G6, is anyone an early user?

[DynaGlide]

On the topic of mandatory upgrading to G6. .I just ordered a G5 yesterday, and asked my sales rep at Solara Medical on multiple occasions.

Q: I just want to confirm that when the G6 is released I will not be forced to switch and that I will be allowed to stay with the G5 sensors/transmitters?

A: I checked with my supervisor again, on the question about if you HAVE to upgrade to the G6. I was told no again,

The Tandem x-2 Pump is compatible with the G5 Dexcom
Medicare is not up-grading to G6 at this time
all supplies will still be available

This may change when ordering direct but it seems for me at least that I will be allowed to stay with the G5 for quite some time.

[meee]

So the inserter is bulkier? I thought so, what a bunch of idiots! How am I going to carry all this crap in my purse? Is the inserter needle bigger too, or the same? They told me they were designing a smaller inserter with a smaller needle, all a bunch of lies.

[meee]

Solara and my insurance automatically sent me the awful touch screen receiver without consulting me so I don’t trust them at all.

[Terry4]

Regarding the not-so-eco friendly G6 inserter, I believe it came about to address the concerns of people with needle-phobia. I am fortunately not impacted with fear of needles but it it’s a real concern for some.

The other trade-off that Dexcom made with the G6 was to design for zero calibrations, but then Dexcom says that led to a required mandatory 10-day sensor life limit.

I guess there is no free lunch!

[Dave44]

Whoa! Calm down! A G5 sensor in it’s package is hardly a miracle of miniaturization itself. A G5 is hardly going to get lost in your purse. Why not wait until you can see a G6 for your self before getting all upset?.

[Dave44]

I can’t imagine being T1 and needle-phobic. I can’t wrap my head around that conundrum. I only hated needles for about the first year. Now I could stick a syringe into me 20 times in a few moments without hesitation.

[Tim35]

@Terry4

Regarding the not-so-eco friendly G6 inserter, I believe it came about to address the concerns of people with needle-phobia. I am fortunately not impacted with fear of needles but it it’s a real concern for some.

I think it is more about the clunkyness of using the old inserter coupled with the pain/discomfort of the old inserter.
And before everybody starts saying about how the old one doesn’t hurt…

Wait until you use the new inserter and then compare the two.

[El_Ver]

@Terry4 Thank you for that tidbit of info! Due to my Tandem pump I may not have to upgrade for another 3 years of your information is correct. Thanks. @Terry4! Best day ever!

[Tim35]

@El_Ver
Do you have the original t:slim or the X2?

[BK1112]

Why, for the love of God, would you need to carry a new sensor in your purse or replace it immediately after the expiration/failure? No way to survive your trip back home? Jeez… I remember the days, only a few years ago when people tested 3-4 times a day, at most, and still survived.

[Tim35]

Couple items from the call which may be of some interest.
Clips taken from various places so without the context of the conversation around them.

… we are offering an upgrade program by which customers who purchase two G5 transmitters during the upgrade window will be able to get a free G6 transmitter when available …

We’re still very, very early in the process, which is frankly why we’re remaining conservative when we’re building our guidance and assuming basically static sensor pricing, right? So if we have an ASP on Gen 5 of around $70 a sensor, for modeling and for guidance purposes we’re going to maintain that. We’ve had some early successes in a few places where we have direct-to-commercial contracts where, as Kevin mentioned, the labeled price per day for a 7 day sensor for a G5 has translated into something higher on the label basis for G6. But it’s very, very early.

Just to be clear, we didn’t say that we’ve made the decision to bring sensor pricing down. What we said is for purposes of our guidance and our internal modeling, we’re assuming that average revenue per patient per year remains static.

We’ve already filed with CMS for Medicare, so that should come sometime in the fall. And we’ll be able to move those patients over, but that pricing isn’t going to change from G5 to G6.

What I’d add on the 14-day sensor, and we’re shooting for 14-day sensors and we’ve done that for a long time, that’s something that we’ve heard from patients for a long time, that they would like to wear fewer sensors.

And while we’re confident in our system that 14 days will perform well enough, we haven’t run the study yet and we need to see how the data looks. We’re very comfortable with where we are with 10. We will need to run a study at the 14 days.

DexCom is really helpful to patients with respect to warranty. If that sensor falls off at day four, we’ve shipped you a new one every time.

I would tell you the thing that I have heard the most about is the insertion system and the ease of use. Every text message I’ve got from a person in the limited launch study, is focused conveniently on the insertion device. They love no calibration also. They say that’s very awesome. But the insertion of this system and the ease-of-use is such a step-up. It’s almost indescribable.

With this device, it is push a button. We saw a video of a child who put on their first G6 today, and she hit the button and said, I don’t feel anything. Is it on? And it was.

With respect to receiver optional, we’re now putting plans together to get that filed. And that really consists of a lot of risk mitigation and human factor study. It’s very apparent FDA is willing to go there, and so we’re contemplating that here now. We’ve had great success with that program in Europe, less than about 40% of our patients even where we have reimbursement are purchasing receivers.

With respect to Medicare and the share function, let me tell you, we work at it diligently. We are writing letters. We’re engaged politically. We meet with CMS on a regular basis. We are hoping to resolve that by the end of the quarter. But I will tell you the commitment I made on behalf of our team to the Medicare population. If we can’t get this resolved, we’ll come up with a Medicare configuration in our product portfolio that does. We’re not going to let seniors go without share. It is absolutely too important to them to have it, and it’s important to their infrastructure and diabetes ecosystem. So I’m really hopeful I have a positive announcement on the next call.

Full transcript with everything in context:
https://seekingalpha.com/article/4168949-dexcom-dxcm-q1-2018-results-earnings-call-transcript?part=single

[Thas]

@Dave44

I can’t imagine being T1 and needle-phobic.

I can – and am, though I work thru it out of necessity. Knowing the fact that these needles do not (usually) hurt doesn’t help, either. And, yes, I’ve encountered people with T1 who are more seriously needle-phobic than I am.

(I still have a /very/ hard time when I have to get blood drawn at the lab, though I haven’t actually passed out… lately.)

[Thas]

@Tim35

I think it is more about the clunkyness of using the old inserter coupled with the pain/discomfort of the old inserter.

Maybe I’m super-agile (I am not!) but I’ve never found it particularly clunky. In fact, my current sensor is on the far backside of my arm and I had zero trouble inserting it - though I find it a bit of a feat to apply extra tape, like Opsite Flexifix to it…). Never had much of any pain from the insertions, either – maybe once or twice, but on those occasions the insertion was in fact bad - bent, or otherwise non-working sensors - which was probably ‘indicated’ to me by the pain.

[El_Ver]

@Tim35, I have the X2.

[DrBB]

@meee

So the inserter is bulkier?

It looks more or less identical to the Medtronic one. In my experience the Mdt “Serter” (stupid name) works fine, but the big issue isn’t waste stream–if this one works like the MdT one, it’s indefinitely re-usable, not something you discard every time. My problem with the Serter is that it’s another fairly bulky piece of paraphernalia you have to tote around with your other pile of D gear when you travel. Even if you don’t have a sensor change expected in the time you’re going to be away–even if it’s just overnight–you still have to cart all this stuff with you in case something craps out.

For me personally, the simplicity of the existing Dexcom insertion system is a major advantage over the Guardian setup with its kludgy over-taping and all. But I can see where a system that hides all that scary needle stuff is a huge benefit for parents & kids.

ETA: correction–the inserter is NOT reusable, unlike the MedT one.

[Dave44]

I hardly notice it when I get a blood test. The needles are so small compared to what they were years ago. So when I was a little kid and the needles were bigger, then yes, it hurt oftentimes.

[Lisa_Craig]

The giant inserter—that is NOT reusable—could be a deal breaker for me. I have never used a CGM and range between 6.0 and 6.8 for years with no complications at the 40-year mark. Carrying a big, bulky item is one thing; disposing of it is another. They must design for the lowest denominator who demand automatic.

[Dave44]

what do you mean by “disposing of it is another”? that’s what trash receptacles are for. And “they must”?? really?

[Lisa_Craig]

We generate too much trash and medical waste. Even if each inserter is recyclable (are they?) I don’t see why they can’t be reusable.

Would you prefer I say, “perhaps, they design for a demand for ease”?

[DrBB]

Excuse me if this is already posted–I looked but didn’t see it on this thread. It’s the Beyond T1 G6 demo, which does show among other things that the sensors come already mounted in their inserters (or “applicator”), so yeah, that’s a disposable item, not re-usable as I thought, based on it’s visual similarity to the MedT “Serter.”