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Simply fantastic article. From the weight loss drugs to glucose monitoring and a broader understanding of how reimbursement works....all in one article. Thank you so much Herb!

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So I have used both Dexcom and Libre and I do agree with Dave’s assessment that the Dexcom is more accurate, particularly when compared to a 90 day blood work analysis as the basis. I do think because Abbott is into so many avenues of medical care and research, I think that they could be the better company to bet on especially if we see technology blending where technology meant for one disease is used in other diseases and general health, like continuous monitoring. When they create one for blood pressure that’ll be the next technological leap forward.

(As an aside, the Medicare & Medicaid programs prefer Dexcom to Libre because Dexcom still provides a reciever unit with its latest version where the Libre Freestyle 3 dropped it assuming everyone will have a smartphone. That’ll be fixed by the time the next iteration is released.)

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Abbott is far more diversified, and is moving quickly to challenge Edwards and, to a lesser extent, Medtronic on the transcatheter heart valve front. I'm biased in favor of Edwards since I own one of their valves, but Abbott seems to be making headway.

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Very helpful - thank you for posting this!

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So I have used both Dexcom and Libre and I do agree with Dave’s assessment that the Dexcom is more accurate, particularly when compared to a 90 day blood work analysis as the basis. I do think because Abbott is into so many avenues of medical care and research, I think that they could be the better company to bet on especially if we see technology blending where technology meant for one disease is used in other diseases and general health, like continuous monitoring. When they create one for blood pressure that’ll be the next technological leap forward.

(As an aside, the Medicare & Medicaid programs prefer Dexcom to Libre because Dexcom still provides a reciever unit with its latest version where the Libre Freestyle 3 dropped it assuming everyone will have a smartphone. That’ll be fixed by the time the next iteration is released.)

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Very interesting, thank you. The points about Apple continuing its foray into health care make perfect sense. It would not surprise me one bit if they introduced their own CGM.

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This was one of the most surprising pieces in the article. With Apple's towering valuation the need to bolt on growth must be crushing for Mr. Cook. Had not idea they might tack into this space. Mr. Greenberg's take that it further binds them to the Apple ecosystem resonated with how that company approaches the customer experience. The idea that Amazon would buy the insulin businesses seems equally compelling. This is a company that, post capex and lease payments (capex buried farther down the cash flow statement), has lost or made negligible cash profits, they have an aggressive affinity for low margin commodity products that they seem willing to sell at a loss (think grocery). They are profit-agnostic and in the relentless pursuit of top-line and this would seem to fit that definition quite well. Thanks for highlighting this - hope you have a wonderful weekend!

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