{"id":50724,"date":"2019-07-12T10:47:26","date_gmt":"2019-07-12T14:47:26","guid":{"rendered":"https:\/\/asweetlife.org\/?p=50724"},"modified":"2019-07-16T16:18:55","modified_gmt":"2019-07-16T20:18:55","slug":"the-dexcom-interview-part-2-introducing-the-dexcom-g7","status":"publish","type":"post","link":"https:\/\/asweetlife.org\/?p=50724","title":{"rendered":"The Dexcom Interview, Part 2: Introducing the Dexcom G7"},"content":{"rendered":"<p><em><strong>\u201cVery few companies would make the bet that we\u2019re making,&#8221; Kevin Sayer.<\/strong><\/em><\/p>\n<p>In the <a href=\"https:\/\/asweetlife.org\/the-dexcom-interview-part-1-standard-of-care\/\">first half of our interview<\/a> with Dexcom CEO Kevin Sayer, we focused on the company\u2019s efforts to expand beyond the Type 1 diabetes community and tap into the much larger Type 2 and pre-diabetes markets. To pull that off, they\u2019ll need to convince insurers that even people with no risk for hypoglycemia can greatly benefit from a continuous glucose monitor (CGM), primarily by the feedback the system can offer regarding diet choices and pharmaceutical dosing. And in all likelihood, they\u2019ll need to make it more accessible, less expensive, and even easier to use.<\/p>\n<figure id=\"attachment_50735\" aria-describedby=\"caption-attachment-50735\" style=\"width: 200px\" class=\"wp-caption alignright\"><img decoding=\"async\" class=\"wp-image-50735 size-medium lazyload\" src=\"data:image\/gif;base64,R0lGODlhAQABAAAAACH5BAEKAAEALAAAAAABAAEAAAICTAEAOw==\" data-src=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-200x300.jpg\" alt=\"Kevin Sayer Headshot\" width=\"200\" height=\"300\" data-sizes=\"auto\" data-srcset=\"https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-200x300.jpg 200w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-683x1024.jpg 683w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-768x1152.jpg 768w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-1024x1536.jpg 1024w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-1365x2048.jpg 1365w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1-600x900.jpg 600w, https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/KevinSayer_ExecHeadshots_CloseUp_Final-1.jpg 1600w\" sizes=\"(max-width: 200px) 100vw, 200px\" \/><figcaption id=\"caption-attachment-50735\" class=\"wp-caption-text\">Kevin Sayer<\/figcaption><\/figure>\n<p>I really wanted to talk about the upcoming Dexcom G7 system, but Sayer wanted first to make sure I understood that they are not at all done improving the G6.<\/p>\n<p>\u201cBefore I get to the G7 let me talk about <a href=\"https:\/\/asweetlife.org\/first-look-at-dexcoms-g6-cgm\/\">the G6<\/a> for a little bit. This product\u2019s only been out for a year, and the response to this product has been overwhelming. We will continue to make the G6 system better.<\/p>\n<p>\u201cWe realized tremendous improvements on the G4 and G5 systems when we upgraded the algorithm. We have developed upgraded algorithms that we can and more than likely will move into G6 to continue to make that better. We\u2019re also going to continue to upgrade the app on the G6. And to make it better as well. So we\u2019re not done with the G6.\u201d<\/p>\n<p>Indeed, Dexcom continues to announce new collaborations with other firms that will enhance the G6\u2019s functionality. In the past year, Dexcom acquired diabetes management system TypeZero and announced partnerships with several other firms to increase the system\u2019s interoperability. And continually improving accuracy is a constant goal with the company, Sayer assured me.<\/p>\n<p>\u201cAll these features we\u2019re putting into the G6 are going into the G7, because the G7 is not a change of the algorithms or app experience, it\u2019s a completely physical change.<\/p>\n<p>\u201cThe insertion will be actually easier than G6. The transmitter will be disposable. The sensor is significantly smaller than the G6. We have committed internally to an extended life of up to 14 or 15 days. It is designed to be manufactured at mass volumes. Our hope is that, over time, it will be a cost-saving endeavor, that it\u2019ll actually save money.<\/p>\n<p>\u201cVery few companies would make the bet that we\u2019re making. For the first 12 years of Dexcom\u2019s commercial life, the insertion system and all of the hardware and all of the parts, they were pretty much the same. We didn\u2019t make any big changes. When we went to the G6, the molds, the plastics, the springs, everything was completely different. When we go to the G7, we\u2019re doing the same thing again. We\u2019re doing something that we waited 12 years to do before, in three. Having the courage and the determination to do something like that, you don\u2019t see that at big companies. G7 is a bigger departure from G6 than G6 was from G5.\u201d<\/p>\n<p>The cost of the G6, of course, is still prohibitive for many. Sayer promises that they are trying to bring the price down, and I asked him how he\u2019d accomplish that:<\/p>\n<p>\u201cOne of the easiest ways to bring the cost down is to make the model for getting sensors to people easier. If we can make this product a one stop shop where you can pick it up at the drug store, or you can get it easily through a mail-order distribution channel, that removes a lot of burden on us here at Dexcom, because that\u2019s a big operating expense. Not only just to get the product to patients but we need to bill and collect payment from the insurance companies, we have to collect the money from patients, insurance companies may not pay the same amount and you have to follow up. If we can simplify the business model, that\u2019s one way costs can go down.<\/p>\n<p>\u201cThe other way costs come down over the next several years, we are designing future products \u2013 and in all candor, we even designed the G6 this way \u2013 to be less expensive on a cost per day per patient than our previous product offerings.<\/p>\n<p>\u201cWe try and be as fair as we possibly can, and one of the reasons the sensors cost more is that it\u2019s not necessarily our cost that\u2019s gone up, it\u2019s the insurance plans have changed. You know many patients now are on high deductible plans and we can\u2019t control or fix that and even if we reduce costs, that isn\u2019t going to reduce costs for those patients, because they have an insurance plan that makes it difficult.\u201d<\/p>\n<p>Sayer also indicated that T1D\u2019s might benefit from some horse trading with the insurers:<\/p>\n<p>\u201cIt is not as simple as just going into the insurance companies and saying \u2018we\u2019d like to cut out prices.\u2019 There are tradeoffs. If we\u2019re going to reduce price on our product we\u2019d like to get something back, like, let\u2019s cover the Type 2 insulin users. And so these are negotiations like any business transaction.\u201d<\/p>\n<p>When I asked Sayer if he had ever envisioned selling different models at different price points, his answer helped underline the complexity of the market:<\/p>\n<p>\u201cI could see that happening. We could also do that just by selling the same product and having a different software app. Where this gets difficult again is back to the people who pay. How do you determine who gets the more advanced feature one versus who gets the basic one? And if you set a low price for a basic one, is the insurance company going to pay the rest on the full feature one?\u201d<\/p>\n<p>The subject of cost led naturally to talk about the various ways in which Dexcom users hack their systems. Undoubtedly, even many enthusiastic Dexcom users could not afford the technology if they were unable to illicitly extend the life of their sensors.<\/p>\n<p>\u201cOur best answer on the length of wear is to answer that in two ways. To make our sensor last longer, and to make it less expensive.\u201d<\/p>\n<p>I also asked Sayer what he thought about the hacker community modifying Dexcom CGMs and using them to build DIY artificial pancreases.<\/p>\n<p>\u201cWell, we think about in a number of ways.<\/p>\n<p>\u201cYou\u2019ve got to understand, medical device companies and hacking, those two concepts don\u2019t go together well. So we were very upset and we were pretty aggressive speaking out that this is not a good thing.<\/p>\n<p>\u201cBut in all reality, the hackers are Dexcom patients. They purchase product from us, they\u2019re so dedicated to it that they use it and try to make their lives better by developing tools that they think are better than ours. The right answer for this community is to put the features into the system that they want to make it better and make it more usable for them. We have ideas to help this community and ideas to embrace and engage them.<\/p>\n<p>\u201cNow let\u2019s go to the flipside of that. The FDA is concerned about this and they\u2019re going to regulate this. I see a day where, maybe not of our own choice, we will have to tighten up our product to whereby that doesn\u2019t happen. And if FDA requires it, we will.&#8221;<\/p>\n<p>As a final question, I asked Sayer for his perspective \u2013 as an expert in a related field \u2013 on the insulin price crisis.<\/p>\n<p>\u201cI just think it\u2019s amazing that somebody cannot have access to something they need to stay alive easily. Let me just start there. It\u2019s foreign to me, I can\u2019t understand it.<\/p>\n<p>\u201cThat being said, this is not the <a href=\"https:\/\/asweetlife.org\/at-eli-lilly-headquarters-diabetes-advocates-will-demonstrate-for-affordable-insulin\/\">insulin companies&#8217; fault<\/a> \u2013 not completely. There\u2019s a lot of middlemen and a lot of stuff that happens by the time insulin gets into your hands. And we have a system that is designed where everybody makes more money if the price is higher: the drug store, the distributor, the pharmacy benefit manager, the insulin company, even the insurance company, because they get bigger rebates. Think about that. I believe that if people knew how much net the insulin companies actually received when it\u2019s all said and done, they\u2019d be shocked. And even when they try and sell a lower cost alternative for cash it doesn\u2019t fit in the system and it doesn\u2019t work either.<\/p>\n<p>\u201cI can\u2019t wait to see it play out. I think it\u2019s something that needs to be addressed across the board, more than just insulin.<\/p>\n<p><strong><em>ASweetLife is a nonprofit publication. If you appreciate our work, please consider <a href=\"https:\/\/diabetesmediafoundation.org\/donate\">making a donation<\/a>\u00a0so we can continue to bring you the most up to date diabetes stories.<\/em><\/strong><\/p>\n","protected":false},"excerpt":{"rendered":"<p>&hellip;<\/p>\n","protected":false},"author":437,"featured_media":50744,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"image","meta":{"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[1437],"tags":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v22.9 (Yoast SEO v22.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>The Dexcom Interview, Part 2: Introducing the Dexcom G7 | ASweetLife<\/title>\n<meta name=\"description\" content=\"I wanted to talk about the upcoming Dexcom G7 system, but Sayer wanted first to make sure I understood that they are not at all done improving the G6.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/asweetlife.org\/?p=50724\" \/>\n<meta name=\"twitter:label1\" content=\"Written by\" \/>\n\t<meta name=\"twitter:data1\" content=\"Ross Wollen\" \/>\n\t<meta name=\"twitter:label2\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data2\" content=\"7 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/asweetlife.org\/?p=50724\",\"url\":\"https:\/\/asweetlife.org\/?p=50724\",\"name\":\"The Dexcom Interview, Part 2: Introducing the Dexcom G7 | ASweetLife\",\"isPartOf\":{\"@id\":\"https:\/\/asweetlife.org\/#website\"},\"primaryImageOfPage\":{\"@id\":\"https:\/\/asweetlife.org\/?p=50724#primaryimage\"},\"image\":{\"@id\":\"https:\/\/asweetlife.org\/?p=50724#primaryimage\"},\"thumbnailUrl\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/Dexcom-G7-Verily.png\",\"datePublished\":\"2019-07-12T14:47:26+00:00\",\"dateModified\":\"2019-07-16T20:18:55+00:00\",\"author\":{\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/dad5417f3e14b1fd142730c7fa616283\"},\"description\":\"I wanted to talk about the upcoming Dexcom G7 system, but Sayer wanted first to make sure I understood that they are not at all done improving the G6.\",\"breadcrumb\":{\"@id\":\"https:\/\/asweetlife.org\/?p=50724#breadcrumb\"},\"inLanguage\":\"en-US\",\"potentialAction\":[{\"@type\":\"ReadAction\",\"target\":[\"https:\/\/asweetlife.org\/?p=50724\"]}]},{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/asweetlife.org\/?p=50724#primaryimage\",\"url\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/Dexcom-G7-Verily.png\",\"contentUrl\":\"https:\/\/asweetlife.org\/wp-content\/uploads\/2019\/07\/Dexcom-G7-Verily.png\",\"width\":1485,\"height\":979,\"caption\":\"Dexcom - G7 Verily\"},{\"@type\":\"BreadcrumbList\",\"@id\":\"https:\/\/asweetlife.org\/?p=50724#breadcrumb\",\"itemListElement\":[{\"@type\":\"ListItem\",\"position\":1,\"name\":\"Home\",\"item\":\"https:\/\/asweetlife.org\/\"},{\"@type\":\"ListItem\",\"position\":2,\"name\":\"The Dexcom Interview, Part 2: Introducing the Dexcom G7\"}]},{\"@type\":\"WebSite\",\"@id\":\"https:\/\/asweetlife.org\/#website\",\"url\":\"https:\/\/asweetlife.org\/\",\"name\":\"ASweetLife\",\"description\":\"The Diabetes Magazine\",\"potentialAction\":[{\"@type\":\"SearchAction\",\"target\":{\"@type\":\"EntryPoint\",\"urlTemplate\":\"https:\/\/asweetlife.org\/?s={search_term_string}\"},\"query-input\":\"required name=search_term_string\"}],\"inLanguage\":\"en-US\"},{\"@type\":\"Person\",\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/dad5417f3e14b1fd142730c7fa616283\",\"name\":\"Ross Wollen\",\"image\":{\"@type\":\"ImageObject\",\"inLanguage\":\"en-US\",\"@id\":\"https:\/\/asweetlife.org\/#\/schema\/person\/image\/\",\"url\":\"https:\/\/secure.gravatar.com\/avatar\/3baf28ef14013e66fec763fe108e4bff?s=96&d=mm&r=g\",\"contentUrl\":\"https:\/\/secure.gravatar.com\/avatar\/3baf28ef14013e66fec763fe108e4bff?s=96&d=mm&r=g\",\"caption\":\"Ross Wollen\"},\"description\":\"Ross Wollen is a chef and writer based in Maine's Midcoast region. 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