what the phase in will look like, but could you get a bit of a churn in the entire, it doesn't really affect you guys because you're still small and taking a share, but amongst the big players, could you get a big churn and who's on what, if you know what I mean, or just people sticky?
Yeah, I mean, people tend to be reasonably sticky, I think. You'll see some of it, but every year you've got, whatever it is, a quarter of people come up for renewal anyway and making that decision as it is. You have a few more, sure, but I don't think you would see more of a shift within that quarter if it's indicative of what you would see in that situation. What do you see? You see people with newer entrants with better technology taking a share. For us, moving to a pay-as-you-go type model is a huge benefit. If you have a massive installed base and you want to hold on to that, it's probably not a good thing. Five years from now, ten years from now, asking the same question, I hope my answer is, yeah, it certainly benefits those with better technology.
That has always been us, and it still is, I hope.
The competitive bidding side of things, at least within the DME, is that a thing or is that not a thing?
There wasn't a single proponent of it in the public comments of competitive bidding. That doesn't mean that it won't actually happen. My perspective is that it's within a rental model, the competitive bidding as it's being proposed at the rates that it's being proposed, specific to Medicare fee-for-service, like only a small subset of people, that it would be a bad thing. I don't believe that it'll actually end up going through. If it did at the particular rental rates that are being contemplated, I think it would be a bad thing. Frankly, our tolerance, and I think probably the other pump company that would be impacted, our tolerance for taking much price concession in that particular small component is already pretty minimal. It wouldn't really impact our business if we frankly just walked away from it. I guess there's a world where we would do that.
Really, to be clear, I just wanted to add one clarification to Sean's points, which are well said, is we are absolutely a huge advocate of pay-as-you-go. The rental model, though, in our public statements, we thought we'd see some logistical problems with a rental model for insulin pumps. You're getting the pump back, kind of refurbishing it. You don't have to sterilize it, but a version of sterilization has to happen for bloodborne pathogens. That has some problems. Pumps don't just get hot swapped from one to the other. That doesn't really work like that. That's kind of how the proposal sort of implied it.
Yeah, that makes a lot of sense.
Yeah, I think that one of the stated goals, and you mentioned it earlier, is to increase choice, this whole thing, right? I think, as Steven was sort of implying there, it's a little bit antithetical to choice to drive people out of that market because you've just simply put too much price pressure on it. It's kind of already on the edge of that now.
This is probably a ridiculous comment, but one of the things I'd wondered about in the past is, does anybody end up making a durable pump that is so durable that you just don't end up needing to replace it? Just because it's like, it doesn't, it lasts for more than four years, and it can be remotely software updated, and it's just built like a tank. I sort of, one of your peers had a smaller pump form factor that I looked at and wondered if that ended up that way because we've run it for so many years. I know it's a weird statement, but.
You know, healthcare and reimbursement is a weird animal. You have to design a product for the best possible product and to fit into the reimbursement system that you have. At the moment, the DME hex fix code-based system is an every four-year thing. It doesn't matter how long it lasts. That being said, if you wanted to redefine that system, that's okay. The product you just described sounds like it fits very well into a rental-based model where you just keep being paid for as long as the user's on it, as long as that thing still lasts. If it doesn't, it's on you to replace it. That would fit very well into the pharmacy channel.
Makes sense. On the pharmacy channel, no one's quite sure how the durable side is going to end up there. You guys have a vision for how that is. There's some others where it's maybe not always clear which way round it's going to go. How do you think that model ends up landing?
It's tough to call an exact shot on this one, especially from our position, which is as market leaders in the movement of durable pumps to pharmacy. Certainly higher than we are now. What's the terminal number? I don't really know. I think we see two things that are probably competing at some level. PBMs, I think, over time see the other PBMs putting these products on the menu, and they're probably starting to fall faster, right? Plans, on the other hand, the ones that are still holding out become the laggards and maybe have a reason for not wanting to do it or haven't been convinced. Those two things are competing. One's going to accelerate things, one decelerate. We just can't call our shot.
I think a very reasonable, how do I put this, as we watch Beta Bionics over the next period of time, that will be our leading indicator of where this can go because we are, by our very nature, leading at this. We'll keep at it.
You guys have a slightly unique opportunity on the licensing side as it relates to dual hormone and that side of things. Maybe give the audience participants an idea of what that is, the opportunity there. Can you be more aggressive in capping the highs if you can protect the lows? Is that a thing?
Oh, absolutely. I mean, the idea of bihormonal is that we can help you forget about having diabetes. That was the best comment we ever heard in our formative clinical trials: I forgot I had diabetes. At some level, a fully closed-loop system takes care of insulin delivery completely. You'd think that would be forgetting about having diabetes, but it's not quite because you still have to worry about those lows, right? Every system, I would include, has the occasional low. You have to be aware and be ready to treat that. Bihormonal eliminates that concern. With that, we can also then additionally eliminate the highs because we can be a little bit more aggressive as well. Where that ends up, how we tune that knob between lowering the highs without increasing lows, we'll see, right? That's the clinical trial that has to happen.
I assume what you were talking about with the license is that, you know, we licensed glucagon, a shelf-stable human pumpable glucagon from Xeris. That puts us in a unique position. It's an exclusive license to be able to provide a bihormonal system. We think that if you truly want to forget about having diabetes, which I think is everybody's goal, bihormonal is really the only way to do that. We've never seen a system that really could eliminate lows without it. The reason for that is insulin's too darn slow. You can turn off insulin, but you can't turn it off fast enough to prevent the insulin already in your body from causing that low if you do something like exercise right after eating or something like that, which is just no way to avoid.
It's a very unique product that we think is going to be truly revolutionary when we get there.
Okay, last one for both of you. I know that you try and eliminate as much wasted time as possible internally, but what's your favorite meeting every month? You have it internally, like what's the...
I only have one. We have our one weekly project management meeting, which is my only real standing meeting a week. It's every week. We all get together, not as a whole company, but senior staff, and we talk about everything. There's not a better way to keep up on what's going on and keep the excitement going on the whole company. I don't know.
I take 15 minutes every Wednesday morning to tell about 25 people on my team what's going on in the business. Just to be radically transparent of what's actually happening. People, I think, if they feel like they're very connected to the business and if the company's being honest with them and they actually know what's going on, they know what the A-plus problems are. You have more people volunteering for the work, and I find that you have people that are ready to run through a wall to try to help. I think it's that. I just do 15-minute, not written down, just radical candor, what's actually happening.
Love it. Sean, Steven, thank you so much. Really appreciate it.
Thank you.
Thanks, everybody.