德康醫療 (DXCM) 2017 Q4 法說會逐字稿

Welcome to the DexCom Fourth Quarter and Full Year 2017 Earnings Release Conference Call. My name is Daryl, and I will be your operator for today's call. (Operator Instructions) Please note that this conference is being recorded.

歡迎參加 DexCom 2017 年第四季暨全年財報發布電話會議。我是 Daryl，將擔任今天會議的接線員。(接線員指示) 請注意，本次會議將被錄音。

I will now turn the call over to Matt Dolan. Matt, you may begin.

我現在將把電話交給 Matt Dolan。Matt，您可以開始。

Thank you, and welcome to DexCom's Fourth Quarter 2017 Earnings Call. With us today is Kevin Sayer, DexCom's President and CEO; Steve Pacelli, our Executive Vice President of Strategy and Corporate Development; and Quentin Blackford, our Executive Vice President and Chief Financial Officer. We will begin with our prepared remarks and then open the call up for your questions. (Operator Instructions) I will begin with our safe harbor statement.

謝謝，歡迎參加 DexCom 2017 年第四季財報電話會議。今天與會者包括 DexCom 總裁兼執行長 Kevin Sayer；策略與企業發展執行副總裁 Steve Pacelli；以及執行副總裁兼財務長 Quentin Blackford。我們將先進行事先準備的發言，接著開放提問。(接線員指示) 我將先宣讀安全港聲明。

Some of the statements that 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. 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, quarterly reports on Form 10-Q and other filings with the Securities and Exchange Commission. Except as required by law, we assume no obligation to update any such forward-looking statements after the date of this presentation or to conform these forward-looking statements to actual results.

我們在今天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。本簡報所包含的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中所預期者有重大差異。可能導致實際結果與任何此等前瞻性陳述所明示或暗示者產生重大差異的因素，已詳載於 DexCom 的 Form 10-K 年度報告、Form 10-Q 季度報告及向美國證券交易委員會提交的其他文件中。除法律要求外，我們不承擔在本簡報日期後更新任何此等前瞻性陳述，或使其與實際結果一致之義務。

Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP with respect to our non-GAAP and cash-based results. The presentation of this additional information should not be considered in isolation or as a substitute for results or superior to results prepared in accordance with GAAP. Please refer to the tables in our earnings release in the Investor Relations portion of our website for a reconciliation of these measures to their most directly comparable GAAP financial measure.

此外，在本次會議中，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。此等補充資訊之呈現不應被單獨看待，亦不應視為可替代依 GAAP 編製之結果，或優於依 GAAP 編製之結果。請參閱我們網站投資人關係專區之財報新聞稿中的表格，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。

With that, I'll turn it over to Kevin.

接下來，我把電話交給 Kevin。

Thank you for joining us on our year-end call today. We're going to do things a little bit differently than we've done on previous calls. I'll provide an introduction and pass it to Quentin for a financial review, followed by Steve, who will provide an update on several of our key strategic initiatives. I will then conclude with my thoughts on the business and our outlook, before we open things up to Q&A.

感謝各位今天參加我們的年終電話會議。我們這次的進行方式會與以往的會議稍有不同。我將先做開場介紹，接著交給 Quentin 進行財務回顧，之後由 Steve 提供我們幾項關鍵策略計畫的最新進展。在開放問答之前，我將以我對業務與展望的看法作結。

2017 was another year defined by a number of important achievements for DexCom, as we initiated our rollout to the Medicare population in the United States; significantly expanded our international presence; made meaningful progress with our product pipeline, including our next-generation system DexCom G6, which is now under review with the FDA; saw the results of our landmark DIaMonD study published along with several other important studies, which provide the best clinical evidence we have ever had to support real-time CGM as an essential tool for all intensive insulin-using patients; and finally, we initiated our first pilot experiences in the non-intensive type 2 diabetes population.

2017 年對 DexCom 而言是另一個充滿多項重要成就的一年：我們在美國開始向 Medicare 族群推廣；大幅擴展國際版圖；在產品研發管線上取得實質進展，包括我們的下一代系統 DexCom G6，目前已送交 FDA 審查；我們的里程碑式 DIaMonD 研究結果發表，並與其他幾項重要研究一同刊登，提供了我們迄今最有力的臨床證據，支持即時 CGM 是所有使用強化胰島素治療患者的必要工具；最後，我們也在非強化治療的第二型糖尿病族群中啟動了首次試點經驗。

Our 2017 financial performance was also strong, with revenue growing at 25% in 2017, led by a very solid fourth quarter where we saw momentum build as we exited the year with sales growth of 29%. I'm pleased to report that U.S. revenue growth accelerated in the last quarter of the year, including our commercial business, which realized its strongest growth quarter of the year. And our international business grew more than 60% for the full year. Our team also demonstrated good expense control, with the P&L improving in the back half of 2017. Consistent with our plans, second half operating expenses grew at a rate of less than half of our revenue growth compared to the second half of 2016. As we look ahead, we believe we're in a very solid position with the major global project launch slated for later this year and multiple strategic initiatives moving forward.

我們 2017 年的財務表現同樣強勁，全年營收成長 25%，其中第四季表現非常穩健，年末動能持續增強，使我們在年底時的銷售成長達 29%。我很高興報告，美國營收成長在年末最後一季加速，包括我們的商業業務，該業務在第四季達成全年最強勁的成長。而我們的國際業務全年成長超過 60%。我們的團隊也展現良好的費用控管能力，2017 年下半年損益表表現有所改善。依照我們的計畫，下半年營運費用的成長率不到營收成長率的一半（相較於 2016 年下半年）。展望未來，我們認為公司處於非常穩健的位置：今年稍晚將進行主要的全球專案上市，且多項策略計畫正持續推進。

More on these key programs in a moment. But now, I will turn the call over to Quentin for a review of our financials.

稍後我會再談這些關鍵計畫。現在，我將把電話交給 Quentin，請他回顧我們的財務表現。

Thanks, Kevin. DexCom reported record revenue of $221 million for the fourth quarter of 2017 compared to $171 million for the same quarter in 2016, resulting in our strongest growth quarter of the year with growth of 29%. Sequentially, revenue was up 20%, driven by a 24% quarter-over-quarter increase in our U.S. business, fueled by the ramp-up of our Medicare business and a greater-than-anticipated increase in our U.S. commercial business. As Kevin alluded to, DexCom's U.S. revenue demonstrated increasing momentum growing 25% year-over-year in the fourth quarter of 2017 and the OUS business posted another solid growth rate at 58% year-over-year.

謝謝你，Kevin。DexCom 2017 年第四季營收創下 2.21 億美元新高，較 2016 年同期的 1.71 億美元增加，使其成為全年成長最強勁的一季，成長率為 29%。就季比而言，營收成長 20%，主要由美國業務季增 24% 所帶動，受惠於 Medicare 業務的放量，以及美國商業業務增幅高於原先預期。如 Kevin 所提及，DexCom 的美國營收動能持續增強，2017 年第四季年增 25%，而美國以外（OUS）業務也再度繳出穩健表現，年增 58%。

And while we are still in the early stages of ramping our Medicare business, we were pleased to see the pickup in the U.S. commercial growth, given the significant distraction we had called out in the first 3 quarters of the year. Our fourth quarter gross profit was $154 million, generating a gross margin of approximately 69% compared to a gross margin of 68% in the same quarter in the prior year. For the full year, gross margin was 68%. As we provided within the tables of our press release, our Q4 geographic revenue mix was more heavily weighted towards our U.S. business given the stronger-than-anticipated performance resulting in a positive impact on gross margins.

雖然我們仍處於 Medicare 業務放量的早期階段，但鑑於我們在今年前三季所提到的重大分心因素，我們很高興看到美國商業業務成長回升。第四季毛利為 1.54 億美元，毛利率約 69%，相較於前一年同期毛利率 68% 有所提升。全年毛利率為 68%。如我們在新聞稿表格中所提供，第四季按地區的營收組合更偏向美國業務，因其表現優於預期，對毛利率帶來正面影響。

In addition, our Q4 products mix favored sensor sales, which are having more favorable margin profile. Average sensor pricing was consistent with recent quarters, while transmitters and receivers saw some reductions, due primarily to: one, the Medicare rollout and the realized pricing for our bundle; and two, some lower upfront cost initiatives in our international markets.

此外，第四季的產品組合更偏向感測器銷售，而感測器具有較佳的毛利結構。感測器平均售價與近期季度一致，而發射器與接收器價格則有所下調，主要原因為：第一，Medicare 推廣以及我們套裝方案的實際定價；第二，我們在國際市場推動部分降低前期成本的措施。

Operating expenses totaled $142 million for Q4 compared to $123 million in Q4 of 2016. This reflects an increase of 15% year-over-year, nearly half the rate of revenue growth for the same period and demonstrates the potential opportunity of our financial leverage over time. Most encouraging was that while spending was approximately up by only half the rate of revenue growth, we continue to invest in our key initiatives, including accelerated direct-to-consumer marketing, OUS expansion in our R&D pipeline.

第四季營運費用合計 1.42 億美元，較 2016 年第四季的 1.23 億美元增加。這反映年增 15%，約為同期營收成長率的一半，並顯示隨時間推移我們財務槓桿的潛在機會。最令人鼓舞的是，雖然支出增幅約僅為營收成長率的一半，我們仍持續投資於關鍵計畫，包括加速的直接面向消費者行銷、OUS 擴張以及我們的研發管線。

Adjusted EBITDA, which excludes the impact of share-based compensation and is a good proxy of the cash earnings of our business, was 19% for the fourth quarter and up 58% from the prior year. Our GAAP to net loss was $9 million or $0.11 loss per share. Included in our GAAP net loss was an $18 million tax expense. This tax expense was driven by the reversal of a tax benefit we realized in the second quarter associated with our convertible notes offering. At the time of recording the tax benefit in Q2, we had anticipated that the company would be in a taxable net loss position for the year, thereby resulting in recording the tax benefit. As result of the strong finish to the year as well as migrating IP associated with our international business in the foreign jurisdictions, we ended the year in a tax profitable position, resulting in the reversal of the previously recorded tax benefit. Excluding the noncash tax expense in Q4, non-GAAP net income was $9 million or earnings per share of $0.10, representing the most profitable quarter in our history.

經調整 EBITDA（排除股份基礎薪酬的影響，且是衡量我們業務現金獲利能力的良好替代指標）第四季為 19%，較去年同期成長 58%。我們依 GAAP 計算的淨虧損為 900 萬美元，或每股虧損 0.11 美元。我們的 GAAP 淨虧損中包含 1,800 萬美元的所得稅費用。此稅費主要來自於我們沖回第二季因可轉換公司債發行而認列的稅務利益。在第二季認列該稅務利益時，我們原先預期公司全年將處於應稅淨虧損狀態，因此認列了該稅務利益。由於年底表現強勁，以及我們將與國際業務相關的智慧財產權移轉至海外司法管轄區，我們全年最終呈現應稅獲利狀態，因而沖回先前已認列的稅務利益。若排除第四季的非現金稅費，非 GAAP 淨利為 900 萬美元，或每股盈餘 0.10 美元，為我們歷史上最獲利的一季。

We ended the year well capitalized with $549 million in cash and equivalents on our balance sheet versus $526 million at the end of Q3 and $124 million at the end of 2016. These higher $200 million revolving line of credit remains available.

我們在年底資本結構穩健，資產負債表上的現金及約當現金為 5.49 億美元，相較於第三季末的 5.26 億美元，以及 2016 年底的 1.24 億美元。這筆提高至 2 億美元的循環信用額度仍可動用。

Looking ahead to 2018, we provided our initial outlook in early January, and we continue to anticipate total revenues of $830 million to $850 million, with sensor volumes, international growth and the patient base all expected to grow faster than our revenues. We remain comfortable with our mid-to-upper 60% expectation for gross margin this year and expect core operating expenses to increase by approximately 10%. As we noted previously, this excludes any additional spend associated with our non-intensive programs, which are beginning to ramp this year.

展望 2018 年，我們在 1 月初提供了初步展望，並持續預期總營收為 8.30 億至 8.50 億美元；感測器出貨量、國際成長以及病患基礎皆預期將快於營收成長。我們仍對今年毛利率維持在 60% 中段至高段的預期感到有信心，並預期核心營運費用約增加 10%。如先前所述，以上不包含與我們非重度（non-intensive）計畫相關的任何額外支出，該等計畫今年開始逐步加速投入。

For the first quarter, we remind investors that our sales will decline sequentially, due primarily to the resetting of annual health insurance deductibles in the U.S. Therefore, we expect seasonality within the year will be consistent with the past several years and anticipate that no more than 20% of our 2018 revenue will be generated in the first quarter.

就第一季而言，我們提醒投資人，由於美國年度健康保險自付額（deductibles）重設，銷售額將呈現季對季下滑。因此，我們預期年內季節性將與過去幾年一致，並預估 2018 年營收中第一季貢獻不超過 20%。

With that, I would like to turn the call over to Steve for a strategic update.

接下來，我想把電話會議交給 Steve，請他提供策略更新。

Thanks, Quentin. Our insulin partners are making significant progress with DexCom integrated systems. Both Tandem and Insulet presented very strong pilot data at ATTD for their automated insulin delivery systems, and we remain heavily invested in these collaborations. Early results demonstrated what would be market-leading outcomes, including very strong improvements to time and range. We believe each of these systems will be highly differentiated once they are commercially available.

謝謝你，Quentin。我們的胰島素合作夥伴在 DexCom 整合式系統方面正取得顯著進展。Tandem 與 Insulet 在 ATTD 上展示了其自動化胰島素輸送系統非常強勁的試點數據，我們也持續大力投入這些合作。初步結果顯示出可能領先市場的成效，包括「目標範圍內時間（time in range）」的顯著改善。我們相信，這些系統一旦商業化上市，將具備高度差異化。

Our recently announced collaboration with Eli Lilly, which is intended to generate both pump and smart pen integration, is also moving forward nicely, and recently saw first-in-human experience. We continue to drive other pump and smart pen integrations and expect to update the market when appropriate.

我們近期宣布與禮來（Eli Lilly）的合作，目標是同時實現幫浦與智慧胰島素筆的整合，目前也進展順利，且近期已完成首次人體（first-in-human）使用經驗。我們也持續推動其他幫浦與智慧胰島素筆的整合，並將在適當時機向市場更新。

Turning to the non-intensive opportunity, development of a fully disposable real-time CGM system with Verily is moving ahead, with the first-generation system currently expected to complete development this year. As we have stated previously, the timing of this product launch is contingent on a number of factors, including our no-calibration and regulatory strategy with G6. Our smaller and more cost-effective second-generation system is taking shape, and we're optimistic in our ability to introduce this device in 2020.

談到非重度（non-intensive）機會，我們與 Verily 合作開發的全拋棄式即時 CGM 系統正持續推進，第一代系統目前預期將於今年完成開發。如先前所述，此產品的上市時程取決於多項因素，包括我們在 G6 上的免校準（no-calibration）與法規策略。我們更小型且更具成本效益的第二代系統也逐步成形，我們對於在 2020 年推出該裝置的能力感到樂觀。

These products are well suited for multiple new opportunities for DexCom, including our expansion into the non-intensive segment of the market. At CES in January, many of you saw the announcement of the initiation of our pilot activities with United Healthcare, and their members are now actively enrolling in this diabetes management program. As we have outlined in prior calls, the goal of this program is to drive both health and economic benefits in the management of people with type 2 diabetes. The ability to provide connected, real-time CGM data will be a critical component of this program, allowing patients and caregivers the ability to see the impact of their behavior and drug therapy and take immediate action.

這些產品非常適合 DexCom 的多項新機會，包括我們擴展至市場中的非重度（non-intensive）族群。在 1 月的 CES 上，許多人看到我們宣布與 United Healthcare 啟動試點活動，其會員目前已開始積極加入此糖尿病管理計畫。如我們在先前電話會議中所說明，該計畫的目標是在第二型糖尿病患者管理上，同時帶動健康與經濟效益。提供可連網的即時 CGM 數據將是此計畫的關鍵組成，使患者與照護者能看見其行為與藥物治療的影響並立即採取行動。

And although we are still early in developing the non-intensive market, the need for better management couldn't be clear. For example, earlier this month, a study was published indicating that of people aged 45 and over who visited the ER, roughly 25% had diabetes, and those patients aged 45 to 64 were almost twice as likely to be hospitalized following a visit to the emergency room. With our CGM technology, we believe we have the ability to fundamentally improve both how these patients manage their diabetes and how they impact our healthcare system. We hope to fully enroll the pilot with United and evaluate next steps by the end of 2018.

雖然我們仍處於開發非重度（non-intensive）市場的早期階段，但對更佳管理方式的需求再清楚不過。例如，本月稍早發表的一項研究指出，在前往急診室（ER）的 45 歲以上人群中，約有 25% 患有糖尿病；而其中 45 至 64 歲的患者在急診就診後住院的可能性幾乎是其他人的兩倍。透過我們的 CGM 技術，我們相信有能力從根本上改善這些患者管理糖尿病的方式，以及他們對醫療體系造成的影響。我們希望在 2018 年底前完成 United 試點計畫的全面招募，並評估後續步驟。

With that, I will pass it along to Kevin.

接下來，我把時間交給 Kevin。

Thank you, guys. I am very pleased with our team's performance in 2017. Our U.S. business accelerated in Q4 and our commercial patient additions were at record levels. Internationally, we had a breakout year after significantly expanding our OUS team beginning in 2016. And from a financial perspective, we are seeing leverage in our P&L, all while maintaining solid revenue growth and preparing for the future. As we look at the balance of 2018, interest in DexCom CGM is robust, with a strong increase in new patient opportunities, fueled in part by our ability to process Medicare-eligible patients.

謝謝各位。我對我們團隊在 2017 年的表現感到非常滿意。我們美國業務在第四季加速成長，商業保險病患新增數達到創紀錄水準。在國際市場方面，自 2016 年開始大幅擴編 OUS（美國以外）團隊後，我們迎來突破性的一年。從財務角度來看，我們在維持穩健營收成長並為未來做準備的同時，也看到損益表（P&L）的營運槓桿效益。展望 2018 年剩餘期間，市場對 DexCom CGM 的興趣依然強勁，新病患機會顯著增加，部分動能來自我們具備處理符合 Medicare 資格病患的能力。

Leaving ATTD in Vienna earlier this month, DexCom was in the spotlight with buzz around strong clinical and competitive data. More broadly, CGM was a consistent theme throughout ATTD and is clear to me that CGM is the standard in diabetes therapy for patients on MDI or pumps and should become the standard for all people suffering with diabetes as we drive early efforts to move into the non-intensive population. Nearly every scientific session included CGM data, whether it was the primary focus of the presentation or simply a measurement of the effectiveness of another device or drug therapy. Considering global penetration rates remained very, very low, we believe this environment creates a significant opportunity for DexCom to capitalize on for the next several years. And as we move to our next-generation platform, we are well positioned to take advantage of this opportunity.

本月稍早離開維也納的 ATTD 時，DexCom 因強勁的臨床與競爭數據而成為焦點，市場討論熱度很高。更廣泛而言，CGM 是 ATTD 全程反覆出現的主題；在我看來，對於使用多次每日注射（MDI）或胰島素幫浦的患者，CGM 已是糖尿病治療的標準，並且在我們推動早期進入非重度（non-intensive）族群之際，CGM 也應成為所有糖尿病患者的標準。幾乎每一場科學議程都包含 CGM 數據，不論其為簡報的主要焦點，或僅作為衡量其他裝置或藥物治療效果的指標。考量全球滲透率仍然非常、非常低，我們相信這樣的環境為 DexCom 在未來幾年提供了重大的可把握機會。隨著我們邁向下一代平台，我們已具備良好條件來掌握此機會。

Our interactions with the FDA continue to be productive. And we believe, we will launch a no-calibration G6 platform globally this year, with the goal of introducing it by midyear. Our outlook reflects these important opportunities, but also accounts for an evolving marketplace, including the potential impact of competitive activity, like we haven't experience in the past; the decision by J&J to transition the Animas pump business and potentially more anticipated pricing pressure than we've experienced in prior periods as well.

我們與 FDA 的互動持續富有成效。我們相信今年將在全球推出免校準（no-calibration）的 G6 平台，目標是在年中前導入。我們的展望反映了這些重要機會，但也納入市場環境的演變，包括競爭活動可能帶來的影響（這是我們過去未曾經歷的程度）；以及 J&J 決定移轉 Animas 幫浦業務，並且也可能出現較以往期間更大的價格壓力。

Now I'll turn it to our product pipeline update. As I mentioned, our biggest priority in 2018 surrounds the launch of our next-generation G6 CGM system. The performance and feature set of this platform represents a step function improvement from what is currently available to people with diabetes. We have improved the ease of use with a simplified applicator, and they were no calibrations and reduced form factor. And the data we have seen to date suggest that patients will benefit from improved performance characteristics, including a better day 1 consistency and no interference from drugs like acetaminophen. We know patients favor DexCom's real-time CGM because of its accuracy, reliability, alerts and connectivity and are excited to soon build on this foundation with the important enhancements offered by G6.

接下來我將更新我們的產品研發管線。如我所提到的，我們 2018 年最大的優先事項是推出下一代 G6 CGM 系統。此平台的效能與功能組合，相較目前糖尿病患者可使用的產品，代表著躍升式（step function）的提升。我們透過簡化的安裝器提升了易用性，並實現免校準（no calibrations）以及更小的外形尺寸。截至目前我們所看到的數據顯示，患者將受益於更佳的效能特性，包括第 1 天一致性更好，且不受乙醯胺酚（acetaminophen）等藥物干擾。我們知道患者偏好 DexCom 的即時 CGM，原因在於其準確性、可靠性、警示與連線能力；我們也很期待很快能在此基礎上，透過 G6 所提供的重要強化功能再進一步提升。

Beyond the core system, we continue to leverage the advantages of DexCom's real-time connectivity with our apps and wearables. The number of customers using mobile devices continues to tick up on both iOS and Android, allowing them to take advantage of our shared system. We recently upgraded our app to offer customizable alert schedule and the option to override the mute function. We know there continues to be questions surrounding Medicare patients and their access to our valuable mobile app. We remain in discussions with CMS and hope to be able resolve this in the next 6 months. Wearables are also becoming increasingly important in driving patient convenience, and we continue to make strides in expanding our offerings there with the Apple Watch, Fitbit and other Android wear devices.

除了核心系統之外，我們持續運用 DexCom 與我們的應用程式與穿戴式裝置之間即時連線的優勢。使用行動裝置的客戶數量在 iOS 與 Android 平台上持續增加，使他們能夠受惠於我們的共享系統。我們近期升級了 App，提供可自訂的警示排程，以及可覆寫靜音功能的選項。我們知道，關於 Medicare 病患及其使用我們寶貴行動 App 的權限，仍然存在一些疑問。我們仍在與 CMS 討論中，並希望能在未來 6 個月內解決此事。穿戴式裝置在提升病患便利性方面也日益重要；我們持續在 Apple Watch、Fitbit 及其他 Android 穿戴裝置上擴展產品供應，並取得進展。

In summary, we had a great finish to the year and we're off to a solid start in 2018.

總結來說，我們在年底表現亮眼，並在 2018 年有一個穩健的開局。

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

我現在想開放電話會議進入問答環節。Matt？

Thank you, Kevin. (Operator Instructions) Operator, please provide the complete Q&A instructions.

謝謝你，Kevin。（接線員指示）接線員，請提供完整的問答說明。

(Operator Instructions) And our first question is from Mike Weinstein from JPMorgan.

（接線員指示）我們的第一個問題來自 JPMorgan 的 Mike Weinstein。

The 2 -- 2 quick questions. I mean, the second one may be less quick. The first is relative to the pre-announcement, you did come in better than you pre-announced so if you could just highlight where the difference came from? And then second, the question's really on the first quarter commentary. I know the historical percentage of sales that have come in the first quarter of the several years, familiar with that, obviously. But your guidance implies 17% to 19% year-over-year growth in the first quarter versus the 29% you did in the fourth quarter, it implies $166 million to $170 million versus The Street's $182 million. So why does revenue growth step down as much as you're guiding to from 4Q to 1Q? What drives that and maybe you could just shed some more color on what the point you're seeing today in the business?

兩個——兩個快速問題。我的意思是，第二個可能沒那麼快。第一個是關於預先公告（pre-announcement），你們實際結果優於先前預告，所以能否說明差異主要來自哪裡？第二個問題主要是關於第一季的評論。我知道過去幾年第一季占全年銷售的歷史比例，對此很熟悉，當然。但你們的指引意味著第一季年增率為 17% 到 19%，相較於第四季的 29%；也意味著營收為 1.66 億到 1.70 億美元，而市場一致預期（The Street）為 1.82 億美元。所以，為什麼你們指引中營收成長會從 4Q 到 1Q 下滑這麼多？是什麼因素驅動的？也許你們可以再多提供一些細節，說明你們目前在業務上看到的狀況？

Yes. Mike, so this is Quentin here. I think with respect to Q4, obviously, JPMorgan was very early in January. We were certainly not going to get ahead of ourselves there. We felt very good about where the quarter had come together, particularly in the U.S. business we knew Medicare was strong. But the commercial business was particularly strong, and we just want to make sure that we had our arms around all of the issues that were going on in that business and like I said, set this up to where we knew we weren't going to get ahead of ourselves, but felt very confident that we'd be able to deliver on that number, and that's the way we approached it as we went into the JPMorgan conference. So that's what you have there. Again, the majority of all of that upside came out of the commercial business in the U.S. With respect to the seasonality, I think a couple of things to keep in mind. The sequential uptick from Q3 into Q4 was about 5 points stronger than what we've historically seen, particularly against last year anyhow or the 2016 year. And we're not in a position yet to call that a trend. Again, we were very happy with momentum that we saw. We saw it play out in the commercial business, but we're 1 quarter into it, and the majority of that came in the back part of the quarter, as well. So we're not going to get ahead of ourselves with respect to that item either. I think, the way to think about it is if you just look historically, that seasonality in Q1 is roughly 20% of about every year that you can go back and look at, and that's the way we're thinking about 2018 for this particular point in time. If we can navigate it well and momentum continues, then we're going to be in a great position, but, again, no need to be out ahead of ourselves here.

是的。Mike，我是 Quentin。我想就第四季而言，顯然，JPMorgan 會議是在一月初就舉行。我們當然不會在那時就過度樂觀。我們對該季的整體表現感到非常好，特別是在美國業務方面，我們知道 Medicare 表現強勁。但商業保險業務尤其強勁，而我們只是想確保能全面掌握該業務中正在發生的所有議題；如我所說，我們希望把事情安排得當，確保不會操之過急，同時也非常有信心能達成那個數字，這就是我們在參加 JPMorgan 會議前的做法。所以你看到的就是這樣。再說一次，那些超出預期的部分大多來自美國的商業保險業務。至於季節性，我認為有幾點需要記住。從第三季到第四季的連續增幅，比我們歷史上看到的水準大約強了 5 個百分點，特別是相較於去年或 2016 年。而我們目前還不準備把這稱為一個趨勢。同樣地，我們對所看到的動能非常滿意。我們看到它在商業保險業務中發揮作用，但我們才經歷了 1 個季度，而且其中大部分也發生在季度後段。因此，對於這一點我們也不會操之過急。我認為可以這樣理解：如果你回顧歷史，第一季的季節性大約占全年約 20%，你往回看每一年大致都是如此，而這也是我們目前對 2018 年的看法。如果我們能妥善因應，且動能持續，那我們將處於非常有利的位置；但同樣地，沒有必要在此時就過度超前。

Yes, Mike, this is Kevin. I'll just add a bit to that. High deductible plans haven't gone our way, if anything, they have increased. We've had, as we said on our call, very good interest early this year. Awareness has been very, very good, and so things have gone well. But the high deductible plans do make it tougher even for the reordering patients because they have to hit those deductibles, and these are headwinds we've encountered in the first quarter every year and it's really no different than it has been before. So, as Quentin said, we'll wait and see if this a trend after a little while and go from there.

是的，Mike，我是 Kevin。我再補充一點。高自付額（high deductible）方案對我們並不有利；如果有什麼變化的話，它們還增加了。正如我們在電話會議上所說，今年年初我們看到非常好的早期興趣。市場認知度非常、非常好，因此進展順利。但高自付額方案確實讓情況更具挑戰性，即使對於回購的病患也是如此，因為他們必須先達到自付額門檻；而這些逆風我們每年第一季都會遇到，與以往並沒有什麼不同。所以，如 Quentin 所說，我們會再觀察一段時間，看看這是否成為趨勢，然後再做下一步。

And our next question comes from Jeff Johnson from Baird.

下一個問題來自 Baird 的 Jeff Johnson。

So maybe I could build on Mike's question just a little bit here on the first quarter guidance. First part of the question, I guess, just what are you seeing in your U.S. commercial business, especially here 2 months into the first quarter? Obviously, competition has increased a bit here over the last 8 to 10 weeks or so as Libre has launched in the U.S. So just wondering kind of any qualitative comments you can provide, or even quantitative, on where U.S. commercial trends have been over the last couple of months?

那我也許可以在 Mike 的問題基礎上，針對第一季指引再延伸一點。問題的第一部分，我想是：在第一季進行到第 2 個月時，你們在美國商業保險業務上看到了什麼，尤其是目前？顯然，過去大約 8 到 10 週競爭加劇了一些，因為 Libre 已在美國上市。

Sure. This is Kevin. I'll comment on that one, all right. Increased awareness has helped our business tremendously. Make no mistake about it. Our DTC campaigns ramped up in the first quarter of the year. Many people I ran into tell me they've seen the DexCom ad, so we are reaching people. On top of that, you have increased awareness being generated by our competitors, as well. When patients go see the physician and say "Hey, I've been aware of CGM technology, what do I need?" Well, physicians definitely know the difference between us and the competitive systems and we're getting a large number of referrals. So the pipeline of new patient opportunities has been outstanding. Where we run into the same thing, we run into the first quarter of every year is, "Okay, how much is my out-of-pocket for this first quarter?" And we have to make sure we manage those expectations and get those patients on as best we can. But right now, we are seeing very good demand and very good response in the U.S. The other thing in the first quarter, again, just remember, as a -- a bigger piece of our first quarter business are our new starts in the first quarter and more than likely Medicare patients, and they have a lower revenue per start than our traditional commercial patients, as do a lot of our European patients as we go in those markets in the first quarter, as well. So all those things kind of blend to the story that we told earlier.

當然。我是 Kevin。我來回答這個問題，好嗎。認知度提升對我們的業務幫助非常大。毫無疑問。我們的 DTC（直接面向消費者）行銷活動在第一季加大了力度。我遇到的很多人都告訴我他們看過 DexCom 的廣告，所以我們確實觸及到了更多人。除此之外，你也看到競爭對手同樣在提升市場認知度。當病患去看醫師並說：「嘿，我知道有 CGM 技術，我需要什麼？」醫師當然清楚我們與競品系統之間的差異，而我們也獲得大量轉介。因此，新病患機會的管線非常出色。我們遇到的情況與每年第一季相同：「好，那我第一季自付要多少？」我們必須確保管理好這些預期，並盡可能讓這些病患順利開始使用。但目前我們在美國看到非常好的需求與非常好的回應。第一季的另一點，同樣請記得：第一季業務中較大的一部分來自新啟用（new starts），而這些很可能是 Medicare 病患；他們每次啟用的營收低於我們傳統的商業保險病患；同樣地，當我們在第一季進入歐洲市場時，許多歐洲病患也是如此。所以，這些因素綜合起來，就形成了我們先前所說的那個故事。

All right. That's helpful. And then my follow-up question, I guess, just on the investment you seem to make, passive investment, but investment in Tandem here recently, looks like you bought some shares on their secondary offering. I know in the past you talked about not wanting to own a pump company, but just wondering kind of is this a first step in that direction or what else maybe drove the buying on their secondary?

好的。這很有幫助。接著我想追問一下，關於你們最近似乎做的那筆投資——看起來是被動投資，但最近在 Tandem 的投資，似乎是在他們的次級發行中買了一些股份。我知道過去你們談過不想擁有一家胰島素幫浦公司，但我想了解這是否是朝那個方向邁出的第一步，或是還有什麼因素驅動你們在他們次級發行中買入？

No. Jeff, this is Steve. I'll take that one. No, this should not be viewed by The Street as a first step to an acquisition by any stretch. In fact, I would start to answer the question by saying we're extraordinarily committed to all of our pump partners, not just Tandem. We're committed to Lilly. We're committed to Insulet. We're committed to others that we're still keeping confidential. So no, I mean, at the end of the day, we discussed it with Tandem, discussed how our participation might influence their offering. We agreed that if they raise a sufficient amount of capital, that we would be willing to participate. And that's really what happened, like with Animas exiting the market. When it was clear -- when it became clear during Tandem's offering that they were going to raise more than enough capital to get to a place where we believe they can have a couple of really significant new product launches that incorporate our technology, it became sort of a no-brainer.

不是。Jeff，我是 Steve。這題我來回答。不，華爾街絕不應把這視為任何形式的收購第一步。事實上，我會先這麼回答：我們對所有的幫浦合作夥伴都極度投入，不只是 Tandem。我們投入於 Lilly。我們投入於 Insulet。我們也投入於其他目前仍需保密的合作夥伴。所以不是。歸根結底，我們與 Tandem 討論過，也討論了我們的參與可能如何影響他們的發行。我們同意，如果他們能募集到足夠的資本，我們願意參與。事情就是這樣發生的，就像 Animas 退出市場一樣。當情況明朗——當在 Tandem 的發行過程中變得清楚他們將募集到遠超足夠的資本、使其達到我們相信他們能推出幾項真正重大的新產品（並整合我們技術）的階段時，這就變成幾乎不用多想的決定。

I would just add one other comment. As we were at ATTD like many others were, and we saw the data from their closed loop system and the data that it produced. As one long-time diabetes person said to me, he looked at the data and said, "I finally believe that this stuff is going to work." It was very, very compelling. And we think it's a very, very good time. We saw the same thing with Insulet. We saw great a deal in Europe with their system as well. So we're beginning to see that we're going to have some closed loop and some automated insulin delivery solutions out there. So both of those events are great for us, too.

我再補充一點。我們和許多人一樣在 ATTD，看到他們閉環系統的數據以及其產出的結果。有位長期從事糖尿病領域的人對我說，他看著那些數據說：「我終於相信這些東西會奏效了。」這非常、非常有說服力。我們認為現在是非常、非常好的時機。我們在 Insulet 身上也看到了同樣的情況。我們也在歐洲看到他們系統的很大進展。因此我們開始看到，市場上將會出現一些閉環與自動化胰島素輸注（AID）解決方案。所以這兩件事對我們也都非常有利。

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

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

Just a couple of quick ones for me. So the U.S. is obviously very strong and that was called out in your remarks. Can you just talk about the ex U.S. business this particular quarter. I think it was flat or marginally down sequentially. And was that just tied -- I think Quentin or [Jay], you mentioned some new hardware strategies ex U.S. So was that the principal driver here sequentially? And how should we think about 2018 in light of the fourth quarter number ex U.S.?

我這邊有幾個很快的問題。美國市場顯然非常強勁，你們在發言中也特別提到。能否談談本季美國以外（ex U.S.）的業務？我記得按季比較是持平或小幅下滑。這是否只是因為——我想 Quentin 或 [Jay] 提到美國以外有一些新的硬體策略，所以按季變化的主要驅動因素是這個嗎？另外，考量到第四季美國以外的數字，我們應該如何看待 2018 年？

It's Quentin here. So obviously, very pleased with the momentum we continue to have in that international business growing nearly 60% in the fourth quarter is something we continue to be happy about. And if you get into the details of it, we end up finding is the direct business that we have there with all in excess of that 60% growth year-over-year, but part of our business there continues to be through distributors, and the distributor business is not as seasonal and then has a bit more lumpiness than is in the direct business. So nothing there that concerns us. We continue to be very encouraged by what we see on both the direct and the distributor side of the business, but nothing to read into from that perspective. As you think about 2018, international is going to continue to be a growth driver for us over the course of the year. So you'll agree, we continue to see growth far in excess of the overall corporate average. I would just remind you, we're probably less than 5% penetrated in that overall marketplace. So there's a lot of runway ahead of us to continue to drive growth there.

我是 Quentin。很明顯，我們對國際業務持續的動能非常滿意；第四季國際業務成長接近 60%，這點我們也持續感到高興。如果深入細節，我們會發現我們在那裡的直營業務年增都超過 60% 的成長；但我們在當地仍有一部分業務是透過經銷商，而經銷商業務的季節性沒那麼明顯，且相較直營業務會更有波動性。所以沒有任何讓我們擔心的地方。我們對直營與經銷兩端所看到的表現都持續感到非常鼓舞，但從這個角度來看不需要過度解讀。談到 2018 年，國際市場在全年仍將持續成為我們的成長驅動力。因此你會同意，我們仍預期其成長將遠高於公司整體平均。我也提醒一下，我們在整體市場的滲透率可能還不到 5%。所以我們前方仍有很長的跑道，可以持續推動那裡的成長。

Okay. Very, very helpful. And then back on the U.S. market, just Medicare commentary, I think, last quarter -- third quarter call, you mentioned 4,000 patients processed 20,000 backlog. Can you update us on those numbers? And sorry, Quentin, I forgot to ask, for you, the expense number for 2018. Can you share any kind of range we can think about for the United spending in '18? And I'll jump back in queue.

好的。非常、非常有幫助。再回到美國市場，關於 Medicare 的評論：我記得上季——第三季電話會議時，你們提到已處理 4,000 名病患、仍有 20,000 的積壓。能否更新這些數字？另外抱歉，Quentin，我忘了問你 2018 年的費用數字。你能否分享一下我們可以如何思考 2018 年在美國的支出區間？我之後再回到隊列。

Yes. So I'll take the spending number real quickly. We've been very committed to finding ways to drive efficiencies in the business, and the company has done a great job in doing that over the course of 2017. You started to see some of that leverage really play out in the third quarter, then again, into the fourth quarter. And what you'll see in the core business next year is that our core spending, excluding this type 2 non-intensive investment, will be up roughly 10% or nearly half the rate of revenue. So we continue on with the plan that the company had already put in place. With respect to non-intensive programs, I would say somewhere between $10 million to $20 million at this point in time is kind of where our heads are at. But at the same time, we're not going to hold back here. If we see the opportunity to really drive incremental growth and invest in the future of this company, we're going to do it. But I think that's probably the right way to frame it up at this point in time based upon what we know. The first question, again, repeat that one? Or do you have it?

好的。我先很快回答支出數字。我們一直非常致力於尋找提升營運效率的方法，公司在 2017 年整體做得非常好。你在第三季開始看到一些營運槓桿的效果顯現，第四季也再次延續。你明年在核心業務上會看到：我們的核心支出（不含這項第二型糖尿病非密集型投資）將約成長 10%，也就是大約只有營收成長率的一半。因此我們會持續推進公司既定的計畫。至於非密集型方案，我會說目前我們的想法大概在 1,000 萬到 2,000 萬美元之間。但同時，我們不會因此裹足不前。如果我們看到能真正推動額外成長、並投資於公司未來的機會，我們就會去做。但就目前我們所掌握的資訊來看，我認為這樣的框架大概是合適的。第一個問題，再說一次是什麼？還是你那邊有？

Yes, I got it. It was Medicare. You talked about Medicare in the pipeline. We're not going to go into our pipeline details anymore. We wanted to let everybody know that we had a valuable Medicare pipeline in patients who are interested. We didn't get many of the patients processed and a lot of it out of the door. Pipeline remains robust, but we're not going to break out Medicare versus commercial revenues as an ongoing thing.

有，我知道了。是 Medicare。你提到 Medicare 在管線中的情況。我們不會再進一步披露我們的管線細節。我們當時想讓大家知道，我們有一個很有價值的 Medicare 病患管線，這些病患是有興趣的。我們當時沒有處理太多病患，也沒有把很多案子推進到出貨。管線仍然強勁，但我們不會把 Medicare 與商業保險收入作為一項持續性的拆分揭露。

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

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

This is actually Alexa in for Margaret. So my first question is actually on the sales force and where the sales team is intended to focus this year. Are they more going to focus on commercial patient adds, pruning existing relationships, Medicare? And how should we think about sales force spending and presence relative to digital marketing spend throughout the year?

我是 Alexa，代替 Margaret 提問。我第一個問題是關於銷售團隊，以及今年銷售團隊預計的重點方向。他們會更聚焦於商業保險新增病患、整理/精簡既有合作關係、還是 Medicare？另外，全年來看，我們應如何思考銷售團隊的支出與人力配置，相對於數位行銷支出的比重與存在感？

Yes, this is Kevin. I can address that one. We did not expand the sales force this year from last in U.S. our commercial sales force. We feel that it's right-sized, and we feel we got a lot of inroads with physicians who we had not called on, on a regular basis last year with the expansion that we did. So we're going to keep that team the size as it is now. They will push all the business, new patients commercial, new patients Medicare. That varies a lot territory to territory. They're compensated based upon bringing new patients to us, and we know they signed a quota for peds or Medicare or adults for commercial patients. Our spend, we will continue to invest in the digital platforms. We've seen very good results in increasing awareness from our digital platforms and we're getting a lot of traction from the ad campaigns that we're running. Our biggest spend on the commercial front, quite frankly, will be the G6 launch. We've been reviewing G6 launch plans for later this year internally and the things that we want to do. That's going to be a very big dollar spend for us. And we'll attack every single avenue that we have when we get that product out there because we really believe it's a home run.

是的，我是 Kevin。我可以回應這個問題。我們今年在美國的商業銷售團隊，並沒有比去年擴編銷售人力。我們認為目前的規模剛剛好，而且我們也覺得，透過先前的擴編，我們在去年對一些過去未能定期拜訪的醫師端，取得了很多進展。所以我們會維持目前團隊的規模不變。他們會推動所有業務，包括商業保險的新病患、以及 Medicare 的新病患。這在不同區域之間差異很大。他們的獎酬是以為我們帶來新病患為基礎，我們也知道他們針對兒科、Medicare，或商業保險的成人病患，都簽有配額目標。在支出方面，我們會持續投資數位平台。我們看到數位平台在提升認知度方面有非常好的成效，而且我們正在進行的廣告活動也帶來了很大的動能。坦白說，我們在商業端最大的支出將會是 G6 的上市。我們內部一直在檢視今年稍晚的 G6 上市計畫，以及我們想做的各項事情。這對我們來說會是一筆非常大的美元支出。而當產品推出後，我們會動用我們所有可用的每一個管道去推進，因為我們真的相信這會是一個大成功。

Okay. Great. That's helpful. And...

好的。很好。這很有幫助。然後……

I'm sorry, she dropped off. Our next question comes from Kyle Rose from Canaccord.

抱歉，她掉線了。我們下一個問題來自 Canaccord 的 Kyle Rose。

So I wanted to take a step back and just ask a little bit more on the G6 side. I mean I appreciate the incremental guidance from a gross margin standpoint, and Kevin, you kind of touched on potentially increased competition leading to price pressures this year. But you're also launching the new products as far as the G6 sensor, the new applicator and new receiver, things of that sort. So just wanted to see, how we should think about those new products for -- just from a cost standpoint, particularly with the new Mesa facility coming online? And just how the G6 and the new introductions over the course of this year will set up the company from a margin perspective relative to potential price pressures we see in the market?

我想先退一步，針對 G6 方面再多問一點。我的意思是，我理解你們在毛利率角度提供的增量指引，而且 Kevin，你也提到今年可能因競爭加劇而導致價格壓力上升。但你們同時也在推出新產品，包括 G6 感測器、新的施打器以及新的接收器之類的。所以我想了解的是，從成本角度來看，特別是新的 Mesa 廠即將啟用的情況下，我們應該如何看待這些新產品？以及今年一整年 G6 與這些新產品導入，從毛利率角度來看，將如何讓公司在面對市場可能出現的價格壓力時做好布局？

Over time, we have long planned to take manufacturing cost out of our products and do things more efficiently. And G6 is going to be a result of that. For example, we have our initial launch transmitter configuration. We have a second transmitter coming not long after that, that promises a significant cost reduction with improved performance. And the way our team has developed automated lines around G6 processing, ultimately, we're very confident that even with the new applicator configuration, the cost per sensor will decrease with -- the 10-day labeled wear, we're hoping that margins are better with that. So as you add all those things up, the margin percentage over time should be the same. But you add in the variable you brought out, we're going to add some fixed costs in for the Mesa factory as we bring it online. So that will affect margins a bit negatively as we get going, we're supporting 2 facilities. But eventually, as we fill that up and volumes even out between the 2, margins will get back to where they need to be. So we've baked that into our assumptions and we'll go from there. I don't know, Quentin, if you have anything you want to add to that?

長期以來，我們一直有計畫要降低產品的製造成本，並以更有效率的方式來做事。而 G6 會是這個策略的成果。例如，我們會先以初期上市的發射器配置推出。在那之後不久，我們會推出第二代發射器，預期在效能提升的同時，能大幅降低成本。而且我們團隊已針對 G6 的製程開發自動化產線；最終我們非常有信心，即使採用新的施打器配置，單顆感測器的成本也會下降——在標示可配戴 10 天的情況下，我們希望毛利會更好。所以把這些因素加總起來，長期來看毛利率百分比應該會維持相同。但你提到的一個變數是，我們在 Mesa 工廠上線的過程中，會增加一些固定成本。因此在起步階段、同時支援兩個廠區時，毛利率會受到一些負面影響。但最終，當我們把產能填滿、兩個廠的產量趨於均衡後，毛利率會回到應有的水準。所以我們已把這些納入假設之中，接下來就按此推進。Quentin，我不知道你是否想補充？

No. I think you hit the nail in the head. Over the course of 2018, as we stand up the Mesa facility, there are going to be a bit of headwinds, and that's what our gross margin guidance contemplates, that's why we talk about it kind of in the mid upper 60s coming off of what is 68% for the 2017 year. So we're trying to dial those in and contemplate those. There's a little bit of pressure from a mix perspective. Obviously, the Medicare business, as we continue to bring new patients into that, has a lower margin profile early on and the OUS business, as it becomes a more meaningful part of the overall revenue contribution, also can weigh on the gross margin. But as you start to scale this Mesa facility into 2019 and on, and you really start to lever the fixed cost overhead that's within that facility, you see meaningful improvements in the gross margin profile over time. So I think '18 is somewhat of a transition year for us. You get into '19 and further you're going to see the cost profile of our products and what's in the product road map really start to come down.

沒有。我覺得你說得非常到位。在 2018 年的過程中，隨著我們建置 Mesa 工廠，會出現一些逆風；這正是我們毛利率指引所考量的，因此我們才會談到大約在 60% 中段到偏高區間，相較於 2017 年全年 68%。所以我們正試著把這些因素調整並納入考量。從產品組合角度也會有一點壓力。很明顯地，隨著我們持續把新病患導入 Medicare 業務，該業務在初期的毛利結構較低；而 OUS（美國以外）業務在整體營收貢獻中變得更重要時，也可能拉低毛利率。但當你開始在 2019 年及之後擴大 Mesa 工廠規模，並真正槓桿化該廠內的固定成本費用時，你會看到毛利結構隨時間出現顯著改善。所以我認為 2018 年對我們來說算是過渡的一年。進入 2019 年及更往後，你會看到我們產品的成本結構，以及產品路線圖中的成本，開始真正下降。

Great. I appreciate the color there. And then kind of dovetailing off some of the previous commentary, OUS. Just wondered if you can give us an updated view on reimbursement internationally? I mean I think last year you talked about hoping to hit your 50% of your contracted lives in Germany. Just thoughts on where we should see that number go in 2018? And then just broader thoughts on any potential reimbursement wins internationally as we move forward?

很好。謝謝你提供這些細節。接著延伸先前的一些評論，關於 OUS（美國以外）。想請問你們能否提供國際給付（reimbursement）的最新看法？我的意思是，我記得去年你們談到希望在德國達到已簽約涵蓋人數（contracted lives）50% 的目標。想請教 2018 年這個數字可能會走到哪裡？以及更廣泛地，隨著我們往前推進，國際上是否有任何潛在的給付進展可望取得？

Yes. I think, we definitely -- we ended the year north of that 50% goal in Germany and we continue to make progress kind of rounding out Germany as a whole. We've made some progress in France. We're still kind of pushing there on some of our legacy technologies. Obviously, we're in a bit of a transition phase as we look to bring G6 to market. So some of this will actually accelerate more as we launch the G6 in some of the global markets besides just the U.S. So I think you could still see some potential for a win in the U.K. We're going to launch -- as we talked about on previous calls, we're going to launch in Japan. There is currently reimbursement for a professional solution in Japan so in theory, we're launching a potential product into an already reimbursed market there, although we do think the consumer version of the product is going to be more appropriate for patients there. So there's a number of things, OUS, without giving you any detailed specific. You can see us make a couple of additional announcements later this year.

是的。我想，我們確實——我們在德國年底的成果已高於 50% 的目標，而且我們也持續在推進，讓德國整體的覆蓋更完整。我們在法國也取得了一些進展。我們仍在那邊推動一些既有技術的給付。很明顯地，隨著我們準備把 G6 推向市場，我們正處於一個過渡階段。因此，當我們在美國以外的一些全球市場推出 G6 時，其中一些進展其實會加速。我認為你們仍可能看到在英國取得一些潛在的進展。我們也將在日本上市——如同我們在先前的電話會議中提到的。日本目前對專業版解決方案已有給付，因此理論上，我們是在一個已經有給付的市場中推出潛在產品；不過我們也認為，消費者版本的產品對當地病患可能更合適。所以在 OUS 方面，有很多事情在進行中，但我不提供任何具體細節。你們可能會看到我們在今年稍晚再發布幾項額外公告。

And our next question comes from JP McKim from Piper Jaffray.

我們下一個問題來自 Piper Jaffray 的 JP McKim。

I want to touch on guidance real quick and just trying to understand the delta between this year next year. So if you finish this year at 25%, and the midpoint for next year is 18%, so the delta is around 8% in terms overall growth rate. Can you help, at least qualitatively, give us how much is that from pricing pressure, maybe more than you think or just taking into volume on the competitive side and handicapping that?

我想很快談一下指引，並試著理解今年與明年之間的差異。所以如果你們今年以 25% 收尾，而明年的中位數是 18%，那麼整體成長率的差距大約是 8%。你們能否至少從定性角度，說明這其中有多少是來自價格壓力（可能比你們預期更大），或是更多來自競爭端的量的因素，以及你們如何評估這些影響？

Yes. Well, Kevin hit a little bit on this in his prepared remarks. The volume side, the U.S. side of the business continues to be very, very healthy. The momentum coming out of Q4, we were very pleased with even into the first part of the quarter. All indications have been very strong. But given the competitive headwinds that are out there, the noise around some of our competitors and new products coming into the marketplace, other folks kind of getting their act together as we move over the course of the year, I think it's prudent for us to think about those as potential headwinds, and that's what we're trying to contemplate in our guidance. So we've talked about there being roughly 5 to 10 points of contemplation in our numbers for those associated impacts, whether it's price or competitive headwinds. If we can navigate that well, then fantastic, we really are going to be in a great position over the course of the year. If they come to fruition, then we've dialed in appropriately.

是的。嗯，Kevin 在他事先準備的發言中已稍微提到這點。在量的面向上，美國端的業務仍然非常、非常健康。從第四季延續出來的動能，我們非常滿意，甚至延伸到本季前段也是如此。所有跡象都非常強勁。但考量到外部存在的競爭逆風、圍繞部分競爭對手的雜音，以及新產品進入市場、其他業者在今年推進過程中逐步把事情做得更到位，我認為我們審慎地把這些視為潛在逆風是合理的，而這也正是我們在財測指引中試圖納入考量的部分。因此我們談到，在我們的數字中大約預留了 5 到 10 個點的考量空間，用於反映這些相關影響，不論是價格或競爭逆風。如果我們能妥善因應，那就太好了，我們在今年的進程中確實會處於非常有利的位置。如果這些因素真的發生，那我們也已經做了適當的調整。

Okay. And then just one on G6. In your early discussions, does it seem like that they will force you to shut the system off after 10 days? Or since you have the ability to maybe calibrate if you want, could have potentially run longer?

好的。接著再問一個關於 G6 的問題。在你們早期的討論中，看起來他們會要求你們在 10 天後把系統關閉嗎？還是說，既然你們具備在需要時進行校準的能力，理論上可能可以運行更久？

We are having discussions on that very subject with the agency, as we speak. And we do have -- one of the things we haven't been real public about but we can talk about on this call since you mentioned it, we did leave the opportunity for a patient if they wish to calibrate the system to go ahead and do it. We think this is very important for our IP partners to be able to calibrate their systems. And there are times and there are users who come to me directly and said, "While we appreciate no-calibration, we're going to want to be able to stick our finger in that from time-to-time just as a comfort matter. So we are going to offer that feature. We don't have final decision on shut off or not.

我們此刻正在就這個議題與主管機關進行討論。而且我們確實有——有一件我們過去沒有太公開談的事，但既然你提到了，我們在這通電話上可以談：我們保留了讓病患在他們願意的情況下，去校準系統並繼續使用的選項。我們認為這對我們的 IP 夥伴能夠校準他們的系統非常重要。也確實有一些時候、一些使用者會直接跟我說：「雖然我們很感謝免校準，但我們仍希望能不時地自己插手校準一下，作為心理上的安心。」所以我們會提供這個功能。至於是否關機，我們還沒有最終決定。

And our next question comes from Doug Schenkel from Cowen.

下一個問題來自 Cowen 的 Doug Schenkel。

This is Ryan on for Doug. I know you said you're not going to break out Medicare revenues, but it is a pretty important growth driver for 2018. Can you provide a little more color on what you saw on the quarter or so far in Q1? As well as what's embedded within your 2018 guidance?

我是 Ryan，代 Doug 提問。我知道你們說不會拆分 Medicare 的營收，但它確實是 2018 年相當重要的成長驅動因素。你們能否多提供一些細節，談談本季看到的情況或第一季迄今的表現？以及你們 2018 年指引中內含了哪些假設？

Well, with respect to Q4, I think most folks had been modeling somewhere around $10 million of revenue or so in terms of a contribution from Medicare. We'll tell you that we didn't deliver the $10 million in the quarter, but we saw a meaningful increase coming off of Q3 into Q4. So very pleased with the way that we see that business continuing to build and ramp, and as we continue to learn how to navigate it internally, the process just becomes an easier and more smooth process for us to navigate through. So you're right, it's going to be a meaningful growth driver for us in 2018, but we're not going to break that out. And you can see us talk about it, but it did uptick well in Q4, but it wasn't at the $10 million run rate that many had modeled.

嗯，就第四季而言，我想多數人原本的模型大概是把 Medicare 的貢獻估在約 1,000 萬美元左右的營收。我們可以告訴你的是，我們在該季並沒有做到 1,000 萬美元，但我們確實看到從第三季到第四季有顯著的成長。因此我們對這項業務持續建立與加速成長的態勢感到非常滿意；而且隨著我們在內部持續學習如何因應與操作，整個流程對我們而言也會變得更容易、更順暢。所以你說得沒錯，它會是我們 2018 年重要的成長驅動因素，但我們不會把它單獨拆出來揭露。你會看到我們談到它；第四季確實有不錯的上升，但並沒有達到許多人模型中假設的 1,000 萬美元運行水準。

Okay. And then on pricing, you talked about anticipating some pricing pressures in your guidance, primarily within durables. Last call, you started to talk about early discussions with U.S. commercial payers regarding pricing. Is there any -- have you had any further conversations and is there any update you can provide on how you're thinking about the longer-term outlook here?

好的。接著關於定價，你們提到在指引中預期會有一些定價壓力，主要是在耐用醫療設備（durables）方面。上一次電話會議中，你們開始談到與美國商業保險支付方就定價進行早期討論。請問——你們是否有進一步的對話？以及你們對較長期展望的思考，有沒有任何更新可以分享？

Sure. This is Kevin, I'll address that. We have had discussions with U.S. payers. And, again, even given the competitive environment, payers are very cognizant of the fact that our device is different than the ones we're competing with, and we've been able to maintain the pricing structure that we have. We'd also be foolish to say they aren't aware of the lower price models that are being offered in the category as well. Combine that with the fact the Medicare pricing model is different than anything that we've ever had in the past with respect to a subscription model, and we do see a lot of noise in the pricing world. For today, our discussions have been very good, our payer team has done a wonderful job keeping us in the right position. We have always been willing to trade price for access and simplicity in getting on the system. And so you'll see us make trades and have discussions of that nature over the course of the year. It's a very exciting time with the payers. Again, increased awareness raises all boats, and it gives us the opportunity to have a lot more candid discussions with them, and we welcome those opportunities. So, so far so good.

當然。我是 Kevin，我來回答。我們確實已與美國的支付方進行討論。而且再次強調，即便在競爭環境下，支付方也非常清楚我們的裝置與我們競爭的產品不同，因此我們得以維持目前的定價結構。但如果我們說他們不知道這個類別中也有人提供較低價的機型，那就太天真了。再加上 Medicare 的定價模式與我們過去任何模式都不同，尤其是相對於訂閱制模式而言，我們確實看到定價領域有很多雜音。就目前而言，我們的討論進展非常好，我們的支付方團隊做得非常出色，讓我們維持在正確的位置上。我們一向願意用價格去交換取得覆蓋（access）以及更簡化的上線流程。因此你會看到我們在今年過程中做出一些取捨，並進行這類性質的討論。對支付方而言，這是一個非常令人振奮的時刻。同樣地，認知度提升會讓整體水位上升，也讓我們有機會與他們進行更坦誠的對話，我們也歡迎這些機會。所以，到目前為止一切都很好。

And our next question comes from Danielle Antalffy from Leerink.

下一個問題來自 Leerink 的 Danielle Antalffy。

Just on the UNH partnership or, I guess, I should say the trial that's ongoing, can you talk a little bit about exactly what you and UnitedHealth are going to be looking for? Maybe give a little bit more color on how you -- how that should inform your go-to-market strategy for type 2 patients? And then last -- I'll call my questions at once. And then last question related to that. What we, as investors, should expect to see come out of that over the next 12 to 18 months?

想請教 UNH 的合作夥伴關係，或者我應該說正在進行的試驗：你們能否更具體談談你們與 UnitedHealth 將會觀察與評估哪些指標？也許再多提供一些細節，說明這將如何影響你們針對第二型糖尿病患者的上市（go-to-market）策略？最後——我把問題一次問完。最後一個相關問題是：在接下來 12 到 18 個月內，我們作為投資人應該期待從這項試驗中看到哪些成果？

So, Danielle, this is Steve. I'll take this one. So -- look, right -- we said this before, 2018 is very much an investment year for us and really exploring together with our partners at UnitedHealthcare what this business model might look like. The goal is obviously clear, it's to drive cost savings and improve outcomes using a variety of technologies, most importantly, CGM. So these patients will have -- they'll wear sensors, they'll have activity tracking data. You saw Fitbit talked about us a little bit in their call. I think it was yesterday. Will have diet, exercise information; will have some real-time coaching. So there's a combination of inputs, and the goal here is to develop a program with the business model that works that we can invest in these patients a little bit and then in the back end, save a bigger chunk of money, whether it's on revisiting their current drug regimen, preventing them from having to go on additional drugs, et cetera. So the type 2s are extraordinarily costly to the system, and as the key sensing component, I mean, we think we're adding the most value to this program. I would tell you, just it really is too early today to try to pin down what the business model is going to look like for us. It'll evolve, out of this, we talked about doing initially about 10,000 patients. It'll really evolve out of that. We'll have to give you guys more color as it evolves.

Danielle，我是 Steve。這題我來回答。所以——你看，對——我們之前說過，2018 年對我們來說非常像是一個投資年，我們會與 UnitedHealthcare 的夥伴一起探索這個商業模式可能長什麼樣子。目標顯然很清楚：運用多種技術、最重要的是 CGM，來推動成本節省並改善結果。因此這些病患會——他們會配戴感測器，也會有活動追蹤資料。你們也看到 Fitbit 在他們的電話會議中稍微提到我們。我想是昨天。也會有飲食、運動資訊；也會有一些即時教練式指導。所以這裡是多種輸入的組合，而目標是建立一個可行的方案與商業模式：我們可以在前端對這些病患多投入一些，然後在後端節省更大一塊成本，例如重新檢視他們目前的用藥方案、避免他們必須再加用其他藥物，等等。所以第二型糖尿病患者對整個體系而言成本極高，而作為關鍵的感測元件，我們認為我們為這個方案帶來了最大的價值。我會告訴你，就目前來說，現在要精確界定我們的商業模式會長什麼樣子，真的還太早。它會逐步演進；我們談過一開始大約做 10,000 名病患。它會在那之後逐步演化。隨著進展，我們會再提供各位更多細節。

And our next question comes from Matt Taylor from Barclays.

我們的下一個問題來自巴克萊（Barclays）的 Matt Taylor。

So I want to ask you about the G6 launch and what you're assuming there. And, I guess, the core of my question is, we've always assumed that you going to no coverage would be a big deal. So I wouldn't think you would argue with that. But could you compare this launch and what you're expecting with G6, assuming it does come mid-year, would there be some initial stocking? And what kind of uptake you think you could drive out of the gate given that big change?

我想請教你們關於 G6 上市以及你們在那方面的假設。我想，我問題的核心是，我們一直假設你們轉向「無需保險給付／無需保險涵蓋」會是件大事。所以我想你們不會反對這點。但你能否比較一下這次上市，以及你們對 G6 的預期？假設它確實在年中推出，是否會有一些初期鋪貨？而且在這個重大改變之下，你們認為一開始就能帶動多大的採用／導入速度？

This is Kevin. I'll take that one. I'll answer it the easiest way I can. I got an e-mail from the parent of a patient today whose child had been on G6 study. The child won't go back to G5. The child wants G6 and we don't have it available yet, and the parent asked, "Is there anything we can do to get back on the system that my child wants to wear?" We think there will be a big uptick, and we think this will be a very exciting launch for us. This is the first all-of-world launch we've ever tried. And I think you all should be cognizant of the fact that this isn't just a new algorithm or it isn't just a new sensor, this is a new everything. The sensor is new, the membranes are new, that applicator is new, the manufacturing processes are different, the algorithm is different, the calibration scheme is different, everything across the board is different than anything we've ever done before. We keep our distributors on a very -- and there, we have great relationships with them. They don't get much past a month of inventory. So there's not going to be a big stock-up opportunity of G6. And in fact, as we see G5 winding down, the beauty of having a 3-month transmitters, they can sell out their G5 stock as these patients have their transmitters that expire and then we can do a very natural shift over to the G6 platform for our patients. So we don't see there's a -- going to be a big stock-up opportunity of this per se, and we really haven't had that with any of our launches. But we will roll it out, and we will have to go get reimbursement contracts across the board. We'll have to get a new Medicare contract for G6 because it's a different product than G5. So there will be a lot of work to do that we have lined out and laid out upon approval. We can't do all this now until we have the product out available in the market. But I can tell you, the response in the community is going to be superb. We're really bullish about this.

我是 Kevin。我來回答這題。我會用我能想到最簡單的方式回答。我今天收到一位病患家長的電子郵件，他的小孩曾參與 G6 的研究。那孩子不會再回去用 G5。孩子想要 G6，但我們目前還沒有供貨，家長問：「我們有什麼辦法可以回到我孩子想戴的那套系統上嗎？」我們認為會有很大的採用增長，我們也認為這會是一次非常令人振奮的上市。這是我們第一次嘗試「全球同步」的上市。我想各位也應該注意到，這不只是新的演算法，也不只是新的感測器，這是「全新的一切」。感測器是新的、薄膜是新的、施用器是新的、製造流程不同、演算法不同、校正方案不同，全面來說都和我們過去做過的任何產品不同。我們對經銷商的庫存管理非常——而且我們和他們的關係非常好。他們的庫存通常不會超過一個月。所以不會有很大的 G6 囤貨機會。事實上，當我們看到 G5 逐步退場時，3 個月效期的發射器的好處在於：當病患的發射器到期時，經銷商可以把 G5 庫存自然賣完，然後我們就能讓病患非常自然地轉移到 G6 平台。因此我們不認為會有所謂很大的囤貨機會，而且我們過去任何一次上市其實也沒有出現過那種情況。但我們會逐步推進上市，同時我們必須全面去取得各項給付／報銷合約。我們也必須為 G6 取得新的 Medicare 合約，因為它和 G5 是不同的產品。所以在核准之後，會有很多工作要做，我們已經把這些工作規劃並安排好了。在產品尚未真正上市、可在市場取得之前，我們現在還無法把這些事情全部完成。但我可以告訴你，社群的反應會非常棒。我們對此非常樂觀。

And you've consistently said that you're going to give us more updates on your next-gen product with we Verily, we get more clarity on when G6 is coming out. Is that still your approach, and when might we see more about that system in terms of form and its function?

你們一直表示，隨著我們對 G6 何時推出有更清楚的掌握，你們會就與 Verily 合作的下一代產品提供更多更新資訊。這仍然是你們的做法嗎？以及我們大概何時能看到更多關於該系統在外形與功能方面的資訊？

Well, the first Verily system is a derivative of G6. It has a G6 sensor and it has the same algorithm as the G6 system has. It is a 14-day use. We have plans over time to take our 10-day G6 out to 14 days as well. And so a lot of that is going to be interconnected. Once we get G6 approved and get through all of our discussions with the FDA on no-calibrations, we'll immediately go back there and say, "Okay, here's our plan to get to 14 days with a new system," and go from there. But activities as far as finalizing the design, validating and verifying the system and making sure it works properly are going on as we speak. Everybody is very busy with the first Verily system and our 14-day version of G6, while at the same time I'm asking them to work over time to do the G6 launch. So we're busy here with all that stuff, and you will hear more as the year goes on.

嗯，第一代 Verily 系統是從 G6 衍生而來的。它使用 G6 感測器，且採用與 G6 系統相同的演算法。它是 14 天使用期。我們也計畫隨時間推進，將我們 10 天使用期的 G6 延長到 14 天。所以其中很多事情會彼此連動。一旦我們取得 G6 核准，並且完成與 FDA 就「免校正」的所有討論，我們會立刻回去說：「好，這是我們用新系統達到 14 天的計畫」，然後從那裡往下推進。但就定案設計、系統驗證與確認（validation/verification），以及確保其正常運作等活動而言，我們此刻正在進行。每個人都非常忙於第一代 Verily 系統與我們的 14 天版 G6，同時我也要求他們持續投入 G6 的上市工作。所以我們在這些事情上都很忙，而隨著今年進展，你們會聽到更多消息。

And our next question comes from Steven Lichtman from Oppenheimer.

我們的下一個問題來自奧本海默（Oppenheimer）的 Steven Lichtman。

I was wondering if you can highlight what direct-to-patient initiatives we should see from you guys this year? And will you look to increase your sales force this year?

我想請問你們能否重點說明一下，今年我們應該會看到你們有哪些直接面向病患（direct-to-patient）的計畫？另外，你們今年會考慮擴增銷售團隊嗎？

The sales force, we're not looking to increase the U.S. commercial force this year. There are some geographies overseas where we will increase our sales force. We have a couple of direct-to-market opportunities where we will increase our presence, but it's not huge hires. We did a German expansion late in 2017, and that force is up in the 20s now in Germany. So that's a good-sized group there. As far as our DTC campaigns, again, we're very focused on different age groups. We have messages for parents and kids. We have messages for adults. We have messages for our seniors. We will ramp that up significantly with the G6 launch, but I can't give you all the details because then I'd be letting the cat out of the bag. So I'll stop.

關於銷售團隊，我們今年不打算擴增美國的商業銷售團隊。在海外有些地區我們會增加銷售人力。我們有幾個直接進入市場（direct-to-market）的機會，會提升我們的在地能見度，但招募規模不大。我們在 2017 年底於德國擴張，而目前德國團隊人數已到 20 多人。所以那邊是一個相當有規模的團隊。至於我們的 DTC（直接面向消費者）行銷活動，同樣地，我們非常聚焦於不同年齡層。我們有給家長與孩子的訊息。我們有給成人的訊息。我們有給高齡族群的訊息。我們會在 G6 上市時大幅加強這些活動，但我不能把所有細節都告訴你，否則就等於洩底了。所以我就先到這裡。

Okay. And then, Kevin, you mentioned some app enhancements with what sounds like some more alerts and alarms, flexibility for patients. Can you talk a little bit more about that, what that will mean for patient?

好的。另外，Kevin，你提到一些 App 的強化，聽起來像是會有更多提醒與警報，並提供病患更多彈性。你能否再多談一點這部分，這對病患意味著什麼？

This is very cool. There are 2 things that are in the new app, and kudos to our team for getting this app. We went -- when we've got non-adjunctive, based on several discussions, we decided that it was bad to override -- to not have the thing alarm all the time on your phone. So we overrode the mute button, and I had an attorney come in here one day explained to me that while he was doing closing arguments with the Jury, his alarm on his phone would not stop and please, will you fix this? And we got -- and I'll count it, we got 80% positive feedback on the mute override, but 20% negative. We now have a feature in the app where you can -- I think it's called you -- the app will run as the phone runs. So you turn that on and it's going to run just like your phone does, and it will mirror the phone. With respect to the alerts and the alarms, we call them flexible alerts and flexible alert schedules. So if you're a patient. During the day, if you want your high or low alerts to be at 1 level, you can set them. And then when you go to bed at nighttime, one of the feedbacks we got from our patients, for example, they might set their low alert a little higher while they're sleeping than they will during the day because they want to be woken up if they're turning down low very quickly. They also might set the high alert even higher because they don't want to have to wake up if they go above 250 while they're sleeping. So what we're going to do is give patients the flexibility to set an alert schedule that goes more with their lifestyle. There's another alarm in the G6 system coming out that is a predictive low glucose event that will -- patients will be able to use and that will basically give them 20 minutes warning -- I think 20 minutes or 30 minutes before they hit the low 55 threshold rather than waiting till they get down below a specific number, which we have got feedback in our studies has been very useful and very well accepted with patients. So this app format is going to give us a lot of flexibility in the future to give patients the features they want. And these, all 3 of these features are things that patients have asked for. So we are responding to what people really need.

這真的很酷。新 App 裡有兩項新功能，也要稱讚我們的團隊把這個 App 做出來。我們曾經——在多次討論後，基於一些非輔助性的考量，我們認為不應該覆寫——也就是不要讓手機上的提醒一直響個不停。所以我們覆寫了靜音鍵；有一天我請了一位律師來這裡，他跟我解釋說，他在陪審團面前做結案陳詞時，手機鬧鐘一直停不下來，拜託你們修一下好嗎？而我們——我算過了，對於靜音覆寫這件事，我們收到 80% 的正面回饋，但也有 20% 的負面回饋。我們現在在 App 裡加入了一個功能，你可以——我想它叫做——讓 App 依照手機的運作方式來運行。你把它打開後，它就會像你的手機一樣運作，並且會鏡像手機的設定。至於提醒與警報，我們稱之為彈性提醒（flexible alerts）與彈性提醒排程（flexible alert schedules）。所以如果你是一位病患。白天如果你希望高或低的提醒設定在某個門檻，你可以自行設定。然後當你晚上上床睡覺時，我們從病患那裡收到的回饋之一是，例如，他們在睡覺時可能會把低血糖提醒設得比白天更高一些，因為如果血糖快速下降到很低，他們希望能被叫醒。他們也可能把高血糖提醒設得更高，因為睡覺時如果血糖超過 250，他們不想因此被吵醒。所以我們要做的是，讓病患能更有彈性地設定符合其生活型態的提醒排程。G6 系統還會推出另一個警報：預測性低血糖事件警報，病患將能使用；它基本上會在血糖降到低血糖 55 的門檻前提供 20 分鐘——我想是 20 或 30 分鐘——的預警，而不是等到血糖已經低於某個特定數值才提醒。我們在研究中收到的回饋顯示，這非常有用，也很受病患接受。因此，這種 App 形式將在未來給我們很大的彈性，去提供病患想要的功能。而這三項功能都是病患提出需求的。所以我們是在回應人們真正需要的東西。

And our next question comes from Jayson Bedford.

下一個問題來自 Jayson Bedford。

I just want to follow up on a comment earlier, Kevin, on new payer contracts associated with G6. Is this something that you'll have in place upon approval? Or will this -- these -- would there be a bit of a delay here before these payer contracts are in place?

我想跟進一下你先前的評論，Kevin，關於與 G6 相關的新付款方合約。這會是在核准時就到位嗎？還是說——這些——在這些付款方合約到位之前會有一些延遲？

It all varies payer to payer. We have some relationships where we can go immediately. We have others where we have to put a new contract in place with the 10-day device and that I believe we'll have to have pricing discussions. So I would imagine, we're going to want to get in front of every payer anyway because this system is such a step up from what we've had before, we want to increase access and make it available to more patients. So the way I look at it is we're going to make this as big event as possible and try -- I want to get in front of all of them. I don't want to just get in front of a few. All of our launches have been like this. We went from G4 to G5, and we suddenly had 4 transmitters a year instead of 2 transmitters a year. And with 7-plus, we had 1 transmitter a year and then to 2. All of this stuff does take time to go through our system. But we're pretty experienced with it and we definitely have a battle plan as to who we're going to call and when and how we're going to get out there. All those steps are being outlined, as we speak.

這會因付款方而異。有些合作關係我們可以立刻推進。也有一些我們必須針對 10 天裝置簽訂新合約，我認為那就需要進行價格討論。所以我想，不管怎樣我們都會希望與每一個付款方先行溝通，因為這套系統相較於我們之前的產品是很大的升級；我們希望提升可近性，讓更多病患能使用。所以我的看法是，我們會把這件事做成一個盡可能大的事件並且——我想要跟所有付款方都先談。我不想只跟少數幾家談。我們所有的上市推進都是這樣做的。我們從 G4 到 G5 時，一年突然變成需要 4 個發射器，而不是 2 個。而在 7-plus 時，我們一年 1 個發射器，後來又變成 2 個。這些事情確實都需要時間在我們的系統裡走完流程。但我們在這方面很有經驗，而且我們確實有一套作戰計畫：要聯絡誰、何時聯絡、以及如何推進。這些步驟此刻都正在規劃中。

Okay. And just following-up on Medicare and kind of the use of the app. Is this dynamic slowing adoption and should we look at it as, as this constraint is lifted, you would look for an acceleration in your Medicare business?

好的。再跟進一下 Medicare 以及 App 使用的部分。這樣的情況是否正在放慢採用速度？我們是否應該這樣看：當這個限制解除後，你們的 Medicare 業務會加速成長？

I don't know that it's necessarily slowing adoption. I certainly would love the opportunity to market the connectivity feature of Medicare and be able to go to the senior community and say, "If you have diabetes and you suffer from hypoglycemia unawareness, your caretakers can now follow you and find out." We can't say that right now. I would love to be able to say that message, and my own personal gut feel is that certainly would enhance our ability to market to Medicare patients. But I have nothing quantitatively to build on that other than my own thoughts.

我不確定這是否真的在放慢採用速度。我當然很希望有機會向 Medicare 市場行銷連線功能，並能對高齡族群說：「如果你有糖尿病且有低血糖無感知，你的照護者現在可以追蹤你並了解狀況。」但我們目前還不能這麼說。我很希望能傳達這個訊息；就我個人的直覺而言，這確實會提升我們對 Medicare 病患的行銷能力。但除了我自己的想法之外，我沒有任何量化數據可以支持。

And we have no more questions at this time. I'll now hand the call back to Kevin for closing comments.

目前沒有更多問題。我現在把電話交回給 Kevin 做結語。

Well, thanks, everybody, for participating today. As we ramp up our discussion on 2017, I really like to celebrate a few of our accomplishments this year and how hard everybody worked to achieve them. We initiated to launch as a direct supplier into the Medicare community with a completely different reimbursement model than we've ever had before. And trust me, this has been a huge undertaking all the while, while continuing to drive our U.S. commercial growth and manage our current patient base. Our international growth exceeded our expectations and really demonstrated a return on the expansion efforts that we've carried out over the past 2 years in a very competitive environment.

好的，謝謝各位今天的參與。在我們逐步加深對 2017 年的討論之際，我很想慶祝今年幾項成果，以及大家為達成這些成果所付出的努力。我們啟動了以直接供應商身分進入 Medicare 社群的上市計畫，採用的是一個與我們過去完全不同的給付模式。相信我，這是一項龐大的工程；同時我們還要持續推動美國商業市場的成長，並管理我們現有的病患基礎。我們的國際成長超出預期，也在競爭非常激烈的環境中，真正展現了過去兩年擴張投入所帶來的回報。

We achieved a whole bunch of milestones on other key initiatives as well, including our data platform with the API infrastructure that we're now offering to potential software partners; expanded manufacturing in our new Arizona facility. This should be up running in 2018. We plan for our future and execute it at the same time. And finally, our early success in developing a non-intensive strategy.

我們在其他關鍵計畫上也達成了許多里程碑，包括我們的資料平台與 API 基礎架構，現在已提供給潛在的軟體合作夥伴；以及在亞利桑那州新廠擴大製造。這應該會在 2018 年開始運轉。我們一邊規劃未來，一邊同步執行。最後，還包括我們在發展非密集（non-intensive）策略上的早期成功。

We believe, we're very well set up for success in 2018. Our expectations here are always high, especially with this new product launch coming, this is going to be the biggest ever than we've ever had. There are many variables in play, but at the end of the day, the CGM market stands to grow significantly in coming years. And as I look at the market space, and my other takeaway from ATTD that I told everybody, I can truly see a day when we can eliminate fingersticks and improve access and expand awareness for these devices. And as the leader in real-time CGM with our product offerings in our pipeline, we're going to be able to lead this category to the standard of care in diabetes treatment. Thank you.

我們相信，我們已為 2018 年的成功做好非常充分的準備。我們對自己的期待一向很高，尤其是即將到來的這次新產品上市，這將會是我們史上最大的一次。雖然有許多變數，但歸根結底，CGM 市場在未來幾年有望顯著成長。而當我看這個市場空間，以及我在 ATTD 跟大家分享的另一個心得時，我確實能看到有一天我們可以消除指尖採血，提升可近性，並擴大對這些裝置的認知。作為即時 CGM 的領導者，憑藉我們現有產品與研發管線中的產品，我們將能帶領這個類別成為糖尿病治療的照護標準。謝謝。

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

也謝謝各位女士、先生。今天的電話會議到此結束。感謝參與。您現在可以掛線。