Re-imagining LGBTQI activism
Diabetes is one of the top three causes of death in Mexico, as well as a leading cause of disability and early retirement. People can suffer for years after being diagnosed with diabetes, and treatments are prohibitively expensive for many. Numerous treatments are required on a regular basis to help manage the disease, including insulin injections, blood sugar test strips, and medications for hypertension and other complications.
Clinicas del Azucar is a venture-backed business that runs low-cost diabetes prevention and treatment clinics throughout Mexico.
Clínicas del Azúcar was created to address the tremendous suffering caused by diabetes and the lack of access to treatment. Celebrating its 10th anniversary in November of this year, Clínicas del Azúcar is a venture-backed business that runs low-cost diabetes prevention and treatment clinics throughout Mexico. The clinics are the first-of-their-kind, efficient, “one-stop-shop clinics” and affordable.
Founded by Javier Lozano, a graduate of ITESM and MIT, Clínicas del Azúcar has grown to more than 25 clinics and employs over 250 experts, including doctors, nutritionists, and educators. The clinics offer a range of services, from consultations to blood testing to eye exams. Conditions currently treated are pre-diabetes, diabetes, cholesterol, obesity, and hypertension. In addition to treating the physical aspects of these ailments, the clinics have specialists who can provide emotional support and help with lifestyle choices around diet and exercise.
Javier was kind enough to share with me the background behind the creation of Clínicas del Azúcar , details of its work, and a look into its future. First, how Clínicas del Azúcar came to be: Javier’s mother has diabetes; at the time, she was exhausted and struggling to get it under control. She would try and fail and then feel bad about herself, not knowing that 95% of people fail. She said she was tired and didn’t care anymore. This made Javier ask why it was so inconvenient and so hard. He then had what he calls his “a-ha moment”, thinking “Can we build the McDonald’s of diabetes care?” When Javier started exploring his idea of diabetes treatment clinics, he discovered that 80% of people couldn’t pay for services. So Javier asked them “How much can you pay?” The answer was $250/year on average. Javier then went to his team and asked, “What can we do for $250?”
When Javier started exploring his idea of diabetes treatment clinics, he discovered that 80% of people couldn’t pay for services. So Javier asked them “How much can you pay?”
There are three fundamental aspects of Clínicas del Azúcar’s business model that make it unique:
- The membership model: they are the first to use a subscription-based model in chronic care; A one-year subscription costs $250: this takes away the patients’ fear of how much additional services will cost;
- Efficiency of the clinics: each time a patient gets a request from the doctor, only half the patients will follow through. For each subsequent request, again only half the people will do it. That’s why only 8% of people get an eye check and 2% of people get a foot check. So Javier and his team decided that all the patient services needed to be in the same place, like an assembly line. Patient treatments are completed in an hour and a half – it’s very efficient;
- Data capture: Clínicas del Azúcar has more than 2,000 data points for each patient, all in one database. This gives them the ability to correlate and analyze patient data, and use that data to improve outcomes.
Another thing that differentiates Clínicas del Azúcar is its use of behavioral science. Javier notes that he can predict which patients will have more of a challenge to reduce glucose levels, and which patients will be harder to control. The messaging to each patient is personalized: some patients are more competitive than others. All patients are also asked to sign a letter committing to six months of treatments for a specific person, e.g., their father or child, etc. To engage low-income patients without increasing costs, Clínicas del Azúcar partnered with Deloitte to create a point system using behavioral economics, attaching patient improvement to points that can be exchanged for rewards. A second partnership with Eli Lilly and MIT Professor Jonathan Gruber does research on how incentives increase retention of patients.
Clínicas del Azúcar offers an affiliate corporate program, so companies can partner with Clínicas del Azúcar to help their employees manage diabetes. The program offers discounts to employees and their families for clinic treatments, services, and educational materials. In addition, the company pays Clínicas del Azúcar to manage all the treatments related to diabetes, hypertension, obesity, and cholesterol of the company’s employees. These programs have had the benefit of improving both the well-being and the productivity of the employees.
Clínicas del Azúcar has been such a success that it now has its own Clínicas del Azúcar Foundation, which grew out of the passion its employees have for their work. Programs include providing services to those without financial means, training educators to go into communities to teach people about diabetes and how to prevent and/or treat it, and offering primary care and dental care options in areas that are far from any hospitals or clinics.
When asked how Covid-19 has affected Clínicas del Azúcar, Javier noted that Covid created a lot of awareness of the dangers of diabetes and hypertension. They launched a virtual clinic a few months ago to reach out to patients in a way that is safer for both the patients and the clinicians. An added benefit of the virtual clinic is that it has enabled Clínicas del Azúcar to reach patients in more remote areas. This virtual clinic is part of a hybrid model – virtual for specialist consultations, and then partnering with diagnostic test companies to do any necessary lab tests.
Looking forward, Javier says that he and his team want to inspire and show others how to use data and AI to reduce healthcare costs, as well as continue their mission to make specialized diabetes care accessible to all. According to Javier, their goal is “to have 80 clinics by 2023 throughout Mexico, and plans to use digital clinics to reach more of the Latino population in the U.S., as well as people in Latin America”. In Q1 of 2022, Clínicas del Azúcar will be doing its next funding round, and wants to expand to the rest of Mexico, while building on their existing data and AI capabilities. Javier wants diabetes treatment to be very high-tech, and feels that using data to personalize treatment is as much a tech problem as a healthcare problem. Clínicas del Azúcar’s immediate goal is to become as patient-specific as possible, not just in what and how many medication doses to provide, but also in the messaging to patients on how best to manage diabetes.
These days, Javier’s mother is feeling much better: she was Clínicas del Azúcar’s fifth patient.