At ZP we are a contract developers of biosensors and IVD, including diagnostics intended for home monitoring.
The poster child of home IVD are glucose strips for self monitoring of blood glucose (SMBG) in Type 1 and Type 2 diabetics. In this note we use the examples of SMBG strips versus cholesterol stips to answer the question why SMBG strips are a successful product whilst cholesterol strips are much more of a niche product.
Whether a home diagnostic test is successful as a product is a complex problem, but in the ZP Triad for home diagnostics adoption we discuss three factors: pain of testing, cost of testing and consequence of not testing. In this note we will will contrast blood glucose testing to blood cholesterol testing. It should be noted that cholesterol is associated with cardiovascular disease and strokes two of the biggest killers in the USA, with diabetes also in the top five, so both cholesterol and glucose home testing have potentially large markets.
When we consider home blood glucose testing and home cholesterol testing we can say that both require the lancing of a finger and have a pain associated with them both; so blood glucose testing does not have a an advantage over cholesterol testing from the consideration of pain of test. It should be noted that when developing a home test the pain associated with the testing is an important consideration. People are much more willing to give other samples such as saliva, urine and breath, whilst giving a blood sample will impede people’s’ willingness to adopt a home test.
If we consider the cost of cholesterol testing versus the cost of glucose testing, they are both fairly low cost tests, so both tests score similarly to one another on cost.
The final consideration is the consequence of not testing. For a Type 1 diabetic to not test their blood glucose it can lead to a hypoglycemic situation where the diabetic becomes disorientated. If the diabetic becomes hypoglycemic whilst sleeping they can become unconscious and if the diabetic is not able to realise their situation they can enter a coma and die. So for a proportion of the diabetic population there is an immediate potential consequence of not testing which can end in death. If we contrast this with a person with high cholesterol the cholesterol can lead to heart disease and strokes, but the the risks associated with cholesterol are not immediate they are long term and gradual, and so there isn’t an immediate risk to the patient of not testing. It is this final point that separates glucose testing from cholesterol testing, in that glucose testing provides information that should be immediately acted upon, whilst cholesterol testing provides information which can affect the longer term health of the patient.
So in summary cholesterol and glucose testing both have a similar cost and pain associated with the tests, but with glucose their is an immediate action that can be taken from the data, but with cholesterol the action and consequences are longer term.
A test that scores well on pain, cost and consequence will more likely be adopted as a home test.