|02.26.20| Ro adds prescription allergy to its offerings; New data from Onduo; Google's Fitbit acquisition could pose privacy issues

Direct-to-consumer virtual health company Ro is now offering allergy care. The launch means that users of Roman and Rory will be able to get prescription allergy medications through the platform’s telemedicine model.

While the company said that the new service will not be treating food allergies or uncontrolled asthma, it will cover seasonal allergies, including conditions like hay fever.

Patients will be able to get prescriptions for the generic forms of Xyzal (levocetirizine), Singulair (montelukast), Flonase (Fluticasone Propionate), Astelin (Azelastine Hydrochloride).

WHY IT MATTERS

According to the CDC, 19.2 million adults in the US were diagnosed with hay fever in the past 12 months. The company is pitching this as a way for users to access doctors and medical care to address this.

In a Medium.com post announcing the new launch, Dr. Lauren Broffman, research scientist at Ro, noted that allergy season is lasting longer, thanks in part to climate change and air pollution.

“We’d prefer if there was less air pollution and that global temperatures stopped rising, but we know that can’t happen overnight," Dr. Lauren Broffman, research scientist at Ro, wrote in a Medium.com post announcing the launch. "In the meantime, we want to provide convenient access to doctor-prescribed allergy treatment plans for anyone who needs it. Our mission is for telemedicine to democratize healthcare, and offering treatment for allergies is no exception.”

THE LARGER TREND

Ro made a name for itself as a platform specifically for men’s sexual health and wellness. Since then it has launched female-focused services under the name Rory. The company has also dipped into smoking cessation, with its platform Zero, which uses a prescription nicotine replacement therapy and behavioral app. The company is also particularly well-funded. In 2018 it landed $85 million to work on Zero. The company’s most recent launch was for a weight management pill.

Ro and competitor Hims, which also works in in the online mail-order sexual health space, came under fire when a New York Times article examined the company’s prescribing practices. The article points out that the clients come to the platforms with a “self-diagnosis” and don’t need to see a doctor in person.

Type 2 diabetes patients who received a continuous glucose monitoring (CGM) system as part of a virtual diabetes clinic program improved their HbA1c and near-uniformly said they were comfortable self-inserting a sensor with guidance from a remote coach, according to study data presented by Onduo at an academic conference last weekend.

Further, while more than half of the study’s nearly 600 participants said that they were unaware of CGM systems prior to enrollment, 95% or more said that their knowledge of diabetes management improved over the course of the program.

"These data serve as a very robust demonstration that it is feasible to ship CGM to people with Type 2 diabetes, train them on how to use the system virtually, and derive significant value from its use,” Dr. Richard M. Bergenstal, executive director of the International Diabetes Center at HealthPartners, and a collaborator on the study, said in a statement. “A majority of these people were not previously familiar with CGM, suggesting that approaches like that used by Onduo can broaden access to this transformative technology.”

TOPLINE DATA

According to the abstract published on the Advanced Technologies & Treatments for Diabetes conference’s website, Onduo Virtual Diabetes Clinic participants who returned a user survey were on average 53 years of age, with 62.4% being female. Three in five said that they were not previously familiar with CGM technology.

Respondents largely said they were satisfied with the CGM (4.5 out of 5 overall satisfaction score), with 94.8% saying that they were comfortable inserting the sensor with remote guidance. Ninety-seven percent said that the program helped them better understand the impact of their eating habits, 95.6% said that their diabetes knowledge increased and 79.5% said that the program improved their ability to control the condition while not wearing a sensor.

"Once people in our program learn about CGM, they can't wait to use it to learn more about their body's responses to food, physical activity, and medication,” Dr. Ronald Dixon, CEO and president of Onduo Professionals, P.C. (the independent company that provides clinical services to Onduo), said in a statement. “We're eager to introduce even more people living with Type 2 diabetes to CGM and use enhanced, personalized decision support to unearth patterns and further improve outcomes.”

In terms of clinical measures of improvement, 372 of the investigation’s 595 respondents decreased their HbA1c levels from 7.7% down to 7.1% (p < .001) over an average follow-up time of 10.2 months. These improvements were greatest among those with initial levels greater than 9% (2.6% decrease; p < .001).

These results, the researchers concluded, “suggest that it is feasible to provide [real-time] CGM directly to individuals with [Type 2 diabetes] through a [virtual diabetes clinic] without in-office training.”

HOW IT WAS DONE

Investigators mailed CGM satisfaction surveys to 762 adult patients with Type 2 diabetes who were participating in Onduo’s program, which also includes remote health coaching. To included, these participants each had to have been evaluated, prescribed and mailed their CGM devices, and have used at least one sensor with their system between March 2018 and July 2019. The researchers also reviewed changes in HbA1c levels from pre- to post-CGM use among a subset of survey respondents.

THE LARGER TREND

These data come a couple of months after Onduo celebrated the publication of its first peer-reviewed clinical outcomes. Here, a six-month study among 740 program participants in 21 US states highlighted similar improvements to HbA1c as a result of the tech-driven management strategy.

But the company’s momentum was short lived, as word came out roughly a week later that Sanofi would be dialing back its role in the company’s operations. Verily, for its part, still seems fairly committed to the ambitious joint venture, based on a statement it released addressing Sanofi’s decision later that week.

ON THE RECORD

“It’s all about convenience. You can have the best tools and doctors in the world, but people need to be able to access them,” Dr. Josh Riff, CEO of Onduo, said in a statement. “Onduo was the first virtual clinic where endocrinologists could remotely prescribe CGMs to patients, have them shipped directly to their home, and have a coach support the remote placement of the device. It’s exciting to see such positive results.”