Coming out of the woodwork

Coming out of the woodwork

Ok so now we have a bunch of companies collecting data and then sending that data to the cloud. Yet as everyone knows getting the data to the cloud is the easy part. For this data to be truly transformative it must be analyzed so that the patient not just understands what all these numbers mean but how this data can used. Simply put data without action is worthless, data which leads to action is transformative.

Recently Diabetic Investor has run across a few companies who believe that patients will pay a fee for this privilege. The question is will patients actually pay for this privilege?

The answer like everything else when it comes to interconnected diabetes management (IDM) isn’t clear. As we have noted in the past IDM has the most immediate impact on insulin using patients, in particular those following multiple daily injection (MDI) therapy. These patients can take immediate action based on information that is transmitted back to them. Yet on the flip side patients using oral medications, a combination of orals and insulin or those on GLP-1 therapy the information transmitted back to them is not immediately actionable.

Let’s look at each group non-MDI group.

Patients using orals alone or orals plus insulin can make changes to their lifestyle, what they eat and whether they exercise or not. However changing their therapy regimen isn’t as easy as these changes require intervention with their physician. Yes the data may reveal their current therapy regimen is not yielding the desired outcomes but the physician must not only concur with this analysis but then make changes to the patient’s therapy regimen. Now this may sound prudent yet this fails to take into account the patients’ health coverage as it may or may not allow for the recommended changes or these changes may require the patient to pay more out of pocket.

The problem with patients using a GLP-1 are twofold. First given the nature of GLP-1 therapy there is no need for these patients to monitor their glucose levels regularly. Yes should they, of course, however in the real world this just isn’t practical. Simply put without data to analyze there is nothing to transmit back.

Secondarily GLP-1 therapy is very effective so there is little incentive for the patient to gather data. The fact is physicians will use HbA1c as their metric for measuring outcomes rather than daily glucose readings.

This quest for what could also be called personalized medicine is linked directly to patients following MDI therapy. It is these patients who can take immediate action based on the information provided to them.

Now all this could change when outcomes truly matter, where the patient is incentivized to achieve better outcomes. Let’s say that Diabetic Investor is correct and one day patients will purchase health coverage much like they do auto insurance today, where they are incentivized with lower premiums for safer driving habits. Habits which can be monitored by a device that is attached to a car. As we have noted all along the exact same principle applies to patients with diabetes. These patients could see lower premiums, co-payments or deductibles based on their health data which is easily obtainable. Given that there is a general consensus of what constitutes good control it is not outside the realm of possibility that a patient following good diabetes management will be rewarded based on the data that is collected.

To put it simply when outcomes impact the patient where it counts, their bank account, they just might be willing to pay a professional for help. Just as people who quit smoking are rewarded with lower premiums so too could patients with diabetes who achieve better outcomes. While some people can quit without any outside assistance many can and do pay good money for smoking cessation products.

Now here is where things get a little wacky, which is par for the course with IDM. Let’s say the patient isn’t the only party who will be receive a bonus for achieving better outcomes.  Let’s say that the patient’s physician, pharmacist, employer or health insurance provider would also get a piece of the pie. Would it not make sense then for these patient assistance programs to be given away for free by those who would benefit?

Take a look at the corporate health and wellness world just by way of example. These programs are exploding as employers can and do draw a straight line between better employee health and lower healthcare costs. Employers know that for their employees with diabetes these savings are significant, as research shows employers can save $3,500 per year per employee by getting their employees with diabetes under good control. They also know that these employees will be more productive as according to the American Diabetes Association (ADA) the average male employee misses 9 days of work due to their diabetes and 11 days for their female employees with diabetes.

Simply put good diabetes management is very good to the bottom line for employers.

This is one reason Diabetic Investor isn’t so sure that enough patients with diabetes will actually pay for help. That these programs as effective as they are will likely be provided to them at no cost. Once again this shows the difference between a good idea and commercially successful business. These program are great we’re just not convinced that as things stand today patients will reach into their wallet and pay for them. Only when good diabetes management impacts their wallet will this happen.