$248 million in cash from Sanofi, and the same amount in a capital contribution by Verily (not in cash) have breathed life to a new company — Onduo — where the two equal partners will wage battle with a formidable enemy: diabetes.
That part — Google’s life science business and a well-known diabetes drug maker is collaborating to create a startup targeting type 2 diabetes patients initially — is clear.
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However, what exactly the platform is and what products will emerge from this new company based in Cambridge, Massachusetts, is far from crystal clear.
Apparently even to the executives involved.
“The reality is that we don’t have a product to start with,” declared Joshua Riff, the CEO of Onduo, in a Google Hangouts interview from Germany, on Monday. “The exact product we don’t know what it is because we haven’t built it because we haven’t identified all the problems that we are trying to solve.”
That’s where the partnerships with Sutter Health in Northern California and Allegheny Health Network of western Pennsylvania come in. As Onduo builds modules that will ultimately be integrated into its platform, they can be tested for type 2 diabetes patients in a clinical care setting.
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A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.
Joshua Riff, CEO of Onduo
“At the end of the day I could tell you that it will be a digital platform that will involve software, hardware, and very importantly service,” Riff said, while the news release also adds “medicine” to the mix. “What we are really trying to do is create a behavioral change platform and so we know that technology is going to be an important part of it, but it’s only going to be part of it.”
Riff was trained in emergency medicine at Johns Hopkins Hospital and he joins Onduo from Optum, the service arm of United Healthcare where he was senior vice president of prevention and well-being. He was previously medical director at Target.
In the formation of Onduo, Verily is charting a path that it has taken before with at least one other healthcare venture. Last year, the company announced that it was teaming up with Johnson & Johnson to create a new kind of surgical robotics company — Verb Surgical.
The set up for both Onduo and Verb Surgical is grounded in the concept of a complementary marriage. In other words, the more established healthcare company brings the experience with patients, providers and clinical expertise, whereas the Verily team brings engineering, data analytics ad machine learning capabilities, not to mention experience in creating products for consumers.
And this latter expertise might mean the difference in the Onduo digital platform that will integrate hardware, software, medicine and service. Riff explained that unlike current approaches to treating type 2 diabetes that have a decidedly provider/clinical slant — how do we prevent amputations, blindness — Onduo’s premise around type 2 diabetes is that better glycemic control is about behavioral change and lifestyle modification and not simply titration or switching meds.
“Type 2 diabetes is really a medication meets lifestyle [disease],” he said. “Behavioral change is really, really hard. We believe we really need to start there.”
The different products that will be included in the program is meant to address those lifestyle pieces – nutrition, physical activity, stress and even sleep. Riff wouldn’t address whether the platform would ultimately involve the cheaper, smaller next-gen continuous glucose monitoring sensor that Verily is building with Dexcom but did reveal that sensors would be core to the platform.
“I anticipate that used appropriately sensors will be a critical part of our strategy,” he said. “I can’t say specifically though if it’s going to be Dexcom or any other device.”
The diabetes management space is crowded to say the least.
You have pre-diabetes management companies like Omada Health and its competitors, to digital health companies like Welldoc, MySugr, Glooko and Livongo. Now even device makers like Medtronic are trying to attack the lifestyle problem by creating digital health apps in partnership with IBM and leverage data from its insulin pumps to help patients manage their condition better.
Then there are artificial pancreas development companies – both startups like Beta Bionics, Bigfoot Medical and established ones like Insulet, Johnson & Johnson, and Medtronic that want to automate insulin delivery. The latter group though is focused on type 1 diabetes, not immediately the concern on Onduo.
Riff, while acknowledging the existence of several companies in the diabetes landscape, dismisses competition entirely. For two reasons.
“Until we understand the product, some people who might seem like competitors could actually become a partner,” he declared.
And then more importantly, “Even if you have somebody on an artificial pancreas when it’s eventually made, if they’re not doing their routine care, if they’re not going to the doctor, if they’re not watching somewhat of what they are eating, it’s a temporary fix. That’s why the lifestyle fix is so important.”
Can technology spark and sustain behavior change in chronically ill patients enough to demonstrate improvements in outcomes and lowered costs? Verily and Sanofi are audaciously saying ‘oui.’
The proof will be in the pudding.
Photo: Onduo
