德康醫療 (DXCM) 2021 Q2 法說會逐字稿

Welcome to the DexCom Second Quarter 2021 Earnings Release Conference Call. My name is Dow, and I'll be your operator for today's call. (Operator Instructions) Please note that this conference is being recorded.

歡迎參加 DexCom 2021 年第二季財報發布電話會議。我是 Dow，將擔任今天電話會議的接線員。(接線員指示) 請注意，本次會議將被錄音。

I will now turn the call over to Sean Christensen. You may begin.

現在我將把電話交給 Sean Christensen。您可以開始了。

Thank you, operator, and welcome to DexCom's Second Quarter 2021 Earnings Call. Our agenda this afternoon includes comments on the company's recent performance and strategic initiatives from Kevin Sayer, DexCom's Chairman, President and CEO; Jereme Sylvain, our Chief Financial Officer; and finally, an update from Quentin Blackford, our Chief Operating Officer. Following our prepared remarks, we will open the call up for questions. (Operator Instructions) Please note that there are also slides available related to our second quarter performance on the DexCom Investor Relations website on the Events and Presentations page.

謝謝，接線員，也歡迎各位參加 DexCom 2021 年第二季財報電話會議。今天下午的議程包括：由 DexCom 董事長、總裁兼執行長 Kevin Sayer 就公司近期表現與策略性計畫發表評論；接著由我們的財務長 Jereme Sylvain 發言；最後由營運長 Quentin Blackford 提供最新進展。在我們的預備發言結束後，將開放提問。(接線員指示) 另請注意，DexCom 投資人關係網站的「活動與簡報」頁面也提供與第二季表現相關的投影片。

With that, let's review our safe harbor statement. Some of the statements we will make in today's call may constitute forward-looking statements. These statements reflect management's intentions, beliefs and expectations 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, and are subject to various risks and uncertainties, and actual results could differ materially from those anticipated in the forward-looking statements.

接下來，我們來回顧安全港聲明。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、信念與預期。本簡報中所有前瞻性陳述均以本日為準，係基於 DexCom 目前可得資訊作出，並受各種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。

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.

可能導致實際結果與任何前瞻性陳述所明示或暗示者出現重大差異的因素，已詳載於 DexCom 的 Form 10-K 年報、最近一期 Form 10-Q 季報，以及向美國證券交易委員會提交的其他文件中。除法律另有規定外，我們不承擔在本簡報日期後更新任何此類前瞻性陳述，或使其與實際結果一致的義務。

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 our tables in our earnings release and the slides accompanying our second 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，我們將就非 GAAP 與以現金為基礎的結果，討論若干未依 GAAP 編製的財務衡量指標。除非另有說明，所有財務指標的提及均以非 GAAP 基礎呈現。此額外資訊不應被孤立看待，亦不應作為依 GAAP 編製之結果的替代，或被視為優於依 GAAP 編製之結果。請參閱我們財報新聞稿中的表格，以及第二季財報簡報隨附投影片，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 great results for our second quarter with 32% revenue growth for the quarter compared to the second quarter of 2020, as well as solid execution on our key strategic initiatives that we will discuss throughout the call today. The $143 million in absolute dollar revenue growth compared to the second quarter in 2020 represents the highest quarterly increase in DexCom's history. We continue to believe that we are early in our story with the potential to drive a far greater impact on global health.

謝謝你，Sean，也謝謝各位加入我們。今天我們公布了第二季的優異成果：本季營收較 2020 年第二季成長 32%，同時在我們將於今天會議中討論的關鍵策略性計畫上也有穩健的執行表現。相較 2020 年第二季，營收絕對金額增加 1.43 億美元，為 DexCom 歷史上單季增幅最高。我們仍然相信，我們的故事才剛開始，未來有潛力對全球健康帶來更大的影響。

Our growth performance is closely related to the progress we've made to advance access on our CGM systems for people with diabetes. And because there is often so much misinformation spread about access to DexCom's CGM in the field, while the cost of our products for people with diabetes. Let me point out several key points that our investors, clinicians and current and potential customers should know. We've advanced pharmacy access in the U.S., where more than 70% of our commercial customers have a monthly out-of-pocket cost of less than $60 per month, and nearly 1/3 of our customers have 0 out-of-pocket costs for their G6 sensors.

我們的成長表現與我們在推動糖尿病患者取得我們 CGM 系統方面所取得的進展密切相關。由於市場上經常流傳許多關於取得 DexCom CGM 的錯誤資訊，以及糖尿病患者使用我們產品的成本。我想指出幾個投資人、臨床醫師，以及現有與潛在客戶應該了解的重點。我們已在美國推進藥局通路的可近性；超過 70% 的商業保險客戶每月自付額低於 60 美元，且近 1/3 的客戶在 G6 感測器上無需自付費用。

According to IQVIA, this is less than the comparable out-of-pocket cost for our nearest competitor. The latest research from diabetes market research firm, Seagrove Partners, confirms our conclusion. With DexCom having the lowest customer co-pays of the 3 largest CGM suppliers in the U.S. for customers on intensive insulin therapy, we've significantly expanded coverage for people with intensively managed type 2 diabetes, with the overwhelming majority of these patients now having coverage for DexCom CGM in the U.S.

根據 IQVIA 的資料，這低於我們最接近競爭對手的可比自付成本。糖尿病市場研究公司 Seagrove Partners 的最新研究也證實了我們的結論。在美國三大 CGM 供應商中，對於接受密集胰島素治療的客戶，DexCom 的客戶自付額最低；我們也已大幅擴大對密集管理之第二型糖尿病患者的給付覆蓋，這些患者中的絕大多數如今在美國都已享有 DexCom CGM 的保險給付。

We also continue to advocate for equitable access to our CGM supplies for populations that are often underserved. As of July 2021, there are now 43 State Medicaid programs providing coverage for DexCom CGM, including a growing number of states providing access through their pharmacy channel for both type 1 and type 2 intensive users. We are building even more on those advocacy efforts in collaboration with several key nonprofit organizations that support the diabetes community.

我們也持續倡議，讓經常被忽視或服務不足的族群能公平取得我們的 CGM 耗材。截至 2021 年 7 月，目前已有 43 個州的 Medicaid 計畫提供 DexCom CGM 給付，其中越來越多州透過藥局通路，為第一型與第二型的密集使用者提供可近性。我們正與多個支持糖尿病社群的關鍵非營利組織合作，在這些倡議工作上投入更多資源。

In June, we launched the global movement for time and range to broaden awareness of time and range and its benefits for people with diabetes and their health care providers. And we hope that this collaboration effort will lead to future solutions for improved CGM access. Our teams have taken a leading role to drive the removal of administrative barriers that prevent people with diabetes from accessing the benefits of real-time CGM. Along these lines, we are pleased to see the update from CMS in the second quarter to remove the requirement of at least 4 daily finger sticks for Medicare customers. This will simplify the CGM onboarding process for both customers and clinicians. We've also made solid progress internationally, building from our position of operational strength to advocate for broader reimbursement for G6. This initiative is moving forward according to plan with several geographies publicly announcing enhancements to their coverage of DexCom CGM in the second quarter.

6 月，我們發起「Time in Range（目標範圍時間）」的全球行動，以提升糖尿病患者及其醫療照護提供者對目標範圍時間及其益處的認識。我們希望這項合作努力能促成未來改善 CGM 可近性的解決方案。我們的團隊也扮演領導角色，推動移除阻礙糖尿病患者取得即時 CGM 效益的行政障礙。在這方面，我們樂見 CMS 於第二季更新政策，取消 Medicare 客戶必須每日至少 4 次指尖採血的要求。這將簡化客戶與臨床醫師的 CGM 導入流程。我們在國際市場也取得穩健進展，憑藉我們的營運優勢，倡議更廣泛的 G6 給付。此項計畫正按進度推進，且第二季已有多個地區公開宣布強化其對 DexCom CGM 的給付覆蓋。

Despite these developments, a majority of people on mealtime insulin continue to manage their diabetes with finger sticks. Even in the U.S., a leader in CGM adoption, we continue to believe that the type 1 market remains less than 50% penetrated and the type 2 intensive market is less than 25% penetrated. So there remains a great opportunity ahead of us, even in the markets that we currently serve.

儘管有這些進展，多數使用餐時胰島素的人仍以指尖採血來管理糖尿病。即使在 CGM 採用率領先的美國，我們仍認為第一型市場的滲透率不到 50%，而第二型密集市場的滲透率不到 25%。因此，即便在我們目前服務的市場中，前方仍有巨大的機會。

At the same time, we are generating a growing evidence base for the use of DexCom CGM. And at the ATTD and ADA industry conferences in June, we presented exciting research affirming the benefits of our product platform, including the ALERTT1 trial. This randomized controlled trial was simultaneously published in the Lancet, showing superior health outcomes associated with the use of DexCom CGM relative to our nearest competitor, Flash Glucose Monitor. These conferences also featured several presentations on the use of CGM for people of type 2 diabetes, including those not using mealtime insulin as well as use in women who are pregnant used in the hospital setting and even conclusions applicable to health and wellness using CGM data.

同時，我們也正在累積越來越多支持 DexCom CGM 使用的證據基礎。在 6 月的 ATTD 與 ADA 產業會議上，我們發表了令人振奮的研究，確認我們產品平台的效益，其中包括 ALERTT1 試驗。這項隨機對照試驗亦同步發表於《刺胳針》（Lancet），顯示相較於我們最接近的競爭對手——Flash Glucose Monitor（閃測式血糖監測）——使用 DexCom CGM 可帶來更佳的健康結果。這些會議也包含多場關於第二型糖尿病患者使用 CGM 的報告，包括未使用餐時胰島素者、孕婦在醫院情境中的使用，以及甚至可將 CGM 數據應用於健康與福祉的相關結論。

Perhaps the most significant of these presentations was the long-awaited readout of our MOBILE trial, which was also published in the Journal of the American Medical Association. MOBILE is another rigorous randomized controlled trial assessing the value of DexCom CGM compared to the current standard of care, finger sticks, for people of type 2 diabetes treated with basal insulin. Importantly, the study looked at a diverse user base representative of the U.S. population, and it assess these people in a primary care clinical environments where they are traditionally served.

或許其中最重要的發表，是我們期待已久的 MOBILE 試驗結果公布，該研究亦發表於《美國醫學會雜誌》（Journal of the American Medical Association）。MOBILE 是另一項嚴謹的隨機對照試驗，針對以基礎胰島素治療的第二型糖尿病患者，比較 DexCom CGM 與目前照護標準——指尖採血——的價值。重要的是，該研究納入具多元性的使用者族群，代表美國人口結構，並在其傳統就醫的基層照護臨床環境中對這些人進行評估。

So what did we see? We saw clinically significant A1c reductions for users of our DexCom CGM systems. And perhaps even more telling, we saw a 16% time and range increase for the CGM cohort, which is 4 additional hours per day spent in the target glucose range. These were results produced with DexCom CGM and DexCom software. We designed the trial with the goal of changing the standard of care for these basal insulin users, a group that we believe includes between 3 million and 4 million people in the U.S. alone. With these results, we feel that MOBILE and DexCom have the potential to do just that, and our teams look forward to driving better awareness and access based on the study outcomes and the JAMA publication.

那麼我們看到了什麼？我們看到使用我們 DexCom CGM 系統的使用者，其 A1c 出現具臨床意義的下降。而且或許更能說明問題的是，我們看到 CGM 組別的目標範圍時間（time in range）增加了 16%，相當於每天多 4 小時處於目標血糖範圍內。這些結果是透過 DexCom CGM 與 DexCom 軟體所達成。我們設計此試驗的目標，是改變這些基礎胰島素使用者的照護標準；我們相信僅在美國，這個族群就介於 300 萬到 400 萬人之間。基於這些結果，我們認為 MOBILE 與 DexCom 具備實現這一點的潛力，我們的團隊也期待能依據研究結果與 JAMA 的發表，推動更高的認知度與更佳的可近性。

We also made great progress in the second quarter to advance the clinical and regulatory pathway for our next-generation G7 CGM system. At ATTD in June, we provided an update on the performance of G7 drawn from our recent clinical trials. Based on the data shown, we expect that G7 will continue the excellent clinical and real world performance and reliability that we have established with our G6 brand. And it will do so with several factors that we believe will enhance our customer experience, including a fully disposable sensor and transmitter, a redesigned app experience and a market-leading 30-minute warmup period.

我們在第二季也取得重大進展，推動下一代 G7 CGM 系統的臨床與法規路徑。在 6 月的 ATTD 會議上，我們提供了來自近期臨床試驗的 G7 表現更新。根據所展示的數據，我們預期 G7 將延續我們在 G6 品牌上所建立的卓越臨床與真實世界表現及可靠性。同時，G7 也將透過多項我們認為能提升客戶體驗的因素來達成，包括全拋棄式感測器與發射器、重新設計的 App 體驗，以及市場領先的 30 分鐘暖機時間。

Our G7 continues to progress according to our plans. During the second quarter, we concluded our U.S. clinical trial that will support our iCGM filing and our teams have now shifted to processing the data and working toward preparing the regulatory filing. In addition, we've recently submitted G7 for CE Mark approval. As we previously discussed, we believe that this timing places us on track to begin the G7 launch by the end of 2021.

我們的 G7 仍依照計畫持續推進。在第二季期間，我們完成了支持 iCGM 申報的美國臨床試驗，目前團隊已轉向資料處理並著手準備法規申報文件。此外，我們近期已提交 G7 以申請 CE Mark 核准。如先前所述，我們相信此時程使我們仍可按計畫在 2021 年底前開始推出 G7。

These are incredible achievements and advances from the quarter and a nice step forward to fulfill the promise presented by our CGM technology. And this is just the beginning. There are several additional areas of progress that Jereme and Quentin will discuss based on the great work of our teams in the past several months.

這些都是本季令人振奮的成就與進展，也是朝向實現我們 CGM 技術承諾的良好一步。而這只是開始。Jereme 與 Quentin 將根據我們團隊在過去幾個月的出色工作，討論其他幾個進展領域。

So with that said, let me turn it over to Jereme for a review of our second quarter financial performance. Jereme?

那麼接下來，讓我把時間交給 Jereme，請他回顧我們第二季的財務表現。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.

謝謝你，Kevin。提醒各位，除非另有說明，今天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）網站上查閱。

For the second quarter of 2021, we reported worldwide revenue of $595 million compared to $452 million for the second quarter of 2020, representing growth of 32% on a reported basis and 30% on a constant currency basis. As Kevin noted, this represents a record for absolute dollar growth in a quarter year-over-year. U.S. revenue totaled $462 million in the second quarter compared to $367 million in the second quarter of 2020, representing growth of 26%.

2021 年第二季，我們全球營收為 5.95 億美元，較 2020 年第二季的 4.52 億美元成長，按報告基礎年增 32%，按固定匯率基礎年增 30%。如 Kevin 所提，這代表單季絕對美元增量的年對年成長創下紀錄。美國營收第二季合計 4.62 億美元，較 2020 年第二季的 3.67 億美元成長 26%。

Our momentum and market leadership position in the U.S. remains strong, and we have been very encouraged with the continued interest in CGM in the marketplace. With the combination of greater depth in our sales force, solid results from our direct-to-consumer marketing campaigns and expanded ability to allow for patients and clinicians to trial the G6 experience, we are beginning to see preliminary results in our effort to further expand our presence into primary care offices and position the company to extend our customer base.

我們在美國的動能與市場領導地位依然強勁，且我們對市場上持續升溫的 CGM 興趣感到非常鼓舞。結合更深厚的銷售團隊配置、直接面向消費者（DTC）行銷活動的穩健成效，以及擴大讓病患與臨床醫師試用 G6 體驗的能力，我們開始在進一步擴展至基層醫療診所、並為公司擴大客戶基礎的努力上，看到初步成果。

International business grew about 58% in the second quarter, totaling $134 million. While the second quarter comp benefited from the impact of COVID on our second quarter 2020 results, we saw good sequential growth momentum as the business once again achieved a new high watermark. The international growth was broad-based across all markets, including core markets like Germany, the U.K., Canada, Australia and the Nordic region.

國際業務在第二季成長約 58%，營收達 1.34 億美元。雖然第二季的比較基期受 COVID 對 2020 年第二季結果的影響而有利，但我們看到良好的環比成長動能，業務再次創下新高水位。國際成長涵蓋各市場，包含德國、英國、加拿大、澳洲與北歐地區等核心市場。

Our shift to the pharmacy channel and sales initiatives in the U.S. and our market expansion initiatives internationally are all progressing according to plan, driving high volume growth in both regions. Volume growth for the second quarter came in around the mid-40% range on a global basis. Perhaps the greatest examples of the international effort during the quarter came from Canada, where we saw public announcements of provincial coverage for G6 from 2 of the largest Canadian provinces: Quebec, where coverage of G6 was established for people with type 1 diabetes; and British Columbia, which became the first Canadian province to cover G6 for people with type 1 diabetes and intentionally manage type 2 diabetes.

我們在美國轉向藥局通路以及銷售推動措施，與國際市場擴張計畫皆按計畫推進，帶動兩個地區的高量成長。第二季全球出貨量成長約落在 40% 中段區間。本季國際推進最具代表性的例子或許來自加拿大：我們看到兩個加拿大最大省份中的兩個，公開宣布 G6 的省級給付涵蓋——魁北克省已為第一型糖尿病患者建立 G6 給付；而卑詩省則成為加拿大第一個為第一型糖尿病患者提供 G6 給付，並涵蓋以第一型糖尿病與有意識地管理第二型糖尿病的人群的省份。

These public announcements are representative of our broader strategy to advance access to our technology for people with diabetes. We are leveraging the increasing strength of our operations and driving a meaningful expansion to the total number of patients that we can address via reimbursed pathways.

這些公開宣布反映了我們更廣泛的策略：推動糖尿病患者取得我們技術的可近性。我們正運用營運能力日益增強的優勢，並透過可獲得給付的途徑，實質擴大我們可觸及的患者總數。

Our second quarter gross profit was $417.1 million or 70.1% of revenue compared to 64.1% of revenue in the second quarter of 2020. We're very proud of the effort that's gone into these results. The 600 basis points of gross margin expansion is another great validation of the growing efficiencies that we've achieved through product design and efficient manufacturing operations. It is these types of efforts that drive the strategic flexibility to expand our addressable market that I just referenced.

第二季毛利為 4.171 億美元，佔營收 70.1%，相較於 2020 年第二季佔營收 64.1%。我們對促成這些成果所投入的努力感到非常自豪。毛利率擴張 600 個基點，再次有力驗證我們透過產品設計與高效率製造營運所達成的效率提升。正是這類努力，帶來我剛才提到的策略彈性，使我們得以擴大可服務的市場範圍。

Operating expenses were $315.6 million for Q2 2021 compared to $213 million for Q2 2020. These results reflect what we previously noted in our discussion of our 2021 plans. We have several areas of investment that we are pursuing, which account for the increase in operating expenses as a percentage of sales relative to the second quarter of 2020. These include the costs associated with our expanded field sales force, the pivotal trial in support of our U.S. G7 regulatory submission, the G7 manufacturing scale-up and global direct-to-consumer marketing.

2021 年第二季營業費用為 3.156 億美元，較 2020 年第二季的 2.13 億美元增加。這些結果反映了我們先前在討論 2021 年計畫時所提到的內容。我們正在推進多個投資領域，這些投資使得營業費用佔銷售額的比例相較 2020 年第二季有所上升。其中包括：擴編外勤銷售團隊的相關成本、支持美國 G7 法規申報的關鍵性試驗、G7 製造擴產，以及全球直接面向消費者行銷。

Our strategic investments have also included our efforts to efficiently scale and lower the cost to serve our customers as we envision a future in which we serve meaningfully more people than we do today. Our global business services operations in Lithuania and the Philippines are key examples of those initiatives that are driving great customer service while leveraging our G&A spend.

我們的策略性投資也包括：在我們展望未來將服務遠多於今日的人數之際，致力於有效率地擴大規模並降低服務客戶的成本。我們在立陶宛與菲律賓的全球商業服務營運，就是這些計畫的關鍵例子；這些計畫在善用我們的 G&A（一般與行政）支出的同時，也提供優質的客戶服務。

Operating income was $101.5 million or 17.1% of revenue in the second quarter of 2021 compared to $76.7 million or 17% of revenue in the same quarter of 2020. The 10 basis point year-over-year improvement was driven by strong improvements to our gross margin, resulting from the design of our products and the manufacturing efficiencies that come there through. These improvements more than offset the strategic investments that we've made during the year.

2021 年第二季營業利益為 1.015 億美元，佔營收 17.1%，相較於 2020 年同季的 7,670 萬美元、佔營收 17%。年對年提升 10 個基點，主要來自毛利率的顯著改善，這源於我們的產品設計以及由此帶來的製造效率提升。這些改善已足以抵銷我們在本年度所進行的策略性投資。

Adjusted EBITDA was $156.6 million or 26.3% of revenue for the second quarter compared to $122.6 million or 27.1% of revenue for the second quarter of 2020. Net income for the second quarter was $75.4 million or $0.76 per share. We remain in a great financial position, closing the second quarter with approximately $2.6 billion in cash and cash equivalents and great financial flexibility to drive our strategic initiatives.

第二季調整後 EBITDA 為 1.566 億美元，佔營收 26.3%；相較於 2020 年第二季的 1.226 億美元、佔營收 27.1%。第二季淨利為 7,540 萬美元，或每股 0.76 美元。我們的財務狀況依然非常穩健，第二季結束時持有約 26 億美元的現金及約當現金，並具備充足的財務彈性以推動我們的策略性計畫。

Turning to guidance. We continue to expect solid volume growth across all of our regions in the back half of the year with momentum driven by growing CGM awareness globally. Based on our second quarter performance, we are pleased to be in a position to once again raise our full year 2021 revenue guidance. We now expect 2021 revenue to be between $2.35 billion to $2.4 billion, representing growth of 22% to 25% over 2020. This increase comes on top of our expectations for approximately $10 million of unfavorable currency impact in the back half relative to prior guidance. This revenue increase is primarily a reflection of our continued growth momentum as well as the ongoing impact of our channel mix and international access expansion strategies.

接著談指引。我們仍預期在今年下半年，所有地區的出貨量都將維持穩健成長，動能來自全球對 CGM 的認知持續提升。基於我們第二季的表現，我們很高興能再次上調 2021 全年營收指引。我們目前預期 2021 年營收介於 23.5 億美元至 24 億美元之間，較 2020 年成長 22% 至 25%。此一上調是在我們預期下半年相較先前指引將有約 1,000 萬美元不利匯率影響的基礎上進行的。這次營收上調主要反映我們持續的成長動能，以及通路組合與國際市場准入擴張策略的持續影響。

We will see a greater revenue per patient impact to our existing base from our international access initiatives in the second half of the year, but we continue to expect the incremental volume driven by these efforts to offset those pressures in our base this year alone. More importantly, this will leave us in a much better position in the years to come.

在今年下半年，我們的國際市場准入計畫將使既有客戶基礎的每位病患營收受到較大的影響，但我們仍預期，這些努力所帶來的新增出貨量將在今年就足以抵銷既有基礎所承受的壓力。更重要的是，這將使我們在未來幾年處於更有利的位置。

Turning to margins. We are increasing our full year 2021 targets. This includes non-GAAP results to be approximately at the following levels: gross profit margins of approximately 67%, operating margins of approximately 14% and adjusted EBITDA margins of approximately 24%.

接著談毛利與利潤率。我們上調 2021 全年目標。其中非 GAAP 結果預計約為以下水準：毛利率約 67%、營業利益率約 14%，以及調整後 EBITDA 利潤率約 24%。

With that, I will now turn the call over to Quentin for a scale and strategy update.

接下來，我把電話交給 Quentin，請他更新規模與策略進展。

Thank you, Jereme. As Kevin and Jereme indicated, we made great progress on our key strategic initiatives during the second quarter. It is hard not to be excited about the market potential for CGM after seeing the depth of research using DexCom technology at the recent ATTD and ADA industry conferences. We saw well over a dozen presentations from DexCom's insulin delivery partners, highlighting the clinical utility of their DexCom integrated systems and DexCom's leadership in the field of interoperable solutions.

謝謝你，Jereme。如 Kevin 與 Jereme 所提到的，我們在第二季於關鍵策略計畫上取得了很大進展。在近期 ATTD 與 ADA 產業會議上看到使用 DexCom 技術的研究深度後，很難不對 CGM 的市場潛力感到振奮。我們看到 DexCom 的胰島素輸注合作夥伴有十多場以上的發表，強調其 DexCom 整合系統的臨床效用，以及 DexCom 在可互通解決方案領域的領導地位。

Outside of the MOBILE and ALERTT publications that Kevin mentioned, we also saw several presentations from our DexCom team members as well as independent investigators with outcomes that are very promising for the continued growth of DexCom CGM. In one study presented by our health economics team, we looked at real world evidence, documenting the cost savings for a significant number of patients with type 2 diabetes using G6, including both the intensive insulin therapy and those who are not treated with mealtime insulin. The results were compelling with the magnitude of cost savings generated for the G6 users being nearly identical to the cost savings we've seen in several of our other pilots. This is yet another data point supporting economic benefits associated with the better glucose control for our customers, and we are excited to leverage this growing evidence base into broader access for people with diabetes around the world.

除了 Kevin 提到的 MOBILE 與 ALERTT 論文之外，我們也看到多場由 DexCom 團隊成員以及獨立研究者所做的發表，其結果對 DexCom CGM 的持續成長非常有前景。在我們健康經濟學團隊發表的一項研究中，我們檢視了真實世界證據，記錄第 2 型糖尿病患者使用 G6 所帶來的成本節省，涵蓋密集胰島素治療者以及未使用餐時胰島素治療者。結果相當具說服力，G6 使用者所產生的成本節省幅度，幾乎與我們在其他多個試點計畫中看到的成本節省相同。這是另一項支持更佳血糖控制可帶來經濟效益的數據點；我們也很期待運用這個日益累積的證據基礎，推動全球糖尿病患者獲得更廣泛的使用可近性。

We also continue to innovate our software solutions to enable differentiated user experiences that meet the needs of the diverse customer bases that we serve. Most recently, in mid-July, we received FDA clearance on a real-time API software solution. This is, to our knowledge, one of the first, if not the first real-time API clearance in the medical device sector that enables integration with third-party apps. As many of you likely know, prior to the clearance of our real-time API, our various digital health partners were limited to the display of CGM data on a 3-hour delayed basis through our retrospective API. With this new API, partners who are now invited by DexCom have the ability to integrate real-time DexCom CGM data into the respective apps and devices. This is another great win for our customers, who will now benefit from the ability to see real-time glucose levels in a variety of new displays according to their needs.

我們也持續創新軟體解決方案，以提供差異化的使用者體驗，滿足我們所服務之多元客群需求。最近在 7 月中旬，我們取得 FDA 對一項即時 API 軟體解決方案的核准。據我們所知，這是醫療器材領域最早、甚至可能是第一個可支援與第三方 App 整合的即時 API 核准。如各位可能知道，在我們的即時 API 核准之前，各種數位健康合作夥伴只能透過我們的回溯式 API，以延遲 3 小時的方式顯示 CGM 資料。有了這個新的 API，現在由 DexCom 邀請的合作夥伴，便能將 DexCom CGM 的即時資料整合到各自的 App 與裝置中。這對客戶而言是另一項重大利多；他們將可依需求在多種新的顯示介面中看到即時血糖數值。

At the time of the approval, we announced Garmin and Teladoc Health Livongo for diabetes program as early users of the new API solution. In addition, Welldoc and UnitedHealthcare's Level2 are also utilizing our real-time connectivity solutions and their integrated offerings. This is an exciting innovation for us and an example of how we are leveraging our leadership in software connectivity to advance our market position in the growing digital health landscape.

在核准當時，我們宣布 Garmin 與 Teladoc Health 的 Livongo 糖尿病計畫將成為這項新 API 解決方案的早期使用者。此外，Welldoc 與 UnitedHealthcare 的 Level2 也正在使用我們的即時連線解決方案及其整合式產品。這對我們而言是一項令人振奮的創新，也展現我們如何運用在軟體連線方面的領導地位，在快速成長的數位健康版圖中強化市場地位。

On the commercial front, we remain well positioned to drive growth in broader DexCom market penetration in several locations. In addition to the significant access expansion efforts that we began to implement last quarter to enable multiples of growth in our core markets, we are growing our presence in locations that are relatively new to our team. This includes Japan, where we've recently sent our first shipment of G6 systems to our local distributor. Although we have had a minor presence in Japan through the use of our G4 professional CGM, these G6 systems represent the expanded use of our product to serve people with diabetes with our core ambulatory solution. We are incredibly excited to bring our CGM technology to empower people with diabetes in Japan and look forward to developing that as a nice growth market for DexCom.

在商業面，我們仍處於有利位置，可在多個地區推動 DexCom 更廣泛的市場滲透與成長。除了我們自上季開始推動、用以在核心市場實現倍數成長的重大准入擴張工作之外，我們也在一些對團隊而言相對較新的地區擴大布局。其中包括日本；我們最近已將第一批 G6 系統出貨給當地經銷商。雖然我們過去透過 G4 專業型 CGM 在日本已有小規模布局，但這些 G6 系統代表我們擴大產品使用範圍，以核心的可攜式（ambulatory）解決方案服務糖尿病患者。我們非常期待將 CGM 技術帶到日本，賦能當地糖尿病患者，並期待把日本發展成 DexCom 一個良好的成長市場。

In addition to the strong G7 performance data showed at ATTD in the clinical and regulatory updates that Kevin provided, our operations team is continuing according to plan in our G7 manufacturing development and scaling efforts. We have automated lines producing G7 product as we speak, with a steady cadence of additional lines scheduled to be delivered through the back half of this year and throughout 2022.

除了 Kevin 在臨床與法規更新中提到、並在 ATTD 展示的強勁 G7 表現數據之外，我們的營運團隊也正按計畫推進 G7 製造開發與擴產工作。目前我們已有自動化產線正在生產 G7 產品，並且在今年下半年及 2022 年將以穩定節奏交付更多產線。

In addition, the vendors in our supply chain are scaling up G7 capabilities alongside us as we sit here today. We will take what we have learned from these automated lines in San Diego and Mesa and use them to quickly replicate and scale in our new manufacturing facility in Malaysia. As we've said before, this effort will be critical to our ability to serve significant customer populations that we think can benefit from our CGM technology, giving us a clear runway to produce more than 200 million sensors per year and a much stronger presence in a key growth region for us.

此外，截至目前，我們供應鏈中的供應商也正與我們同步擴充 G7 產能。我們將把在聖地牙哥與梅薩（Mesa）這些自動化產線所學到的經驗，運用於馬來西亞新製造基地的快速複製與擴產。如同我們先前所說，這項工作對我們服務龐大、可望受益於 CGM 技術的客群至關重要，並為我們提供清晰的產能跑道，使我們每年可生產超過 2 億個感測器，同時在對我們而言的關鍵成長區域建立更強的布局。

Our team is doing a great job to advance our efforts in what continues to be a challenging environment to navigate because of the impact of the pandemic globally. We are currently building out the manufacturing facility while also scaling our supply chain, putting us on track to be ready for production in 2022. As you can see from our 70% gross margin this quarter, we're making this progress on G7, while also advancing our efforts towards operational excellence, resulting in even greater improvements in efficiencies to our G6 manufacturing, procurement and distribution capabilities.

在全球疫情影響下、環境仍具挑戰且難以應對之際，我們團隊在推進相關工作方面做得非常出色。我們目前一方面建置製造設施，一方面擴充供應鏈，使我們按計畫在 2022 年具備投產準備。從本季 70% 的毛利率可見，我們在推進 G7 進度的同時，也持續朝營運卓越邁進，進一步提升 G6 製造、採購與配送能力的效率。

Overall, as I think Kevin and Jereme would agree, we are very proud of the work of our teams to execute on the ambitious plans that we set forth in 2021.

整體而言，我想 Kevin 與 Jereme 也會同意，我們對團隊在 2021 年所設定的宏大計畫之執行成果感到非常自豪。

With that, I'll pass the call back to Kevin.

接下來，我把電話交回給 Kevin。

Thanks, Quentin. I agree with that message as we are all very pleased with the progress that we made during the quarter. To be able to raise guidance across the board, including another revenue raise, with $65 million added to the midpoint of guidance is a great result for the company. We're excited to continue that momentum into the second half of the year.

謝謝，Quentin。我也同意這個說法，我們都對本季取得的進展感到非常滿意。能夠全面上調指引，包括再次上調營收，且指引中位數增加 6,500 萬美元，對公司而言是非常好的成果。我們也很期待在今年下半年延續這股動能。

I would now like to open up the call for Q&A. Sean?

接下來我想開放進入問答。Sean？

Thank you, Kevin. As a reminder, we ask our audience to limit themselves to only 1 question at this time and then reenter the queue if necessary. Operator, please provide the Q&A instructions.

謝謝你，Kevin。提醒各位聽眾，目前請每人先限制只提 1 個問題，如有需要可再重新排隊。接線員，請提供問答環節的操作說明。

(Operator Instructions) And our first question comes from Robbie Marcus.

(接線員指示) 我們的第一個問題來自 Robbie Marcus。

I want to congratulate you guys on a really nice quarter. If I can ask, I think we're all interested in updated G7 approval timing sounds like you haven't filed in the U.S. yet. And you had a great international number. I'd love if you could provide just any examples or tangible examples of how the expansion of benefit is already helping you? And how it might continue to help you the rest of this year and next year?

我想恭喜各位這一季表現非常出色。如果我可以問一下，我想大家都很關心 G7 核准時程的最新進展，聽起來你們在美國還沒有遞交申請。而你們的國際業績數字也很亮眼。我很希望你們能提供任何例子或具體案例，說明給付範圍擴大已經如何在幫助你們？以及它在今年剩餘時間與明年可能會如何持續幫助你們？

Well, I'll start with G7, then I'll let Quentin and Jereme take over the benefit expansion. With respect to G7, we're very deliberate about what we disclose. We have filed for CE Mark and we are on schedule for that. We hit our goal there. And we are now gathering the data from the U.S. pivotal study. It was a much larger study than the data that was presented at ATTD. However, the trial was run under actually what we think are improved protocols from what we ran before. So we have no reason to not expect great data. We believe the product will be very robust.

好的，我先談 G7，接著再讓 Quentin 和 Jereme 接手說明給付擴大的部分。就 G7 而言，我們對外揭露的內容非常審慎。我們已經提交 CE Mark 申請，而且進度符合時程。我們達成了那邊的目標。目前我們正在彙整美國關鍵性試驗（pivotal study）的數據。那是一項比 ATTD 上所呈現數據大得多的研究。不過，這次試驗實際上是依照我們認為比先前更完善的流程（protocols）來執行。因此我們沒有理由不期待會有很好的數據。我們相信這個產品會非常穩健。

We will make sure that we deliver that file in a very pristine manner. We hear a lot of things about FDA delays and things of that nature. We don't want to create any delays. It's been our experience over time when we deliver what the FDA expects, they move very quickly and are very cooperative with us. We have no reason to believe the file we're preparing isn't going to meet those expectations. We're moving along those lines. So again, with the CE Mark filing, we're on track for an OUS launch later this year, and we'll update you more on the U.S. as time goes on. Quentin?

我們會確保以非常完善、非常乾淨的方式提交這份檔案。我們聽到很多關於 FDA 延遲之類的說法。我們不希望造成任何延誤。依我們長期的經驗，只要我們交付 FDA 所期待的內容，他們就會非常迅速且非常配合。我們沒有理由認為我們正在準備的檔案無法符合那些期待。我們正朝這個方向推進。所以再次強調，CE Mark 申請方面我們仍按計畫進行，預計今年稍晚在美國以外（OUS）市場上市；至於美國的進度，我們會隨時間推進再向各位更新。Quentin？

Yes, Robbie. With respect to your question or comment on the OUS business, look, there was strength really across the board in that entire portfolio of ours. So we're very encouraged by what we're seeing there, primarily on the heels of awareness just continuing to grow. To be honest with you, I don't think we've seen the benefit yet of the increased access that we spoke to really back in the first quarter. And the team has made incredible progress and working with the payers and negotiating these contracts, I'd say we're through 90% or so of those all landing in favorable positions where we probably increased or improved access for nearly 1 million patients in the first half of the year alone in that OUS business. But the reality is that benefit is not going to show up until the back half of the year. So the strength in the second quarter, I wouldn't attribute that to the increased access just yet, but we're very excited about how we're positioned as we go into the back half of the year around those access efforts.

是的，Robbie。關於你對 OUS 業務的提問或評論，你看，我們整個產品組合在各方面都展現出強勁表現。因此我們對目前看到的情況非常受到鼓舞，主要是因為市場認知度持續提升。坦白說，我不認為我們已經看到我們在第一季所談到的「提高可近性」所帶來的效益。團隊在與付款方合作、協商這些合約方面取得了驚人的進展；我會說大約 90% 左右已經完成，而且結果都落在有利的位置——僅在今年上半年，於 OUS 業務中，我們可能就為將近 100 萬名病患增加或改善了可近性。但現實是，這個給付效益要到下半年才會反映出來。所以第二季的強勁表現，我還不會把它歸因於可近性的提升，但我們對於在下半年、圍繞這些可近性努力所處的位置感到非常興奮。

And our next question comes from Bob Hopkins.

我們的下一個問題來自 Bob Hopkins。

Okay. Just to maybe a comment on 2 quick things. First Quentin, I think this is what you're referencing in terms of the access piece, but I'm just curious if there's any more detail on just how that the process of the price cuts and negotiating better access, just how you feel that's going? I think and I apologize if that's kind of what you were referencing with that last question.

好的。我想快速評論兩件事。第一，Quentin，我想你剛才提到的應該就是可近性這一塊，但我很好奇，關於降價與協商更好可近性的流程，你是否能提供更多細節？你覺得進展如何？我想——如果這其實就是你剛才在上一題所提到的內容，也請見諒。

And then, Kevin, I'd love you to just give a quick update on -- just a little more time has passed since the MOBILE trial. Just curious as to kind of what you're hearing from insurance partners or other important parties in terms of the potential impact on that data on facilitating greater reimbursement for a broader range of patients going forward?

另外，Kevin，我也希望你能簡短更新一下——距離 MOBILE 試驗又過了一些時間。我想了解你從保險合作夥伴或其他重要利害關係人那邊聽到什麼，關於這些數據在未來促成更廣泛病患族群取得更高給付（reimbursement）的潛在影響？

Sure. So I'll jump on that first one, Bob. We are talking the exact same thing there in terms of the fact that we've negotiated or worked through the majority of those negotiations through the course of the second quarter, more than 90% or so of them behind us, all landing in favorable positions relative to improving the access for the patients, reducing the administrative burdens that were there, so that folks get on the technology a whole lot easier. So very bullish around where we're at and creating incremental access for our patients and how that sets up into the back half of the year. The pricing assumptions have come right in line with what we expected as we were going into it. No surprises there. So from our perspective, all is very positive on that front.

當然。Bob，我先回答第一個。我們談的是同一件事：在第二季期間，我們已經完成或推進了大多數協商，約 90% 以上都已經在我們身後，而且結果都落在有利的位置——相較於改善病患可近性、降低原本存在的行政負擔，讓大家更容易採用這項技術。因此我們對目前的進展非常樂觀，這將為病患創造額外的可近性，也讓我們在下半年有更好的布局。定價假設也完全符合我們在進入協商前的預期。沒有任何意外。所以就我們的角度來看，這方面一切都非常正面。

And Bob, with respect to the MOBILE study, obviously, we're very excited about it. just a little time has passed here. We also have a bunch of other analyses on this data, that are coming that will support our position on basal insulin reimbursement for these patients. It's time to get the word out now. I think one of the big areas here is going to be CMS discussions down the line because a lot of these patients fall into the Medicare bucket, haven't done any of that yet, but we are looking forward and we are preparing because this data is just really -- is very, very strong.

Bob，至於 MOBILE 研究，顯然我們非常興奮。目前也才過了一點時間。我們還有一系列針對這些數據的其他分析即將出爐，將支持我們對這些病患之基礎胰島素（basal insulin）給付的立場。現在是把訊息傳出去的時候了。我認為其中一個重點領域，將會是未來與 CMS 的討論，因為許多這類病患屬於 Medicare 類別；我們目前還沒有進行那些討論，但我們正在向前看並做準備，因為這些數據真的——非常、非常強。

And our next question comes from Jeff Johnson.

我們的下一個問題來自 Jeff Johnson。

Just staying on maybe the international side for a second. Jereme, last quarter, you talked about a $50 million incremental headwind. From Quentin's comments, it sounds like maybe those really haven't started to flow in yet. So do we think about that $50 million headwind kind of a next 12-month number? Is that how to think about it? And then those initial $200 million headwinds that we kind of were expecting heading into this year, the first quarter kind of straight-lined in right at about $50 million. Did it straight line again in the second quarter at about the $50 million on the U.S. side and still thinking about the international then $50 million over the next 12 months?

我想先在國際面再追問一下。Jereme，上季你提到有 5,000 萬美元的額外逆風。從 Quentin 的評論聽起來，這些影響可能還沒有真正開始反映。所以我們是否應該把那 5,000 萬美元的逆風視為未來 12 個月的數字？是這樣理解嗎？另外，我們在今年初預期的那 2 億美元初始逆風，第一季大致呈線性落在約 5,000 萬美元。第二季在美國端是否也同樣線性落在約 5,000 萬美元？而國際端則仍是未來 12 個月 5,000 萬美元？

Sure. So the full year guidance around pricing or channel mix headwinds is still the same. And so the $200 million on what we call the original shift mix primarily in the U.S. is still the same. And in the second quarter, it came in a little bit lighter than the first quarter, but generally in line. And so I think we're seeing that stable. And we talked about it at the beginning of year being pretty stable throughout the course of the year.

好的。關於定價或通路組合（channel mix）逆風的全年指引仍維持不變。因此，我們所稱的原始組合轉移（original shift mix）主要在美國端的 2 億美元仍然不變。第二季的影響比第一季略輕一些，但整體而言大致符合預期。所以我認為我們看到的是穩定的走勢。而我們在年初也提到，這會在全年期間相對穩定。

To your point on the international incremental headwinds about the access for price conversation, that has started. It is back half loaded. We certainly will have some of those in the first half of next year as we anniversary some of those contracts. So the $250 million we talked about was really the impact on 2021. And so you'll see the $50 million in the back half of the year. There will be a little of that into 2022. We'll go into that in the future, but that will happen over a 12-month period.

至於你提到的國際端、因可近性與價格對話所帶來的額外逆風，那已經開始了。它會集中在下半年反映。而在明年上半年，隨著部分合約進入續約週期（anniversary），我們也確實會看到其中一些影響。所以我們提到的 2.5 億美元，主要是指對 2021 年的影響。因此你會在今年下半年看到那 5,000 萬美元。2022 年也會有一小部分延續。我們之後會再進一步說明，但這會在 12 個月期間內發生。

And our next question comes from Matthew O'Brien.

我們的下一個問題來自 Matthew O'Brien。

I know traditionally, DexCom has been pretty conservative with their outlook. But I think, Jereme, you just said the pricing concessions are going to be impactful in the back half. But as I look at the model, the back half of the year has easier comps than the first half, and you just put up a monster in Q2, especially in the U.S. So is there something specifically you're trying to call out as far as incremental pressure in the back half of the year that we should be aware of?

我知道傳統上，DexCom 對其展望一向相當保守。但我想，Jereme，你剛才提到價格讓利在下半年會帶來影響。不過從模型來看，下半年的比較基期比上半年更容易，而且你們第二季表現非常亮眼，尤其是在美國。所以，關於下半年是否有什麼你們特別想提醒我們、需要留意的額外壓力？

Yes. No, thanks for the question. Certainly, nothing that we're trying to call out. I think when we thought about guidance, we certainly talked about the performance in the first half of the year and certainly thinking about that patient base and how that plays out for the balance of the year. So that's contemplated in the guidance. And look, we raised the guidance, $65 million at the midpoint and $75 million when you exclude the impact of currency. So we've certainly raised it and passed through some of that for the balance of the year.

是的。不，謝謝你的提問。當然，我們並沒有特別想要點出什麼。我想在思考指引時，我們確實談到了上半年表現，並且也把那個病患基礎以及它在今年剩餘期間的影響納入考量。所以這些都已反映在指引之中。另外，我們也上調了指引：以中位數計增加 6,500 萬美元；若排除匯率影響則是 7,500 萬美元。因此我們確實已經上調，並把其中一部分反映到今年剩餘期間。

As we think about the back half of the year, we simply don't want to get ahead of ourselves. We talked about the impact, and you pointed out the international access, but there still is COVID out there and the delta variant is out there. And so rather than increase it and get bullish and get ahead of ourselves, we want to see how it plays through for the balance of the year. We do hear instances out there outside the U.S. where primary care physicians are taking their practice and ultimately using their time to administer vaccinations. While we've done a great job navigating through those thus far this year, we do want to be prudent and make sure that we are contemplating. And look, if we can deliver more than that, we certainly will, and we'll talk to it if we are able to.

談到下半年，我們只是不想操之過急。我們談到了影響，你也提到國際市場的可及性，但外面仍然有 COVID，而且 Delta 變異株也仍在。因此與其再上調、變得更樂觀、走在事情前面，我們希望先看看它在今年剩餘期間會如何發展。我們確實聽到一些美國以外的情況：基層照護醫師把診所業務調整，最終把時間用來施打疫苗。雖然今年到目前為止我們在應對這些方面做得很好，但我們仍希望保持審慎，確保已將這些因素納入考量。而且，如果我們能交出高於此的表現，我們當然會做到；若我們能做到，也會再對外說明。

And our next question comes from Mathew Blackman.

我們的下一個問題來自 Mathew Blackman。

Jereme, I just was curious about the second half cadence and whether we should be thinking about sort of a typical third quarter or fourth quarter cadence? Or are we sort of at the point or approaching the point where things like increasing pharmacy access may make the year somewhat less 4Q weighted as we've seen historically? Any help there would be appreciated.

Jereme，我想請教一下下半年的節奏，我們應該把它視為典型的第三季或第四季節奏嗎？或者我們是否已經到了、或接近一個階段：像是藥局通路可及性提升等因素，可能讓全年不像過去那樣明顯偏重第四季？若能提供一些指引將不勝感激。

Yes. Sure. Absolutely happy to take it. So the way to think about Q3 and by default, you'll back into Q4. Q3 generally is not that impacted by changing in shifts and dynamic. In fact, I think for the past few years, you've generally seen it right around that 26% of full year revenue. And we expect the same to happen this year. So I think that will help you at least think about Q3 and the balance of the year. We do expect Q4 to have less of a weighting you saw in Q1 as a result of the move to the pharmacy where the year gets a little bit less seasonal. I think you'll expect the same in Q4, where you don't have folks in the DME channel rushing to meet benefits. So I do think you'll see, as we've talked about before, as we make more and more moves to the pharmacy, less heavy weighting on Q4 and less light weighting on Q1 and start to move out of that seasonality. But hopefully I gave you some context. Q3 in the near term, we do expect Q3 to mirror that of prior periods, which is generally in that 26% seasonality.

是的。當然。很樂意回答。關於第三季的思考方式，而第四季你自然就能推算出來。第三季通常不太會受到變動、轉換與動態的影響。事實上，我想過去幾年你們一般看到第三季大約占全年營收的 26%。我們預期今年也會如此。所以我想這至少能幫助你思考第三季以及今年剩餘期間的情況。我們確實預期第四季的權重會比你在第一季看到的那種季節性更低，原因是轉向藥局通路後，全年會變得比較不那麼季節性。我想你在第四季也會看到同樣情況：不會再有 DME 通路的客戶為了趕在福利到期前而集中採購。因此我確實認為，如同我們之前談過的，隨著我們越來越多轉向藥局通路，第四季的偏重會降低、第一季的偏輕也會改善，季節性會逐步淡化。希望這些說明能提供一些脈絡。就短期而言，我們預期第三季會與過去期間相近，通常就是約 26% 的季節性占比。

And our next question comes from Matt Taylor.

我們的下一個問題來自 Matt Taylor。

So I wanted to ask one on the margins here. I guess the way I'll ask it is, you showed significant progress. Quentin, you talked about a lot of the scaling and automation activities you're doing in these facilities. Has the results that you've had so far in being able to raise guidance changed your view on the longer term potential for margins at all to the positive versus the LRP?

我想問一個關於毛利率的問題。我想我會這樣問：你們展現了顯著進展。Quentin，你談到你們在這些設施中進行了許多擴產與自動化活動。你們目前的成果，以及能夠上調指引，是否讓你們對長期毛利率的潛力看法有所改變（相較於 LRP 更偏正面）？

Yes. What I would say is, look, our confidence level continues to increase and our ability to keep it in that mid-60s range that we've guided to long term. Is there the opportunity to take it north of there over time? If so, you can bet on it that we're going to flow that through and give that up, if possible. But look, we're in the midst of evaluating a lot of different potential business models. As you look at the whole type 2 non-intensive space as it opens up, we're looking at the international business continue to expand in a significant way. Pharmacy access continues to grow. All of these things are going to continue to put a bit of pressure on the gross margin profile. But if you saw the way that we were able to take cost out of the product from a design perspective and improve the process efficiencies around manufacturing this, your confidence level only increases and where we can keep that gross margin over time.

是的。我會說，我們的信心持續提升，能夠在長期指引所提到的 60% 中段區間維持毛利率。隨著時間推進，有沒有機會把它提高到更高的水準？如果可以，你可以相信我們一定會把這些改善反映出來，並在可能的情況下把成果交出來。但你看，我們正在評估許多不同的潛在商業模式。當整個第二型糖尿病非密集治療市場逐步開放時，我們也在看國際業務持續以顯著幅度擴張。藥局通路可及性也持續成長。所有這些因素都會持續對毛利率結構帶來一些壓力。但如果你看到我們如何從設計角度降低產品成本、並提升製造流程效率，你對我們長期維持毛利率的信心只會更高。

So we're incredibly excited by what we're seeing. A lot of that doesn't contemplate the fact that over time, you probably see us move into a 15-day where cycle on the product itself, and so there's significant benefits that come there also. So again, a bit back to Jereme's point earlier, this is not an area that we're going to get ahead of ourselves, but we feel like we have the flexibility we need to really get after the market opportunities that present themselves and still deliver a very attractive gross margin profile in this business.

所以我們對目前看到的情況感到非常振奮。其中很多還沒有把一個事實納入：隨著時間推進，你可能會看到我們把產品本身推進到 15 天的使用週期，因此也會帶來顯著效益。所以再次呼應 Jereme 先前的觀點，這不是我們會操之過急的領域，但我們覺得自己具備所需的彈性，能夠積極把握市場機會，同時仍在這項業務中交出非常具吸引力的毛利率結構。

And our next question comes from Margaret Kaczor.

我們的下一個問題來自 Margaret Kaczor。

I wanted to follow up a little bit on the real-time APIs and you guys got approval for. And it seems like to me like it could be one of the next evolutions for the business. So I was curious if you could talk to us how important it is today versus 3 years from now, what it can facilitate both clinically and commercially? I guess, just to round it out, what's been the reaction from the potential partners to the API so far?

我想再追問一下你們獲得核准的即時 API。在我看來，這似乎可能是業務下一個演進方向之一。所以我想請你們談談：它在今天的重要性相較於三年後如何？它在臨床與商業面各自能促成什麼？另外，補充問一下，到目前為止潛在合作夥伴對這個 API 的反應如何？

Well, maybe I'll start with the reaction. The reaction has been incredibly positive. I think folks understand and desire to see the real-time information coming into their tools and being able to put that into the hands of the patients. The more real time that information is, the more reactive, the patient can be to that information and improve their outcomes over time. And I think we're incredibly bullish in the sense that we believe we have the capability and a platform to build these tools off of, and that's exactly where we want to be. We want to provide as much input to these tools as we possibly can and work with as many partners as possible.

嗯，也許我先從反應談起。反應非常正面。我想大家理解並且希望看到即時資訊能導入他們的工具中，並能把這些資訊交到病患手上。資訊越即時，病患就越能對資訊做出反應，並隨時間改善其治療結果。而且我們非常看多，因為我們相信自己具備能力與平台，可以在其上建構這些工具，而那正是我們想要的位置。我們希望盡可能為這些工具提供更多輸入，並與盡可能多的合作夥伴合作。

I think from the very beginning, we've always had a bit of a different approach to the value of information, data and software, in particular. And what you're seeing play out right now is part of that vision that we've had there and the approval of the real-time API. We've invested heavily in the ability to produce this capability. We understand the importance of interoperability, the importance of putting information in the hands of the patients. That's who DexCom is. And you're going to continue to see us invest in that area and really use it as a differentiator.

我認為從一開始，我們對資訊、數據，尤其是軟體的價值，一直採取稍微不同的做法。而你現在看到的發展，正是我們當時願景的一部分，以及即時 API 獲得核准的成果。我們已大力投資於打造這項能力。我們理解互通性的重要性，以及把資訊交到病患手中的重要性。這就是 DexCom 的定位。而你將會持續看到我們在這個領域投入，並真正把它作為差異化優勢。

In terms of how that evolves into the future and is there opportunity to create value in that monetization of the data stream or the real-time API. Those are all things we'll evaluate over time. That's not our strategy today. Today, it's all about improving outcomes for patients that's going to show up in the way of incremental sensor sales over time, and we're very happy with that approach. But it leaves us with some great flexibility.

至於未來這將如何演進，以及是否有機會透過數據串流或即時 API 的變現來創造價值，這些都是我們會隨時間推移加以評估的事項。這不是我們今天的策略。今天，我們的重點完全在於改善病患的治療結果，而這將隨時間反映在感測器增量銷售上，我們對這種做法非常滿意。但這也讓我們保有很大的彈性。

And our next question comes from Travis Steed.

下一個問題來自 Travis Steed。

Congratulations on a good quarter. I know you talked about the OUS launch of G7 here in the back half. And just curious if you could put some context on expectations for how we should think about that launch? And which countries if you're willing to share that? And you've also got probably 40 million to 50 million G6 sensors that you're making a year. And just curious what you're going to do with the G6 capacity as G7 launches?

恭喜你們交出一個不錯的季度。我知道你們談到 G7 在美國以外（OUS）將於下半年推出。想請教你們能否提供一些背景脈絡，讓我們理解應該如何看待這次上市的預期？以及如果你們願意分享，會是哪些國家？另外，你們一年大概生產 4,000 萬到 5,000 萬個 G6 感測器。想請教隨著 G7 上市，你們打算如何處理 G6 的產能？

That's a great question. I'll take that one. We're not going to give you color on the specific countries because we don't want to -- for competitive reasons, we don't want to release the playbook, but we are on track for that. And as we look going forward, it is a very interesting question for us and one for us to debate how do we use our G6 capacity while we're bringing up G7 lines at the same time because the 2 don't intersect. We believe we'll have a market for G6 for quite some time. While we're going to do a global launch and go very quickly, there will be places where G7 isn't going to be available immediately. Our partners are going to take a while to catch up on the automated insulin delivery side. We're working with them now on G7, but we've got -- we've still got some G6 room to grow there. And there are some countries where we aren't yet or some geographies where we need to get started, where we can offer G6 in those areas while we sell G7 and others.

這是個很好的問題。我來回答。我們不會就特定國家提供更多細節，因為我們不想——出於競爭考量，我們不想公開作戰手冊，但我們確實正按計畫推進。展望未來，這對我們而言是個非常有意思、也需要討論的問題：在同時擴建 G7 產線的情況下，我們要如何運用 G6 的產能，因為兩者並不重疊。我們相信 G6 在相當長一段時間內仍會有市場。即便我們會進行全球上市並快速推進，仍會有一些地方無法立即取得 G7。我們的合作夥伴在自動化胰島素輸送（AID）端也需要一些時間跟上。我們目前正與他們就 G7 合作，但在那裡——我們在 G6 方面仍有成長空間。此外，也有一些國家我們尚未進入，或一些地理區域我們需要開始布局；在那些地區，我們可以在銷售 G7 與其他產品的同時，提供 G6。

So we are planning this. It's one of our areas of great debate, and I think we'll manage as best we can. We won't be bashful about taking down G6 lines if G7 is ready to go and is the home run we think it's going to be. And we've got several -- in all fairness, Quentin and his operating relations team, along with our R&D guys have developed some absolutely spectacular manufacturing methods for G7 that can give us a tremendous amount of flexibility to expand their very, very quickly and very thoughtfully. So we'll monitor that very closely. That's a really good question and something we think about a lot here.

所以我們正在規劃這件事。這是我們內部高度討論的領域之一，我想我們會盡可能妥善管理。如果 G7 已準備就緒，並且如我們所預期成為一支全壘打，我們也不會忌諱縮減 G6 產線。而且——公平地說，Quentin 與他的營運關係團隊，加上我們的研發同仁，已為 G7 開發出一些極其出色的製造方法，能讓我們在擴產上具備非常、非常大的彈性，並且能非常快速且周全地擴張。因此我們會非常密切地監控。這真的是個很好的問題，也是我們在這裡經常思考的事情。

And our next question comes from Danielle Antalffy.

下一個問題來自 Danielle Antalffy。

I'll echo everyone's congrats on a really strong quarter. I'm not sure who this question is for. But it's on the DTC initiative, you guys had a very successful Super Bowl ad campaign. Just curious if there's any way to quantify what you're seeing from a return perspective yet? I mean this quarter, what seemed exceptionally strong to me. I'm wondering if we're seeing any benefit from that, not sure if you can even tell or if you can tell us. But if so, we'd love to hear even qualitative feedback there.

我也跟大家一樣，恭喜你們交出非常強勁的一季。我不確定這題該問誰。但我想問的是 DTC（直接面向消費者）計畫，你們的超級盃廣告活動非常成功。想請教目前是否有任何方式可以量化你們從投資報酬角度看到的成效？我的意思是，這一季看起來特別強勁。我想知道我們是否已經看到一些效益，不確定你們是否能判斷，或是否能告訴我們。但如果可以，我們也很想聽聽即使是定性的回饋。

Sure. Yes, we'll take that question. And I think there's probably 2 data points that we can give you that will help you get your arms around the feedback we're seeing. First off, Q2 was a record quarter for new patient adds. So we're continuing to see record new patient adds. No doubt in many ways driven by the work we're doing around DTC and sales force as well as samples. So I think you've got certainly a data point that's helpful.

當然。是的，我們來回答這個問題。我想我們可以提供兩個數據點，幫助你掌握我們看到的回饋。首先，第二季是新增病患數創紀錄的一季。所以我們持續看到新增病患數創新高。毫無疑問，這在很多方面是由我們在 DTC、業務團隊以及樣品推廣上的工作所帶動。因此我認為這是一個相當有幫助的數據點。

The other piece is, over the past 18 months, we've doubled the active prescribers of our product. And no doubt, as we get out and get into the field and see endocrinologists, but also primary care physicians, the work we're doing around expanding that access has yielded really incredible benefits for the amount of prescribers that are out there that are: one, aware; and two, prescribing our product. I think those 2 things are just clear indications of the investments we're making in the awareness, in the DTC, in the sales force is paying off. And hopefully, that gives you some context, of course, looking at the quarter's revenue performance also helps as well. So those all data points, I think, really give you some color as to why we think it's still an incredible investment and why we think the returns still are some of the best in the business.

另一個部分是，在過去 18 個月裡，我們產品的活躍開立處方醫師數量增加了一倍。毫無疑問，當我們走出去、進入市場，拜訪內分泌科醫師，也拜訪基層醫療（家庭醫師／一般科）醫師時，我們在擴大可近性方面所做的工作，為可開立處方的醫師數量帶來了非常驚人的效益：第一，知道我們；第二，會開立我們的產品。我認為這兩點清楚顯示，我們在提升認知度、DTC 以及業務團隊上的投資正在奏效。也希望這能提供一些脈絡；當然，觀察本季營收表現也同樣有幫助。因此，這些數據點我認為確實能讓你更了解，為什麼我們仍認為這是一項極具價值的投資，以及為什麼我們認為其回報仍是業界數一數二。

And our next question comes from Jayson Bedford.

下一個問題來自 Jayson Bedford。

Just a quick one. I wanted to get back to the gross margin line of questioning. What weighs on gross margin in the second half of the year to get to the 67% for the year? Is it international pricing? Is the buildup of Malaysia? And just if you can comment on -- it seems like a large portion of these costs may be transitory. Any color there would be helpful.

我快速問一個。我想回到毛利率這條線的提問。下半年有哪些因素會拖累毛利率，使全年達到 67%？是國際定價嗎？是馬來西亞產能爬坡的建置嗎？另外，如果你們能評論一下——看起來這些成本中有很大一部分可能是短期性的。任何補充說明都會很有幫助。

Sure. Yes. So there's 2 that are the biggest. The first one is some of the international pricing. You're correct. If some of that plays through, we'll have a little bit of pressure on margin. The other one is the launch of G7. When we launch G7, those lines won't be at full capacity and they won't be at full yield. Just like when we launched G6 and we launched some of the automation around G6, it took a little bit of time to work through some of the kinks on these automated lines. And while we still expect incredible output right out the gate, that's going to cost us a little bit more. And so I think what you're seeing is some of the international access, but then when we launched G7 and those lines start to appreciate, the cost of producing those in that shorter period are going to be a little bit higher.

當然。是的。主要有兩個最大因素。第一個是部分國際定價。你說得沒錯。如果其中一些因素反映出來，毛利率會承受一些壓力。另一個是 G7 的上市。當我們推出 G7 時，這些產線不會立刻達到滿載，也不會立刻達到滿良率。就像我們推出 G6、以及在 G6 上導入部分自動化時一樣，這些自動化產線需要一些時間來排除問題、磨合到位。雖然我們仍預期一開始就能有非常可觀的產出，但成本會稍微高一些。因此我認為你看到的是：一方面是部分國際市場准入／定價的影響；另一方面是當我們推出 G7、產線逐步成熟時，在較短期間內生產的成本會略高一些。

To your question is that transitory, all the work that the team is doing around the capability of manufacturing at high capacity as well as high yields, all of that will bounce back and play through. And if this quarter is any demonstration of how good they are, you can see the margins that you see this quarter have shown that this team does an incredible job of yielding out these lines over time. And we expect that to turn around with G7 into the future. But there will be some time as we launch G7 as we get those lines up and running, where there will be a little bit of weight just similar to what we had with G6 that we're going to have to navigate through. But again, I think we're still super bullish on the capability, and we're super proud of the team and really expecting that team to do an incredible job as we launch G7.

針對你關於這是否屬於短暫性的問題，團隊目前在高產能製造能力以及高良率方面所做的所有工作，這些都會回彈並逐步反映出來。而如果本季能作為他們有多優秀的任何證明，你可以看到本季的毛利率已經顯示，這個團隊隨著時間推進，能在這些產線上把良率做得非常出色。我們也預期，隨著未來導入 G7，情況會好轉。但在我們推出 G7、讓產線啟動並順利運轉的過程中，會有一段時間出現一些壓力，類似我們在 G6 時期所經歷的，我們需要加以因應。不過再說一次，我們對這項能力仍然非常看多，也為團隊感到非常自豪，並且非常期待在推出 G7 時，這個團隊能做出令人驚豔的成果。

And our next question comes from Joanne Wuensch.

下一個問題來自 Joanne Wuensch。

Nice quarter. Two questions. Was there any stocking in the quarter either in the U.S. or the OUS market? And then you gave a sort of a blended volume price number. Could you sort of parse that out for the U.S. and for the international sales dynamic?

本季表現不錯。兩個問題。本季在美國或美國以外（OUS）市場是否有任何備貨（stocking）？另外你們提供了一個混合的量價（volume/price）數字。能否把它拆分說明美國與國際市場的銷售動態？

Yes. So there was no stocking in the quarter, nothing out of the normal. Everybody was at normal levels. In terms of your question on a blended number, I'm not sure what you're referring to. Certainly, we have a price dynamic of around the $250 million. When we say price, it's really more channel, but we want to make sure we're very clear. It's really that shift in channel as well as the international access. We also talked about unit volumes, and I'm not sure if you're referencing that, but our unit volumes on the quarter, the growth year-over-year were in the mid-40% range. And so certainly a strong unit volume growth quarter. So hopefully that answers your question. And if you have any others, certainly follow-up, we can happy to be -- happy to clarify.

是的。所以本季沒有備貨，沒有任何異常。大家都維持在正常水位。至於你提到的混合數字，我不太確定你指的是哪一個。我們確實有大約 2.5 億美元左右的價格動態。當我們說「價格」時，其實更偏向通路（channel），但我們希望表述得非常清楚。這主要是通路組合的轉移，以及國際市場的可及性（access）。我們也談到出貨量（unit volumes），如果你指的是這個的話，本季出貨量年增率在 40% 中段。因此本季出貨量成長確實很強勁。希望這回答了你的問題。如果還有其他問題，當然也歡迎追問，我們很樂意——很樂意進一步釐清。

Actually, it's a unit volume number, that mid-40%, that's what I call a blended number. What is that number in the U.S. and international?

其實是出貨量的數字，那個 40% 中段，我稱之為混合數字。美國與國際市場各自的數字是多少？

We don't break it out. That's our global number, but we can tell you that the growth on unit volume was strong in both the U.S. and outside the U.S.

我們不會把它拆分揭露。那是我們的全球數字，但我們可以告訴你，美國與美國以外市場的出貨量成長都很強勁。

And our next question comes from Steve Lichtman.

下一個問題來自 Steve Lichtman。

Kevin, you talked about momentum in intensive type 2. Where do you think U.S. penetration into that market can go over the next 2 years? Are there any hurdles to drive penetration? Or are you feeling good now where awareness and payer coverage are to continue to drive penetration there?

Kevin，你提到在重度第二型（intensive type 2）方面的動能。你認為未來兩年美國在該市場的滲透率可以提升到什麼程度？推動滲透率是否有任何障礙？或者你現在對於市場認知度與支付方（payer）給付覆蓋的現況感到樂觀，足以持續推動那裡的滲透？

We feel very good about coverage we have there. On the commercial side, it's up over 80% of the intensive type 2 patients now covered for commercial payers plus the Medicare coverage that we have that covers a number of these patients already. So access for these patients isn't going to be a problem. It's now all about awareness. We went and doubled the size of our sales force at the beginning of this year, so we get access to more primary care physicians who do see a lot of the insulin using type 2 patients. And we've seen great results from that team. We've had a huge increase in the number of prescribers of our product over the course of this year. So that is a big win. For us, it's about getting to him and explaining to him what technology is available. We think this market will be every bit as penetrated as type 1 at some point. We view it as a very strong opportunity.

我們對那裡的給付覆蓋情況感到非常好。在商業保險端，目前重度第二型患者中，商業支付方的覆蓋率已超過 80%，再加上我們已取得的 Medicare 覆蓋，已經涵蓋其中相當一部分患者。因此，這些患者的可近性（access）不會是問題。現在關鍵完全在於認知度。我們在今年年初把銷售團隊規模加倍，因此能接觸到更多基層照護醫師（primary care physicians），而他們確實會看診許多使用胰島素的第二型患者。我們也從該團隊看到很好的成果。今年以來，開立我們產品處方的醫師數量大幅增加。所以這是一個重大勝利。對我們而言，就是要接觸到他並向他說明目前有哪些可用的技術。我們認為這個市場在某個時間點的滲透程度會與第一型一樣高。我們把它視為非常強勁的機會。

Our next question comes from Anthony Petrone.

下一個問題來自 Anthony Petrone。

Great. Congratulations. Great quarter. And hope everyone is doing well on the team. Maybe a quick one on Malaysia and G7. Is it safe to assume G7 will exclusively be manufactured out of there? And if so, what does that mean for the margin of that product? And then maybe a quick update on the integrated device partnerships, Control-IQ and eventually Omnipod 5, just how you see those partnerships in those product cycles evolving over the next 24 months?

很好。恭喜。本季表現很棒。也希望團隊每位成員都一切順利。我想快速問一下馬來西亞與 G7。是否可以假設 G7 將完全在那裡獨家製造？如果是，這對該產品的毛利率意味著什麼？另外也想請你簡要更新一下整合式裝置合作夥伴關係，Control-IQ 以及未來的 Omnipod 5，你如何看待這些合作在未來 24 個月的產品週期中演進？

Yes, I'll speak to the Malaysia question. Kevin will jump on the last part of that. With respect to Malaysia, it will not be exclusive -- G7 will not be exclusive to that location. We will start with G7 here in the States, both in San Diego and Mesa. As a matter of fact, lines are there as we speak, and we'll continue to ramp up there into the back part of this year and into next year as well. As Malaysia comes online and the buildings up out of the ground, and we validated the clean room and the capability there, we'll begin to build out the G7 capability there as well. So we'll have G7 in both locations over time, that's going to give us an opportunity to produce north of 200 million sensors altogether.

是的，我先回答馬來西亞的問題。Kevin 會接著回答最後那一部分。就馬來西亞而言，並不會是獨家——G7 不會只在那個地點生產。我們會先在美國這邊啟動 G7 的生產，包括聖地牙哥與 Mesa。事實上，產線目前就已經在那裡，我們會在今年下半年以及明年持續擴產爬坡。隨著馬來西亞廠區上線、建物完工，以及我們完成無塵室與相關能力的驗證，我們也會開始在那裡建置 G7 的產能。因此隨著時間推進，我們會在兩個地點都生產 G7，這將讓我們有機會合計生產超過 2 億顆感測器。

And when you think about the distribution of those sensors and where they're going, both in the U.S. and internationally speaking, I think it makes a lot of sense to continue to have a capability here in the States as well in Malaysia, particularly when you start to look at the logistical distribution costs associated with moving that product around in the volumes that we're talking. So it will exist in both locations. I do think over time, the lower cost profile will come out of that Malaysia business. That's a big part of the value proposition there, but that's going to let us serve a lot of those international markets very effectively and efficiently.

而當你思考這些感測器的分配與出貨目的地——無論是在美國或國際市場——我認為同時在美國與馬來西亞保有產能是很合理的，特別是當你開始考量在我們所談的這種出貨量規模下，搬運產品所涉及的物流配送成本。所以它會同時存在於兩個地點。我確實認為，隨著時間推進，較低的成本結構會來自馬來西亞的業務。那是那裡價值主張的重要一環，但也將讓我們能非常有效率、非常高效地服務許多國際市場。

Yes. And with respect to the integrated systems, we're very excited for these opportunities. I actually made it out in the field last week. There is a whole bunch of pent-up demand for Omnipod 5. People are very ready for it. They've been ready for it for a long time, and we're looking forward to that day as well. On the Tandem side, we know they're working on new products and have new projects. I think the best thing I can talk about with Tandem is just a recent story. I got to know it on my computer, somebody wanted to give me a Facebook message, and it was a person who told me he spent 22 years on Medtronic systems and is now on Tandem Control-IQ with DexCom and he has never been healthier, never had a lower A1c, never had better -- he said my whole life has changed. He goes, this system is amazing. So we believe the integrated systems driven by DexCom sensors are game changers. People get accurate sensor information that can take these sophisticated algorithms and make proper decisions. We're very bullish and optimistic on the -- on both of these opportunities going forward. Very excited.

是的。至於整合式系統，我們對這些機會感到非常興奮。我其實上週到第一線拜訪。市場對 Omnipod 5 有大量被壓抑的需求，大家都非常準備好了。他們已經期待很久了，我們也同樣期待那一天。在 Tandem 方面，我們知道他們正在開發新產品並推進新專案。我想我能談到關於 Tandem 最好的例子，是最近的一個故事。我在電腦上看到，有人想透過 Facebook 傳訊息給我，他說他使用 Medtronic 系統 22 年，現在改用 Tandem Control-IQ 搭配 DexCom，從來沒有這麼健康過，A1c 從來沒有這麼低，也從來沒有更好——他說我的整個人生都改變了。他說，這套系統太驚人了。所以我們相信，由 DexCom 感測器驅動的整合式系統是改變遊戲規則的產品。人們獲得準確的感測器資訊，讓這些精密的演算法能做出正確決策。我們對未來這兩個機會都非常看多、非常樂觀。非常興奮。

Our next question comes from Ravi Misra.

我們的下一個問題來自 Ravi Misra。

Just on the DexCom API. Can you talk a little bit about how you chose some of the partners that you're working with? I understand Livongo, of course, but with Garmin. And then just more on that. Just walk us through kind of how you envision this being separate or integrated with CLARITY in the future? Just curious why this is for industry rather than kind of providers itself?

關於 DexCom API。能否談談你們是如何選擇一些正在合作的夥伴？我當然理解 Livongo，但像 Garmin 呢？另外也想再多了解一些。請帶我們梳理一下，你們如何看待未來它會與 CLARITY 分開運作或整合？也很好奇，為什麼這是面向產業，而不是更偏向醫療服務提供者本身？

Yes. This is Kevin. I'll handle the CLARITY piece. With the live API, the patient still has to run the DexCom app in the background. So the data will go straight to CLARITY, and it will be there as is. Now the better question is, will we ever have a CLARITY type system for those who don't have the same needs as intensive insulin users. And I think over time, you'll see us migrate our tools to that platform. Hence, you heard these guys talk about software investments over the last half of the year. And as we look at 2022, we see the same. We are quickly becoming a software company in addition to a sensor company It's very exciting there. Quentin, do you want to talk?

是的。我是 Kevin。我來回答 CLARITY 的部分。使用即時 API 時，病患仍然必須在背景執行 DexCom 應用程式。因此資料會直接進到 CLARITY，並以原樣呈現。更好的問題是：對於需求不像密集胰島素使用者那樣的人，我們是否會推出類似 CLARITY 的系統。我認為隨著時間推進，你會看到我們把工具逐步遷移到那個平台上。因此你也聽到他們在過去半年談到軟體投資。展望 2022 年，我們也看到同樣的趨勢。除了感測器公司之外，我們正快速成為一家軟體公司，這非常令人振奮。Quentin，你要補充嗎？

Yes, in terms of the partners, I mean you think about the Teladoc Livongo's diabetes program, the UnitedHealth, the Welldoc and Garmin, these are partners that we've established relationships with in the past. There is a little bit of integration work that goes into providing the real-time API and the connection into their systems. These were the easy ones out of the gate that really sync up with and get the programs going with. But I think the important thing is we want to be a foundation that we can provide this sort of information into many programs out there and really improve the outcomes for the patients themselves. And I don't think we could be better positioned to be able to do that right now. So incredibly thrilled with where it's at and expect more partners to be lining up.

是的，就合作夥伴而言，你可以想到 Teladoc Livongo 的糖尿病計畫、UnitedHealth、Welldoc 以及 Garmin，這些都是我們過去就建立過合作關係的夥伴。要提供即時 API 並連接到他們的系統，需要做一些整合工作。這些是我們一開始最容易快速啟動、並能讓計畫運作起來的合作對象。但我認為重點是，我們希望成為一個基礎平台，能把這類資訊提供給市面上許多計畫，並真正改善病患本身的結果。我不認為我們此刻還能有比現在更好的定位來做到這件事。所以我們對目前的進展感到非常興奮，也預期會有更多夥伴加入。

And our next question comes from Marie Thibault.

我們的下一個問題來自 Marie Thibault。

Congrats on the nice quarter and thanks for the time today. Just a quick follow-up, I think, on the comments around the sales force. I know that you doubled the sales force this year. So I just want to get an update on where they are in their productivity ramp? I know we typically think of at least 6 to 9 months to get to a more normal productivity level. So I would love to hear kind of a status update on that.

恭喜本季表現亮眼，也謝謝今天撥冗。我想就你們對銷售團隊的評論做個快速追問。我知道你們今年把銷售團隊規模加倍。所以我想了解一下，他們的生產力爬坡目前進展如何？我知道一般我們會認為至少需要 6 到 9 個月才能達到較正常的生產力水準。因此很希望聽到你們對此的最新狀況。

I think you're right on target. It does take about 6 to 9 months for everybody to get up to speed. The one thing we are saying if I can just give you one trend, though, as we try and expand our coverage into the PCP offices where we haven't been before. It's a lot of work. We haven't been there. And as we knock on doors, it's taken these guys a while to get appointments. Once they get in, we're finding the physicians do not know a whole lot about DexCom. And if anything, we've totally validated our assumptions in this expansion. We had to get out there. We had to get more feet on the street and more faces to be as competitive as we wanted to and to achieve our goals.

我想你的判斷很到位。確實大約需要 6 到 9 個月讓大家完全上手。不過如果我可以給你一個趨勢：當我們嘗試把覆蓋範圍擴展到過去未曾進入的基層照護（PCP）診所時，這需要大量工作。我們以前沒在那裡。而當我們去拜訪時，這些同仁需要一段時間才能約到門診會面。一旦進去之後，我們發現醫師對 DexCom 的了解其實不多。如果說有什麼的話，我們完全驗證了這次擴張的假設。我們必須走出去。我們必須增加外勤人力、增加拜訪面孔，才能達到我們想要的競爭力並實現目標。

And our next question comes from Gibran Ahmed.

我們的下一個問題來自 Gibran Ahmed。

This is actually Kyle Rose on from Canaccord. So I just wanted to -- obviously, you made some big investments on the commercial side this year with DTC, doubling the sales force and the trialing. I'm just trying to understand, if you had to call out maybe one of those as a bigger driver rather than the other, which one would it be? Just trying to understand how far into realizing some of the productivity gains on the sales force we might really be seeing from the primary care channel?

其實我是 Canaccord 的 Kyle Rose 代為提問。我想問的是——顯然你們今年在商業端做了不少重大投資，包括 DTC、銷售團隊加倍以及試用推廣。我想了解，如果你必須點出其中一項相較於其他項目更大的驅動因素，會是哪一項？也想理解一下，在基層照護通路上，我們大概已經走到哪個階段，能真正看到銷售團隊生產力提升所帶來的成效？

Yes, I can take that. So at first, there's -- these all really needed to be done in conjunction. But the immediate one that you get returns on is obviously awareness. And awareness comes in many forms and factors, but clearly through DTC. I think at this point, they all go hand in hand because you're making folks aware, you're getting out into the physician's office, you're making the physician aware certainly through your rep. And through the Hello DexCom program, people are getting the opportunity to trial it. And so we all -- we did them all together. So maybe early out the gate, DTC was the immediate shot in the arm. But at this point, they're all really contributing in conjunction. And so that's the way we think about it.

是的，我可以回答。首先，這些其實都需要同步搭配進行。但能最立即看到回報的，顯然是知名度（awareness）。而知名度來自很多形式與因素，但很明顯 DTC 是其中之一。我認為到目前為止，它們彼此相輔相成：你讓大眾知道、你走進醫師診所，透過業務代表讓醫師更了解。同時透過 Hello DexCom 計畫，讓人們有機會試用。所以我們——我們是一起做的。因此如果說一開始最早見效的，DTC 是立即的強心針。但到目前這個時間點，它們確實是以組合方式共同貢獻。這就是我們的看法。

Over the longer haul, you think that feet on the street are going to be incredibly important as these physicians need to have relationships with folks in conjunction with all the other offerings that we provide. We have to validate that over time. Kevin referenced it as we get in front of these doctors, we're educating them. But the way I think about it is DTC was the immediate -- is the immediate more quick return. But I think at this point, they're all contributing equally.

從更長期來看，隨著這些醫師需要與人建立關係，並結合我們提供的其他所有方案，你會認為外勤人員將會極其重要。我們必須隨時間推移去驗證這一點。Kevin 提到，當我們面對這些醫師時，我們正在教育他們。但我的看法是，DTC 帶來的是立即——也就是更快速的回報。不過我認為到目前為止，它們都在同等程度上做出貢獻。

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

目前沒有更多問題。我想把時間交回給 Kevin Sayer 做結語。

Thank you very much, and thank you, everybody, for participating in and listening to our earnings report today. In summary, this was a quarter of tremendous accomplishment, just under $600 million in revenue for this quarter with our highest ever absolute revenue dollar increase when compared to the previous year's quarter. Our worldwide field and access expansion efforts are working exactly the way we planned, positioning us very well for the rest of 2021 and beyond. 70% gross margins during a period of continued planned annual revenue per patient reductions to increase global access for all diabetes customers, new record operating income during a period of increased investment in what I believe is the most robust product pipeline we've ever had.

非常感謝，也謝謝各位今天參與並收聽我們的財報電話會議。總結來說，這是一個成果斐然的季度：本季營收接近 6 億美元，與去年同期相比，創下我們史上最高的營收絕對增量。我們在全球外勤與市場准入的擴張努力，正如我們規劃般運作，讓我們在 2021 年剩餘時間及未來都處於非常有利的位置。在持續按計畫降低每位病患年度營收、以提升全球所有糖尿病客戶可近性的期間，我們仍達到 70% 的毛利率；同時在我認為是我們歷來最強健的產品研發管線上加大投資的期間，營業利益也創下新高。

G7 progress continues. Very important measurable milestones have been achieved on schedule this quarter. And there's nothing like being around here as we approach a deadline. It is just energizing. Other projects here made great progress as well. And finally, we are laying the groundwork for our future growth with irreputable fact-based clinical evidence. This technology will have a major impact in health care all over the world.

G7 的進展仍在持續。本季按計畫達成了非常重要、可衡量的里程碑。而且在接近截止期限時待在這裡，感覺無與倫比。這真的很振奮人心。其他專案也取得了很大進展。最後，我們正以無可辯駁、以事實為基礎的臨床證據，為未來成長奠定基礎。這項技術將對全球醫療照護產生重大影響。

Thanks, everybody, and have a great day.

謝謝各位，祝大家今天愉快。

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

謝謝各位女士、先生。今天的會議到此結束。感謝各位參與。您現在可以掛線。