The future of Dexcom with CEO Kevin Sayer

WRITTEN BY: Todd Boudreaux

Beyond Type 1 last spoke with Dexcom CEO Kevin Sayer just days after the FDA approved the Dexcom G6. At the time, he told us about his career in the pharmaceutical industry and what people could expect from the G6 when it launched. We recently caught up with Sayer at ADA 2019 to discuss expected updates to G6, the future of Dexcom G7 and interoperability, and continued concerns over access.

Beyond Type 1: What’s new with Dexcom’s current offerings?

Kevin Sayer: The Dexcom Clarity App has had some updates recently. We have G6 updates planned. We have always had updates in our system. Certainly, we’ll continue to evolve the app, we just launched a new Follow app — the structure was recently changed. We have some changes planned for later this year but I’m not going to give them away. The nice thing about this system though, is because the center is so good, that changing all the things around the edges is actually almost fun.

We’re not going to change it too much because we’re really all hands on deck with the next technology. You look at resources and we do need to spend time with our G6 changes, for our current patient base but at some point in time we need to cut things off and get more invested in the next one and we monitor that, we plan that very carefully.

What can we expect from G7?

Dexcom G7 takes all the good of G6 and takes it to another level. The whole system becomes disposable, the transmitter and sensor all become one piece. We’re shooting for an extended life within the batteries of the iCGM standards. Connected, easier insertion, you just go down the list — what do patients want? And that’s what we’ve tried to make.

It’s going to be a spectacular product offering. Before the G6, from 2006 to literally 2018, the physical thing you wore on your body never changed. G6 changed all that and we’ve just been through this very complicated changeover. The G7, we’re now going to take it on again. So we’re going to make sure we have this worked out before we go. We’ve learned with G6 that patients’ willingness to change is pretty big. We thought there’d be this gradual influx of change but no… People wanted to change very, very quickly. And G7 is going to create the exact same thing.

It was recently announced that Dexcom is the official iCGM partner of Tidepool Loop — Can you tell us a little bit about how that partnership came about?

I’m thrilled that it has come about. I have a tremendous amount of respect for Howard Look (Tidepool Founder and CEO) and what they’re doing. We have tried to be interoperable throughout our whole history and in all candor, sometimes to our detriment. It has caused our devices to be more sophisticated. For example, our transmitter is configured to talk to two things at the same time, not one. No other CGMs are like that. That requires a level of engineering that is complex.

When [Tidepool] approached us with the idea, and it was quite a while ago, I was very excited about it. At the end of the day, CGM can be a driver for good, and the most important thing is for patients to interact with the management options of their choosing. We have learned that there are some patients who want to interact with the pen. We’ve learned that there are patients who want to interact with the pump. We’ve learned there will be patients who will prefer one algorithm to another or one pump to another. We want to be the CGM system that works with everything.

Tell me about the shift from the Durable Medical Equipment (DME) channel to the pharmacy channel that Dexcom is pursuing.

It’s an educational process for the payers. It’s an educational process for our patients. The distribution channel, this needs to be simpler for patients to get. We have a slide, you can see it on our website, on our investor deck, that walks through the steps a patient has to go through to get DME. Some people joke it’s easier to buy a house than to get a Dexcom. With a drugstore, you turn in your prescription, if they have it in stock you get it, and if not maybe it’s the day later, and I just think we need to make it easier for patients. I don’t want that to be a hang-up. We have coverage in over half the commercial plans in the United States and we will continue to push that agenda. And some of the plans say, “We just won’t do it,” some of them, it requires education. I think as awareness grows, the more people use it, that evolution will happen over time. But it is very important for us to meet our patients where they are and not in some distribution channel that they’ve never heard of.

What else is Dexcom doing in terms of access?

We are selling to Medicare patients now. We did not launch the G6 system to Medicare yet, that’ll be our next Medicare milestone. We have a very strong, good Medicare base now. One of our access focuses is quite candidly Medicaid. The Medicaid programs have been slow to follow Medicare. And you know the states’ financial situation. It’s not easy to walk in and say, “Spend more money,” conversely, when you look at how many Type 1 kids are in Medicaid programs around the country, it’s really important to get that Medicaid coverage for — in particular — that market. We have an access team that works all over the country, all over the world, around the clock, we’ve developed health economics teams to pitch the health economic benefits of CGM to increase access. We’re all over it and we’ve been championing that cause forever.

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The ability to have the Dexcom G6 as a prescription drug under my ObamaCare prescription drug program would certainly make life a lot easier. I currently use a Durable Medical Equipment supplier called CCS Medical. They’re fine, and deliver my equipment on-time, but they’re not flexible. I am using my sensors on “extended time” for up to 18 days each. CCS Medical sends me a box of 3 sensors every month whether I want them or not. Under a prescription drug plan, I could go pickup the sensors as I need them at my local pharmacy.

I wonder how to tell Dexcom to contact my health insurance provider to change the G6 supplies from Durable Medical Equipment to a prescription drug???

My Doc just advised me to pick up my new Dexcom G6 from a pharmacy in the city. We have one kinda special pharmacy in downtown that provides supplies. He said it was cheaper. I was surprised to know that was an option.

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Unfortunately for some of us, the switch from DME to pharmacy means a higher OOP cost. G6 is only covered under pharmacy with my daughter’s plan. Our OOP would almost double, so barring any unforeseen changes, we won’t be upgrading.

Dunno if you have Walgreens where you are but they’ve been carrying Dexcom supplies for a while.

Had to go on Medicaid for awhile, and they will not cover. My Health exchange plan prior, would have set the price so high I still could not do it. I’ll wait for Libre to introduce the new system with alarms. Hopefully they keep prices down.

Thanks for your suggestion. In South Bend, they do not carry Dexcom. Interestingly enough, CVS carries the Dexcom G5, but not the G6. Weird huh???

We have one Walgreens that does. Its a special walgreens. They had a receiver and sensors - the whole system in stock. I was shocked. Its a new option here. Its practical if your near the city, but otherwise you may have to drive a long way.

I’d just like to be able to get the G6 in Australia at all.