Friday, October 27, 2006

Halloween and Competition in the Sugar Market

Some people who read Amy's DiabetesMine blog may have already caught a preview of my topic du jour in the comments section of her recent post "Finger Lickin' Good". However, in honor of halloween, I couldn't think of a better topic to discuss than sugar, especially since this holiday, perhaps more than any other, is really all about sugar. Many people with diabetes rely on glucose tablets for quick relief of hypoglycemia. It works quickly and is easily measured, helping to prevent overtreatment.

For many years, the market for glucose tablets has long been dominated by Can-Am Care Corp., the maker of the Dex 4 brand, and also manufacturer for private label brands for most major pharmacy chains, including Walgreens, CVS, Longs, PayLess and countless others. The price for a bottle of 50 tablets is like $5 or more. Lets face it, making dextrose tablets is not complex drug engineering, but we saw little innovation in this market until about 2 years ago, when a little-known New Jersey-based company called Raritan Pharmaceuticals Inc. decided to enter the market. They are responsible for innovation beyond the icky orange, grape and raspberry flavors that had long been standard. Raritan started selling what they called "Tropical Fruit" flavored glucose tablets under Wal Mart's Reli-On Brand, as well as NYC's Duane Reade Drug Stores (if you closely look at the tablets, you will notice the ones with the imprint "RP", which stands for Raritan Pharmaceuticals). Aside from the huge opportunitity by landing Wal-Mart, the company had to prove their product was different from Can-Am's and would sell.

So what did Raritan do that the giant Can-Am did not? Two things. First, Raritan did something very different by selling a package with 3 different flavors in the same container, and second, their product tasted much, much better. To review some actual comments on these flavors from people with diabetes, please see the posted comments at: or the archives at for more on this topic.

Consumers immediately recognized the difference, and they flew off the shelves. When Tropical Fruit first hit the market, Wal-Mart couldn't keep them on the shelves, and they are still harder to find than the plain old orange or grape flavors. That satisfied Wal-Mart, and the rest, they say, is history. But the story did not end there.

As a result of this competition, Can-Am has since come back with its own multi-flavored variety sold under the name "Assorted Fruit" flavors which I have found in CVS Drugstores, and they are also sold under Can-Am's Dex 4 brand (Can-Am does not list it on their website, but Diabetes Health magazine does, and if you view this link, some of my readers will also note some other new flavors including "Tropical Coconut" and "Wild Cherry". I'm not sure about the Wild Cherry flavor, but I'll have to try it.) Regardless, both Raritan's "Tropical Fruit" and Can-Am's "Assorted Fruit" are much more palatable than the old flavors.

I am also doing some investigation into competition in the insulin market, or rather the lack of competition, so keep your eyes posted for that story in the future! Anyway, try not to indulge too much in the sugar-laden holiday, and I'll post my article on generic insulin in soon!


Scott K. Johnson said...

I really like those Reli-On brands. They really do taste better!

I thought I was in heaven when I first found those "Tropical Fruit" flavored tabs! Ahhhh... The things that please us sometimes eh?

Looking forward to your article in Diabetes Health! Way to go! That's very exciting!

Johnboy said...

I don't typically consume glucose tabs. If at home, I find that an evil HFCS-containing juice drink is lightning fast. For easier dry porting, Smarties is my first choice.

Last Halloween, I committed myself to eat no candy and started a disciplined exercise routine. That's what I now think about this time of year. :)

Scott S said...

Thank you both for your comments! Regardless of whether you use glucose tabs or not, market innovation and competition in the market benefits all of us. As a side note, personally, I do not get too excited by halloween, but some people do, and it is not uncommon for parents to raid their children's trick-or-treat baskets (when I was growing up, my father used to ... LOL).

Bernard said...


Amen to more competition in the diabetes market. I think competition and innovation have to be great for any marketplace.

How about test strips? How long have these been around and they still cost about $0.50 each on average. Don't tell me that's due to the cost of R&D - these are a cash cow for meter manufacturers.

Scott S said...

Hey Bernard,

Sorry I did not respond sooner, but you're 100% correct about test strips. Believe it or not, at one time, there actually WAS one generic test strip manufacturer, and that company was based in your home state of Massachusetts (actually, they were a Scottish company with U.S. HQ there). Do you remember a Waltham-based company called Inverness Medical Inc.? Probably not, since Johnson & Johnson's Lifescan division acquired the company.

I'm not sure why U.S. antitrust regulators did not even question that, but if you examine the SEC filings, you see the issue of reducing competition never even came up in the hearings.

Patent law also plays a role here. Ever wonder why after a few years, the manufacturers make minor changes to the strips and call them "new and improved"? For example, J&J/Lifescan once sold a meter and test strips called "FastTake", which were modified only slightly to become the OneTouch Ultra. I would expect a new version in the next few years, since the OneTouch Ultra patents will start to expire shortly. Basically, this pattern enables them to extend the life of their patents without having to do much of anything. Its kind of an underhanded thing to do, but as publicly-held companies, they do have a fiduciary responsibility to their shareholders. Universal healthcare would go a long way towards addressing this, and perhaps the new rules in Massachusetts will show the rest of the U.S. how to do it!