The Dexcom Q4 2018 quarterly conference call was held February 21, 2019. A transcript is available via https://seekingalpha.com/article/4243194-dexcom-inc-dxcm-ceo-kevin-sayer-q4-2018-results-earnings-call-transcript
Here’s the news as I see it.
The Dexcom G7 (the small, fully-disposable CGM developed together with Verily) is anticipated for release in late 2020 or early 2021.
To meet the demand, Dexcom is greatly expanding their manufacturing capability. They intend to double the number of CGMs they can produce by the end of this year, and they’re making other business changes to handle their new larger size.
It looks like they are laying off patient-support staff in San Diego and Arizona in favor of a new call center in the Philippines and also unnamed third-party companies. They talked about how they need to scale up their ability to handle the need for enormous growth in patient support in a sustainable way.
In addition to planning for the roll-out of Control-IQ on the Tandem t:slim X2, they are working with Insulet (the pod people) on their Horizon hybrid closed-loop system, and with Lilly on a smart pen system (I take this to be insulin dosing advisor software that reads CGM and also the amount of insulin dosed by the smart pen.)
They are starting studies for CGM use in hospital settings and for gestational diabetes. With respect to CGM during a hospital stay, there’s interest because CMS (Medicare) won’t reimburse the hospital for readmissions that are caused by poor glucose control.
They are working with United HealthCare and others on multiple private, highly-proprietary studies of CGM use in Type 2, for non-intensively treated patients. The idea is that short-term use of a disposable G7 CGM could help the patient and physician to see what’s happening, and to better understand the effect of diet, exercise, and choice of medicines.
Dexcom continues to push the delivery of CGM through pharmacy benefits as preferable to going through the Durable Medical Equipment process, which requires lots of documentation and time from all the organizations involved. It’s much easier for the physician to write a prescription and the patient to just pick it up from the pharmacy. There was no discussion of the implications in the case of pharmacy coverage that involves large deductibles or a “donut hole” where there’s no insurance reimbursement.
They still expect to start shipping the revised, low-cost G6 transmitter later this year. It’s not clear that any of the cost savings will be passed along until they are forced to drop prices to stay competitive. So far they have been able to command premium prices because their CGM is so good.
They are working on extended wear time for the G6 if they can meet the requirements for iCGM, and also at the possibility of improved algorithms for the G6 or G7 as well as TypeZero decision support software for patients and caregivers.