Axios Pro Exclusive Content

Diabetes care vendors say scathing study doesn't tell full story

Illustration of a red cross balancing atop a syringe

Illustration: Natalie Peeples/Axios

A scathing new study concluding that digital diabetes tools don't improve patients' health and increase overall spending doesn't tell the whole story, companies mentioned tell Axios.

Why it matters: The study is one of the first large-scale pieces of research to question the benefits of digital diabetes care, long considered a proof point for the overall sector.

What they found: Researchers concluded that digital diabetes tools from companies like Omada, Vida Health, Verily-Onduo and Teladoc-Livongo "do not deliver meaningful clinical benefits, and they increase health care spending relative to usual care."

  • "The evidence showed that improvements in glycemic control for patients using digital diabetes management solutions were minimal and short-term," the researchers add.
  • "After accounting for the average price of these products, these solutions increase net health care spending for purchasers," they say.

The other side: "The missing piece here is that the diabetes population has many treatment goals," says Omada Health chief medical officer Carolyn Bradner Jasik.

  • Jasik takes issue with the study's primary focus on A1C, a representation of average blood sugar levels over the past three months.
  • "It would be like evaluating how well a primary care office treats acute asthma and using that to assess the whole clinic," Jasik says.

Yes, but: The metric is logical, considering the researchers took a methodological tack to their study similar to ones researchers apply to therapeutics, or medications with only one treatment outcome.

The intrigue: Virta Health was the only company in the assessment for which the researchers concluded there was enough evidence to "support broader adoption."

  • "Before Virta ever signed its first customer, we invested in a clinical trial to determine the effectiveness of our approach for treating metabolic disease," said Adam Wolfberg, Virta Health chief medical officer, in an emailed statement to Axios.

The big picture: The study prompts bigger questions about the digital health industry and how outcomes should be measured.

  • The question is whether virtual care is a just new way of delivering standard in-person care (and should be assessed as such) or an entirely alternate channel of care that should be measured differently.
  • Jasik, who says she thinks of Omada as similar to in-person care, believes in the former framing.
  • "What's broken [in diabetes care] is not the care itself," she adds, "but the access to that care — people can't get to the hospital to get it."

The fine print: The group responsible for the study is the Peterson Health Technology Institute (PHTI), launched by the nonprofit Peterson Center on Healthcare with $50 million to assess the clinical benefits and economic impact of digital health tools.

Between the lines: Omada's Jasik also noted the PHTI study considered only the research that Omada had available at the time, which was limited to four-month sponsored studies.

  • Omada recently unveiled a new 12-month sponsored study, which found that members with Type 2 diabetes with high A1C levels (>8%) saw an average 1.8-point decline in A1C over that period.
  • That's a significant drop that has been linked to a reduced risk of heart attack and stroke and fewer diabetes-related deaths.
  • That study was published in the journal The Science of Diabetes Self-Management and Care before PHTI had time to consider it, per Jasik.

Follow the money: Since 2010, companies providing virtual diabetes care have drawn $5.7 billion in venture capital, per Rock Health data, with transactions including mergers and acquisitions totaling $58 billion, per PitchBook data.

Follow the money: Since 2010, companies providing virtual diabetes care have drawn $5.7 billion in venture capital, per Rock Health data, with transactions including mergers and acquisitions totaling $58 billion, per PitchBook data.

Go deeper