JPM Day One Afternoon Sessions

Since we’ve started a trend lets run with some of the non-business stuff before we get to the real point of this conference. While we haven’t quite figured out what the climate crisis has to do with healthcare a group of climate activists got into the conference for a very loud and thankfully very short protest. Guess the high cost of prescription medications are somehow contributing to global warming, who knew?

Next in the ultimate sign of hubris, actually we think its obnoxious, inside the Hilton is a vending machine that dispenses champagne. Yep according to a twitter post attendees can now celebrate the deals they make without waiting for the waiter to bring the champagne. The real bummer is not just this sends the wrong message but it’s pretty average champagne. Listen if the machine had Vue or Le Rev a great champagne from Domaine Carneros we’d get excited. However to dispense average champagne at what we are sure are crazy high prices is just obnoxious.

Ok onto business and the afternoon presentation from Verily. In a packed overflowing room Verily explained their foray into diabetes via their Google/Sanofi partnership OnDuo. Let’s state from the outset we believe Verily/OnDuo has their eyes set on the right market, patients with Type 2 diabetes. As we have noted many times while this is a much tougher nut to crack it’s a huge and untapped market.

Next we were a little surprised to learn that G7 from Dexcom which is an integral part of the Verily/OnDuo ecosystem contains an accelerometer, something that was not mentioned during the Dexcom presentation. It’s possible we we’re aware of this before but after a long day  we didn’t remember it.

We also liked the idea of a virtual clinic as the company correctly noted the many obstacles the patient faces when trying to get in front of their physician.

Here’s the hinky part, and we think hinky is a word, while the system gathers glucose and step data from the G7 and provides for easy consults with a physician, to gather food intake data the patient is supposed to take a selfie of the food they eat. Now we know this has become somewhat of social media thing with people constantly posting pictures of what they are eating but we can’t help but wonder how much this feature will be used after the novelty wears off. It’s one thing to post a picture of that huge steak you just ordered from Gibson’s, one of the best steakhouses in Chicago. Or another to post what Gibson’s considers a slice of cake, which is more like one huge cake. But seriously expecting patients to take pictures of everything they eat is just asking a little much.

Now we’re pretty sure all the non-diabetics will see this for what it is, way cool whiz bang. But for those of us who live each day with diabetes this is like a champagne vending machine, a little obnoxious. Granted this won’t matter much to the investment community as anything attached with Google is considered great and a sure fire winner. Never mind that just because a company is very good at one thing this in no ways means that they will be good at all things. Here in the Valley that axiom falls on deaf ears. Yep if it’s way cool whiz bang attached to Google or Apple it must be great even though when it comes to diabetes neither company has proven anything of substance.

One company that should be concerned with this way cool whiz bang platform is Livongo and not just because Verily has a ton more money. Nope as we anticipated Verily is not just targeting the same customers as Livongo they are also expanding into other chronic disease states, the same ones Livongo has added. Now we may be naïve but with a lower cost platform, much more capital at their disposal, the connection to Google and all the way cool whiz bang Livongo has every reason to worry. Frankly we think both OnDuo and Livongo should be worried as there is a ton of back chatter here about whether or not digital health is for real or not.

We hate to jump on our soap box but not every problem can be solved by way cool whiz bang technology. Yes technology can help no question about it but with diabetes in particular all this way cool whiz bang is way worthless if the patient does not use it, does not have access to it or doesn’t pay attention to it. What everyone here in the Valley believes is that technology can solve every problem on earth. However as Dexcom correctly pointed out during their presentation this morning here we are with the best technology, best drugs and still the majority of patients are not achieving anywhere close to good control.

Common sense would say that more way cool more whiz bang isn’t the answer but that would be logical and we can’t have any of that.