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DISCLAIMER: This text is the output of AI based transcribing from an audio recording. Although the transcription is largely accurate, in some cases it is incomplete or inaccurate due to inaudible passages or transcription errors and should not be treated as an authoritative record. Nothing that you read here constitutes advice medical or otherwise. Always consult with a healthcare professional before making changes to a healthcare plan.

Scott Benner 0:01
Hello friends and welcome. Hello friends and welcome to Episode 234 of the Juicebox Podcast. Those of you who listen every week are going to be like, wait, what's happening? There's another episode out, but I already got an episode this week. Oh my gosh, what have I done to deserve this? The answer to that question is simple. you've subscribed to the Juicebox Podcast. Today's episode is sponsored by Omni pod Dexcom and dancing for diabetes, you can go to dancing the number four diabetes.com dexcom.com forward slash juice box or my omnipod.com forward slash juice box to find out more. I can't really tease who's on the show because you guys see it in your podcast app. So not gonna bother doing all that. But I'm very excited today to have Kevin Sayer back on the show CEO of Dexcom. He's going to be talking about everything that's going on. Little bit about the future. A little bit about g six upgrades that are coming in to find out what happened at Costco, talking about their manufacturing, their phone service, and so much more. I want to say two things. First, of course, nothing you hear on the Juicebox Podcast should be considered advice, metal or otherwise, always consult a physician before becoming bold with insulin, or making any changes to your medical plan. And the second thing I want to tell you is thank you to everybody who follows me on social media who sent in their questions. The ones that trend towards Kevin's expertise were given to Kevin. And I've set up another interview to get Jake leech back on the program to ask the other stuff. So if you don't hear your question today, I'm telling you, you're going to hear it very soon in an upcoming episode.

Kevin Sayer, Dexcom CEO 1:46
Hi, Scott, how are you

Scott Benner 1:47
very well. Thank you How you been?

Unknown Speaker 1:50
busy.

Scott Benner 1:52
That's a good I was gonna say that's excellent.

I have a couple of questions for you from my audience. But I really want to hear what's going on. I think I know one of the things you're going to say. And it was overwhelmingly one of the questions that people asked so your timing on on this is a big deal. So I guess Let me ask you about Apple Watch first.

Kevin Sayer, Dexcom CEO 2:19
Okay, and and I will, I will say this here, your audience and your listeners to everybody. We are working on that frantically. What we are planning on doing with our apple watch release is that requires a different firmware and all the transmitters. And a different interface with Bluetooth then is in the current transmitters that are out in the field. Over the course of time after we get the software revision that supports direct to Apple Watch. All then files approved by the FDA. As we get through all the transmitters that are out there, we will then release this. This is not something quite honestly Scott, we're going to turn on overnight. Because then the switchboard would break. And everybody say I have it This isn't working and why Yeah, and the reason isn't working because you don't have the right hardware. So as we cycled through our transmitter cycles, one day, you're all gonna wake up and direct to Apple Watch is going to be there. I personally am using the direct to Apple Watch app, trying it out the engineers Let me try everything out before everybody else and I gotta say it's, it's really nice. What I like best about it was like one night, I put my phone away and use the direct to Apple Watch as my nighttime thing. And I you know, I don't have lows or highs but at night, I just woke up and took a look and fun and that is good. And then ultimately, if you have the cell plan on the Apple Watch, I believe and I'm speaking a little bit out of turn, I'm not sure how the first release works. But over time, theoretically you the Apple Watch can go to share as well. So I I think direct Apple Watches is something that our patients really want and and detect, you know, the programming is about there. We just have to cycle through some hardware and do this guy's manner. Well, I think that

Scott Benner 4:18
I think that there's a there's always the the desire to just get people excited about something like, Hey, we have this great thing coming. You guys have been looking at it for a while you know how exciting it is. And you tease it because you're like, Look, it's coming but then if you don't hit that date, it just it's I don't know, it seems it's something Yeah, yeah, it's it's thanks for that happens.

Kevin Sayer, Dexcom CEO 4:40
I understand but you also understand because you read the blogs and sometimes our phones go wacko and then oftentimes through no fault of our own and I don't want to deliver customer service experience with respect to the Apple Watch Apple Watch. Direct launch, that becomes a negative because I'm trying, we're trying to swap out every transmitter in the United States. It don't we don't want to go through that we don't want to put our patients through that. It will happen, it will happen in organized.

Scott Benner 5:15
Listen, it would be amazing. If you just got it into everyone's hands, they didn't realize they had it. Then one day, you just make one grand announcement say, hey, by the way, that transmitter you're using right now works with your Apple Watch. And that's kind of what we're, that's what we're shooting. That's excellent. Elizabeth forest was diagnosed with Type One Diabetes at the age of 10. As a dance student, Elizabeth decided to start a nonprofit organization. So this was not something that she had thought about doing before. But of course, either was having type one diabetes. After her diagnosis, she was driven by determination to not let diabetes negatively impact her life. And so what started as a community fundraiser organized by a middle school students, is today a full scale theatrical production. And that is really just the beginning of what dancing for diabetes does. To find out what else Elizabeth has born into the world, go to dancing for diabetes.com. That's dancing number four diabetes.com. To what is it you've been talking about recently,

Kevin Sayer, Dexcom CEO 6:18
we have a lot going on, you know, an ADA leaving ADA, the first thing that struck me while I was there was this Prop, the response I got from physicians and patients on the gen six system. We've always had great technology. But the response when I would ask people tell me about your Gen six experience was literally more emotional than anyone I've ever had. With our other product launches, this product has hit the right spot with ease of use, and with the no calibrations. And with the features that we've put in. It really is a great product. I recently, we recently had a 360 Management Review here. And one of the things they said to me, is you're really good at praising people for a short time, and then you turn around and say, Okay, let's go. And what Ada showed me is, I really respect the effort that our engineering team has put into this one, we will never not improve the product we have added in the field. So we are looking at the software features to add revisions to our apps and things that we can do to make it more reliable in the field. Or even looking at you know, things like new tape, is there a tape that would be more sticky to eliminate some of the sensors that fall off. Rather than, you know, I'm sure people will still use the overtake as well. And we're looking at all sorts of G six revisions of that nature over the next 18 months 1824 months to get g six exactly where it needs to be. The other thing that's very exciting for us and one of our corporate goals, is to double the capacity for the number of G six sensors that we can make if we double that capacity and can make it available to more patients. And more accessible, I think that serves the community very well. Two other exciting things. For me, you know, the announcements at Ada around artificial pancreas work. Next con was pretty much in the middle of all of them. And it certainly was tandems data or IQ systems system and the data obviously presented by by our type zero people who who wrote that algorithm and the influent data with with their horizon system. And then the loop announcements where we're looking at open architecture and open world whereby even possibly a Medtronic pump patient but in an authorized manner to run an algorithm with a dexcom sensor on their pump. Yeah, that's staggering. We've come a long way as a company and and where we used to just be this tiny little group, we're kind of at the center of everything. And the last piece is we're very excited about in addition to J six, our future product pipeline, I can't push our G seven technology I can't push the guy's fast enough on that either it is it is going to be as big a step forward as G six was over g five. From the experience particularly the ease of use and the physical components with just one piece. Throw away transmitters smaller and assertion system. One button push, fewer steps and G six longer were period I had it really addresses A lot of things people would like to see us address. With g six, we've addressed a lot of things with G six, but we'll address more there. It is a, it is a time of continual innovation for us. And as BGM gets more and more accepted, we've made the goal publicly in our investor presentations, we want to replace finger sticks. Yeah, I don't know if I really believe that in 2012 and 2013, and 14, you believe it now? Oh, yeah, I believe that there will come a day when CGM will be so accessible. And the experiences can be defined in so many different ways that anybody dealing with their diabetes can have a great experience with the CGM product that will give them more information that they can get from any anything else, and they can do it on a cost effective manner.

Scott Benner 10:48
I have a question about that. So how do you get the product that you have now into a form factor that allows it to be as accessible as a blood glucose meter to everybody like financially,

Kevin Sayer, Dexcom CEO 11:00
you know, it is not the form or even the cost of manufacturing the product. As far as getting it there is access through the payer community, we have an entire team whose sole goal in life is to make access to Dexcom products, easier for our patients. And we believe the easiest way to get our product over time is going to be through the traditional channels where our patients get everything else. And right now that's through the pharmacy, or through a pharmacy benefit with their insurance carrier in the form factor, there are some some form factor considerations, but they're, they're very high level, I mean, just like boxes, and having transmitters, receivers, and sensors and that type of thing with our G seven system, it will be much easier, but we're trying to lay the groundwork and do that now with G six, we have coverage as a pharmacy benefit and more than half of the insurance carriers. But it's not overly well known because they cover it in the DMV, DMV world the same way they've covered in the past. If we can make it easier for our patients to get this we know over time, with increased assets, access, we get more patients, and pricing will move down. As you get more and more people on the system, we're prepared for that. Where it gets very expensive for us is even through the reorder process. Every time we answer that phone, and then we call the doctor and then we call the insurance company and then we call you back. And there's all these steps, it takes like two days, it takes almost less time to buy a house. And we need to eliminate that and and so we need to increase access and get our patients there. And you'll see aggressive steps by us to do that. Over the next several months as part of that

Scott Benner 12:51
by partnering with people like sort of in the same way that you've you've got these relationships now with insulin and tide pool and all that stuff is it isn't to get those those like what happened to Costco I guess I have to ask you but like is that the idea Costco, Walgreens, CVS that Costco the

Kevin Sayer, Dexcom CEO 13:08
great Costco is a great thing. And I'll tell you exactly what happened at Costco. And it's an unintended consequence. We said Costco club, whereby patients could go in and buy sensors. And as we set that up, we did a structure with our wholesaler and all the people involved to make the transmitter extremely low cost. Other patients could pay cash for the sensors. And quite honestly, we ate the cost of the transmitter. So that was a good project Scott. When the patient community found out they could get transmitters cheaply at Costco, and they went there paid cash for their transmitters, but did not buy the sensors there. And so we're losing money hand over fist for something we did to be nice. Yep. And so we've restructured that and and and that will come in a different way in the future. And again, the law of unintended consequences, we did something nice and and it ended up getting a lot of people into Costco. A lot of people are interested in our product in Costco, and not in a manner that we'd hope.

Scott Benner 14:19
So you're gonna have some safeguards in place and reintroduce it in a way that you will 100% need to be a cash payer and you will need to be or through pharmacy contract again,

Kevin Sayer, Dexcom CEO 14:33
is our patients check. If they check with their pharmacist, the pharmacist can find out whether or not they're covered in the pharmacy benefit or contact their Dexcom person. Our patients could probably switch over to the drugstore if they want to now who have not and and not just the drugstore, not just Walgreens but several of the others as well. We're working through that whole time. developing relationships with the Costco as Walmart, CVS Rite Aid, Walgreens, we've announced digital and digital content sharing programs with Walgreens where we're going to work with them to provide a better experience for our patients in the Walgreens environment, to whereby walk Walgreens Dexcom becomes part of the Walgreens infrastructure for our patients and, and there can be data sharing if, obviously, if the patient chooses subject to the same privacy requirements we've had in the past. But you know what we'd like to see Sunday, that is on the G search app, when you run out of sensors, you have to Walgreens or, or whatever button and say, I want to pick up some more and you go pick him up, and you're done. And I believe we can do that, it's going to take some time. But those are the types of investments we need to make, make this more accessible for our patients and make it your farm to get

Scott Benner 15:59
it absolutely does need to be I just while you were looking, I just took a look. And this is just a one day, just one day, it's the last 24 hours. But in the last 24 hours, my daughter's estimated a one C is 4.7. Her standard deviation is 29 are average blood sugar's 88.

Kevin Sayer, Dexcom CEO 16:15
He's better than me.

Scott Benner 16:16
Well, I tell you all the time I tell people all the time, the way we get to those numbers, doesn't really exist without Dexcom. Like I can't make the decisions that I make without, without the information that comes back from the sensor. It's just that simple, really. And it's heartbreaking that everybody can't have it. Who wants it? You know,

Kevin Sayer, Dexcom CEO 16:35
I don't know how a person would do this, I have a complaint. I really don't know how a person would do this other than eat the same thing every day, at the same time, and literally make your life the most regimented thing in the world. I have tremendous empathy for our patients. I really do. I think we we've made this easier in many respects. There are other ways we can make it easier. In the future, you saw the interconnected announcements I went over earlier, and these automated insulin delivery systems will help a number of patients there will still be patients who don't want an insulin delivery device attached to their body, we believe with the things coming with integrated pens, from independent companies and also directly from the insulin manufacturers that we can develop decision support infrastructure, to replicate some of the things you do on a daily basis. You know, I asked the patient recently, tell me, tell me what you want. And it was a mom and she said, a newly diagnosed sentence. She said, I am so tired of making these decisions for my boy. And she should I don't even know if I'm also the time because just learning. This is exhausting. And it was a young woman, a young mother that I know from a long time ago. She's about the same age as my children and listening to that and just created a tremendous amount of empathy. We have technology to do that but we need to get that out in an organized and thoughtful manner to our patients. Now for sure.

Scott Benner 18:21
Let me ask you a couple quick questions g six for Medicare is that close by any chance?

Kevin Sayer, Dexcom CEO 18:26
More than likely fourth quarter we plan on doing it this year the G six for Medicare has been in a tough one for me personally. We've not had capacities like g six product the entire all the user base around the world and to six global launch manage that rather than then launch into Medicare and then tell everybody you get to wait even longer for product and upset all our customers we've had to do what we've done. We'll get this product to Medicare before the end of the year and I think that patient base will be absolutely thrilled with it.

Scott Benner 19:06
Hey listen I don't know if you've ever seen it or heard tell of it but I got to walk through insolence new manufacturing facility a Massachusetts I have to it is spectacular. No kidding. It's it's an incredible. I tell people all the time like that's a company really putting their money where their mouth is like look, we're gonna build our manufacturing right here at home. And it's it's state of the art in a way that it's hard to put into words. I'm actually trying to interview the gentleman who oversaw its its design and construction because it's just you

Kevin Sayer, Dexcom CEO 19:35
know what, I have such admiration for what they've done. We are doing similar things in our Arizona factory. We will have a number of G six automated lines up and running. In Arizona literally Where were the robots put the sensors together? Yeah. And we believe the quality from the robotic lines will be extremely good. We are Balancing the number of automated g six lines we put up in place as we develop manufacturing processes for the G seven. One of our big dilemmas, Scott is a perfect example, the insertion device for G six and every part in that is different than what everything was for the previous 12 years. Every piece, and when we go to the g7 system, we've not saved much from G six, we're going through what one refer to as the cost of innovation again, and are you willing to bet on that and make those type of capital investments? And we are cuz this is what we do. But it is it is interesting to sit and strategically figure out how much to spend where and how and that's why I really love the way in Flint made their decision right out there factory it is. It's awesome. And and we will be replicating that in Arizona will always will we our hope is to manufacture 75 to 80% of our product there over the next five years and then the other 25% here in San Diego, and then decide when and if we build yet another manufacturing plant and what the capacity for that would have to be is

Scott Benner 21:21
quality manufacturing the key to stable sensors like ones that last the 10 days they need to last or what like what do you know what I'm saying?

Kevin Sayer, Dexcom CEO 21:31
Oh, no, I absolutely know what you're saying. I think there are a number of variables in their quality of manufacturing is very helpful. But by and large, the quality of our manufacturing is pretty good. There are a couple other things that drive to the early sensor show off one of them is the CGM standards, we we have an obligation to perform at an accuracy level with the G six product that is higher than anything we've ever had. And by the way, we allow for no calibrations. And there are times in our software where we detect the data would not be adequate, or the ice jam standards that are applicable for us and the design of this product. So quite candidly, we shut it off and haven't stopped working when in reality, our users with our previous systems would have relied on that data and they would have been fine. Because of the accuracy bar that we're performing to now we have some sensors that shut off the things we do to fix that with with G six, are we looking at the algorithm, because we've always been able to launch an algorithm with every generation of products that we've launched while we improve performance, we look at a new sensor membrane materials that might be more stable and in reality that those will probably come in G seven, we probably would not roll them into g six. And we look at you know the mainly the algorithm and we contemplate different manufacturing techniques that we can do within the range that we've submitted to the FDA. But I think the most reliability change in the short term we can get is is our algorithm updates and with 188 points coming in per patient per day, be our servers we have a lot of things we can simulate algorithm development can move very quickly here and our guys have some really good good ideas and so we'll we'll work on that all throughout the lifetime of the G six.

Scott Benner 23:35
So you think it's time to try out and on the pod? You can request a free experience kit today a pod experience kit by going to my Omni pod.com forward slash juice box. Here's the important part tubeless insulin pump, no tubing, not connected to anything small. wearable doesn't get in the way can sleep with it can bathe with it can swim with it. Hmm. How exciting is this? I mean it's hard to get really super jacked up about an insulin pump I guess but you should because Omni pod is that next level is what you're looking for. My daughter Arden has been wearing it on the pod since she was four years old, is about to turn 15 every day from four to now. wearing it on the pod is absolutely a staple in her life. Giving yourself in some with a push of a button is amazing. Not being attached to a tube is free. Miami pod.com forward slash juicebox You don't even have to take my word for it. Get a free pod experience kit sent to your home. Try it on for yourself. See what you think. I'm now going to sing an impromptu love songs on the pod. Oh Nearpod we love you so much. It happens smooth. Your insulin is cool. The way you make me

Unknown Speaker 25:01
feel

Scott Benner 25:04
doesn't I'm but I'm not a songwriter at all. But that just became painfully obvious to admit. You know what you're lucky here though, because on the pod makes insulin pumps way better than I sing my ami pod comm forward slash juice box with links in your show notes or Juicebox podcast.com. Do you share that data with anyone or is that used just internally like your you this tide pool, for instance, have access to it,

Kevin Sayer, Dexcom CEO 25:33
I pull absolutely a patient if a patient goes to type one says I want my dexcom data. And they they there's a security protocol they go through with us. And then that patient's data would be available in title, we have created an API infrastructure to allow patients if they want their data on other apps, to grab their data. Now, we do make it retrospective a three hour delay. But no, we we make data available to a number of partners, we make data available retrospectively to Apple healthkit for patients who want to access their data that way. So we do make that data available for patients, we do not make the entire servers or the data available to the open world. We have a developer portal index column for the API's that contains the identified patient data that if somebody wanted to go in and develop an app around m data, we have a data lake of sample data that they could go work with and develop something with, without a whole lot of difficulty.

Scott Benner 26:42
Listen, I'm gonna just tell you this. So I don't forget. But overall, with the really hundreds of messages I got, there were just so many people who just want to say thank you and show their gratitude. So I will

Kevin Sayer, Dexcom CEO 26:53
give you an extra five minutes to play. So got a 1030 you're very

Unknown Speaker 26:57
nice. Okay, so

Scott Benner 26:58
I'm looking at my list, I'm trying to side with it. This one's a little bit of a, I don't This isn't a humble brag, but the podcast is spreading in such a way that I received the same message from Canada, Australia, Hong Kong and hungry, they all would like you to throw your weight around a little bit and get them to JSX as fast as you can. hungry, especially who said they're still using the G for

Kevin Sayer, Dexcom CEO 27:20
hungry is is not been a large market. For us, we have some plans to get to these other markets. It has a large extent been the same issue that has delayed the launch with Medicare, we have not had the capacity to go all these places, as we build out our factory and build out our manufacturing lines, we will we will launch in an organized manner in these places. And again, I spend time with our Australian distributor did a meeting I had dinner with him I heard loud and clear. And in Europe in some of the smaller geographies, we're developing some innovative plans, possibly into some other distribution strategies to get there because we may not have found the right distribution partner. So hungry in some other markets. Hold on, we'll we'll get there.

Scott Benner 28:09
Okay, so in the same vein of, of you flexing your muscles, I have a question I hear over and over again, from people about the stress around getting their supplies in time the idea that insurance won't let me reorder till something happens. And if I experience a transmitter that doesn't last as a, you know, six days as long as it should, or, or that it's expected to, that people have an incredible amount of stress around that is there a way to change what the norm is around letting people reorder so that they don't experience gaps because, you know, Dexcom becomes such an just an integral part of their life. And then all of a sudden, it's gone for a couple of days. And some people are just panicked by it. And

Kevin Sayer, Dexcom CEO 28:53
this is the bane of my existence. In all honesty. I would love to make this easier. I want to go on record, we've created some of these problems this year. Again, with the supply constraints we have been experiencing, we've had to delay shipments for patients from time to time. And sometimes it's it's a one day delay, sometimes it's a three day delay. Sometimes it's been longer. And so when a patient orders and then we create a delay, that's very problematic. The other thing that happens and a lot of this, this behavior is dictated by the terms we have with the insurance companies that you can only order in some specific timeframe and they do make it difficult. I would love to make it easier. We're exploring a number of business models. I'll give you two examples that I bounced off people at ADA. The Medicare business model is our Medicare patients pay a monthly fee and they get what they need. And the way Medicare is actually designed and there's 25 they get strips and sensors every month. They get what they need every month, right? They get transmitters when they need them and Medicare pays the same fee every month, and the patient pays their copay, a subscription model for our patients, I would love that. And the other thing is, again, getting using them to the drugstore, getting them easier for patients to get where this gets tricky. And so our counter was something back to you is is the warranty. Index, counter warranty policy is a gold standard of our company, we replace most everything anybody calls about. At some point in time, we've got to figure out a way to better interact with with the patient community. And I guess that that's more accountability for Dexcom and more accountability for our patients. So let me throw a theoretical out there. If we have a 15 day set, and last for 12, and it falls off and I and I send you a new one, we've now lost 13 days of patient revenue, because we were good. So the cost of that isn't just the cost of the sensor. There's a cost to us, economically. And, and I know our patients bear such a burden, that it's only fair today. But as this becomes more accessible as costs come down, as we become more accountable, I think we need business models where we're all more accountable and where Dexcom has to be more accountable, as our products have to be more reliable. And we think we've done well would you fix that I set the bar very high for those guys. And and in. And so I think this whole business model is to make it easier for patients has to be it has to change. And it's an effort between Dexcom the payers and, and making that structure that was easier. I totally empathize. In fact, one of your peers said to me, I hope you don't read all the blogs. And I said, Tell me why. He said because you might take personally people's frustration with the supplies. And he said Please don't. The reason they're frustrated is they really depend on this device. And when they don't have it. It really ruins your day. And it ruins your week. And and it's very uncomfortable. And you know what? That's a perspective we have to take. We need to make sure patients have it. And and and we're looking at a number of ways to do that. I haven't found the perfect answer yet. But but we're trying.

Scott Benner 32:39
I think that's a that needs to be the message. I think for some people who have the frustrations is that it's I hope they don't imagine you guys all sitting around going I

Kevin Sayer, Dexcom CEO 32:51
really think that I go home at night saying I was able to mess with these people. They didn't get their product today, right? I mean, no, that is the last thing that we want to happen.

Scott Benner 33:02
I think that's even a good look at what you were talking about, about the frustration because of how much you count on how much you love it. So I think Dexcom doesn't really need an official add in this episode, because we've just heard from Kevin, and we're about to hear more about how fantastic the product is. And I can tell you this, my daughter has been working at Dexcom. It seems like forever. It's been so long, I don't remember a life without it. And everything you hear us talk about on this podcast stems from the data that comes back from the Dexcom. If you're not using Dexcom now, and you don't think you want it or you don't think that it's for you, I would implore you to take a shot. Because it is life altering. It will change the way you live, love laugh, run, jump sleep, everything gets better when you can see the data that comes back from the Dexcom g7 not having to wonder what your blood sugar is doing and actually being able to see it is transformative. I can't stress it enough. dexcom.com forward slash juice box. There's also links in your show notes and at Juicebox podcast.com. If you're not a believer, take a leap. I think you'll be happy that you did. And if you're sitting on the fence, get off the fence, you're gonna hurt your butt.

I have a question for you. So you moved your your phone, your your CSRS in the Philippines. Is that right?

Kevin Sayer, Dexcom CEO 34:39
Yeah. And our tech support function and I'm happy to address that too.

Scott Benner 34:44
I just want to know what the what the process is like because it's not a that's not a turnkey operation. I would imagine imagine you have to get it there and there are bugs to

Kevin Sayer, Dexcom CEO 34:51
work. It has not been a turnkey operation. And in fact, we kept all those who wanted to stay with Dexcom who had those jobs domestically. We've kept for a significant amount of time. And we literally had double the people that we had, it has not been turnkey at all, we've done this in as much of an organized manner as we can. Over time, the way this will work, our inside sales will be over overseas, we will have some high level support people here in the States. And the same with tech support, the first level tech support will be in our Philippines call center with the specialists who when you get down to my reading appears to be three tenths of a point off at 515. Every day, could you help me, that person is going to be here, that person's not going to be over in the Philippines, we've got very good results on the tech support side, we are still working through the bugs on the inside sales side. And and it just, it takes some time, as we looked at how to do this, we could not add enough people in San Diego and Arizona to meet the demand that we see coming with our patients. We couldn't add enough buildings in San Diego and Arizona in an organized manner. There are 1.2 million people in the Philippines that work for us based call centers, much of the healthcare emphasis is healthcare degrees there and let me turn that off. And so over time, this will be a good thing for our for our patients that some may experience some bugs, this this will become better. Yeah,

Scott Benner 36:37
it's funny because I, I see people say oh, my sensor didn't last as long as it should, I should tell you, that never happens to us. And in and maybe it does once or twice a year. And I don't recognize it. But it happens so infrequently. I just think of it as not happening. And it's your experience is personal. You know, a lot of times, even with customer service, like you don't listen, I have a tendency when I get on the phone with customer service to talk too much. And I realized one day that when I take a person who's trying to follow their job, and I start, you know, interacting with them about the Superbowl or something like that, they're not focused then and I, one day, my wife said to me, she's like, stop talking to them so they can do their job. And I was like, Whoa, that makes a lot of sense. So you don't know. I'm not saying if you've had a bad experience with any customer service, it's your fault. I'm just saying that you're everyone's different. And you know, everybody has good days and bad days, you know, and the person you get on the phone might not have a great moment. But you guys are looking for a way to put that together. And so that it works well as often as it can for people and continues to get better. Yeah. That's, I'm done with that. So let me ask you one question, because I know we're too far out from g7, for me to say to you, when is that happening? But, Mike, my question would be on bigger, bigger ideas like size, where time and cost? When will you be able to start talking about that publicly? Not when is it going to be in my hands, but when are you going to get to a settled point where that's a shareable concept.

Kevin Sayer, Dexcom CEO 38:07
Next year, we've shown pictures of size, I can tell you it's significantly smaller, but the pictures don't show the whole thing is much thinner. It's not the size of an m&m, as we were shooting for in the beginning, but it is it is it is smaller than than anything else on the marketplace. And anything else we've done, and it's very, very thin. We'll get into where length and everything. As time goes on, we have to run the trial. To do that right now. What we are doing is we're doing a lot of feasibility work on G seven, we've done a lot of the hard part. Verily, Google's diabetes are and healthcare division really was instrumental in developing the electronics in that system, and it has completely new electronics. And we've worked very hard on the mechanical aspects of the system and designing the insertion device to work differently to be smaller, as we did listen to what everybody said about g six, and we're trying to use less materials. And what we're working on now is what that product is going to look like and we have to optimize it for a longer wear and make sure we meet the accuracy standards that have been established by the FDA. So we're looking at things like algorithms and membrane changes, manufacturing process, alternate manufacturing processes, fine tuning the things that Dexcom is really good at. So we can get gone with this trial next year as the trials begin to happen. More minion to happen. Word lakes innovation community. We've done some focus groups. And all I can tell you every focus group when we get the g7 out, they just say yeah, that's it. That's that's all we want. It's a I think it's just going to be wonderful product offering but what I learned VA is supposed to fix. It's a big step up from what we've had before it has been

Scott Benner 40:05
for us. Yeah, absolutely. Listen, I think that in the next year to two years, we'll look back on how diabetes was done prior. And just think, Oh, my God, that's, you know,

Kevin Sayer, Dexcom CEO 40:19
never never again get a look. It'll look medieval and and when we say that 80% of intensive insulin users will be on some form of sensor. I absolutely believe that. Now, I, I think they have to be, because I just think they do so much better. And I think the cost of all this will come down. That's excellent overtime.

Scott Benner 40:41
Kevin, I can't thank you enough for coming on and doing this. We were supposed to do this while you were at ADA. But I had a personal thing where I had to move and I apologize for that. Yeah, and I have a ton of questions here that aren't specific to you. So I have sent an email just so everybody knows who sent in their questions. And we're gonna get Jake Leach back on real soon to talk about the

Kevin Sayer, Dexcom CEO 41:00
you can get Jake back on He's great. Excellent. There's nobody and and CGM science in the world. They have the perspective Jake does because he oversees everything.

Scott Benner 41:13
He's, he's been fantastic every time he's been on. And he's, he's very open as the way you are. And let me ask you this last question. And I'll let you go. Is that, uh, am I just getting lucky speaking with you and Jake, or is that, uh, is that the way the company works at the like, from the top down?

Kevin Sayer, Dexcom CEO 41:31
That is the culture that I hope to drive. There are times when when we are probably more close than we should be. Or maybe sometimes I'm more open than I should be been Dexcom has been built on those types of relationships. And and I learned that way back in my mini med days, got the more we inaccurate people and the more open we are, the more success we will have. There's some things we can't share. But figuring out where those fences are, and then walking around them. It is easy.

Scott Benner 42:03
Yeah, I believe that and I see it too. I ask questions of sometimes people in other companies. And you can hear the pause. And that pause says is the guy who I report to are going to be mad if I say this? And I never I never hear that pause when I'm speaking with you. Of course, you're not reporting to anybody but Jake. And and it's just refreshing Yankees had afraid of what I would say to him, either.

Kevin Sayer, Dexcom CEO 42:27
He he really understands what we do. And he and I speak so frequently. We're always on the same page. And speed is a pleasure to work with. I

Scott Benner 42:36
agree. I and I hope maybe one day I can venture out to Arizona and see how you guys are doing that out there too. That would be really,

Kevin Sayer, Dexcom CEO 42:42
it was a few months. But yeah, come first here. We'll

Scott Benner 42:45
show you I'd be beautiful. All right, Kevin, thanks so much for taking the time. I hope you have a great weekend. All right, bye bye. Take care. Huge thanks to Omni pod dancing for diabetes and Dexcom for sponsoring the Juicebox Podcast always. And to Kevin, of course for coming on and sharing what's going on with the dexcom g six g seven and everything else that he shared with us today. I hope you agree. Because I certainly do. Kevin is a he's an open guy. And he talks about some things that I don't think are completely comfortable for a CEO to talk about. And he does that with grace. And I just appreciate him coming on and being that open. We're getting ready guys. Pretty soon we're going to be talking about it. 1,000,000th episode celebration this summer, I am putting together a gift bag like you've never seen. Let me tell you what I've got so far in there. Even though we haven't even announced even though I haven't announced anything about it yet. Just let me let me tell you a little bit here. Let me just throw something out here. Let me get my list up on the pod and Dexcom swag dancing for diabetes swag. Ooh, bunch of stuff from stay put medical, and you're gonna get a myabetic bag. The winner is going to get a myabetic bag for free. That's nice. How about a 30 minute conversation with Jenny Smith, the CD you all love from our diabetes pro tip episodes. That's just the beginning. I am still getting more one winner is going to get everything on the complete list and explanation of how we're going to celebrate the million downloads of the Juicebox Podcast coming soon. I just thought I would tease you a little bit with some stuff. And that nice, that's a good list common there. I'm gonna get more on here for you though.