德康醫療 (DXCM) 2020 Q2 法說會逐字稿

Welcome to the Dexcom Second Quarter 2020 Earnings Release Conference Call.

歡迎來到 Dexcom 2020 年第二季度收益發布電話會議。

My name is Adrienne, and I'll be your operator for this call.

我叫 Adrienne，我將擔任您的電話接線員。

(Operator Instructions) Please note, this conference call is being recorded.

（操作員說明）請注意，正在錄製此電話會議。

I'll now turn the call over to Sean Christensen.

我現在將電話轉給 Sean Christensen。

Sean, you may begin.

肖恩，你可以開始了。

Thank you, operator, and welcome to Dexcom's Second Quarter 2020 Earnings Call.

謝謝運營商，歡迎來到 Dexcom 的 2020 年第二季度收益電話會議。

Our agenda begins with Kevin Sayer, Dexcom's Chairman, President and CEO, who will provide a summary of the quarter; followed by a financial review and outlook from Quentin Blackford, our COO and CFO; and then a strategic update from Steve Pacelli, our Executive Vice President of Strategy and Corporate Development.

我們的議程從 Dexcom 董事長、總裁兼首席執行官 Kevin Sayer 開始，他將提供本季度的總結；隨後是我們的首席運營官兼首席財務官 Quentin Blackford 的財務回顧和展望；然後是我們的戰略與企業發展執行副總裁 Steve Pacelli 的戰略更新。

Following our prepared remarks, we will open the call up for your questions.

在我們準備好的評論之後，我們將打開您的問題的電話。

(Operator Instructions)

（操作員說明）

Please note there are also slides available related to our second quarter performance on the Dexcom Investor Relations website on the Events and Presentations page.

請注意，在 Dexcom 投資者關係網站的活動和演示頁面上，還有與我們第二季度業績相關的幻燈片。

With that, let's review our safe harbor statement.

有了這個，讓我們回顧一下我們的安全港聲明。

Some of the statements we will make in today's call may constitute forward-looking statements.

我們將在今天的電話會議上發表的一些聲明可能構成前瞻性聲明。

These statements reflect management's intentions, beliefs and expectations about future events, strategies, competition, products, operating plans and performance.

這些陳述反映了管理層對未來事件、戰略、競爭、產品、經營計劃和業績的意圖、信念和期望。

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 uncertainties, and actual results could differ materially from those anticipated in the forward-looking statements.

本演示文稿中包含的所有前瞻性陳述均根據 Dexcom 目前可獲得的信息在本新聞稿發布之日作出，受各種風險和不確定因素的影響，實際結果可能與前瞻性陳述中預期的結果存在重大差異。

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 and other filings with the Securities and Exchange Commission.

可能導致實際結果與任何這些前瞻性陳述中明示或暗示的結果存在重大差異的因素在 Dexcom 的 10-K 表格年度報告和提交給美國證券交易委員會的其他文件中有詳細說明。

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.

除非法律要求，否則我們不承擔在本演示文稿日期後更新任何此類前瞻性陳述或使這些前瞻性陳述與實際結果相符的義務。

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.

此外，在電話會議期間，我們將針對我們的非 GAAP 和基於現金的結果討論某些未根據 GAAP 準備的財務措施。

Unless otherwise noted, all references to financial metrics are presented on a non-GAAP basis.

除非另有說明，否則所有對財務指標的引用均按非 GAAP 原則提供。

The presentation of this additional information should not be considered an isolation or as a substitute for results or superior to results prepared in accordance with GAAP.

此附加信息的呈現不應被視為孤立或替代結果或優於根據 GAAP 編制的結果。

Please refer to the 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.

請參閱我們的收益發布中的表格和我們第二季度收益演示文稿的幻燈片，以了解這些措施與其最直接可比的 GAAP 財務措施的對賬情況。

Now I will turn it over to Kevin.

現在我將把它交給凱文。

Thank you, Sean, and thank you, everyone, for joining us today.

謝謝肖恩，也謝謝大家今天加入我們。

We entered the second quarter with several areas of uncertainty as COVID-19 quickly spread, and I'm incredibly proud of how the Dexcom teams have responded.

隨著 COVID-19 的迅速傳播，我們進入第二季度時有幾個不確定的領域，我為 Dexcom 團隊的反應感到無比自豪。

We established 3 pillars for our organization: to ensure the safety of our employees; to maintain service continuity for our customers who rely on their G6 CGM systems; and third, to do our part to assist our communities as we address this novel virus.

我們為我們的組織確立了三大支柱：確保員工的安全；為依賴 G6 CGM 系統的客戶保持服務連續性；第三，在我們應對這種新型病毒時盡我們的一份力量來幫助我們的社區。

We are executing well on all 3 of these measures.

我們在所有這 3 項措施上都執行得很好。

And the results are indicated in our second quarter financial and operational performance.

結果顯示在我們第二季度的財務和運營業績中。

Total revenue grew 35% on a constant currency basis in the second quarter, driven by our significant growth in new patient additions over the past year.

第二季度總收入在固定匯率基礎上增長了 35%，這得益於我們在過去一年中新增患者的顯著增長。

This represents more than $115 million of absolute dollar growth over the same period in 2019.

這比 2019 年同期的絕對美元增長超過 1.15 億美元。

This includes steady traction in the type 2 market, where we continue to see strong new patient additions as coverage expands.

這包括 2 型市場的穩定牽引力，隨著覆蓋範圍的擴大，我們繼續看到強勁的新患者增加。

As of the close of the second quarter, the type 2 patient population exceeds 20% of our total U.S. patient base, reflecting our growing traction as market access expands.

截至第二季度末，2 型患者人數超過我們美國患者總數的 20%，這反映出隨著市場准入的擴大，我們的吸引力也在不斷增強。

Even with rising CGM awareness, there remain many people who continue to rely on fingersticks to manage diabetes, and we believe that there remains a significant opportunity for growth ahead in our core type 1 and type 2 intensive markets.

即使隨著 CGM 意識的提高，仍有許多人繼續依靠指尖來控製糖尿病，我們相信在我們的核心 1 型和 2 型密集型市場中仍有重要的增長機會。

As we discussed in April, new patients were slowed at the start of the quarter as clinicians transitioned to support their patients via telemedicine.

正如我們在 4 月份討論的那樣，隨著臨床醫生轉而通過遠程醫療為患者提供支持，新患者在本季度初的速度有所放緩。

We did see a nice recovery in new patient additions in late April and over the remainder of the quarter, especially in the U.S. with our sales and patient care teams doing a great job to ensure that both customers and clinicians were aware of the full set of Dexcom tools to enable virtual care.

我們確實看到 4 月下旬和本季度剩餘時間的新患者增加情況有了很好的恢復，尤其是在美國，我們的銷售和患者護理團隊做得很好，以確保客戶和臨床醫生都了解全套支持虛擬護理的 Dexcom 工具。

The strength of our core business also reflects our focus on the service experience that we provide.

我們核心業務的實力也反映了我們對我們提供的服務體驗的關注。

Whether through our pharmacy channel initiative, the scaling of our customer support organization or the user interface and tools we built to our software solution, we are prioritizing the needs of our customers.

無論是通過我們的藥房渠道計劃、客戶支持組織的擴展，還是我們為軟件解決方案構建的用戶界面和工具，我們都在優先考慮客戶的需求。

We are now 2 years into the launch of our G6 system and the feedback that we continue to receive from our patients is incredible.

我們推出 G6 系統已經 2 年了，我們不斷從患者那裡收到的反饋令人難以置信。

In fact, Net Promoter Scores for G6 have now reached all-time highs according to both third-party industry analysis as well as our own internal measurements.

事實上，根據第三方行業分析和我們自己的內部測量，G6 的淨推薦值現已達到歷史新高。

This includes the most recent Q&A industry survey of type 1 and type 2 intensive patients, in which G6 received a Net Promoter Score of 83, well ahead of our competitors and in line with the initial results that we saw immediately after the launch of G6 in 2018.

這包括最近對 1 型和 2 型重症患者進行的問答行業調查，其中 G6 獲得了 83 的淨推薦值，遠遠領先於我們的競爭對手，並且與我們在 G6 推出後立即看到的初步結果一致2018.

Our scores have been especially high among new Medicare customers, where the transition to our no-fingerstick G6 system has been very well received by both type 1 and type 2 intensive users.

我們的分數在新的 Medicare 客戶中特別高，其中 1 類和 2 類密集用戶都非常接受向我們的無指尖 G6 系統的過渡。

Our customers are achieving these results while paying an out-of-pocket cost that is comparable or often less than the out-of-pocket cost of our largest competitor.

我們的客戶在取得這些成果的同時支付的自付費用與我們最大的競爭對手的自付費用相當或通常更低。

As we've mentioned before, G6 has the lowest out-of-pocket cost for Medicare patients and will be at parity with any other CGM classified as a Class II iCGM by the FDA.

正如我們之前提到的，G6 對 Medicare 患者的自付費用最低，並將與 FDA 歸類為 II 類 iCGM 的任何其他 CGM 持平。

The pharmacy channel has also proven to be a wonderful option for many of our customers and remains our preferred long-term channel.

藥店渠道也被證明是我們許多客戶的絕佳選擇，並且仍然是我們首選的長期渠道。

For customers using pharmacy benefits now, nearly 70% have an out-of-pocket cost less than $60 per month and 30% pay no out-of-pocket cost.

對於現在使用藥房福利的客戶，近 70% 的自付費用每月不到 60 美元，30% 的自付費用沒有支付。

Notably, this data is based upon the first 5 months of 2020, when patients are more likely to have deductibles still outstanding.

值得注意的是，該數據是基於 2020 年前 5 個月的數據，當時患者更有可能有未支付的免賠額。

As you can see, our products continue to demonstrate their ability to perform in real-world settings and drive patient outcomes at affordable levels.

如您所見，我們的產品繼續展示其在現實環境中發揮作用的能力，並以可承受的水平推動患者治療效果。

This includes the use of Dexcom CGM in additional populations beyond those with an insulin intensive diabetes.

這包括在胰島素密集型糖尿病患者以外的其他人群中使用 Dexcom CGM。

As we mentioned on the first quarter call, on April 1, we received an allowance from the FDA to provide Dexcom CGM to hospitals during the COVID crisis, allowing for remote monitoring on any of their hospitalized patients.

正如我們在第一季度電話會議上提到的那樣，4 月 1 日，我們獲得了 FDA 的津貼，可以在 COVID 危機期間向醫院提供 Dexcom CGM ，從而可以對任何住院患者進行遠程監控。

Our primary goal in this initiative was and continues to be the assistance of frontline workers during the pandemic, and the team has been working continually with sites to get CGM implemented.

我們在這項計劃中的主要目標是並將繼續是在大流行期間為一線工作人員提供幫助，並且該團隊一直在與現場不斷合作以實施 CGM。

We have made great progress to date in training hospitals and the feedback we have received from the care teams has been great.

迄今為止，我們在培訓醫院方面取得了很大進展，我們從護理團隊收到的反饋也很好。

An example near to us in San Diego, Scripps Health published a case study on their use of Dexcom G6 since the start of the COVID pandemic and highlighted several encouraging points.

在我們附近的聖地亞哥，Scripps Health 發布了一份關於自 COVID 大流行開始以來使用 Dexcom G6 的案例研究，並強調了幾個令人鼓舞的觀點。

The use of G6 was eagerly embraced by the hospital and nursing teams with high rates of satisfaction among patients as well.

G6 的使用受到醫院和護理團隊的熱烈歡迎，患者的滿意度也很高。

Early data indicates a trend toward reduced incidence of low- and high glucose values across all patients who use CGM.

早期數據表明，所有使用 CGM 的患者都有降低低血糖和高血糖發生率的趨勢。

And specific to COVID-19 patients, visits into the patient's rooms have been decreased by 30% to 50% during the length of stay, saving valuable equipment and also reducing viral exposure for the hospital staff.

針對 COVID-19 患者，在住院期間進入患者房間的次數減少了 30% 至 50%，從而節省了寶貴的設備並減少了醫院工作人員的病毒暴露。

As we stated previously, our hospital efforts were not a material driver of revenue in the second quarter, and we do not expect it to be for the current year.

正如我們之前所說，我們在醫院的努力並不是第二季度收入的重要推動力，我們預計今年也不會。

But the data that we are generating is invaluable as we assess the regulatory pathway forward for this important market.

但是，在我們評估這個重要市場的監管路徑時，我們生成的數據非常寶貴。

Whether it is the shift to telemedicine, the hospital initiative or our efforts to expand access for the type 2 population with our various partnerships, our team continues to press forward in the midst of the challenges brought on by COVID.

無論是向遠程醫療的轉變、醫院倡議，還是我們通過各種合作夥伴努力擴大 2 型人群的可及性，我們的團隊在 COVID 帶來的挑戰中繼續向前推進。

We've successfully doubled G6 capacity in the first half of the year, putting us in a great position operationally to address the significant market opportunities ahead of us.

今年上半年，我們成功地將 G6 產能翻了一番，這使我們在運營方面處於有利地位，可以應對擺在我們面前的重大市場機遇。

G6 is a platform technology.

G6是一種平台技術。

During the past 12 months, we have seen the launch of a very successful automated insulin delivery system at Tandem, significant progress at Insulet and other automated insulin delivery partners, introduction of the first [daily-enabled] MDI systems, utilization of an app developed specifically for the type 2 diabetes program at UnitedHealthcare and the recent launch of G6 Pro to meet a very important market need.

在過去的 12 個月中，我們看到 Tandem 推出了非常成功的自動化胰島素輸送系統，Insulet 和其他自動化胰島素輸送合作夥伴取得了重大進展，引入了第一個 [每日啟用] MDI 系統，利用開發的應用程序專門針對 UnitedHealthcare 的 2 型糖尿病項目和最近推出的 G6 Pro，以滿足非常重要的市場需求。

We plan for numerous customer experience and product enhancement as well as new market opportunities for this platform over the next 2 years, and many of these initiatives will be incorporated into the G7 platform going forward.

我們計劃在未來 2 年內為該平台提供大量客戶體驗和產品改進以及新的市場機會，其中許多舉措將被納入未來的 G7 平台。

And finally, on to G7, where we are pressing forward on several fronts.

最後，關於 G7，我們正在幾個方面推進。

As we said on the last call, COVID-19 has affected our time lines on this project.

正如我們在上次電話會議上所說，COVID-19 影響了我們在該項目上的時間表。

Specifically, pivotal studies would be delayed for at least 6 months due to uncertainty at the clinics.

具體而言，由於診所的不確定性，關鍵研究將至少延遲 6 個月。

And we are going to be fully ready for a G6 conversion when we launch.

當我們啟動時，我們將為 G6 轉換做好充分準備。

Some G7 manufacturing scale activities have been delayed as some of our vendors shut down for meaningful periods of time.

由於我們的一些供應商在有意義的時間段內關閉，一些 G7 製造規模的活動已被推遲。

And let me remind you, we are going to be fully ready for a G7 conversion when we launch.

讓我提醒您，我們將在啟動時為 G7 轉換做好充分準備。

And a very small amount of G6 equipment can be used for G7.

並且極少量的G6裝備可以用於G7。

I am not going to provide you a specific clinical trial, filing and launch dates today.

今天我不會為您提供具體的臨床試驗、申請和發布日期。

In this competitive world, we have no interest in sharing our playbook with the entire industry.

在這個競爭激烈的世界中，我們沒有興趣與整個行業分享我們的劇本。

There will not be a limited launch of G7 in 2020.

2020年不會限量推出G7。

Such a launch would not provide a meaningful financial impact and rushing to accommodate such a launch would ultimately delay our long-term plans.

這樣的發布不會產生有意義的財務影響，急於適應這樣的發布最終會推遲我們的長期計劃。

Design of our hardware sensor and electronics is locked and the G7 algorithm is complete.

我們的硬件傳感器和電子設備的設計已鎖定，G7 算法已完成。

We have used our extra time to add some great enhancements to the system.

我們用額外的時間為系統添加了一些重要的增強功能。

We are back in the clinics.

我們回到了診所。

We are in the process of finalizing clinical sites and timing for the U.S. and OUS pivotal studies.

我們正在為美國和 OUS 關鍵研究確定臨床地點和時間安排。

Our first fully automated G7 line is up in San Diego.

我們的第一條全自動 G7 生產線在聖地亞哥上線。

Additional G7 automation equipment is arriving regularly in San Diego, Mesa and at third-party contract manufacturers.

額外的 G7 自動化設備定期抵達聖地亞哥、梅薩和第三方合同製造商。

I will now turn the call over to Quentin for a review of our financials.

我現在將把電話轉給昆汀，讓他審查我們的財務狀況。

Thank you, Kevin.

謝謝你，凱文。

As a reminder, unless otherwise noted, the financial metrics presented today will be discussed on a non-GAAP basis.

提醒一下，除非另有說明，否則今天提供的財務指標將在非 GAAP 基礎上進行討論。

Reconciliations to GAAP can be found in today's earnings release as well as on our IR website.

與 GAAP 的調節可以在今天的收益發布以及我們的 IR 網站上找到。

For the second quarter of 2020, we reported worldwide revenue of $451.8 million compared to $336.4 million for the second quarter of 2019, representing an absolute dollar increase of more than $115 million and growth of 34% on a reported basis and 35% on a constant currency basis.

2020 年第二季度，我們報告的全球收入為 4.518 億美元，而 2019 年第二季度為 3.364 億美元，絕對美元增長超過 1.15 億美元，報告基礎上增長 34%，恆定增長 35%貨幣基礎。

The strong growth continued despite some of the challenges posed early in the quarter by the pandemic with continued new patient growth reflecting the overall momentum behind real-time CGM in both the type 1 and type 2 patient populations.

儘管本季度初大流行帶來了一些挑戰，但強勁的增長仍在繼續，新患者的持續增長反映了實時 CGM 在 1 型和 2 型患者群體中的整體勢頭。

As Kevin noted, we are meeting this shift toward real-time CGM with a product in G6 that customers love, leading to our record Net Promoter Score levels.

正如 Kevin 指出的那樣，我們正在通過客戶喜愛的 G6 產品迎接這種向實時 CGM 的轉變，從而導致我們創紀錄的淨推薦值水平。

Our U.S. business remained very strong in the second quarter with growth of 38% over the second quarter of 2019.

我們的美國業務在第二季度仍然非常強勁，比 2019 年第二季度增長了 38%。

This growth extended across all 3 of our primary U.S. channels, pharmacy, DME and Medicare.

這種增長擴展到我們在美國的所有 3 個主要渠道，即藥房、DME 和醫療保險。

Pharmacy remains the fastest-growing channel among the three, and our teams continue to prioritize this as a key component of our long-term strategy based on the benefits provided to Dexcom, clinicians and especially our customers.

藥房仍然是這三個渠道中增長最快的渠道，我們的團隊繼續根據為 Dexcom、臨床醫生，尤其是我們的客戶提供的利益，將其作為我們長期戰略的關鍵組成部分。

The majority of national plans and PBMs are now covering Dexcom via the pharmacy benefit with many incorporating a dual pharmacy and DME benefit.

大多數國家計劃和 PBM 現在都通過藥房福利覆蓋 Dexcom，其中許多包含雙重藥房和 DME 福利。

Our international business grew 22% in the second quarter on a constant currency basis, with consistent growth across our direct and distributor markets.

我們的國際業務在第二季度以固定匯率計算增長了 22%，我們的直營和分銷商市場保持一致增長。

We did see a greater impact to new patients in certain international markets as a result of COVID in the second quarter compared to the U.S.

與美國相比，我們確實看到第二季度 COVID 對某些國際市場的新患者產生了更大的影響。

Unlike the first quarter, the reduced access for in-clinic visits for new patients did not allow us to offset our anticipated second quarter price impact with the same degree of volume gains.

與第一季度不同，新患者的門診就診機會減少，這使我們無法以相同程度的銷量增長來抵消我們預期的第二季度價格影響。

However, we remain confident in our long-term strategy as we saw improvement throughout the quarter with new patient growth recovering and our direct markets returning to strong growth in June as well as distributor orders beginning to rebound early in the third quarter.

然而，我們對我們的長期戰略仍然充滿信心，因為我們看到整個季度有所改善，新患者增長正在恢復，我們的直接市場在 6 月份恢復強勁增長，分銷商訂單在第三季度初開始反彈。

We are creating streamlined pathways for new patients to access Dexcom CGM through different channels in our international markets.

我們正在為新患者創建簡化的途徑，通過我們國際市場的不同渠道訪問 Dexcom CGM 。

Building from the successful launch of our Canadian e-commerce platform, which drove record new patient growth following its launch in 2019, we recently expanded the e-commerce opportunity to our U.K. market and are encouraged by the similar early results.

我們的加拿大電子商務平台在 2019 年推出後成功推出，推動了創紀錄的新患者增長，在此基礎上，我們最近將電子商務機會擴展到我們的英國市場，並對類似的早期結果感到鼓舞。

Canada and the U.K. were amongst our highest growth markets in the second quarter.

加拿大和英國是我們第二季度增長最快的市場之一。

Our second quarter gross profit was $289.7 million or 64.1% of revenue compared to 61.4% of revenue in the second quarter of 2019.

我們第二季度的毛利潤為 2.897 億美元，佔收入的 64.1%，而 2019 年第二季度為 61.4%。

The gross margin was sequentially consistent with our Q1 performance and consistent with the expectations that we noted on the Q1 call for a more muted improvement between Q1 and Q4 of 2020 as we continue to ramp costs associated with the introduction of our G7 lines.

毛利率與我們第一季度的業績連續一致，並且與我們在第一季度呼籲中指出的預期一致，即隨著我們繼續增加與推出 G7 系列相關的成本，2020 年第一季度和第四季度之間的改善將更加溫和。

Importantly, we now have our first G7 line in place in producing product for clinical trials.

重要的是，我們現在擁有第一條 G7 生產線，可以生產用於臨床試驗的產品。

The 270 basis point year-over-year margin improvement was driven primarily by product design developments, most notably our lower cost transmitter.

270 個基點的同比利潤率提高主要是由產品設計開發推動的，最顯著的是我們的低成本變送器。

Operating expenses were $213 million for Q2 2020 compared to $200.3 million in Q2 2019.

2020 年第二季度的運營費用為 2.13 億美元，而 2019 年第二季度為 2.003 億美元。

This reflects an increase of 6% year-over-year and a 1,240 basis point reduction as a percent of revenue from the second quarter of 2019.

這反映出與 2019 年第二季度相比同比增長 6%，佔收入的百分比減少 1,240 個基點。

As an organization, we continue to make great strides as we invest in the initiatives that will drive Dexcom's long-term growth, while also remaining disciplined as an organization and this is evident in our second quarter results.

作為一個組織，我們繼續取得長足進步，因為我們投資於將推動 Dexcom 長期增長的計劃，同時作為一個組織保持紀律，這在我們第二季度的業績中顯而易見。

Just as COVID did impact our top line, it also had an impact on certain spending activities, which resulted in some of the operating margin improvement during the quarter and were therefore, temporary in nature.

正如 COVID 確實影響了我們的收入一樣，它也對某些支出活動產生了影響，這導致本季度的營業利潤率有所提高，因此是暫時的。

As a result, we expect moderation in the year-over-year margin comparisons in the second half of the year as we invest in several key initiatives for the company.

因此，我們預計下半年的同比利潤率比較會有所緩和，因為我們為公司投資了幾項關鍵舉措。

Including the G7 clinical trials, G7 manufacturing scale-up, our new market efforts and direct-to-consumer advertising that we began to accelerate late in the second quarter.

包括 G7 臨床試驗、G7 製造規模擴大、我們在第二季度末開始加速的新市場努力和直接面向消費者的廣告。

Operating income was $76.7 million or 17% of revenue in the second quarter of 2020 compared to $6.2 million or 1.8% of revenue in the same quarter of 2019.

2020 年第二季度營業收入為 7670 萬美元，佔收入的 17%，而 2019 年同期為 620 萬美元，佔收入的 1.8%。

This reflects a year-over-year improvement of more than 1,500 basis points in operating margin for the quarter.

這反映出本季度營業利潤率同比提高了 1,500 多個基點。

Adjusted EBITDA was $122.6 million or 27.1% of revenue for the second quarter compared to $45.9 million or 13.6% of revenue for the second quarter of 2019.

調整後的 EBITDA 為 1.226 億美元，佔第二季度收入的 27.1%，而 2019 年第二季度為 4590 萬美元，佔收入的 13.6%。

Net income for the second quarter was $77.1 million or $0.79 per share?

第二季度的淨收入為 7710 萬美元或每股 0.79 美元？

Over the past 2 years, we have made tremendous progress towards becoming a profitable company.

在過去的 2 年裡，我們在成為盈利公司方面取得了巨大進步。

As a result, it is now becoming evident that we're going to be able to utilize the significant historic tax benefits that's we have accrued over time and we are approaching a position where in the near future, we expect to release the valuation allowance that we have been required to place against many of our tax benefits in the past.

因此，現在越來越明顯的是，我們將能夠利用我們隨著時間的推移積累的重大歷史稅收優惠，並且我們正在接近一個位置，我們希望在不久的將來釋放估值津貼過去，我們被要求抵消我們的許多稅收優惠。

This is something that we have been in front of and planning for, including the implementation of a global tax structure over the last couple of years that will allow us to continue to expand rapidly and efficiently on a global basis.

這是我們一直在做和計劃的事情，包括在過去幾年實施全球稅收結構，這將使我們能夠繼續在全球範圍內快速有效地擴張。

As we set expectations for 2021, we will look to provide clarity around our annual tax rate expectations and leverage the benefits associated with the tax structure we put in place in contemplation of such an event.

在我們設定 2021 年的預期時，我們將尋求明確我們的年度稅率預期，並利用與我們為考慮此類事件而製定的稅收結構相關的好處。

In early May, we took advantage of market conditions to further solidify our balance sheet with a new convertible note offering.

5 月初，我們利用市場條件通過發行新的可轉換票據進一步鞏固我們的資產負債表。

On the strength of the offering, we closed the quarter in a great financial position with more than $2.5 billion of cash, utilizing a combination of the cash generated from the convertible note offering as well as Dexcom's stock, we redeemed the majority of our 2022 convertible notes in the second quarter and will redeem the remainder later this week.

憑藉發行的實力，我們以超過 25 億美元的現金結束了本季度的良好財務狀況，利用可轉換票據發行產生的現金以及 Dexcom 的股票，我們贖回了 2022 年可轉換債券的大部分第二季度的票據，並將在本週晚些時候贖回剩餘部分。

Our cash position leaves us in great shape to pursue the growth opportunities ahead of us, including support of the development of new markets, opportunistic investment and capabilities that complement our growth and capital allocation into our G7 scale-up in Malaysian manufacturing facility.

我們的現金狀況使我們處於良好狀態，可以尋求我們面前的增長機會，包括支持新市場的開發、機會投資和能力，以補充我們的增長和資本分配到我們在馬來西亞製造工廠的 G7 規模擴大。

As we look to the second half of the year, there remains several areas of uncertainty as we contemplate the continuation of the COVID pandemic and its global impact, including employment rates and uptake of our patient assistance program in the U.S. Nevertheless, based on our experience in the second quarter, the tools that our teams have developed to support virtual patient care and the growing clinical awareness of the value of CGM, particularly in the current environment, we believe there is enough visibility to reinstate full year guidance.

展望下半年，考慮到 COVID 大流行的持續及其全球影響，包括就業率和我們在美國的患者援助計劃的實施情況，仍然存在幾個不確定的領域。然而，根據我們的經驗在第二季度，我們的團隊為支持虛擬患者護理而開發的工具以及臨床對 CGM 價值的認識不斷提高，特別是在當前環境下，我們相信有足夠的知名度來恢復全年指導。

We now expect 2020 revenue to be approximately $1.85 billion representing growth of 25% over 2019.

我們現在預計 2020 年收入約為 18.5 億美元，比 2019 年增長 25%。

This represents an increase of $100 million from the midpoint of our initial 2020 guidance, resulting from the strength of the business in the first half of the year.

這比我們最初的 2020 年指引的中點增加了 1 億美元，這得益於今年上半年的業務實力。

Our teams have responded well and continued to drive new patient adoption and ensure the satisfaction of our existing patients.

我們的團隊反應良好，並繼續推動新患者的採用，並確保現有患者的滿意度。

Given the recent uptick in COVID cases globally and in the U.S. in particular, our guidance assumes approximately 75% to 80% of our original expectations for global new patients in the back half of the year, which was consistent with what we had experienced in late March and into April at the outset of the COVID outbreak globally.

鑑於最近全球尤其是美國 COVID 病例的增加，我們的指導假設了我們對今年下半年全球新患者的最初預期的大約 75% 到 80%，這與我們最近的經歷一致全球 COVID 爆發之初的三月和四月。

Turning to margins.

轉向利潤率。

We now anticipate the following non-GAAP results to meet or exceed the following levels, which are ahead of what we established at the start of the year, including increasing gross margin expectations to meet or exceed 65%, representing a steady improvement over 2019.

我們現在預計以下非 GAAP 業績將達到或超過以下水平，這高於我們年初設定的水平，包括增加毛利率預期以達到或超過 65%，這比 2019 年穩步改善。

This includes costs associated with the initial development of our Malaysian manufacturing facility in support of the growth of our international business and is in line with our long-term expectations for gross margins in the mid-60s.

這包括與我們馬來西亞製造工廠的初始開發相關的成本，以支持我們國際業務的增長，並且符合我們對 60 年代中期毛利率的長期預期。

We are now increasing operating margin expectations to meet or exceed 14%.

我們現在將營業利潤率預期提高到或超過 14%。

This revised guidance contemplates the increased second half spending associated with the initiatives that I previously mentioned, yet still demonstrating annually year-over-year improvement as we leverage our strong top line results.

修訂後的指引考慮了與我之前提到的舉措相關的下半年支出增加，但由於我們利用強勁的頂線結果，每年仍顯示出同比改善。

Finally, we are increasing our expected adjusted EBITDA margins to meet or exceed 24% for the year.

最後，我們將提高我們今年預期的調整後 EBITDA 利潤率，以達到或超過 24%。

Our team has done a great job to execute on our goal of doubling G6 capacity in the first half of 2020 despite an extraordinarily difficult and unanticipated operating environment, putting the company in its best position since the launch of G6 to meet the many opportunities in front of us.

儘管經營環境異常困難和出乎意料，但我們的團隊在實現 2020 年上半年 G6 產能翻番的目標方面做得非常出色，使公司處於 G6 推出以來的最佳位置，迎接面前的眾多機遇我們。

And we now look forward to replicating that momentum with the scale-up of our G7 lines.

現在，我們期待通過擴大 G7 產品線來複製這種勢頭。

With that, I will now turn the call over to Steve for a strategic update.

有了這個，我現在將把電話轉給史蒂夫進行戰略更新。

Thanks, Quentin.

謝謝，昆汀。

We continue to make great strides in executing on our strategic priorities even as we navigate the current environment with the utmost care for the health of our employees, the continued service of our patients and assistance to our communities.

我們在執行我們的戰略重點方面繼續取得長足進步，即使我們在當前環境中以最大程度地關注我們員工的健康、為我們的患者提供持續服務並為我們的社區提供幫助。

The doubling of G6 capacity in the first half of the year has placed us in a great position to creatively target new customers and extend the launch of G6 in several of our existing markets.

今年上半年 G6 產能翻了一番，這使我們處於有利地位，可以創造性地瞄準新客戶，並在我們的幾個現有市場中擴大 G6 的推出。

We are gaining steady traction among type 2 insulin-intensive customers, building from our efforts to drive expanded access beyond Medicare into commercial payers as we've seen with UnitedHealthcare and more recently, Aetna, both of which now provide access to the pharmacy.

正如我們在 UnitedHealthcare 和最近的 Aetna 中看到的那樣，我們正在努力推動 Medicare 以外的商業支付者獲得更多的服務，這兩家公司現在都提供藥房服務，因此我們在 2 型胰島素密集型客戶中獲得了穩定的吸引力。

At the recent virtual ADA conference, we presented encouraging data on a subset of our type 2 intensive patients after their first 12 weeks of usage of G6.

在最近的虛擬 ADA 會議上，我們展示了部分 2 型重症患者在使用 G6 的前 12 週後的令人鼓舞的數據。

The data demonstrated average A1c reduction of 1.5%, significant improvement to quality of life metrics and 95% customer satisfaction with G6.

數據顯示 A1c 平均降低 1.5%，生活質量指標顯著改善，G6 的客戶滿意度達到 95%。

COVID has also brought a clear focus to the long-term potential for CGM and the importance of glycemic control.

COVID 還明確關注了 CGM 的長期潛力和血糖控制的重要性。

We've spoken at length about the large market opportunities ahead for Dexcom, including our focus on the broader type 2 market, hospital use and use during pregnancy.

我們已經詳細討論了 Dexcom 未來的巨大市場機會，包括我們對更廣泛的2型市場、醫院使用和懷孕期間使用的關注。

The fact that all 3 of these populations have now received exemptions to allow for broader access to Dexcom CGM during the pandemic, provides validation for these new market expansions.

事實上，所有這三個人群現在都獲得了豁免，以允許在大流行期間更廣泛地使用 Dexcom CGM，這為這些新的市場擴張提供了驗證。

In early April, the FDA made a special allowance to permit the use of CGM in the hospital setting.

4 月初，FDA 給予特別津貼，允許在醫院環境中使用 CGM。

In early May, we saw a special ruling from CMS to allow access to all people with diabetes who are diagnosed with COVID-19.

5 月初，我們看到了 CMS 的一項特殊規定，允許所有被診斷出患有 COVID-19 的糖尿病患者使用。

And earlier this month, Health Canada issued an interim order for the use of G6 for all women with diabetes who are pregnant during the pandemic, and more and more data continue to emerge supporting these decisions and the value of CGM beyond the intensive insulin-using population.

本月早些時候，加拿大衛生部發布了一項臨時命令，要求所有在大流行期間懷孕的糖尿病女性使用 G6，越來越多的數據不斷出現支持這些決定以及 CGM 的價值，而不是強化胰島素使用人口。

At ADA, our partners at Onduo presented data comparing the impact of CGM versus non-CGM use in their virtual diabetes clinic.

在 ADA 上，我們在 Onduo 的合作夥伴展示了在他們的虛擬糖尿病診所中比較 CGM 與非 CGM 使用的影響的數據。

While both cohorts or patients ultimately saw a significant A1c decrease.

雖然隊列或患者最終都看到了顯著的 A1c 下降。

The group using Dexcom G6 saw a reduction nearly 2x as much as those not using CGM.

使用 Dexcom G6 的小組比不使用 CGM 的小組減少了近 2 倍。

In addition, earlier this month, UnitedHealthcare announced the expansion of their level 2 digital health therapy to more than 230,000 people with type 2 diabetes.

此外，本月早些時候，UnitedHealthcare 宣布將其 2 級數字健康療法擴展到超過 230,000 名 2 型糖尿病患者。

This program, which utilizes G6 as a core component, saw great results in United's initial pilot work, including the [fairly] significant A1c reduction for those with a baseline A1c greater than 8 and significant reductions to medication usage with some participants even achieving remission and no longer needing medication.

該計劃以 G6 作為核心組成部分，在美聯航的初步試點工作中取得了很好的成果，包括基線 A1c 大於 8 的人的 [相當] 顯著的 A1c 減少以及藥物使用量的顯著減少，一些參與者甚至達到了緩解和不再需要藥物治療。

We are pressing forward in support of our various partnerships to reach the whole type 2 population, including our work with UnitedHealthcare, Intermountain Healthcare, Livongo, WellDoc, Onduo and others.

我們正在努力支持我們的各種合作夥伴關係，以覆蓋整個 2 型人群，包括我們與 UnitedHealthcare、Intermountain Healthcare、Livongo、WellDoc、Onduo 等的合作。

We are also excited about the launch of our G6 professional product, which has several appealing use cases as we explore the full value of our CGM platform.

我們也很高興推出我們的 G6 專業產品，在我們探索 CGM 平台的全部價值時，它有幾個吸引人的用例。

We are also excited about the launch of our G6 professional product, which has several appealing use cases as we explore the full value of our CGM platform.

我們也很高興推出我們的 G6 專業產品，在我們探索 CGM 平台的全部價值時，它有幾個吸引人的用例。

The product provides a natural extension into the type 2 non-intensive market by leveraging the strong existing reimbursement framework for professional CGM with a tool that empowers clinicians.

該產品通過利用強大的現有專業 CGM 報銷框架和賦予臨床醫生權力的工具，自然擴展到 2 型非密集型市場。

G6 Pro gives doctors the flexibility to assess a patient's glycemic health in real time for all patients with diabetes.

G6 Pro 使醫生能夠靈活地實時評估所有糖尿病患者的血糖健康狀況。

As a single-use product, G6 Pro will also serve as a great introduction for a patient looking to experience the functionality of Dexcom CGM.

作為一次性產品，G6 Pro 也將為希望體驗 Dexcom CGM 功能的患者提供很好的介紹。

G6 Pro can also be prescribed for use in blinded mode where the patient does not see the real-time data to all people, ages 2 years and up, not just people with diabetes, providing all people with the opportunity to assess their glycemic health.

G6 Pro 還可以規定在盲模式下使用，在這種模式下，患者不會看到所有 2 歲及以上人群的實時數據，而不僅僅是糖尿病患者，從而為所有人提供評估其血糖健康狀況的機會。

Our strategy of prioritizing interoperability and patient choice continues to leave us well positioned as the insulin delivery market shifts toward commercial connected devices.

隨著胰島素輸送市場轉向商業連接設備，我們優先考慮互操作性和患者選擇的戰略繼續使我們處於有利地位。

In early May, we signed an agreement to collaborate with Ypsomed, adding another key partner to our existing partners in Eli Lilly, Insulet, Novo Nordisk and Tandem Diabetes.

5 月初，我們簽署了與 Ypsomed 合作的協議，為禮來、Insulet、諾和諾德和 Tandem Diabetes 的現有合作夥伴增加了另一個重要合作夥伴。

Thank you, Steve.

謝謝你，史蒂夫。

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

（操作員說明）Adrienne，請提供問答說明。

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

（操作員說明）我們的第一個問題來自 Baird 的 Jeff Johnson。

Great.

偉大的。

Thanks for all the information on the call and congratulations on the quarter.

感謝您提供有關電話的所有信息，並對本季度表示祝賀。

So Kevin and Steve, you both touched on hospital and pregnancy, gestational use.

所以凱文和史蒂夫，你們都談到了醫院和懷孕，妊娠期使用。

I guess what I'd love to hear an update on is maybe the pathway and time lines to maybe extending some of those reimbursements to more of a permanent nature, whether that's Canada, the U.K., where we've seen some of the movement on gestational over the last year or even in the U.S. Just again, pathway and time lines on how we should think about when those can become more permanent contributors to the model?

我想我想听到的更新可能是將其中一些報銷擴展到更多永久性質的途徑和時間表，無論是加拿大，英國，我們已經看到了一些運動在過去一年甚至在美國都處於孕育之中。再說一遍，關於我們應該如何考慮何時可以成為該模型的更永久貢獻者的途徑和時間表？

You bet.

你打賭。

I'll take that, Jeff.

我會接受的，傑夫。

On the hospital side, we are really now just starting to gather data from the centers that use CGM.

在醫院方面，我們現在真的才剛剛開始從使用 CGM 的中心收集數據。

When we started the whole hospital initiative, it was just let's get the product out there and help the staff at the hospitals and also make patients healthier.

當我們啟動整個醫院的倡議時，只是讓我們把產品放在那裡，幫助醫院的工作人員，也讓病人更健康。

And we navigated through a series of things that we really didn't anticipate very well, such as the IT systems of the hospital and things of that nature.

我們經歷了一系列我們確實沒有預料到的事情，例如醫院的 IT 系統和那種性質的事情。

So we're now starting to gather data.

所以我們現在開始收集數據。

We also have learned, interestingly enough that a lot of the hospitals, even though they all got the same product, had different protocols in a different way they use CGM.

我們還了解到，有趣的是，很多醫院，即使他們都得到相同的產品，也有不同的協議，以不同的方式使用 CGM。

Some of these centers would put it on anybody with diabetes.

其中一些中心會把它放在任何患有糖尿病的人身上。

Some of the -- would put on anybody with elevated glucose levels and others would take the approach we're not going to do this until somebody's really sick.

其中一些 - 會讓任何血糖水平升高的人服用，而其他人會採取我們不會這樣做的方法，直到有人真的病了。

So we're going to learn more about the protocols and how it was used, and then start gathering data about the sensor and how it works.

因此，我們將更多地了解協議及其使用方式，然後開始收集有關傳感器及其工作原理的數據。

And also we're going to try and gather data with respect to how these patients were treated from a drug side as well.

而且我們還將嘗試收集有關如何從藥物方面治療這些患者的數據。

Anecdotally, what we've heard is our product performed in the hospital the way we thought it would, that its accuracy and performance really wasn't affected by the compounds used to treat these patients.

有趣的是，我們聽說我們的產品在醫院按照我們認為的方式進行，其準確性和性能確實不受用於治療這些患者的化合物的影響。

And we should have a pretty good picture of where it is.

我們應該對它的位置有一個很好的了解。

We've not had any additional discussions with the agency on the hospital data yet because we really haven't had anything in a form that we could present that would start us down a path.

我們還沒有與該機構就醫院數據進行任何額外的討論，因為我們確實沒有任何可以呈現的形式可以讓我們走上正軌。

As far as next steps in the hospital, we'll take -- we still have the ability to use the product in the system.

至於醫院的下一步，我們將採取——我們仍然有能力在系統中使用該產品。

And with COVID not going away, I think we'll be able to gather more data.

由於 COVID 不會消失，我認為我們將能夠收集更多數據。

And now that we've been through this initial wave of learning, we'll probably get better data and more data and know what we're looking for going forward and put together data.

既然我們已經經歷了最初的學習浪潮，我們可能會獲得更好的數據和更多的數據，並知道我們正在尋找前進的方向並將數據放在一起。

We'll present that to the FDA and at the same time, we'll present them what the plan as to what we think we need to do next.

我們將把它提交給 FDA，同時，我們將向他們介紹我們認為下一步需要做什麼的計劃。

That's going to be a while.

這將是一段時間。

And -- but we've got some time to gather more data.

而且 - 但我們有時間收集更多數據。

On the gestational side and the pregnancy side, we have seen some countries open up and say, "Hey, let's go do this." The U.K. and Canada that you pointed out.

在妊娠方面和懷孕方面，我們看到一些國家開放並說，“嘿，讓我們去做吧。”你指出的英國和加拿大。

We've had very detailed discussions with the FDA as to what we need to do on the pregnancy side to get that label, and we are working on that.

我們已經與 FDA 就我們需要在懷孕方面做些什麼來獲得該標籤進行了非常詳細的討論，我們正在努力解決這個問題。

We all know the product works very well in pregnancy.

我們都知道該產品在懷孕期間效果很好。

All you've got to do is go to social media and sell the Dexcom patients who have had a child that they never thought they would have, who have diabetes of our type 1 patients on gestational side, we think our opportunity is outstanding, not only from a -- manage those patients who have gestational diabetes but as a predictor of those who may, in fact, get it.

你所要做的就是去社交媒體賣掉那些生了孩子的 Dexcom 患者，他們從未想過自己會生孩子，他們患有妊娠期 1 型糖尿病患者，我們認為我們的機會非常好，而不是僅來自 - 管理那些患有妊娠糖尿病的患者，但作為那些實際上可能患上糖尿病的患者的預測指標。

And again, we are running studies.

再一次，我們正在進行研究。

There are studies being run by many others to determine what that model looks like.

許多其他人正在進行研究以確定該模型的外觀。

I think our first step there, Jeff, is we need to get just a pregnancy indication with the FDA rather than a specific gestational one, and then head down the line to develop a product and a platform that fits into that market on a cost-effective and a positive outcome basis, but we're very optimistic that it will.

Jeff，我認為我們的第一步是我們只需要獲得 FDA 的妊娠適應症而不是特定的妊娠適應症，然後繼續開發適合該市場的產品和平台，成本-有效和積極的結果基礎，但我們非常樂觀地認為它會。

And our next question comes from Kyle Rose with Canaccord.

我們的下一個問題來自 Canaccord 的 Kyle Rose。

I just wanted to talk a little bit about the quarter and maybe just kind of understand any differences you're seeing in underlying the patient behavior or patient demand in states or geographies that have high levels of COVID currently or any states or geographies that don't.

我只是想談談這個季度，也許只是想了解您在當前 COVID 水平較高的州或地區或任何沒有高水平 COVID 的州或地區的患者行為或患者需求方面所看到的任何差異。噸。

I'm just trying to understand how much of an impact we saw to new patient starts with respect to COVID in the quarter and how we should think about the potential for the rising case volumes to potentially increase in the second half of the year?

我只是想了解我們在本季度看到的新患者對 COVID 的影響有多大，以及我們應該如何考慮下半年病例數量增加的可能性？

Yes, we didn't quantify exactly what we believe the impact to be in the second quarter, but we tried to give some color, and it's the foundation for how we thought about the back half of the year as well.

是的，我們沒有準確量化我們認為第二季度的影響，但我們試圖給出一些顏色，這也是我們考慮下半年的基礎。

If you look at the end of March and into April, new patient starts when COVID was really starting to ramp at that point in time was roughly 75% of kind of that normal range that we would have expected.

如果你看看 3 月底和 4 月，當 COVID 真正開始在那個時間點上升時，新患者開始出現，大約是我們預期的正常範圍的 75%。

So you saw about a 25% impact on the new patient starts at that point in time.

所以你看到在那個時間點開始對新患者產生了大約 25% 的影響。

Now I will say over the course of the quarter, end of June, we saw that rebound nicely back in line with previous expectations as things started to come under a bit of control.

現在我要說的是，在本季度的整個過程中，即 6 月底，隨著事情開始受到一些控制，我們看到反彈很好地回到了之前的預期。

Now we saw it pick up a little bit in July as the Covent cases have increased a bit more that we're all aware of, and we were very clear in our guidance that we're assuming roughly 75% to 80% of new patient starts throughout the back half of the year.

現在我們看到它在 7 月份有所回升，因為考文特病例增加了一點，我們都知道，我們在指導中非常清楚，我們假設大約 75% 到 80% 的新患者整個下半年開始。

That's the best data point we have at this point in time.

這是我們目前擁有的最佳數據點。

So I would just take you back to that reference point of 75%, 80% roughly, new patient starts throughout the month of April, is kind of how we saw the impact in the quarter.

所以我只想帶你回到 75% 的參考點，大約 80%，新患者在整個 4 月份開始，這就是我們如何看待本季度的影響。

And our next question comes from Ryan Blicker from Cowen.

我們的下一個問題來自 Cowen 的 Ryan Blicker。

Can you talk a bit more about the recent launch of UnitedHealthcare's level 2 program?

您能否多談談最近推出的 UnitedHealthcare 二級計劃？

How significant of a catalyst is this for non-intensive type 2 adoption in the U.S.?

這對於美國非密集型 2 型採用有多重要的催化劑？

And do you believe that this program together with Intermountain data that you've shared suggests that CGM use will be more frequent and sustained among non-intensive type 2 patients over the long term than the intermittent use case you've historically discussed?

你是否相信這個項目連同你分享的 Intermountain 數據表明，從長遠來看，與你過去討論過的間歇性使用案例相比，CGM 在非強化 2 型患者中的使用會更頻繁和持續？

Yes.

是的。

I think -- this is Steve.

我想——這是史蒂夫。

It's certainly evolving, but I think these are all validating points for us, right, that certainly, UnitedHealthcare serves more than 230,000 noninsulin-taking type 2 patients, and we would hope that over time, that program has expanded pretty dramatically beyond where it is today.

它肯定在不斷發展，但我認為這些都是對我們的驗證點，對，當然，UnitedHealthcare 為超過 230,000 名未服用胰島素的 2 型患者提供服務，我們希望隨著時間的推移，該計劃已經大大擴展到現在的水平今天。

We're in the midst of just continuing to capture data and prove out the value of this technology in the non-intensive patient population.

我們正在繼續收集數據並證明這項技術在非重症患者群體中的價值。

We know we have something there.

我們知道我們在那裡有東西。

We know it's important.

我們知道這很重要。

Whether it becomes a real-time all-the-time use case, over time, it very well could be.

隨著時間的推移，它是否會成為一個實時的全時用例，它很可能會成為。

We're seeing some very positive outcomes for people using it for, frankly, a longer period of time than maybe we would have cited previously.

我們看到人們使用它的一些非常積極的結果，坦率地說，比我們之前引用的時間更長。

So there is an opportunity.

所以有機會。

Reimbursement is still in its infancy in the noninsulin-using patient population.

在不使用胰島素的患者群體中，報銷仍處於起步階段。

So we've not only got to prove the outcomes, we've got to get the product paid for.

因此，我們不僅要證明結果，還要讓產品得到付款。

So it's still not, even the balance of this year, not going to be a material piece of the business, but it's going to continue to grow over the coming years, for sure.

所以它仍然不是，即使是今年的餘額，也不會成為業務的重要組成部分，但它肯定會在未來幾年繼續增長。

And our next question comes from Bobby Marcus from JPMorgan.

我們的下一個問題來自摩根大通的 Bobby Marcus。

Appreciate the question.

感謝這個問題。

And congrats on a good quarter.

祝賀一個好的季度。

Quentin, I want to maybe spend a little bit on the guidance here.

昆汀，我想在這里花點時間做指導。

You touched on new patient expectations.

你談到了新的患者期望。

Usually at the beginning of the year, at JPMorgan, when you give guidance, you give us a little flavor for how we should think about revenue per patient and the headwind expected there for throughout the year as you shift into pharmacy and restructure some of your negotiations on price and international.

通常在年初，在摩根大通，當你給出指導時，你會告訴我們應該如何考慮每位患者的收入，以及隨著你轉向藥房和重組你的一些業務，全年預期的逆風價格和國際談判。

So I was wondering if you could give us a little bit more flavors.

所以我想知道你是否可以給我們多一點口味。

We're halfway through the year, what's baked into guidance?

今年已經過半，指南中包含哪些內容？

And also, if you could spend some time walking us through the bottom line expectations.

而且，如果你能花一些時間讓我們了解底線期望。

You put a fantastic adjusted EBITDA this quarter.

您本季度調整後的 EBITDA 非常棒。

How much of that really is the new baseline?

其中有多少真的是新的基線？

And if you could quantify how much was just deferred spending that we should expect in the back part of the year.

如果你能量化我們應該在今年下半年預期的遞延支出有多少。

Great.

偉大的。

So with respect to the first part of that question around top line and revenue per patient or maybe the pricing headwinds that we've talked about historically, certainly, we came into the year with an expectation that, that was going to be somewhere around $125 million to $150 million, likely being closer to that $150 million range.

因此，關於這個問題的第一部分，關於收入和每位患者的收入，或者我們歷史上討論過的定價逆風，當然，我們進入這一年的預期是，這將在 125 美元左右百萬到 1.5 億美元，可能更接近 1.5 億美元的範圍。

I can tell you that based upon where we saw price come in Q2, it was right in line with our expectation.

我可以告訴你，根據我們在第二季度看到的價格，它符合我們的預期。

We have not changed our pricing assumption, our full year guidance at this point in time, we still expect it to be around that $150 million range.

我們沒有改變我們的定價假設，我們目前的全年指導，我們仍然預計它會在 1.5 億美元左右。

So not anything significant in terms of a change there.

因此，就那裡的變化而言，沒有什麼重大意義。

The strategy we've put in place to step this down over time continues to play out exactly as we had expected.

隨著時間的推移，我們已經制定的逐步減少這種情況的策略將繼續按照我們的預期發揮作用。

So that continues to be consistent.

所以這仍然是一致的。

With respect to the bottom line, we've made incredible progress from a profitability perspective, really over the last call it, 4 or 5 quarters now, with nearly 1,500 basis points of improvement in operating margin profile in Q2 alone.

關於底線，從盈利能力的角度來看，我們已經取得了令人難以置信的進步，實際上是在上次調用它時，現在已經有 4 或 5 個季度了，僅第二季度的營業利潤率就提高了近 1,500 個基點。

There's no question that some of the spending was impacted in the quarter, particularly around efforts like DTC as we started to pull back some of that early in the quarter just with the uncertainty around how COVID was going to impact things over the course of the quarter and into the back part of the year.

毫無疑問，本季度的一些支出受到了影響，特別是圍繞 DTC 等努力，因為我們在本季度初開始撤回部分支出，只是因為不確定 COVID 將如何影響本季度的事情並進入今年的下半年。

I will tell you, we did start that back up in early Q3.

我會告訴你，我們確實在第三季度初開始備份。

So you're going to see incremental spending in the back half of the year around things like DTC.

因此，您將在今年下半年看到圍繞 DTC 之類的支出增加。

The other thing to keep in mind that's going to impact your spending trends that won't allow the same kind of improvement in Q2 to play through in the back half of the year is the fact that we're starting up the G7 trials.

另一件要記住的事情會影響你的支出趨勢，這將不允許第二季度的同樣改進在今年下半年發揮作用，因為我們正在啟動 G7 試驗。

We've been very open and deliberate about the spend that's going to go into that.

我們對將要投入其中的支出一直非常開放和深思熟慮。

We're putting forward quite a bit of resources around standing up those manufacturing capabilities and ensuring that capacity is going to be there right out of the gate.

我們正在圍繞建立這些製造能力並確保產能將立即投入使用提供了大量資源。

We do have the first lineup.

我們確實有第一陣容。

There's incremental lines coming right behind it as we speak and building out that entire supply chain capability.

在我們說話和構建整個供應鏈能力時，它後面有增量線。

And then finally, we've already spent some time talking about it on the call today, but you look at opportunities like hospital, gestational.

最後，我們已經花了一些時間在今天的電話中討論它，但你會看到像醫院、妊娠這樣的機會。

Those are significant revenue drivers for us into the future.

這些是我們未來的重要收入驅動因素。

We're going to make sure that we're spending in those areas to ensure that we open those up and provide for growth into the future.

我們將確保我們在這些領域進行支出，以確保我們開放這些領域並為未來的增長做好準備。

So we are going to spend in the back part of the year.

所以我們打算在今年下半年花錢。

You're not going to see the same sort of improvement.

你不會看到同樣的改進。

But at the same time, we're committed that over time, we will continue to mature as an organization.

但與此同時，我們承諾隨著時間的推移，我們將作為一個組織繼續成熟。

We're going to step towards the long-term goals of profitability that we've laid out.

我們將朝著我們制定的長期盈利目標邁進。

And I think we've made great progress towards it, but you're not going to see these sorts of improvement every single quarter.

而且我認為我們在這方面取得了很大進展，但你不會在每個季度都看到這些改進。

I think you need to look at it over a period of time.

我認為你需要過一段時間再看。

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

我們的下一個問題來自威廉·布萊爾的瑪格麗特·卡佐爾。

I wanted to follow-up on the type 2 mix this quarter.

我想在本季度跟進 2 型組合。

The 20% number seemed pretty strong, and it seems like it's increasing.

20% 的數字看起來相當高，而且似乎還在增加。

So can you guys give us any sense around where these patients are coming from?

那麼你們能告訴我們這些患者來自哪裡嗎？

Are they top prescribers for Dexcom or other T1s?

他們是 Dexcom 或其他 T1 的頂級處方者嗎？

Or anything on patient profile, new to CGM or early adopters?

或者關於患者資料、CGM 新手或早期採用者的任何內容？

Long story short, as we look at that Q2 growth, even within the intensive population going into the back end of this year and into next.

長話短說，當我們看到第二季度的增長時，即使在今年年底和明年的密集人口中也是如此。

Is it push or pull?

是推還是拉？

Or is it getting easier at all?

還是變得更容易了？

Well, this is Kevin.

嗯，這是凱文。

I'll take that.

我會接受的。

It is getting easier.

越來越容易了。

And I think the biggest catalyst in all this was when we got Medicare approval a while ago, and now we're getting Medicare awareness with these insulin-using patients because a large number of insulin-using patients in this type 2 population are, in fact, Medicare patients.

我認為所有這一切中最大的催化劑是我們不久前獲得醫療保險批准，現在我們正在讓這些使用胰島素的患者了解醫療保險，因為這類 2 型人群中有大量使用胰島素的患者，事實上，醫保患者。

So that has been a big catalyst for growth, particularly as we've gotten better at serving and taking care of those patients.

因此，這一直是增長的重要催化劑，特別是當我們在服務和照顧這些患者方面變得更好時。

I think the other catalyst is just the approvals we were seeing from some of the large payers.

我認為另一個催化劑就是我們從一些大支付者那裡看到的批准。

Steve pointed out, UnitedHealthcare data covering type 2 patients on non-intensive insulin recently, again, giving more patients access to it.

Steve 指出，UnitedHealthcare 的數據最近覆蓋了使用非強化胰島素的 2 型患者，再次讓更多患者能夠使用它。

As these patients are having positive outcomes, access is growing, and they're matching the CMS approvals that we've already received.

由於這些患者取得了積極的成果，獲得的機會也在增加，並且他們與我們已經獲得的 CMS 批准相匹配。

So it's coming across the board and it's not coming to us from our primary prescribers are coming from everywhere.

所以它是全面的，它不是來自我們的主要處方者來自世界各地。

Many of these patients don't even see endocrinologists.

其中許多患者甚至沒有去看內分泌學家。

So they're finding out about Dexcom and coming to us directly because of our marketing efforts and because what they've heard or to mouth or what they've seen from others.

因此，由於我們的營銷努力以及他們所聽到或口中的內容或他們從他人那裡看到的內容，他們正在了解 Dexcom 並直接來找我們。

We've always felt this would be a great use of our technology, and it's proving to be exactly that.

我們一直認為這將是對我們技術的一種很好的利用，事實證明確實如此。

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

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

So I guess, just on the international business, it looks like that's probably the only place you could really pick at here.

所以我想，就國際業務而言，看起來這可能是您在這裡唯一可以真正選擇的地方。

Quentin, can you just summarize why the growth was a bit slower than historical trends you seem to infer that trends in the direct market picked up in June and in distributor markets in July, can we assume that you expect a greater than seasonal impact in international sales in the second half?

Quentin，你能不能總結一下為什麼增長比歷史趨勢慢一點？你似乎推斷直銷市場的趨勢在 6 月份回升，分銷市場的趨勢在 7 月份回升，我們是否可以假設你預計國際市場的季節性影響更大？下半年銷量？

Yes.

是的。

It's a fair question.

這是一個公平的問題。

I think it's a bit premature to speak to that fact in terms of playing out over the course of Q3 with respect to the distributor orders.

我認為就第三季度分銷商訂單的表現而言，現在談論這個事實還為時過早。

Certainly, we saw those orders start to come through and in the third quarter, I think the question becomes based upon what was happening with COVID in the broader environment today, do we see that actually rebound and double up in terms of the orders in Q3 or does everything just kind of defer and push a bit.

當然，我們看到這些訂單開始出現，在第三季度，我認為問題是基於今天在更廣泛的環境中 COVID 發生的事情，我們是否看到第三季度的訂單實際上反彈並翻了一番或者做任何事情都只是推遲和推動一點。

Our guidance would contemplate the fact that it better pushes at this point in time.

我們的指導將考慮這樣一個事實，即它最好在這個時間點推動。

Just based upon the best information that we have.

僅基於我們擁有的最佳信息。

If it were to all come in and terrific, I think we'd be very happy.

如果所有人都進來並且很棒，我想我們會很高興。

Just a little bit of color around that OUS result.

OUS 結果周圍只有一點顏色。

I think what you're seeing there is very comparable to what the broader marketplace and the industry realized over the course of the quarter as well.

我認為你所看到的與更廣泛的市場和行業在本季度的實現情況非常相似。

I think if you look at the data points that have been put out there by our competitors, thus far, they saw a slowdown in growth in Q2 in their international business, just as we did sequentially, absolute dollars step down from Q1 into Q2 which we certainly saw as well.

我想如果你看看我們的競爭對手提供的數據點，到目前為止，他們看到他們的國際業務第二季度增長放緩，就像我們連續做的那樣，絕對美元從第一季度下降到第二季度我們當然也看到了。

But the broad market saw the same thing.

但大盤也看到了同樣的情況。

So I don't think you're seeing anything that's unique to Dexcom.

所以我認為你沒有看到任何 Dexcom 獨有的東西。

I think over time, we remain as bullish as ever on the international opportunity.

我認為隨著時間的推移，我們仍然一如既往地看好國際機遇。

We've stated the fact that we're going to step down price over time in the international space as well.

我們已經聲明，我們也將隨著時間的推移降低國際空間的價格。

And when you have a quarter like Q2 where the ability for new patients to get into the clinic and come on to the product becomes a bit muted you see a bit more of a pronounced impact.

當你有一個像第二季度這樣的季度時，新患者進入診所並使用產品的能力變得有點減弱，你會看到更明顯的影響。

So that's all part of a long-term strategy that we believe in and are very bullish around.

所以這是我們相信並且非常看好的長期戰略的一部分。

So we're still very, very optimistic and excited about that international business, but that's a bit of color that played out in Q2.

因此，我們仍然對國際業務非常、非常樂觀和興奮，但這是第二季度出現的一些色彩。

And with respect to Q3, our view is that things probably push.

關於第三季度，我們的觀點是事情可能會推動。

But if we see it rebound, it's been great, there's upside to the number.

但如果我們看到它反彈，那就太好了，這個數字還有上升空間。

Our next question comes from Joanne Wuensch from Citibank.

我們的下一個問題來自花旗銀行的 Joanne Wuensch。

Nice quarter.

不錯的季度。

ADA seems like a million years ago now, June, but can you give us an idea of what the key things were that you walked away from that you think we'll be talking about over the next 18 months?

ADA 似乎是一百萬年前的六月，但是您能否告訴我們您認為我們將在接下來的 18 個月內討論的關鍵事情是什麼？

Yes, I'll take that one.

是的，我會拿那個。

I think, again, the walk away from ADA is how important CGM has become in all this.

我再次認為，離開 ADA 是 CGM 在這一切中變得多麼重要。

Almost every presentation you went to every presentation we saw the performance of drugs or the performance of other systems is based on CGM data.

幾乎您參加的每個演示文稿我們看到的藥物性能或其他系統的性能都是基於 CGM 數據的。

From Dexcom's perspective, obviously, the drive of the automated insulin delivery systems was largely driven by Dexcom sensors.

從 Dexcom 的角度來看，很明顯，自動胰島素輸送系統的驅動主要由 Dexcom 傳感器驅動。

Regardless of who the presenter was up at the pulpit other than Medtronic.

除了 Medtronic 之外，無論主持人是誰站在講台上。

And we can see our sensor can drive great outcomes there.

我們可以看到我們的傳感器可以在那裡取得很好的成果。

I think the other takeaway is we're not stopping innovation in diabetes.

我認為另一個要點是我們不會停止糖尿病方面的創新。

Everybody is still pushing forward, and we still think there's better ways to attack this.

每個人都在向前推進，我們仍然認為有更好的方法來解決這個問題。

This is a big cost and health care problem in our country and around the world.

這在我們國家和世界範圍內都是一個巨大的成本和醫療保健問題。

And I don't think anybody is going to slow down.

而且我認為沒有人會放慢腳步。

But our biggest takeaway, compare that to your first ADA, Joanne, where we had to beg for anybody to even listen to us.

但我們最大的收穫，與你的第一個 ADA Joanne 相比，我們不得不乞求任何人甚至聽我們的。

And now every place we go and just our industry growth, CGM has become the dominant technology here across all of the diabetes treatments.

現在我們去的每一個地方以及我們的行業增長，CGM 已經成為這裡所有糖尿病治療的主導技術。

And we're looking forward to just continuing to be better.

我們期待著繼續變得更好。

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

我們的下一個問題來自 Piper Sandler 的 Matt O'Brien。

This is Jason on for Matt.

這是馬特的傑森。

Congrats on a nice quarter here.

祝賀你在這裡度過了一個愉快的季度。

Kevin or Steve, high-level question on the non-intensive side.

凱文或史蒂夫，非密集方面的高級問題。

I appreciate some of the comments you made, but I hope you can discuss maybe how you perceive these models or programs evolving over the next few years?

我感謝您提出的一些評論，但我希望您可以討論一下您如何看待這些模型或程序在未來幾年的發展？

Do you expect the revenue model to be similar to what you see with the intensely managed population?

您是否希望收入模式與您在集中管理人口中看到的相似？

Or do you expect it to take different forms with maybe some possible risk-sharing or shared cost-saving developments?

或者您是否希望它採取不同的形式，可能會出現一些可能的風險分擔或共享成本節約的發展？

Just anything you can offer there and how you see the contracts coming together over time, now that you've been engaged with payers and other partners on various models.

既然你已經與付款人和其他合作夥伴就各種模式進行了接觸，那麼你可以在那裡提供任何東西，以及你如何看待合同隨著時間的推移而結合在一起。

Yes.

是的。

This is Kevin.

這是凱文。

I'll add a bit to Steve's comments earlier.

我將對 Steve 之前的評論進行一些補充。

We don't see one solution yet.

我們還沒有看到一種解決方案。

We are working with a number of partners on the payer front.

我們正在與付款人方面的許多合作夥伴合作。

We're working with clinics.

我們正在與診所合作。

We're working with a lot of these diabetes management systems as well to provide CGM data to that to figure out what the best model for these patients is.

我們正在與許多此類糖尿病管理系統合作，並為其提供 CGM 數據，以找出適合這些患者的最佳模型。

We're not only working with these partners, but we're doing a lot of market research on our own.

我們不僅與這些合作夥伴合作，而且我們自己進行了大量的市場調查。

And one of Steve's comments that is becoming very evident in all the work that we do is type 2 patients are more than open to wearing CGM and learning what's going on with their bodies.

史蒂夫的評論之一在我們所做的所有工作中變得非常明顯，即 2 型患者非常願意佩戴 CGM 並了解他們的身體發生了什麼。

They want a different experience than we offer today for the type 1 patients connecting to insulin pumps and Bluetooth pens and sophisticated predictive alerts and alarms and things like that we have today are not as important to that group.

他們想要一種不同於我們今天為連接到胰島素泵和藍牙筆的 1 型患者提供的體驗，以及復雜的預測警報和警報以及我們今天擁有的東西對那個群體來說並不那麼重要。

But what is important to that group is that they're healthy and that we can reduce their meds, that we can reduce their cost that we can make their physician visits more productive and we can make changes in their health that save them these complications over the years.

但對那個群體來說重要的是他們是健康的，我們可以減少他們的藥物，我們可以降低他們的成本，我們可以讓他們的醫生就診更有效率，我們可以改變他們的健康狀況，讓他們避免這些並發症這些年。

So I think what you'll see is we'll continue to pursue all these models.

所以我認為你會看到我們將繼續追求所有這些模型。

At the same time, we're going to pursue the proper product configuration.

同時，我們也將追求產品的合理配置。

And reimbursement models for us.

以及我們的報銷模式。

I've been in numerous discussions where we ask, if we get paid X for an intensive patient for a year, what should we what should be the reimbursement rate for non-intensive type 2 because the fact is we aren't saving their life on a near-term basis with an alert and alarm, we are not giving them something that determines their drug dosing decision, but we are giving them information to better manage their lives.

我參加過很多討論，我們問，如果我們為一名重症患者支付 X 一年的費用，我們應該為 2 型非重症患者支付多少報銷率，因為事實是我們沒有挽救他們的生命在近期的警報和警報的基礎上，我們不會給他們一些決定他們藥物劑量決定的東西，但我們正在給他們提供信息以更好地管理他們的生活。

So we think there may ultimately be a different class of product here and a different form of reimbursement.

所以我們認為最終可能會有不同類別的產品和不同形式的報銷。

And patients wear them all the time, which is, again, another reason we're investing so much in scale here because we like these things everywhere.

病人一直都戴著它們，這也是我們在這里大規模投資的另一個原因，因為我們到處都喜歡這些東西。

I think the market is developing nicely and the constant thread coming from all these approaches is this thing works.

我認為市場發展良好，所有這些方法的持續線索是這件事有效。

And our next question comes from Travis Steed from Bank of America.

我們的下一個問題來自美國銀行的 Travis Steed。

Just wanted to touch on the hospital channel a bit more.

只是想多談談醫院頻道。

I'd just love to hear how you're going to approach the commercial aspect longer term if you don't really have reps in the hospital.

如果您在醫院沒有真正的代表，我很想听聽您將如何長期處理商業方面的問題。

Do you need a partner there?

你需要一個合作夥伴嗎？

Or are you planning to build out a separate sales force?

或者您打算建立一支獨立的銷售隊伍？

And also, I don't know if you're willing to say the revenues generated in the hospitals this quarter if that was a few million dollars or more than that.

而且，我不知道你是否願意說本季度醫院產生的收入是幾百萬美元或更多。

The revenues in the hospital wouldn't have a significant impact on the financials.

醫院的收入不會對財務產生重大影響。

The costs far exceeded the revenue.

成本遠遠超過收入。

So we'll leave it at that.

所以我們就此打住。

With respect to the channel, we've not made a decision there as far as how we'd pursue that.

關於頻道，我們還沒有就如何追求它做出決定。

We are early enough in this process that we're not ready to adopt a commercial model.

我們在這個過程中還處於早期階段，我們還沒有準備好採用商業模式。

We want to leave our options open.

我們希望保留我們的選擇權。

We would explore partners.

我們將探索合作夥伴。

We would explore doing it ourselves.

我們會探索自己做。

But we'll figure out where to best use our dollars.

但我們會想辦法把我們的錢用在什麼地方。

And then we haven't made a decision there yet.

然後我們還沒有在那裡做出決定。

And our next question comes from David Lewis from Morgan Stanley.

我們的下一個問題來自摩根士丹利的大衛劉易斯。

Quentin, just a quick follow-up here for you on guidance.

昆汀，這裡只是為您提供指導的快速跟進。

So in the second half, you're effectively assuming that new patient start rates are similar to sort of the trough of COVID, even though there probably has been some improvement, and you're not assuming any distributor sort of recoup in ex U.S. markets.

因此，在下半年，你實際上假設新患者的開始治療率與 COVID 的低谷期相似，儘管可能有所改善，而且你沒有假設任何分銷商在美國前市場獲得補償.

And just kind of related to that, can you just give us a sense ex U.S. whether this was country-specific or just broadly ex U.S.?

與此相關的是，您能否讓我們了解美國以外的情況，這是特定國家/地區還是廣泛的美國以外？

Because our sense is maybe Germany performed differently than Canada, performed differently than France.

因為我們的感覺是德國的表現可能與加拿大不同，與法國的表現不同。

So those 2 quick ones.

所以那兩個快速的。

Yes.

是的。

I think in the prepared remarks, we were pretty clear with the fact that we saw COVID did impact certain countries a little bit differently than others, U.K. and Canada performed incredibly well, particularly on the e-commerce platform that we had put in place.

我認為在準備好的發言中，我們非常清楚這樣一個事實，即我們看到 COVID 對某些國家的影響確實與其他國家略有不同，英國和加拿大的表現非常好，特別是在我們已經建立的電子商務平台上。

Germany certainly was impacted in our distributor markets were certainly impacted.

德國肯定受到影響，我們的分銷商市場肯定受到影響。

On the distributor point, again, I think it's just too early to tell if that's going to double up in Q3 or if that's just going to be simply something that pushes out over the course of the remainder of the year.

在分銷商方面，我認為現在判斷第三季度是否會翻倍，或者這是否只是在今年剩餘時間內推出的東西還為時過早。

I think at some point in time, it will catch up to itself, and we'll be back on that same trajectory.

我認為在某個時間點，它會趕上自己，我們會回到同樣的軌道上。

It's just too hard to predict if that happens in the next 6 months or not.

很難預測未來 6 個月內是否會發生這種情況。

And our guidance would be based off the fact that it does not, that it's been pushed.

我們的指導將基於這樣一個事實，即它沒有，它被推動了。

That's kind of how we thought about it.

這就是我們的想法。

So -- and then your point on just the new patient starts in the back half of the year.

所以——然後你對新病人的觀點從今年下半年開始。

Like I said, we're trying to create some clarity for you guys in the back half of the year around what we're confident that we can deliver on.

就像我說的，我們正試圖在下半年為你們澄清我們有信心可以實現的目標。

We're using the best data points that we have from our own experience.

我們正在使用我們從自己的經驗中獲得的最佳數據點。

And that 75% to 80% new patients start as what we realized early in the second quarter as COVID was kind of starting to really gain some traction.

75% 到 80% 的新患者開始於我們在第二季度初意識到的情況，因為 COVID 開始真正獲得一些牽引力。

We've seen COVID numbers increasing here recently in the third quarter as well so that's the best data point that we have.

我們最近在第三季度也看到這裡的 COVID 數量有所增加，所以這是我們擁有的最好的數據點。

So that's how we went about putting the numbers together.

這就是我們將數字放在一起的方式。

Obviously, if we can navigate through that.

顯然，如果我們可以通過它。

More effectively or to a better degree, then there's going to be opportunity in the guidance number, but we don't want to get ahead of ourselves at this point.

更有效或更好的程度，然後會有指導數字的機會，但我們不想在這一點上超越自己。

And our next question comes from Larry Biegelsen from Wells Fargo.

我們的下一個問題來自 Wells Fargo 的 Larry Biegelsen。

Kevin, as you mentioned upfront, Medicare is not enforcing the clinical criteria for CGM during the pandemic it's unclear if this applies to all type 1 and type 2 patients or just those affected by COVID.

凱文，正如你前面提到的，醫療保險在大流行期間沒有強制執行 CGM 的臨床標準，目前尚不清楚這是否適用於所有 1 型和 2 型患者，還是僅適用於受 COVID 影響的患者。

How broadly physicians interpreted this rule?

醫生在多大程度上解釋了這條規則？

And what impact have you seen in the market?

您在市場上看到了什麼影響？

And do you expect CMS to continue to allow this exception through next year?

您是否希望 CMS 明年繼續允許此例外？

You bet.

你打賭。

We do not believe it's had an exceptional impact on our business as far as bringing more Medicare patients to the table.

就將更多 Medicare 患者帶到餐桌上而言，我們認為它不會對我們的業務產生特殊影響。

And -- but they are coming.

而且 - 但他們來了。

On a broad scale basis, as we look at the Medicare ruling, we would be very pleased if we could get the criteria for Medicare patients much more condensed and much more realistic.

在廣泛的基礎上，當我們審視 Medicare 裁決時，如果我們能夠使 Medicare 患者的標準更加簡潔和更加現實，我們將非常高興。

We actually met on that this morning.

今天早上我們實際上就此見過面。

And one of the things pointed out yet again to me is Medicare requires our patients to document that they do 4 fingersticks a day before they go to CGM and our patients only reimbursed for 3 fingersticks a day by CMS.

再次向我指出的一件事是，Medicare 要求我們的患者記錄他們在去 CGM 之前每天進行 4 次指尖刺穿，而我們的患者僅通過 CMS 報銷每天 3 次指尖刺穿。

So there are large inconsistencies there.

所以那裡有很大的不一致。

And this is a product that has tremendous impact with these patients.

這是一種對這些患者產生巨大影響的產品。

It would certainly be our goal to have these coverage criteria and the steps that patients have to go through to get CGM simplified and more broadly applied across all of diabetes.

我們的目標當然是讓這些覆蓋標準和患者必須經歷的步驟來簡化 CGM 並更廣泛地應用於所有糖尿病。

But that's something we're working on now, and I can't anticipate where CMS is going to go.

但這是我們現在正在努力的事情，我無法預料 CMS 將走向何方。

But it certainly makes sense that we do that.

但我們這樣做當然是有道理的。

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

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

Congrats on another very strong quarter.

祝賀又一個非常強勁的季度。

Just a quick question on the type 2s.

只是關於 2 型的快速問題。

I think you mentioned it's now 20%.

我想你提到現在是 20%。

I think you said of your installed base, correct me if I'm wrong, maybe you said new patient adds.

我想你說的是你的安裝基礎，如果我錯了請糾正我，也許你說新病人增加了。

But how has that changed versus the year ago period?

但這與去年同期相比有何變化？

Just trying to get a sense of how that might be growing?

只是想了解它可能會如何增長？

Yes.

是的。

No, it's certainly increasing nicely, particularly as we continue to focus in that particular area.

不，它肯定增長得很好，特別是當我們繼續關注那個特定領域時。

The 20% is of the installed base.

20% 是安裝基礎。

So we didn't give a sense in terms of the overall growth in that particular area.

因此，我們沒有就該特定領域的整體增長給出任何意義。

But we've talked about our focus there in opening up those channels.

但我們已經談到了我們在開放這些渠道方面的重點。

And I think the fact that we're now talking about it just indicates the progress that we're making there.

而且我認為我們現在正在談論它這一事實恰好表明我們正在取得的進展。

So that's the extent of the detail we've given around it.

這就是我們圍繞它提供的詳細信息的範圍。

And our next question comes from Mathew Blackman from Stifel.

我們的下一個問題來自 Stifel 的 Mathew Blackman。

And Quentin, thanks for the color on new patient start headwind.

還有昆汀，感謝新病人開始逆風的顏色。

I was hoping you could extend those comments to the installed base.

我希望您能將這些評論擴展到已安裝的基礎上。

Was there notable change in attrition or utilization rates during the quarter first half of '20?

20 世紀上半年的人員流失率或利用率是否有顯著變化？

And are you making any changes as to how you're thinking about those same attrition utilization risks in this new guidance?

在這份新指南中，您是否對如何考慮這些相同的減員利用風險做出了任何改變？

Yes.

是的。

Great question.

很好的問題。

We didn't really see anything over the course of Q2.

在第二季度的過程中，我們並沒有真正看到任何東西。

But to be fair, I think it's probably a bit early to really understand whether or not we will see an impact.

但公平地說，我認為現在真正了解我們是否會看到影響可能還為時過早。

And therefore, we have contemplated something in our guidance in the back part of the year around our patient assistance program or attrition.

因此，我們在今年下半年圍繞我們的患者援助計劃或減員考慮了一些指導意見。

And keep in mind, we announced during the second quarter that we would be putting in place a patient assistance program, but that wasn't going to be effective until the third quarter.

請記住，我們在第二季度宣布我們將實施患者援助計劃，但該計劃要到第三季度才會生效。

Our view is that if a patient were going to attrit, they would likely fall into that program.

我們的觀點是，如果患者要流失，他們很可能會被納入該計劃。

So when we talk about guidance in the back half of the year, you've got a couple of things playing out there.

因此，當我們談論下半年的指導時，你會遇到一些事情。

You've got the new patient starts that we've been very clear.

你有新的病人開始，我們已經非常清楚了。

75% to 80% is how we've modeled it.

75% 到 80% 是我們建模的方式。

But then we also are assuming that we're going to see some impact on attrition, and they're going to fall into this patient assistance program, which is going to mean quite a bit less revenue to us, obviously, than what we might have normally received from them.

但是我們也假設我們會看到對自然減員的一些影響，他們將加入這個病人援助計劃，這對我們來說意味著收入比我們可能要少得多通常從他們那裡收到。

So that's playing out in the back part as well.

所以這也在後面的部分發揮作用。

Our next question comes from Chris Pasquale from Guggenheim.

我們的下一個問題來自古根海姆的 Chris Pasquale。

Quentin, 2 quick model questions.

Quentin，2 個快速模型問題。

First, just any numbers you could put around the expense shift from 2Q to the back half of the year.

首先，關於從第二季度到下半年的費用轉移，你可以給出任何數字。

The leverage was really impressive.

槓桿真的很可觀。

It would be great to have a better sense for how much of that was one time.

如果能更好地了解其中有多少是一次性的，那就太好了。

And then can you give us any broad strokes on what you're thinking in terms of the tax rate once you start reporting one from an income statement perspective?

一旦你開始從損益表的角度報告一個稅率，你能給我們任何關於你在稅率方面的想法的粗略描述嗎？

Yes.

是的。

We're not going to talk to the tax rate just yet.

我們現在不打算討論稅率。

I think we need to get to the point where we flip that valuation allowance.

我認為我們需要達到翻轉估值津貼的地步。

We don't know exactly when that's going to be just yet, but we know that it's coming here in the near future.

我們還不知道確切的時間，但我們知道它會在不久的將來到來。

And the last thing I want to do is, like I said, put a couple of hundred million dollar gain through the financial statements that surprises everybody in the particular period.

我最不想做的事情就是，就像我說的那樣，通過財務報表獲得幾億美元的收益，讓特定時期的每個人都感到驚訝。

I think it's important to know we're out in front of this.

我認為重要的是要知道我們已經領先於此。

We anticipate it.

我們期待它。

We've put a tax structure in place that's going to allow us to have a very efficient global tax structure and grow globally in a very efficient way with a very attractive tax rate.

我們已經建立了一個稅收結構，這將使我們擁有一個非常有效的全球稅收結構，並以非常有吸引力的稅率以非常有效的方式在全球範圍內增長。

So we've been well in front of this for quite some time, and the point is just to start to put it on your radar.

所以我們在這方面已經有很長一段時間了，重點是開始把它放在你的雷達上。

With respect to the other question, sorry, remind me what the other question was.

關於另一個問題，抱歉，請提醒我另一個問題是什麼。

OpEx in the back part of the year.

今年下半年的運營支出。

Yes.

是的。

So there wasn't a significant impact that moved the needle meaningfully in the second quarter.

因此，第二季度並沒有產生有意義的重大影響。

I mean, call it, roughly $10 million or so of spend that likely would have showed up in the quarter had we not been impacted.

我的意思是，如果我們沒有受到影響，本季度可能會出現大約 1000 萬美元左右的支出。

But I think importantly, the back half of the year is where you're going to see a significant ramp in the overall spend profile, particularly with G7 clinical trials getting go and G7 scale really taking off.

但我認為重要的是，今年下半年你將看到整體支出狀況顯著上升，特別是隨著 G7 臨床試驗的開始和 G7 規模的真正起飛。

And then turning on the DTC spigot for the first time in a significant way.

然後以重要的方式第一次打開 DTC 龍頭。

I think one of the things that maybe is not as appreciated by folks is that historically, we've always been constrained from an inventory position.

我認為人們可能不喜歡的一件事是，從歷史上看，我們一直受到庫存狀況的限制。

We exited Q2 in the strongest inventory position that we've been in with respect to G6 in our company's history.

我們以公司歷史上關於 G6 的最強庫存狀況退出了第二季度。

That allows us to start to open up opportunities like DTC in a significant way that we believe can drive growth into the future.

這使我們能夠開始以一種我們認為可以推動未來增長的重要方式開拓像 DTC 這樣的機會。

So you're going to see that play out.

所以你會看到結果。

Spending is going to be significantly higher in the back half.

下半年的支出將顯著增加。

When you do your modeling, it's going to be almost $100 million of spend higher in the back half.

當您進行建模時，後半部分的支出將增加近 1 億美元。

We recognize that and realize it.

我們認識到這一點並意識到這一點。

But those things that I just indicated are going to be the areas that we primarily focus on in our spending.

但我剛才指出的那些事情將成為我們在支出中主要關注的領域。

(Operator Instructions) And Ravi Missy from Berenberg Capital.

（操作員說明）還有 Berenberg Capital 的 Ravi Missy。

It's Misra.

是米斯拉。

I just want to pick your brains a little bit more around the reimbursement for some of this less intensive insulin management patients, Steve or Kevin.

我只是想就一些胰島素管理強度較低的患者史蒂夫或凱文的報銷問題多徵詢您的意見。

Can you help out to think about what's the index, comps control in terms of what you think you need to do to establish that use case in a kind of payment?

你能幫忙想想什麼是索引，comps control 你認為你需要做什麼才能在一種支付中建立這個用例？

Yes.

是的。

Obviously, first and foremost, it's to build, as Kevin mentioned, to build the right products for this patient population.

顯然，正如凱文提到的那樣，首先是要為這個患者群體打造合適的產品。

We think the products are going to be different.

我們認為產品會有所不同。

They're not going to have all the -- there won't be nearly as -- I don't want to say nearly as robust because the performance of the underlying sensor will be the same.

他們不會擁有所有 - 幾乎不會 - 我不想說幾乎一樣強大，因為底層傳感器的性能將是相同的。

But having some of the bells and whistles that we need for the intensive insulin population just don't apply to type 2. The software experience needs to be different.

但是，我們需要的一些花里胡哨的胰島素人群並不適用於類型 2。軟件體驗需要有所不同。

So those types of things are within our control or even, frankly, within the control of some of our partners that we've talked about, like Livongo offers a patient experience to their patients.

因此，這些類型的事情在我們的控制範圍內，甚至坦率地說，在我們談到的一些合作夥伴的控制範圍內，例如 Livongo 為他們的患者提供患者體驗。

United, the level 2 program is an experience that we've developed together with United, but it's really a UnitedHealthcare patient experience.

United，2 級計劃是我們與 United 共同開發的體驗，但它確實是 UnitedHealthcare 患者體驗。

So we're not going to -- there's not going to be a one-size-fits-all here.

所以我們不會 - 這裡不會放之四海而皆準。

We're going to offer our own tools.

我們將提供我們自己的工具。

We do offer our own tools today, and we're going to enable multiple players in this business to offer the appropriate tools to this patient population because we know it's such a massive opportunity that [it makes sense] to just make our sensors available to anybody who's a viable company.

我們今天確實提供了我們自己的工具，我們將使該行業的多個參與者能夠為這個患者群體提供適當的工具，因為我們知道這是一個巨大的機會，[有意義]讓我們的傳感器可供使用任何一個有活力的公司。

And the next question comes from Steven Lichtman from Oppenheimer.

下一個問題來自 Oppenheimer 的 Steven Lichtman。

Wondering if you could provide some more color on the e-commerce initiatives that you mentioned are expanding internationally.

想知道您是否可以為您提到的正在國際擴張的電子商務計劃提供更多色彩。

In what ways has it helped in Canada and now U.K. during COVID in terms of driving new patients and getting them started on CGM.

在 COVID 期間，它在推動新患者並讓他們開始使用 CGM 方面以何種方式幫助了加拿大和現在的英國。

Certainly, I think from an access perspective, it just makes it very easy for the patient to be able to find our product available right on the web in their particular country.

當然，我認為從訪問的角度來看，它只是讓患者能夠非常容易地在他們特定國家/地區的網絡上找到我們的產品。

And in many ways, it becomes something we can scale relatively easily as we choose new countries to take it into.

在許多方面，當我們選擇新的國家將其納入其中時，它會變得相對容易擴展。

And I think that when folks are searching or trying to learn about the product and then they have the ability to purchase it right there at their fingertips in a web platform, it just makes it naturally easier to come on to the technology.

而且我認為，當人們正在搜索或嘗試了解該產品，然後他們有能力在網絡平台上觸手可及地購買它時，這只會自然而然地更容易接觸到該技術。

And I think you see what played out in Canada in terms of record number of new patients shortly after we launched it.

而且我想你看到了加拿大在我們推出後不久就創紀錄的新患者數量方面的表現。

The early success in the U.K. clearly speaks to the benefit of the e-commerce platform as well.

在英國的早期成功也清楚地說明了電子商務平台的好處。

So I think it's something that we can scale over time as we take into new countries and it clearly has the benefits with it.

所以我認為這是我們可以隨著時間的推移擴展到新國家的東西，它顯然有好處。

I think you heard in the prepared remarks, nearly 70% of all of our patients come on to our product for their first time through some sort of either virtual training or online training capability or in-app capability.

我想你在準備好的評論中聽說過，我們所有患者中有將近 70% 是通過某種虛擬培訓或在線培訓功能或應用程序內功能首次使用我們的產品。

So the e-commerce platform kind of lends itself very naturally into that ability to come on to the product.

因此，電子商務平台很自然地具有這種能力，可以推出產品。

And our next question comes from Matt Taylor from UBS.

我們的下一個問題來自瑞銀的馬特泰勒。

This is actually Young in for Matt.

這實際上是 Young in for Matt。

Maybe a question on the DTC ads.

也許是關於 DTC 廣告的問題。

Can you talk a little bit about the impact that might have on second half growth?

你能談談這對下半年增長可能產生的影響嗎？

What's the focus in terms of the patient segment or geographically?

就患者細分或地域而言，重點是什麼？

Are you able to take advantage of lower ad rates to go a little bit more aggressive on that?

您能否利用較低的廣告費率在這方面採取更積極的態度？

Yes.

是的。

This is Kevin.

這是凱文。

I'll take that.

我會接受的。

With respect to the ad rates and the spending, I don't get too involved in that one anymore.

關於廣告費率和支出，我不再過多地參與其中。

I leave that to the other guys.

我把它留給其他人。

But our team is very targeted with respect to the ads that we develop, where we run them, when we run them, and we have tremendous systems in place to monitor the leads that come in from those ads.

但是我們的團隊非常有針對性地關注我們開發的廣告，我們運行它們的地方，我們運行它們的時間，並且我們有大量的系統來監控來自這些廣告的線索。

We have, again, a team in place that if you watch our ad and e-mail us a lot of information, we get back to those patients very quickly.

同樣，我們有一個團隊，如果您觀看我們的廣告並通過電子郵件向我們發送大量信息，我們會很快回复這些患者。

They don't wait for several days.

他們不會等幾天。

It's a matter of hours, and we give back those patients and let them know we are here, and we will help them and educate them and want to get their insurance information, their doctor information, everything that patient might need.

這只是幾個小時的問題，我們回饋那些患者並讓他們知道我們在這裡，我們將幫助他們並教育他們並希望獲得他們的保險信息、他們的醫生信息以及患者可能需要的一切。

We do track that spending and where we spend it, we track the results from it, and then we invest in those places where we think it will be better.

我們確實跟踪支出和支出地點，我們跟踪支出的結果，然後我們投資於我們認為會更好的地方。

But we are seeing -- working from home now, we see Dexcom ads wherever we watch television a lot more than we used to.

但我們看到——現在在家工作，無論我們在哪裡看電視，我們都會看到 Dexcom 的廣告，這比以前多了很多。

And I think they've been very successful, and our team is really good at this.

我認為他們非常成功，我們的團隊非常擅長這一點。

And I would just say, from a return on investment perspective, there's not a better investment that we can make inside of these 4 walls today than direct-to-consumer spending.

我只想說，從投資回報的角度來看，沒有比直接面向消費者的支出更好的投資了。

It's amazing the capability that the team has put together in the targeted effort there to drive results.

令人驚奇的是，團隊在有針對性的努力中匯集了推動成果的能力。

Thank you, ladies and gentlemen.

謝謝你們，女士們，先生們。

This concludes today's Q&A session.

今天的問答環節到此結束。

I will now turn the call back over to Kevin Sayer for final remarks.

我現在將把電話轉回給 Kevin Sayer 做最後的評論。

Thank you very much, operator, and thanks, everybody, again, for being on our call today.

非常感謝接線員，再次感謝大家今天接聽我們的電話。

We saw a headline come across our phones while we're sitting here, what pandemic Dexcom rocks here.

當我們坐在這裡時，我們看到手機上出現了一條標題，Dexcom 在這裡爆發了大流行病。

I just want to tell everybody that we did have a great quarter, but we were affected by this like everybody else.

我只想告訴大家，我們確實有一個很棒的季度，但我們和其他人一樣受到了影響。

Our commercial teams had to completely change the way they worked.

我們的商業團隊必須徹底改變他們的工作方式。

And I had a town hall meeting with our team in the Philippines last week and the stories of some people who literally kept themselves locked up in the city for 2 months, away from their families to help our patients are incredibly inspiring.

上週我在菲律賓與我們的團隊舉行了一次市政廳會議，一些人為了幫助我們的病人而將自己關在城裡 2 個月，遠離家人，他們的故事非常鼓舞人心。

We've all been affected by this and working from homes.

我們都受此影響並在家工作。

And it's safe to say like everybody else, we've never experienced anything or planned for anything like this.

可以肯定地說，像其他人一樣，我們從未經歷過或計劃過這樣的事情。

But what an amazing 6-month this company has had in this environment.

但是這家公司在這種環境下度過了多麼驚人的 6 個月。

I just want to list a few accomplishments over the last 6 months in closing today.

在今天結束時，我只想列出過去 6 個月的一些成就。

We completed a financing that gives us the balance sheet strength necessary to accomplish all of our long-term goals.

我們完成了一項融資，使我們擁有實現所有長期目標所需的資產負債表實力。

We achieved an absolute worldwide absolute dollar sales growth increase of USD 240 million during this chaotic time.

在此混亂時期，我們實現了 2.4 億美元的全球絕對美元銷售額增長。

Our type 2 business on the intensive insulin side is demonstrating strength and the outcomes we always said we'd have with these patients.

我們在強化胰島素方面的 2 型業務正在展示實力和我們一直說我們會對這些患者產生的結果。

We've waited a long time to execute on this plan, and we finally got it at the hospital and we think that will be a great market for us.

我們等了很長時間才執行這個計劃，我們終於在醫院拿到了它，我們認為這對我們來說將是一個很好的市場。

Our financial performance is exceeding all of our plans on the bottom line, providing us with operating cash to reinvest in our business as we talked about money that we need to spend over the next 6 months of the year.

我們的財務業績超出了我們所有的底線計劃，這為我們提供了運營現金，可以在我們談到今年未來 6 個月需要花費的資金時對我們的業務進行再投資。

Our G6 satisfaction scores are at all-time highs, again, during this period of chaos.

在這段混亂時期，我們的 G6 滿意度得分再次創下歷史新高。

We have a great product supported by a very dedicated team.

我們有一個非常敬業的團隊支持的偉大產品。

Let's not forget our pipeline.

讓我們不要忘記我們的管道。

G7 progress is excellent.

G7 進展非常好。

As I said earlier in the call.

正如我早些時候在電話中所說的那樣。

The groups working on this project are hitting on all cylinders.

從事該項目的小組正在全力以赴。

And there is nothing more exciting at Dexcom than the sense of urgency related to a platform change like this is such a monumental effort.

在 Dexcom，沒有什麼比與平台變化相關的緊迫感更令人興奮的了，因為這是一項巨大的努力。

We are redoing everything that we do now to bring this incredible product to market.

我們正在重做我們現在所做的一切，以將這款令人難以置信的產品推向市場。

G7 is not the only thing in our pipeline.

G7 並不是我們籌備中的唯一項目。

We're spending numerous hours talking about Gs 8, 9 and 10 and whatever else comes in the future, but we're also making sure we don't ignore G6.

我們花了很多時間討論 Gs 8、9 和 10 以及未來出現的任何其他問題，但我們也確保不會忽略 G6。

We have numerous product improvements and patient experience improvements with G6 that will be out over the next couple of years.

G6 將在未來幾年內推出，我們將對產品進行大量改進並改善患者體驗。

We don't ever sit still.

我們永遠不會坐以待斃。

I just completed a series of virtual presentations for various groups here at Dexcom.

我剛剛在 Dexcom 為各個小組完成了一系列虛擬演示。

And one of the questions I was asked to answer is, why has the company been so successful?

我被要求回答的問題之一是，為什麼公司如此成功？

And I narrowed my answer down to a very simple statement.

我將我的答案縮小到一個非常簡單的陳述。

We provide a solution to a very serious problem, and we do it better than anybody else ever has.

我們為一個非常嚴重的問題提供了解決方案，而且我們比任何人都做得更好。

As we look to the future, we can continue to do that and only we can do it much better than we do it today, and we believe we can solve many more problems in the same manner.

展望未來，我們可以繼續這樣做，而且只能做得比今天好得多，我們相信我們可以用同樣的方式解決更多的問題。

It's going to thrill the health care community and more importantly, we're going to save patients, caregivers, health care professional and payers' time, money and we're going to continue to save lives.

這將使醫療保健界興奮不已，更重要的是，我們將節省患者、護理人員、醫療保健專業人員和付款人的時間、金錢，我們將繼續拯救生命。

Thank you, everybody.

謝謝大家。

Thank you.

謝謝。

Ladies and gentlemen, this concludes today's conference call.

女士們，先生們，今天的電話會議到此結束。

Thank you for participating.

感謝您的參與。

You may now disconnect.

您現在可以斷開連接。