德康醫療 (DXCM) 2018 Q2 法說會逐字稿

Hello, and welcome to the DexCom Second Quarter 2018 Earnings Release Conference. My name is Michelle, and I will be your operator for today's call. (Operator Instructions) Please note that today's conference is being recorded.

各位好，歡迎參加 DexCom 2018 年第二季財報發布電話會議。我叫 Michelle，將擔任今天電話會議的接線員。(接線員指示) 請注意，今天的會議將被錄音。

I will now turn the call over to Mr. Matt Dolan, Vice President of the Corporate Development. Sir, you may begin.

現在我將把電話交給企業發展副總裁 Matt Dolan 先生。先生，您可以開始。

Thank you, operator, and welcome to DexCom's Second Quarter 2018 Earnings Call. Our presentation today will begin with Kevin Sayer, DexCom's Chairman, President and CEO; followed by Quentin Blackford, our Executive Vice President and Chief Financial Officer; and Steve Pacelli, our Executive Vice President of Strategy and Corporate Development. We will begin with our prepared remarks, and then Kevin will conclude, and open the call up for your questions. (Operator Instructions)

謝謝接線員，歡迎各位參加 DexCom 2018 年第二季財報電話會議。今天的簡報將由 DexCom 董事長、總裁暨執行長 Kevin Sayer 開場；接著是執行副總裁暨財務長 Quentin Blackford；以及策略與企業發展執行副總裁 Steve Pacelli。我們將先進行事先準備的發言，之後 Kevin 將作結並開放各位提問。(接線員指示)

I will begin with our safe harbor statement. 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.

我先宣讀我們的安全港聲明。我們在今天電話會議中所做的部分陳述，可能構成前瞻性陳述。這些陳述反映管理層對未來事件、策略、競爭、產品、營運計畫與績效的意圖、信念與預期。本簡報所包含的所有前瞻性陳述，均以本簡報日期為準，係基於 DexCom 目前可得資訊作出，並受各種風險與不確定性影響；實際結果可能與前瞻性陳述所預期者有重大差異。

The factors that could cause actual results to differ materially from those expressed or implied by any of these forward-looking statements are detailed in DexCom's annual report on Form 10-K, 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.

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 季度報告及其他向美國證券交易委員會提交的文件中。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，或使該等前瞻性陳述與實際結果一致的義務。

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

此外，在本次電話會議中，我們將就非 GAAP 與以現金為基礎的結果，討論若干未依 GAAP 編製的財務衡量指標。此等補充資訊之呈現不應被單獨看待，亦不應作為依 GAAP 編製之結果的替代，或被視為優於依 GAAP 編製之結果。請參閱我們的財報新聞稿及公司網站投資人關係專區中的表格，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。

With that, I will turn it over to Kevin.

接下來，我把電話交給 Kevin。

Thank you for joining us today. Before we jump into the quarter and our outlook, I would like to address the additional press release we issued after the close. Terry Gregg, our Executive Chairman, is retiring, and our board has appointed me to assume the role of Chairman. I am honored to expand the scope of my responsibilities to DexCom and believe we are making this transition from a position of strength, as you can see in the results we just released. For the many analysts, investors, clinicians, patients and colleagues who know Terry, it goes without saying that he's had an immeasurable impact on both DexCom and the diabetes industry.

感謝各位今天加入我們。在我們進入本季表現與展望之前，我想先說明我們在收盤後發布的另一則新聞稿。我們的執行董事長 Terry Gregg 即將退休，董事會已任命我接任董事長一職。我很榮幸能擴大我在 DexCom 的職責範圍，並相信我們是在強勢的基礎上完成這次交接，正如各位從我們剛發布的業績中所見。對於許多認識 Terry 的分析師、投資人、臨床醫師、病患與同仁而言，不言而喻，他對 DexCom 以及糖尿病產業都產生了無可估量的影響。

Terry joined DexCom's Board of Directors in 2005, served our CEO from June 2007 through January 2015 and has been our Executive Chairman since then. This transition is the final step in a vision we shared when I became President of the company in 2011.

Terry 於 2005 年加入 DexCom 董事會，自 2007 年 6 月至 2015 年 1 月擔任我們的執行長，之後一直擔任執行董事長至今。這次交接是我在 2011 年成為公司總裁時，我們共同分享之願景的最後一步。

Terry and I have worked together in this industry for a long time, and this incredible chapter of DexCom is one that I will cherish forever. The company and I wish Terry and his family an enjoyable and well-deserved retirement. If Terry were here participating with us, he would undoubtedly say, "Enough already. Get on with the quarterly report."

Terry 和我在這個產業合作已久，而 DexCom 這段精彩篇章將是我永遠珍惜的回憶。公司與我衷心祝福 Terry 與家人享受愉快且實至名歸的退休生活。如果 Terry 今天也在場與我們一同參與，他肯定會說：「夠了夠了。快進入季度報告吧。」

And what a quarter it was. I'm proud to say that we posted another record revenue performance, with sales up 42% over the same period last year. Not only did we exceed our annual growth guidance for the second consecutive quarter, but the business continues to accelerate. All of our key segments demonstrated strong year-over-year growth, with U.S. and OUS revenues up 35% and 78%, respectively.

而這確實是一個精彩的季度。我很自豪地宣布，我們再次創下營收新高，銷售額較去年同期成長 42%。我們不僅連續第二個季度超越全年成長指引，而且業務仍在加速成長。我們所有主要業務區塊均展現強勁的年增率，美國與美國以外（OUS）營收分別成長 35% 與 78%。

From a profitability perspective, DexCom continues to demonstrate leverage as revenue growth outpaced the increase in operating expenses by more than 2x for the first half of the year. Quentin will provide you with more detail around our financial performance and outlook in a moment.

從獲利能力角度來看，DexCom 持續展現營運槓桿效益，上半年營收成長速度超過營運費用增幅逾 2 倍。稍後 Quentin 將就我們的財務表現與展望提供更詳細的說明。

As I left the American Diabetes Association conference in Orlando late in the quarter, it was apparent that CGM awareness and acceptance is stronger than ever, and this trend is driving our growth globally. Looking ahead, we believe innovations like the Dexcom G6 will continue to push CGM toward the standard of care for intensive insulin management. As many of you that attended ADA could see, we generated significant excitement around our G6 platform, which was unveiled at the meeting late in the quarter.

在本季接近尾聲時，我離開於奧蘭多舉行的美國糖尿病協會（ADA）年會時，很明顯地看到，市場對連續血糖監測（CGM）的認知與接受度比以往任何時候都更強，而這股趨勢正推動我們在全球的成長。展望未來，我們相信像 Dexcom G6 這樣的創新，將持續推動 CGM 成為密集胰島素管理的照護標準。如同許多出席 ADA 的各位所見，我們在會議接近季末時揭露的 G6 平台引發了高度關注與熱烈回響。

By combining market-leading performance with a leap forward in user experience, feedback on G6 has been unambiguously positive so far. As we have said in the past, G6 represents the most important and complex launch in our history, highlighted by the new applicator, improved form factor, and market-leading performance, all without fingerstick calibrations. We are well positioned and the team remains intently focused on launching our new G6 system.

透過結合市場領先的效能與使用者體驗的大幅躍進，目前對 G6 的回饋明確且正面。如同我們過去所說，G6 是我們歷史上最重要且最複雜的一次上市，亮點包括全新施打器、改良的外形設計，以及市場領先的效能，而且完全不需要指尖採血校正。我們已做好充分準備，團隊也持續高度專注於推出全新的 G6 系統。

Interest for DexCom CGM across both G5 and G6 has been strong to date, and as a result, we have increased our growth outlook for 2018. However, strong demand has driven delays in processing and fulfilling orders. To our patient and physician customers, please rest assured the team is working around the clock to get product to you.

截至目前，市場對 DexCom CGM（涵蓋 G5 與 G6）的需求一直很強勁，因此我們上調了 2018 年的成長展望。然而，強勁需求也導致訂單處理與出貨履約出現延遲。對我們的病患與醫師客戶，請放心，團隊正日以繼夜地努力，盡快將產品交付到您手中。

Although we had originally planned for a G6 launch in the second half of the year, after the March approval, we recognized the importance of the G6 offering and made the decision to get this product into customers' hands as soon as possible. This has put a strain on the organization on a number of fronts, but we expect to get ahead of this by the end of third quarter.

雖然我們原先規劃在下半年推出 G6，但在 3 月獲得核准後，我們認知到 G6 產品的重要性，並決定盡快讓客戶拿到這項產品。這在多個面向對組織造成壓力，但我們預期在第三季末前可望趕上並改善。

Reflecting on the first half of the year, we have had a fabulous 6 months, exceeding our growth targets while continuing to demonstrate leverage. I'm particularly impressed by our performance in light of the fact that we were only 3 weeks into the G6 launch during the second quarter.

回顧上半年，我們度過了非常出色的 6 個月，在持續展現槓桿效益的同時，也超越了成長目標。尤其令我印象深刻的是，考量到第二季期間我們才剛進入 G6 上市的第 3 週，仍能交出這樣的表現。

With that, I will now turn the call over to Quentin for a view of our financials.

接下來，我把電話交給 Quentin，請他說明我們的財務概況。

Thank you, Kevin. Today, we reported worldwide revenue of $243 million for the second quarter of 2018 compared to $171 million for the same quarter in 2017, representing growth of 42% on a reported basis or 41% excluding the impact of currency, a meaningful acceleration in our growth profile as the awareness of the value of CGM continues to be understood by the diabetes community.

謝謝你，Kevin。今天我們公布 2018 年第二季全球營收為 2.43 億美元，相較於 2017 年同季的 1.71 億美元，按報告基礎計算成長 42%；若排除匯率影響則成長 41%。隨著糖尿病社群對 CGM 價值的認知持續加深，我們的成長動能出現顯著加速。

As Kevin mentioned, this acceleration comes just as we begin to introduce G6, which only launched in the last month of the quarter. The teams have done a tremendous job and I congratulate each of them on driving outstanding results, and note that each of the key growth categories we called out at the beginning of the year improved in the second quarter, after what was already a very strong first quarter. U.S. revenue again accelerated, growing at its fastest pace in nearly 2 years at 35% over the comparable quarter a year ago driven by both of our commercial and Medicare businesses.

如 Kevin 所提到的，這波加速正好發生在我們開始導入 G6 之際，而 G6 也僅在本季最後一個月才剛上市。各團隊表現非常出色，我要恭喜每一位同仁推動了亮眼成果；並且要指出，我們在年初點名的每一個關鍵成長類別，在第二季都較第一季（而第一季本已非常強勁）進一步改善。美國營收再度加速成長，在近 2 年來以最快速度成長，較去年同期成長 35%，成長動能來自我們的商業保險與 Medicare 業務。

The international business increased 78% year-over-year on a reported basis or 71% excluding the impacts of currency, while all international regions performed very well, the focused efforts of our teams in our direct markets are driving the overall strength in our international results. And importantly, growth from global sensor and other revenue continued to accelerate and was up 47% over Q2 2017, the fastest pace of growth in more than 2 years.

國際業務以申報口徑年增 78%，若排除匯率影響則年增 71%；同時所有國際區域表現都非常出色，我們團隊在直營市場的聚焦努力正帶動國際業績的整體強勁表現。更重要的是，全球感測器及其他營收的成長持續加速，較 2017 年第二季成長 47%，為超過 2 年來最快的成長速度。

Our second quarter gross profit was $154 million, generating a gross margin of 63.3% compared to a gross margin of 68.9% in the same quarter last year. Gross margin experienced approximately 320 basis points of pressure from some nonrecurring expenses as we ramped production volumes more quickly than anticipated due to extraordinary demand, including the startup of our Mesa, Arizona facility, and an earlier-than-anticipated G6 launch, which resulted in unexpected excess in obsolete charges related to our G5 hardware. Importantly, excluding these near-term impacts, our underlying gross margin for the second quarter remained in line with our prior expectations, which contemplated some expected reduction in gross margin versus the prior year as a result of a greater mix of revenues coming from our lower gross margin international and Medicare businesses.

我們第二季毛利為 1.54 億美元，毛利率為 63.3%，相較去年同期毛利率 68.9%。由於非經常性費用，毛利率約承受 320 個基點的壓力；原因在於面對異常強勁的需求，我們將產量提升速度快於預期，包括亞利桑那州梅薩（Mesa）廠的啟用，以及 G6 上市時間早於預期，導致與 G5 硬體相關的過時存貨費用出現非預期的超額。重要的是，若排除這些短期影響，第二季的基礎毛利率仍符合我們先前的預期；該預期已考量到相較前一年毛利率可能下滑，主因是營收組合中來自毛利率較低的國際與 Medicare 業務占比提高。

As presented in the tables of our press release, international revenue represented 22% of our global revenue, its highest contribution to date and continues to be a primary area of focus for us where CGM is still significantly underpenetrated. Average sensor pricing by channel continued to be consistent in the quarter.

如同我們新聞稿表格所示，國際營收占全球營收的 22%，為迄今最高貢獻度；這也持續是我們的主要聚焦領域，因為 CGM 在國際市場的滲透率仍明顯不足。本季各通路的平均感測器定價維持一致。

Operating expenses were $159 million for Q2 2018 compared to $131 million in Q2 2017. This reflects an increase of 21% year-over-year and compares favorably to our 42% revenue growth in the quarter. For the first half of the year, we have realized top line growth of 36%, while operating expenses have grown at less than half of that rate at 16%. This represents incremental leverage of more than 1,000 basis points versus the prior year, while at the same time, we continue to invest in our strategic priorities.

2018 年第二季營業費用為 1.59 億美元，對比 2017 年第二季為 1.31 億美元。這反映年增 21%，相較本季 42% 的營收成長，表現更為有利。就上半年而言，我們的營收（top line）成長達 36%，而營業費用僅以 16% 的速度成長，不到營收成長率的一半。這代表相較前一年增加超過 1,000 個基點的槓桿效益，同時我們仍持續投資於策略性優先事項。

Adjusted EBITDA, which excludes the impact of share-based compensation and $43 million of investment income, was $27.4 million or 11% of revenue for the second quarter. Our GAAP net income was $30 million or $0.34 per share. Adjusting to exclude the investment income previously noted and $3 million of noncash interest expense related to our convertible notes, non-GAAP net loss was $9 million or a $0.10 loss per share.

調整後 EBITDA（排除股份基礎給付影響及 4,300 萬美元投資收益）為 2,740 萬美元，占第二季營收的 11%。依 GAAP 計算的淨利為 3,000 萬美元，或每股 0.34 美元。若調整排除前述投資收益，以及與可轉換公司債相關的 300 萬美元非現金利息費用，則非 GAAP 淨損為 900 萬美元，或每股虧損 0.10 美元。

Our balance sheet remains strong, having ended the quarter with $606 million in cash and equivalents and our $200 million revolving line of credit is still available.

我們的資產負債表仍然穩健，本季末現金及約當現金為 6.06 億美元，且 2 億美元的循環信用額度仍可動用。

Looking to 2018, our first half performance has exceeded our expectations and we now anticipate total revenue of approximately $925 million for the year or growth of 29% versus our original and prior guidance of 15% to 20%.

展望 2018 年，我們上半年表現超出預期，因此我們現在預估全年總營收約為 9.25 億美元，較原先及先前指引的 15% 至 20% 成長，上修至年增 29%。

With this outlook, we continue to consider a number of variables in the second half including the potential impact of pricing, channel mix shifts and competitive dynamics. For the rest of the P&L, we now anticipate a gross margin of around 64% for 2018, which now contemplates the impact of the factors I mentioned earlier. These issues will be remedied over the course of the remainder of the year, but considering the stronger demand, we have made the decision to prioritize our customers receiving product that has slowing production to address these inefficiencies in the near term. Our gross margin outlook assumes the third quarter will remain under pressure from these items and rebound in the fourth quarter.

在此展望下，我們仍持續考量下半年多項變數，包括定價的潛在影響、通路組合變化以及競爭態勢。就損益表（P&L）其餘項目而言，我們目前預期 2018 年毛利率約為 64%，此預期已納入我先前提到的因素影響。這些問題將在今年剩餘期間逐步改善；但考量需求更為強勁，我們決定優先確保客戶能收到產品，因此短期內放慢生產節奏，以處理這些效率不彰的問題。我們的毛利率展望假設第三季仍將受上述因素壓抑，並在第四季回升。

We now anticipate that core operating expenses will increase by approximately 14%, up from our original guidance of a 10% increase, which is primarily driven by the much stronger top line performance and the impact on the associated variable cost of the business. This excludes any additional spend associated with our non-intensive efforts.

我們目前預期核心營業費用將增加約 14%，高於原先指引的 10% 增幅；主要由更強勁的營收表現，以及對應的業務變動成本影響所驅動。此預期不包含與我們非密集型（non-intensive）工作相關的任何額外支出。

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

接下來，我將把電話會議交給 Steve，請他提供策略更新。

Thank you, Quentin. DexCom had a number of important strategic wins late in the quarter. We received a CE Mark for G6 and we are currently formulating our OUS launch plans for the balance of the year. We were also very excited to learn that Medicare made the decision to allow patients to use their mobile devices, together with their DME receivers, to view and share their CGM data. This is a great win for patients and their caregivers, and we applaud CMS for understanding the importance of data sharing for real-time CGM.

謝謝你，Quentin。DexCom 在本季後段取得多項重要的策略性勝利。我們取得了 G6 的 CE 認證，目前正規劃今年剩餘期間的 OUS（美國以外）上市計畫。我們也非常振奮地得知，Medicare 決定允許病患使用其行動裝置，搭配其 DME 接收器，來檢視並分享其 CGM 資料。這對病患及其照護者而言是一項重大利多；我們也肯定 CMS 理解資料分享對即時 CGM 的重要性。

As you might expect, our biggest strategic priority for the balance of 2018 is the G6 launch, especially with the demand we have seen out of the gate. But beyond this all-encompassing effort, we continue to see benefits from the FDA's new ICGM classification, which only DexCom G6 carries today. In fact, near the end of Q2, and just before the start of ADA, the FDA approved tandems predictive low glucose suspend or PLGS system called Basal-IQ which uses the Dexcom G6 sensor platform. This represents a great example of why the agency took the step to establish the integrated CGM category. We applaud the FDA for making this decision and improving the tandem system within 3 months of our own G6 platform being approved.

如各位所料，我們在 2018 年剩餘期間最大的策略優先事項是 G6 上市推進，尤其是我們看到上市初期的需求表現。但除了這項全方位的工作之外，我們也持續受惠於 FDA 新的 ICGM 分類，而目前只有 DexCom G6 具備此分類。事實上，在第二季末、且就在 ADA 開始之前，FDA 核准了 Tandem 的預測式低血糖暫停（PLGS）系統 Basal-IQ，該系統使用 Dexcom G6 感測器平台。這正是一個很好的例子，說明主管機關為何要建立整合式 CGM 類別。我們肯定 FDA 做出此決定，並在我們的 G6 平台獲准後 3 個月內就核准了 Tandem 系統的改良。

We have ongoing discussions with our other insulin delivery partners to capitalize on this new environment and we'll update the market when appropriate. However, the bottom line is we believe this will provide the ability for our industry to bring innovation and choice to the diabetes community more efficiently, all while maintaining the important guardrails that ensure we optimize CGM performance and patient safety.

我們正與其他胰島素輸送合作夥伴持續討論，以把握這個新環境帶來的機會，並將在適當時機向市場更新。不過，重點是我們相信，這將使產業能更有效率地為糖尿病社群帶來創新與選擇，同時仍維持重要的防護欄（guardrails），以確保我們最佳化 CGM 表現與病患安全。

In the meantime, we are seeing good progress across our insulin delivery partners, including both automated insulin delivery systems and Smartpen platforms, and remain confident that our pipeline of integrated diabetes management systems leaves us in a strong position competitively.

同時，我們也看到各胰島素輸送合作夥伴均有良好進展，包含自動化胰島素輸送系統與 Smartpen 平台；我們仍有信心，整合式糖尿病管理系統的產品管線使我們在競爭上維持強勢地位。

Beyond insulin delivery, we are actively exploring new market opportunities, especially given our belief that the G6 sensor and algorithm truly represent a platform for DexCom. We continue to make meaningful progress with our fully disposable sensors. However, in light of an increasingly competitive environment, we're keeping the details of our next-generation product pipeline plans close to the vest.

除了胰島素輸送之外，我們也正積極探索新的市場機會，尤其基於我們相信 G6 感測器與演算法確實代表 DexCom 的一個平台。我們在全拋式（fully disposable）感測器方面持續取得實質進展。然而，鑑於競爭環境日益激烈，我們將對下一代產品管線規劃的細節保持低調。

Our first generation Verily device is in validation and verification, and the second generation device remains on track for a late 2020 early '21 commercial launch. Let me again remind you that the first device is intended to help us optimize the clinical and commercial rationale for these disposable devices, with the goal of establishing our go-to-market strategy for the second-generation system. We look forward to bringing you more updates as we continue to make progress.

我們第一代 Verily 裝置正處於驗證與確認（validation and verification）階段，而第二代裝置仍按計畫於 2020 年底至 2021 年初進行商業化上市。我再次提醒各位，第一代裝置旨在協助我們最佳化這些拋棄式裝置在臨床與商業上的合理性，目標是為第二代系統建立我們的上市策略（go-to-market strategy）。隨著我們持續推進進度，我們期待帶來更多更新。

And with that, I'll pass it back to Kevin.

說到這裡，我把時間交回給 Kevin。

Thanks, Steve. Halfway through the year, DexCom's performance has clearly been impressive, with revenue growth accelerating in the face of multiple new market dynamics. By the numbers, fingersticks still represent a global market leader in glucose management by far. But as CGM awareness grows and the advantages of real-time CGM drive better diabetes management, we have a tremendous opportunity to convert patients and lead the category to the standard of care. We have been very pleased with the initial market reaction to the Dexcom G6 system. The improvements this system brings relative to prior generations are substantial and our feedback so far validates our bullish view of G6. The biggest complaint that I've received so far is when am I going to get my G6 system?

謝謝你，Steve。今年上半年，DexCom 的表現顯然令人印象深刻，在多項新的市場動態下，營收成長加速。就數據而言，指尖採血在血糖管理方面仍然是全球市場的絕對領導者。但隨著 CGM 認知度提升，以及即時 CGM 的優勢帶來更好的糖尿病管理，我們有巨大的機會轉換病患，並引領此類別成為照護標準。我們對市場對 Dexcom G6 系統的初期反應感到非常滿意。相較於先前世代，這套系統帶來的改進幅度很大，而目前收到的回饋也驗證了我們對 G6 的樂觀看法。到目前為止，我收到最大的抱怨是：我什麼時候才能拿到我的 G6 系統？

We get it. DexCom's CGM technology can have a major impact on diabetes management. To our customers, we appreciate your patience as we ramp up this great new system.

我們理解。DexCom 的 CGM 技術能對糖尿病管理產生重大影響。對我們的客戶，我們感謝你們在我們擴大這套優秀新系統產能之際的耐心等待。

With respect to our outlook, you heard from Quentin that we have increased our sales growth, guiding significantly given the strength we have seen across the board through the first 6 months of the year. Our original 2018 revenue growth guidance called for an increase in the mid to upper teens, and we now expect annual growth just under 30%.

關於我們的展望，你們已聽 Quentin 提到，鑑於今年前 6 個月我們在各方面看到的強勁表現，我們已上調銷售成長指引，且上調幅度相當顯著。我們原先的 2018 年營收成長指引為中到高十幾%的增幅，而我們現在預期全年成長將接近 30%但略低於 30%。

Despite our success so far, we continue to execute through a growing number of variables in our marketplace. This requires us to remain thoughtful around our assumptions for market share and pricing dynamics. First, CGM is the market in health care, and therefore, an increasingly competitive one. It remains clear from our latest performance that the benefits of DexCom's real-time solution, such as accuracy, performance, connectivity and consistency, are significant drivers of patient and clinician preference.

儘管目前取得成功，我們仍持續在市場中日益增加的變數下推進執行。這要求我們在市占率與定價動態的假設上保持審慎。首先，CGM 是醫療保健領域的一個市場，因此競爭日益激烈。從我們最新的表現仍可清楚看出，DexCom 即時解決方案的優勢——例如準確度、效能、連線能力與一致性——是驅動病患與臨床醫師偏好的重要因素。

Second, and more specifically, G6 affords us the potential opportunity to simplify our distribution channels, which could include the pharmacy channel or Medicare type bundling arrangements. While this should drive a positive impact on our operating efficiency, it could also impact pricing.

第二，更具體地說，G6 讓我們有潛在機會簡化我們的通路分銷，可能包括藥局通路或類似 Medicare 的打包式安排。雖然這應能對我們的營運效率帶來正面影響，但也可能影響定價。

To wrap up, we are having a great 2018 and are still just getting started with bringing DexCom's real-time G6 CGM to our customers. We look forward to providing you with additional updates next quarter.

總結來說，我們在 2018 年表現非常出色，而將 DexCom 的即時 G6 CGM 帶給客戶的工作也才剛開始。我們期待在下個季度向各位提供更多更新。

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

接下來我想開放電話會議進入問答。Matt？

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

謝謝你，Kevin。(Operator Instructions) 接線員，請提供完整的問答說明。

(Operator Instructions) The first question in the queue comes from Danielle Antalffy from Leerink Partners.

(Operator Instructions) 佇列中的第一個問題來自 Leerink Partners 的 Danielle Antalffy。

Quentin, I just wanted to ask a question on the guidance, your updated guidance for the year. The revenue of $925 million, it's very specific. And so I just wanted to get a little bit more color about some of the puts and takes to that. What gets you confident that $925 million is the right number versus a range? And is the right way to think about this is that, that $925 million number is implying that your -- the specificity of it is implying that the growth for the year is really limited by the supply constraints that you guys have talked about on this call?

Quentin，我想就你們更新後的年度指引問一個問題。營收 9.25 億美元，這個數字非常精確。所以我想更了解一些其中的利多與利空因素。是什麼讓你們有信心認為 9.25 億美元是正確的數字，而不是給一個區間？另外，是否可以這樣理解：9.25 億美元這個精確數字所隱含的是，你們今年的成長其實主要受到你們在這通電話中提到的供應限制所約束？

Thanks, Danielle. No. I wouldn't read into it around that way. What I would say is, obviously, Q2 is much stronger than what we had anticipated. We like the setup going into the quarter, but the $243 million of revenue was far beyond our expectations. And I think what you're seeing is that we're at the very early stages of significant awareness being captured around the value of CGM. And just how quickly that penetration goes into the marketplace is yet to be seen, but we're incredibly bullish around it. So what we tried to do with our guidance was contemplate those potential headwinds that we knew were out there in the back half of the year. We know we continue to work through contract discussions with the payers, some moving towards the pharmacy channel, some moving towards the subscription model, dialing in those potential headwinds so that as they end up playing out, they don't result in a downside surprise. But giving us a baseline then to know that if we execute well from that, then there's upside beyond the numbers. So that's really how we thought about it. That was the number we were able to dial into. We could've provided a range, but like I said, the beat in Q2 was far beyond what we expected, and it's really going to come down to how fast the penetration into the CGM marketplace goes. But at $925 million, we felt very good with that.

謝謝你，Danielle。不是。我不會用那種方式去解讀。我會說，很明顯地，第二季比我們原先預期強很多。我們喜歡進入該季度時的態勢，但 2.43 億美元的營收遠超出我們的預期。我認為你們看到的是，市場對 CGM 價值的認知正在非常早期的階段快速累積。而這種滲透進入市場的速度究竟有多快仍有待觀察，但我們對此非常樂觀。因此，我們在制定指引時，試圖把我們知道在下半年可能存在的逆風納入考量。我們知道我們仍在與支付方進行合約討論，有些正轉向藥局通路，有些正轉向訂閱模式；我們把這些潛在逆風因素調整進去，讓它們在實際發生時不至於造成下行意外。同時也給我們一個基準，讓我們知道如果在此基礎上執行得好，數字之上仍有上行空間。這就是我們的思考方式。那是我們能夠校準到的數字。我們本可以提供一個區間，但如我所說，第二季的超預期幅度遠超我們想像，而最終將取決於 CGM 市場滲透速度有多快。但以 9.25 億美元來看，我們對此感覺非常良好。

Okay. And just one quick follow-up on the gross margin guidance. I just want to make sure that I'm clear on this. So appreciate that gross margin's excellent time items would've been in line with prior. Is that true of the lower guidance for gross margins for 2018 as well that, that lower 64% number is really just due to the pressures that you talked about in Q2?

好的。另外再快速追問一下毛利率指引。我只是想確認我理解正確。所以，若排除一次性項目，毛利率本來會與先前一致，謝謝你的說明。那 2018 年毛利率較低的指引也是同樣的情況嗎？也就是說，較低的 64% 其實只是因為你們在第二季提到的壓力所致？

Yes. Q2, and then Q3, Danielle. So the way we're thinking about it is the incremental demand that's been placed on to the organization has put us in a position where we're bringing up incremental production lines faster than what we ever expected. We're bringing the Mesa facility up and online and we're hiring a lot of production workers into the organization, which just bring with it some natural inefficiencies in the early stages of getting them up to speed with what we're trying to do. We expect that's going to continue to play out in Q3, and I think you'll see it rebound nicely in Q4. But if you were to exclude those incremental headwinds really driven by the demand, you would see that gross margin for the full year is right in that guidance range that we had provided. So there's nothing else that's playing out there at all. It's just trying to work through the pressures of the higher demand and making sure we can fulfill that, and in the near term, expediting product into the hands of our patients that we do think we get turned around in the fourth quarter.

是的。第二季，然後第三季也是，Danielle。我們的看法是，組織所承受的新增需求，讓我們必須以比以往預期更快的速度擴增額外的生產線。我們正在讓 Mesa 廠區啟用並上線，同時也大量招募生產人員加入組織；在他們剛開始熟悉我們要做的事情時，初期自然會帶來一些效率不彰。我們預期這種情況會在第三季持續發生，而我認為你們會在第四季看到毛利率明顯回升。但如果排除這些主要由需求驅動的新增逆風，你會看到全年毛利率其實就在我們先前提供的指引區間內。除此之外沒有任何其他因素在發生。這只是要消化更高需求帶來的壓力，並確保我們能夠履約；短期內加速把產品交到病患手上，而我們確實認為在第四季可以扭轉過來。

The next question in the conference comes from J.P. McKim from Piper Jaffray.

本次電話會議的下一個問題來自 Piper Jaffray 的 J.P. McKim。

I wanted to just ask one on kind of the new users you're getting from G6. Is there anything unique about them in terms of, are you getting more type 2s than you've had before? Or are you getting more -- now that you have Basal-IQ out there with G6, are you getting more pumpers on? Is there anything unique about the G6 kind of customer base you're seeing compared to what you had in the past?

我想問一個關於你們透過 G6 新增使用者的問題。就他們的特性而言，有沒有什麼特別之處？例如，你們是否比以前獲得更多第二型糖尿病患者？或者，現在你們在 G6 上推出了 Basal-IQ，是否吸引到更多使用胰島素幫浦的使用者？相較於過去，你們現在看到的 G6 客戶基礎有沒有任何獨特之處？

This is Kevin. I would tell you that our G6 new customers is everybody. If anything, the one thing I would tell you about the G6 product is a little bit different, is it is reaching a broader base of people. It is reaching more users who have not experienced CGM before because as they walk into their caregivers and learn about its features with no calibration, so an easy insertion. And the profile, it is more attractive to a broader market of patients than what we've offered in the past. So we are seeing a broader user group, but I would say it's been very well accepted across the board.

我是 Kevin。我會告訴你，我們 G6 的新客戶就是所有人。如果要我說 G6 產品有哪一點比較不同，那就是它正在觸及更廣泛的人群基礎。它正在觸及更多以前沒有使用過 CGM 的使用者，因為當他們走進照護提供者那裡並了解其免校正等功能、以及容易插入的特性時。而且就產品外形與特性而言，相較於我們過去提供的產品，它對更廣泛的病患市場更具吸引力。所以我們看到更廣泛的使用者族群，但我會說它在各方面都獲得了非常好的接受度。

JP, just as a clarification. I don't think Basal-IQ has launched yet. I think their guidance is it's going to launch sometime in Q3.

JP，我只是澄清一下。我認為 Basal-IQ 還沒有上市。我想他們的指引是會在第三季某個時間點上市。

Got you. Yes. That's helpful. And then, just in terms of -- it sounds like your guidance contemplates this, you ramping up inventory and supplies. So is that the biggest bottleneck right now, is just being able to supply the sensors? And what gives you confidence in being able to ramp up Mesa fast enough to hit that supply? Or is that all contemplated in guidance? And if you can ramp supply faster, that's where the upside happens from.

了解。是的。這很有幫助。接著，就——聽起來你們的指引已經把你們提高庫存與供應品的爬坡納入考量。所以目前最大的瓶頸是不是就是感測器的供應能力？你們有什麼信心能把 Mesa 的產能拉升得夠快，以滿足那樣的供應？還是說這些都已經反映在指引裡？如果你們能更快拉升供應，那就是上行空間的來源。

This is Kevin. I'll take that. Again, as I said in my comments and our prepared remarks, we originally anticipated launching this product mid-year -- I mean mid-Q3, sometime there. We moved that launch up significantly, putting a lot of stress on everybody. Our guidance contemplates that we work through building up inventories and having more (inaudible) on hand. We've turned suppliers on, as we also kind of remarked, it's 24/7 all the time right now as far as manufacturing. We have things coming in. We have planned the shift from G5 to G6 for a little bit later in the year. We forced that shift to go earlier, putting pressure on both G5 and G6 from a manufacturing perspective. So we didn't make it easy for anybody here. But as we worked through the third quarter, and as we said, again, in our remarks, it will take us 3 months to work through all this, but we believe by the end of 3 months, we'll be in very good shape.

我是 Kevin。我來回答。再次重申，正如我在評論以及我們事先準備的發言中所說，我們原本預期在年中推出這個產品——我是說在第三季中段左右的某個時間。我們把上市時間大幅提前，讓所有人都承受很大壓力。我們的指引已將我們逐步建立庫存、並備有更多（聽不清）現貨納入考量。我們也已啟動供應商，如同我們提到的，就製造而言目前是全天候 24/7 運作。我們有物料持續進來。我們原本規劃在今年稍晚把 G5 轉換到 G6。我們迫使這個轉換提前，從製造角度對 G5 與 G6 都造成壓力。所以我們沒有讓任何人輕鬆。但隨著我們在第三季逐步消化，並且如我們在發言中再次提到，這需要 3 個月來處理完所有事情；但我們相信在 3 個月結束時，我們會處於非常好的狀態。

The next question in the queue comes from Travis Steed with Bank of America.

下一個排隊提問的是美國銀行（Bank of America）的 Travis Steed。

So Quentin, Q2 came in roughly like $35 million ahead of your expectations. Can you just talk about what specifically drove the upside in the quarter? Was that new patients? And then, you raised in the second half by another $35 million. So just kind of walk through your assumptions in the second half, and to what you're assuming in terms of competition and pricing and the various headwinds.

Quentin，第二季的表現大約比你們的預期高出 3,500 萬美元。你能談談本季超預期的具體驅動因素是什麼嗎？是新病患嗎？另外，你們把下半年又上調了 3,500 萬美元。所以請帶我們走一遍你們對下半年的假設，以及你們對競爭、定價與各種逆風因素的假設。

Yes. So I can tell you in the second quarter, it was across the board. I think Kevin indicated that in his prepared remarks and I commented on it as well. Really, all key revenue factors that I think are most indicative of future growth potential in the company were up strongly over where they were at in Q1 and well beyond what we had expected. So you can think of that as new patient. You can also think of that as just further adoption within the existing customer base and really on a global basis both in the U.S. and international. I think the thing that we try to contemplate in the back half of the year that we've talked about just a little bit earlier was the fact that there are potential headwinds out there around the move towards a pharmacy-type pricing model or a subscription type model as well as some of the competitive headwinds that are out there with -- Libre's got the expanded label we've seen. You've got Medtronic out there with Guardian Connect. I can tell you we feel incredibly good about how we're positioned to compete against those folks. But I think we need to be mindful of the potential impact that could be out there. So we've tried to dial it on to our guidance. But outside of that, we're not trying to deliver any other message other than we're very bullish on the year and where the opportunity exists within this marketplace.

是的。我可以告訴你，第二季是全面性的。我想 Kevin 在他事先準備的發言中提到過，我也有評論。確實，所有關鍵營收因素——我認為這些最能反映公司未來成長潛力的指標——相較第一季都大幅上升，也遠超出我們的預期。你可以把這理解為新病患。也可以理解為既有客戶基礎內的進一步採用，而且是在全球範圍內，不論美國或國際市場。我認為我們在今年下半年試圖納入考量、且稍早也提到的一點是：外部可能存在一些逆風，例如朝向藥局型定價模式或訂閱型模式的轉變，以及一些競爭逆風——例如我們看到 Libre 擴大標示適應症。還有 Medtronic 的 Guardian Connect。我可以告訴你，我們對自身在與這些對手競爭時的定位感到非常有信心。但我認為我們必須留意這些潛在影響。因此我們已把這些因素調整納入我們的指引。除此之外，我們不想傳遞任何其他訊息，除了我們對今年以及這個市場中的機會非常看多。

I think I'd add too, when we talk about competitive headwinds, when Quentin talked about move to the pharmacy and the subscription model, quite honestly, those are strategic opportunities for us. We've said launch of the G6 affords us the opportunity to be more flexible with some pricing structures and we're going to continue to explore this. We don't know the exact timing of when those might come to fruition, but we're certainly hopeful that long side, if we could move the whole business to the pharmacy, that would be a great win for us. We'd be willing to give up a little top line price.

我想我也補充一下，當我們談到競爭逆風時，Quentin 提到轉向藥局與訂閱模式，坦白說，這些對我們而言是策略性機會。我們說過，G6 的上市讓我們有機會在某些定價結構上更具彈性，我們會持續探索。我們不確定這些何時會真正落地，但我們當然希望，從長期來看，如果我們能把整個業務轉到藥局通路，對我們會是很大的勝利。我們願意在營收端的單價上做一些讓步。

Can you quantify those headwinds in the second half? And then, also, in terms of Q3, it's usually about 8% above Q2 sequentially. How does that play out? Is that a decent level this year? Or does the G6 launch change that in any way?

你能量化下半年這些逆風的影響嗎？另外，就第三季而言，通常會比第二季季增約 8%。今年會如何呈現？今年這樣的水準合理嗎？或者 G6 的上市會在某種程度上改變這個走勢？

Well, I will tell you this. We've contemplated the headwinds to be more heavily weighted towards the fourth quarter. Obviously, we're into the third quarter. We see how that's playing out. There is some pressure dialed into Q3, but more heavily weighted into Q4. It's about 700 basis points of headwind that we've dialed in to the back half of the year in total. So that gives you a sense of just how we've quantified it internally. Obviously, Q2 was incredibly strong. So if you look at historic seasonality and anticipate that Q3 is going to look similar in terms of sequential change off of what we believe is an incredibly strong Q2 and we're not quite ready to call that a trend just yet, I think you should expect that seasonality is going to look different in the back half of the year than what you would've seen in the past couple of years.

嗯，我可以告訴你的是：我們在評估時，將逆風的權重更多放在第四季。顯然我們已進入第三季。我們也看到目前的發展情況。第三季確實已納入一些壓力，但更大的權重在第四季。我們在全年下半年合計納入了約 700 個基點的逆風。這讓你了解我們內部是如何量化的。顯然第二季非常強勁。所以如果你看歷史季節性，並預期第三季在環比變化上會與過去相似——而我們認為第二季極為強勁、但我們還不準備把它稱為趨勢——我認為你應該預期今年下半年的季節性表現會與過去幾年不同。

The next question in the queue comes from Margaret Kaczor from William Blair.

下一個排隊提問的是 William Blair 的 Margaret Kaczor。

So just to follow-up on the G6 conversion process. I think in the past, you've talked about that being a little bit faster -- expected it to be a little bit faster than G5. Now that you guys are a few months into the process, is there any update on that progress? Are we 10% of patients in G6 for example, and then, are you assuming any kind of change to your prior assumptions on G6 utilization, given the 10-day hard shut-off?

我想追問一下 G6 的轉換流程。我記得過去你們談到，這個轉換速度會比 G5 快一些——預期會快一些。現在你們已經進行了幾個月，這個進度有沒有更新？例如，是否已有 10% 的病患在使用 G6？另外，考量到 10 天的硬性停用（hard shut-off），你們是否假設 G6 的使用量會相較先前假設有所改變？

Margaret, we only were 3 weeks into the launch by the end of Q2. So we really don't have a good number to give you as to how many patients are switching over. The second quarter was largely driven by G5. As we go into Q3, we are flipping patients over at their request, when they want to, and we are moving rapidly. I really don't have a good percentage to give you. We believe, over time, this is a technology that will replace the other one, as you said earlier, more rapidly than before, simply because it is so different from a user perspective. We haven't given data as to when we think everybody is going to be flipped over to G6. With respect to utilization, we'll do that again. We're very early into the process and we'll see where it ends up, and we don't have enough data to answer those things -- those questions, completely, right now.

Margaret，到第二季末為止，我們推出上市其實才剛滿3週。所以我們真的沒有一個好的數字可以提供給你，說有多少病患正在轉換過來。第二季主要是由G5所帶動。進入第三季後，我們會在病患提出需求、他們想要的時候，協助他們轉換，而且我們推進得很快。我真的沒有一個好的百分比可以提供你。我們相信，隨著時間推移，這項技術會取代另一項技術；如你先前所說，速度會比以前更快，單純因為從使用者角度來看它差異非常大。我們也尚未提供資料說我們認為何時所有人都會轉換到G6。至於使用率方面，我們會再做一次。我們目前還在非常早期的階段，會看看最後會落在哪裡，而現在我們沒有足夠的資料來完整回答那些事情——那些問題。

Okay. And then, as a follow-up to some of the discussion earlier on subscription contracts and the pharma contracts. At the private payer level, is this something that you guys are seeing happen at a faster rate? Or are you saying more of these discussions happened right now? And is that related to the G6? I mean, if we look out over the second half of this year, it sounds like you're expecting more of an impact from that maybe in Q4. But how should we think about '19 and the revenue rec impact from that there?

好的。接著，延續先前關於訂閱合約與藥廠合約的一些討論。在私人保險支付方（private payer）的層級，你們是否看到這類事情發生得更快？還是你們是說，現在只是有更多這類討論正在進行？而這是否與G6有關？我的意思是，如果我們看今年下半年，聽起來你們可能預期在第四季會有更大的影響。那我們應該如何看待2019年，以及那對收入確認（revenue rec）的影響？

One of our great policies is we don't give guidance for '19 today. So that I won't answer. With respect to these contracts and our efforts with managed care, we've used G6 as an opportunity to get in front of people -- I've even been out on the field by myself, just to gauge and to learn and see what goes on. There's still very much an educational process with payers that we have to go beyond just pricing as to what the outcomes our system offers, the protection and dangerous lows that we offer and the A1c improvement outcomes that we see in all the studies that we do that our competitors do not. So we are going through all those things. I would tell you we've been very creative and very aggressive in structures. A lot of those are pending. Some have been accepted. Some we would've done their directions. We have a goal to make this successful to everybody who wants it, at a price that's reasonable for DexCom and reasonable for our company to make a profit. We're going to try several different bottles over the next year or so to see what is the most efficient way to get this product to our patients, and we'll keep learning. If we find something that we hit on, we'll go there. We started pharmacy several years ago, and we haven't got full reimbursement there. Yes, we do have -- we have improved there. We've got some, but it's not all there yet. We've improved in the DME channel somewhat with some payers; with others, we haven't. And it's a process. As Quentin said earlier, as we look at pricing headwinds and things like that, it would have an impact more in the fourth quarter and into 2019 than into the third, and has not impacted us this year as much as we'd originally planned, when we gave our guidance, hence why we beat so much. And we have really strong volumes as well. So we'll just play it by ear, but we are -- we're aggressively proposing these structures, to make this easier.

我們有一個很棒的政策：今天不提供2019年的指引。所以那個我不會回答。至於這些合約以及我們在管理式醫療（managed care）上的努力，我們把G6當作一個機會，去更直接地與各方接觸——我甚至自己到前線跑了一趟，只是為了觀察、學習並了解實際情況。對支付方而言，仍然有很大一部分是教育過程；我們必須超越單純的價格，去說明我們系統所帶來的結果（outcomes）、我們提供的保護、對危險性低血糖的防護，以及我們在所有研究中看到的A1c改善成效，而這些是競爭對手所沒有的。所以我們正在把這些都逐一推進。我可以告訴你，我們在架構設計上非常有創意，也非常積極。其中很多仍在等待中。有些已被接受。有些我們會依照他們的方向去做。我們的目標是讓所有想要的人都能成功使用這項產品，同時價格對DexCom合理、也讓我們公司能合理獲利。接下來一年左右，我們會嘗試幾種不同的模式，看看哪一種是把產品最有效率地送到病患手上的方式，並持續學習。如果我們找到一個有效的方法，我們就會往那個方向走。我們幾年前就開始走藥局通路（pharmacy），但那邊還沒有拿到完整的給付。是的，我們確實——我們在那邊有改善。我們拿到了一些，但還沒有全部到位。在DME通路方面，我們對某些支付方也有所改善；但對其他的，還沒有。這是一個過程。如Quentin先前所說，當我們看定價逆風（pricing headwinds）等因素時，它對第四季以及進入2019年的影響會比對第三季更大，而且今年對我們的影響沒有我們在給出指引時原先預期的那麼大，這也是為什麼我們超出預期這麼多。而且我們的出貨量也非常強勁。所以我們會視情況調整，但我們——我們正積極提出這些架構，讓事情更容易。

And the next question in the queue comes from Jeff Johnson with Baird.

接下來隊列中的下一個問題來自Baird的Jeff Johnson。

I know you don't give patient add numbers, but -- and this is a lot more art than it is science. But when I try to back-end the numbers, Quentin, would it be crazy to think about your Medicare patients sequentially? The adds in 2Q were twice what they were in 1Q? And your international patient adds might have been 2 to 3x what they were on kind of the last few quarter average. Just trying to figure out what would have driven such a big sequential move in both those patient adds, if I'm anywhere close to being right on those numbers?

我知道你們不提供新增病患數，但——而且這比較像是藝術而不是科學。不過當我嘗試倒推這些數字時，Quentin，如果我認為你們的Medicare病患在序列上（sequentially）新增數在第二季是第一季的兩倍，這樣想會不會太離譜？第二季的新增是第一季的兩倍？而你們的國際新增病患可能是過去幾季平均的2到3倍。我只是想弄清楚，如果我對這些數字的推估大致接近，究竟是什麼驅動了Medicare與國際兩邊新增病患都出現這麼大的序列變動？

Yes. Jeff, we're not going to give any color around patient adds at this point. Obviously, we've talked about moving away from that. So we're not going to give any incremental color around those kind of things. I think it's safe to say, the awareness of CGM is growing meaningfully in the marketplace, and you've got not only ourselves, but you've got other folks out there who continue to educate on the value of it, and it's being heard. And you're seeing that show up through the fact that new patients are coming in to realize that CGM has value. So we're not going to get the specifics of the numbers, but absolutely new patient volumes are a big driver.

是的。Jeff，我們目前不會就新增病患數提供任何額外說明。很明顯地，我們已經談過要逐步不再提供那類資訊。所以我們不會就這些事情提供更多增量的細節。我想可以很安全地說，市場對CGM的認知正在顯著提升；不只是我們，還有其他業者也持續在教育市場其價值，而市場確實有聽進去。你也看到這反映在：有新的病患進來，開始意識到CGM是有價值的。所以我們不會談具體數字，但毫無疑問，新病患量是很大的驅動因素。

Okay. Maybe the corollary there, were there any onetime bills or adds to pay? And anything at all that was more onetime in nature in the quarter?

好的。那相關的問題是，本季是否有任何一次性的帳單（onetime bills）或新增應付（adds to pay）？以及本季是否有任何更偏一次性性質的項目？

No. Nothing in particular. I will tell you, we ended up -- we talked about the deferral potential back in Q2 -- or sorry at the end of Q1, when we talked about the Q2 guidance associated with our G6 promotion program. That came in a little bit lighter than what we thought. We said that there could be $10 million of headwind. It ended up being about $5 million of headwind. So maybe you had $5 million of upside to that expectation that played through the numbers, but obviously, that doesn't explain the big beat. The big beat is really driven by underlying volumes across all segments or all channels in the business.

沒有。沒有特別的。我可以告訴你，我們最後——我們在第二季曾談到遞延（deferral）的可能性——抱歉，是在第一季末，當我們談到與G6促銷方案相關的第二季指引時。那部分的影響比我們想的稍微小一些。我們當時說可能會有1,000萬美元的逆風。最後大約是500萬美元的逆風。所以相較於原先預期，可能有500萬美元的上行（upside）反映在數字裡，但很明顯地，那並不能解釋這麼大的超預期。這次大幅超預期，主要是由所有事業區隔或所有通路的基本面出貨量所驅動。

All right. Great. And just on my last question, just on ICGM. Are you seeing any progress from a competition standpoint on getting towards ICGM designation? How long do you think you might have that advantage? It looks like the [15 15] numbers from the updated approval on Abbott probably will fall short of that designation. So just wondered what you're seeing on the competitive with movement towards ICGM.

好。很好。我最後一個問題是關於ICGM。從競爭的角度來看，你們是否看到競爭對手在取得ICGM認定（designation）方面有任何進展？你們覺得自己大概還能保有這個優勢多久？看起來Abbott更新核准後的[15 15]數據可能仍達不到那個認定標準。所以想請教你們目前看到競爭對手在朝ICGM推進方面的動態如何。

Yes. I mean, just reviewing the data that Abbott -- that was published, I think, on Monday, on the next generation Libre. I don't think they're closed clearly in hypoglycemia range. Their performance just isn't good enough to meet the ICGM standards. So I don't -- we've looked at Medtronics' data on the Guardian Connect stand-alone, it falls a little short. So at this point, I don't think there's anybody coming.

是的。我的意思是，僅僅回顧 Abbott——我想是在週一——所公布的下一代 Libre 的資料。我不認為他們在低血糖範圍內的表現有明確達標。他們的表現就是不夠好，無法符合 ICGM 標準。所以我不——我們看過美敦力 Guardian Connect 獨立版的資料，它也差了一點。所以就目前而言，我不認為會有任何人能進來。

The next question in the queue comes from Jayson Bedford with Raymond James.

下一個排隊的問題來自 Raymond James 的 Jayson Bedford。

I just have a couple here. I think, Quentin, you mentioned that the G6 demand has driven delays. Is there any way to quantify the delays in terms of the impact on 2Q revenue?

我這裡有兩個問題。我想 Quentin，你提到 G6 的需求導致了延遲。有沒有辦法量化這些延遲對第二季營收的影響？

Yes. I don't know that it's necessarily delayed revenue. What we've said is it's created tremendous strain on the organization to keep up with that demand. So we're doing everything we can to bring incremental lines up from a production perspective, hiring folks in to run those lines, introducing automation into the production facilities, setting up our Mesa manufacturing facility. But I would say we're meeting the demand at this point in time. We're not missing opportunities, but it's putting a lot of strain on the business. And to be clear, it's not just G6 that's driving that, the G5 demand in the second quarter is far and away what drove the outperformance.

是的。我不確定那是否必然是延後認列的營收。我們說的是，它讓組織在跟上需求方面承受了巨大的壓力。所以我們正盡一切所能，從生產角度增加額外產線、招募人員來操作這些產線、在生產設施導入自動化、並建置我們在 Mesa 的製造廠。但我會說，就目前這個時間點，我們是在滿足需求的。我們沒有錯失機會，但這確實讓業務承受很大壓力。而且要說清楚，不只是 G6 在推動這件事，第二季的 G5 需求才是遠遠推動超預期表現的主因。

Okay. That's helpful. And just maybe to piggyback on the last line of questioning, in terms of the Medicare opportunity, do you expect the new CMS regulations around the use of a mobile phone to have an impact on demand and uptake within the Medicare population?

好的。這很有幫助。另外，或許延續上一個問題的脈絡，關於 Medicare 的機會，你們是否預期 CMS 對於使用手機的新規定，會影響 Medicare 人口中的需求與採用？

No. I think it's just a good win for patients. I mean, we don't -- we've long said that we don't think that patients -- that folks in the Medicare population were deferring -- going on to DexCom CGM because they couldn't use their phone. But what everybody in the community was saying this is just silly because the share feature functionality is one of the critical aspects to the technology of real-time CGM. So obviously, we were pleased that Medicare will allow patients to actually use that technology now.

不會。我認為這只是對病患的一個好消息。我的意思是，我們一直以來都說，我們不認為 Medicare 人口中的病患——那些人——會因為不能用手機而延後使用 DexCom 的 CGM。但社群裡每個人都在說這很荒謬，因為分享（share）功能是即時 CGM 技術的一個關鍵面向。所以很顯然，我們很高興 Medicare 現在會允許病患實際使用這項技術。

This is Kevin. I've been out in the field right along a couple of times over the past few months. And I think this will help us drive more Medicare interest, more demand. I don't know how many were sitting on the bench waiting for this, but I do think the ability for us to market through this and say, look, we can now share your data with those who are caregivers with you. I think it can be very powerful, just like it's been for us in pediatrics. So it will take some time, but let's see how it plays out.

我是 Kevin。過去幾個月我有幾次到第一線跟著跑。我認為這會幫助我們在 Medicare 端帶來更多興趣、更多需求。我不知道有多少人一直在場邊等這件事，但我確實認為，我們能夠藉此行銷並說：你看，我們現在可以把你的資料分享給照護你的人。我覺得這會非常有力，就像它在兒科領域對我們一樣。所以這需要一些時間，但我們看看後續會如何發展。

The next question in queue comes from Robbie Marcus with JPMorgan.

下一個排隊的問題來自 JPMorgan 的 Robbie Marcus。

Two questions, one on volumes, one on pricing. First, can you help us in international, still relatively small but impressive growth in the quarter? Can you help us break down sort of what's driving that there? Is there an uplift in reimbursement? Or mix? Or utilization? How -- what's driving that strong growth there?

兩個問題，一個關於出貨量，一個關於定價。首先，國際市場在本季仍然相對小，但成長令人印象深刻。你能否幫我們拆解一下那邊的成長動能是什麼？是給付提高嗎？或是產品組合？或是使用量？那邊強勁成長的驅動因素是什麼？

Yes. So international, as we noted, 22% of total revenue contribution in the quarter, up 78% year-over-year, one of the strongest quarters that we've seen to date and what is still an incredibly unpenetrated or underpenetrated market opportunity. I would tell you that the strength is across the board. It's across all of Europe. It's across all of the rest of the world for us, with every one of the regions really performing well. Pricing is holding steady. Utilization, I would say, is improving, but a lot of it is driven by new patient interest and just continued further adoption within those marketplaces. So it really is across the board and not any one particular geography that's driving it. It is across the regions.

是的。所以國際市場，如我們所提，本季占總營收貢獻的 22%，年增 78%，是我們迄今看到最強勁的季度之一；而這仍是一個滲透率極低或滲透不足的市場機會。我會告訴你，強勁表現是全面性的。涵蓋整個歐洲。也涵蓋我們在世界其他地區的業務，每個區域的表現都非常好。定價維持穩定。使用量我會說正在改善，但很大一部分是由新病患的興趣，以及在那些市場持續更進一步的採用所帶動。所以真的是全面性的，而不是由某一個特定地理區域所驅動。是跨區域的成長。

okay and then, on pricing, can you spend a minute and talk about what your negotiations since the G6 has been approved have been like? Are insurance plans looking at this as a total cost to therapy? Or versus a -- the lowest cost therapy? Or are they evaluating this more on a per-day basis in the avoidance of hypoglycemia or other hospitalization events? Maybe give us some insight into how your contract negotiations have been and how they're addressing it. And maybe give us an update into what's baked into guidance because I remember last quarter, it was $70 per sensor. Is that still what's assumed in guidance?

好的，那接著在定價方面，你能花一點時間談談自從 G6 獲准後，你們的談判情況如何嗎？保險計畫是把這視為整體治療成本來看嗎？還是相對於——最低成本治療？或者他們更以每日成本、以及避免低血糖或其他住院事件的角度來評估？也許給我們一些你們合約談判的洞見，以及他們是如何處理這件事的。另外也請更新一下指引中已反映的假設，因為我記得上季是每個感測器 70 美元。指引中仍然假設是這個數字嗎？

Robbie, this is Kevin. I'll let the other guys kick in after I take a bit of this. One thing you can understand for sure is we do not have any difficulty explaining to third-party payers the difference between our product and others. Our product with no calibrations and connectivity and sharing data and the ease of use. As a feature set, they incorporate anything good that any other products do and we've got it all. So that is not difficult for us to explain with G6. I would tell you with the payers, it varies payer to payer, payer and meeting to meeting, some of them look at cost per day. Some of them look per member per month. Some of them look at annual therapy. Some of them -- and so whatever the presentations are geared towards, the people that we meet with, some, quite frankly, are geared towards Medicare. Here's Medicare pricing. Where do we go from here? It all depends on who we're talking to. We tailor our approach with everybody we meet with, and we'll see how these things play out over the next several months, particularly now that we have G6 approved in the market, that's another thing we all have to remember. While we're selling G6, a lot of the G6 reimbursement now is grandfathered in from a G5 contract that we had before. And in those cases, we got paid per sensor per day, and that will change over time and that will change as we put new arrangements and new plans in front of payers, but that's how we approach it. We approach it strategically in each and every individual meeting. The best way to go about it, we approach it from pharmacy channel, from DME channel depending upon the payer and what they have an appetite for. So this is very much -- it's a wide-scale effort. It's -- unfortunately, I'd love it not to be a shotgun approach, but it is an approach where we have to address each audience the way they want to talk to us.

Robbie，我是 Kevin。我先回答一部分，之後再讓其他人補充。你可以確定的一點是：我們在向第三方支付方解釋我們產品與其他產品的差異時，完全沒有困難。我們的產品不需要校正、具備連線與資料分享、而且易於使用。就功能組合而言，任何其他產品做得好的地方都涵蓋了，而且我們全部都有。所以對我們來說，用 G6 來說明這點並不困難。我會說，對支付方而言，會因支付方不同而不同，也會因會議而異；有些看每日成本。有些看每位會員每月成本。有些看年度治療成本。有些——坦白說——是以 Medicare 為導向。這是 Medicare 的定價。我們接下來怎麼走？這完全取決於我們在跟誰談。我們會針對每一位我們會面的對象量身打造方法，而接下來幾個月我們會看看這些事情如何發展，特別是現在我們的 G6 已在市場上獲准，這也是大家都必須記住的另一點。雖然我們在銷售 G6，但目前很多 G6 的給付其實是沿用我們先前的 G5 合約而「沿襲」下來的。在那些情況下，我們是按每個感測器、按天計費收款；這會隨時間改變，也會在我們提出新的安排與新的方案給支付方後而改變，但我們就是這樣來處理的。我們在每一場個別會議中都以策略性方式來推進。最好的做法是：依支付方及其偏好，我們會從藥局通路或 DME 通路來切入。所以這非常——是一項大規模的工作。這——很遺憾，我希望不必用散彈槍式的方法，但確實是一種我們必須用他們想要的方式，去對每一種受眾溝通的做法。

Okay. So when you list pricing as a potential headwind or a concern in second half, it's more -- you're not seeing a pricing headwind? Or there's no immediate concern of pricing, but given that there are other competitors out there, it's something that we should all be aware of? Is that the way to think about it?

好的。所以當你把定價列為下半年可能的逆風或疑慮時，這更像是——你們並沒有看到定價逆風？還是說目前沒有立即的定價疑慮，但鑑於外面還有其他競爭對手，這是我們都應該留意的事情？應該這樣理解嗎？

It's something we should be aware of. And as I also said in my prepared remarks, and I believe Quentin mentioned earlier, where we have an opportunity to go to pharmacy and increase access and availability for patients, we are willing to give some price to increase volume and get the technology to more people. That's just one example, and we've done the same thing with some DME plants as well. So we know there may be some plans accepted that would have an effect on what we're doing. And competition can drive some of that also. Both Medtronic and Abbott have talked about -- Medtronics said they're going to price lower than what we've been in the past. But we all know that Libre's priced much lower than where we are. We see that market -- and add another factor onto that. Medicare got approved in 2017 and that pricing is lower than where we've been in the past as well. So pricing pressures are not an if, they're a when. We're addressing it very proactively and building business models that will work best for us. At the end of the day, look at the numbers we just put up. They're pretty strong.

這是我們應該留意的事情。而且正如我在事先準備的發言中也提到的，我相信Quentin先前也提過，在我們有機會進入藥局通路、提升病患的可近性與可得性時，我們願意在價格上做一些讓步，以提高出貨量，讓更多人使用這項技術。這只是其中一個例子，我們在一些DME（耐用醫療設備）方案上也做過同樣的事。所以我們知道，可能會有一些被接受的方案，會對我們正在做的事情產生影響。競爭也可能推動其中一部分。Medtronic和Abbott都談到過——Medtronic表示他們會把價格訂得比我們過去的水準更低。但我們都知道，Libre的定價遠低於我們目前的水準。我們看到那個市場——再把另一個因素加進來。Medicare在2017年獲得核准，而那個定價也比我們過去的水準更低。所以定價壓力不是會不會發生的問題，而是何時發生的問題。我們正非常積極地主動因應，並建立最適合我們的商業模式。歸根結底，看看我們剛交出的數字。相當強勁。

The next question in the queue comes from Doug Schenkel with Cowen and Company.

下一個排隊提問的是Cowen and Company的Doug Schenkel。

This is Ryan on for Doug. Any update on your plans to extend the (inaudible) time of G6 to 14 days? And you do still expect to run that trial this year?

我是代Doug提問的Ryan。關於你們把G6的（聽不清）使用時間延長到14天的計畫，有沒有最新進展？你們仍然預期今年會進行那項試驗嗎？

We're working on that right now. We have several alternatives in the pipeline, but going out to 14 days. ICGM is an important consideration for us. We do believe that is a very important development with the FDA having 510(k) and the ability for us to move faster within the structure where we play. When we got the ICGM rules and the standards and the accuracy guidelines, we have to make sure our 14-day product will perform there. So we're doing work on that. I think for us right now, getting the 10-day product out to everybody, getting G6 launch is most important. We are looking at 14 days, but I don't really have an update or a timeline for you right now.

我們現在正在推進這件事。我們的研發管線裡有幾個替代方案，目標是延長到14天。iCGM對我們來說是一個重要考量。我們確實認為這是一項非常重要的進展，因為FDA有510(k)途徑，讓我們能在我們所處的架構內更快推進。當我們拿到iCGM規則、標準與準確度指引後，我們必須確保我們的14天產品能符合那些要求並有相同表現。所以我們正在做相關工作。我想就我們目前而言，最重要的是先把10天產品推廣到所有人手上，把G6上市推進好。我們確實在看14天，但我現在沒有可以提供的最新進度或時間表。

Got it. And then, maybe just a follow-up on the pharmacy channel and monthly bundles that you've been talking about. Can you give us a sense of what proportion of your U.S. commercial business you've already committed to deals with? Is that still a very small proportion? And is this potential headwind in the back half really conceptual at this point, if more deals are struck?

了解。接著可能追問一下你們一直在談的藥局通路與每月套裝（monthly bundles）。你們能否讓我們了解一下，你們美國商業保險業務中，已經承諾簽下這類交易的大概占比是多少？這仍然是非常小的比例嗎？而你們所說下半年可能的逆風，在目前階段是否仍然只是概念性的，取決於是否會談成更多交易？

We've never broke out those percentages as to what we sell through the pharmacy and what we sell through other channels. A lot of this is very conceptual at this point in time, and we'll leave it at that.

我們從未拆分過這些百分比，也就是我們透過藥局通路銷售多少、透過其他通路銷售多少。目前很多事情仍然相當概念性，我們就先說到這裡。

Next question in the queue comes from Joanne Wuensch from BMO Capital.

下一個排隊提問的是BMO Capital的Joanne Wuensch。

Can we just take a second about competition? It's a little surprising to me as we go around talking with investors that there's still concern regarding the next generation Abbott product, the next generation Libre, or what may happen with other products coming on to the market. What is your experience as you go out there and you talk to people? And what are the pros and cons as you position G6 now against them?

我們能不能花一點時間談談競爭？我在和投資人交流時有點意外，大家對於下一代Abbott產品、下一代Libre，或其他產品進入市場後可能發生的事，仍然感到擔憂。你們在外面與人交流時的經驗是什麼？以及你們現在把G6與它們相比來定位時，各自的優缺點是什麼？

Well, I'll speak. There's nothing that Libre does that we don't do better. I can leave it at that or I can go on. With respect to the physicians that we meet with, when we meet with them, G6 has so many features, with connectivity, with its performance in the high and the low range, with its consistency, with the form factor, the ease of insertion. This product is a home run for us. So I mean look at how our business -- and this growth this quarter was without G6. There's a very, very broad acceptance for G6 right now. I guess the other thing to remember that I think everybody else who gets very hung up about, there's a lot of patients out here that have diabetes. The world's not just going to be one CGM company. It's going to be numerous ones. So there's opportunities for all of us. Our market is still very underpenetrated regardless of what Abbott does or says or Medtronic does or says, what we do or say or what startups do or say. We have a lot of room to grow. This platform with G6 really gives us the opportunity to grow into areas where we haven't gone before because it is so much easier to use, and the thought of not sticking your finger anymore given the -- combined with the performance of the system really is very appealing to people. And so we're excited with what we have going on and we're not going to spend a lot of time worrying about the others.

我來回答。Libre能做的事情，沒有一件是我們做得不更好的。我可以就此打住，也可以繼續說。就我們接觸到的醫師而言，G6有非常多功能，包括連線能力、在高值與低值區間的表現、一致性、外形設計、以及更容易的插入方式。這個產品對我們來說是一次大成功。所以你看我們的業務——而且本季的成長是在沒有G6的情況下達成的。目前市場對G6的接受度非常、非常廣泛。我想另外一點是，我認為大家常常過度糾結的一件事：有非常多糖尿病病患。這個世界不會只有一家CGM公司。會有很多家。所以我們所有人都有機會。不論Abbott做什麼或怎麼說、Medtronic做什麼或怎麼說、我們做什麼或怎麼說、或新創做什麼或怎麼說，我們的市場滲透率仍然很低。我們還有很大的成長空間。G6這個平台真的讓我們有機會拓展到以前沒進入的領域，因為它更容易使用；再加上系統的表現，想到不必再扎手指測血糖，對人們非常有吸引力。因此我們對目前的進展感到興奮，也不會花太多時間去擔心其他人。

The next question in the queue comes from Anthony Petrone from Jefferies.

下一個排隊提問的是Jefferies的Anthony Petrone。

Maybe just a little bit on something that the company spoke a bit about just as it relates to Abbott's presence, in other words, their launch of Libre has actually opened up the discussion around CGM. I'm just wondering, is any of that reflected in the numbers this quarter? Was it really just the anticipation of G6? Did you get more G5 users to adopt -- to bridge to the pathway to G6? And then, I'll have a follow-up.

想再追問一點，公司先前提到與Abbott的存在相關的一件事，換句話說，他們推出Libre其實打開了市場對CGM的討論。我想問的是，本季的數字是否反映了其中任何影響？還是說真的只是因為大家期待G6？你們是否讓更多G5使用者採用——也就是先銜接、走向G6的路徑？然後我還有一個追問。

Well, we can tell you, the strength in the quarter, as I mentioned earlier, was really driven by G5. And I think just the natural uptick in the awareness being created in the marketplace by having more competitors here is what's fueling that opportunity. And then, obviously, you have the G6 launch, which creates -- or peak's people's interest and they start to look and feel good more about it, and it brings them our way as well. So I guess I would just leave it at that.

我們可以告訴你，如我先前提到的，本季的強勁表現主要是由G5帶動的。我認為，因為有更多競爭者進入，市場上的認知度自然提升，這正是推動這個機會的原因。然後很明顯地，G6上市也會帶來——或說激起大家的興趣，大家開始關注並更有信心，也會把他們帶到我們這邊來。所以我想我就先說到這裡。

Fair enough. And the follow-up would be just on, as you look at the revised guidance into the second half, I'm just wondering -- there's a lot of discussion on price. It sounds like the gross margin shift was more on the manufacturing. I just want to confirm if there's anything in gross margin guidance as it relates to price. And then, again, lastly, the t:slim X2 launch, does the revenue outlook contemplate anything from that launch as well?

了解。接著追問一下，當你們看下半年修訂後的指引時，我想請教——市場上對價格有很多討論。聽起來毛利率的變動更多是來自製造端。我想確認一下，毛利率指引中是否有任何與價格相關的因素。然後同樣地，最後一個問題：t:slim X2 的上市，營收展望是否也有納入該上市帶來的任何貢獻？

Well, I'll take the gross margin question on price. You may have to repeat the last question there. But from a pricing perspective, we haven't seen that play out any different than what we had originally anticipated in the broader range of 65% to 68%. In Q2, price or mix depending on what you want to call it, I guess, is revenue per patient associated with the lower revenue per patient in the Medicare channel and the international business, that did weight out margins year-over-year by a couple of hundred basis points. But that was in line with what we would have anticipated. Last quarter -- or sorry last year, same quarter, we were at 68.9%. If you take a couple of hundred basis points off of that, you're down around 66%, 67% right where we thought we would be. So price is coming together just like we anticipated and we've dialed in the back half of the year to be relatively consistent with what we expected in that 65% to 68% range, but now you're dealing with some of the headwinds of the incremental demand that we're trying to ramp up the organization to be able to fulfill. So that's the only real difference in the gross margin.

好，我來回答毛利率中與價格相關的問題。你可能需要把最後一個問題再重複一次。但就定價角度而言，我們看到的情況並沒有偏離我們原先在 65% 到 68% 的較大區間內所預期的走勢。在第二季，價格或產品組合（看你想怎麼稱呼），也就是每位病患的營收，因為 Medicare 通路以及國際業務的每位病患營收較低，確實使得毛利率年對年下滑了幾百個基點。但這與我們原先的預期一致。上一季——抱歉，是去年同一季，我們是 68.9%。如果從那裡扣掉幾百個基點，就會落在約 66%、67%，正好就是我們原本認為會到的位置。所以價格的表現正如我們所預期，我們也把下半年的假設調整到與 65% 到 68% 區間內的預期相對一致，但現在你還要面對一些逆風，也就是我們正試圖擴充組織以滿足新增需求、提升履約能力所帶來的影響。因此，毛利率唯一真正的差異就在這裡。

And the next question comes from David Lewis of Morgan Stanley.

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

I had just one quick question on pricing, then a follow-up on guidance. Steve or Quentin, I think I heard you say pricing in the quarter was stable. Is that inclusive of the G6 launch? Or exclusive of the G6 launch?

我只有一個關於定價的快速問題，然後再追問一個關於指引的問題。Steve 或 Quentin，我想我聽到你們說本季定價是穩定的。這是包含 G6 上市的影響嗎？還是不包含 G6 上市？

Well, the G6 launch only contributed for about 3 weeks. And this quarter was largely driven -- as Quentin mentioned, it was largely driven by G5. I mean, this quarter was actually all about G5.

嗯，G6 上市只貢獻了大約 3 週。而本季主要是由——如 Quentin 提到的，主要是由 G5 帶動。我的意思是，本季其實完全就是 G5 的表現。

So even if G6 pricing were higher, would that necessarily have moved pricing up in the quarter?

所以即使 G6 的定價更高，也不一定會讓本季的定價上升嗎？

No.

不會。

Not enough to see it in the overall results yet, David.

David，就整體結果來看，目前貢獻還不足以在總體數字中看得出來。

Okay. Very helpful. And then, Quentin -- or actually, maybe one for Kevin and one for Quentin. They're kind of related. Kevin, I think everyone's trying to figure out sort of what drove the inflection in the U.S. market this quarter. Obviously, it's underlying demand, but could you help us just force rank, if I gave you sort of 3 options, market expansion, Medicare, or G6, how you'd force rank those in terms of impact it had on U.S. market this quarter? And then, for Quentin, just look at the back half, I think everyone looks at that number and says, it looks conservative. You talked about some of the pressures in the U.S. potentially. Is there a way to think about the back half U.S. ex U.S., some deceleration that these pressures do materialize, but a more stable environment ex U.S.? I'm just trying to think of the relative terms here as you move into the back half.

好的。非常有幫助。接著，Quentin——或者其實可能一題問 Kevin、一題問 Quentin，兩題有點相關。Kevin，我想大家都在試著釐清本季美國市場出現轉折點（inflection）的驅動因素是什麼。顯然是底層需求，但你能否幫我們做個排序：如果我給你三個選項——市場擴張、Medicare、或 G6——你會如何依其對本季美國市場的影響程度做排序？

Well, I'll take the easy one, where I get to think about force ranking 3 variables. I would tell you, first, the overall market expansion. Second would be Medicare and third would be G6 because you're back to Steven and Quentin's earlier comments, we only had about 3 weeks' worth of G6 to ship. And it's been our experience over time that very seldom do patients with DexCom buy our old technology because of the upgrade program and move on. If they really want the new product, our patients, to their credit, manage their money and their finances as closely as they can because this disease is not inexpensive. So if I had to rank the 3, I would say overall market expansion and stickiness of our current patients combined with new patients then I would add Medicare in the U.S. as a second driver and third would be G6. Then I'll turn the other one over to Quentin. You go ahead.

好，我先回答比較簡單的那題，也就是要把三個變數做影響力排序。我會告訴你，第一是整體市場擴張。第二是 Medicare，第三是 G6，因為回到 Steven 和 Quentin 先前的評論，我們只有大約 3 週的 G6 可以出貨。而我們長期以來的經驗是：DexCom 的病患很少會去買我們的舊技術，因為有升級方案，他們會直接升級並往前走。如果他們真的想要新產品，我們的病患——值得肯定的是——會盡可能仔細地管理他們的金錢與財務，因為這個疾病的治療並不便宜。所以如果要我把這三項排序，我會說第一是整體市場擴張，以及現有病患的黏著度（stickiness）加上新病患；第二個驅動因素是美國的 Medicare；第三才是 G6。接著我把另一題交給 Quentin。你來吧。

Yes. So in terms of the back half of the year, David, I would say we feel like the international markets are quite stable, yet at the same time, 78% growth that we put up in the second quarter, we're not ready to call that a trend just yet. So I think when you look at your models and I understand when you drive them into the $925 million guidance, you're going to come up with first half growth rate of 36% slowing to potentially 23% in the back half of the year. I think a couple of things to keep in mind. One, the comp in the back half of the year is just -- it's going to be more difficult. We started to see acceleration in the business last year, particularly in Q4, but that's about 400 basis points of a headwind if you're just trying to quantify the impact of the tougher comp. And then, we've noted that we've got 700 basis points in there relative to revenue per patient or kind of pharmacy subscription, mix shift in the commercial business. So between those 2, you start to work yourself back into a growth rate that's pretty comparable to the first half of the year after contemplating those headwinds. So that's how we think about it. That's how we've dialed into our expectations. And to the degree that we can navigate it well, terrific. We're all going to be very happy.

好的。David，就下半年而言，我會說我們認為國際市場相當穩定；但同時，第二季我們繳出 78% 的成長，我們還不準備把它直接定義為一個趨勢。所以我想當你把模型推到 9.25 億美元的指引時，你會得到上半年成長率 36%，下半年可能放緩到 23%。我認為有幾點要記住。第一，下半年的比較基期（comp）就是——會更困難。我們去年開始看到業務加速，特別是在第四季；如果你只是想量化更嚴峻基期的影響，那大約是 400 個基點的逆風。另外，我們也提到，還有 700 個基點與每位病患營收、或可說是藥局訂閱（pharmacy subscription）、以及商業業務中的組合轉移（mix shift）相關。把這兩項合在一起考量後，你就會把成長率推回到一個與上半年相當可比的水準——前提是你已經把這些逆風納入。所以我們是這樣思考的。這也是我們如何校準我們的預期。而如果我們能夠把它執行得很好，那就太棒了。我們大家都會非常開心。

The next question comes from Kyle Rose with Canaccord.

下一個問題來自 Canaccord 的 Kyle Rose。

And I got a sentiment on the robust quarter here. I just wanted to quickly touch on your market awareness in some of the DTC campaigns and activities you guys are doing. I know that you've got a number of digital, but then also some TV advertising. So just wanted to kind of see how you think about DTC as a way to drive patient awareness and kind of your ability to throttle some of your campaigns on an inter-quarter basis, particularly given we're still only in the first 3 to 6 weeks of G6. Then I have one follow-up.

我想先談談本季表現強勁的整體氛圍。我想快速觸及一下你們在一些 DTC（直接面向消費者）活動與行銷中，對市場認知度的掌握情況。我知道你們做了不少數位投放，同時也有一些電視廣告。所以想請你們談談：你們如何看待 DTC 作為提升病患認知度的方式，以及你們在跨季度（inter-quarter）層面調整（throttle）部分活動強度的能力，特別是考量到我們仍然只處於 G6 上市後的前 3 到 6 週。然後我還有一個追問。

Yes. This is Kevin. I'll take that. We monitor those campaigns very closely. We've had a great deal of success with our DTC, our digital efforts and our television efforts, everything that we tried. We monitor their effectiveness. We adjust. We move, and change our approach literally on a real-time basis. We think that's very helpful in driving new patient demand. I would tell you, on the G6 front, we've had significant demand from our traditional channel, driven by our field sales team and their physicians, educators and nurse practitioners. So those are our 2 major channels for getting patients. I would tell you that once it come from the field have a higher percentage of turning into a sale, but we have very detailed systems as far as qualifying leads that come into our digital sources and from our TV programs to determine how strong our lead is and very, very detailed programs to call them within a very short period of time to keep their interest going. These are systems we've been building out over time. That's been a long road for us. We're really proud of that team. They've done a really good job.

是的。我是 Kevin。我來回答這個。我們非常密切地監控那些行銷活動。我們在 DTC、數位行銷以及電視行銷等各項嘗試上都取得了很大的成功。我們會監控它們的成效。我們會調整。我們會移動並改變我們的方法，幾乎是以即時的方式。我們認為這對於帶動新病患需求非常有幫助。我想告訴你，在 G6 方面，我們的傳統通路需求相當強勁，主要由我們的外勤銷售團隊以及他們所合作的醫師、衛教師與護理師（含專科護理師）所帶動。所以，這就是我們獲取病患的兩大主要通路。我會說，來自外勤的線索轉換成銷售的比例更高；但對於從數位來源與電視節目進來的線索，我們也有非常完善的系統來進行資格判定、評估線索強度，並且有非常、非常細緻的流程在很短時間內致電聯繫，以維持他們的興趣。這些系統是我們隨著時間逐步建立起來的。對我們而言，這是一段漫長的路。我們對那個團隊感到非常自豪。他們做得非常出色。

And then, last question just on the non-intensive population. I mean, I know that you have the pilot program going on with UnitedHealthcare. I mean, when we were at ADA, we saw a big focus, particularly on the clinical data front as far as diabetes prevention program data. I just want to see if you've given any thought to the non-intensive population and how you see that business model evolving, say, over the course of the next couple of years as we think about Verily Gen 1 starting to come in.

接著，最後一個問題是關於非密集治療族群。我的意思是，我知道你們正在與 UnitedHealthcare 進行試點計畫。我的意思是，當我們在 ADA（美國糖尿病學會年會）時，我們看到很大的焦點，特別是在臨床數據方面，例如糖尿病預防計畫（DPP）的數據。我只是想了解你們是否已經思考過非密集治療族群，以及你們如何看待在未來幾年、尤其是當 Verily Gen 1 開始導入時，這個商業模式會如何演進。

We give a lot of thought to that population because it's a very large market and we believe CGM can be a very, very powerful tool there. The question for us and the things we have to develop our models to whereby that tool is used most efficiently. On our current structure, for example, a Type 2 non-intensive patient wearing CGM all the time at today's prices is not feasible. But it is feasible for them to have an experience whereby they wear a CGM intermittently. One, 2, 4, 6x a year to determine that those meds they're taking are working properly and that -- and to see if there are improvements we can make in overall diabetes health with respect to diet and exercise. We have the UnitedHealthcare pilot. We have other pilots we're working on. We have the Verily Gen 1 product and also Verily's joint venture with Sanofi, Onduo, has made a lot of progress in that area too. We speak with a number of type 2 programs that are ongoing. And one of the things we see evolving over time is with the API platform we've built there may be in fact an opportunity for us to provide data feeds to some of these programs and develop an entire new business model that way. It's a very exciting area for us. I think the big question is the business model, what is the revenue per patient? How do we monetize our asset and our product? And how do we make it to whereby those who pay the bills can see the benefit for it because it's not just going to be throw devices at these people. There's going to have to be returns on it, and we're excited to demonstrate that and we've talked a lot about our UHC pilot. We think that will certainly demonstrate returns over time and there are others that we think will be beneficial as well. It's going to take a while, but it is going to be a very large market for it.

我們對那個族群投入了很多思考，因為那是一個非常龐大的市場，而且我們相信 CGM 在那裡可以是一個非常、非常有力的工具。對我們而言的問題，以及我們必須建立的模式，是要讓這個工具以最有效率的方式被使用。以我們目前的架構來看，例如第二型糖尿病的非密集治療病患若以今天的價格全天候配戴 CGM，並不可行。但讓他們以間歇方式使用 CGM 的體驗是可行的。例如一年配戴 1、2、4、6 次，用來確認他們正在使用的藥物是否有效運作，並且——也用來看看在飲食與運動方面，是否能在整體糖尿病健康上做出改善。我們有 UnitedHealthcare 的試點。我們也在進行其他試點。我們有 Verily Gen 1 產品；此外，Verily 與 Sanofi 的合資公司 Onduo 在這個領域也取得了很大進展。我們也與多個正在進行的第二型糖尿病方案保持溝通。而我們看到隨時間演進的一件事是：透過我們建立的 API 平台，實際上可能有機會向其中一些方案提供資料串流（data feeds），並以此發展出一個全新的商業模式。這對我們而言是非常令人振奮的領域。我認為最大的問題是商業模式：每位病患的收入是多少？我們要如何將我們的資產與產品變現？以及我們要如何讓付費者看見其效益，因為這不會只是把裝置丟給這些人就好。必須要有投資回報，而我們很期待能證明這一點；我們也談了很多關於 UHC 試點的內容。我們認為那將會隨時間清楚展現回報，另外也有其他我們認為同樣會帶來效益的方案。這會需要一些時間，但它將會是一個非常龐大的市場。

And the next question in the queue comes from Steven Lichtman from Oppenheimer.

接下來排隊的問題來自 Oppenheimer 的 Steven Lichtman。

So given the accelerated demand you're seeing, are you contemplating an expansion of the sales force here? And is that factored into the old OpEx guidance? Or was that solely higher variable, expenses on the higher revs?

鑑於你們看到需求加速成長，你們是否正在考慮擴編銷售團隊？而這是否已經反映在原先的營運費用（OpEx）指引中？還是那只是因為營收更高而帶來的較高變動費用？

It's variable expenses on the higher revs across the board. There's a number of areas. We're not contemplating a field sales force increase for 2018. Right now our field team is performing spectacularly, as is, we will evaluate the size and structure of the field sales force as part of our 2019 planning, which is going to be starting very soon, and we'll see how that goes. But for now, we're happy with the group that we have.

那是因為更高營收所帶來的各項變動費用。涉及的領域有好幾個。我們並未考慮在 2018 年增加外勤銷售人力。目前我們的外勤團隊表現非常出色；我們會在 2019 年規劃的一部分中評估外勤銷售團隊的規模與架構，而那個規劃很快就會開始，之後再看情況。但就目前而言，我們對現有團隊很滿意。

Got it. And then, just one quick follow-up. Can you remind us on the timing of the second gen transmitter and the benefits of it?

了解。接著再追問一個很快的問題。你能提醒我們第二代發射器的時程，以及它的優點嗎？

Our next-generation transmitter is literally complete electronics redesign. There will be significant cost advantage to that. I don't think we've disclosed the numbers, but it will be significant, and it will perform. As far as its range of transmission and user experience, we think it will be even more consistent, better than what we have now. We're working really hard to get that through validation or verification, so we can launch that sometime next year. That will have a very positive impact on our business.

我們的下一代發射器基本上是電子元件的全面重新設計。這將帶來顯著的成本優勢。我不認為我們已經披露具體數字，但會是很顯著的，而且它的表現也會更好。就傳輸距離與使用者體驗而言，我們認為它會更一致，甚至比我們目前的產品更好。我們正在非常努力地完成驗證或確認流程，以便能在明年某個時間推出。這將對我們的業務帶來非常正面的影響。

And the next question in the queue comes from Chris Pasquale with Guggenheim.

接下來排隊的問題來自 Guggenheim 的 Chris Pasquale。

Quentin, a 700 basis point headwind from channel shift seems like an awfully big number. Can you give us any help on the math you're doing there? And why that scenario is a realistic possibility?

Quentin，通路轉移帶來 700 個基點的不利影響，看起來是個非常大的數字。你能否協助我們理解你們在這裡的計算方式？以及為什麼那種情境是現實上可能發生的？

Look, what we said was there's potential channel shifts in there. So again, pharmacy subscription model as well as some of the competitive headwinds that could exist out there as well. So we're not going to break it down any more than that or quantify it any differently than that, but that's how we got into that number. Okay.

你看，我們說的是其中存在潛在的通路轉移。所以再說一次，包含藥局訂閱模式，以及也可能存在的一些競爭逆風。因此我們不會再進一步拆解、也不會用不同方式去量化；但我們就是這樣得出那個數字的。好的。

Okay. And then, the average wait time for a new patient today, if they want to get G6, what's that running at?

好的。那麼，目前新病患如果想要取得 G6，平均等待時間大概是多少？

I don't have that number off the top of my head. I don't think the total average waiting time is a whole lot higher than before, but there are times when -- and you can see this online where we've had certain components where you're going to have to wait 3 to 5 days for a little while. And then, we've had other times when you've had to wait a little bit longer. Our situation with having supply constraints has been very much more short term than a long-term situation where we've had to say, "Hey, you're not getting anything for a month". It's been more of "Here's a few days, and wait a few days on that." We're trying to manage this as close as we can and certainly keep everything as low as possible. But there are wait times and it varies. It literally varies based on production, and when we get goods in the inventory.

我一時沒有那個數字。我不認為整體平均等待時間比以前高很多，但有些時候——你也可以在網路上看到——我們某些零組件會需要等 3 到 5 天一段時間。另外也有其他時候需要等更久一點。我們目前的供應受限情況，比較偏向短期，而不是那種長期必須告訴你「你一個月都拿不到任何東西」的狀況。比較像是「這個等幾天，那個也等幾天」。我們正盡可能貼近地管理，並且確保把一切降到最低。但確實存在等待時間，而且會有所不同。它真的會隨著產量以及我們何時把貨品補進庫存而變動。

The next question in the queue comes from Suraj Kalia with Northland Securities.

隊列中的下一個問題來自 Northland Securities 的 Suraj Kalia。

Kevin, can you help me reconcile your comments about 3 weeks of G6 launch in the quarter? And I believe you also said there was inability to supply enough product, and there was an impact, nonrecurring impact, on gross margins. I don't think so I got the number down. But can you just tie both of those together and help us understand the 3 weeks and why the impact -- such a big impact from gross margins from G6?

Kevin，你能幫我釐清你提到本季有 3 週的 G6 上市這件事嗎？而且我相信你也說過供應不足，並且對毛利率造成了影響，是一次性的影響。我想我沒有把數字記下來。但你能否把這兩點串起來，幫我們理解這 3 週的情況，以及為什麼 G6 對毛利率的影響——會有這麼大的影響？

Yes. Suraj, this is Quentin. I'll jump in and take that for you. What Kevin was alluding to was G6 really was only available in the last 3 weeks or so of the quarter. The demand was really driven out of the G5 product lines. But if you can imagine, as you're starting to ramp or anticipating the ramp in G6, you're starting to slow down some of your G5 production line. At the same time, you have demand going the other way. So they'd have to reignite those or to bring other lines back up to meet that demand is highly inefficient. So we're doing it to get product into the hands of the patients, which is the right thing to do, but you're doing it in a less efficient way than what you had anticipated being able to do it had everything moved to G6 more quickly or if the demand hadn't come in as strongly as they had. But we had produced a whole lot more throughput through the plan that we had originally anticipated. So that's what's driving the inefficiency.

是的。Suraj，我是 Quentin。我來回答這個問題。Kevin 所指的是，G6 實際上只在本季最後大約 3 週左右才開始供應。需求其實主要是由 G5 產品線所帶動。但你可以想像，當你開始爬坡、或預期 G6 要爬坡時，你會開始放慢部分 G5 的生產線。同時，需求卻往相反方向走。因此，他們必須重新點燃那些產線、或把其他產線再拉回來以滿足需求，這是非常沒有效率的。所以我們這麼做是為了把產品交到病患手上，這是正確的事，但你採用的方式比原先預期的效率更低；如果一切能更快轉到 G6，或需求沒有來得這麼強勁，本來是可以更有效率地完成的。但我們實際透過原先規劃所預期的產出吞吐量要高得多。這就是造成效率不彰的原因。

Fair enough. And Kevin, I was asked this question by a client, and I've completely confessed it stumped me. I've never heard of this through my field checks. But maybe you can just kind of see if this is in the realm of possibility. And the question was, like UnitedHealthcare paired up with Medtronic as a preferred pump supplier. And Medtronic is offering risk-sharing programs. And I was asked specifically, can you anticipate any of the payers going down this route on the CGM side. And I confess I had no idea how to respond to that question. Love to get your thoughts on this.

了解。另外，Kevin，有位客戶問了我一個問題，我坦白說完全被問倒了。我從我的通路調查中從未聽過這種情況。但也許你可以看看這是否在可能範圍內。問題是，像 UnitedHealthcare 與 Medtronic 合作，把 Medtronic 作為偏好（preferred）的幫浦供應商。而 Medtronic 正在提供風險分攤（risk-sharing）方案。對方特別問我，你是否預期在 CGM 端也會有任何付款方走這條路。我坦白說不知道該怎麼回答這個問題。很想聽聽你的看法。

I appreciate the question. We don't have Medtronic's balance sheet. I wish we did. With respect to risk-sharing, the risks that we prevent are severe hypoglycemia and the outcomes that we generate are reduced A1cs. To the extent a payer has a very, very accurate mechanism for measuring those things, we would invite the opportunity to make those type of proposals. The other thing that we all need to be cognizant of is we certainly haven't read how those risk-sharing arrangements work for other companies. With respect to being a preferred CGM provider, I know people ask for that and look for that. With our current market share, if you -- like the T1D data that was, I think, near 80% from those patients and stuff. We appear to be the preferred CGM provider of patients. Anyway, so we'll continue to push that and being a leader here. We don't anticipate being aced out there, but we are not afraid to take make those types of proposals ourselves. We just don't have any -- that have won. Not afraid of that.

謝謝你的提問。我們沒有 Medtronic 那樣的資產負債表。我倒希望我們有。就風險分攤而言，我們所預防的風險是嚴重低血糖，而我們帶來的結果是降低 A1c。如果某個付款方有非常、非常精準的機制來衡量這些事情，我們樂於有機會提出這類提案。另外大家也需要注意的是，我們當然沒有讀到其他公司那些風險分攤安排是如何運作的。至於成為偏好的 CGM 供應商，我知道大家會問、也會尋找這種安排。以我們目前的市占率來看，如果你看——例如 T1D 的數據，我記得那些病患大概接近 80% 之類的。看起來我們已經是病患偏好的 CGM 供應商。總之，我們會持續推進並在這裡保持領先。我們不預期會被排擠出局，但我們也不害怕自己提出這類提案。只是我們目前沒有——已經成功贏得的案例。但不害怕。

The next question in the queue comes from Ravi Misra from Berenberg.

隊列中的下一個問題來自 Berenberg 的 Ravi Misra。

I'll go to the next question. Next question in the queue comes from Isaac Ro with Goldman Sachs.

我先進到下一個問題。隊列中的下一個問題來自 Goldman Sachs 的 Isaac Ro。

Quentin, just a question on what happened in the quarter and what it implies for the back half? So if I look at the growth rate, sequentially, the huge acceleration, the biggest in years. And at the same time, the first quarter sequential growth rate from fourth quarter was actually down, right? So it was a big inflection in the short period of time. And I would appreciate a little bit more detail as to why the market would inflect so much this quarter. I know there's a lot of things happening in the marketplace, but it just seems like a really acute dynamic in the market.

Quentin，我想問一下本季發生了什麼，以及這對下半年意味著什麼？如果我看成長率，按季比較出現了大幅加速，是多年來最大的一次。同時，第一季相對第四季的按季成長率其實是下滑的，對吧？所以在很短時間內出現了很大的轉折點。我希望能多一些細節，說明為什麼市場會在這一季出現這麼大的轉折。我知道市場上有很多事情在發生，但這看起來像是非常急劇的市場動態。

Well, sequentially, Q1 has always been down from Q4. I think you just naturally have that, particularly with the heavy weight of our business that flows through the U.S. commercial business where insurance deductibles kind of -- from that kind of behavior. So that's natural to see. You're right. The sequential increase from Q2 or off of Q1 into Q2 was far beyond anything you've seen historically, and I think that's part of what we're articulating here is that we're incredibly bullish on where this has the opportunity to go and just the early aspect of CGM adoption. But at the same time, we're not going to call it a trend just yet. That's 90 days of experience that was far beyond your expectations and it just puts a strain on the organization. We're responding to it, and we'd love to have that challenge continue to be played out in Q3 and Q4, but we're not going to call it just yet. We want to see that play out further.

嗯，按季來看，Q1 一直都會比 Q4 低。我想這是很自然的，尤其我們業務中很大一部分來自美國商業保險市場，保險自付額（deductibles）會帶來那種行為模式。所以看到這種情況很正常。你說得對。從 Q1 到 Q2 的按季增幅遠超過你歷史上看到的任何情況，我想這也是我們在此要表達的一部分：我們對這個機會能走到哪裡非常看多，也看到 CGM 採用仍處於早期階段。但同時，我們還不會把它稱為趨勢。那是 90 天的經驗，遠超出你們的預期，也確實讓組織承受壓力。我們正在回應，我們也希望這個挑戰能在 Q3 和 Q4 持續上演，但我們現在還不會下定論。我們想再觀察它後續的發展。

Okay. Helpful. And then, just a follow-up on the product. If I look at the same conversation from a product mix standpoint, you guys have mentioned that -- on the call here, that the demand was mostly for G5. And I'm curious it seemed to be the market or these patients were aware that G6 was coming. It was, obviously, going to be a big improvement. So why would demand for G5 ramp so much sequentially, if patients knew G6 was around the corner?

好的。很有幫助。接著就產品再追問一下。如果我從產品組合的角度看同一段對話，你們在這通電話中提到——需求主要是 G5。我很好奇，市場或這些病患似乎知道 G6 即將推出。而且顯然會是很大的改進。那麼如果病患知道 G6 就在眼前，為什麼 G5 的需求還會按季大幅攀升？

It comes back to general awareness. I just think awareness in this marketplace is increasing significantly. You've got big players out here who are putting big dollars to work to advertise and create awareness around the space. And I think as we've said from day 1, multiple players are going to have success here. It's not going to be one player or another. All of us are going to win together and I think that's exactly what you just saw play out in Q2.

這要回到整體認知度（awareness）。我只是認為這個市場的認知度正在顯著提升。你看到一些大型玩家投入大量資金做廣告，並在這個領域建立認知。而且我想我們從第一天就說過，這裡會有多個玩家取得成功。不會只有某一個玩家贏、另一個輸。我們大家會一起贏，而我想這正是你在 Q2 看到的情況。

And the question in the queue comes from Ravi Misra from Berenberg.

隊列中的問題來自 Berenberg 的 Ravi Misra。

So just to piggyback on Isaac's question there. I'm just curious, just versus our numbers at least, the sensor outperformance was pretty significant, suggesting transmitter and receiver beats -- while (inaudible) were not as strong as that. Just curious, given that G5 and G6 is going to have some transition at some point, are you seeing any higher reorder rates from existing customers? Particularly stocking up on sensors given that they know a fixed life is coming down the pike? And then, secondly, my follow-up is, I think in the past, you've referred to the Abbott Libre performance has created a patient population for you to siphon off some customers once they realize that, that technology isn't as capable as yours. A little bit more color around the new patient starts. Is that still continuing? And how should we think about that?

我就順著 Isaac 的問題再追問一下。我只是好奇，至少相較於我們的數字，感測器的超預期表現相當顯著，顯示發射器與接收器的表現優於預期——而（聽不清）則沒有那麼強。想請教，考量到 G5 與 G6 在某個時間點會有轉換，你們是否看到既有客戶有更高的再訂購率？特別是他們知道固定使用壽命即將到來，因此提前囤貨感測器？第二個追問是，我記得過去你們提到 Abbott Libre 的表現為你們創造了一群病患族群，讓你們能在他們發現那項技術不如你們的技術那麼強時，吸引部分客戶轉換過來。能否再多補充一些關於新病患啟用（new patient starts）的情況？這個趨勢是否仍在持續？我們應該如何看待這件事？

Well, I'll talk to the revenue growth rate across kind of the categories that you mentioned, transmitters, receivers being a bit slower than what you saw on the sensor side. I think, for a couple of reasons. One, in this international space, it's receiver-optional for us. So you don't necessarily always see folks purchasing the receiver as they come to become a DexCom user, and that plays out in the results. We talked about this promotional program of G5 into G6. That played out in the quarter and there's still a bit of deferral that would come back in the back part of the year over the next 6 months at some point roughly $5 million or so that didn't come in Q2. You normalize for that and you got a growth rate in your transmitter business that's right back up in line, close to that sensor business, which I think you can triangulate that back to a combination of, obviously, a ramp in new patients coming in to the business that awareness is being created in the space and continued strong utilization from your existing user base.

我先談談你提到的各類別營收成長率：發射器、接收器相較於感測器端看起來慢一些。我想原因有幾個。第一，在國際市場，我們的產品是「接收器可選」。因此，當使用者成為 DexCom 用戶時，不一定都會購買接收器，這也反映在結果上。我們也談到過從 G5 升級到 G6 的促銷方案。這在本季有所反映，而且仍有一部分遞延將在今年後半、未來大約 6 個月內回補，約 500 萬美元左右在第二季沒有入帳。把這個因素正常化後，你會看到發射器業務的成長率就回到與感測器業務相當、非常接近的水準；我想你也可以交叉驗證，這主要來自幾個因素的組合：顯然是新病患持續加速導入、在市場上建立起更多認知，以及既有用戶群持續強勁的使用量。

And then, just around that -- the Abbott commentary. Is that awareness that they're creating there creating an expanding group of patients for you to kind of siphon off from them?

那再回到——關於 Abbott 的評論。他們在那邊所建立的市場認知，是否正在擴大一群病患，讓你們可以從他們那裡「吸引」過來？

Ravi, we don't have exact numbers saying how many patients have come to us from that. We can anecdotally tell you, we've heard this, and we've heard this for years in Europe. Particularly, as you get somebody intensively managing their diabetes, they tried the Abbott technology and aren't getting the experience that they're looking for, the experience of alerts, alarms and continuous readings. So yes, that happens, but I can't quantify it.

Ravi，我們沒有精確數字可以說有多少病患是從那邊轉到我們這裡。但我們可以用一些軼事經驗告訴你，我們確實聽到這樣的情況，而且在歐洲我們多年來一直都有聽到。特別是當某位病患更密集地管理糖尿病時，他們試過 Abbott 的技術，但沒有得到他們想要的體驗——例如警示、警報以及連續讀值的體驗。所以，是的，確實會發生，但我無法量化。

We have no further questions at this time. I'll turn the call back over to Kevin Sayer for closing remarks.

目前沒有其他問題。我把電話交回給 Kevin Sayer 作結語。

Well, we'd like to thank everybody for listening in and participating in our call today. As you can see in our results, the diabetes community remains bullish on DexCom, and our outlook going forward is stronger than it's ever been.

我們要感謝各位今天收聽並參與我們的電話會議。從我們的結果可以看到，糖尿病社群對 DexCom 仍然看多，而我們對未來的展望也比以往任何時候都更強勁。

G6 is not just a product launch for us, but it's a generational platform shift. This platform provides us with the technological foundation to take CGM across all of health care. There's no technology out there that can provide a glucose management experience that cannot be achieved through the G6 platform, only G6 does it better.

對我們而言，G6 不只是一次產品上市，而是一個世代的平台轉移。這個平台為我們提供了技術基礎，讓我們能把 CGM 推廣到整個醫療照護領域。市面上沒有任何技術能提供一種血糖管理體驗，而這種體驗無法透過 G6 平台達成；只有 G6 能做到，而且 G6 做得更好。

That being said, rest assured, we'll never sit still. We're already driving the team to get going on our next-generation systems to expand our manufacturing, transactional capacity and provide more meaningful tools for our patients and partners, all the while trying to navigate the day-to-day realities of launching our new system, and to this much more competitive and complex global marketplace.

話雖如此，請放心，我們絕不會停下腳步。我們已經在推動團隊啟動下一代系統，以擴充我們的製造與交易處理能力，並為病患與合作夥伴提供更有意義的工具；同時也努力在推出新系統的日常現實中前行，並面對這個競爭更激烈、也更複雜的全球市場。

I want to once again recognize all the substantial efforts of all the DexCom teams through this time. And once again, thanks, Terry. Thank Terry for his leadership, mentorship, and vision, over the past 13 years. This ride isn't going to slow down anytime soon. Thank you, everybody.

我想再次肯定 DexCom 各團隊在這段期間所付出的巨大努力。也再次謝謝 Terry。感謝 Terry 在過去 13 年的領導、指導與遠見。這段旅程短期內不會放慢。謝謝大家。

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

謝謝。各位女士、先生，今天的電話會議到此結束。感謝各位參與。您現在可以掛線。