News from the Dexcom Q1 2019 conference call

Dexcom held their Q1 2019 conference call on 5/1/19; a transcript is available at https://seekingalpha.com/article/4258907-dexcom-inc-dxcm-ceo-kevin-sayer-q1-2019-results-earnings-call-transcript

Here’s the news as I see it.

The G7 fully-disposable 1-piece sensor+transmitter unit is expected to launch late in 2020 or early in 2021. They are very enthusiastic about the wearing experience because the G7 is so much smaller than the G6+transmitter.

In going from the G5 to the G6 their strategy was to keep the same revenue per patient-year. It sounds like they are planning the same for the transition from the G6 to the G7 unless competition from the Libre 2.0 forces them to lower prices. At present they think they will be able to maintain their prices because they think their current reputation in the medical community is that they provide the high-quality CGM whereas the Libre is the lower-cost but inferior alternative and nobody wants the stand-alone Medtronic CGM. They think this ranking will persist when the Libre 2.0 full CGM becomes available; even more when the G7 comes out.

For the G6, they expect to be shipping the new transmitter in volume during Q4 2019. This transmitter will have less than half the manufacturing cost of the current one, but it sounds like they will keep that as enhanced profits until competition forces them to do otherwise.

They are working on decision-support software and enhancements for the Dexcom app, maybe for later this year. However, improvements to the algorithm to give better CGM data may be deferred until the G7 so they don’t have to run a new clinical trial on the G6. Although there have been thoughts about seeking FDA approval for extended-wear of the G6, perhaps 14-day wear, this definitely will not happen in 2019.

They talked about a significant reduction in hypos on the G6 because of the new “predicted severe low” alert that notifies someone of a trend to below 55 while there’s still time to prevent it.

They expect that their high point at the ADA conference will be the Tandem+Dexcom+TypeZero closed-loop system. Evidently they think the results will be a source of joy.

They’re working on “new markets” which in this context means new uses for CGM, not new geographic regions. Among these are 1) reducing the medication cost for non-insulin using diabetics; 2) in the hospital improving time in range to reduce the amount of nursing time, and to move more quickly from ICU to general wards to discharge; 3) in the hospital avoiding delayed healing from hyperglycemia and adverse events from hypos because both of these can lead to various financial penalties; 4) support during gestational diabetes; and 5) better diagnosis of diabetes than provided by the oral glucose tolerance test. They describe a desirable scenario for a planned hospital stay in which the patient, prior to admission, gets a CGM installed and running well. This should enable higher time in range, leading to better outcomes, faster healing, and earlier discharge.

They mentioned that the Philippines customer-support call center they set up is getting higher patient-satisfaction metrics than the US call center.

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Thanks @bkh for that very concise extrapolation of the Dexcom earnings call. Very exciting news, and I would have to agree that for now the Phillipines call center is better. Time will tell though.

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A call center is only as empowered as they allow the team to be. As long as they allow the CS reps flexibility to solve problems great. Once they start restricting that, then the complaints follow. It isn’t as if the CS reps want to make it hard for you, but companies can certainly do that by restricting their patients.

@Chris I agree, but attitude matters too. It seemed like late last year the attitude was poor with an underlying current of my hands are tied.

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They are very nice and professional. Wonderful people. But I can barely understand what they are saying. The couple of reps I spoke with had annoyingly heavy accents. Every other sentence I had to ask them to repeat themselves.

Frustrating for me and I imagine frustrating for them.

On the survey after the call they have a question about rep’s communications ability. I’d like to see the statistics for that one question.

My one interaction with the new call center was quite good (as all my interactions with the old call center have been).

It’s interesting though that a health care company like Dexcom would hire night shift workers, since it seems to be bad for workers’ health (I haven’t tried to verify that this is actually true). I heard somewhere that some countries are trying to ban night shift work. Dexcom’s support hours are 9pm to 8am in the Philippines.

If Dexcom wanted to move its support center to a cheaper country than the US, I imagine they could find one that’s in similar time zones.