Livongo Clinical and Financial Outcomes Report

Published June 2016 © Livongo Health

Empowering People With Diabetes to Live a Better Life The Livongo for Diabetes Program offers the latest technology and coaching to empower people with diabetes to make better decisions. As a chronic condition, diabetes is a lifelong journey and the ongoing goal is to spend more time in the safe zone.1

LIVONGO FOR DIABETES The Latest Technology: The Livongo connected meter uses cellular technology to automatically upload blood glucose readings and provide our members with real-time personalized insights. The meter also enables seamless sharing of data between members and their loved ones as well as with their doctors. Coaching Anytime and Anywhere: We provide tailored support to each member to enable them to make better diabetes management decisions via our meter, mobile app, and coaches. Our coaches are Certified Diabetes Educators and are available 24 hours a day to answer diabetes questions ranging from nutrition to lifestyle changes. 1

Keeping People in the Safe Zone The safe zone, the healthy place for people with chronic conditions like diabetes, is not a destination - it’s an ongoing goal through someone’s life. The Livongo for Diabetes Program is designed to help people move to the safe zone and stay in the safe zone. According to the American Diabetes Association, the target range for blood glucose (BG) is 80 - 180 mg/dL and for HbA1c is 7%.1 By avoiding low blood glucose episodes, people can prevent urgent visits to their primary care physician or the emergency room.2 And by reducing the occurrence of high BG, people are able to prevent long term complications of diabetes such as microvascular events (kidney failure, blindness) and macrovascular events (heart attacks, strokes) - leading indicators of quality of life and cost savings.3

LIVONGO HELPS PEOPLE STAY IN AND MOVE TO THE SAFE ZONE

Livongo members are more likely to be in the target range within 30 days of activating and achieve substantial, sustained improved time-in-range over the course of their membership. After one year, Livongo members reduce their likelihood of having a BG reading of 180mg/dL by up to 21%.4

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Reducing HbA1c Improves Health4

Glycemic control in the form of lower HbA1c produces savings.5 HbA1c is a standard test to measure a person’s average blood glucose levels over three months. It is the most common measure used to assess how well a person with diabetes has managed their condition. Improving glycemic control improves and extends lives. With a reduction of HbA1c by 1%, we reduce health risks6: Death from Diabetes

Heart Attacks

Microvascular Complications

Peripheral Vascular Disease

21%

14%

37%

43%

HBA1C DECREASES FOR LIVONGO MEMBERS6 8.0%

7.5% HbA1c

For Livongo membersa who utilize the latest technology and coaching (Livongo for Diabetes Program) the mean HbA1c decreases from 8.0% at registration to 7.1% at 90 days and the reduction is sustained to 7.0% at 180 days.b Each point in reduction is directly correlated to cost savings.

7.0%

6.5% Self Reported at Registration

90 Days

180 Days

a

Livongo members who checked frequently enough to qualify for Nathan’s method and who received coaching as defined by alert outreach after high or low blood glucose readings or scheduled coaching sessions.

b

Members self-report HbA1c at registration and Livongo estimates HbA1c from mean blood glucose values at 90 days and 180 days. 3

Livongo Can Deliver Cost Savings5,6

People with diabetes incur total medical costs of $11,000 to $13,700 each year, of which $7,900 are diabetes-specific costs including diabetes supplies ranging from $180 - $660 annually. With complications, the annual cost of a person with diabetes can be as much as $20,700 compared to the $4,000 annual cost of healthcare for a person without diabetes.8,9

$73−99 Estimated Cost Savings per Member, per Month

1.2−4.2x Return on Investment in the first 6 months

c

Studies have shown that a 1% reduction in HbA1c yields substantial savings. If we apply a diabetes cost model5 to the HbA1c decrease of 1% for Livongo members observed in the first 180 days, estimated cost savings for Livongo members is $73 - $99 per month.c

Subtracting the $15 - 55 per person monthly cost of diabetes supplies replaced by Livongo and assuming the Livongo list price of $75 per member per month, an investment in the Livongo for Diabetes Program yields a 1.2 - 4.2x ROI in the first six months of the program.

Using the Bureau of Labor Statistics medical index to inflate cost savings from 1995 to 2016. 4

High Member Satisfaction and Increased Self-monitoring Livongo members are highly satisfied. As a result of this positive experience, Livongo members check their blood glucose more than 2x the national average.10

88%

Positive Experience

75% Feel More Confident

71%

Would Recommend

An increase in blood glucose check frequency is associated with a reduction in cost savings.10

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SOURCES 1. American Diabetes Association - Checking Your Blood Glucose. http://www.diabetes.org/living-with-diabetes/treatment-and-care/blood-glucose -control/checking-your-blood-glucose.html. 2. Shetty S, Secnik K, Oglesby AK. Relationship of glycemic control to total diabetes-related costs for managed care health plan members with type 2 diabetes. Journal of Managed Care Pharmacy. 2005;11(7):559-564. doi:10.18553/jmcp.2005.11.7.559. 3. World Health Organization Global Report on Diabetes. April 2016: 1-88. 4. Downing J, Bollyky J, Schneider J. Fewer Days of High and Low Blood Glucose Readings and HbA1c Reduction with Cellular-Enabled Glucose Meter. American Diabetes Association Scientific Meeting. June 2016. 5. Gilmer TP, O'Connor PJ, Manning WG, Rush WA. The cost to health plans of poor glycemic control. Diabetes Care. 1997;20(12):1847-1853. 6. Stratton IM, Adler AI, Neil HA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ. 2000;321(7258):405-412. 7. Nathan DM, Kuenen J, Borg R, et al. Translating the A1C Assay Into Estimated Average Glucose Values. Diabetes Care. 2008;31(8):1473-1478. doi:10.2337/dc08-0545. 8. The United States of Diabetes: Challenges and opportunities in the decade ahead. UnitedHealth. November 2010:1-60. 9. Economic Costs of Diabetes in the U.S. in 2012. Diabetes Care. May 2013:1-26. doi:10.2337/dc12-2625/-/DC1. 10. Karter AJ, Parker MM, Moffet HH, et al. Longitudinal study of new and prevalent use of self-monitoring of blood glucose. Diabetes Care. 2006;29(8):1757-1763. doi:10.2337/dc06-2073.

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ABOUT LIVONGO Livongo is a consumer digital health company that empowers people with chronic conditions to live a better life. Livongo has developed a completely new approach for diabetes management that combines the latest technology with coaching. We start with our connected meter, which provides real time personalized insights and also opens up communication with our Certified Diabetes Educators. As a result, our members receive personal tips and expert advice at anytime. We make diabetes management simpler and easier so our members can live the life they want.

To learn more about bringing Livongo to your organization, contact your Livongo Sales Representative or call 866.435.5643. Visit us at www.livongo.com. Clinical and Financial Outcomes Report Published June 2016 © Livongo Health