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Enable Injections

Enable Injections

Home Infusion Platform

Andrew Kuzemczak
October 10, 2025

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TL;DR

Enable Injections’ enFuse wearable allows patients to self-administer large-volume biologics at home, replacing hours-long IV infusions with a quiet, hands-free, subcutaneous system.
The device benefits individuals with chronic, autoimmune, neurodegenerative, and rare diseases by improving adherence, comfort, independence, and overall quality of life while reducing the burden of frequent clinic visits.
By enabling self-administration and improving adherence, enFuse can reduce hospital visits, emergency interventions, and healthcare costs, generating billions in savings in the U.S. and globally while supporting the growing homecare and biologics markets.

Hi friend,

Welcome back to Future Human! Thank you to all who have reached out about the HLTH conference in less than 2 weeks. We are very excited to go and cover one of the biggest events of the year! We are already fielding a number of emails from attendees looking to have us speak with their founders/CEOs. Isabelle, Nicholas, and I are packing our schedule to talk to everyone and learn from a bunch of amazing speakers. If you want to be covered by Future Human, reach out! We are all ears and would love to meet you.

If you’re one of our readers not heading to Nevada, look out for amazing content via LinkedIn and the newsletter. Everything will not be a deep dive, so for the busiest among us, you will still have some short form content to read in a pinch.

Before we get there next weekend, we still need to update you on another amazing healthtech company changing medicine.

So with that, let me ask you:

What if the future of chronic and rare disease treatment didn’t mean hours tethered to an IV pole, but instead relied on a discreet, mechanical wearable capable of administering high-volume therapies at home?

The Story

For patients who rely on powerful biologic drugs, every treatment can mean hours linked to an IV in a clinic — time lost from work, family, and normal life. For years, doctors and engineers dreamed of a simpler way to deliver these complex therapies, one that could move the infusion experience from the hospital to the home. Out of that vision came a breakthrough: a wearable device capable of administering large volumes of medication beneath the skin, safely and hands-free.

That device is enFuse, the first purely mechanical, on-body drug delivery system — and the innovation at the heart of Enable Injections, a healthcare technology company founded in 2010. Headquartered in Cincinnati, Ohio, Enable Injections set out to reimagine how patients receive biologics and other high-volume drugs, replacing cumbersome IV infusions with a quiet, wearable patch that delivers the same therapy subcutaneously. The goal was as bold as it was practical: make treatment simpler, more comfortable, and less disruptive to daily life.¹

Leading this mission is Mike Hooven, a serial medical device entrepreneur with more than three decades of experience and over 100 issued and pending patents. A University of Michigan–trained physicist and mechanical engineer, Hooven began his career at Cordis Corporation and Siemens/Pacesetter before leading internal product development at Ethicon Endo-Surgery. In 1994, he founded Enable Medical, a surgical device company that would later be acquired by AtriCure, where he served as chairman and CEO. After years at the forefront of minimally invasive surgery, Hooven turned his attention to another frontier—transforming how biologics are administered to patients outside the hospital setting.

From its Cincinnati base, Enable Injections has raised more than $300 million to advance this mission. A major $215 million Series C round in 2022, led by Magnetar Capital alongside investors like GCM Grosvenor and Cincinnati Children’s Hospital Medical Center, allowed the company to expand global commercialization of enFuse. In 2024, a strategic collaboration with Swedish Orphan Biovitrum (Sobi) brought the technology to rare disease patients, followed by regulatory approval in Brazil in 2025—marking a key step toward worldwide adoption.²^,³

For Hooven and his team, these milestones aren’t just business achievements but markers of a broader shift in care delivery. From a small Ohio startup to a global medtech innovator, Enable Injections is rewriting what it means to receive care—turning a burdensome medical procedure into something nearly invisible.

The Tech

Traditional IV infusions are bulky, time-consuming, and confining. Now that I am nearing my clerkship year at WCM, I am spending more time on the floor in the hospital and let me tell you the IV systems are far from discrete. The enFuse wearable platform replaces the clinic-bound infusion with a small, self-contained device that adheres to the skin and delivers volumes of medicine subcutaneously—quietly, efficiently, and without wires, tubing, or electronics. The engineering behind enFuse reflects more than a decade of refinement: a purely mechanical system capable of handling biologics while maintaining precision. For those who hear “purely mechanical” and think archaic, I invite you to suspend your assumptions for a moment and dive a bit deeper. Enable is magnificently slick.

At its core, enFuse is designed for large-volume delivery, capable of administering between 5 and 25 milliliters of medication with a single device — enough for many biologic therapies that traditionally require an IV line. Up to four devices can be worn at once, allowing higher-dose administration without sacrificing comfort or mobility. The platform accommodates a wide range of drug viscosities (1–100 cP) and features a custom needle design that ensures consistent subcutaneous delivery while minimizing pain and tissue trauma.¹

The device’s hands-free design is central to its appeal. Roughly palm-sized and fully self-contained, enFuse allows patients to move freely during administration. There are no wires, tubing, or external power sources—only a quiet, mechanical system that uses stored spring energy to drive medication through the skin at a carefully controlled rate. This enables patients to carry out light daily activities while the device works invisibly beneath their clothing.

Underpinning this reliability is a significant body of validation. To date, Enable Injections has amassed 50+ issued patents, manufactured over 200,000 units, and completed 80 preclinical evaluations—all successful. Clinically, more than 10,000 devices have been tested on over 300 patients in 25 countries, contributing to six completed clinical trials and more than 8,000 commercial uses worldwide. Each iteration has focused on refining usability, accuracy, and patient comfort.¹

Complementing the wearable itself are the enFuse Transfer Systems, which simplify how drugs move from vial or syringe into the device. Both systems preserve the drug’s original container closure, meaning pharmaceutical partners can use existing packaging and logistics workflows without modification. For patients, the process is intuitive and needle-free—the hidden needle design prevents patients from ever seeing the needle, while the device automatically handles drug transfer and injection. Over 30 usability studies have validated that enFuse can be used safely and effectively either in the home or in a clinical setting.

Enable Injections is also developing a Dual Vial Transfer System, an automated mixing technology that combines a dilute and freeze-dried drug at the point of use. This system eliminates manual syringe-based reconstitution, reducing needle-stick risk and drug exposure while ensuring consistent mixing—a major advantage for complex biologics and combination therapies.¹

Looking ahead, the company is marketing their Smart enFuse moving beyond mechanical and integrating Bluetooth connectivity with a companion mobile app, transforming the device into a digital health platform. It records dosing data, provides real-time injection guidance, and captures patient-reported outcomes, all securely stored in the cloud. This data can feed into analytical dashboards for both clinical trials and real-world use, offering physicians insight into adherence and treatment response.

The first commercial integration of this smart platform is with Empaveli (pegcetacoplan), a therapy for paroxysmal nocturnal hemoglobinuria (PNH) that patients can self-administer at home in approximately 30 to 60 minutes. We for one love to see precision engineering with new software producing life changing impact for patients.⁴

The Market

The market for injectable drugs and delivery systems is enormous—and expanding rapidly. As chronic diseases become more prevalent worldwide, injections have become the preferred route for many therapies because they offer rapid systemic effects and higher bioavailability than oral medications. Between 2025 and 2032, the global injectable drugs market is projected to grow from $614 billion to $1 trillion, representing a 7.7% compound annual growth rate (CAGR). This growth is being driven not only by rising rates of cancer, autoimmune, and metabolic diseases but also by the growing acceptance of self-administered injectables, which give patients the freedom to treat themselves at home.⁵

By molecule type, small molecules will make up nearly three-fifths of the global injectable drugs market by 2025, while intravenous delivery will remain the dominant route of administration, accounting for more than two-fifths of market share. Oncology continues to be the largest therapeutic category, expected to generate roughly $218 billion in annual revenue by 2025. However, the convenience and comfort of subcutaneous delivery—particularly when combined with wearable or connected devices—are positioning this segment for faster long-term growth.

The injectable drug delivery devices market, which includes autoinjectors, wearable injectors, and related systems like enFuse, is growing even faster than the drug market itself. Valued at $468 billion in 2023, it is projected to reach $823 billion by 2030, expanding at an 8.7% CAGR. The demand is being fueled by the rise of biologic therapies and the global shift toward home-based care. Autoimmune diseases — such as rheumatoid arthritis, lupus, and multiple sclerosis—accounted for 43.3% of total device revenue in 2023, reflecting the need for long-term, self-administered biologics.⁶

The homecare segment is emerging as the fastest-growing environment for injectable delivery, with a projected 9.2% CAGR through 2030. As aging populations and chronic disease management shift toward outpatient and home settings, user-friendly delivery systems like enFuse are becoming essential. They empower patients to manage their own care, increase adherence, and reduce costs associated with clinic-based infusions.

Enable Injections competes within a crowded but dynamic ecosystem of pharmaceutical giants and specialized medtech developers. On the pharmaceutical side, major injectable drug producers include AstraZeneca, Pfizer, Merck, Sanofi, Roche, Bristol-Myers Squibb, and Amgen, all of whom rely heavily on injection-based biologics. In the device space, competitors include Becton Dickinson (BD), Terumo Corporation, Ypsomed, and Gerresheimer, which manufacture syringes, autoinjectors, and other delivery platforms.⁵^,⁶

Meanwhile, several emerging biotech companies are pushing innovation in drug delivery. AmacaThera is developing an injectable hydrogel platform that enables sustained release of drugs post-surgery. Mercator MedSystems specializes in catheter-based microfluid injection systems for targeted vascular therapies. TriSalus Life Sciences is developing its Pressure-Enabled Drug Delivery (PEDD) platform to improve therapeutic penetration into solid tumors.⁷

Within this rapidly evolving landscape, Enable Injections occupies a distinct niche—large-volume, wearable subcutaneous delivery. As the market for injectable therapies surpasses a trillion dollars, the company’s enFuse platform positions it at the intersection of two powerful trends: the rise of biologics and the decentralization of care from the hospital to the home.

The Sick

The patients who stand to benefit most from innovations like wearable subcutaneous injectors are those living with chronic, lifelong, or rare diseases that require regular infusions or injections. For these individuals, treatment can mean hours tethered to an IV pole, frequent hospital visits, and significant lifestyle disruption. A device that allows biologics or enzyme therapies to be administered comfortably at home—without a nurse or infusion center—can completely reshape the experience of living with disease.

One example is paroxysmal nocturnal hemoglobinuria (PNH), a rare and life-threatening blood disorder affecting roughly six people per million each year. Caused by a genetic mutation in bone marrow stem cells, PNH leads the immune system to attack red blood cells, resulting in dark, blood-stained urine and potentially severe complications such as hemolytic anemia, kidney disease, and thrombosis. Patients typically require ongoing infusions of complement inhibitors to prevent blood cell destruction—treatments that can be lengthy, frequent, and burdensome. Enabling these therapies to be self-administered at home could not only improve quality of life but also reduce the clinical and financial burden of managing a chronic rare disease.⁸

Chronic diseases more broadly—including diabetes, heart disease, stroke, and cancer — remain the leading causes of death in the United States and worldwide. Back to Future Human’s most overused stat category, heart disease and cancer. In 2022, heart disease and cancer alone accounted for nearly 40% of all U.S. deaths, while diabetes was responsible for over 103,000 deaths in 2021. Approximately 37 million Americans are currently living with diabetes, and nearly 100 million more have prediabetes (wow…). For these patients, injectable therapies such as insulin, GLP-1 receptor agonists, and monoclonal antibodies are essential to daily management, but adherence often suffers due to the discomfort, inconvenience, and frequency of injections. A simplified, wearable delivery system can transform the experience from a disruptive medical event into a discreet, manageable part of daily life.⁹

Neurodegenerative conditions like Alzheimer’s disease are also emerging as critical areas for biologic and antibody-based therapies. In 2022, Alzheimer’s was the seventh leading cause of death in the U.S., affecting an estimated 6.7 million Americans aged 65 and older. As disease-modifying treatments continue to reach the market, the ability to administer large-molecule drugs easily and safely at home will be vital—especially for patients with cognitive decline or mobility challenges who face barriers to frequent clinic visits.

Autoimmune diseases represent another rapidly growing patient population in need of flexible delivery options. Autoimmunity is rising globally, with the prevalence of autoimmune diseases increasing by an estimated 12.5% annually. In the United States, thyroid autoantibodies are present in 18% of adults, and nearly one in three people over age 60 have at least one measurable autoantibody. Conditions such as rheumatoid arthritis, lupus, and multiple sclerosis often require biologic therapies that are currently administered via IV infusion in clinical settings. Wearable injectors can shift this paradigm, empowering patients to self-administer these therapies at home, maintain independence, and improve adherence without sacrificing treatment efficacy.¹⁰

Taken together, these groups—from those with rare diseases like PNH to the millions managing chronic or autoimmune conditions—illustrate why patient-centric drug delivery is no longer optional. It is the future of medicine: one where care moves from the infusion suite to the living room, improving access, autonomy, and outcomes for the sickest among us.

The Economy

The financial burden of chronic disease represents one of the greatest economic challenges of the 21st century. By 2030, the global cost of chronic conditions—including diabetes, heart disease, and respiratory illnesses—is expected to reach an astonishing $47 trillion (wow…again). In the United States alone, chronic diseases account for more than $1 trillion in healthcare spending each year, straining both public and private systems. Cardiovascular disease costs the nation over $407 billion annually, cancer adds another $180 billion (with projections to reach $246 billion by 2030), and dementia care already exceeds $345 billion—a figure that could climb to nearly $1 trillion by 2050. These numbers are not only a reflection of medical complexity but also of inefficiency: hospital-based care, infusion center costs, and frequent readmissions all amplify the economic weight of managing lifelong disease.

Globally, the situation mirrors this unsustainable trend. The worldwide burden of cancer alone is projected to surpass $25 trillion between 2020 and 2050, and the cost of dementia currently drains $1.3 trillion annually from the global economy. Diabetes management represents another growing crisis, costing the U.S. $237 billion each year and the world nearly $1 trillion in direct expenditures. As populations age and chronic diseases become more prevalent, these figures are expected to escalate dramatically unless systemic efficiencies are introduced—particularly those that move care out of hospitals and into the home.

A major driver of these escalating costs is poor medication adherence. Even the most effective drugs fail to deliver value when patients do not take them as prescribed. Non-adherence is responsible for an estimated 125,000 preventable deaths per year in the U.S. alone — roughly equal to the combined annual deaths from breast, prostate, and colorectal cancers. It also accounts for 10% of all hospitalizations and costs the healthcare system between $100 and $300 billion annually through wasted medications, unnecessary tests, and preventable complications . For chronic illnesses that require frequent injections or infusions, adherence drops even further due to pain, inconvenience, or the logistical burden of visiting clinics. By simplifying administration and making treatments discreet, wearable injectors can drastically improve adherence, reduce emergency visits, and minimize expensive hospitalizations.¹¹^,¹²

Data from inflammatory bowel disease (IBD) patients illustrate this impact clearly: individuals who were non-adherent to their biologic therapies had significantly higher rates of emergency department visits and hospitalizations, resulting in more than double the healthcare costs compared to adherent patients. Improving self-administration adherence through user-friendly injectors thus represents a direct and measurable way to lower system-wide costs while improving outcomes.

Self-injectable treatments also have demonstrated downstream financial benefits for patients and payers. In rheumatoid arthritis, for example, over 80% of patients using biologics preferred self-injection over in-clinic administration, finding it more convenient despite slightly higher per-visit out-of-pocket costs. The reduction in hospital visits and the ability to receive several months of medication at once translated into overall annual savings and improved continuity of care. These savings extend beyond dollars—reducing missed workdays, travel expenses, and the psychological toll of recurrent hospital visits.¹³

The economic case is clear: technologies that improve adherence, shift care into the home, and simplify complex drug delivery can generate billions in savings annually while expanding access to life-sustaining therapies worldwide. In an era where chronic disease drives both human suffering and fiscal instability, the adoption of such platforms represents not just innovation—but economic necessity.

My Thoughts

Enable Injections shows how a brilliantly engineered, purely mechanical device can gain remarkable traction in a world dominated by digital and high-speed technology. The enFuse platform moves complex, time-consuming therapies from hospital settings into patients’ homes, improving adherence, comfort, and quality of life. Its hands-free, spring-powered design demonstrates that innovation doesn’t always require electronics or software—elegant mechanics can deliver precision, reliability, and safety at scale. As chronic, autoimmune, and rare diseases continue to rise, technologies like this could redefine what it means to manage illness, offering autonomy, dignity, and efficiency to millions. Enable is not just reshaping patient care—it is proving that mechanical ingenuity can thrive even in today’s fast-paced medtech landscape.

To more lives saved,

Andrew, Nicholas, and Isabelle

I always appreciate feedback, questions, and conversation. Feel free to reach out on LinkedIn @andrewkuzemczak.