Dexcom CEO Talks: Product Differences, Cost Expectations, and Mental Health
Coverage of the American Diabetes Association (ADA) Scientific Sessions is brought to you by the ADA x BT1 Collab.
Beyond Type 1 sat down with Dexcom CEO, Kevin Sayer, during the American Diabetes Association’s (ADA) 82nd Annual Scientific Sessions. In this coverage, Sayer explains what’s new with the Dexcom G7, and shares cost expectations, affordability programming, and how Dexcom is helping to reduce the emotional burden of diabetes for patients.
Differences between the Dexcom G6 vs. G7
BT1: How does the Dexcom G7 differ from G6?
Kevin Sayer, Dexcom CEO: “Every single thing is different, from the angle of insertion to the algorithm to determine the glucose value based on the signal to every single manufactured part. The sensors, however, are pretty close to the same.”
“The (standard) app is different too. We’ve got the graph and icon we’ve always had, but at the same time, we have time in range data below. You can see 3, 7, 14, or 90-day time in range data. This gives users a picture of how they’re doing right on their phone. That was the most important additional stat we thought we could add to the app. It is a vastly different experience.”
A different insertion protocol: During this interview, Sayer demonstrated how the G7 is applied on the body. Unlike the G6, there is no transmitter, which he noted “often gets (unintentionally) thrown away by first-time users.” When you get your hands on the G7 insertion system, you simply twist off a cap, then push down with the insertion device on your body, and the sensor sticks via a pre-included adhesive.
It only takes 30 minutes to warm up. In addition to the 10-day wear period, Sayer shared there is a 12-hour grace period at the end of the sensor life that users can take advantage of. Within that 12-hour period, users will be alerted they need to change their sensor, but the sensor will still work. This is a valuable feature if you need to change your sensor overnight, Sayer explained.
BT1: What do you think users will find most valuable in the G7?
Sayer notes the G7 is “60 percent smaller than the G6—it’s smaller than a quarter, and a little bigger than a nickel. It’s very wearable. G7 is just that much easier.”
“The ease of use and instruction will be extremely easy for people going on a CGM for the first time. I can’t tell you how many times people throw the transmitter away after the first insertion. The performance of the G7 is rock solid.”
Cost expectations of the G7
Affordable access to diabetes technology like continuous glucose monitors (CGM) is a concern for many people. Dexcom anticipates the same coverage for the G7 as the G6 in Medicaid and Medicare programs. Concerning users with commercial health insurance, Sayer says Dexcom is “looking to keep costs and pricing consistent.”
BT1: What can Dexcom users expect the cost of the G7 to be?
Kevin Sayer, Dexcom CEO: “We’re not looking to sell this product at a premium. We want to get this product to as many people as we can.”
“When people think about Dexcom, one thing they don’t realize is that—on the commercial pharmacy side—30 percent of people who want Dexcom have zero co-pay. And 70 percent are paying equal to or lower than our closest competitor at their nearest drugstore. Yet, people sometimes have a perception that we’re high-priced, but we are very favorable. We work very hard to reduce individual burdens on pricing.”
BT1: CGMs are important for improving health outcomes in people with diabetes, yet many can’t access them due to cost. How will Dexcom address this burden with future products (G6, G7, Dexcom One)?
Kevin Sayer, Dexcom CEO: “There are a couple things we’re doing. Globally, we announced Dexcom One. It’s been launched in smaller countries in the Central Eastern Europe area, strictly as an e-commerce business, priced much lower than the G6. It’s a more simple software solution. ‘Share’ and ‘follow’ have been disabled, for example, and you can’t connect to other devices.”
“We’ve had a wonderful response to it in these countries. In the European market, CGM reimbursement is in two categories: patients in ‘higher risk’ categories, such as those on pumps or people who are hypo-unaware, and (category two) replacing CGMs with fingersticks. We haven’t played in that area because we’ve been largely identified as a product for those who want to control their blood sugar levels. Dexcom One falls into the other category. This lets us get it to the masses.”
“In the U.S., we’ve done a good job of trying to get our products covered through the reimbursement system. The big question becomes: ‘What do we want to do for someone who just wants to pay cash? How does that fix the problem for the underserved?’ It really doesn’t. Out of pocket, under most insurance plans, is less than the cash price would be with us if we were selling cash product.”
“The bigger problem, as far as access, isn’t so much access as it is awareness and perceptions. We run clinical studies through every metric you can imagine—it’s very intuitive for someone like me or you to think that someone could easily figure out Dexcom. But that’s not reality.”
Regarding access, Sayer and his team have learned paperwork stands in the way for providers: “Not everyone sees diabetes specialists,” Sayer said. “Non-diabetes specialists don’t always want to fill out the forms to help their patients get CGMs. One of my wife’s childhood friends who has type 2 diabetes…encountered this.”
“He went to his primary care doctor…and said he wanted Dexcom, and his doctor said he wouldn’t do it for him because he didn’t want to fill out the paperwork. We have to change these perceptions and keep working hard in the payer community to help get Dexcom covered.”
Sayer said Dexcom G7 doesn’t require much training, which helps address one form of accessibility.
BT1: Affordability is an issue for the diabetes community. What patient assistance or cost savings programs can people expect from Dexcom?
Kevin Sayer, Dexcom CEO: “There are some. We need to be mindful of this, and we can all do better as companies. The counter-argument to that is that we’re a public company—this is all we do. I have to report a lot on our financial statements. We have to have a good balance. I don’t think other companies do more than Dexcom does.”
“We’d always like to do more. Over time, I think you’ll see us do that. We’re a maturing, rapidly-growing business. We’ll get there. We have some good programs now, but I think you’ll see better over time.”
Integration with other devices
BT1: What will future integrations between the Dexcom G7 and other devices like insulin pumps and smart pens look like?
Kevin Sayer, Dexcom CEO: “Insulet and Tandem are both working on G7 integrations as we speak. I would expect the two of them to get out relatively quickly after we get G7 on the market, but it will take a while.”
“We’re also planning to integrate with Bluetooth pens from Novo and Lilly. We’ll have that integration down the road—not too far. We’ve always had an open-architecture approach.”
“As far as other devices, time will tell! It can get tricky when everything’s commercial. We have to ask ourselves: ‘What experience are we creating with our partners and products? Does that make sense to us?’”
Dexcom’s role in addressing the mental health burdens of diabetes
BT1: When we talk about the future of patient care, we think of connected devices but we also think of other important factors like empathy and personalization—the emotional side of diabetes. There’s a large mental health burden this community faces, especially with the state of the world we’re in.
How will Dexcom address the emotional side of diabetes, too?
Kevin Sayer, Dexcom CEO: “When you look at the emotional issues people with diabetes face, one of the worst things that can happen is when a device lets you down or produces unreliable data or is unreliable. But G7 will fit right within the niche we’ve built with G6 and amplify it—it will perform even better.”
“G7 is also smaller, and smaller—especially to young kids—is a very big deal. They don’t want to be identified by their diabetes. The size of G7 should be very helpful in their environment.”
“Another thing, over time, as we refine this experience, is anticipating—what makes an unsatisfactory experience? One of the most common complaints we hear is about signal loss. If we see, within your first 60 days of using our product if you’re a new customer, we now send people an email to notify them about that and give suggestions to resolve it.”
“Sensors also fail. Our app knows when sensors fail. We thought it would be much better if the app let you request a new sensor if it fails to reduce the emotional burden and prevent you from having to give us a call. That’s a major thing we’ve done over the years.”
“It sounds simple, but another thing is being able to get our products at the drugstore for pickup rather than traditional channels of distribution we’ve used. It makes a difference to be able to get it all in one place. All of these things add up.”