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Post by Deleted on Jan 12, 2018 8:35:08 GMT -5
Can't provide link but the deal exists. Data is the measurement stick which in the future will determine how much $$ healthcare provide will get paid. NPV for healthcare costs on non-compliant patient is much bigger than the cost of the Rx. How much is laser eye treatment, how much is surgical procedure for amputation and subsequent costs to take care of patients. CV issues, bypass, etc. Renal failure?dialysis. In 5 years, will patient have economic skin in the game, gain share for compliance, cost share for non-compliance?
I think yesterday, DXCM indicated they are going to get Medicare reimbursement (PODD said theirs was coming early next year if I read correctly). Current Dex sensor I think they said will go calibration free and that the first gen sensor developed by they and Verily may launch later this year. When joint sensor launches and is readily available in pharmacy things will start to move.
Abbott has lower price but it does not automatically send data to smartphone or their device that records data. May not sound like big deal but it is in a world where real time info will be critical and not relying on patient to download data and transmit ensures data gets sent on time all the time.
Hippa compliance is important but a minimal barrier.
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Post by sayhey24 on Jan 12, 2018 9:14:36 GMT -5
DBC, your post has much validity in the current environment. I don't think the current environment is going to last. The DXCM relationship with Verily gives Dex the first $1B in data proceeds and as I understand it, Verily views that amount as pocket change because the upside value of the data is so massive. Assuming they (Verily) acts in their own self interest, I would suspect they would take these big amounts of data, redact patient identifiers and make the information well known to the right entities to demonstrate who does and does not produce proper outcomes. Once this happens, it puts pressure on all interested parties to measure patient compliance in a new manner (not A1c). There are some people with diabetes who no matter what they do, struggle to control glucose levels and these people have been dealt a very very challenging hand. For many PWD, diet and exercise would make a monumental difference to their health, quality of life and cost reductions for their healthcare. As previously stated, the financial trajectory we are on is not sustainable and diabetes, due to prevalence and massive costs due to health complications can bankrupt the healthcare system. Its going to change and some entrenched entities will not benefit financially from the changes, as such, they will not go willingly. My understanding which maybe incorrect is Verily long term wants to be the Cloud based one stop shop for Telemed and insurance through Onduo. I don't think they are looking to sell data. They want to own the market. They have been working on the G6 and the M&M sensors for Dexcom but they have also been working on the non-invasive to compete with the IWatch. IMO, in 5 years there is no DXCM in its current form. The elephant in the room is it goes beyond patient compliance once you introduce real-time sensors. The PWD can take metformin till the cows come home and be 100% compliant and they will never be able to address the issue which the CGM will report which is the post meal sugar spike. Going 200+ for the T2 is pretty normal using our current ADA Step program. Its this spike which cause all the CV and its like a stake in the heart. If you can keep the PWD in a non-diabetic range until they are 65 there are huge costs savings across the board. If you look at this big push for 2018 with a number of the insurance companies they are introducing "coaching" programs which will tell you to cut back on the snacks and take a walk. At some point one of these programs will address the elephant. What we do know is Steve Edelman is the architect for Onduo's treatment program so I hold hope Steve is actively incorporating afrezza into the protocol. |
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Post by agedhippie on Jan 12, 2018 10:47:13 GMT -5
Real time is all very well but you should see what running a Dexcom G5 in real time mode does to your phones battery life! That is not even in real time but at 5 minute intervals.
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Post by mango on Jan 12, 2018 12:38:12 GMT -5
Dexcom annouced at the J.P. Morgan Healthcare Conference a new relationship with United Healthcare and will be starting Type 2 programs. The G6 (no calibration) will be rolling out later this year ~ mid year/2H.
Dexcom will be heavily focused on the Type 2 market going forward. The analytics will be completely different for T2D.
Dexcom and Verily will launch their first product in 2019 and will be a limited run. The second launch with Verily is their main focus and is expected to launch in 2020. Will be disposable, small and discreet, no calibration, fully loaded and ready to connect to any smart device via bluetooth, etc.
Dexcom CEO said he expects/anticpates the company to launch more in the next few years than the past 15 combined.
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Post by drman7 on Jan 12, 2018 12:58:41 GMT -5
Dexcom annouced at the J.P. Morgan Healthcare Conference a new relationship with United Healthcare and will be starting Type 2 programs. The G6 (no calibration) will be rolling out later this year ~ mid year/2H. Dexcom will be heavily focused on the Type 2 market going forward. The analytics will be completely different for T2D. Dexcom and Verily will launch their first product in 2019 and will be a limited run. The second launch with Verily is their main focus and is expected to launch in 2020. The completed STAT study for T1D uses the Dexcom G5. I hope there will be another STAT study for T2D with the upcoming G6 along with Afrezza ofcourse? |
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Post by sayhey24 on Jan 12, 2018 14:11:43 GMT -5
Dexcom annouced at the J.P. Morgan Healthcare Conference a new relationship with United Healthcare and will be starting Type 2 programs. The G6 (no calibration) will be rolling out later this year ~ mid year/2H. Dexcom will be heavily focused on the Type 2 market going forward. The analytics will be completely different for T2D. Dexcom and Verily will launch their first product in 2019 and will be a limited run. The second launch with Verily is their main focus and is expected to launch in 2020. Will be disposable, small and discreet, no calibration, fully loaded and ready to connect to any smart device via bluetooth, etc. Dexcom CEO said he expects/anticpates the company to launch more in the next few years than the past 15 combined. I wonder if the Onduo launch will follow the G6 launch? I see little reason for a T2 not on insulin to be using a CGM. Any idea whats incorporated when they say analytics? |
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Post by dreamboatcruise on Jan 12, 2018 17:14:45 GMT -5
Can't provide link but the deal exists. Data is the measurement stick which in the future will determine how much $$ healthcare provide will get paid. NPV for healthcare costs on non-compliant patient is much bigger than the cost of the Rx. How much is laser eye treatment, how much is surgical procedure for amputation and subsequent costs to take care of patients. CV issues, bypass, etc. Renal failure?dialysis. In 5 years, will patient have economic skin in the game, gain share for compliance, cost share for non-compliance? True about NPV at a societal level. However, most insurers do not consider the NPV of long term costs for the reasons I stated... the benefits of long term costs savings may well accrue to a different payer, either another insurance company or Medicare, and the fact that execs at most insurers, as with most all companies, have monetary performance incentives based on short term results not long term. Medicare does have Value-Based Payment Modifier program that covers diabetes. However, it is based on current total per capita cost. So doctors would be put in the situation of needing to increase current costs (such as prescribing insulin sooner rather than metformin), which would work against their immediate financial interests since per capita cost would be higher in short term, betting on the patients they are helping stay healthy might still be with their practice long down the road when the cost savings from fewer complications kick in. I'd love to learn that Medicare had pay for performance for diabetes based on a near term metric such as A1c (or better yet time-in-range... but we know that isn't the case since they only recently approved CGMs and certainly don't require them), but in researching just now I didn't find any pay for performance for diabetes other than this Value-Based Payment Modifier. I believe this Value-Based Payment Modifier does not apply to Medicare Advantage programs. Those would fall under the same business dynamics of any other commercial insurance. I'm not knocking the idea of pay for performance, but even if the change will eventually happen it may be slow... and I don't think the healthcare industry will do this without being forced into it, and with political dysfunction I don't have huge confidence that healthcare will be forced to change. Are we two steps forward one step back, or one step forward two steps back. |
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Post by dreamboatcruise on Jan 12, 2018 17:22:31 GMT -5
Real time is all very well but you should see what running a Dexcom G5 in real time mode does to your phones battery life! That is not even in real time but at 5 minute intervals. That sounds like they have some major glitch/bug in their software... or a problem with your particular phone's bluetooth. It is bluetooth used to connect phone to Dexcom, isn't it? From a technical standpoint there is no reason that collecting data once every 5 minutes should be a significant drain on battery. |
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Post by dreamboatcruise on Jan 12, 2018 17:38:01 GMT -5
Dexcom annouced at the J.P. Morgan Healthcare Conference a new relationship with United Healthcare and will be starting Type 2 programs. The G6 (no calibration) will be rolling out later this year ~ mid year/2H. Dexcom will be heavily focused on the Type 2 market going forward. The analytics will be completely different for T2D. Dexcom and Verily will launch their first product in 2019 and will be a limited run. The second launch with Verily is their main focus and is expected to launch in 2020. Will be disposable, small and discreet, no calibration, fully loaded and ready to connect to any smart device via bluetooth, etc. Dexcom CEO said he expects/anticpates the company to launch more in the next few years than the past 15 combined. I wonder if the Onduo launch will follow the G6 launch? I see little reason for a T2 not on insulin to be using a CGM. Any idea whats incorporated when they say analytics? Onduo is launching before then. According to recent press release... "Pilots will begin in the first quarter of 2018 in Arkansas, Georgia and South Carolina with select Blue Cross and Blue Shield (BCBS) members who are eligible." Linvongo seems to be a bit ahead of Onduo. They've partnered with the same company as Onduo for insulin dosing recommendation software (Voluntis Insulia) which I think is already in use with patients via Livongo. BTW... Insulia got its FDA approval in Dec 2016. |
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Post by esstan2001 on Jan 12, 2018 17:44:16 GMT -5
Real time is all very well but you should see what running a Dexcom G5 in real time mode does to your phones battery life! That is not even in real time but at 5 minute intervals. That sounds like they have some major glitch/bug in their software... or a problem with your particular phone's bluetooth. It is bluetooth used to connect phone to Dexcom, isn't it? From a technical standpoint there is no reason that collecting data once every 5 minutes should be a significant drain on battery. Certainly there is no reason, as this is just transferring a few bits of data over a BT link for a millisecond... must be a beta DEMO version SW issue where they leave everything up and linked... |
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Post by digger on Jan 12, 2018 18:21:49 GMT -5
joeypotsandpans ... would be interesting to know of your Afrezza supportive doc, what percent of patients needing to have prandial added to their treatment is he now prescribing Afrezza? Is it basically all that have insurance coverage? Is he switching some patients already on RAA to Afrezza? Good questions, I can ask on next visit Who's your endo? |
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Post by mango on Jan 12, 2018 21:27:43 GMT -5
Dexcom annouced at the J.P. Morgan Healthcare Conference a new relationship with United Healthcare and will be starting Type 2 programs. The G6 (no calibration) will be rolling out later this year ~ mid year/2H. Dexcom will be heavily focused on the Type 2 market going forward. The analytics will be completely different for T2D. Dexcom and Verily will launch their first product in 2019 and will be a limited run. The second launch with Verily is their main focus and is expected to launch in 2020. Will be disposable, small and discreet, no calibration, fully loaded and ready to connect to any smart device via bluetooth, etc. Dexcom CEO said he expects/anticpates the company to launch more in the next few years than the past 15 combined. I wonder if the Onduo launch will follow the G6 launch? I see little reason for a T2 not on insulin to be using a CGM. Any idea whats incorporated when they say analytics? Several things were mentioned, but overall will be completely different than how they have it set up for type 1s. It's like 22 minutes if you want to listen to the presentation. investor.shareholder.com/dexcom/events.cfmReally hope Dexcom and MannKind form a partnership since Dexcom will be focusing a lot of time and resources into their type 2 programs with United Healthcare. I really think the two partnering would be a great thing, IMO. |
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Post by agedhippie on Jan 13, 2018 9:47:08 GMT -5
Real time is all very well but you should see what running a Dexcom G5 in real time mode does to your phones battery life! That is not even in real time but at 5 minute intervals. That sounds like they have some major glitch/bug in their software... or a problem with your particular phone's bluetooth. It is bluetooth used to connect phone to Dexcom, isn't it? From a technical standpoint there is no reason that collecting data once every 5 minutes should be a significant drain on battery. That was my thought as well. It makes a serious dent on an iPhone battery though. As well as collecting the data from the phone it also uploads the data so maybe it's keep the phone awake more than it otherwise would and not letting it fall back into deep sleep. |
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Post by agedhippie on Jan 13, 2018 9:50:38 GMT -5
That sounds like they have some major glitch/bug in their software... or a problem with your particular phone's bluetooth. It is bluetooth used to connect phone to Dexcom, isn't it? From a technical standpoint there is no reason that collecting data once every 5 minutes should be a significant drain on battery. Certainly there is no reason, as this is just transferring a few bits of data over a BT link for a millisecond... must be a beta DEMO version SW issue where they leave everything up and linked... That is possible as well. That was back in the early days. Reflecting I think it may have been more to do with the upload to the cloud side than the BT side. |
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