Finally the patient is winning

Just to prove to everyone that we are not constantly cynical nor a cold hearted unfeeling bastard who has nothing better to do than wax poetic about the exploits of broom Hilda, we did find several positives coming out of this years conference so let’s get right to it;

1. The patient at long last is the biggest winner of all, insulin using patients the biggest winner as the day is quickly approaching when all the insulin using patient will need to do is decide how they want their insulin delivered. Everything else all the decision making all the heavy lifting much of the burden will be done by the app which talks with the CGM.

But we cannot ignore the strides for non-insulin using patients whether it be the growing options in the GLP-1 space or more sophisticated orals.

The reality is we now have some of the best drugs and devices and there is even more on the horizon. This is excellent news and even better that patients will win.

2. The conference itself was upbeat and this we find refreshing. Having been to over 20 of these events we have seen everything from over the top jubilation to outright depressing. There was a positive spirit on the floor and generally the attendees seemed happy. Maybe it was the outstanding weather but we think there’s more to it as business is good and looking to get better.

3. Although none of the drug companies here will admit it they actually owe a debt of gratitude to that crusading cardiologist Dr. Steven Nissen. All the studies now being run regarding cardiovascular impact, prevention of renal impairment, etc. are being done because of the Avandia controversy. Although Dr. Nissen was wrong about Avandia his crusade is responsible for these new studies. It may be the law of unintended consequences but as Momma Kliff says sometimes good does come out of bad.

4. As far as winners and losers go we need to break that down by category as really there was no winner of best in show although Dexcom came pretty damn close. Insulet won the insulin pump category as they stayed above the fray of the growing fight between Medtronic and Tandem, showed good data with Horizon and have a nifty advantage over both Medtronic and Tandem with their pharmacy benefit as opposed to DME approach.

A quick word here to all the Medtronic folk get it through your stubborn thick skulls there is no way in hell that calibrating a sensor is a good thing and better for the patient. The calibration train left the station long ago and the sooner you jump on this train the better.

We’d have to call it a draw between Lilly and Novo Nordisk the two diabetes drug heavyweights, as each made a compelling case for their current and/or new offerings. Even with all the great data for the oral version of semaglutide our concerns about it’s complex dosing regimen remain. We are also concerned that their connected pen launched and then recalled in Sweden will slow their entry into the Tyler market but alias Lilly’s Tyler effort isn’t going much better. Perhaps at some point these companies will realize that getting Tyler to market first is more important than whether Tyler came out of their wombs.

There are plenty of Tyler companies, Companion being one Common Sensing being another who’d be happy to do a deal or be acquired.

Not sure we could call Livongo a winner or loser but damn everyone wants to see their S-1 as no one believes they are making any money and likely losing millions. Yet in true Livongo fashion check this out;

“Research: Livongo for Diabetes Program Improved Diabetes Distress Levels

Livongo, an Applied Health Signals company empowering people with chronic conditions to live better and healthier lives, today announced the findings of a study conducted in collaboration with Eli Lilly and Company that demonstrated 94 percent of Livongo program Members who participated in a program survey achieved improved Diabetes Empowerment Scale-Short Form (DES-SF) or Diabetes Distress Scale 2 (DDS2) in year one.”

Now we hate say this is meaningless “study” merely designed to keep the company in the news but that’s exactly what it is and yep investors are going to eat this stuff up. Listen we give the team at Livongo a ton of credit as they know how to take full advantage of an opportunity, they understand that digital health is the hottest thing going and although they don’t have a long term sustainable business model best to strike the iron when the iron is hot. So Kudos to the Livongo team for not missing their window to enrich management and investors.

This didn’t happen at the show at least not to our knowledge but its being reported that Dance Pharma has raised more money in their quest to be the next MannKind. Now we aren’t quite sure why anyone would want to be a MannKind in the first place but heaven knows we don’t need two of them. Inhaled insulin as good as Afrezza is, is nothing more than a niche product and MannKind after all their ups and downs is doing a pretty good job with it.

We don’t need another inhaled insulin even if it’s cheaper, fat chance, better than Afrezza, fatter chance and has a more patient friendly connected delivery device, who the hell cares.

Listen if investors want to throw money into a diabetes company that has no long term prospects but will make these investors a boatload of money, invest In Livongo. Livongo may be an old idea put in a shiny new box but it looks really good in that box and it’s in the hottest space going digital health.

So there you have it another ADA in the books and a good one to boot. See everyone next year in the city with the big shoulders.