Have they learned anything?

The biggest question we have whenever we visit one of these toy fairs is have the companies in this wacky world of ours learned anything. Have they figured out that success in diabetes is not related to patient outcomes? Have they figured out that it’s not about the toys in the toy chest?

Interestingly it’s the drug companies who have learned the most. That as much as they would like it to be about who has the best therapy options win. They have resigned themselves to the fact that it’s the payor who controls their destiny. That in a commodity market it’s price/discounts/rebates and formulary position that matter. They don’t like it, more like hate it, but to their credit they accepted it and are dealing with it.

This doesn’t mean they will not continue to look for innovative new therapy options. Rather they will be more strategic and thoughtful about where they spend their money. Although we still wonder if our friends in France have received the memo and actually read it. As crazy as this may sound but Sanofi who’s not known for doing much well in diabetes, a company that seems to have the reverse Midas touch is going from bad to worse. And given how bad things were before that is saying something.

Looking at all the CGM and Insulin Pump wannabes they too haven’t read the memo. Just once we’d like one of these wannabes to tells us that yes their toy is whiz bang and way cool but that doesn’t matter and they are developing a commercial strategy to get this toy into the hands of patients. That they want to be a commercially viable toy company. That they don’t have to have the “best” toy. That they have to the best strategy, tactics and team to make money.

Perhaps the biggest failure is the continued clinical view of diabetes management. Seriously if we see one more study that says this drug or toy lowers HbA1c by X or that this drug or toy lowers the chances of hypoglycemia by Y we are going to go out of what’s left of our mind. Now let’s be clear here we are not saying these things aren’t important but they aren’t important to the people who really matter, payors and patients.

Payors care about money while patients care about simplicity. Payors want the lowest cost possible, patients want diabetes management simplified. Payors understand the power they have, patients unfortunately understand they are powerless. While payors are treated like King’s, patients are an after thought.

Frankly we aren’t sure if these companies began to understand that patients are CONSUMERS of healthcare that anything would change. That yes, diabetes is chronic disease but the people who have it and must manage it are CONSUMERS. Consumers who want to be treated with respect not talked down to. Consumers who will NOT respond to nor care about the clinical aspects of diabetes. Consumers who most of whom couldn’t even define outcomes let alone care about them.

Yes, there is a small percentage of patients who get it. Patients who are actively engaged with their diabetes management. Patients who care. BUT THIS IS THE MINORITY WITH AN OUTSIZED INFLUENCE ON THE COMPANIES HERE.

Now this is going to be shocking as we are about to say something nice about OneDrop, a company known for using fuzzy math when making outrageous outcomes claims. That the part that OneDrop does gets and gets very well is that these CONSUMERS respond very well to CONSTANT POSITIVE REINFORCEMENT. That it’s nice to be part of a community where the other members get it. OneDrop along with the many patient groups on social media demonstrate this clearly. Yet the companies that are supposed to cater to these CONSUMERS still don’t. They still look upon these CONSUMERS as patients.

This morning we get a detailed look at the new DASH system from Insulet, which on balance is major improvement over the old PDM. We were surprised to learn that the DASH does not communicate directly with the Dexcom G6 or the FreeStyle Libre. That the patient must manually enter the number they see on their phone or watch into the DASH. Hopefully this issue will be fixed in the very near future.

We were also surprised by the lack of allowing a CONSUMER to customize not just the DASH but many of the way cool whiz bang toys and apps here. Anyone with a smartphone gets this. Who hasn’t customized the wallpaper on their phone or added a friends picture to their profile so when they call this picture comes up. Wouldn’t it be nice if these CONSUMERS could put their picture on the PDM or chose which information to see on the home screen? This goes for any app or device these CONSUMERS use we aren’t trying to pick on the DASH.

Wouldn’t it be even nicer if the toy or app gave the CONSUMER a pat on the back when they do something good. What’s wrong with having a smiley face come up whenever the CONSUMER is in range. Or what about a message that says something like “David you’ve been a great job lately keep up the good work.” We don’t know a person on this planet who does not respond well to CONSTANT POSITIVE REINFORCEMENT.

These CONSUMERS are human. They are not clinicians, they are not physicians, they are not researchers THEY ARE HUMAN. They have feelings and emotions. They unfortunately have a chronic disease which requires regularly management which can be one big pain in the ass. They get little if any POSITIVE REINFORCEMENT.

So have the toy makers learned anything unfortunately no.