德康醫療 (DXCM) 2021 Q3 法說會逐字稿

Welcome to the DexCom Third Quarter 2021 Earnings Release Conference Call. My name is Darryl, and I will be your operator for today's call. (Operator Instructions). Please note that this conference is being recorded. I will now turn the call over to Sean Christensen. Sean, you may begin.

歡迎參加 DexCom 2021 年第三季財報發布電話會議。我叫 Darryl，將擔任今天會議的接線員。（接線員指示）請注意，本次電話會議將被錄音。現在我將把電話交給 Sean Christensen。Sean，您可以開始了。

Thank you, operator, and welcome to DexCom's Third Quarter 2021 Earnings Call. Our agenda begins with Kevin Sayer, DexCom's Chairman, President and CEO, who will provide a summary of our progress on our third quarter highlights and strategic initiatives; followed by a financial review and outlook from Jereme Sylvain, our Chief Financial Officer. Following our prepared remarks, we'll open the call up for your questions. Our Chief Technology Officer, Jake Leach, will also be present with us for the Q&A period. (Operator Instructions)

謝謝您，接線員，也歡迎各位參加 DexCom 2021 年第三季財報電話會議。我們的議程首先由 DexCom 董事長、總裁兼執行長 Kevin Sayer 開場，他將就第三季重點成果與策略性計畫的進展提供摘要；接著由我們的財務長 Jereme Sylvain 進行財務回顧與展望。在我們的預先準備發言之後，我們將開放各位提問。我們的技術長 Jake Leach 也將出席問答環節。（接線員指示）

Please note that there are also slides available related to our third quarter performance on the DexCom Investor Relations website on the Events and Presentations page. With that, let's review our safe harbor statement.

請注意，DexCom 投資人關係網站的「活動與簡報」頁面亦提供與我們第三季表現相關的投影片。接下來，讓我們回顧安全港聲明。

Some of the statements we will make in today's call may constitute forward-looking statements. These statements reflect management's intentions, beliefs, expectations and assumptions about future events, strategies, competition, products, operating plans and performance. All forward-looking statements included in this presentation are made as of the date hereof based on information currently available to DexCom, are subject to various risks and uncertaintiesand and actual results could differ materially from those anticipated in the forward-looking statements. The factors that could cause actual results to differ materially from those expressed or implied by any of these forward-looking statements are detailed in DexCom's annual report on Form 10-K, most recent quarterly report on Form 10-Q and other filings with the Securities and Exchange Commission. Except as required by law, we assume no obligation to update any such forward-looking statements after the date of this presentation or to conform these forward-looking statements to actual results.

我們在今天電話會議中所做的部分陳述可能構成前瞻性陳述。這些陳述反映管理層對未來事件、策略、競爭、產品、營運計畫與績效的意圖、信念、預期與假設。本簡報中所有前瞻性陳述均以本簡報日期為準，係基於 DexCom 目前可得資訊作出，並受多項風險與不確定性影響，實際結果可能與前瞻性陳述所預期者有重大差異。可能導致實際結果與任何此等前瞻性陳述所明示或暗示者有重大差異的因素，已詳載於 DexCom 的 Form 10-K 年度報告、最近一期 Form 10-Q 季度報告及向美國證券交易委員會提交的其他文件中。除法律要求外，我們不承擔在本簡報日期後更新任何此等前瞻性陳述，或使其與實際結果一致之義務。

Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP with respect to our non-GAAP and cash-based results. Unless otherwise noted, all references to financial metrics are presented on a non-GAAP basis. The presentation of this additional information should not be considered in isolation or as a substitute for results or superior to results prepared in accordance with GAAP. Please refer to the tables in our earnings release and the slides accompanying our third quarter earnings presentation for a reconciliation of these measures to their most directly comparable GAAP financial measure.

此外，在本次電話會議中，我們將討論若干未依 GAAP 編製的財務衡量指標，涉及我們的非 GAAP 與以現金為基礎的結果。除非另有說明，所有對財務指標的提及均以非 GAAP 基礎呈列。此額外資訊之呈現不應被孤立看待，亦不應視為可替代依 GAAP 編製之結果，或優於依 GAAP 編製之結果。請參閱我們的財報新聞稿中的表格，以及隨第三季財報簡報附上的投影片，以取得這些衡量指標與其最直接可比之 GAAP 財務衡量指標的調節表。

Now I will turn it over to Kevin.

現在我把時間交給 Kevin。

Thank you, Sean, and thank you, everyone, for joining us. Today, we reported another strong quarter for DexCom with third quarter revenue growth of 30% compared to the third quarter of 2020 and 28% growth on an organic basis. This revenue growth rate represents continued momentum from DexCom CGM adoption around the world, as we once again achieved a record quarter of new customer growth. The third quarter also saw several strategic accomplishments across our teams that lay the foundation for our future growth opportunities.

謝謝你，Sean，也謝謝各位的參與。今天我們公布 DexCom 再度交出強勁的一季成績，第三季營收較 2020 年第三季成長 30%，以有機基礎計算成長 28%。此營收成長率反映 DexCom 連續血糖監測（CGM）在全球採用的持續動能，我們再次達成新客戶成長的單季紀錄。第三季我們各團隊亦完成多項策略性里程碑，為未來的成長機會奠定基礎。

In the U.S., we received FDA clearance for 2 key software solutions that continue to differentiate our connected products from those of our competitors and position us as a partner of choice across a health care and wearables ecosystem. First, in July, we received FDA clearance for our real-time API. For those of you who are unaware, an API is the tool that allows one app to connect with another app. Prior to this clearance, our customers and clinicians could only utilize our retrospective API, which integrated DexCom data into third-party apps on a 3-hour delayed basis.

在美國，我們取得 FDA 對兩項關鍵軟體解決方案的核准，這些方案持續使我們的連網產品與競品有所區隔，並使我們在醫療照護與穿戴式裝置生態系中成為首選合作夥伴。首先，在 7 月，我們取得即時 API 的 FDA 核准。對於不熟悉的各位，API 是讓一個 App 能與另一個 App 連接的工具。在取得此核准之前，我們的客戶與臨床醫師只能使用回溯式 API，該 API 以延遲 3 小時的方式將 DexCom 資料整合至第三方 App。

We believe that by putting the power of choice at our users' fingertips with real-time data, we can help ease the daily burden of diabetes management and significantly improved quality of life for our customers. This tool will be available to partners invited by DexCom, and we already have several that have begun the development process to enable real-time displays for their communities. This includes Garmin, which became the first partner to launch apps connected to our real-time API 2 weeks ago, bringing DexCom readings into their portfolio of wearables and cycling computers.

我們相信，透過即時資料把選擇權交到使用者手中，我們能協助減輕糖尿病日常管理負擔，並顯著提升客戶的生活品質。此工具將提供給 DexCom 邀請的合作夥伴使用，而我們已有數家合作夥伴開始開發流程，以便為其社群提供即時顯示功能。其中包括 Garmin；Garmin 於兩週前成為首家推出與我們即時 API 連結之 App 的合作夥伴，將 DexCom 讀數導入其穿戴式裝置與自行車電腦產品組合。

Second, on the heels of the real-time API clearance, we received FDA clearance in August for the DexCom app, an app module. This module was specifically designed for people with nonintensive type 2 diabetes and can directly integrate into another third-party health care app. With the integrated DexCom app, it is now even easier for our partners to access and display our CGM data, enabling single app solutions that simplify the experiences for DexCom users.

第二，在即時 API 核准之後，我們於 8 月取得 FDA 對 DexCom app（App 模組）的核准。此模組專為非密集治療的第二型糖尿病患者設計，並可直接整合至另一個第三方醫療照護 App。透過整合式 DexCom app，我們的合作夥伴如今更容易存取並顯示我們的 CGM 資料，進而實現單一 App 解決方案，簡化 DexCom 使用者的體驗。

UnitedHealth Group became our first partner to launch the integrated DexCom app in app module in late September, bringing the embedded app into their Level 2 diabetes care program. Our connectivity, software and data infrastructure solutions are our core strength of DexCom. These 2 recent FDA clearances reflect the increased investment that we put into software development and we believe increase our competitive advantages moving forward. In late September, we also announced the launch of DexCom 1 in 4 international markets where we previously had no presence. Bulgaria, Latvia, Lithuania and Estonia.

UnitedHealth Group 於 9 月下旬成為首家推出整合式 DexCom app（App 模組）的合作夥伴，將嵌入式 App 納入其 Level 2 第二型糖尿病照護計畫。我們的連線能力、軟體與資料基礎設施解決方案是 DexCom 的核心優勢。近期這兩項 FDA 核准反映我們對軟體開發的加大投資，我們相信將在未來提升我們的競爭優勢。9 月下旬，我們也宣布在 4 個先前尚未布局的國際市場推出 DexCom 1：保加利亞、拉脫維亞、立陶宛與愛沙尼亞。

DexCom 1 leverages the G6 hardware platform and a completely redesigned software experience that focuses on simplicity, and ease of use for our customers. This is the first product launch in our history that started exclusively through the DexCom e-commerce platform, a platform that has been embraced by our customers in Canada and the U.K. over the past 2 years. With the proven performance of our CGM systems, the new software experience and efficient e-commerce solution and affordable pricing plans, we believe that DexCom 1 will be an important product for us as we drive the business toward our long-term targets.

DexCom 1 採用 G6 硬體平台，並搭配全新重新設計的軟體體驗，聚焦於簡潔與易用性。這是我們歷史上首次僅透過 DexCom 電子商務平台啟動的產品上市；在過去兩年中，該平台已在加拿大與英國獲得客戶廣泛採用。憑藉我們 CGM 系統經驗證的效能、全新的軟體體驗、高效率的電商解決方案以及可負擔的定價方案，我們相信 DexCom 1 將是推動業務邁向長期目標的重要產品。

Most importantly, this differentiated product is a key step for us to bring DexCom CGM to significantly more people with diabetes who previously did not have access to our products. Early feedback around the product has been very favorable, and we look forward to seeing the full results from these launches as we leverage the full breadth of our expanding product portfolio to achieve our 2020 Investor Day goal of tripling our international addressable market by the end of 2023.

更重要的是，這項差異化產品是我們將 DexCom CGM 帶給更多糖尿病患者的關鍵一步，這些人過去無法取得我們的產品。市場對該產品的早期回饋非常正面；隨著我們運用不斷擴充的產品組合的完整廣度，我們也期待看到這些上市的全面成果，以達成我們在 2020 年投資人日所提出、於 2023 年底前將國際可服務市場規模提升至三倍的目標。

Building from the strength of our mobile trial that was published in the Journal of the American Medical Association in June, investigators published the results from the extension phase of the trial in Diabetes care during the third quarter. In this extension phase, we rerandomized the population who are initially on CGM to see if the benefits would be retained for those who stayed on CGM compared to those who returned to fingerstick monitoring. Once again, the results were clear. Those who stayed on our G6 systems maintain greater time and range improvements over the 6-month extension phase compared to those who did not. The results confirmed that for the significant population of people with type 2 diabetes on basal insulin, there is significant benefit in continuous CGM use to optimize therapy and support behavior modifications. Our teams are working hard to leverage the conclusions from mobile into greater access to our technology for people with type 2 diabetes. And this is just one area in which we are building the foundation for our long-term growth.

基於我們於 6 月發表在《美國醫學會期刊》（Journal of the American Medical Association）的行動試驗（mobile trial）成果，研究人員在第三季於《Diabetes Care》發表了該試驗延伸階段的結果。在此延伸階段中，我們將最初使用 CGM 的受試者重新隨機分派，以觀察與回到指尖採血監測者相比，持續使用 CGM 者是否能保留其效益。結果再次非常明確：在 6 個月延伸期間，持續使用我們 G6 系統者，相較於未持續者，維持了更高的目標範圍內時間（time in range）與範圍改善。結果證實，對於相當龐大的、使用基礎胰島素的第二型糖尿病族群而言，持續使用 CGM 對於最佳化治療與支持行為改變具有顯著效益。我們的團隊正努力運用 mobile 的結論，為第二型糖尿病患者爭取更廣泛的技術可近性。而這只是我們為長期成長奠基的其中一個領域。

We are advancing our pilot efforts with UnitedHealth Level 2, Teladoc's Livongo for Diabetes, WellDoc, Onduo and others. We are generating strong clinical evidence for expanded indications for CGM use in inpatient settings and for women who are pregnant. We continue to leverage our advantages in connectivity by gaining new customers and progressing our pipeline of solutions with our leading insulin delivery partners.

我們正推進與 UnitedHealth Level 2、Teladoc 的 Livongo for Diabetes、WellDoc、Onduo 等夥伴及其他機構的試點工作。我們也在住院場景以及孕婦族群的 CGM 使用擴大適應症方面，累積強而有力的臨床證據。我們持續運用連線能力的優勢，透過獲取新客戶並推進與領先胰島素輸送合作夥伴的解決方案管線。

Finally, we continue to advance our G7 scale-up and regulatory efforts during the quarter. We've had excellent communication with our notified body in Europe and believe that we remain on track to begin the launch of our G7 system in the fourth quarter upon receiving CE Mark clearance. In the U.S., we've made great progress in preparation for our regulatory submission. I believe that we are now in the final stages of that effort.

最後，我們在本季持續推進 G7 的量產擴增與法規相關工作。我們與歐洲的公告機構（notified body）保持極佳的溝通，並相信在取得 CE Mark 核准後，我們仍按計畫於第四季開始推出 G7 系統。在美國方面，我們在法規申報準備上取得重大進展。我相信我們目前已進入該工作的最後階段。

We look forward to the comprehensive G7 510(k) submission, including G7 hardware and full Android and iOS software to the FDA in the next few weeks. As you can see, our teams are working very hard and making great progress to advance our core strategic efforts, whether it is in expanding our product portfolio, creating differentiated user experiences or laying the foundation for new market opportunities that will drive our future growth. So with that said, let me turn it over now to Jereme for a review of our third quarter financial performance. Jereme?

我們期待在未來幾週內向 FDA 提交完整的 G7 510(k) 申請，內容包含 G7 硬體以及完整的 Android 與 iOS 軟體。如各位所見，我們的團隊正非常努力並取得重大進展，以推動核心策略工作，不論是擴充產品組合、打造差異化的使用者體驗，或為將驅動未來成長的新市場機會奠定基礎。接下來，我把時間交給 Jereme，請他回顧我們第三季的財務表現。Jereme？

Thank you, Kevin. As a reminder, unless otherwise noted, the financial metrics presented today will be discussed on a non-GAAP basis. Reconciliations to GAAP can be found in today's earnings release as well as on our IR website. For the third quarter of 2021, we reported worldwide revenue of $650 million compared to $501 million for the third quarter of 2020, representing growth of 30% on a reported basis and 28% on an organic basis. In late July, we were proud to complete the acquisition of our distributor in Australia and New Zealand. With this acquisition, we began generating revenue for certain non-CGM health care products, which we have categorized as inorganic growth for the quarter. This non-CGM distribution revenue contributed approximately 2% to our reported growth for the third quarter.

謝謝你，Kevin。提醒一下，除非另有說明，今天所呈現的財務指標將以非 GAAP 基礎進行討論。與 GAAP 的調節表可在今日的財報新聞稿以及我們的投資人關係（IR）網站上找到。2021 年第三季，我們的全球營收為 6.50 億美元，較 2020 年第三季的 5.01 億美元成長，按報告基礎成長 30%，按有機基礎成長 28%。7 月下旬，我們很自豪完成了對澳洲與紐西蘭經銷商的收購。透過此收購，我們開始就部分非 CGM 的醫療保健產品產生營收，我們將其歸類為本季的非有機成長。此非 CGM 的經銷營收約為我們第三季報告成長貢獻了 2%。

The transition from distributor markets to direct sales is one of several important strategic initiatives that we outlined at our 2020 Investor Day as we seek to significantly grow our international presence. We believe a larger direct international footprint will give us greater control to leverage our marketing strength, invest in accelerating our growth and ensure that the direction of these core markets is aligned to our strategic interest.

從經銷市場轉向直營銷售，是我們在 2020 年投資人日所概述、用以大幅擴展國際版圖的數項重要策略舉措之一。我們相信，更大的國際直營佈局將使我們能更有效掌控並運用行銷優勢、投入資源以加速成長，並確保這些核心市場的發展方向與我們的策略利益一致。

In terms of the financial impact of the third quarter acquisition, we expect the transaction to be approximately neutral to our operating margin for the full year as it was in the third quarter. U.S. revenue totaled $490 million in the third quarter compared to $399 million in the third quarter of 2020, representing growth of 23%. We continue to see good momentum in the U.S. where we are benefiting from the increased market access and field presence that we've enabled over the past year. New customer growth remains strong across all segments of the population including people with type 1 diabetes, intensively manage people with type 2 diabetes where we have significantly expanded market access in the past year and even early adopters in the type 2 non-intensive population.

就第三季收購的財務影響而言，我們預期該交易對全年營業利益率大致為中性影響，與第三季相同。第三季美國營收合計 4.90 億美元，較 2020 年第三季的 3.99 億美元成長 23%。我們在美國持續看到良好動能，受惠於過去一年我們所推動的市場准入提升與前線團隊能見度增加。新客戶成長在各族群區隔仍然強勁，包括第一型糖尿病患者、需要密集管理的第二型糖尿病患者（我們在過去一年已大幅擴大其市場准入），甚至也包括第二型非密集族群中的早期採用者。

Our international business grew 57% in the third quarter, totaling $161 million. Excluding the impact of non-CGM distribution revenue generated by our acquisition of our distributor in Australia and New Zealand, growth for our international business was 46% in the third quarter. We continue to see very encouraging growth across the board in our international markets with the majority of our markets delivering record sales in the third quarter. Although it is still early, we believe that our strategic moves to broaden access in several markets have been very successful thus far and have left us well positioned to expand our growth profile internationally, and you see that in the reflected current quarter results.

我們的國際業務在第三季成長 57%，達 1.61 億美元。若排除因收購澳洲與紐西蘭經銷商而產生的非 CGM 經銷營收影響，第三季國際業務成長為 46%。我們持續在國際市場全面看到非常令人鼓舞的成長，多數市場在第三季創下銷售新高。雖然仍屬早期階段，我們相信我們在多個市場擴大准入的策略行動迄今非常成功，使我們在國際上擴展成長曲線方面具備良好定位，而你也可從本季結果中看到反映。

Along those lines, our global volume growth in the third quarter remained strong, exceeding 40% for the quarter. This is well above our 28% organic revenue growth rate and supports the momentum behind DexCom CGM globally, as we aggressively seek to advance access to our technology and drive better health outcomes and quality of life for people with diabetes.

在此脈絡下，我們第三季的全球出貨量成長仍然強勁，本季超過 40%。這明顯高於我們 28% 的有機營收成長率，並支持 DexCom CGM 在全球的動能；我們正積極推動技術可近性，以改善糖尿病患者的健康結果與生活品質。

As Kevin mentioned, the launch of DexCom 1 adds to our product portfolio and provides another key element of our strategy to expand access to CGM globally. As we continue to scale our business in conjunction with our ambitious plans for customer growth, we are creating tools that allow us to serve our growing base in an efficient manner, and the use of our e-commerce platform for the initial DexCom 1 launch is a good example of that focus.

如 Kevin 所提到，DexCom 1 的上市擴充了我們的產品組合，並為我們擴大全球 CGM 可近性的策略增添另一項關鍵要素。隨著我們在推動客戶成長的宏大計畫下持續擴大業務規模，我們也在打造工具，使我們能以高效率服務不斷成長的客戶基礎；在 DexCom 1 初期上市時採用我們的電商平台，就是這項聚焦的良好例證。

Our third quarter gross profit was $446.9 million or 68.7% of revenue compared to 68% of revenue in the third quarter of 2020. The year-over-year gross margin expansion is an impressive result, especially when you factor in our strategic efforts this year to drive greater mix to the pharmacy channel and expanded international access. This is a credit to our teams who have innovated and embrace change where necessary to drive efficiencies and position us to maximize our strategic opportunities. We continue to demonstrate the ability to leverage both our manufacturing operations and R&D teams to be ever more efficient in the delivery of our products.

第三季毛利為 4.469 億美元，或佔營收 68.7%，相較於 2020 年第三季佔營收 68%。毛利率年增擴張是令人印象深刻的成果，尤其考量到我們今年在策略上致力於提高藥局通路占比以及擴大國際准入。這要歸功於我們的團隊在必要時持續創新並擁抱改變，以提升效率並讓我們能把握最大的策略機會。我們持續展現出同時運用製造營運與研發團隊、以更高效率交付產品的能力。

Operating expenses were $323.1 million for Q3 2021 compared to $245.7 million in Q3 2020. Operating expenses, as a percentage of sales were relatively flat year-over-year as we offset investments in software development, G7 scale-up and our expanded global commercial sales force with strong leverage of our general and administrative functions. Operating income was $123.8 million in the third quarter of 2021 compared to $95 million in the same quarter of 2020, holding flat 19% of revenue. As this result indicates we've been able to retain much of our operating margin this year even as we have significantly reinvested in our business.

2021 年第三季營業費用為 3.231 億美元，較 2020 年第三季的 2.457 億美元增加。營業費用占銷售額的比例年對年大致持平，因我們以一般與行政職能的強勁槓桿效益，抵銷了在軟體開發、G7 擴產（scale-up）以及擴大全球商業銷售團隊方面的投資。2021 年第三季營業利益為 1.238 億美元，較 2020 年同期的 9,500 萬美元增加，並維持在營收的 19% 水準。此結果顯示，即使我們今年大幅再投資於業務，我們仍能保留相當程度的營業利益率。

Adjusted EBITDA was $173.5 million or 26.7% of revenue for the third quarter compared to $146.9 million or 29.3% of revenue for the third quarter of 2020. Net income for the third quarter was $89.5 million or $0.89 per share. We closed the quarter with approximately $2.7 billion in cash and cash equivalents, giving us great financial flexibility to drive our strategic initiatives. This includes the continued build-out of our manufacturing facility in Malaysia and G7 scale-up in Mesa, Arizona as well as opportunities that are relying on our business objectives, such as our recent distributor acquisition.

第三季調整後 EBITDA 為 1.735 億美元，或佔營收 26.7%，相較於 2020 年第三季的 1.469 億美元或佔營收 29.3%。第三季淨利為 8,950 萬美元，或每股 0.89 美元。本季結束時，我們持有約 27 億美元的現金及約當現金，為推動策略舉措提供了極佳的財務彈性。這包括持續擴建馬來西亞製造廠，以及在亞利桑那州梅薩（Mesa）進行 G7 擴產，並包含符合我們業務目標的機會，例如近期的經銷商收購。

Turning to guidance. Our third quarter performance has placed us in a position to once again raise our full year 2021 outlook for revenue and margins as we look to wrap up another excellent year. We now expect 2021 revenue to be between $2.425 billion and $2.450 billion, representing growth of 26% to 27% over 2020. This guidance includes approximately 100 basis points of non-CGM inorganic growth related to our recent distributor acquisition.

接著談財測。我們第三季的表現使我們得以再次上調 2021 全年營收與利潤率展望，為另一個出色年度畫下句點。我們目前預期 2021 年營收介於 24.25 億至 24.50 億美元，較 2020 年成長 26% 至 27%。此指引包含約 100 個基點的非 CGM 非有機成長，與我們近期的經銷商收購相關。

Turning to margins. We are increasing our full year 2021 targets. This includes non-GAAP results to be approximately at the following levels, which include a neutral impact from our distributor acquisition. Gross profit margins of approximately 68%, operating margins of approximately 16%, and adjusted EBITDA margins of approximately 25%.

接著談利潤率。我們上調 2021 全年目標。以下為非 GAAP 結果預估約落在的水準，並包含經銷商收購帶來的中性影響：毛利率約 68%、營業利益率約 16%，以及調整後 EBITDA 利潤率約 25%。

With that, I will now turn the call back to Kevin.

接下來，我將把電話會議交回給 Kevin。

There are a number of things that we could celebrate, and I'd like to take the time now to thank all of the teams at DexCom and specifically highlight a few things that we are proud of. First, to our new DexCom team members in Australia and New Zealand, we are absolutely thrilled to have you with us on our journey to empower people to take control of diabetes. We look forward to working together and learning from you as we bring our technology to those in need in these key markets. Our operations team has provided another highlight in the third quarter as our G6 manufacturing yields reached all-time highs, and our warranty rates reached all-time lows. Those are the kind of metrics that lead to the margin improvements that we've seen and reflect countless hours of work from our talented employees.

有許多事情值得我們慶祝，我想藉此時間感謝 DexCom 的所有團隊，並特別強調幾項我們引以為傲的成果。首先，對於澳洲與紐西蘭新加入的 DexCom 團隊成員，我們非常高興你們與我們一同踏上賦能人們掌控糖尿病的旅程。我們期待攜手合作並向你們學習，將我們的技術帶給這些關鍵市場中有需要的人。第三季我們的營運團隊也帶來另一項亮點：G6 製造良率達到歷史新高，而保固率降至歷史新低。這些正是帶動我們所見利潤率改善的指標，也反映出我們才華洋溢的員工投入了無數工時的努力。

And finally, our R&D team continues to innovate with several updates to our sensor pipeline as well as our leadership in data and software solutions. The 2 FDA clearances this quarter are a testament to those efforts and a nice validation of the strategy that we discussed to leverage software as a competitive advantage and a key area of investment.

最後，我們的研發團隊持續創新，對感測器產品線（sensor pipeline）進行多項更新，並在資料與軟體解決方案方面保持領先。本季取得的 2 項 FDA 核准（clearances）正是這些努力的證明，也很好地驗證了我們所討論的策略：將軟體作為競爭優勢並作為關鍵投資領域。

As Sean mentioned at the start of the call, we've invited Jake Leach, our Chief Technology Officer, to join us for the Q&A portion of the call in order to address any questions around these clearances and our product innovation. I would now like to open the call up for Q&A. Sean?

如 Sean 在電話會議一開始所提到，我們邀請了首席技術長 Jake Leach 加入問答環節，以回應任何關於這些核准以及我們產品創新的問題。現在我想開放進入問答。Sean？

(Operator Instructions) Operator, please provide the Q&A instructions.

（接線員指示）接線員，請提供問答指示。

(Operator Instructions) And our first question comes from Jeff Johnson from Baird.

（接線員指示）我們的第一個問題來自 Baird 的 Jeff Johnson。

I know we focused so much on T1 and intensive T2 most of the time, but I wanted to ask this time maybe on the nonintensive in the prediabetes markets. I guess I'm wondering more than anything your latest thoughts on how big those 2 markets could be over the next year or 2, especially with so many we see all these behavioral services popping up with levels and super Sapiens and others in prediabetes and obviously, Level 2 and some of the others on the commercial side. it feels like your real-time APIs and your app and app approvals would be helpful for some of those programs. So just kind of how do you see those 2 markets developing in the short run kind of 1 to 2 years in your market share in those 2 areas, maybe over the next couple of years as well?

我知道我們大多數時候非常聚焦在第一型（T1）以及需要密集管理的第二型（intensive T2），但這次我想問的是，或許關於糖尿病前期市場中的非密集（nonintensive）族群。我最想了解的是，你們對於未來一到兩年這兩個市場規模可能有多大、最新的看法是什麼；尤其是我們看到在糖尿病前期領域出現了許多行為服務，例如 Levels、Super Sapiens 等等，另外在商業端也有 Level 2 以及其他一些方案。感覺你們的即時 API、你們的 App 以及 App 的核准，對其中一些計畫會很有幫助。所以，想請教你們如何看待這兩個市場在短期（一到兩年）的發展，以及你們在這兩個領域的市占率在未來幾年可能會如何變化？

Thank you, Jeff. This is Kevin. I'll take that one. We think those markets can develop nicely. We have some work to do on the product labeling side and some work to do with the FDA as we migrate down that path, and we've had some of those discussions. But the results are spectacular as we've seen people use this product. In fact, we recently got an e-mail from a physician. And again, this is in the type 2 world, nonintensive, but was telling us about a recent experience with a patient who had gone from an A1c in the 12 down to no medications and an A1c of 5.5 or something like that. It works there.

謝謝你，Jeff。我是 Kevin。我來回答這題。我們認為這些市場可以很好地發展。我們在產品標示方面還有一些工作要做，並且在我們沿著這條路徑推進時，也需要與 FDA 做一些工作，我們也已經進行過部分討論。但從我們看到人們使用這項產品的結果來看，成效非常驚人。事實上，我們最近收到一位醫師的電子郵件。再次強調，這是在第二型糖尿病領域、非密集治療的情境，但他向我們描述了一位病患最近的經驗：A1c 從 12 降到不需要任何藥物，A1c 變成 5.5 或類似的數字。在那裡確實有效。

It works there. It works also very much on the -- just the metabolic front-end general, anybody who wears a CGM and watches that data, and particularly if you set those lines narrow between like 70 and 120, if you go above the 120 mark, you ask yourself what you ate. You can usually figure out and go back to something that you could do different, the effects of exercise, the effects of poor sleep, the effect of stress of an earnings call is going to be demonstrated in CGM graph.

在那裡有效。在代謝端的前端、一般族群也非常有效；任何配戴 CGM 並觀察數據的人，尤其是當你把目標區間設定得很窄，例如 70 到 120 之間，如果你超過 120，你就會問自己吃了什麼。你通常可以找出原因，回頭想到有哪些地方可以做得不同；運動的影響、睡眠不佳的影響、壓力的影響——甚至財報電話會議的壓力——都會在 CGM 圖表上呈現出來。

I think it's a wonderful market opportunity. The data has to be presented properly. That's where the Live API and the approvals we talked about today come in. The API is a quick way to get there. And Jay knows the technical stuff better than me, but the API also requires a person to run a DexCom app and the other app. With the other -- the app in app module that we talked about today, some of these larger programs, again, like Level 2 with UnitedHealth Group, you have one app experience with like a DexCom button or a DexCom experience right in the middle of it. So if you're branding a wellness situation and really want that to be your focal point, we can resign in that app and you can have that experience.

我認為這是一個很棒的市場機會。數據必須以正確的方式呈現。這就是我們今天談到的 Live API 與核准事項的用武之地。API 是一個快速達成目標的方法。Jay 對技術細節比我更了解，但 API 也需要使用者同時執行 DexCom 的 App 與另一個 App。至於我們今天談到的另一種——App 內嵌模組（app in app module）——對於一些較大型的方案，例如 UnitedHealth Group 的 Level 2，你會有單一 App 的使用體驗，中間就像有一個 DexCom 按鈕或 DexCom 體驗直接嵌在其中。因此，如果你在打造一個健康管理（wellness）的情境並希望它成為焦點，我們可以在那個 App 裡重新設計，你也可以擁有那樣的體驗。

So we think both solutions, they offer speed, but they also offer different experiences. And then we'll pick the partners we want to work with on both sides. Those that have the best need for 1 versus the other. So we're excited for both of them, Jeff. We're very excited for these markets, and it's long been part of our long-term strategy. but we need the technology to get there, and our product pipeline truly supports going there over time.

所以我們認為兩種解決方案都能提供速度，但也提供不同的體驗。接著我們會在兩邊挑選想合作的夥伴——那些對其中一種方案有最佳需求的夥伴。因此我們對兩者都很興奮，Jeff。對這些市場我們非常興奮，而且這長期以來一直是我們長期策略的一部分。但我們需要技術來達成，而我們的產品管線確實支持我們隨時間推進到那裡。

And our next question comes from Robbie Marcus from JPMorgan.

下一個問題來自摩根大通（JPMorgan）的 Robbie Marcus。

This is actually Lilia on for Robbie. Can you talk briefly about dynamics that you're seeing in Europe right now? You guys had a great quarter there. So any tangible stories of success from the increased patient access efforts that you've implemented over the last few months? Any color on that you could share would be helpful.

我其實是代 Robbie 提問的 Lilia。你們能否簡要談談目前在歐洲看到的動態？你們在那裡這一季表現非常好。所以，過去幾個月你們推動增加病患可近性（patient access）的努力，有沒有任何具體的成功案例？如果能分享一些細節會很有幫助。

Sure. Yes. Thanks for the question. What you see in Europe, and certainly, it's really in all the markets we've gone in with our access strategy as we've moved into various countries and obviously, exchange price for access to populations that we historically haven't been able to get to. And what you see in the quarter, I think we talked a little bit about on the call is it was a record revenue quarter in most of our international markets. So I think you see it playing through on the revenue front. I think you saw a 46% organic growth rate outside the U.S., which again, another incredibly strong quarter fueled by a lot of the access that we've been able to create.

當然。是的，謝謝你的問題。你在歐洲看到的情況——其實在我們採取可近性策略進入的所有市場都是如此——當我們進入不同國家，並且很明顯地以價格交換來換取我們過去無法觸及的人群可近性。你在本季看到的，我想我們在電話會議上也稍微提到，是我們多數國際市場都創下營收新高的一季。所以你可以看到它在營收端反映出來。我想你也看到美國以外地區有 46% 的有機成長率，這同樣是又一個非常強勁的季度，主要由我們所創造的可近性所帶動。

And then you look at the new patient growth. It's another record quarter for new patient adds in this quarter, again, all pointing to some of the access that we've created outside the U.S. So I think some of the examples, I think we talked a little bit about them publicly last quarter with Canada, for example, in multiple different provinces allowing us access to those publicly reimbursed channels. And I think in those channels, you're seeing just that. A lot of people now have the access to DexCom CGM technology, and they're taking advantage of that. So we'll continue to expect that to play through. It's why we ultimately made the decision to do it. And I think you've seen it play through in the financial results and our expectation is you continue to see it play through over the long haul.

再看新增病患成長，本季新增病患數也是另一個創紀錄的季度，同樣都指向我們在美國以外所創造的一些可近性。我想一些例子，我們上季也在公開場合稍微談過，例如加拿大，多個不同省份讓我們得以進入那些由公費給付（publicly reimbursed）的通路。我想在那些通路中，你看到的正是如此：現在有很多人能夠取得 DexCom 的 CGM 技術，並且正在善用它。所以我們會持續預期這會逐步反映出來。這也是我們最終做出這個決定的原因。我想你已經在財務結果中看到它的反映，而我們的預期是，長期來看你會持續看到它發酵。

And our next question comes from Danielle Antalffy from SVB Leerink.

下一個問題來自 SVB Leerink 的 Danielle Antalffy。

Congrats on a really strong quarter. Jereme, just a question for you. You guys have been investing pretty significantly in direct-to-consumer marketing and ramping up the sales force initiatives around primary care physicians. I'm wondering if you can talk, now we're 3 quarters into this sort of more concerted effort in the U.S. And whether we're -- we can really talk about how you're seeing a return on that investment as far as incremental new patient adds and maybe just where we are from a primary care physician coverage perspective?

恭喜你們交出非常強勁的一季。Jereme，我有個問題想請教你。你們在直接面向消費者（direct-to-consumer）的行銷上投入相當多，也在基層醫療（primary care physicians）醫師端的銷售團隊計畫上加速推進。我想問的是，現在我們已經進行到美國這項更有組織、更集中的努力的第 3 個季度了，你們是否已經能談談投資報酬的情況——例如新增病患的增量——以及從基層醫師覆蓋（coverage）的角度來看，我們目前處於什麼位置？

Sure. And absolutely. So where we sit today, and we talked a little bit about it last quarter, but I want to reiterate it is, in the U.S., we've doubled our covering prescriber coverage over the past 18 months. And so what I mean by that is the amount of physicians that are writing DexCom's scripts has doubled in 18 months. That's a testament to the work that's being done by the U.S. commercial team, which has been fueled by multiple things, certainly, direct-to-consumer advertising, doubling the size of the sales force, those all really play into folks adopting the technology.

當然，絕對可以。就我們目前的狀況而言——我們上季也稍微談過，但我想再次強調——在美國，我們在過去 18 個月把覆蓋的開立處方醫師（prescriber）覆蓋率提高了一倍。我所說的是：在 18 個月內，開立 DexCom 處方的醫師數量翻倍。這證明了美國商業團隊所做的工作，而這也受到多項因素的推動，當然包括直接面向消費者的廣告、銷售團隊規模加倍，這些都確實促使更多人採用這項技術。

Just a couple of tangible things, which I think are helpful to see, again, another record quarter for new patient adds. I think you can see that playing through. And in many ways, that's driven by the sales force. So you see that continued momentum. I'd say the one thing that we have noticed that hasn't prevented us from being at completely full effectiveness is some of the impacts of the Delta variant. I think that's probably the only thing that we've seen that's been a challenge, and that's just getting access to some of these offices when they're no longer seeing folks in person.

再舉幾個具體的點，我想有助於理解：本季新增病患數再次創下紀錄。我想你可以看到這正在反映出來。而在很多方面，這是由銷售團隊所驅動的，所以你看到這股動能持續。我會說，我們注意到唯一讓我們尚未達到完全效能的因素，是 Delta 變異株的一些影響。我想這可能是我們看到的唯一挑戰，也就是當一些診所不再面對面看診時，我們較難進入那些診所。

And so you've seen a lot of physicians opening up in those locations we're doing incredibly well. So there's more to work through, and that's a function of just navigating through these COVID landscapes more than anything else. So I think in short, you're seeing the performance, you're seeing the growth, seeing the new patient adds, and we've ramped up very nicely. It's been an incredible year for us thus far and very bullish on what it means for next year. So I think that's really the feedback thus far. And again, as we get more and more data, we'll continue to share it as it becomes available.

因此你也看到在那些地點，許多醫師開始重新開放，我們表現得非常好。所以還有一些需要持續推進的地方，而這更多是因為要在這些 COVID 環境中穿梭應對，而不是其他因素。簡而言之，你看到的是績效、成長、新增病患數，而我們的擴張也進展得非常順利。到目前為止，這對我們來說是非常出色的一年，並且對這對明年的意義非常樂觀。所以這就是目前為止的回饋。同樣地，隨著我們取得越來越多數據，我們會在可分享時持續對外更新。

And our next question comes from Matthew Blackman from Stifel.

下一個問題來自 Stifel 的 Matthew Blackman。

I wanted to ask about the G6 rollout in Japan. Just any commentary on early trends there. Could you also just remind us the sizing of the incremental opportunity in Japan? And how meaningful a contributor do you think it could be to either worldwide growth or OUS growth, how would you want to frame it as we move into 2022?

我想問一下 G6 在日本的推廣（rollout）。能否分享一下目前早期趨勢的看法？也請你們提醒我們，日本這個增量機會的市場規模大概是多少？以及當我們進入 2022 年時，你們認為它對全球成長或美國以外（OUS）成長會是多重要的貢獻者——你們會如何框架這件事？

Yes. This is Kevin. We're early on in that launch with our partner, Terumo. We've got some good traction. But literally with launch happening in earlier this summer, we're in a position of educating physicians, getting samples out there really teaching people about our product. We think over time, the Japan market could be a very good one for us. While there's not a tremendous amount of type 1 diabetes, there's also -- there is a large amount of type 2 diabetes.

是的，我是 Kevin。我們與合作夥伴 Terumo 的上市推進還在早期階段。我們已經取得一些不錯的進展。但由於上市是在今年夏天較早的時候才開始，我們目前主要在教育醫師、發放樣品，真正教大家了解我們的產品。我們認為隨著時間推進，日本市場可能會對我們非常有利。雖然第一型糖尿病的數量並不算非常多，但第二型糖尿病的數量很大。

If we can get across that broad spectrum with our product offerings, we can see this being one of our -- certainly one of our top 8 markets, possibly even a top 4 or 5 in the world as time goes on. We also know from a technological perspective, the physicians we've spoken with are very bullish on the performance of our product and tremendously value the accuracy and precision of what we do and the connectivity and all of those things. So we believe we have the right system for the market. But we're in early phases right now.

如果我們能透過我們的產品組合覆蓋那個廣泛的族群，我們可以看到日本成為我們的——當然會是我們前 8 大市場之一，甚至隨著時間推進，可能成為全球前 4 或前 5 大市場。我們也知道，從技術角度來看，我們交流過的醫師對我們產品的表現非常看好，並且高度重視我們所提供的準確性與精密度，以及連線能力等各項特性。因此我們相信我們有適合這個市場的系統。但我們現在仍處於早期階段。

Yes. And just to give you -- I know you asked for the size of the market, that's a market of around 300,000 to 400,000 intensively managed patients across type 1 and type 2. So it's a large market with a lot of folks, a smaller prevalence of T1, but obviously, a market that can be an incredible landing spot for us in that space.

是的。再補充一下——我知道你問的是市場規模——那是一個大約有 30 萬到 40 萬名需要密集管理（intensively managed）的病患市場，涵蓋第一型與第二型。所以這是一個很大的市場，有很多人；第一型的盛行率較低，但很明顯地，對我們在那個領域而言，這個市場可能會是一個非常理想的落腳點。

And our next question comes from Margaret Kaczor from William Blair.

下一個問題來自 William Blair 的 Margaret Kaczor。

So the question is a little bit more of a theme and an expansion maybe on some of the partnerships that you referenced and just getting a better sense around how many of your patients out today, for example, may come from these partnerships. And when we talk about expanding them, is that in the form of covered lives? Is it something else? And just as a follow-on since Jake on the call, I guess, the products and subscription services that you guys may offer these partnerships, how do those evolve, I guess, over time? And could that potentially accelerate some of the capabilities that DexCom offers or the new products that they offer away from pure technology that you've been in the past towards some of these other software or other potential offerings we have?

所以這個問題比較偏向一個主題，可能也是延伸到你們提到的一些合作夥伴關係，想更清楚了解例如目前你們的病患中，有多少可能是透過這些合作夥伴而來。當我們談到擴大這些合作時，是以涵蓋人數（covered lives）的形式嗎？還是其他形式？另外作為追問，既然 Jake 也在線上，我想問你們可能提供給這些合作夥伴的產品與訂閱式服務，隨著時間推移會如何演進？而這是否可能加速 DexCom 所提供的某些能力，或他們所推出的新產品，讓你們從過去較純粹的技術，走向一些其他軟體或我們可能提供的其他潛在方案？

Sure. Yes. So let me start with maybe the financials side and how that migrates over time. And then Jake is obviously here. He'll take you through the technical aspect of it and why we're so excited about it. So today, these partnerships are a combination of expanding TAM and expanding people that would want to access CGM technology over time. And today, it's in the form of sensors. But over time, and as we've demonstrated with a couple of other software features, we've obviously added over the past 6 months or so, software can be a part of that package. And so we're really -- the monetization of that will come over time. Today, it's about how do we get as many folks as possible on sensors to realize the value of CGM. So that's how we expand it. Jake, maybe you can take it through just kind of the general theme of where we're going in that space.

當然。是的。那我先從財務面開始，談談這些合作隨時間如何轉變。然後 Jake 也在，他會帶你了解技術層面，以及我們為什麼對此如此興奮。就目前而言，這些合作夥伴關係結合了擴大 TAM（總可服務市場）以及擴大隨時間推移會想要使用 CGM 技術的人群。今天主要是以感測器的形式呈現。但隨著時間推移，且正如我們在過去大約 6 個月左右新增的一些軟體功能所展示的，軟體也可以成為該套裝的一部分。因此，我們真正的——其變現（monetization）會隨時間逐步到來。今天的重點是：如何讓盡可能多的人使用感測器，去體會 CGM 的價值。這就是我們擴大的方式。Jake，也許你可以談談我們在這個領域要走向哪裡的大方向。

Yes, sure, Jereme. Thanks for the question. So really, the way we think about it is the technology that we are bringing to market through these software features is really about providing unique experiences for customer segments. And so if you think about the type 1 segment or the type 2 segment nonintensive. You really -- you're solving different types of problems in those. And so what these software tools such as our Live API provide is a way for our partners to serve those needs with DexCom CGM and a connection to our product. The real-time API is a real advancement in our cloud strategy, and we're really excited about the list of partners that are working to integrate that into their systems to provide their customers with unique experiences.

好的，當然，Jereme。謝謝你的問題。我們的思考方式是：我們透過這些軟體功能推向市場的技術，核心在於為不同客戶族群提供獨特的使用體驗。若你想想第 1 型族群或第 2 型（非密集治療）族群，你其實是在解決不同類型的問題。而像我們的 Live API 這類軟體工具，提供了一種方式，讓合作夥伴能透過 DexCom CGM 以及與我們產品的連結，來滿足那些需求。即時 API 是我們雲端策略上的一項重大進展，我們也對一系列正在把它整合進其系統、以便為其客戶提供獨特體驗的合作夥伴名單感到非常興奮。

And our next question comes from Matthew O'Brien from Piper Sandler.

下一個問題來自 Piper Sandler 的 Matthew O'Brien。

So a lot of moving parts here, and I'm not sure if I'm doing the math right, but I'm getting like $60 million to $70 million of a pricing headwind this quarter. And I'm not sure what the distributor conversion, if that's right or not. I guess I'm just asking, is that about right? Are we seeing a little bit more of the pricing headwind this quarter than we've seen over the last couple. So we'll see maybe a little less next year. It's getting pulled forward to the '21-- And then the reason I'm asking is that the increase sequentially from Q3 to Q4 is a little bit below trend line. Is that because you're expecting more of the pricing headwinds to be seen here in '21 versus '22?

這裡有很多變動因素，我不確定我算得對不對，但我算出本季大概有 6,000 萬到 7,000 萬美元的定價逆風。我也不確定經銷商轉換（distributor conversion）那部分是否正確。我想問的是：大致上是這樣嗎？我們是否看到本季的定價逆風比過去幾季更大一些，因此明年可能會少一點，等於被拉到 2021 年提前反映——我問這個的原因是，從 Q3 到 Q4 的季增幅度有點低於趨勢線。這是因為你們預期在 2021 年會看到更多定價逆風、相較於 2022 年嗎？

Yes. So there's a couple of pieces. So I'll first and foremost, reiterate, the total pricing expectation for the year, the $250 million is still the expectation. If anything, we might come a little bit light on that, but that still is the expectation. And so then the pricing in Q3 was generally in line with prior quarters, a little bit elevated, but it's not a material step change. And that's a function of some of those OUS contracts kicking in. So really, that's where we come from a pricing perspective.

是的。這裡有幾個部分。我首先重申：全年總體的定價影響預期，2.5 億美元，仍然是我們的預期。若有的話，我們可能會略低於這個數字，但這仍是預期。因此，Q3 的定價影響大致與前幾季一致，略微偏高，但不是重大的階梯式變化。這主要是因為一些 OUS（美國以外）合約開始生效。所以從定價角度來看，我們的情況就是如此。

So it's not necessarily pulling anything in. We've often talked about 2022 being relatively similar to 2021, and we're still on that trajectory. So I wouldn't necessarily expect any of that. To your question on how Q4 plays out in the guide and doing the math there, and you're doing the math right. One of the things we're mindful of, and there's really 2 pieces to it, as you think about it. There's the piece we talked about a little bit earlier, which is the Delta variant and getting into new primary care offices and making sure that we're seeing that over time before we count on it. So that's the first piece of it, and we're mindful of that.

所以這不一定是把什麼提前拉進來。我們過去常說 2022 年會與 2021 年相對類似，而我們仍在那條軌跡上。因此我不會特別預期會有那種情況。至於你問到 Q4 在指引中的呈現、以及你在那裡做的計算——你算得沒錯。我們留意的一件事，主要有兩個部分。第一個部分是我們稍早提到的 Delta 變異株，以及進入新的基層醫療（primary care）診所，並確保我們能隨時間看到那個趨勢後才把它納入預期。這是第一點，我們對此保持謹慎。

And then the second piece of it as more and more of our product is fulfilled through the pharmacy, the historical trends over time, you're going to see start to migrate just a little bit. You saw it start this year in Q1. If you look back to Q1, our sequential pullback from prior year Q4 into Q1 was a bit mooted. And you're going to see the same thing in this Q4, which means as more and more goes to the pharmacy, you no longer have folks in the DME space than on they have the high deductible health plans, where folks are maximizing benefits at the end of the year. So we expect a little bit less seasonality as we progress. And in turn, we expect a little seasonality in Q1 of next year. So that's what you're reading into it. That's ultimately what comes through in the guide. So you're doing the math right, but those are some of the expectations that went into it.

第二個部分是，隨著越來越多的產品透過藥局（pharmacy）通路履約，從歷史趨勢來看，季節性型態會開始出現一些轉移。今年 Q1 你已經看到一些端倪。如果你回頭看 Q1，我們從前一年 Q4 到 Q1 的季減幅度被稍微削弱了。而你也會在這次的 Q4 看到同樣的情況：也就是說，當更多轉到藥局通路後，你就不再有那麼多在 DME（耐用醫療設備）通路的使用者，因為那裡常見的是高自付額健康保險計畫（high deductible health plans），人們會在年底把福利用到最大。因此，隨著我們持續推進，我們預期季節性會稍微降低；相對地，我們也預期明年 Q1 會有一些季節性。這就是你從中讀到的訊息，也就是最終反映在指引裡的內容。所以你算得沒錯，但這些就是我們納入的部分預期。

And our next question comes from Travis Steed from Barclays.

下一個問題來自 Barclays 的 Travis Steed。

Jereme, just a follow-up on the distributor. It sounds like the revenue impact this quarter was $13 million, all in the OUS line. And just kind of curious how to model that going forward, is that about $13 million a quarter for 3 more quarters and then it gets into the base and how to think about, like, is there a pricing benefit here without the distributor margin? Just a little more color on the distributor acquisition, if you will.

Jereme，我想就經銷商再追問一下。聽起來本季的營收影響是 1,300 萬美元，全部都在 OUS 那一行。我想了解未來要怎麼建模：這是否大概是每季 1,300 萬美元、再持續 3 個季度，之後就納入基期？以及該如何看待——例如少了經銷商毛利後，是否會有定價上的好處？如果可以的話，能否就經銷商收購（distributor acquisition）多提供一些背景說明。

Sure. So we'll -- so the pricing, we don't necessarily break down the pricing USO, U.S. and the overall number. And so at the end of the day, we're on the trajectory of the total company we talked about. And so obviously, you guys will do the math. But at the end of the day, we're on that same trajectory. In terms of your question on the distributor, the impact of the distributor acquisition on growth in the quarter in our CGM business, it rounds to 0%. And so it's because there was 2 months in the quarter and that markup on the margin in the distributor market is relatively small. The question is, well, why do you do it? And what do you -- it's our ability to control penetrating deeper into these markets, and that's ultimately why we do it. It's not to try to get a margin uplift. It's actually to try to control investment.

當然。我們——在定價方面，我們不一定會把定價拆分成 OUS、U.S.（美國）以及整體數字的細項。總之，我們仍在我們先前談到的全公司整體軌跡上，當然你們可以自行推算。但最終我們仍在同一條軌跡上。至於你問到經銷商：本季經銷商收購對我們 CGM 業務的季度成長影響，四捨五入約等於 0%。原因是本季只有 2 個月納入，而且在經銷商市場的加價（markup）幅度相對較小。那問題是：那你為什麼要做？你想得到什麼？這是因為我們希望能更深入地滲透這些市場並加以掌控，這才是我們這麼做的根本原因。不是為了提高毛利率；而是為了掌控投資。

We're a company that has cash on the balance sheet. We're willing to invest in these markets, and we want to continue to invest in these markets. So as we take them direct, the goal is then to reinvest and make sure that we're driving adoption. So the impact of the distributor really nominal on our organic growth rate, like I said, it rounds to 0. So the 28% is the organic growth rate, even including that. So hopefully, that helps you around the acquisition. There isn't much there that changes the results this quarter.

我們是一家資產負債表上有現金的公司。我們願意在這些市場投資，也希望持續投資。因此當我們改為直營（take them direct）時，目標就是再投資，並確保我們推動採用率。因此，經銷商的影響對我們的有機成長率非常有限，如我所說，四捨五入為 0。所以 28% 是有機成長率，即使把那部分也包含在內。希望這能幫助你理解這次收購。這一季沒有太多會改變結果的因素。

And our next question comes from Matt Taylor from UBS.

下一個問題來自 UBS 的 Matt Taylor。

I was hoping you could give me more color on how things are going in the primary care channel. Could you give us any sense for how the sales force is maturing, how productive they are and if there's more to go there.

我希望你能就基層醫療通路的進展提供更多細節。你能否讓我們了解銷售團隊的成熟度、他們的生產力如何，以及那裡是否還有更多成長空間？

Yes, this is Kevin. I'll take that. There's still more to go, but it is going very well. Our targets are going very well as far as we call on. We've also learned there are some we have not had on the target list, and we're expanding that coverage as well. We've had numerous situations where it's taken our person several attempts to get into an office. But once they get in, and once we get a person on a DexCom, the response is so good based on the quality of the product that we get more. But it is a progressive effort. And it doesn't -- we don't walk in and all of a sudden get, hey, here's 50 new patients this month. It takes a little time, and we have to build a lot of credibility. But the primary care audience, particularly for those on insulin, it's gone very well so far, but it is a process, and it does take some time.

是的，我是 Kevin。我來回答這題。還有更多工作要做，但目前進展非常順利。就我們拜訪的目標而言，我們的目標達成得很不錯。我們也發現有一些原本不在目標名單上的對象，因此也在擴大覆蓋範圍。我們遇到過很多情況，我們的同仁需要嘗試好幾次才能進到診所/辦公室。但一旦進去、而且一旦我們讓一位病患使用 DexCom，基於產品品質帶來的回饋非常好，因此我們會獲得更多採用。不過這是一個循序漸進的努力。我們不會走進去就突然說，嘿，這個月就有 50 位新病患。這需要一些時間，我們也必須建立大量的可信度。但就基層醫療（primary care）族群而言，特別是使用胰島素的患者，到目前為止進展非常好；但這是一個流程，也確實需要一些時間。

And our next question comes from Joanne Wuensch from Citi.

下一個問題來自花旗（Citi）的 Joanne Wuensch。

It seems to me like the increasing clinical evidence that you're building is going to really help the type 2 population. But could you give us sort of an update on where you think or what you think you'll need to get into the non-intensive type 2s?

在我看來，你們正在累積的臨床證據愈來愈多，應該會對第二型糖尿病族群很有幫助。但你能否更新一下：你認為要切入非密集治療（non-intensive）的第二型糖尿病患者，你們還需要什麼？

This is Kevin. I'll take that. We've taken a several-pronged approach to get in there, and we're not going to deviate from that approach. We're working with health care professionals who are prescribing product for non-intensive type 2 site right now and getting great outcomes. We work with the payer network. For example, the Level 2 program at UnitedHealth that's produced some very good results for them and very visible in their marketing materials and their efforts. The programs and with the technologies Jake outlined, that we got approved today, the app in the app and the interfaces that will be great for partners because they do want to control that experience for patients and ultimately getting to people directly.

我是 Kevin。我來回答。我們採取多管齊下的方式來切入該市場，而且不會偏離這個策略。我們正與目前就已在為非密集治療第二型糖尿病患者開立產品的醫療專業人員合作，並取得很好的成效。我們也與支付方（payer）網絡合作。舉例來說，UnitedHealth 的 Level 2 計畫為他們帶來非常好的成果，也在他們的行銷素材與推動工作中相當醒目。再加上 Jake 提到、我們今天獲准的那些計畫與技術——包含 app 內的功能以及各種介面——對合作夥伴會很有價值，因為他們確實希望能掌控病患的使用體驗，並最終能直接觸及個人。

We've been very successful in our DTC campaigns for the intensive insulin users. There will come a time when we'll be able to go direct to those consumers in the type 2 and IT, as we call it, nonintensive insulin therapy or not on insulin therapy, get to these guys as well. And we have a high level of confidence in the products we're designing and the things we're planning, combined with the ability of our team to reach these markets once we turn them loose once we have the opportunity to do so. So we'll go through all those steps. We'll continue on all 4 fronts. We're not going to back off on 1 of them.

我們針對密集胰島素使用者的 DTC（直接面向消費者）行銷活動非常成功。未來會有一個時點，我們也能直接面向第二型糖尿病的消費者；以及我們所稱的 IT，也就是非密集胰島素治療（nonintensive insulin therapy）或未使用胰島素治療的族群，也能觸及這些人。我們對正在設計的產品與規劃中的事項非常有信心；再加上我們團隊一旦有機會、放手去做，就有能力觸及這些市場。因此我們會走完所有這些步驟，並持續在四個面向同時推進，不會在其中任何一個面向退縮。

And our next question comes from Cecilia Furlong from Morgan Stanley.

下一個問題來自摩根士丹利（Morgan Stanley）的 Cecilia Furlong。

I wanted to ask just on gross margin. As you think about 4Q is implied with your updated guidance step down, but just what you're factoring in from the international access component versus G7 initial launch, not quite being at scale? And how we should think about the trajectory heading into '22?.

我想問一下毛利率。依你們更新後的指引來看，第四季（4Q）似乎隱含毛利率會下滑；你們在假設中，國際市場准入（international access）擴張的影響，與 G7 初期上市尚未達到規模（not quite being at scale）的影響，各占多少？以及我們應該如何看待進入 2022 年的走勢？

Sure. So the gross margin in Q4, we do expect to take a bit of a step back. Some of it is the international access as that ramps up. And the other piece, to your point, is the launch of G7 and turning on all of the machine, the depreciation, and therefore, the yields. A majority of that is going to be the G7 launch. And the reason why is we're not at full capacity at that point. Now once we get to full capacity, there's no reason why we don't get back to our long-term gross margin guide, and we'll get into 2022 when we get there. But there's nothing structurally in those lines that would prevent us from meeting what we had talked about from our long-term gross margin guide.

好的。第四季的毛利率，我們確實預期會稍微回落。其中一部分是國際市場准入隨著放量而帶來的影響。另一部分如你所說，是 G7 的上市：啟用所有設備、開始計提折舊，進而影響良率。影響的大多數會來自 G7 上市，原因是那個時間點我們尚未達到滿載產能。不過一旦達到滿載，就沒有理由不能回到我們長期毛利率指引的水準；等到進入 2022 年、到達那個階段時我們會再說明。但在這些項目上，沒有任何結構性的因素會阻止我們達成先前談到的長期毛利率指引。

There may be ebbs and flows quarter-by-quarter as we ramp up. But I don't expect there to be any issues there. So if you're kind of asking the question, well, how would I wait the 2, most of the impact is upon the launch of G7 and turning on those machines and the depreciation associated with it. As we get into 2022 and volumes start to build on those machines and you're able to absorb those fixed costs there's nothing structurally that can't get us back to the gross margin profiles that we've set for an organization.

在我們爬坡的過程中，季度之間可能會有起伏，但我不預期會有任何問題。所以如果你的問題是：兩者之間該如何權衡？大部分影響來自 G7 上市、啟用那些設備，以及相關折舊。進入 2022 年後，當這些設備上的出貨量開始增加、你能吸收那些固定成本時，從結構上來看沒有任何因素會讓我們無法回到我們為公司所設定的毛利率輪廓。

And our next question comes from Jayson Bedford from Raymond James.

下一個問題來自 Raymond James 的 Jayson Bedford。

This is Pavel on for Jason. I have 2 quick questions here. First, will we see G7 clinical data before U.S. approval? And the second one is how close are you guys to getting to the 75% of commercial payers into the pharmacy channel?

我是 Pavel，代 Jason 提問。我有兩個簡短問題。第一，在美國核准之前，我們會看到 G7 的臨床數據嗎？第二，你們距離讓 75% 的商業保險支付方（commercial payers）進入藥局通路（pharmacy channel）還有多近？

Yes. So thanks for the question, this is Jake. So the -- we presented actually earlier this year, we presented at ATTD G7 data, showing an MARD of sub-9% and a very strong clinical accuracy better than G6 in fact. So we're very excited and happy with the result of the U.S. pivotal, and we'll be releasing that in the future.

是的，謝謝你的問題，我是 Jake。關於第一點——我們其實在今年稍早於 ATTD 發表了 G7 數據，顯示 MARD 低於 9%，臨床準確度非常強，甚至優於 G6。因此我們對美國關鍵性試驗（pivotal）的結果非常興奮也很滿意，未來也會對外發布。

Yes. So now that you've seen that data, I think you have a feel for it. And obviously, that data -- as these -- as more products launch over time, you'll get access to it. But I think some folks ask, well, how do I know what it's going to look like before there is public data available at ATD that should set kind of North Star. In terms of the transition, the migration in the pharmacy, we talked about this glide path from approximately 50% turning into 2021 or at the end of 2020 into really 75% by the end of 2022. We're on that glide path right now. And so we're making headways. We haven't given a specific update as a percentage. But as you're charting that course, we're right where we'd be expected and right where you'd expect from a linear transition over time. So hopefully, that helps.

是的。既然你已看過那些數據，我想你大概有概念了。當然，隨著時間推移、更多產品上市，你也會取得更多資料。不過有些人會問：在 ATTD 公開數據之前，我怎麼知道它大概會長什麼樣？那份資料應該可以作為一個「北極星」般的參考。至於藥局端的轉換/遷移，我們談過這條滑行路徑：從 2020 年底（或進入 2021 年時）約 50%，到 2022 年底達到 75%。我們目前正沿著這條路徑前進，也正在取得進展。我們沒有提供最新的具體百分比更新，但如果你用線性轉換的方式來描繪這條路徑，我們就在預期的位置、也符合你對隨時間推移線性轉換的期待。希望這能解答你的問題。

Our next question comes from Larry Biegelsen from Wells Fargo.

下一個問題來自富國銀行（Wells Fargo）的 Larry Biegelsen。

This is Nathan Treybeck on for Larry. Can you just provide us an update on how you're thinking about CGM for hospital and gestational diabetes?

我是 Nathan Treybeck，代 Larry 提問。你能否更新一下你們如何看待 CGM 在醫院端以及妊娠糖尿病（gestational diabetes）的應用？

Yes. This is Jake. So let's start on the hospital first. So the way we're thinking about that is that really with the accuracy and reliability that we have built into the G6 and G7 systems that it's a great CGM platform to then build a purpose-built hospital product. So we're in the early stages of understanding what is the exact CGM that meets the needs in the hospital. We've seen good success with G6 under times of COVID use in the hospital. It is really serving a need, but it's not exactly the right workflow for the hospitals. And so what we want to do is better understand how do we build a CGM that really meets the needs of that segment. On the pregnancy side, we're very excited about the building in pregnancy functionality and providing information that's important for expected mothers into the G7 product. And so that's part of our road map, and we're actively working on building that into the G7.

是的，我是 Jake。我們先從醫院端開始。我們的想法是：憑藉我們在 G6 與 G7 系統中建立的準確度與可靠性，這是一個很好的 CGM 平台，接著可以在其上打造一款為醫院量身打造（purpose-built）的產品。因此我們正處於早期階段，正在釐清究竟什麼樣的 CGM 才能精準滿足醫院的需求。我們看到在 COVID 期間，G6 在醫院使用上取得不錯的成功，確實滿足了一個需求，但它並不是完全符合醫院工作流程的解決方案。因此我們想更深入了解：要如何打造一款真正符合該細分市場需求的 CGM。至於懷孕端，我們對在 G7 產品中加入妊娠相關功能、並提供準媽媽重要資訊感到非常興奮。這是我們產品路線圖的一部分，我們也正積極把這些功能建置到 G7 中。

And our next question comes from Steven Lichtman from Oppenheimer.

下一個問題來自 Oppenheimer 的 Steven Lichtman。

Kevin, you mentioned earlier all the work you continue to do on non-intensive with partners, payers and collecting data. Wondering what your latest thoughts are on potential revenue per patient in that population or utilization overall for the nonintensive.

Kevin，你先前提到你們持續與合作夥伴、支付方合作，並在非密集治療族群上蒐集數據。想請問你目前對該族群的單一患者潛在年收入（revenue per patient）或整體使用量（utilization）的最新看法是什麼？

At this point in time, the total revenue amount per year is still something we model out on a number -- in a number of cases. What we've learned and what the data that we've seen most recently supports and we'll continue to talk about is continuous use of the system provides much better health care outcomes than intermittent or sporadic use the things that patients learn with this technology, having that feedback full time provides a much better outcome. With respect to the long-term revenue model, and again, I'm speculating a bit here, but I'll just repeat what I say to the team internally, we're solving a much different problem for somebody who's not on insulin.

就目前而言，每位患者每年的總收入金額，我們仍會在多種情境下進行建模。我們學到的、以及近期看到的數據所支持、而且我們也會持續對外溝通的是：系統的持續使用，相較於間歇性或零星使用，能帶來更好的醫療結果。患者透過這項技術所學到的東西，以及全天候的回饋，能帶來顯著更好的成效。至於長期營收模型——我在這裡稍微推測一下——但我只想重申我在內部對團隊說的話：對於未使用胰島素的人，我們正在解決的是一個截然不同的問題。

It is not a life-and-death decision for them. So I can see the revenue per patient being lower for this group over time even in continuous use, but I don't know how much yet. There will certainly be intermittent use models that might be available and lead to good outcomes. But one of the mistakes that a lot of these programs make in the beginning is they try and minimize the number of sensors because they're worried about the costs, they're trying to control. And in reality, the benefits to these patients and these customers who use the systems get -- are derived from CGM data. So we have to balance those things and balance that against our current business model as well. But we do believe it's going to be a very good population and there was long a belief that all these patients won't want to wear it all the time. No, they do. They very much enjoy the data and really like knowing where they are. That has not been a problem at all.

這對他們而言並不是攸關生死的決定。因此，即使在持續使用的情況下，我也可以預期這一族群隨時間推移的每位病患營收會較低，但目前我還不知道會低多少。當然，未來一定會有間歇性使用的模式可供選擇，並且可能帶來良好結果。但許多這類方案一開始常犯的錯誤之一，就是因為擔心成本、想要控管費用，而試圖把感測器數量降到最低。實際上，這些病患與使用系統的客戶所獲得的效益——是來自 CGM 數據。因此，我們必須在這些因素之間取得平衡，也要與我們目前的商業模式做權衡。不過我們確實相信，這會是一個非常好的族群；而且長期以來一直有人認為這些病患不會想要一直戴著它。不是的，他們會。他們非常享受這些數據，也真的喜歡知道自己目前的狀態。這完全不是問題。

And our next question comes from Ravi Misra from Berenberg.

下一個問題來自 Berenberg 的 Ravi Misra。

So I guess I'll use my one question on the New Zealand, Australian distributor. Just curious, how quickly can you basically get through this, I guess, inorganic revenue in terms of the impact to guidance? Like is there still kind of non-CGM revenue that we assume in quarter 4? And maybe help us think about, I guess, what the market size that you think you're able to kind of go after with this acquisition? Or do you need to do more in this arena, this country or continent space to really get access to the population?

我想我會把我唯一的一個問題用在紐西蘭、澳洲的經銷商上。想請教一下，你們基本上能多快把這部分我想稱之為「非有機」營收消化掉，亦即它對財測指引的影響會多快反映完畢？例如在第 4 季，我們是否仍應假設會有某種非 CGM 的營收？另外也請幫我們思考一下，透過這次收購，你們認為能夠切入、可追逐的市場規模大概有多大？還是說在這個領域、在這個國家或洲別的布局上，你們還需要做更多，才能真正觸及這個人口族群？

Sure, I can take that. So when we acquired the distributor, the distributor had multiple different product lines. And they have sales reps that cover these multiple different product lines. And so -- and ultimately, a distributor is about people, and it's an incredible group of people. And so the key here is making sure we keep everybody together. So we'll stay in that line. What we tried to identify for you is the contributions to the overall guide in basis points. And so in our guide, we talked about 100 basis points on the full year. You'll do the math and figure out what the approximate impact is in Q4. And I think you'll have a pretty good feel for it. We'll make sure that we isolated out over the long haul, so that you're able to identify what is and what isn't out there.

好的，我來回答。當我們收購該經銷商時，該經銷商有多條不同的產品線；他們也有業務代表負責覆蓋這些不同的產品線。因此——歸根結底，經銷商的核心在於人，而這是一群非常出色的人。關鍵在於確保我們能把大家凝聚在一起，所以我們會維持在那條路線上。我們試著為各位釐清的是：以基點（basis points）來看，對整體指引的貢獻。因此在我們的指引中，我們談到全年 100 個基點。你們可以自行計算，推估第 4 季的大致影響，我想你們會有相當不錯的掌握。我們也會確保長期來看能把它隔離出來，讓你們能辨識哪些是、哪些不是。

So I think you can feel comfortable there, provided it's material. In terms of the actual acquisition itself, and being able to get into the market, this was -- this is a group of folks who have done an incredible job with CGM adoption in that country. And so when we get into these countries, we want to make sure, one, we have the team. We make sure that there's nothing in their way from continuing to develop CGM awareness and develop CGM adoption. So there's nothing that prevents us under the structure. The only thing we mentioned in terms of investment is very similar to the way you've thought about our organization in the U.S.

所以我認為你們可以放心，只要它是重大的。在實際收購本身以及進入市場的能力方面，這——這是一群在該國推動 CGM 採用做得非常出色的團隊。因此當我們進入這些國家時，我們希望確保：第一，我們擁有這個團隊；第二，我們確保沒有任何事情會阻礙他們持續提升 CGM 認知並推動 CGM 採用。因此在這個架構下，沒有任何事情會限制我們。至於我們提到的投資，唯一要說的是，這與你們對我們在美國組織的理解非常相似。

We know that investment in DTC and in sales reps where it makes sense and in sampling. And all of the things that we've put in place makes great sense in other markets. You've seen us do some of that in Europe. And certainly, we've done some in Canada. And we expect to do more of that. And when we take it direct, we can do a little bit more of that. And so that's really what we're talking about. So there's nothing structurally that prevents us from taking the acquisition and continuing to proliferate CGM adoption in those countries.

我們知道在 DTC（直接面向消費者）以及在合理之處投入業務代表、以及提供試用（sampling）等方面的投資——我們已經建立的所有措施——在其他市場同樣非常合理。你們已經看到我們在歐洲做了一些；當然在加拿大我們也做了一些，而且我們預期會做得更多。當我們改為直營時，我們可以在這方面做得更多一些。所以這就是我們在談的重點。總之，從結構上來說，沒有任何因素會阻止我們透過這次收購，並在這些國家持續擴大 CGM 的採用。

Yes. This is Kevin. I would just add to that. One of the reasons we do things of this nature, take a look at our direct business in Canada and the wins we just had with the provinces and reimbursement there. With our financial muscle at the corporate level, we can take much more risk than a distributor could on their own. And so we view this investment in Australia and New Zealand as one where we're going to be able to go after a broader market increased access reimbursement and really make an impact those -- this team needed our muscle to do that financially and we needed their talent to do it as well. So it works for both of us.

是的，我是 Kevin。我再補充一下。我們之所以做這類事情，其中一個原因是：看看我們在加拿大的直營業務，以及我們最近在各省與那邊的給付（reimbursement）所取得的勝利。以公司層級的財務實力而言，我們能承擔的風險遠高於經銷商單靠自己所能承擔的。因此我們把在澳洲與紐西蘭的這項投資視為一個機會：我們將能夠開拓更廣泛的市場、提升給付可近性，並真正產生影響——這個團隊在財務上需要我們的「肌肉」來做到這點，而我們也需要他們的才能來一起完成。所以這對雙方都有利。

And our next question comes from Marie Thibault from BTIG.

下一個問題來自 BTIG 的 Marie Thibault。

Spending a little bit of time on the DexCom 1 site. It strikes me as a very consumer-friendly website. And I'm just curious, whether this is sort of a glimpse at the future. I know it's been launched into some Eastern European countries. But is this a model that you would look at in terms of sort of flexible pricing and subscription plans and bulk order discounts? Is this something that's sort of a preview of the broader appeal of CGM may be into prediabetes and end consumer markets?

我花了一點時間看 DexCom 1 的網站。它看起來非常以消費者為導向、很友善。我想請教，這是否算是對未來的一種預告。我知道它已在一些東歐國家推出。但這是否是一種你們會考慮的模式，例如更彈性的定價與訂閱方案、以及大量訂購折扣？這是否可視為 CGM 更廣泛吸引力的預覽，可能延伸到糖尿病前期（prediabetes）以及終端消費者市場？

Yes, this is Kevin. This is a very important launch for us. It's the first time we've launched a product on a new software platform and had a new product launch. We're in a position now of volume and manufacturing wise that we want to get this product to as many people as we can. And what DexCom 1 represents is really an opportunity where we can get DexCom technology into a geography easier than we could if we went through our traditional means with our G Series product. So we're offering this.

是的，我是 Kevin。這對我們而言是一個非常重要的上市。這是我們第一次在新的軟體平台上推出產品，並完成一個新產品上市。我們現在在出貨量與製造能力方面已經到了一個位置，我們希望把這個產品帶給盡可能多的人。而 DexCom 1 所代表的，確實是一個機會：相較於透過我們傳統的 G 系列產品路徑，我們可以更容易地把 DexCom 技術帶進某些地理市場。因此我們提供了這個方案。

And yes, as you talked about, flexible pricing plans, subscription models and things of that nature to get this product to this patient group. It definitely can be a precursor of things we can do in the future to take advantage of the scale that we've created within the business with our ability to manufacture more and again, while the website is very easy to use, I assure you the app that Jake's team and our marketing team have developed is every bit as easy to use as the website. This truly is a step-up for us from a product experience, and then we'll evaluate those opportunities over time, where we have a market where we can increase our volumes and gain more traction with this type of product offering rather than our traditional G Series, we will explore that.

而且是的，正如你提到的，透過彈性定價方案、訂閱模式以及諸如此類的方式，把這個產品帶給這個病患族群。這確實可能是我們未來可做事情的前導，讓我們能利用我們在業務中建立的規模——包括更高的製造能力——來推進更多可能性。再者，雖然網站非常容易使用，但我向你保證，Jake 的團隊與我們的行銷團隊所開發的 App 也同樣非常好用。就產品體驗而言，這確實是我們的一次升級；接下來我們會隨時間評估這些機會——在那些我們能提高出貨量、並透過這類產品供應方式（而非傳統 G 系列）取得更多動能的市場，我們會去探索。

And our next question comes from Josh Jennings from Cowen.

下一個問題來自 Cowen 的 Josh Jennings。

This is actually Neil on for Josh. We've had some consultants recently talked about the potential for monitoring other analytes. I was just wondering if you could maybe share any updates there in terms of any development plans or program for extending monitoring analytes outside of glucoses like ketones.

其實我是代 Josh 提問的 Neil。我們最近有一些顧問談到監測其他分析物（analytes）的潛力。我想請教你們是否能分享一些最新進展，例如在把監測範圍從葡萄糖延伸到其他分析物（例如酮體 ketones）方面，有沒有任何開發計畫或專案？

Sure. Yes. The wearable platform that we've developed with the electrochemical sensors can be extended to other analytes, and we do have active research programs within DexCom and also with some of our university colleagues that are researching other analytes that we could use on our platform. Today, we're not talking about exactly which ones, but we do feel that this platform can be extended to multiple analytes and provide more value around the CGM component.

當然。是的，我們以電化學感測器所開發的穿戴式平台可以延伸到其他分析物；我們在 DexCom 內部也有積極的研究計畫，同時也與一些大學夥伴合作研究，探索哪些其他分析物可以在我們的平台上使用。目前我們不會談論具體是哪一些，但我們確實認為這個平台可以延伸到多種分析物，並在 CGM 元件之外提供更多價值。

Our next question comes from Anthony Petrone from Jefferies.

下一個問題來自 Jefferies 的 Anthony Petrone。

And I hope everyone is doing well. Two quick questions. One would be on supply chain constraints. Just wondering how that is expected to play out into 2022, hearing a lot about inflationary upward pressure on cost of goods sold. So wondering how that's playing out for DexCom and what the offsets are. And then as we look into the '05 launch, just maybe an update on what percent of existing Omnipod users are currently not users of DexCom solutions?

希望大家都一切順利。兩個簡短問題。第一個是供應鏈限制。想請教這在 2022 年預期會如何發展；我們聽到很多關於通膨對銷貨成本（cost of goods sold）造成上行壓力的說法，所以想了解這對 DexCom 的影響如何，以及有哪些抵銷因素。第二個是，當我們展望 '05 上市時，能否更新一下：目前既有的 Omnipod 使用者中，有多少比例目前並不是 DexCom 解決方案的使用者？

Sure. So I'll go ahead and take the inflationary and supply chain. So I think everybody is -- nobody is immune to certain products and certain areas that do have pressure based on supply chain -- supply and demand. One of the things I think our team has done, there's 2 pieces of it. One, do you have enough product? And two, can you manage the cost? And I think our team has done an incredible job in lining up the product. Now that doesn't mean everybody is out of the woods, that everybody's got supply chains they're naturally running through. But this team got ahead of it very early and has been working collaboratively with all of our suppliers well in advance to make sure that we're properly communicating the value of our product and making sure that we're working with them to secure supply.

好的。我先來回答通膨與供應鏈的部分。我想大家都——沒有人能對某些產品與某些領域的壓力免疫，因為供應鏈在供需之間確實會產生壓力。我認為我們團隊做得很出色的其中兩個面向是：第一，你是否有足夠的產品；第二，你是否能管理成本。我認為我們團隊在確保供應方面做得非常好。當然這不代表所有人都已經完全脫離困境，畢竟每家公司都有其自然要面對的供應鏈流程。但我們的團隊很早就超前部署，並且提前很久就與所有供應商協同合作，確保我們能適當溝通我們產品的價值，並與他們一起努力以確保供應。

And that's ongoing, but that work has been done well in advance of everybody else kind of jumping on it. So we're very proud of that team. In terms of the inflationary measures, we're in a bit of a unique environment. There have been absolutely inflationary measures, but we're also making a lot more product. And so you kind of get economies of scale and purchasing power, which offset some of the challenges associated with inflation. So our expectation is we're able to navigate both of those and it will not impact kind of our longer-term gross margins because of that nature. So -- hopefully that answers your question. Maybe I could turn it over to...

而且這項工作仍在持續進行，但我們早在其他人開始跟進之前就已經把這些工作做得很到位。所以我們對那個團隊感到非常自豪。就通膨措施而言，我們所處的環境有點獨特。確實存在通膨壓力，但我們同時也在生產更多產品。因此你會獲得規模經濟與採購議價能力，能抵消部分與通膨相關的挑戰。所以我們的預期是，我們能同時應對這兩者，且由於這種特性，它不會影響我們較長期的毛利率。所以——希望這回答了你的問題。也許我可以把問題轉交給……

Well, I can answer the Omnipod questions. So with Pod 5, there are a decent amount of folks using it. There's some studies out there I don't want to quote them just because I don't know how accurate they are. We generally have a good feel for it, although we haven't put it out there publicly. We can let Omnipod do that if they want to. But we do know once Omnipod 5 is launched and the integration associated with DexCom, it could provide a catalyst certainly for us. The 1 thing we will say is when we continue to say it all the time, is CGM first. And so we do believe that a lot of folks do come to CGM and then ultimately could choose to go on to an integrated system. And -- Most folks that do get on to our product today now are MDI. And so a lot of those are out there. That all being said, another AID system with 1 is novel as Omnipod. I think it's certainly something that's interesting. And for patients that like patch pumps, I think this is an incredible opportunity for folks to get on that platform.

好，我可以回答關於 Omnipod 的問題。關於 Pod 5，目前有相當多的人在使用。外面有一些研究，但我不想引用，因為我不確定其準確性。我們一般對情況有不錯的掌握，雖然我們尚未對外公開。如果 Omnipod 想要，他們可以自行公布。但我們確實知道，一旦 Omnipod 5 上市，並且與 DexCom 的整合到位，這很可能會成為我們的催化劑。我們一直反覆強調的一點是：先 CGM。因此我們相信，很多人會先使用 CGM，之後最終可能選擇進入整合式系統。而且——目前大多數開始使用我們產品的人是 MDI（多次每日注射）。所以這樣的族群其實很多。話雖如此，像 Omnipod 這樣新穎的 AID 系統也很有意思。我認為這確實是值得關注的。對於喜歡貼片式幫浦的病患而言，這是讓大家進入該平台的一個絕佳機會。

And our next question comes from Kyle Rose from Canaccord?

我們的下一個問題來自 Canaccord 的 Kyle Rose？

I just wanted to maybe ask another question on DexCom 1. I mean you've -- you talked a couple of times just about patient experience being different and having a different app. And I understand that the software is obviously completely different on the e-commerce side, but maybe help us understand just what specifically is different from a patient-facing perspective with DexCom 1 versus what we've seen historically with G6 and the previous generation products?

我想再問一個關於 DexCom 1 的問題。我的意思是——你們提過幾次，病患體驗不同，且會有不同的 App。我理解在電商端軟體顯然完全不同，但能否幫我們理解，從病患端的角度來看，DexCom 1 與我們過去看到的 G6 以及前一代產品相比，具體有哪些不同？

Yes, it's Jake. I'll take that one. Yes, DexCom 1 from the beginning, our intent around the design of that product was to make it simple. And so that kind of flows through as you mentioned, the e-commerce experience, but into the app, the mobile app itself. It's a new -- completely new app architecture for us. So it's a new piece of software. And the first part that users will see that's quite different is the onboarding module. So we basically spent a lot of time studying human factors and how users use the products, particularly in those -- when they're first learning how to use it.

是的，我是 Jake。我來回答。是的，DexCom 1 從一開始，我們在產品設計上的意圖就是讓它更簡單。因此如你提到的，這會延伸到電商體驗，也延伸到 App、本身的行動 App。這對我們來說是全新的——完全新的 App 架構。所以這是一套新的軟體。使用者第一個會看到、且相當不同的部分是導入（onboarding）模組。我們基本上花了很多時間研究人因工程，以及使用者如何使用產品，特別是在——他們第一次學習如何使用時。

So what the onboard module does is really walks them through a simple process in how to get up and running quickly on their CGM. The other thing about it that's different than G6 is it has a simplified alert scheme -- So it doesn't have some of the more sophisticated predictive alerts that G6 does it. It has a very simple, easy-to-use approachable alert scheme. The other thing that we added is with our current G6 system, a lot of the kind of data over time statistics are built into our Clarity software with DexCom 1, we've actually incorporated that into the DexCom 1 app. So typical statistics like average glucose time and range estimated A1C. That's all built into the single DexCom 1. And then finally, in that vein of simplicity, there's no AID connectivity for DexCom 1. It also doesn't have the share remote monitoring feature. So it's really about bringing a simple CGM product to people who've never had access to DexCom CGM and haven't experienced life without fingersticks.

所以導入模組真正做的，是帶著他們走過一個簡單流程，讓他們能快速開始使用他們的 CGM。另一個與 G6 不同之處是，它有一個簡化的警示機制——因此它沒有 G6 那些更精密的預測性警示。它是一個非常簡單、易用、容易上手的警示機制。另一個我們新增的功能是：在我們目前的 G6 系統中，許多長期數據統計是建在我們的 Clarity 軟體裡；而在 DexCom 1，我們把這些功能整合進 DexCom 1 App。像是平均血糖、目標範圍內時間、估算 A1C 等典型統計，都整合在單一的 DexCom 1 裡。最後，同樣基於簡化的理念，DexCom 1 沒有 AID 連線能力；也沒有分享（share）的遠端監測功能。所以它的核心是把一個簡單的 CGM 產品帶給那些從未能使用 DexCom CGM、也未曾體驗過不必扎手指生活的人。

And our next question comes from Chris Pasquale from Guggenheim.

我們的下一個問題來自 Guggenheim 的 Chris Pasquale。

I want to piggyback on that last question because I think that answer was instructive in terms of some of the differences here. And so it leads me to wonder who you're targeting specifically with this platform? It sounds like with the loss of sharing and predictive alerts, this is probably not going to be a type 1 or a pediatric product. Do you see this as a way to get more into the type 2 population specifically? Is it a way to approach some emerging market territories where reimbursement may not be in place? I would just love some thoughts on where you see this going over time and who this product is really for.

我想延續上一個問題，因為我覺得那個回答對理解這裡的一些差異很有幫助。因此這讓我想知道，你們這個平台具體鎖定的是哪些族群？聽起來因為少了分享與預測性警示，這可能不會是一個第一型或兒科產品。你們是否把它視為更深入切入第二型族群的一種方式？是否是用來切入一些新興市場、而那些地區可能尚未建立給付？我很想聽聽你們對於它隨時間發展的方向，以及這個產品真正是為誰而設的想法。

It's all of those things. Certainly, you look at the 4 countries we launched in, they're not huge countries, but they're markets where we've never been before. So with the e-commerce platform and the creative pricing structures we have for subscription plans and things of that nature. It gives a group of people access to our technology that have never had it before. And as far as they're not sharing and they're not connecting to the ID systems, you're exactly right. It is a lower level of technology with respect to net than what we offer. And so it is targeted different people. Certainly, we'll have access to more type 2 patients and access to insulin users. But again, some of these geographic plays in countries where there isn't anything, -- We felt this simpler solution is a better product to offer out of the gate than the other one. And then we'll evaluate over time what products we offer where. So you were right on point with pretty much all your observations.

以上皆是。當然，你看我們首波上市的 4 個國家，它們不是很大的國家，但都是我們以前從未進入過的市場。因此透過電商平台，以及我們為訂閱方案等設計的創新定價結構，讓一群以前從未接觸過我們技術的人能夠使用。至於沒有分享、也不連接到 AID 系統，你說得完全正確。就我們所提供的內容而言，這是一個技術層級較低的產品。因此它是針對不同的人群。當然，我們會觸及更多第二型病患，也能觸及胰島素使用者。但同樣地，在某些地理布局上、在一些什麼都沒有的國家——我們認為這種更簡單的解決方案，作為一開始就推出的產品，比另一個更合適。接著我們會隨時間評估在各地提供哪些產品。所以你的觀察幾乎都非常到位。

And we have no more questions at this time. I'd like to turn it back to Kevin Sayer for final comments.

目前沒有更多問題。我想把時間交回 Kevin Sayer 做最後結語。

Thank you, and thank you, everyone, for your questions and continued interest and support of DexCom. We've once again reported a number of important developments to position DexCom for the future on top of outstanding financial performance and continued growth. I'm going to wax a bit philosophical today, but my father passed away in late 2020, but he never missed an earnings call. And our routine after the calls was very simple. He'd call me up and he'd say, this is what you guys were trying to say, and he was pretty much always right on point. So I'm preparing my closing remarks today, let me reiterate what we're trying to tell you.

謝謝，也謝謝各位提出問題，並持續關注與支持 DexCom。我們再次報告了多項重要進展，在卓越的財務表現與持續成長之上，讓 DexCom 更能為未來做好定位。我今天稍微哲學化一點：我父親在 2020 年底過世，但他從不錯過任何一次法說會。每次會後我們的例行流程很簡單：他會打電話給我，然後說，你們其實想表達的是這些，而他幾乎總是說得很到位。所以在我準備今天的結語時，讓我重申我們想告訴各位的重點。

Leverage and growth continue. Our 28% revenue growth achieved through sensor volume growth in excess of 40% demonstrates the continued commitment and talent of our commercial organization. Profitability continues to improve as well, yet we remain mindful of the investments we need to make in the future. Our global access strategy is working. We continue to achieve the numbers we've achieved while we've expanded access to our product globally through strategically shifting our customers to channels, which was sold in reduced revenue per customer annually and yet margins have increased.

槓桿效益與成長仍在延續。我們 28% 的營收成長，是透過超過 40% 的感測器出貨量成長所達成，這展現了我們商業組織持續的投入與才能。獲利能力也持續改善，但我們仍謹記未來需要進行的投資。我們的全球可近性（access）策略正在奏效。在我們透過策略性地將客戶轉移到不同通路、使得每位客戶的年度營收下降的同時，我們仍持續達成既有的數字，而且毛利率反而提高。

Next, G7 is on schedule, and it's coming. All of the efforts related to G7 are moving at a frenetic pace around here. I've never seen our people so engage in a single-minded purpose. And finally, our software development and data platform commitments are going to be critical in the future and you saw big steps this quarter. We've spent a great deal of time talking about software as a differentiator today and we haven't over the past several months. you're beginning to see -- you're seeing the beginning of a great change with DexCom 1 and the data sharing and experience-enhancing technologies recently approved by the FDA also demonstrate this. It's only the beginning. Our long-term focus has always been for the data generated from our devices to be consumed in a way that really makes an impact on people's lives and on their health care in general. Thanks, and everybody, have a great day.

接下來，G7 進度如期，而且即將到來。所有與 G7 相關的工作在這裡都以極快的節奏推進。我從未見過我們的團隊如此投入於單一且明確的目標。最後，我們對軟體開發與資料平台的承諾在未來將至關重要，而你們在本季也看到了重大進展。我們今天花了很多時間談軟體作為差異化因素，而過去幾個月我們並沒有這麼做。你開始看到——你正在看到 DexCom 1 所帶來的重大變革的開端；而近期獲 FDA 核准的資料分享與體驗增強技術也證明了這一點。這只是開始。我們長期的焦點一直是，讓裝置產生的資料能以真正對人們生活與整體醫療照護產生影響的方式被使用。謝謝，各位祝有美好的一天。

Ladies and gentlemen, this concludes today's conference. Thank you for participating. You may now disconnect.

各位女士、先生，今天的會議到此結束。感謝各位參與。您現在可以中斷連線。