Why BGM Failed

Why BGM Failed

As the conventional blood glucose monitoring (BGM) market continues its death spiral into oblivion it amazes Diabetic Investor how many companies are trying to build a better mousetrap. As we predicted Google’s recent disclosure that they were working on contact lenses to measure glucose levels received widespread attention as once again the mainstream media focused on the way cool technology rather the practical realities of the BGM market. Just the other day a story was posted on the DiabetesMine blog regarding a device that measures glucose levels using a patient’s saliva. Again the focus was on the way cool technology.

Perhaps it would be wise if Google and everyone else who seems to think they can build a better mouse trap to take a look at the real reason why the conventional BGM failed as this history lesson could well influence how they move forward. Now many will point competitive bidding as the reason why BGM failed but as we have noted in the past competitive bidding is not the main reason for BGM’s failure. The fact is the competitive bidding merely hastened the markets demise it did not cause the market to fail.

The true reason the BGM market failed was the destruction of value, the focus on the collection of data. Take a walk through time and look at all the advancements in BGM technology, more accurate test results, smaller blood samples, alternate site testing, faster test results and meters that allowed patients to transfer readings to a patients PC or smartphone. There is no question that while far from perfect meters today are light years ahead of where they were just a few years ago. Still for all these advancements in BGM technology one fact remains unchanged; average daily testing frequency hasn’t increased remaining at less than two tests per day per patient. Even more distributing is the fact that a growing majority of patients, particularly those who do not use insulin, aren’t testing at all.

Now some will note that the reasons patients don’t test as frequently as they should or worse don’t test at all is because testing is still too complex and painful. This is argument advanced by the companies who continue to believe in the Holy Grail – a true non-invasive glucose monitor. The theory has always been that if testing wasn’t painful, if the patient did not have to prick their finger to draw a blood sample patients would test more regularly. Considering that no one has successfully developed or commercialized a true non-invasive glucose monitor we cannot completely dismiss the theories these companies continue to advance. However Diabetic Investor has long maintained that even if such a system would become available average testing frequency would remain where it has stood for the past several years.

Why, because like the new mousetraps being built today the focus is on the collection of data rather than what this data means to the patient. This is reason BGM failed as the focus has always been on the collection of data, making it easier for the patient to get a number. BGM companies never took the next logical step once they made the act of performing the test easier, they never educated the patient on what do with this data, how to apply this data point. Simply put for the majority of patients the test result became a meaningless data point as there was no action step to take after the test was performed and no corresponding positive impact on their diabetes management.

While Diabetic Investor is delighted to see that meters can now transmit data easily to the cloud, where in theory a patient’s healthcare team can see and analyze this data therefore helping the patient better manage their diabetes, these systems by and large are expensive and not platform agnostic. BGM still haven’t learned that while the iPhone is way cool and very popular, there are more Android systems on the market.

Yet it is still somewhat of a fantasy to believe that even if this newer systems where platform agnostic and affordable that we’d see a change in average testing frequency. The simple fact is someone has to pay for the data analytics. Yes it is true that software can perform some analytical functions but software doesn’t know when or if a patient is taking their meds, how much they’ve had to eat, etc.  While it is true the patient can enter this information manually but this adds to rather detracts from the patients daily burden. Yet even if the all the data is collected easily, this does not solve the fundamental problem of who will pay for the data analytics.

Ironically this would not be a problem had the BGM companies done their job in the first place, had they spent just a fraction of what they did on whiz bang useless technology on patient education. There are literally hundreds of studies that prove conclusively that the most effective method for increasing average testing frequency is not making collecting the data easier rather the most effective method is patient education. As the old saying goes; give a hungry man a fish you feed him for a day, teach a hunger man how to fish and you feed him for a lifetime. The fact is BGM companies were focused on giving patients whiz band technology not educating them as to how this technology would improve their lives.

Ultimately this is why the BGM market is in a death spiral. The focus has been and continues to be on the collection of data, not what to do with the data once it is collected. Is there anyone who seriously believes that patients would not use their meters more frequently if they viewed their meters as actually helping make their lives better. The curse and ultimate failure of the BGM market is it’s always been about getting the data and not about what how valuable this data is and how it can be used to help patients better manage their diabetes.