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Digital Health for Chronic Conditions: A Conversation with the CEO of Omada Health

Insight by

Charles Rhyee, Cowen’s Healthcare Technology analyst speaks with Sean Duffy, Co-founder and CEO of Omada Health, a digital care company that supports patients with pre-diabetes, type 2 diabetes, hypertension, behavioral health and musculoskeletal disorders via data-powdered human coaching, connected devices and curriculum.

In this episode they discuss digital chronic care management, Omada’s partnership with Abbott Laboratories, the impact of COVID-19 on remote telehealth, and a randomized trial on diabetes prevention through digital health and coaching.

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The FutureHealth Podcast is a monthly series that continues Cowen’s efforts to bring together thought leaders, innovators, and investors to discuss how the convergence of healthcare, technology and consumerism is changing the way we look at health, healthcare and the healthcare system. Click here for more episodes.

Transcript

Voiceover:

Welcome to Cowen Insights, a space that brings leading thinkers together to share insights and ideas shaping the world around us. Join us as we converse with the top minds who are influencing our global sectors.

Charles Rhyee:

Hello, my name is Charles Rhyee and I’m Cowen’s healthcare technology analyst, and welcome to Cowen’s Future Health Podcast.

Charles Rhyee:

Some listeners will recall several podcasts we recorded around Cowen’s fifth annual Future Health Conference earlier this June. And today’s podcast is the first episode in a new monthly series that continues Cowen’s efforts to bring together thought leaders, innovators, and investors to discuss how the convergence of healthcare technology and consumerism is changing the way we look at health, healthcare, and the healthcare system.

Charles Rhyee:

And I’m really excited that for our first guest is Sean Duffy, co-founder and CEO of Omada Health, one of the leading digital health companies focused on diabetes and other chronic conditions.

Charles Rhyee:

Sean is not only a thought leader in digital diabetes management, but also on how digital tools are changing the way we manage chronic conditions into the future.

Charles Rhyee:

So, Sean, thanks for joining us today.

Sean Duffy:

Happy to be here, Charles, and honored to be the first guest.

Charles Rhyee:

Great. So, just real quickly, why don’t we start with a little background on Omada? What is Omada Health and what is the company trying to solve for?

Sean Duffy:

Yeah, happy to. So, Omada Health is a digital care company. Right now we offer support for patients with pre-diabetes, type two diabetes, hypertension, behavioral health, and musculoskeletal disorders.

Sean Duffy:

So, in many ways you can really think of us as a digital center of excellence in those condition areas with the thesis that every single one of those can best benefit on the vectors of value and outcomes with a digital first approach. And each of those condition areas requires significant depth of expertise and nuance to delivering on the end promise which is a promise of healthcare that’s more convenient, that’s more accessible, that feels better to a user and saves money in the system. So, that is the mission we’ve been on from day one and continue to drive towards.

Charles Rhyee:

And following up on that, if I remember correctly, you guys kind of started more in the pre-diabetes space, but that’s really expanded over the years. You talk about musculoskeletal. I know you moved into type two diabetes, behavioral health as well.

Charles Rhyee:

In a broad sense, where else are you moving and maybe

[inaudible 00:02:43]

, is that following the needs of where the buyers of Omada Health are pushing you?

Sean Duffy:

Yeah, absolutely. So, there’s really two lenses that we use as we look toward expanding in condition areas and capabilities. One is, what’s practical and will work for a person? So, what are the clinical realities that someone’s up against and is digital the right solution? You have to be pragmatic Omada, we’re not going to be doing hip surgeries anytime soon here.

Sean Duffy:

So, there’s the clinical side and what can work and save a cost, [inaudible 00:03:19] cost to the system. And the second is that is, what are customers asking for? So, primarily Omada’s go to market involves educating self-insured employers about our solution set and then primarily working with either their plans or their PBMs to deploy. So, that’s a voice that we listened to frequently and we found that over the past couple of years, it was very consistent on the asks and it was pre-diabetes type two, hypertension, behavioral and musculoskeletal as really the key that would come up the most.

Sean Duffy:

So, it doesn’t mean that we won’t entertain and, and think about other condition areas, those are just the ones that we viewed as the critical top ones that employers need to be solved. And if they can find a partner that can do a great job in each of those, we felt that that they would move toward doing that. So, that’s been a bit of the strategy,

Charles Rhyee:

And we’ll touch on obviously Covid and everything that’s gone on this year, but even prior to that, it seems like the digital diabetes management space and just digital health in general has gone through really rapid changes even prior to this year. And just maybe from your vantage point, what do you think some of the biggest changes that you’ve seen that’s driven that? Maybe start there.

Sean Duffy:

Yeah. Well, I mean, it’s a beautiful thing that the world’s recognized that what had been done to date is not working in diabetes. And anybody who’s spent an hour or so in the home of someone who’s diagnosed with type two diabetes and ask them what their care experience is like and what their day-to-day realities are like, I think quickly recognizes that there’s no way we’re going to stem the tide of chronic disease with status quo.

Sean Duffy:

So, the beautiful thing is there’s a recognition that something had to change. I mean, if you look at even just the past decade of clinical progress against key diabetes care measure, there’s been very little. Actually, an embarrassingly little amount if you think about it from the lens of what our country and society needs to do.

Sean Duffy:

So, what’s happened here is, A, a recognition that what was done in the past is not going to cut it for tomorrow. And there’s a crisis. It’s a five alarm fire here. And then secondly, consumers are starting to use technologies in new ways. Every single person, it doesn’t matter demographics, is likely to have a phone in their pocket. Every industry is being expected to create digital experiences, and so innovators like Omada in our competitive set have come along and said, “All right, the world’s waking up to this clinical challenge that we’re up against here and there are new tools and new consumer patterns that allow us to deliver different care that has the potential to solve some of the problems that we’ve seen.”

Sean Duffy:

So, with that as a backdrop, there’s a lot of excitement in this space. It is early innings. I mean, if you add up the numbers of people that have been supported from Omada, from our competitive set, really no one’s had the sort of impact that’s required here for us to really see a change in the epidemiology curves. We’ve passed the tipping point, the boulder is rolling down the hill, now it’s time for it to carry its momentum forward and make a dent in chronic disease in a big way.

Charles Rhyee:

You talked about, we’ve hit this tipping point, maybe you can help translate that a little bit into some of the growth that you’ve seen so far at Omada over the last years?

Sean Duffy:

Years. Yeah, no, it’s been a really exciting last couple of years for the business. I mean, we don’t publicly report revenues yet, but we entered this year and crossed the thousand employer customer mark which was a neat milestone in the business and that’s growing quickly.

Sean Duffy:

And I think the biggest thing for us right now, and the thing that we’re really excited by is customers that are adopting more from Omada and the customers that have asked, “Hey, would you ever consider MSK?” We’re really excited to see that we acquired an amazing company called Physera. Customers that had long been asking us to think about how to support their employees, not just with pre-diabetes but type two are really excited to see some of the innovation.

Sean Duffy:

And in diabetes in particular, so much is happening. So much innovation is being done there and we’re really excited with a number of elements and progress. We’ve got a really neat partnership with Abbott as an example, to be Omada’s continuous glucose monitor that we fulfill, we distribute, we integrate.

Sean Duffy:

But yeah, lots of innovation on all fronts.

Charles Rhyee:

Yeah. Maybe let’s talk about Abbott. It’s been almost a year since you announced the partnership with Abbott, maybe first give us some context around that partnership. What made you decide and what maybe helped them decide as well to partner with Omada on the FreeStyle Libre?

Sean Duffy:

Yeah, absolutely. Let me just start with the vision. So, wee have an approach at Omada. We tend to call it a preferred device approach. So, if someone has a need for the device, we’ll get it to them. So, we have a cellular connected glucometer, a cellular connected scale, blood pressure cuff, and now in our arsenal is the FreeStyle Libre.

Sean Duffy:

The reason we take that approach is because we want to make the setup and the integration as powerful as possible. So, this is not just a, “Oh, great, your CGM data’s piped in and you can see it inside the Omada app.” This is you have all sorts of insights, context, we distribute and fulfill a Libre, get it to you. Your coaches have all the view panes, all the insights from the CGM data in a deep integration that’s really a collective R & D effort between Omada and Abbott.

Sean Duffy:

And then on the backend, of course, we’re creating a lot of robust clinical development plans. So, spinning up a number of research studies to show the power of CGM plus programs like Omada.

Sean Duffy:

We think that there’s a number of innovators in the CGM space, a number of incredible companies, and applaud them all. If a patient has preference, that’s absolutely fine, we’ll listen to it. The reason that FreeStyle Libre felt like a fit for Omada was a combination of the user experience and the price point and the relevance to really as broad of a set of patients with diabetes as possible.

Sean Duffy:

It’s under the belief that in time, it’s not going to happen overnight, but in time, three, four years out, our belief is the vast majority of sugar readings as it relates to supporting someone’s health in diabetes will be done via the CGM landscape. So, working now to set all those foundations and make sure that they’re solid foundations such that when that world comes, we’re helping to lead it.

Charles Rhyee:

I think there’s a general view that we’re moving that direction for sure. When we think about traditional sort of diabetes management, though, it centers around these periodic blood sugar readings. And when you look at some of the earlier offerings in the space, it’s really designed around a moment in time, some type of coaching element, try to change the behavior and then move on.

Charles Rhyee:

Once you add CGM into that mix, where you’re having continuous information coming, how does that change the model then for programs like Omada? You kind of alluded to, at the beginning here, data coming in, but wrapping around a lot of other services. What is the fundamental changes in how you deliver that service then?

Sean Duffy:

Well, it’s a really big deal because, A, there’s the power of the data itself. Having continuous readings of your sugar is meaningful behaviorally because it’s a connection point. You, as a participant, can now see a physiological reading which is an output of your body on a real-time basis and reflect on what you ate, your behaviors against that and what might influence it. So, it creates a neat feedback loop.

Sean Duffy:

It’s best powered by interactions with coaches. So, all of our coaches are trained to interpret CGM data, the visuals and the dashboards and all of their homegrown tools. Omada’s built all of our care team platform ourself. It creates this feedback loop between coach and participant where they can notice either themselves or through machine learning insights or logic based algorithms, notice things in the data patterns that they can surface the participant and create that elegant interaction that maximizes the value and the power.

Sean Duffy:

So, there’s a lot in the nuance on the “how?”, But the power of CGM is amazing because the tricky thing with glucometers is, one, it’s kind of the obvious, but you have to prick your finger and A, it starts being a scary thing at first, but then it becomes such a negative part of your life. An embarrassing part of your life. Something that you just don’t want to do, that it leads you to be in a place where you start to just give up. You almost don’t, as a patient, want to even do it or know what’s on the other side or the reading.

Sean Duffy:

And then the value is tricky. I mean, there are some readings that have high utility, like a fasting reading, but the challenge is if you’re trying to get a sense for how a meal affected you, let’s say you eat the meal and you take a reading 20 minutes after versus 30, you might have a night and day different result because you’re on a curve here. And you might think different things based on the result and interpret things that are real or not, because you’re only getting a snapshot and a point in time.

Sean Duffy:

So, CGM is very powerful. I think on its own, CGM is quite powerful. I think CGM is maximized in the context of a program like Omada because you can look at physiological sugar variability and help support clinical and behavioral decisions against it in a way that can lead someone to have better optimized medications, to have more controlled sugars, and that foregoes many of the costly aspects of diabetes that people face as the disease progresses.

Charles Rhyee:

Yeah. Any surprises over the last year? Any things that you didn’t expect either in how your members responded or reception in the market? Anything kind of jump out at you?

Sean Duffy:

Well, yeah. Employers were loving it, which is awesome. Participants are loving it.

Sean Duffy:

What are the big surprises? I think it’s funny. It had a really cool cultural … I kind of knew. I felt the market would really like this and the participants would value it, but even at Omada, it made our team so proud because it’s so neat to be able to … You’re wearing a CGM, you swipe your phone with it, you see it in the Omada app, the coach reaches out. It’s like the overall orchestration made people at Omada feel really proud.

Sean Duffy:

And it’s tip of the sphere, it’s innovative, it’s kind of where care’s going, it’s not there yet. It’s going to take time to really get to the panacea here. But I would say the biggest surprise, funnily enough, it was internal. It really rallied Omadans around our diabetes solution, why it’s differentiated and why we should be really proud about it above and beyond what I expected.

Charles Rhyee:

Yeah. Obviously you guys aren’t alone here. I think companies like Livongo and Dexcom, they announced a partnership a little while ago. It seems like this is a lot of where the market is definitely going, integrating these kind of devices to these broader platforms.

Charles Rhyee:

If we extrapolate this then and think more broadly, what do you think this means for digital chronic care management more broadly? How do you think about that?

Sean Duffy:

Well, I think, similar, if you use the provider analogy like if you’re the Mayo Clinic, you use devices to support your patients against your principles of care and what you believe is right to be done. So, I would hope that A, all companies in our space are constantly thinking about where devices are going and how it can compliment their care. But most importantly, how they’re going to uniquely use the data. That’s where I think we just rest on our first principles of what makes Omada special and different in that it’s a very, very proactive approach, proactive program, very tight coupling in integrations between a diabetes coach and a [CDE who 00:15:51] who knows you, knows you persistently, is the same throughout the journey, gets to know you before you even get set up and uses the data to generate insights that we think are Omada unique.

Sean Duffy:

But I think that devices will be an amplifier for the entire space here, and we’ll encourage even more innovation for Omada, for our competitors, and that’s great that. Rising tide lifts all those here.

Charles Rhyee:

Is one of the things that you have to factor in though, is once you start getting continuous data coming in, not let’s say just from CGM now from other devices that are constantly feeding information, how do you work from a technology standpoint to filter that information? Because you don’t want your coaches responding to potentially noise. How do you make sure you get proper signal coming out of all this data?

Sean Duffy:

Well, the nice thing CGM is there is really, you can think of it as less noise ridden reading where you can get … I mean, I’ve seen it first hand. I’ve seen people say, “Oh, I tested my sugars today after breakfast and it was, 130 and yesterday it was 135.” And come up with a hypothesis on why, and it might be just noise in the data [inaudible 00:17:04].

Sean Duffy:

So, CGM is actually less noisy data, which is great, but our belief is that you really do need that complement of a person that’s leveraging technology to generate insights to support our participant. But a sanity check helps interpret the data, really helps support an understanding on how behavior is influencing the data. It really is there to be your sidekick as you think about your journey toward living more easily with a chronic disease and optimizing your health outcomes here.

Charles Rhyee:

Okay, great. Let’s move on topic, I’m sure a lot of people will understand is 2020 has been an exceptional year, probably not in the way most people would prefer but with Covid. No one anticipated this, but maybe talk about Covid has impacted Omada this year and your relationship with your clients.

Sean Duffy:

Yeah. So, it’s been a wild journey for the whole world here. I think in March and April, so much incredible uncertainty. Still a lot of uncertainty. I think what happened as it relates to healthcare is hundreds of millions of Americans woke up on the same day and said, “How can I get care remotely?” Because they were nervous to show up in person.

Sean Duffy:

I think that that at the end of the day is the fundamental thing that happened. People are talking a lot about regulatory changes. All those are very, very important, but the fact that people have tried getting care in new ways and in many instances liked what they saw will have transformational impact in the healthcare system.

Sean Duffy:

I think it’ll settle, I don’t think the level of virtual visits and telecare that we saw in peak Covid [inaudible 00:18:57] moments is the end state, I think it’s kind of somewhere in between here. But pulling more and more care to the cloud. And we’ve seen a recognition from employers that they have to offer solutions for their employees that enable care in the pocket and in the home, and Omada’s a piece of that.

Sean Duffy:

We’ve had companies that, my gosh, have had so many market headwinds. Have had to furlough or lay off more than half their workforce that I had thought, “Look, they’re probably not going to be customers of Omada because we’re just getting to know them,” still close and still get to the finish line because they recognize that for the employees they do have, they have to take care of them. And that they need innovative solutions that properly bring care into their employee’s home to make sure to avoid the downstream costs and problems that are going to come from foregoing important care, especially in the realm of chronic disease.

Charles Rhyee:

It’s interesting you say that. And I think virtual care has been sort of one of those bright spots in the market here, potentially to that point. There’s the recognition that even though all of this access to care is a very critical part of it. Do you think that might negatively impact growth next year? This pull forward effect that people rush to stand up some type of virtual care this year just as recognition that we needed something? How do you think that plays out over the next couple of years?

Sean Duffy:

I don’t personally think so because, it’s funny, I think it’s still really early innings. Frankly I think that people don’t quite realize how big some of these companies can become. Because when you look at the percent of overall care that’s delivered in the US virtually is still quite small. Again, we talked about diabetes, you add up our participant count in our major competitors and neither one of us have made really an impact in epidemiology yet.

Sean Duffy:

So, I think it’s actually early innings. What I do think happens is there’s a recognition that you need digital care and I think you look at adoption curves and this has pulled more employers and plans into our world recognizing that, “You know what? This is a must have. This is a must have. This isn’t a bell and whistle on top, this is a foundational core part of how care needs to be delivered tomorrow.” And I think we’ll see the acceleration of that over many, many years to come as it bears itself out.

Charles Rhyee:

Particularly as we think about this year. This year, probably a lot of people with chronic conditions probably have not been managing their illness effectively because of that lockdown restrictions. Do you see potential for some knock on effects, really, as we head into 2021, then?

Sean Duffy:

Yeah, I do. I think it’s a problem. We were looking at some data recently where from just about 50% of people with a chronic disease have skipped some sort of healthcare visit. I mean, we’ve seen it in our population where people will report to us, “I really don’t want to get my A1C checked. I’m nervous to go into the lab,” and we’re like, “You know what? We have some at-home kits here that we historically used for research purposes, but let’s get you one. Try that out.”

Sean Duffy:

So, I do think that it is a problem. I think it’s the headline behind a headline, not just in chronic disease, but elsewhere as well where there’s a lot of care that’s likely not happening and there’s going to be a toll. And the goal is to, for our participants, help prevent that, of course, but help show the world why digital needs to be a critical piece in minimizing that to the extent possible.

Charles Rhyee:

Yeah. How is Covid, do you think, really shifting consumer’s expectations about accessing care? To your point, woke up one day, everyone found out, “You know what? I can’t go see my doctor. What am I going to do?” Obviously telehealth, big in the news these days.

Charles Rhyee:

As time has progressed here, people have gotten a little bit more comfortable with it. What changes have you seen in member expectations for what they expect now that a digital experience should deliver to them?

Sean Duffy:

Yeah. I mean, for us, we never had any in-person components to Omada so it’s interesting. A lot of times people sign up with expectations that, “Great, I’m going to get digital support finally for the first time ever. And it’s going to be continuous and longitudinal.” I think there was an appreciation for that and got many of our users just reporting how great it felt knowing that you’d have support without having to show up in person.

Sean Duffy:

What I think it will do to the country is really reinforce this concept of in-person is option B, where it’s no, that in-person care is not important. It is, it absolutely is, but the idea that every single entity needs to ask themselves, “Can I solve that person’s need from afar without requiring them to come in safely?” And if the answer is, “yes” great, do it. If the answer is “no” or it’s the patient preference to come in, listen to it.

Sean Duffy:

It’s similar to return-to-work dialogue that’s happening here. I think you’ll find folks saying like, “Oh, it’s going to go back exactly as it was, offices are going to be the same,” you’ll find folks being like, “Everyone’s going to just be digital now, offices won’t even exist.” And the reality is probably a middle ground here where each modality has its core set of purposes and innovation in the world [inaudible 00:24:42] evolve to what makes the most sense to drive a great consumer experience and efficiency. But we’ll see that with digital care too.

Charles Rhyee:

And you say that though, you see some of the third party data, I think like at QV or whatever have reported, virtual businesses reversed and physical visits, in-person visits have jumped back up not quite to pre-Covid levels, but still pretty close.

Charles Rhyee:

To me it seems maybe a little bit more inertia because physicians are just so used to their office and want people to come in. Is that going to be something where it’s going to take the consumers to really push and say, “You know what, I don’t want to come in. I want a virtual visit.”?

Charles Rhyee:

What’s going to get the overall health care system to say, “We need to really have a virtual component to our practice.”?

Sean Duffy:

Well, I think what’s going to get it is when patients demand it and providers that differentiate when market share and employers that have capabilities to support their employees like Omada win the hearts and minds of their employees and save costs. So, it’s funny.

Sean Duffy:

There’s a little bit of a pendulum, it’s hard to read in the month to month because what happens is in a world where everyone’s very, very scared to go in person, you get a lot of foregone care and then all of the sudden you get a wave of backlog where it’s like, “Oh, my gosh, my tooth has been chipped for so long. What am I, going to wait till next spring to get this taken care of? I just got to do it.”

Sean Duffy:

So, the minute to minute, it’s hard to interpret. But I mean, you go around the room and you ask friends and family, using my mom as an example, she only did in-person care, now is doing FaceTime visits with her doc. She’s a chronic pain patient and I asked her, “Well are you going to go back? Assuming that your doctor’s still offer video, are you going to drive in?” And she’s like, “No way. Maybe like once or twice a year but that was a 30 minute drive and I had to wait in the waiting room. This is awesome.”

Sean Duffy:

I think you’ll get the consumer expectations to doing so. I think reimbursement, maybe not at the same rates, but it will be enabled, and the best providers and the best companies like Omada will listen very, very close to that and try to deliver value.

Charles Rhyee:

Yeah. And talking about Omada here, has this experience this year changed how you think about the business model itself? Like how you were going to market beforehand, do you see this experience changing how you go to market in the future?

Sean Duffy:

Yeah. It’s accelerated some things that were like, “We’ll probably do that over the next couple years.” Like we’ve brought in a lot of things that either we currently have in our product or on the roadmap yet to be shared and announced, but it’s made the future feel closer and it’s honestly made the weight of that feel heavier. This has been such a horrible thing for the globe, everyone wants to try to use your own agency, your personal energy and your passions to make some good out of it. Everybody wants that. This is one of the areas where every single CEO of every single digital health company or founder, every innovator, is feeling the immense pressure to don’t let this slip. Grab this one by the reins and make sure that good comes out the other side of this, because there has to be moments of silver linings for the purpose of humanity out of this tragedy for the globe here.

Sean Duffy:

And I think digital care is one of the ways that it can happen, but it doesn’t happen just by sitting back and lying on your back with your mouth open waiting for it to rain, you have to grab it. So, I think for us, it feels like we have more of a mission imperative than ever and we got to work harder and we got to be hungrier, and we got to be even more ambitious than we were before..

Charles Rhyee:

You talked about that maybe pulled forward some of the things in your roadmap. Maybe without going too deep into it, maybe some examples of you might’ve been looking at something and you want to pull forward that because of this has changed. Any examples you can maybe provide us?

Sean Duffy:

Well, CGM is kind of interesting because that’s the definition of getting someone a device that can monitor from afar, such that you can take action in the home and quickly and persistently. So, huge investments on the product side and accelerating that roadmap and the product capabilities, some in the context Covid here.

Sean Duffy:

A lot of focus on labs, a lot of focus on medication support and how we think about meds in the concept of chronic disease. We will have, of course, more to share on that in later times, but really bringing as much capabilities to bear as possible to make living with chronic disease as easy as it can be.

Charles Rhyee:

Okay. One of the things I think you guys have really been good at is really using data and clinical validated studies to demonstrate the efficacy of your programs. So, clinical evidence has been extremely important for Omada and certainly I think it’s something that is necessary to differentiate digital health companies going forward.

Charles Rhyee:

Last January, you guys announced plans to conduct probably one of the largest randomized controlled studies of a digital diabetes prevention tool. I think it’s, [inaudible 00:30:15] said it was predicts, preventing diabetes with digital health and coaching. I think it was in partnership with the University of Nebraska Medical Center, Wake Forest University. Maybe give us some context from the study and what the [inaudible 00:30:29] the decision to engage with a large randomized trial.

Sean Duffy:

Yeah. For that one, A, we were real excited by it, it’s been submitted. It’ll be presented in conference and then hopefully shortly thereafter out of a peer review process, it stands to be the definitive study in our space.

Sean Duffy:

We had plenty of trial data, the reason we did it is it hadn’t been done and at the end of the day, digital health is the underdog. Now maybe that’s become a little bit less so thanks to Covid, but our view is that the only way to really get to the promised land of digital health is just to constantly publish and constantly prove such that even the most conservative medical leader and policy maker can look at the data and say, “Oh, yah. This does work.”

Sean Duffy:

Despite us having many, many trials, we hadn’t done the definitive RCT because it’s very, very expensive. It’s many, many years. I mean, this in the works for years. Multiple years long undertaking, especially given that you’d need like a full year of data readout.

Sean Duffy:

And we’re excited that it’s coming to the finish line. And I think it will enable even broader acceptance and adoption of the clinical possibility and realities of diabetes prevention programs.

Charles Rhyee:

And what I find interesting here is that the study, if I’m not mistaken, tracks a wide range of outcomes not just A1C levels? I think it includes weight loss, changes in cardiovascular risk, quality of life. Many of the things. What was the reasons including such a wide range of outcomes?

Sean Duffy:

I mean, some of these are just hypotheses for like, “You know what? I bet by being in a program like this, it might influence that.” And then in a trial setting, you can collect the data [inaudible 00:32:24] validate some of those hypotheses. That’s kind of a big piece of it.

Sean Duffy:

And we wanted to take the opportunity to contribute to the literature in a meaningful way. It’s like, if we’re running the study, let’s answer as many unanswered questions about how our program works in practice as possible. And so that led to laundry list that we worked with our investigators to refine and pin down.

Charles Rhyee:

Yeah. Has the data been un-blinded yet or do you have a sense on what you’ve seen so far on it?

Sean Duffy:

We’ll soon be presenting it. So, it’s been analyzed. We’re very, very excited with the results and look for some news soon.

Charles Rhyee:

And maybe just for the listeners here, where will it be presented in?

Sean Duffy:

At the Obesity Society Conference, I’m forgetting the specific date on when that is, but that’ll be the first public unveiling here.

Charles Rhyee:

Great.

Charles Rhyee:

Doing such large trials, obviously as you mentioned, takes significant time and investment. How do you think the study changes the value proposition for the company? Do you see that as an important differentiator? I ask this question particularly because Omada as a digital health company kind of falls outside of the, you’re not in that regulatory pathway as defined by the FDA, right? You don’t necessarily have to conduct this. [inaudible 00:33:51] not submitted to FDA.

Charles Rhyee:

Does that change the way you think about proceeding here? Is there any reason that you wouldn’t want to submit, would that do something for you?

Sean Duffy:

It’s very clear where Omada sits relative to the regulatory infrastructure which is more of as a provider, a provision kind of care than as what the FDA would look out here.

Sean Duffy:

The big way that’ll help, the more randomized definitive evidence the better as it relates to this destination of making it such that, let’s just use diabetes prevention as an example, every single clinical guideline on the planet says, “If someone walks into your office with pre-diabetes or diabetes risks, as a PCP, you should refer them to an intensive intervention modeled off foundational literature in the space.” You cannot find a guideline that’s dissonant. I mean, even abroad, you look at what [NICE 00:34:50] says, what the [ADA 00:34:51] says, the problem is it doesn’t happen in practice.

Sean Duffy:

So, we want to create a world where 80% plus of the time, it’s just core. It’s an innate medical policy benefit. You’d be crazy if you’re writing a medical policy, not including it based on its merits. The destination for that is a long destination. The destination for that involves level one evidence like this RCT. So, it’s really planting the seeds for a future where instead of leaving a doctor’s office with a pamphlet, if you have pre-diabetes and a clinician saying, “Hey, you really should lose weight.” You have an evidence evidence-based program and clinical service capabilities that are covered, that are viewed as preventive, and that’s done through these sorts of investments.

Sean Duffy:

They’re just really long game. There’s no shortcuts in the spaces we’re in, so you constantly have to imagine five years out and think of what you have to do this quarter and this one fits in the five year out category.

Charles Rhyee:

Yeah. You think about the model today, you talked earlier about your thousand employer, customer. With this kind of data in hand, is this something where you go into the provider community and work with health systems and large physician groups to say, “Hey, let us be a core part of how you deliver care to your patients and manage them on an ongoing basis.”

Sean Duffy:

Mm-hmm (affirmative). I do think it opens up options like that in a very compelling way. For the plan landscape, as you’re writing medical policies, ideally you’ll look at data like this and like, “Yeah, all right, I hear you. This is real. This is really working. This is gold standard evidence here, this is level one evidence. It’s definitive.”

Charles Rhyee:

We’re kind of running on time here, and I want to really thank you for doing this. Really appreciate it.

Sean Duffy:

[crosstalk 00:36:48] Oh, for sure. [crosstalk 00:36:49].

Charles Rhyee:

Maybe lastly, you kind of touched on it at the beginning. Digital health, Omada and others, still retains such a small part of the market in terms of what type of care can be delivered. And it certainly seems like I’d say this year has been a tipping point unfortunately, because of Covid, you talked about about as a leader here at Omada and others, you need to take this by the reins. How do you see this playing out then for the next few years? What should investors look out for then?

Sean Duffy:

Yeah. From the perspective of investors, and I hope to earn the right to be thought of in this category, but the companies that I think that are going to be best positioned here are the companies where you’ve actually been imagining this world for a long time already and you’ve laid the five to six years of foundations needed to make it happen. And all the infrastructure’s laid, you’ve got the assets, you’ve got the growth.

Sean Duffy:

And if you’re betting that over the next five years, we’re going to see a minute by minute push to more care services being brought to the cloud. You’ve got to ask yourself, “Well, what are the current organizations that are well positioned to capitalize on that?” And I don’t think it’s necessarily you’re like, “I’m literally in a room right now with a co-founder starting a company.” I don’t necessarily think it’s the existing ecosystem because hiring a huge team of software engineers and designers and machine learning experts is a heavy endeavor.

Sean Duffy:

So, I think it’s companies that are scaled enough such that they’re ready for that next chapter but had this vision actually for a long time and Covid just serves as a catalyst to bring forward a future that they’ve long imagined would come through hard work, energy, and persistence.

Charles Rhyee:

Obviously a lot to look out for. Sounds like hopefully Omada will be a big contributor as well.

Sean Duffy:

We hope so. We, every year, stay hungry, so we’ll continue that path.

Charles Rhyee:

Great.

Charles Rhyee:

Well, hey Sean, really appreciate you joining us today. I’m really excited to have you as our first guest on the podcast and thanks for being part of this and thanks everyone for listening and look forward to having everyone tune in for our next episode.

Sean Duffy:

Absolutely. It was an honor to be here.

Charles Rhyee:

Thanks.

Voiceover:

Thanks for joining us. Stay tuned for the next episode of Cowen Insights.


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