Money buys lots of things but not this

Money buys lots of things but not this

One of the more interesting phenomenon’s that takes place in our wacky world is how old ideas that didn’t work get recycled. No area has seen more of this than the quest to develop a non-invasive glucose monitor. Many consider this to be the Holy Grail of diabetes devices assuming that if patients did not have to stick themselves they would monitor their glucose regularly and by extension achieve better outcomes. Millions of dollars have spent on this quest and still nothing.

From the start our contention is that even if by some miracle this device became available it would do nothing to change patient outcomes. Our contention is that even if these readings could be gathered painlessly this is not why patients do not monitor their glucose regularly. The reality is most patients have no idea what these numbers mean and there is no action step taken after they get the number. Simply put the number has no value to the patient therefore why do it.

The entire world of interconnected diabetes management (IDM) is based on this. The goal of IDM is to transform data into patient relevant, patient actionable information. As we keep writing you can’t swing a dead cat without hitting a company that offers a way cool whiz bang cloud enabled meter.

Now that continuous glucose monitoring is becoming the standard for glucose measurement it makes perfect sense that the quest for the Holy Grail has been tweaked. Now the ultimate way cool whiz bang diabetes device would be a non-invasive continuous glucose monitor. Just as millions have been wasted on the original Holy Grail millions more have been wasted on this new Holy Grail. The landscape is littered with companies who have tried and failed.

Given that we have written extensively on this topic everyone should know how this works and it does not matter if it’s a conventional point to point non-invasive system or a continuous non-invasive system. A company comes up with a good “idea” and a great PowerPoint presentation. They go out and raise enough money to test this “idea” and the initial results are encouraging. Naturally the next step is to raise even more money. Yet somewhere along the way they discover the damn thing just doesn’t work so after bilking investors out of millions they close their doors only to reopen later under a new name and the process starts all over again.

Now one might just think that large well-respected companies would not fall into this trap. That they would perform their due diligence and avoid making large bets on a technology that just does not work. You could think that but you would be wrong. Johnson and Johnson (NYSE: JNJ) and GE are just two examples that quickly come to mind but the list is long and distinguished.

Still some very well-respected companies continue to fall into this trap the latest is none other than the maker of all things way cool whiz bang Apple. We’re not sure when Apple feel in but they did. The company went out and assembled an impressive team of experts on non-invasive technology, the best of the best. For years now the company has been working on this technology and even with all their money and talent they have some up with a big fat goose egg. But being Apple, they continue this pursuit of the Holy Grail.

Let’s just for moment assume that Apple can do what no else has been able to do and they discover the Holy Grail, what next? The belief is they would incorporate this technology into the Apple Watch or a separate wearable device that communicates with the iPhone. Naturally there would be an app that would transform all this data into patient relevant, patient actionable information and naturally the patient would achieve better outcomes. Oh, the happy dance that would ensue. That is until reality is attached to this fantasy.

First let’s look at the usability of this device. Although current versions of CGM technology must be worn on the patient’s body we see this as an advantage. A problem that is never discussed with any wearable device is that it must be worn and charged. Given that the newer sensors last for 7 or more days and transmit data to a smartphone they are more patient friendly. No need to make sure the wearable device is worn all the time or charged. What happens when they patient is not wearing the device? No data no analytics no nothing.

Second and this cannot be overstated but can this way cool whiz bang device be manufactured on a massive scale. As we have seen with the Libre from Abbott (NYSE: ABT) and the new Enlite sensor from Medtronic (NYSE: MDT) this is not easy.

Next comes another important point that also gets overlooked, will this device be reimbursed. Or what about an even simpler question, who would use it. As we keep stating the day is coming, especially with the newer sensors under development when CGM will transform from a tool used mostly by insulin patients to when ALL patients will use it. The difference being that non-insulin using patients would just use it differently than an insulin patient would.

Yet all these questions are mute as Apple must get the damn thing to work and so far even with all their talent and all their money they have been unbale to get around some very complex technical hurdles. What’s crazy here is so many people assume they will be successful just because they are Apple. It’s as if the rules don’t apply to them, that because they have talent and money they will eventually succeed.

Momma Kliff used to say that money buys lots of things but it can’t buy happiness. Well in the quest for the Holy Grail of diabetes devices money buys lots of things but it cannot overcome some extraordinarily complex technical issues.

Will this stop Apple and others from trying, nope. Like so many others who have tried and failed they have become enamored with the quest. They believe if successful it will lead to untold riches. Yet they like so many others have forgotten to ask the most basic question of all.

Do we really need the damn thing?