Diabetes Medication Adherence Made Simpler with Amin Zayani, CEO at MedAngel

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: Welcome back once again to the outcomes rocket podcast. Today I have an outstanding guest for you. His name is Amin Zayani. He’s out of Berlin Germany. He’s the CEO of MedAngel. I mean is a very interesting individual because he’s a patient entrepreneur. He has lived with Type 1 diabetes since 2006. He’s a solar energy engineer by training and a hardware expert by trade. After a frustrating accident in 2013 when his insulin was frozen in a domestic refrigerator he became discovered a massive flaw in the way that medications are stored and handled at home. And he decided to found MedAngel to solve that problem. Since then he’s received the patient Entrepreneur Award by Novo Nordisk and life bulb in 2017. This award is given to patients that innovate technologies to make life exponentially better. He’s currently leading a team of engineers, pharmacists and designers to revolutionize the interaction of patient medication and bring peace of mind to everybody. And so what I want to do is give him a warm welcome and open up the microphone to fill in any of the gaps of that introduction. Amin such a pleasure to have you on the podcast my friend.

: Thank you, Saul. Thank you for having me. It’s an honor to be on this podcast. I’m a huge fan. I think my bio does me more than justice, it’s very flattering. Thank you so much. I wouldn’t do anything except that I wouldn’t be here without the outstanding work of my incredible team. And this is not a one man show. This is teamwork and they deserve all the credit. I’m just here behind the mic. It’s a team of operational people business, finance, designers, engineers, pharmacists. Most importantly our investors, angel investors and institutional investors so they just get all the credit.

: That’s awesome now for sure, Amin. There’s definitely no way we could do it without the help of an outstanding team and your team is top notch over there. What is it that makes you your patient. You live with type 1 diabetes. What was that one thing that that got you to say you know what I’m going to get involved?

: It’s pretty simple but before I really would like to highlight that I don’t like the term patients or patients for people who go to the hospital with a sickness. When you live with type 1 diabetes or other chronic conditions you’re a healthy individual who lives with a let’s say a health condition or a metabolic disorder. So it’s extremely important. I know it may sound a little bit too strict but I think it’s important that in this space and in this scene as professionals we should push for this and advocates for this language is extremely important.

: I think it’s a good call out I mean it’s a great callout.

: Thanks. Thanks a lot. So to answer your question how would decide to get in the medical sector. Two reasons. The first is when you get an autoimmune disease like type 1 diabetes you don’t have a choice. You have to become a health professional or expert of some sort. To manage it right, type 1 diabetes is a 24/7 condition that requires real time management. It’s not an injection a week. It’s really every bite you eat every effectivity just so you have to it’s not like you have a choice. And the second trigger for me to make it a full time professional occupation is frustrating an accident. I had in summer 13. I woke up with my blood glucose was really high. I took a shot to bring it down and it didn’t work. It took a couple of other shots, I took a new too pentrum to fridge nothing worked. I ended up in the emergency room and I was so frustrated at the end everything was fine. So they sent me back home with a fresh batch of insulation and luckily I didn’t get any complications. But I was really really frustrated and really wanted to know what went wrong because if I don’t know the cause of the problem it will happen again. And it was a Saturday and Saturday is a horrible day to have a medical emergency in Germany. Probably in most countries in the world. So it was a really frustrating situation and to make a long story short, I started troubleshooting and they traced the problem to my fridge my refrigerator, froze my insulin it’s a fridge that freezes everything during the night was closed and there was no way to find it. And I thought it was ridiculous. I thought that’s the year 2013. It’s really funny because the night before we were watching a recording of NASA robot landing on Mars. So after that I thought it was ridiculous that I can see the landing of robots on the foreign planet in real time. But I don’t know if my insulin is still effective or not in my refrigerator at home so I thought it was silly. It was ridiculous and also to make a long story short. This became my I decided to solve this problem because there was no solution on the market and this is how MedAngel was born and this is how I have to become an expert of some sort and medical design and technology.

: Quite a story. I mean and I appreciate you sharing that. And you’re right. You know we don’t have to tolerate low standards. And I love that you stepped up. There was a solution and you decided to build one. So maybe for the for the sake of the listeners that don’t know as much as you or I about your company since you already had a had a chance to educate me on it what does MedAngel do. What are you guys focused on?

: Okay well thanks for asking this question that Asia is a very simple and elegant solution to a major problem. So what we do is we give medications or in the case of diabetes insulin the ability to communicate and react with people who use it is the most important of my relationship with my insulin is the most important relationship in my life. Without it I’m dead. But Mycenaean does not communicate with me so I’m the guy who does all the work here. It’s a dysfunctional relationship somehow and with MedAngel we give the medication entirely. In my case a voice a way to interact. The solution is consists of two parts: a hardware component to smart sensor that is placed with the medication either on the go into the they carry with me every day or in the refrigerator. My stock is continuously monitors the temperature and communicates with an app on my phone. All the magic happens on the app. It’s very well designed I think and what it does is with a single glance at it you know if you’re good to use it or not. And that’s basically what we do. We eliminate the uncertainty about the storage of transport the conditions of temperature sensitive medications and first we fix the relationship individual medication.

: I think that’s pretty cool. So this is a portable device that stays at the right temperature so you don’t have to worry about it.

: You’re absolutely right. So it’s basically a smart sensor that is very small and elegant and you placed the mitigations and it’s communicates with your iPhone, with your smartphone in the background. And every time there’s a problem you get an alarm. And every time anything reassurance you just check the app.

: I think that’s so cool. So no need to worry about the temperature of that because you have a way to track it. Folks if you haven’t checked it out, it’s pretty cool. It’s for sale here in the U.S., it’s for sale in Europe right now. Amin and his team are offering this to consumers. They’re also working on an offering this more broadly to populations through payers and providers and even employers so excited to dive into this a little bit further with you, Amin. Thanks for sharing that with the listeners.

: Sure, thanks for giving us the stage.

: Hey, so obviously the hot topic is chronic diseases and managing medication but what would you say for the leaders listening to this podcast. What needs to be on their agenda today?

: And I think what I’m going to mention is already on their agenda it’s everyone’s agenda and it’s been for a couple of years. The billion dollar or the hundred billion dollar question is how to make it work or how to make it happen. And that’s basically the fact that every single aspect of our lives is now digital or in a way digital. So the way entertainment think of how we listen to music or how we watch shows, how we shop, we do our finances or banking, how we travel, book accommodation,how we meet other people, how we stay in touch with our loved ones. It is all digital. Today it’s made possible by these tiny supercomputers that are sitting in our pockets and they’re permanently connected to the internet and are packed with sensors. And the only or the last field but the last industry that did not catch up is health. So in a way that’s alarming. But on the other hand there is a huge opportunity I think for us as individuals and as a society it is extremely urgent to bridge this gap and to bring the health care and the health industry as a whole in the digital age.

: Yeah I think I think that’s really great. You know and as we as we take a look at these digital advances I mean let’s face it you know in healthcare I’ve had several guests here talk about the real innovation in healthcare is actually implementation because we’ve got so many advances we just got to figure out how to put them to use.

: Yeah. Yeah and the answer it’s really funny, funny industry because where I come from another core and the right from consumer electronics or from I.T. startups. Right. So for me discovering this like behind the curtains as a non as someone who sees behind the curtain that just consumes health services was a massive surprise. The number of parties involved in the tiniest of health related actions is huge and the amount of politics around it is massive. Just think about prescribing simple medication. So the person who prescribes the medication is different than the person who dispenses it is different than the person who uses it consumes it is different than the person who produces and is different from the person who pays for it. Or the party that pays for it. So if you try to put down on a piece of paper on a white board. The simplest action in this space you end up with a very very complex landscape. And for someone like me who comes from a completely different corner of the economy was really impressive.

: Yeah. Now it’s it’s a good call out, Amin. You know one of the things that I love about having leaders like you that come from different backgrounds is that you really cannot force the discussion about how much we need to simplify what we do in healthcare and so it’s wonderful whenever we have leaders come in with outside experiences because you force healthcare leaders that are traditional to the space to think outside the box and so as we consider this. What would you say today some stories that you have that have helped your organization improve outcomes by thinking differently?

: What is very simple. We think differently because that’s how we think. We didn’t think OK what’s being done and let’s try something else. We started from scratch. So what we did. We did not really invent anything. You just took ready the readily available technology and we did a lot of work researching all aspects of it. Medical Expert, clinical aspect, business aspect, design aspect. We did a lot of design work and the result of this is a very clean, disaffiliated user experience that fits in the essay everyday routine of people who use it and it solves a massive problem for them. So the thing is if you’re trying to reinvent a lot of stuff the barriers to other options are high. So I think the key is to go for shortcuts for clever ways of ensuring adoption and that’s by not changing people’s word just to become part of it. So what we do is something that requires very very little action from our users and the same time introduces major amounts of anxiety, uncertainty and financial waste. I think it’s key to approach problems from this angle. I can give you an example that’s outside MedAngel as well and that’s the way people think or some economies societies think about taking electronic health records to the digital age that say that the biggest problem is they think how can we do something that we used to do on paper with pen and paper to software? And the thing is if you think that you already lost you need to think what can software do for me how can I think that rethink the entire process why do I have to stick to something that was invented in the 40s and bring it to yourself to a new way to think to rethink things from scratch requires quiet really deep research. It requires challenge the status quo and thinking a lot of why not right. So that’s how we operate. That’s that’s our philosophy. That’s what I really want to do it not necessarily as the driving business philosophy but at least as an exercise for sure.

: No I think that’s a great call, Amin. and so as you’ve built this team and you guys have put forth the product into the market it obviously hasn’t come without mistakes or setbacks. Can you share one of those setbacks with our listeners and what you learned from it.

: Let’s see. I think I can talk for three days. Does that mean we wake up or do we make mistakes right. That’s what we do. They just have to be smart mistakes and not stupid mistake. So let me think if I had to pick up one I would call it a mistake. I would call it a misjudgment or something that needed calibration. I think that we underestimated the effort and the cost and the time it takes to go to market with an innovative product. So being a product driven founder like product and the solution we make and how it works and how people interact with it is at the center of my attention. I am obsessed with what I do but what I’ve realized is that if you want to bring that to the masses it’s not even 5 percent of the work they having a ready product it’s not even 5 percent of the work. There’s so much work that needs to be done to go to market to achieve product market fit to work on make sure that people know about it, buy it, use it, don’t stop using it. So I think we underestimated a lot the effort it takes to educate the market, to go to market, to develop the business launch. In retrospect I think it would have allocated three times four times as much to these activities more than product development itself but I think it’s very normal if you launch something so innovative it takes a little bit of time it takes lot of patience and a lot of calibration to do it. You just need to look at the first two years of something like the iPod. So I underestimated that our team underestimated that but luckily we did a soft launch and we could recalibrate on time and raising that investment to to fix this whole time. So at the end of the day I don’t think it was a big failure or a mistake it was just a reality check to recalibrate. So if I had to or if I give it advice to anyone who is listening and you’re launching an innovative product in a market that’s not exist right so don’t underestimate that. Be ready for a lot of recalibration. It’s going to take time, it’s gonna probably take more money than you think.

: And if you had to put a number on it would you say two times, more three times more?

: Than my estimate. Yeah 3x at least.

: 3x There you have it, listeners you know and we’ve heard this before from other entrepreneurs on the podcast Amin so definitely a good reminder folks you always have to make sure you think about this. It’s going to take longer it’s going to cost more especially in health care so 3x is the rule of thumb here and plan for it. And obviously resilience. Right. Amin and his team were resilient. They recalibrated and they figured it out. So congrats on getting over that hump. I mean and now that you’re over it it’s onto the next challenge is right because of always going to be challenges.

: Absolutely. Thanks for the compliment, Saul. You’re absolutely right. Resilience is extremely important in the wake up every day. You think: do I keep doing this or do I stop? And it’s a hard journey but the reward is really very fulfilling when you wake up one day and you read your e-mails and you have a user who writes back to you. Thank you so much. Thanks to your solution we could save like 500 or a thousand dollars worth of medications in our fridge right on time before it broke or during our holidays. It’s FREE MONEY for a family. Oh yeah you read an e-mail from a mother who says Finally I understand why my kid’s blood glucose is out of range all the time. That’s very very fulfilling. And you think OK I’m going to continue doing this today and tomorrow and next month and next year. So yeah we’re not doing this just for the money right. So health is really a hard space hard market but it’s so fulfilling.

: Totally agree. I mean totally agree. And what you’re doing is super impactful. What would you say. One of the proudest medical leadership moments you’ve had to date.

: Definitely definitely the life of Novo Nordisk a word that we won in November 2017. That’s a major achievement it’s recognition from the world’s largest insulin manufacturer and it’s the competition was furious. It was like really high high level startup’s who is a player is when you win against such competition. That’s a real recognition. And to see that the community that recognizes that this is a real need. That’s what we do is important. That’s priceless. And that also opens doors for a startup that’s happening its way right. And so that was an amazing moment. It was an amazing achievement. And the second one there is a very recent developments I’m really proud to announce on the spot guests that we are coming to retain in the USA with CBS. So our product solution will be available in pharmacies in California.

: Congratulations.

: Thank you very much. Soon as a pilot before scaling up to the rest of the USA and it’s really a major achievement because you have this idea in your head that your hassling away for three years and then you walk into the pharmacy and it’s there. Right. So that’s that’s amazing.

: Man it’s awesome, man.

: Our team is really proud of it.

: That’s so cool. Congratulations to you guys. And you know let’s face it. I mean what we’re dealing with here guys is is an opportunity for people to live more fulfilling lives without having to worry about their medications. If you know if you go to medangel.co, they’ve got a blog and I mean some pretty cool stories here folks. Like for instance when my insulin froze under the burning Greek sun summer holidays with diabetes seasun and insulin frozen stuck on an island that doesn’t have your insulin right. These are very real stories. And what Amin and his team are doing are are helping people live more fulfilling lives by keeping this just so easy. So really awesome stuff here, Amin. What would you say a focus that your company is working on today that you’re excited about?

: I think they’ve reached good validation in the consumer space. We decided to go the B2C route early on because we realized that working with other businesses is slow. Say cyclers or extremely slow in health it’s just because that’s how it is right. So right regulation and politics and business is just a very slow moving industry so what we decided to take advantage of the fact that our product is also consumer product and we went B2C and we were successful in let’s say establishing ourselves in this space. The next also mainly positioning for diabetes. So people with diabetes. I think the next challenge for us is to scale this up to other conditions so there is a number of chronic conditions that require using biologic injections TNF inhibitors and other biologics and these are extremely extremely costly medications. Just to give you an example, 18 out of the top 50 best selling meds in the world are temperature sensitive. Most of them are biologics. Maybe your listeners will recognize the best-selling drug of all times Humira by AbbVie. It’s a blockbuster it’s a miracle drug. Most users who are on it love it or taste their lives but it also generates 18 billion dollars in sales a year and that’s free money. And if you cannot be sure at the moment of injection if you’re banned or a syringe will be effective or not that’s pretty bad. And we hear this a lot from older users who use humira and other biologics. And so our next step is basically to bring many into to other chronic conditions like from a crisis MS inflammatory bowel diseases crawling number of growth disorders and most importantly to work with providers, payers, employers to bring this innovation to their customers or to their members for example what is really key or extremely important in having a solid B2C strategy or a solid consumer base is that you prove that people see the value of this and that they are willing to pay for it. They’re willing to bear the cost of this. And so it’s really an advantage for payers when you go to them and not ask for full reimbursement but for Copé and the outcome or the financial gain out of co-paying with the users is huge for all parties. So this is this is are our focus for the next 18 months. I would say.

: Super exciting. Love the business strategy and your approach and it’s working so keep up the awesome work.

: Thank you.

: So I mean let’s pretend you and I are building a medical leadership course on what it takes to be successful in medicine, it’s the 101 or the ABC’s. I mean of Amin Zayani. And so we’re going to write out a syllabus here. I’ve got four options for you lightning round style, so quick answers on these and then we’ll follow up with your all time favorite book. You ready?

: Ok I’m ready.

: All right what’s the best way to improve health care outcomes?

: It’s very simple. It’s to give people the power and the tools to manage their conditions and by that how you empower them. You basically reduce the time required by ACTs to provide care that reduce the costs for the users and the payers and most importantly people are willing to take this responsibility they have this responsibility. So if you want to improve healthcare outcomes give power and tools to the people and they will know how to use it, trust me.

: Love it. What’s the biggest mistake or pitfall to avoid?

: To keep traditional mindsets from 10-20-30 years ago and expect that things are going to change or be OK. So you’ve got to think outside the box.

: How do you stay relevant as an organization despite constant change?

: It’s very simple to be changed. If you are the constant change and you are a changed you can live with change.

: So what’s one area of focus that should drive everything in your company?

: Reaching product market fit and because it summarizes all aspects of the business. It means that you reach the sweet spot of right business model, the right product, the right channels, the right user experience and the right culture and the team internally so product market fit. That should be the true metric.

: Beautiful. What book would you recommend to the listeners, Amin?

: Hands down The hard thing about hard things by Ben Horowitz.

: Awesome, that has been recommended before. What do you like about it?

: It’s real. You know it’s not like I read so many business books and management books and all sorts of things that give you advice and tell you how to work according to plan. But anyone who’s been in the trenches including you, Saul that probably 90 percent of your listeners know that once you’re in like you go out there to real worked with a plan. Two weeks later that becomes irrelevant. That tells you how to do it. There is no that says you have to deal with it. And this one is it does right. It’s really it’s true. There is no hot air in it. There is no trying to make the work look better. There is no theory, it’s all practice. The guy that’s been there has been burned. He’s honest he’s authentic. I love it. There is a chapter in it that’s called the struggle. They read it probably more than 60 times. It’s amazing a recommend it to everyone who listens.

: What a great recommendation and thank you for that summary before we conclude, Amin, this has been so much fun. Really really appreciate your insights and sharing your stories and just the tidbits that you know that went into your struggles and also of your team’s successes. It’s been a really fun episode. Can you just share a closing thought with the listeners and then the best place that they could get in touch with you or follow you.

: Sure. So the best place is very easy it’s medangel.co we have a number of channels they can contact me and my team directly I read everything they see everything. Just if you want to contact me any channel will do. A closing thought is we’re very committed. We have a very clear vision and we are very committed and we want to bring peace of mind and we want to take uncertainty away. We want to reduce the cost of care and we want a better life for people who live with chronic conditions and if you are a provider or an insurer or an employer or any kind of whatever your professional position is that if you think that anything I said resonates with you or if you think that it is we have common interests. Please reach out to me and to my team and I’m very much looking forward to interacting with you and to drive change in healthcare.

Amin, thanks so much. Listeners, take Amin up for this invitation if something that he said or that him and his team are doing resonate with your goals and what you guys are working to improve health outcomes for your patients and your populations. Please reach out to him. Just go to outcomesrocket.health/medangel and you’re going to find all the show notes and links of the transcript and all the contact channels for Amin on that outcomesrocket.health/medangel. So I mean just want to say a big thanks my friend. Super thankful that you made time for us today and excited for the journey that you and your team have embarked on. Stay in touch.

: It’s my pleasure, Saul. Thank you so much for the invitation. And then we’ll definitely stay in touch.

Thanks for tuning into the outcomes rocket podcast if you want the show notes, inspiration, transcripts and everything that we talked about on this episode. Just go to outcomesrocket.health. And again don’t forget to check out the amazing Healthcare Thinkathon where we could get together took form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that’s outcomesrocket.health/conference be one of the 200 that will participate. Looking forward to seeing you there.

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