德康醫療 (DXCM) 2013 Q4 法說會逐字稿

Welcome to the DexCom fourth-quarter and full-year 2013 earnings release conference call. My name is Joe and I will be your operator for today's call. At this time, all participants are in a listen-only mode and later we will conduct a question-and-answer session. Please note that this conference is being recorded.

歡迎參加 DexCom 2013 年第四季及全年財報發布電話會議。我是 Joe，將擔任今天會議的接線員。目前所有與會者將以僅聆聽模式參與，稍後我們將進行問答環節。請注意，本次會議將被錄音。

I will now turn the call over to Terry Gregg. Mr. Gregg, you may begin.

現在我將把電話交給 Terry Gregg。Gregg 先生，您可以開始。

Thank you, operator, and thank you to everyone for joining DexCom for our fourth-quarter 2013 conference call. As usual, I will ask Steve Pacelli to provide you with our Safe Harbor statement.

謝謝，接線員，也感謝各位加入 DexCom 2013 年第四季電話會議。依照慣例，我將請 Steve Pacelli 向各位宣讀我們的「安全港」聲明。

Thank you, Terry. Some of the statements that we will make in today's call may constitute forward-looking statements. These statements reflect management's expectations about future events, operating plans, and performances and speak only as of the date hereof. These forward-looking statements involve a number of risks and uncertainties. A list of factors that could cause actual results to be materially different from those expressed or implied by any of these forward-looking statements is detailed under Risk Factors and elsewhere in our annual report on Form 10-K, our quarterly reports on Form 10-Q, and our other reports filed with the SEC. We undertake no obligation to update publicly or revise these forward-looking statements for any reason.

謝謝你，Terry。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、營運計畫與業績表現的預期，且僅以本日為準。這些前瞻性陳述涉及多項風險與不確定性。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存在重大差異的因素清單，已在我們的 Form 10-K 年報、Form 10-Q 季報以及其他向 SEC 提交的報告中的「風險因素」及其他章節詳述。我們不承擔因任何原因公開更新或修訂這些前瞻性陳述的義務。

Additionally, we will discuss certain financial information that has not been prepared in accordance with GAAP with respect to our cash operating loss. This non-GAAP information is provided to enhance your overall understanding of our current financial performance. 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. Terry?

此外，我們將討論若干未依 GAAP 編製的財務資訊，涉及我們的現金營運虧損。提供此非 GAAP 資訊旨在增進您對我們目前財務表現的整體理解。此額外資訊之呈現不應被孤立看待，亦不應作為依 GAAP 編製結果的替代，或被視為優於依 GAAP 編製的結果。Terry？

Thank you, Steve. Well joining me today are Kevin Sayer, our President and Chief Operating Officer; Jess Roper, our Chief Financial Officer; and you just heard from Steve Pacelli, our Executive Vice President of Strategy and Corporate Development.

謝謝你，Steve。今天與我一同出席的還有：我們的總裁兼營運長 Kevin Sayer；財務長 Jess Roper；以及剛才各位聽到的策略與企業發展執行副總裁 Steve Pacelli。

Our agenda for today's call is fairly typical. I will provide some introductory thoughts. Kevin will review our detailed fourth-quarter 2013 financial results, and provide our customary operations update, and then I will offer some concluding thoughts.

今天會議的議程相當典型。我將先做一些開場說明。Kevin 會回顧我們 2013 年第四季的詳細財務結果並提供例行的營運更新，接著我將做一些結語。

At the JPMorgan Healthcare Conference in January, we announced Q4 and full-year 2013 product revenue of approximately $51 million and $157 million, respectively. What we did not disclose at JPMorgan, but I am pleased to announce today, is that for the second straight quarter, and for all FY2013, DexCom was cash flow positive.

在 1 月的摩根大通醫療健康大會（JPMorgan Healthcare Conference）上，我們宣布 2013 年第四季及全年產品營收分別約為 5,100 萬美元與 1.57 億美元。我們在摩根大通大會上未揭露、但我很高興今天宣布的是：連續第二個季度，以及 2013 全年，DexCom 的現金流為正。

Before I turn the call over to Kevin, I would like to update the investment community on my evolving role at DexCom. As you know, I joined DexCom in 2005 as an independent member of the Board, and came out of my then retirement in 2007 to become the President and CEO. As a management team, we have grown the business over the past several years, and enjoy an elite status in the med-tech space.

在把電話交給 Kevin 之前，我想向投資界更新我在 DexCom 逐步演變的角色。如各位所知，我於 2005 年以董事會獨立董事身分加入 DexCom，並於 2007 年自當時的退休狀態復出，擔任總裁兼執行長。作為管理團隊，我們在過去幾年推動業務成長，並在醫療科技領域享有領先地位。

In 2011, we added Kevin Sayer as our President, and he assumed the title of Chief Operating Officer in 2012, to the expectation that he would mature into the role of Chief Executive Officer as my successor, and I would move to the position of Executive Chairman. As most of you are aware over the past several years, my role has become increasingly external. I have spent the vast majority of my time in the field, being with clinicians and other key stakeholders in diabetes.

2011 年，我們延攬 Kevin Sayer 擔任總裁；他於 2012 年取得營運長頭銜，並以他將逐步成熟、接任我成為執行長為目標，而我則將轉任執行董事長。過去幾年多數人都知道，我的角色愈來愈偏向對外。我把絕大部分時間花在第一線，與臨床醫師及糖尿病領域的其他關鍵利害關係人互動。

During that time, Kevin has been largely responsible for the day-to-day operations of DexCom, and he has done a remarkable job, as witnessed by our growth and success. So on behalf of the Board of Directors, I am pleased to announce that effective January 1, 2015, Kevin will assume the title of President and Chief Executive Officer, and I will transition in to my role as Executive Chairman, remaining, of course, as an employee and active member of the Senior Management Team.

在此期間，Kevin 主要負責 DexCom 的日常營運，而且他做得非常出色，從我們的成長與成功即可見一斑。因此，我很高興代表董事會宣布：自 2015 年 1 月 1 日起，Kevin 將出任總裁兼執行長，而我將轉任執行董事長；當然，我仍將以員工身分留任，並作為高階管理團隊的積極成員持續參與。

With that I would like to turn the call over to Kevin Sayer.

接下來我想把電話交給 Kevin Sayer。

Thank you, Terry. I will start off with our financial update. DexCom generated $51.3 million in product revenue for the fourth quarter of 2013, compared to $31.7 million for the same quarter in 2012, a $19.6-million, or 62%, increase. We are especially pleased with our year-over-year financial performance. When you consider that we are comparing the fourth quarter of 2013 to a quarter in which we had very robust product sales in connection with our Q4 2012 launch of the G4 Platinum.

謝謝你，Terry。我先從財務更新開始。DexCom 2013 年第四季產品營收為 5,130 萬美元，較 2012 年同季的 3,170 萬美元增加 1,960 萬美元，增幅 62%。我們對年對年的財務表現尤其感到滿意，因為我們是在將 2013 年第四季與 2012 年第四季相比；而 2012 年第四季因 G4 Platinum 於該季上市而帶動產品銷售非常強勁。

Sequentially, product revenue for Q4 of 2013 increased 21% from the prior quarter. Total revenue for the fourth quarter of 2013 was $51.7 million, compared to $33.3 million during the same quarter in 2012. Our product gross profit totaled $34.1 million, generating a product gross margin of 66% for the fourth quarter of 2013, compared to product gross profit of $17.2 million and a product gross margin of 54% for the same quarter in the prior year. Sequentially, product gross margin for Q4 of 2013 increased only slightly from the entire quarter.

以季對季來看，2013 年第四季產品營收較前一季成長 21%。2013 年第四季總營收為 5,170 萬美元，較 2012 年同季的 3,330 萬美元增加。產品毛利合計 3,410 萬美元，使 2013 年第四季產品毛利率達 66%；相較之下，前一年同季產品毛利為 1,720 萬美元、產品毛利率為 54%。以季對季來看，2013 年第四季產品毛利率僅較上一季略有提升。

Although we are now achieving our gross margin target of 70% to 75% on our sensor disposables and approximately 50% on our hardware, going forward, we will continue to seek improved gross margins through increased volumes, continued manufacturing improvements, the continued shift of the sales mix to more disposable revenue, along with our future product designs.

雖然我們目前在感測器耗材已達成 70% 至 75% 的毛利率目標，且硬體約為 50%，但展望未來，我們仍將透過提高出貨量、持續改善製造、持續將銷售組合轉向更多耗材營收，以及未來的產品設計，來追求更高的毛利率。

Some final thoughts on our product revenue and gross profits: during Q4, we added more new patients and sold more sensors than any other previous quarter. Consumable and durable revenues both increased significantly from Q3 2013. The improvements in patient retention and increased sensor utilization with the G4 Platinum system we spoke of during our last earnings call held steady during Q4.

關於產品營收與毛利的最後幾點：在第四季，我們新增的新病患數與感測器銷售量均創下歷來單季新高。耗材與耐用品營收相較 2013 年第三季皆大幅成長。我們在上次財報電話會議中提到的 G4 Platinum 系統病患留存改善與感測器使用率提升，在第四季仍維持穩定。

Our mix between durable and consumer products is approximately 30% durable and 70% consumable, a mix we expect to remain fairly consistent going forward. ASPs for sensors has stayed consistent at approximately $70 per sensor, and the ASP for our hardware continued at approximately $850 per starter kit. Finally, our international business performance exceeded our expectations in 2013, as it was up approximately 80% year over year and represents approximately 8% of product revenue.

我們在耐用品與耗材產品之間的組合約為 30% 耐用品、70% 耗材；我們預期此組合未來將大致維持一致。感測器的平均銷售單價（ASP）維持在每個約 70 美元，而硬體的 ASP 仍約為每套入門組 850 美元。最後，我們 2013 年的國際業務表現超出預期，年增約 80%，並約占產品營收的 8%。

Research and development expense totaled $12.6 million for Q4 of 2013, compared to $8.6 million in Q4 of 2012, with the increase due primarily to additional payroll-related costs and expenses related to work on our near-term product pipeline. Sequentially, R&D expense was up 7%, with the increase primarily due to additional payroll costs and non-cash charges related to our SweetSpot acquisition and share-based compensation expense. As we move forward into 2014, we expect that R&D expense for the full year will be up between 10% to 20% versus 2013.

2013 年第四季研發費用合計 1,260 萬美元，較 2012 年第四季的 860 萬美元增加；增加主要來自額外的人事相關成本，以及與我們近期產品管線工作相關的費用。以季對季來看，研發費用增加 7%，主要因額外的人事成本，以及與我們收購 SweetSpot 相關的非現金費用與股份基礎給付費用。展望 2014 年，我們預期全年研發費用將較 2013 年增加約 10% 至 20%。

Some expenses, such as overhead and our share-based compensation expense, will increase as a cost of doing business. Additional increases will depend upon our development progress and regulatory timelines with respect to continued system performance improvements, development of our G5 and G6 systems, our mobile and cloud-based data platforms, and a variety of clinical trial opportunities we expect to explore during 2014.

部分費用（例如管理間接費用以及我們的股份基礎給付費用）將隨著業務經營而增加。其他額外增加則將取決於我們在系統性能持續改善、G5 與 G6 系統開發、行動與雲端資料平台，以及我們預期於 2014 年探索的各項臨床試驗機會之研發進度與法規時程。

Selling, general, and administrative expense totaled $23.8 million in Q4 of 2013, compared to $17.3 million during the same quarter in 2012. The increase was primarily related to increased headcount in our sales organization and increased variable compensation for the sales team related to our robust product sales during the quarter. The increase also included $1.1 million of additional non-cash share-based compensation.

2013 年第四季銷售、一般及行政（SG&A）費用合計 2,380 萬美元，較 2012 年同季的 1,730 萬美元增加。增加主要與我們銷售組織人力擴編，以及因本季產品銷售強勁而提高銷售團隊的變動薪酬有關。此增加亦包含 110 萬美元的額外非現金股份基礎給付費用。

As we look to fiscal 2014, we expect an increase in SG&A expense of approximately 20% to support our growth, driven primarily by increased share-based compensation expense, as well as investments in sales and marketing and our infrastructure necessary to support growth.

展望 2014 會計年度，為支持成長，我們預期 SG&A 費用將增加約 20%；主要驅動因素為股份基礎給付費用增加，以及對銷售與行銷的投資，並強化支持成長所需的基礎設施。

Our net loss for the fourth quarter of 2013 totaled $2.6 million and included $9.3 million in non-cash expenses, centered in share-based compensation, depreciation, and amortization. Absent these charges, our net income would have been $6.7 million for Q4 2013. Also, absent our non-cash charges, our net income for fiscal 2013 would have been $5.2 million. Compare this to an adjusted cash-based net loss of $2.2 million for the same quarter last year and an adjusted cash-based net loss of $29.2 million for the full year in 2012.

我們2013年第四季的淨損失合計為260萬美元，其中包含930萬美元的非現金費用，主要來自股份基礎給付、折舊與攤銷。若不計入這些費用，我們2013年第四季的淨利將為670萬美元。此外，若不計入非現金費用，我們2013會計年度的淨利將為520萬美元。相較之下，去年同一季度經調整、以現金為基礎的淨損失為220萬美元，而2012年全年經調整、以現金為基礎的淨損失為2,920萬美元。

If I could summarize our operating performance, it's pretty simple. During 2013, our product revenues increased by $64 million. And our cash base, operating results increased by $34 million. It's an amazing accomplishment for our team.

如果要我總結我們的營運表現，其實很簡單。2013年期間，我們的產品營收增加了6,400萬美元；而以現金為基礎的營運結果改善了3,400萬美元。這對我們團隊而言是了不起的成就。

Our loss per share for the quarter was $0.04. With respect to our balance sheet, we ended the fourth quarter with $54.6 million in cash and marketable securities and debt availability of $28 million.

本季每股虧損為0.04美元。就資產負債表而言，我們在第四季末持有5,460萬美元的現金與有價證券，並有2,800萬美元的可用債務額度。

I would like to close the discussion of our financial results with some thoughts on the first quarter of 2014. While we do not give specific quarterly guidance, as we've discussed on numerous occasions, the fourth quarter is typically the strongest of the year for those in the durable medical equipment business, as annual deductibles have generally been met and flexible spending account deadlines loom. So patients who participate in these employer-sponsored programs must utilize any excess funds they have saved prior to year end.

我想以對2014年第一季的一些看法來結束對財務結果的討論。雖然我們不提供具體的季度指引，但如同我們多次討論過的，對耐用醫療設備業者而言，第四季通常是一年中最強勁的季度，因為年度自付額一般已達成，且彈性支出帳戶的截止期限將至。因此，參與這些雇主贊助計畫的病患，必須在年底前使用其先前儲存的任何剩餘資金。

Just as a point of reference, our Q4-2013 product revenue exceeded our total product revenue for 2010 by over $10 million. Obviously our strong Q4 performance begs the question, what will our growth be in 2014? As a reminder, at the JPMorgan Healthcare Conference in January, we issued guidance of estimated full-year 2014 product revenue ranging from $205 million to $225 million, and we remain comfortable with that guidance.

作為參考，我們2013年第四季的產品營收，比2010年全年的產品營收還高出逾1,000萬美元。顯然，我們強勁的第四季表現引出了問題：2014年的成長會是多少？提醒各位，在1月的摩根大通醫療健康大會上，我們發布了2014年全年產品營收的指引，估計介於2.05億至2.25億美元之間，我們仍對該指引感到有信心。

While we do not provide specifically quarterly guidance, I remind investors that the first quarter is traditionally a seasonally slow quarter for our business, as annual insurance deductibles reset and flexible spending accounts are largely unfunded. As a result, our patients typically purchase as much product as they can during the fourth quarter, and 2014 was no exception.

雖然我們不提供具體的季度指引，但我提醒投資人，第一季傳統上是我們業務的季節性淡季，因為年度保險自付額重置，且彈性支出帳戶多半尚未入金。因此，我們的病患通常會在第四季盡可能多購買產品，2014年也不例外。

We now have data to support that the average out-of-pocket expense for a patient during the first quarter of a given year is approximately 40% to 50% higher than the average out-of-pocket expense for a patient during the fourth quarter of the prior year. That out-of-pocket expense decreases gradually through each quarter over the course of the year.

我們現在已有數據支持：在某一年度的第一季，病患平均自付費用約比前一年度第四季病患的平均自付費用高出約40%至50%。該自付費用會在一年中隨著每一季逐步下降。

I also remind investors that in past years, including 2013, approximately 40% to 45% of our product revenue was generated in the first half of the year, and 55% to 60% was generated in the second half. And we do not view 2014 any differently. Finally, last year Q1 accounted for approximately 20% of our annual revenue, and we would expect similar performance in the first quarter this year.

我也提醒投資人，過去幾年（包括2013年），約40%至45%的產品營收來自上半年，55%至60%來自下半年。我們不認為2014年會有不同。最後，去年第一季約占我們全年營收的20%，我們預期今年第一季也會有類似表現。

I will move on to our business update. I am pleased to share that we have achieved another significant operational milestone. Just two weeks ago, we received FDA approval of an expanded indication for our G4 Platinum to include patients as young as two years of age. We began taking orders for our pediatric product immediately upon approval, and we completed our initial shipments to patients within a matter of days.

接下來我將說明我們的業務更新。我很高興分享我們達成了另一個重要的營運里程碑。就在兩週前，我們獲得FDA核准，將我們G4 Platinum的適應症擴大至最小兩歲的病患。我們在核准後立即開始接受兒科產品訂單，並在數天內完成對病患的首批出貨。

I would like to acknowledge the hard work of the people at DexCom, especially our outstanding clinical, regulatory and operations teams, who have enabled DexCom to bring such an important technology to virtually all people with diabetes. We have several additional filings pending before the FDA, including a PMA supplement seeking approval of the DexCom share system and a PMA supplement seeking an expanded indication for G4 Platinum for professional use. We continue to have active dialogue with the agency regarding these important products.

我想肯定DexCom同仁的辛勤付出，特別是我們傑出的臨床、法規與營運團隊，讓DexCom得以將如此重要的技術帶給幾乎所有糖尿病患者。我們仍有數項額外申請案在FDA審查中，包括一項PMA補充申請，尋求核准DexCom share系統，以及一項PMA補充申請，尋求將G4 Platinum的適應症擴大至專業用途。我們持續就這些重要產品與主管機關保持積極對話。

Turning to our future CGM product offerings, we remain focused on increasing [connectivity] and convenience as a near-term goal, and replacing finger sticks is our primary long-term objective. We continue to work on both Gen5 and Gen6 in an effort to achieve these goals. We continue to believe that simplicity, patient convenience, and expanded connectivity, paired with our superior technology will enable us to maintain our leadership position in the CGM market.

談到我們未來的CGM產品供應，我們仍聚焦於在短期內提升[連線性]與便利性，而以取代指尖採血作為我們主要的長期目標。我們持續推進Gen5與Gen6的研發，以達成這些目標。我們仍相信，簡易性、病患便利性與更廣泛的連線性，結合我們卓越的技術，將使我們能在CGM市場維持領導地位。

Shifting to our integration partnerships, both Animas and Tandem continue to press forward with final development, testing, and regulatory matters with their respective sensor-augmented pump systems, and we continue to assist them in these endeavors when asked.

轉到我們的整合合作夥伴，Animas與Tandem皆持續推進其各自的感測器整合胰島素幫浦系統之最終開發、測試與法規相關事項；在對方提出需求時，我們也持續協助其推動這些工作。

I would now like to turn the call over to Terry for some concluding remarks.

現在我想把電話會議交給Terry，請他做一些結語。

Thank you, Kevin. I would like to start by highlighting our 2013 financial performance. Product revenue clearly exceeded our expectations, both in Q4 and for the full year, but I am equally pleased by our operating performance. As you know, our Board set a stretch goal for us to reach cash operating breakeven for full-year 2013, and we achieved that goal. Needless to say, I'm excited by the long-term profitability profile we believe we can achieve here at DexCom.

謝謝你，Kevin。我想先強調我們2013年的財務表現。產品營收在第四季與全年都明顯超出我們的預期，但我對我們的營運表現同樣感到滿意。如各位所知，我們董事會為我們設定了一個具挑戰性的目標：在2013全年達到現金營運損益兩平，而我們達成了該目標。不用說，我對我們相信DexCom能達成的長期獲利能力輪廓感到振奮。

Having just returned from the annual ATTD meeting in Europe, we remain convinced that sensor accuracy is what matters most. And while the competition tries to confuse the issue, in multiple independent studies, our G4 Platinum sensor is significantly more accurately than Medtronic's Enlite sensor.

我剛從歐洲年度ATTD會議返美，我們仍深信感測器準確度才是最重要的。儘管競爭對手試圖混淆焦點，但在多項獨立研究中，我們的G4 Platinum感測器明顯比美敦力（Medtronic）的Enlite感測器更為準確。

At this point, most investors are aware of the work by Boston University where Doctor Steven Russell shared comparative data from patients simultaneously wearing the G4 Platinum and Medtronic's Enlite, with reported MARD of 10.8% from the G4 Platinum and 17.9% from the Enlite. And during our last earnings call, we discussed data presented by Harvard Children's Hospital examining the use of CGM in critically ill infants, and reporting an MARD for the Enlite of 17.8% and an MARD of 11.7% for the G4 Platinum.

此時，多數投資人都已了解波士頓大學的研究工作，Steven Russell醫師分享了病患同時配戴G4 Platinum與美敦力Enlite的比較數據，報告顯示G4 Platinum的MARD為10.8%，Enlite為17.9%。此外，在我們上一次法說會中，我們也討論了哈佛兒童醫院所發表的數據，該研究檢視CGM在重症嬰兒中的使用，並報告Enlite的MARD為17.8%，G4 Platinum的MARD為11.7%。

Well, earlier this month at ATTD, data from the SPACE2 study was presented. SPACE2 is yet another independent, head-to-head study, and this time, the data showed an MARD range of 12.2% to 13.6% for the G4 Platinum and 16.6% to 19.9% for the Enlite. This data also showed particularly poor hypoglycemia performance for Enlite

而在本月稍早的ATTD上，發表了SPACE2研究的數據。SPACE2是另一項獨立的正面對決研究；這次數據顯示，G4 Platinum的MARD範圍為12.2%至13.6%，而Enlite為16.6%至19.9%。該數據也顯示Enlite在低血糖情境下的表現特別不佳。

Yet again, it seems that no independent investigator can reproduce the Medtronic data. And while we continue to see some distraction in the field, by and large, we have not seen much of an impact to our business as a result for the 530G launch.

看來又一次，沒有任何獨立研究者能重現美敦力的數據。儘管我們仍看到市場上有一些干擾因素，但整體而言，530G上市並未對我們的業務造成太大影響。

As I close this conference call, I would like to add some additional color on my transition to Executive Chairman at the end of this year. One of my [three] personal goals was to help the Company achieve positive cash flow. As we presented today, we have achieved that for the full year in 2013. A year earlier than predicted.

在結束本次電話會議之際，我想就我在今年年底轉任執行董事長一事補充一些說明。我個人的[三]項目標之一，是協助公司達成正向現金流。正如我們今天所呈現的，我們已在2013全年達成該目標，比原先預測早了一年。

I remain passionate about DexCom. My wife has often referred to DexCom as my mistress. As Executive Chairman, I will continue to provide DexCom with vision and strategy as we continue to lead the category with superior technology and outstanding execution.

我對DexCom仍充滿熱情。我太太常把DexCom稱作我的情婦。作為執行董事長，我將持續為DexCom提供願景與策略，並在我們以卓越技術與出色執行持續領先此一類別之際，支持公司前進。

Kevin and his leadership team must continue to focus on our core business. The growth opportunity for CGM in both the type 1 and the type 2 diabetes population is tremendous.

Kevin與其領導團隊必須持續專注於我們的核心業務。CGM在第一型與第二型糖尿病族群中的成長機會都非常龐大。

We had over 7,000 unique prescribers in 2013, and yet we called on only approximately 2,000 prescribers with our sales force. It is clear that patients are pulling the product through the channel, as we predicted. We need to expand our efforts to reach this growing population.

2013年我們有超過7,000位獨立開立處方的醫師，但我們的業務團隊實際拜訪的僅約2,000位。很明顯，正如我們所預測的，病患正在透過通路拉動產品需求。我們需要擴大投入，以觸及這個持續成長的人口族群。

I will remain intimately involved with Kevin and his and his leadership team in driving our core business. But I also believe our technology is expandable for other markets. As an example, I mentioned above a study involving 900 critically ill infants with diabetes, utilizing our G4 Platinum CGM in the ICU at Harvard Children's Hospital. The results were remarkable and convinced us once again that glucose is a vital sign in this environment, along with the more traditional vital sign measurements.

我將持續與 Kevin 以及他和他的領導團隊緊密合作，推動我們的核心業務。但我也相信，我們的技術可擴展至其他市場。舉例來說，我在上面提到一項研究，該研究在哈佛兒童醫院的加護病房（ICU）中，使用我們的 G4 Platinum 連續血糖監測（CGM），針對 900 名罹患糖尿病的重症嬰兒進行監測。結果非常顯著，再次讓我們確信，在這樣的環境中，血糖與較傳統的生命徵象量測一樣，是一項重要的生命徵象。

We also know that there is tremendous benefit to non-insulin using type 2 patients utilizing CGM as a diagnostic behavior-modification tool. I am excited to explore these and other opportunities in greater depth.

我們也知道，對於未使用胰島素的第二型糖尿病患者而言，將 CGM 作為診斷與行為改變的工具，具有極大的效益。我很期待更深入探索這些以及其他機會。

Just last summer we used our G5 system to monitor 30 cyclists remotely from San Diego for over 13 days during a race from Brussels to Barcelona. I want to accelerate that capability on a global basis, and we are exploring opportunities with broadband carriers as part of that effort.

就在去年夏天，我們使用 G5 系統，從聖地牙哥遠端監測 30 位自行車選手，並在一場從布魯塞爾到巴塞隆納的賽事期間，連續監測超過 13 天。我希望在全球範圍加速這項能力的推進，並且作為該努力的一部分，我們正在與寬頻電信業者探索合作機會。

For the last several seasons of the reality show, The Biggest Loser our CGM technology has been utilized as a part of this weight-loss program. I believe CGM can play a very important role in the obesity market, particularly with behavior modifications. These are all areas I will focus on as Executive Chairman, and I will be actively involved in helping DexCom develop programs to address these markets as our products evolve along a well-planned developmental pipeline.

在實境節目《The Biggest Loser》過去幾季中，我們的 CGM 技術已被用作該減重計畫的一部分。我相信 CGM 能在肥胖市場扮演非常重要的角色，特別是在行為改變方面。這些都是我作為執行董事長將聚焦的領域；隨著我們的產品沿著周密規劃的研發管線持續演進，我也將積極參與，協助 DexCom 開發計畫以因應這些市場。

I've been called a dreamer at times, but many of my dreams have come true. Over the past 20 years, I have been involved in several companies that have grown to some $15 billion of market cap. It is rare when a CEO has the opportunity to hand pick his successor, work with him to build a world-class organization, and hand the reins over with complete confidence in his leadership skills and his vision for the Company.

我有時被稱為夢想家，但我的許多夢想都已成真。在過去 20 年裡，我參與過數家公司，這些公司成長到約 150 億美元的市值。CEO 能夠親自挑選接班人、與他一起打造世界級組織，並在對其領導能力與公司願景充滿信心的情況下交棒，這樣的機會並不多見。

I also remind the audience that I remain the largest individual shareholder of DexCom stock, so I have a significant incentive to remain engaged and to see that DexCom continues to be highly successful. I am not retiring; I am just graduating.

我也提醒各位，我仍是 DexCom 股票最大的個人股東，因此我有很強的誘因持續投入，並確保 DexCom 繼續取得高度成功。我不是退休；我只是畢業了。

Thank you, and we will now turn it over to questions.

謝謝，接下來我們將進入提問。

Thank you. We will now begin the question-and-answer session.

謝謝。我們現在開始問答環節。

(Operator Instructions)

（接線員指示）

Our first question here is from Mr. Ben Andrew from William Blair. Please go ahead, sir.

我們的第一個問題來自 William Blair 的 Ben Andrew 先生。先生，請發問。

Good afternoon, guys. Thank you for taking the question. I wanted to ask a little bit on two topics, first is the peds ramp. Terry, do have some sense of what percentage of clinics are reflexively prescribing CGM on diagnosis at this point? We've got some high-profile examples, but is that becoming more commonplace?

各位下午好。謝謝讓我提問。我想就兩個主題請教一下，第一個是兒科的推進（peds ramp）。Terry，你是否大概知道，目前有多少比例的診所會在確診時就反射性地開立 CGM？我們看到一些高知名度的案例，但這是否正變得更普遍？

Obviously from -- I will take the second question and turn the first question back over to Kevin. Obviously, when you look at the large number of prescribers that we don't call on, it is clear to us that there is an opportunity there to grow that market. And I think it is reflective of the tools that we need to develop from electronic conductivity, as well, to reach out and expand that capability.

顯然，關於——我先回答第二個問題，第一個問題我再交給 Kevin。顯然，當你看到我們沒有拜訪到的大量開立者時，我們很清楚那裡存在擴大市場的機會。我認為這也反映出我們需要開發的工具，包括電子連結性等，以便觸及並擴展這項能力。

With respect to the peds ramp, Ben, as we've said earlier, currently, our patient base is between 8% and 10% pediatric patients, and we expect it to grow to be about 30%. That ramp will take some time as we begin to call on these pediatric endocrinologists we haven't called on before. We'll build trust; we'll get a few patients on the system. We expect it to take off from there.

關於兒科推進，Ben，如同我們先前所說，目前我們的患者基礎中，兒科患者約占 8% 到 10%，我們預期會成長到約 30%。隨著我們開始拜訪先前未拜訪過的兒科內分泌科醫師，這個爬坡需要一些時間。我們會建立信任，先讓少數患者使用系統，之後我們預期會從那裡開始加速成長。

It will take a little bit of time. Our team is focused on calling on these clinics. They have made initial calls. As we look at our daily leads that come in, we are seeing a lot of pediatric patients. But it is not wildly disproportionate to our regular patients. It is growing, and it is growing gradually, and it's growing very nicely.

這需要一點時間。我們的團隊專注於拜訪這些診所，也已進行初步拜訪。從每天進來的潛在客戶線索來看，我們確實看到很多兒科患者。但並沒有相對於一般患者出現極端不成比例的情況。它正在成長，而且是逐步成長，成長得非常好。

So Kevin, 30% of your users would be just a little bit -- it would be pretty close to the overall type 1 population. So is that --

所以 Kevin，若你們的使用者有 30% 是兒科，那就——會非常接近整體第一型糖尿病人口的比例。所以那是否——

It won't happen in a year.

不會在一年內發生。

It won't happen in a year; you're talking two, three, four years in your view?

不會在一年內發生；你的看法是需要兩、三、四年？

Two to three.

兩到三年。

Okay, and then as we think about, again, this notion of utilization and retention remaining steady, I think is what your comment in the commentary, was that related to the fourth quarter specifically? So it was flattish, and you didn't -- so you delivered the revenue, but without seeing an increase in utilization or retention versus Q3?

好的，然後再談到——同樣地，關於使用量與留存率維持穩定這個概念，我想你在說明稿中的評論是指第四季特別如此嗎？也就是說它大致持平，你們——所以你們達成了營收，但沒有看到相較於第三季使用量或留存率的提升？

The trends are consistent over time, Ben. Our point is we are certainly a lot better than we were year ago. As far as the specific percentage increase, I can't give you one.

Ben，這些趨勢長期來看是一致的。我們的重點是，我們當然比一年前好很多。至於具體的百分比提升，我無法給你一個數字。

But it was --

但那是——

Things where very good; if anything, patients bought more sensors in Q4 than they did in Q3. So if we were to look at that raw data from an individual point in time, it would look higher just cause of volumes, but I wouldn't skew that because of year-end purchases. We look at (inaudible) over time and things are very good; they're what we want them to be.

表現非常好；如果硬要說的話，第四季患者購買的感測器比第三季更多。所以如果我們從某個單一時間點去看原始數據，因為量的關係看起來會更高，但我不會因為年終採購而扭曲解讀。我們看的是長期（聽不清）趨勢，整體非常好；符合我們希望看到的狀態。

Okay great. And then the last question is, you mentioned the development progress with G5 and G6. Anything in particular on the timing with those or when we might see a regulatory submission or studies? Thank you.

好的，很棒。最後一個問題，你提到 G5 和 G6 的研發進展。就時程而言，有沒有什麼特別可以分享的，例如我們何時可能看到法規送件或研究？謝謝。

We run early phase studies on all of our technologies before we go to publication, and we're running early phase studies on several different versions of these products in the pipeline now.

在進入發表之前，我們會對所有技術進行早期階段研究；目前我們也正在對研發管線中數個不同版本的這些產品進行早期階段研究。

As far as timing, we need to get share approved first, and that is really our first foray into the Gen5 market; that will be our first cloud-based mobile application where you can share your data with others. I think once we get that approval, that will trigger a lot of efforts and a lot of thoughts on our part as to how we can accelerate things and how fast we can go.

就時程而言，我們需要先取得 share 的核准，而那其實是我們首次切入 Gen5 市場；那將是我們第一個以雲端為基礎的行動應用程式，讓你可以與他人分享你的資料。我認為一旦取得該核准，就會觸發我們在如何加速、以及能多快推進方面的許多努力與思考。

Now those product lines are both in pretty heavy development right now.

目前這兩條產品線都在相當密集的開發中。

Thank you.

謝謝。

Our next question comes from Mr. Bill Plovanic from Canaccord. Please go ahead.

下一個問題來自 Canaccord 的 Bill Plovanic 先生。請發問。

Great, thank you. Good evening. A couple of questions, gentlemen. First, on -- can you separate out the specifics of G5, like what exactly will be the benefit to G5 over G4, and then the same for G6? And then I have one follow-up question.

很好，謝謝。各位晚安。我有幾個問題，先生們。首先，關於——你們能否分別說明 G5 的具體內容，例如相較於 G4，G5 的效益究竟是什麼；然後 G6 也是一樣？接著我還有一個追問。

G5 is going to be focused largely on connectivity, mobility, and convenience. And it will come out more than likely as a series of launches, rather than one big launch, with the end goal of G5 being a simplified application system at the end, combined with connectivity to a phone, in addition to being connected to your receiver and cloud-based data.

G5 將主要聚焦在連結性、行動性與便利性。它很可能會以一系列的推出方式上市，而不是一次大型上市；G5 的最終目標是提供一個簡化的應用系統，並可連結到手機，同時也能連結你的接收器與雲端資料。

We will go there in the series of steps. That system will use the Gen4 sensor as currently configured, but with new algorithms that we've developed over the course of the past two years that will improve accuracy and reliability. With respect to the Gen6 system, that is our first step toward doing a couple-- three things: eliminating some of the calibrations, getting a replacement claim or a dosing claim so you can dose insulin, and then ultimately eliminating finger sticks altogether.

我們會以一連串步驟達成。該系統將使用目前配置的 Gen4 感測器，但搭配我們在過去兩年所開發的新演算法，以提升準確度與可靠性。至於 Gen6 系統，那是我們朝幾件事邁出的第一步：減少部分校正、取得替代性宣稱或給藥宣稱（讓你可以據此施打胰島素），並最終完全取消指尖採血。

As far as accuracy, we will see how much better we can get. As you hear from Terry on the clinical data we've had on free capital and [Don Miyano] and Steven Russell's work, we're already down to 10, which is pretty close to where meters are anyway and lab instruments aren't a whole lot better than that. So we will continue to pick up accuracy points.

至於準確度，我們會看看還能提升多少。正如你從 Terry 對我們在 free capital 以及 [Don Miyano] 與 Steven Russell 的臨床數據工作所聽到的，我們已經降到 10 左右，這其實已相當接近血糖機的水準，而實驗室儀器也不會好太多。因此我們會持續在準確度上再爭取一些提升。

The other thing that we will note with Gen6 in the future is we will eliminate the interference. We will block the interference that we have some contraindications for, and this goes along with what Terry said: as we get to a Gen6 sensor, we can go to these other markets. We can go to the hospital, because that sensor will block the effect of all compounds that those patience are taking; we can also go to maybe a type 2 market, because you wouldn't need necessarily all the calibrations; and if we get advanced enough, as we talk about eliminating, then that becomes a very simple system for someone who had type 2 diabetes or type 2 diagnostics.

另外，未來在 Gen6 上我們會注意的一點是，我們將消除干擾。我們會阻擋那些目前有一些禁忌的干擾因素；這也呼應 Terry 所說的：當我們做到 Gen6 感測器時，我們就能進入其他市場。我們可以進入醫院，因為該感測器將能阻擋那些病患正在使用的所有化合物所造成的影響；我們也可能進入第二型市場，因為你不一定需要所有的校正；而如果我們進一步做到如我們所談的取消（指尖採血），那對第二型糖尿病患者或第二型診斷而言，就會成為一個非常簡單的系統。

So as far as timing, we're going to keep that pretty much under wraps for now.

就時程而言，我們目前會把這部分大致保密。

Okay. And then my second question, is to talk on disposable manufacturing. You are obviously printing a lot of disposables at this point, probably somewhere 0.5 million a quarter you probably sold, maybe a little more than that. The question is, what is current capacity per quarter, and what do you need to do to expand that? Thank you.

好的。那我的第二個問題是關於一次性耗材的製造。你們目前顯然印製了大量的一次性耗材，可能每季大約賣出 50 萬個左右，或許還略多一些。問題是，目前每季的產能是多少？以及你們需要做什麼才能擴充產能？謝謝。

Bill, we're not even on two shifts yet, and our capacity is certainly above what you just quoted as our 0.5 million a quarter. The manufacturing processes have become much more robust and much more standard. We've got plenty of space. We can replicate any of these equipment lines quite quickly.

Bill，我們甚至還沒開始兩班制，我們的產能肯定高於你剛才提到的每季 50 萬個。製造流程已變得更強健、也更標準化。我們有充足的空間，也能很快複製任何一條設備產線。

We grew 69% last year on an operating plan that was 40%, and we never missed a shipment. I don't think you will find a place more flexible and more robust than this one, so we're not concerned about that.

去年我們在營運計畫預期成長 40% 的情況下實際成長了 69%，而且從未延誤出貨。我想你很難找到比這裡更具彈性、也更強健的地方，所以我們不擔心這個。

Excellent. Thank you.

非常好。謝謝。

Our next question comes from Kim Gailun from JPMorgan. Please go ahead.

下一個問題來自 JPMorgan 的 Kim Gailun。請繼續。

Great, thank you and congratulations to both Kevin and Terry on today's announcements. So first question, I wanted to follow-up on the commentary around the attrition and the utilization. In my model, I've got attrition -- and I know you don't call it out, but I've got the attrition trending down pretty consistently since the launch of G4, and then the sensors per patient actually picking up modestly from third quarter to fourth quarter. So does that seem about right to you?

很好，謝謝，也恭喜 Kevin 和 Terry 今天的公告。第一個問題，我想追問一下你們對流失率（attrition）與使用率（utilization）的評論。在我的模型裡，我把流失率——我知道你們不特別揭露——設定為自 G4 上市以來相當持續地下滑，而每位病患的感測器用量則從第三季到第四季小幅回升。這樣看起來符合你們的觀察嗎？

And as we think about 2014, understanding the comments you made on the first quarter and the seasonality, do you think that these two trends continue to improve? Or do you think you've reached a stable working point?

另外，展望 2014 年，考量你們對第一季與季節性的說法，你們認為這兩個趨勢會持續改善嗎？還是你們已經達到一個穩定的運作水準？

Kim, this is Steve. I'll take this one. On the first thing, on -- you had attrition trending down. I'm not sure that's actually the right way to look at it. I think what we saw is a pretty dramatic shift starting with the launch of the G4 Platinum in attrition to coming into a much more, what I would call, a normalized world.

Kim，我是 Steve。我來回答。第一點，你提到流失率在下降，我不確定這是正確的看法。我認為我們看到的是，自 G4 Platinum 上市開始，流失率出現相當明顯的轉變，進入一個我稱之為更「常態化」的狀態。

And I think what we've talked about publicly before -- we're not -- without, again giving out specific numbers, what the gang here saw back in the mini-med days, something that we're just more comfortable with. Certainly attrition on the Seven Plus was much worse, potentially even than we expected as we converted the base over.

而且我想我們之前也公開談過——在不再次提供具體數字的前提下——這裡的團隊看到的情況，回到 mini-med 時代，是我們更能接受、也更舒服的水準。當然，Seven Plus 的流失率要糟得多，甚至可能比我們在把用戶基礎轉換過來時所預期的還要差。

On the utilization side, the way you need to look at utilization is at a point -- and I think it was either Ben or Bill that asked the question, is utilization continuing to improve? There's going to be a point at which we know not all patients are going to use sensors all the time. We think most patients, a greater number of patients are using sensors virtually all of the time now, as opposed to Seven Plus where it was much more sporadic.

至於使用率，你需要這樣看：在某個點上——我想是 Ben 或 Bill 問的——使用率是否還會持續提升？會有一個點是我們知道並非所有病患都會一直使用感測器。我們認為現在大多數病患幾乎是全天候在使用感測器，相較於 Seven Plus 時期使用更零星。

But at the end of the day, patients can still extend the life, so you are never going to see a point where patients are using -- where all patients or a vast majority are using four sensors a month. I think we used to quote 2 to 2.5 sensors a month on average, and that's probably bumped up, but I don't think we expect, going forward, I don't think we expect utilization, per se, to pick up dramatically.

但歸根結底，病患仍然可以延長感測器的使用壽命，所以你永遠不會看到所有病患或絕大多數病患每月使用四個感測器。我想我們以前常引用的平均值是每月 2 到 2.5 個感測器，這可能已經上升了一些，但我不認為我們預期未來使用率本身會大幅提升。

What's important is we continue to add new patients to the base, and those patients continue to use sensors virtually all the time. In essence, the utilization continues to be very robust. Does that make sense?

重要的是，我們持續把新病患加入用戶基礎，而這些病患幾乎是一直在使用感測器。也就是說，使用率仍然非常強勁。這樣說清楚嗎？

Yes, that's helpful. So the implication is that yes, there's a little bit of room for improvement.

是的，這很有幫助。所以含意是，確實還有一點改善空間。

Yes, at some point, patients are going to continue to extend the life of the sensors, so (inaudible) we can improve utilization by (inaudible).

是的，在某個時點，病患會持續延長感測器的使用壽命，所以（聽不清）我們可以透過（聽不清）來提升使用率。

Anecdotally, we ask most every patient we meet, how long do you wear your sensors? And we very seldom hear, I swap it out every seven days.

就我們的經驗來說，我們幾乎會問每一位遇到的病患：你們的感測器會戴多久？我們很少聽到有人說，我每七天就換一次。

So if they're wearing it 10 days, or 10 or so days, that's 3 sensors a month; 10 to 14 days is 2 sensors a month. It's somewhere in between there.

所以如果他們戴 10 天或大約 10 天，那就是每月 3 個感測器；10 到 14 天就是每月 2 個感測器。大概介於兩者之間。

A follow-up, I don't know if you guys updated your expectations for the timing of Vibe in the US.

追問一下，我不知道你們是否更新了對 Vibe 在美國上市時程的預期。

No we didn't. They're still working diligently. It's one of the things we've made the decision publicly not to speak on behalf of our partners anymore; so I would defer you to Animas and Tandem for specifics on timing, particularly Tandem, as they are a newly public company. We don't want to step on their toes, so I would defer you to the partner.

沒有，我們沒有。他們仍在努力推進。我們已公開決定不再代表合作夥伴對外發言；因此，關於具體時程我會請你向 Animas 和 Tandem 詢問，尤其是 Tandem，因為他們是新上市公司。我們不想越俎代庖，所以會請你以合作夥伴的說法為準。

Okay. Thank you.

好的。謝謝。

Our next question here comes from Danielle Antalffy from Leerink Partners. Please go ahead.

下一個問題來自 Leerink Partners 的 Danielle Antalffy。請繼續。

Thank you so much. Thank you guys for taking my question. Congratulations to you, Terry, on graduating and, Kevin, on your upcoming new role. That's great.

非常感謝。謝謝你們回答我的問題。恭喜你，Terry，順利畢業，也恭喜 Kevin 即將擔任新職務。很棒。

So I wanted to follow-up on Animas [side] and Tandem. I understand you can't talk about timing. But how do we think about progression through the year on? Maybe not in 2014, but in 2015 and beyond, how do we think about the impact to new patient adds from both of those products?

我想追問 Animas（那邊）和 Tandem。我了解你們不能談時程。但我們該如何看待今年內的推進？也許不是 2014 年，而是 2015 年及之後，這兩項產品對新增病患數的影響該如何評估？

I think we've said when we gave our guidance at JPMorgan, we were pretty clear that we don't have any contribution from our pump partners domestically in our guidance for 2014.

我想我們在 JPMorgan 提供財測指引時已說得很清楚：我們對 2014 年的指引中，並未納入我們在美國本土的幫浦合作夥伴所帶來的任何貢獻。

Right.

對。

There is some contribution, obviously, from Animas who's been commercial in Europe for several years now. I think we've said this on multiple conferences. I think the relative importance of our pump partners, sitting where we are in 2014 and going forward, is frankly it's just less than it used to be. Back in 2008, 2009 we were a much smaller organization with a much smaller sales force; today, we out-man Animas probably close to two to one in the field. Tandem is doing a great job growing their sales force; I think Tandem could certainly be more additive there.

當然，Animas 在歐洲已商業化好幾年，所以那邊確實有一些貢獻。我想我們在多場會議上都提過：以我們 2014 年目前的位置以及往後來看，坦白說，幫浦合作夥伴對我們的相對重要性已不如以往。回到 2008、2009 年，我們規模更小、銷售團隊也更小；而今天，我們在前線的人力可能接近 Animas 的兩倍。Tandem 在擴張其銷售團隊方面做得很好；我認為 Tandem 在那方面確實可能帶來更多增量。

But I think the way I would really look at the pump partnerships going forward is they're additive. I can't give you specifics on how additive in terms of specific numbers of patients. I think you would need to -- look at -- extrapolate what Tandem is going to give in terms of guidance and to the extent you can get information from Animas.

但我認為，未來看待幫浦合作關係的方式是：它們是增量（additive）的。我無法就新增多少病患提供具體數字。我想你需要——去看——外推 Tandem 在其財測指引中會提供什麼，以及你能從 Animas 取得資訊的程度。

But I think we look at it additive; they are certainly not transformative to us. And I think particularly as we look to Gen5 and we move to the phone, we believe patients are going to more than likely prefer to use their iPhone as the means of display and interaction with their CGM data than pulling out their pump. We even have some data to suggest in Europe, patients who have been purchasing the Vibe had actually purchased a separate DexCom G4 Platinum receiver, because oftentimes, patients try to hide their pump, and it's easier to pull a G4 Platinum receiver out of their pocket.

但我們把它們視為增量；它們對我們而言當然不是「顛覆性」（transformative）的。尤其當我們展望 Gen5 並轉向手機時，我們相信病患更可能偏好用 iPhone 作為顯示與互動 CGM 數據的方式，而不是拿出他們的幫浦。我們甚至有一些數據顯示，在歐洲，購買 Vibe 的病患其實也另外購買了一台 DexCom G4 Platinum 接收器，因為病患常常會想把幫浦藏起來，而從口袋拿出 G4 Platinum 接收器更容易。

So as we move to the phone, I think that's really, as Kevin mentioned in the prepared remarks, the convenience and connectivity of the phone is really where our future lies.

因此，當我們轉向手機時，我認為正如 Kevin 在事先準備的發言中提到的，手機的便利性與連結性才是我們未來所在。

Great. My next question is, obviously, Medtronic is pursuing the low-glucose suspend role as the next step toward the artificial pancreas. Curious, so now that you guys are working on integrating with pump companies, what your view of is as it relates to the next step toward the artificial pancreas? Will you guys pursue a low-glucose, suspend-type technology, or what's next with the integrated system?

很好。我的下一個問題是，顯然 Medtronic 正在推進低血糖暫停（low-glucose suspend）作為邁向人工胰臟的下一步。我很好奇，既然你們現在也在與幫浦公司進行整合，你們對於邁向人工胰臟的下一步有什麼看法？你們會追求低血糖暫停這類技術嗎？或者整合式系統接下來會是什麼？

This is Terry. As we've stated before, we are, obviously, the premier sensor component. Of the overwhelming majority of artificial pancreas programs that are in place around the world, most of these are academic-based, and they use a wide variety of different insulin-delivery devices.

我是 Terry。如同我們先前所說，我們顯然是首屈一指的感測器元件供應商。在全球現行的絕大多數人工胰臟計畫中，多數是以學術機構為主導，並且使用各式各樣不同的胰島素輸注裝置。

Certainly Tandem, Insulet is in that group; Roche is in that group; Animas is also in that group, and in many ways we are somewhat agnostic from that perspective. So any ultimate commercialization of a technology that, within this classification of artificial pancreas, will really be driven by the commercialization partner, not by DexCom.

當然，Tandem、Insulet 都在那個群組裡；Roche 也在那個群組裡；Animas 也同樣在那個群組裡，而在很多方面，從這個角度來看我們相對是中立的。因此，任何最終在這一類人工胰臟技術中的商業化，真正會由商業化夥伴來推動，而不是由 DexCom 來推動。

We are happy to support those efforts. We are happy to lend our expertise, but the reality of what our mission statement is, and that's replace finger sticks. So we never lose sight of that each and every day. We look at the global market and the increase in total number of patients either having diabetes or over the next 10, 20 years, developing diabetes.

我們很樂意支持這些努力。我們也很樂意提供我們的專業，但事實是，我們的使命宣言是取代指尖採血。因此我們每天都不會忘記這一點。我們觀察全球市場，以及糖尿病患者總數的增加，無論是已經罹患糖尿病的患者，或是在未來 10、20 年內將會發展成糖尿病的族群。

What we do really well is we develop advanced technology and sensor capability, and that's what we will continue to focus our energies on.

我們真正擅長的是開發先進技術與感測器能力，而這也將是我們持續投入精力的重點。

Thank you so much.

非常感謝。

Our next question here comes from Mr. Jason Bedford from Raymond James. Please go ahead.

下一個問題來自 Raymond James 的 Jason Bedford 先生。請發問。

This is Mike Rich calling in for Jason. Can you hear me okay?

我是 Mike Rich，代 Jason 來電。你們聽得到我嗎？

Absolutely.

當然聽得到。

Thank you for taking the questions. Since your gross margins where obviously the highlight of 2013, I think sometimes gets overlooked. I was wondering where you think that can exit 2014? And now that you think it can trend above that previous 75% range, do you have a longer-term goal?

謝謝你們回答問題。由於你們的毛利率顯然是 2013 年的亮點，我覺得有時候會被忽略。我想請教你們認為 2014 年毛利率可以落在什麼水準？另外，既然你們認為它可以高於先前 75% 的區間，你們是否有更長期的目標？

Terry and I have made this statement before as we evolve into next generations of sensors, we think we can get closer to 80%. That will require some changes in the fundamental assembly process, and some molding, some tooling. So there's a lot that's got to go on there, and we're working on all those things.

Terry 和我之前都提過，隨著我們演進到下一代感測器，我們認為毛利率可以更接近 80%。這需要在基本組裝流程上做一些改變，還有一些模具成型、治具與工具的投入。因此有很多事情要做，我們也正在推進所有這些工作。

One of the things that it's just a 80-base hit for us, the fact is, being in San Diego with our overhead rates, volume increases do a lot to help us on the sensor manufacturing side. So as we continue to grow at very healthy percentages, we pick up margin points there and we get more efficient.

另外一點，對我們來說算是很穩健的加分：事實上，我們位於聖地牙哥，固定費用率的結構下，出貨量增加對感測器製造端的幫助很大。因此，當我們持續以非常健康的百分比成長時，我們在那裡會拿到更多毛利點數，效率也會提升。

So right now, we think as you look at 2014, we move to the higher end of our 70% to 75% range, and over time, we'd have targets to go from 75% to 80%, again, assuming all pricing remains the same. And we've got plans to do that. There's no question our guys are working on that and very cognizant of that on a daily basis.

所以目前我們認為，展望 2014 年，我們會往 70% 到 75% 區間的高端移動；而隨著時間推進，我們的目標會從 75% 走向 80%，同樣是假設所有定價維持不變。而我們也有計畫去達成。毫無疑問，我們的團隊每天都在做這件事，並且非常清楚這個目標。

Okay great. That's helpful. As a housekeeping item, Kevin, can you give us an idea what percent of your hardware revenue in the quarter went to new patients?

好的，很好，這很有幫助。作為一個例行問題，Kevin，你能否說明一下，本季你們硬體營收中有多少百分比來自新病患？

We gave the number at JPMorgan that we've sold 60,000 G4 kits since the launch of the product in 2012, and that's what we're -- and we gave, I think it was 10% of those were to patients who already had one Gen4 system. So that's where we are staying with that.

我們在摩根大通（JPMorgan）那場活動上提供過數字：自 2012 年產品上市以來，我們已售出 60,000 套 G4 套件；這就是我們目前所——而且我們也提到，我記得其中約 10% 是賣給已經擁有一套 Gen4 系統的病患。所以我們目前就維持這個說法。

Obviously as we sell more transmitters and have more patients by a second transmitter because the first one runs out, those numbers even become more cloudy for us internally. So start with the 60,000 patient -- 60,000 G4 kit number we gave out in early January, and you can work back from there.

顯然，隨著我們賣出更多發射器，且有更多病患因為第一個發射器到期而購買第二個發射器，這些數字在我們內部也會變得更難釐清。所以你可以先從我們在一月初提供的 60,000 名病患——60,000 套 G4 套件這個數字開始，再從那裡回推。

Okay. Thank you.

好的，謝謝。

Our next question comes from Mimi Pham from ABR Health Co. Please go ahead.

下一個問題來自 ABR Health Co. 的 Mimi Pham。請發問。

Good afternoon and congratulations, Kevin and Terry. Regarding Medtronic's comments on their quarterly call about taking 4 points of sequential share in the pump and CGM market, can you address that? Is that -- because it doesn't sound like that's consistent with your commentary. Are they talking about perhaps in [centers] beyond your focus 2000?

午安，也恭喜 Kevin 和 Terry。關於 Medtronic 在他們的季度電話會議上提到，他們在幫浦與 CGM 市場的市占率連續提升了 4 個百分點，你們能否回應一下？因為那聽起來與你們的評論不一致。他們是不是在談你們重點之外的某些[中心]，例如超出你們聚焦的 2000 家？

Mimi, this is Terry. Thank you, it's always good to graduate. A couple of comments.

Mimi，我是 Terry。謝謝你，畢業總是件好事。幾點評論。

The first one is, it's always difficult when you hear somebody from Medtronic speak as to how they calculate anything. It always reminds me of Pinocchio, quite frankly, when I hear a Medtronic person speak.

第一點是，當你聽到 Medtronic 的人談論他們如何計算任何數字時，總是很困難。坦白說，每次聽到 Medtronic 的人說話，都讓我想到小木偶（Pinocchio）。

So it's very difficult for me to, as to as I mentioned, three independent investigators have far different numbers than Medtronic [from a science]. So I don't know what they're talking about.

所以我很難判斷他們在說什麼。正如我提到的，三位獨立研究者得出的數字，與 Medtronic 的[科學]說法差異很大。因此我不知道他們在談什麼。

I read their transcript. It said, pump and CGM, 4 percentage points. We obviously didn't see it. We had a $51-million quarter; we saw more patients than we've ever seen before.

我讀了他們的逐字稿，上面寫的是幫浦與 CGM，提升 4 個百分點。我們顯然沒有看到。我們本季營收 5,100 萬美元；我們看到的病患數比以往任何時候都多。

We're not feeling it, I mean we do channel checks to our customers. We still have a lot of Medtronic patients.

我們沒有感受到，我是說我們也會對客戶做通路查核。我們仍然有很多 Medtronic 的病患。

They may have tried it, because Medtronic forced them to buy the sensor components, so maybe there is some of that calculated into their numbers; we will see. I think they are recurring, obviously, a lot of those Medtronic patients who tried it are still our patients, because they actually want an accurate sensor. From that standpoint, time will tell. Time will tell.

他們可能有嘗試，因為 Medtronic 強迫他們購買感測器元件，所以也許他們把其中一些算進了他們的數字；我們會再看。我認為這些 Medtronic 病患中，很多嘗試過的人顯然仍然是我們的病患，因為他們其實想要的是準確的感測器。從這個角度來看，時間會證明一切。時間會證明一切。

That's helpful. Regarding also the -- going to the ATTD, did you see any data or hear any feedback on -- they talked about their next-gen Enlite enhanced CGM, any thoughts on that?

這很有幫助。關於——去 ATTD 的部分，你有看到任何數據或聽到任何回饋嗎——他們談到他們的下一代 Enlite 強化版 CGM，你對此有什麼看法？

No. Quite frankly, we listened to whatever they had to say, and we saw nothing. They said they've launched in five or six countries; we haven't seen any from our international group, anybody commenting on it.

沒有。坦白說，我們聽了他們要說的內容，但什麼也沒看到。他們說已在五、六個國家上市；我們的國際團隊那邊也沒有看到任何人對此發表評論。

Looked at whatever data they presented; it didn't appear to be all that different than the Enlite 1. So not sure. Again, I think we've -- experience level will determine what is truth and what is fiction.

我們看了他們展示的任何數據；看起來並沒有比 Enlite 1 有多大不同。所以不確定。再一次，我認為——經驗層面會決定什麼是真、什麼是假。

Got it. And then last, you talked more about your CGM first strategy at the ADA or ADE, can you talk about how is that having any impact at any certain centers that might be implementing that more?

了解。最後，你在 ADA 或 ADE 上更深入談到你們的「CGM 優先」策略，你能談談這是否在某些中心產生影響，尤其是那些可能更積極導入該策略的中心？

I think obviously, by our numbers, it's been pretty successful. I think we have impacted, and in fact, you take some of the largest centers in the United States, in particular, where now it is a standard operating procedure to put a patient on CGM well in advance of pumps.

我想很明顯，從我們的數字來看，這相當成功。我認為我們確實產生了影響；事實上，你看美國一些最大的中心，特別是那些地方，現在已經把「在使用幫浦之前很早就先讓病患上 CGM」當作標準作業流程。

And let the patient ultimately decide on what method of insulin delivery that they want, that pumps are in fact, a secondary choice, lifestyle choice, not necessarily a need. That when you're talking about glycemic variability, you have to know about your glycemic variability in order to do something about it.

並讓病患最終自行決定他們想要的胰島素輸注方式；幫浦其實是第二順位的選擇，是生活型態的選擇，不一定是必需品。當你在談血糖變異度時，你必須先了解自己的血糖變異度，才能對它採取行動。

Pumps are a convenience, and so I think that is finally resonating. We have been at it now over a year since we started messaging, and again $157 million for the year. I think we're pretty successful versus a little under $100 million in 2013.

幫浦是一種便利性，因此我認為這個觀念終於開始引起共鳴。自從我們開始傳達這個訊息以來，現在已經超過一年；而且全年 1.57 億美元。我認為相較於 2013 年不到 1 億美元，我們相當成功。

That's helpful. Thank you so much.

這很有幫助。非常感謝。

Our next question comes from Mr. Anthony Petrone with The Jefferies Group. Please go ahead.

下一個問題來自 Jefferies Group 的 Anthony Petrone 先生。請發問。

Thank you, gentlemen, and congratulations again on the new appointments. A little bit on the headcount need for pediatrics, and on the approval there in the US, 800 to 1,000 pediatric endocrinologists. So wondering how should we be thinking about SG&A, specifically leverage, as you look in to 2014 based on the needs to expand the sales force there a bit?

謝謝兩位先生，也再次恭喜新的任命。想請教一下兒科方面的人力需求，以及在美國的核准之後，美國大約有 800 到 1,000 位兒科內分泌科醫師。因此想問，我們在看 2014 年、基於需要稍微擴充那邊的銷售團隊時，應該如何思考 SG&A，特別是槓桿效應？

Then a comment on utilization, specifically within the pediatric market, where is that today within that 8% of total sensor volumes today? And I'm assuming that would be extrapolated throughout the pediatric user base as that expands. And then one quick follow-up on potential Gen5 and Gen6 products.

另外關於使用率，特別是在兒科市場，目前在你們今天感測器總出貨量中約 8% 的那一部分，兒科的使用率現在在哪裡？我假設隨著兒科使用者基礎擴大，這也會被外推到整個兒科使用族群。最後再快速追問一下潛在的 Gen5 與 Gen6 產品。

With respect to the sales force expansion, we took care of that in Q4. We added literally 30% more field bodies than we had before, and that expansion was, for all intents, complete by mid-Jan, just a couple left to hire in early January and those have been hired. We're expanded as far as we're going to, at least today, for 2014.

關於銷售團隊擴編，我們在第四季就已經處理了。我們實際上把外勤人力比之前增加了 30%，而且就各方面而言，這次擴編在一月中旬前就已完成，一月初只剩下幾個名額要補，現在也都已經補齊。至少以目前來看，2014 年我們的擴編就到這個程度。

And that expansion wasn't really pediatric driven, it was driven by all of our business territories, and all of our reps will sell pediatrics and regular patients. Our territories have been redone; our new reps are on the ground and doing very well. So the expansion has occurred.

而那次擴張其實並不是由兒科所驅動，而是由我們所有的業務區域所驅動；我們所有的業務代表都會同時銷售兒科與一般患者。我們的區域已重新劃分；我們的新業務代表已在第一線運作且表現非常好。所以擴張已經發生。

With respect to utilization of pediatric patients, we don't have separate data broken out. Anecdotally I can speak, and Terry, if you have anything to add. In a very young pediatric patient, you have a parent that's driving therapy, so a parent is going to make the decision to have the child use the sensor all the time. As the pediatric patients get older, particularly in their teenage years, that utilization becomes a little bit different, as kids don't want to have everything connected to their bodies all the time.

關於兒科患者的使用率，我們沒有另外拆分的數據。就經驗而言我可以說明一下，Terry，如果你有要補充的也請加入。在非常年幼的兒科患者身上，通常是家長在主導治療，因此家長會決定讓孩子一直使用感測器。隨著兒科患者年齡增長，特別是進入青少年時期，使用情況會有些不同，因為孩子不想一直把所有東西都連接在身上。

Our utilization should be at least equal to, if not better than, it is for adults in the pediatric market, particularly as you look at the younger segment.

在兒科市場中，我們的使用率應至少與成人相當，甚至可能更好，尤其是看較年幼的族群時。

That's helpful. And the follow-ups on G5 and G6, and I know it's a little premature. You have the sensor ASP around $70 overall today on the G4. I'm curious as to thoughts on pricing G5, and then, G6 or beyond potentially, when we do move away completely from finger sticks, where you envision sensor pricing can go overall? Thank you.

這很有幫助。接著追問一下 G5 和 G6，我知道現在談可能還有點早。你們目前在 G4 上的感測器 ASP 大約是整體約 70 美元。我想了解你們對 G5 的定價想法，以及未來可能到 G6 或更後面、當我們完全不再需要指尖採血時，你們認為整體感測器定價可能會走到哪裡？謝謝。

Sensor prices are computed on a per-day reimbursement rate with our payers, and that $70 reflects an average of about $10 a day for a sensor wire. As we go out further over time, our best chance for price increase is probably extending the wear more days versus seven days, and getting a price increase that way.

感測器價格是以與付款方（payers）協議的「每日給付（reimbursement）費率」來計算，而那個 70 美元反映的是感測器導線平均約 10 美元/天。隨著時間往後推進，我們最有機會提高價格的方式，可能是把可佩戴天數延長到超過七天，並透過這種方式取得價格提升。

On a per-day basis, possibly if we eliminated calibrations, we could get some of that. But ultimately, we are committed to the fact that this therapy is going to have to save money in our current healthcare environment if it's going to continue to grow and be successful.

以每日計價來看，如果我們能取消校正（calibrations），或許可以爭取到其中一部分。但最終我們堅持的一點是：在目前的醫療照護環境下，這項治療若要持續成長並成功，就必須能夠節省成本。

So we are running our business, planning on driving our costs down, being as efficient as possible, and being able to deal with every pricing scenario that come our way. If we can replace finger sticks and have a sub-10 MARD with our sensor, it might be feasible that we go ask for more pricing, but we are not focused on that today. We need to get there first.

因此我們在經營與規劃上，是以降低成本、盡可能提高效率為前提，並且能夠因應任何可能出現的定價情境。如果我們能取代指尖採血，且感測器達到低於 10 的 MARD，那麼我們去爭取更高定價或許是可行的，但我們今天並不把重點放在那裡。我們得先做到那一步。

If I could add one in there about gross margin, it seems like you have pretty good volume coverage to reduce overhead in the factories. A little bit more detail on gross margins again, for maybe sensors specifically, and where potentially -- how do you get from the level today to where the vision is for potentially 80% gross margins on sensors, if it's not necessarily price-driven?

如果我可以再加問一題關於毛利率，看起來你們的出貨量覆蓋得不錯，能降低工廠的間接費用。能否再多談一些毛利率細節，可能特別針對感測器，以及如果不一定是由價格驅動，你們要如何從目前水準走到你們所設想的、感測器可能達到 80% 毛利率？

Again, we have never had our margin -- we have never as we've talked about margins going up, driven them up based on increase prices. It's already been on improvement in our processes.

再說一次，我們從來沒有——我們在談毛利率提升時，從來不是靠提高價格來推升。一直都是靠流程改善。

The key word there is automation. A lot of the things that we do today, we still assemble applicators, and there's still a lot of manual processes in the things that we do. We have plans to automate a lot of those things over time that are largely dependent upon how quickly we go with our future product generations.

關鍵字是自動化（automation）。我們今天做的很多事情仍然需要人工，例如我們仍在組裝施用器（applicators），而且我們做的事情裡還有很多手動流程。我們計畫隨時間推進把其中很多環節自動化，而這在很大程度上取決於我們未來產品世代推進的速度。

Another thing that will help margins over time, just margins as a percentage, when we go to the cell phone model of Gen5, the receiver won't be as intricate. We may lose a few dollars on the revenue side with respect to selling fewer receivers, but that will pick up more as we add more customers and sell more sensors to those customers. So you would see a mix shift in the sales to more disposable products.

另一個會隨時間改善毛利率的因素——就百分比毛利而言——是當我們進入 Gen5 的手機模式時，接收器（receiver）就不需要那麼複雜。我們在營收端可能會因為賣出較少接收器而少幾美元，但隨著我們增加更多客戶、並向這些客戶賣出更多感測器，這部分會補回來。因此你會看到銷售組合轉向更多一次性（disposable）產品。

But automation gets us there. On our future product designs, we don't design anything without it being cost-effective and more cost-effective than what it's replacing. So these guys have been innovating for a number of years. In fact, we joke about it; we've got everything stacked; We've got five years of innovation stacked right on top of each other, that we need to get out the door and get through the agency. These designs are all more cost-effective than what we do today.

但自動化會帶我們到那裡。在我們未來的產品設計上，我們不會設計任何不具成本效益、或不比它所取代的產品更具成本效益的東西。這些人已經創新了很多年。事實上我們還拿這件事開玩笑；我們把所有東西都堆疊起來；我們有五年的創新成果一層一層疊在一起，必須把它們推出去並通過主管機關審查。這些設計都比我們今天的做法更具成本效益。

Helpful. Thank you again.

很有幫助。再次謝謝。

Our next question here comes from Ken Wald from The Benchmark Company. Please go ahead.

我們下一個問題來自 The Benchmark Company 的 Ken Wald。請說。

Good afternoon and congratulations on the quarter and congratulations on promotions. I may be the last that says that to you. I have a couple questions; a lot of questions have already been asked.

下午好，恭喜本季表現，也恭喜升遷。我可能是最後一個對你們說這些的人。我有幾個問題；很多問題已經被問過了。

It seems to me that the revenue versus OpEx has -- you have a nice ratio there, $64 million in sales, $30 million in OpEx, something along those lines. Should we see continued improvement in that? If so, how are you going to drive especially the OpEx side of that ratio?

在我看來，營收相對於營業費用（OpEx）——你們的比例很不錯，銷售 6,400 萬美元、OpEx 3,000 萬美元，大概是這樣的量級。我們是否會看到這個比例持續改善？如果會，你們打算如何推動，特別是 OpEx 端的改善？

That is a very good question. As we look at going forward, as Terry graduated and I'm just starting school, I guess would be the best way I could describe it, we have to balance three things: this continued accelerated revenue growth. Our goal is always to grow the bottom line faster than the top, and we will run the business that way.

這是個非常好的問題。展望未來，隨著 Terry 畢業、而我才剛開始上學——我想這是我能用來形容的最佳方式——我們必須在三件事之間取得平衡：持續加速的營收成長。我們的目標一向是讓淨利成長快於營收成長，我們也會以這種方式來經營公司。

But the third piece of that is getting this innovation out to the market, and how much do we spend to get these new products out? And how much do we spend to expand our field efforts and get more people aware of our technology? So we're always balancing those three things.

但第三個部分是把這些創新推向市場：我們要花多少錢把這些新產品推出去？以及我們要花多少錢擴大前線團隊的投入，讓更多人認識我們的技術？所以我們一直在平衡這三件事。

Our ratios have clearly improved in 2013. We would hope they continue to improve in 2014, and certainly that's our plan.

我們的比率在 2013 年確實改善了。我們希望 2014 年能持續改善，這當然也是我們的計畫。

That being said, as we look at our innovation opportunities, as we look at clinical studies we plan to do, as we look at possibly, additional field expansion if things go very well, we will wait and see how those ratios shake out for next year. We will feel the need to keep going fast and go faster. And so that's how we look at it day to day.

話雖如此，當我們看我們的創新機會、看我們計畫進行的臨床研究、以及看如果事情進展非常順利是否要進一步擴張前線團隊時，我們會再觀察明年這些比率會如何呈現。我們會覺得有必要保持快速、甚至更快。因此我們每天就是用這樣的方式來看待。

Okay. A question on the European markets, how do you -- what's going to be your approach for expansion there? How are you going to attack those markets?

好的。關於歐洲市場的問題，你們——你們在那邊的擴張策略會是什麼？你們要如何切入那些市場？

Our biggest win there over the past few months, as we are starting to gain traction to get reimbursement from the reimbursement authorities for CGM as a standalone. A couple of countries, Switzerland and Slovenia have now approved CGM for patients, and there is efforts ongoing in several of the larger countries as well, because they see the benefit of that.

過去幾個月我們在那邊最大的進展，是我們開始取得動能，讓給付主管機關對「獨立使用的 CGM」提供給付（reimbursement）。目前已有幾個國家——瑞士與斯洛維尼亞——已核准 CGM 供患者使用，而在幾個較大的國家也正在推動相關工作，因為他們看到了其效益。

Right now, our European business is to a large extent, cash pay from patients or also physicians who use it as a diagnostic. They're not getting reimbursed by insurance. As we get reimbursement in the European companies, that will be our biggest driver in those other markets.

目前我們在歐洲的業務在很大程度上是由患者自費（cash pay），或是醫師把它當作診斷工具使用。他們並沒有獲得保險給付。當我們在歐洲各國取得給付時，那將會是我們在其他市場最大的驅動力。

Thank you very much, and congratulations again.

非常感謝，也再次恭喜。

The next question here comes from Tao Levy from Wedbush. Please go ahead.

下一個問題來自 Wedbush 的 Tao Levy。請說。

Hello, good afternoon. A couple quick questions, I think in prior calls you've talked about either the penetration of CGM into the type 1 diabetics in the US market in the upper single digits, close to 10%. And assuming you're splitting share with Medtronic, we're still at that level. Were your guesstimates off last year, in the sense that maybe the penetration was lower than you thought? Or was it a lot of attrition of CGN patients in prior years?

你好，下午好。幾個快速問題。我想在先前的電話會議中你們談到，美國市場第一型糖尿病患者使用 CGM 的滲透率在高個位數、接近 10%。假設你們與 Medtronic 分食市占，我們仍在那個水準。你們去年對滲透率的估計是否有偏差，也就是說實際滲透率可能比你們想的更低？或者是過去幾年 CGM 患者流失（attrition）很多？

I don't think our estimates were off, per se. I do think we had a bigger attrition [provincy]. Here's the other factors.

我不認為我們的估計本身有偏差。我確實認為我們的流失（attrition）更大一些。[provincy]。另外還有其他因素。

We don't have great visibility into Medtronic's numbers. We know what our numbers are, and we're pretty comfortable at what percentage penetration we have into the type 1 market in the US.

我們對 Medtronic 的數字沒有很好的能見度。我們知道我們自己的數字，而且我們對我們在美國第一型市場的滲透率百分比相當有把握。

While our attrition on Seven Plus may have been a little bit worse than we had initially anticipated as we converted the (inaudible), we remain very comfortable with our prior statements where we were, and particularly over the course of this past year in 2013, and where we're growing. It's hard sometimes I think to compare apples to apples between our numbers and the numbers that Medtronic puts out because our patients go on CGM and they continue to use CGM on a go-forward basis.

雖然在我們把（聽不清）轉換過來時，Seven Plus 的流失可能比我們一開始預期的稍微更糟，但我們仍然非常有信心我們先前所說的我們所處的位置，特別是回顧 2013 年這一年，以及我們的成長情況。有時我覺得很難把我們的數字與 Medtronic 公布的數字做真正的同類比較，因為我們的患者一旦開始使用 CGM，之後會持續使用 CGM。

We believe that in Medtronic's numbers, there are a number of things. There are patients who may try the sensor, may fall off the sensor. There are also -- they report revenues and sensor utilization for a completely different product, for their iPro product, which is really just a diagnostic product. If they lumped that into quotations using CGM, it's not really apples to apples, because these are not patients who are using CGM on a real-time basis going forward; these are patients who might use it once a quarter or once or twice a year.

我們認為，在美敦力（Medtronic）的數據裡面，包含了好幾種情況。有些病患可能會試用感測器，但之後可能就不再使用了。另外，他們也會針對一個完全不同的產品回報營收與感測器使用率，也就是他們的 iPro 產品；那其實只是診斷用產品。如果他們把那也一併算進使用 CGM 的報價/統計裡，就不太能做同類比較，因為這些病患並不是未來會持續以即時方式使用 CGM 的病患；他們可能是一季用一次，或一年用一到兩次。

So it's hard to characterize those, in my opinion, as real-time CGM users. So it gets really tough to quantify when we don't have great visibility into their numbers as to what the overall CGM penetration into the type 1 space is.

所以在我看來，很難把那些人界定為即時 CGM 使用者。當我們對他們的數字缺乏足夠能見度、無法看清整體 CGM 在第一型族群的滲透程度時，要量化就變得非常困難。

So basically, but the math and how you're seeing the attrition now with the G4, penetration rates should materially move higher.

所以基本上，從數學推算以及你現在看到 G4 的流失情況來看，滲透率應該會顯著上升。

We've given guidance, and obviously in that guidance, it assumes a pretty healthy new patient add rate over the course of the year. And we've talked about our reduced attrition rates, et cetera. So yes, we assume that we at DexCom are going to continue to penetrate and grow our share of the type 1 space in the US for sure.

我們已經提供了指引，而很明顯地，在那個指引中，我們假設全年會有相當健康的新病患新增速度。我們也談到我們降低的流失率等等。所以是的，我們假設 DexCom 將會持續滲透並擴大我們在美國第一型市場的市占與成長。

One big-picture question, as more providers start entering into accountable-care type arrangements and potentially share some of those cost savings tied to patients achieving certain A1C levels, does the discussion with these doctors start to revolve around the use of CGM, their ability to get their patients' A1C levels down? And the doctors in return, they get paid more from the insurance companies and patients do well, and DexCom does well. Are we there yet, or is it still too early in the conversations?

一個宏觀層面的問題：隨著更多醫療提供者開始進入責任照護（accountable-care）類型的安排，並可能分享部分與病患達成特定 A1C 水準所連結的成本節省，與這些醫師的討論是否開始會圍繞在 CGM 的使用、以及他們把病患 A1C 降下來的能力？醫師因此從保險公司拿到更多報酬、病患表現更好、DexCom 也表現更好。我們已經到那一步了嗎？還是說這些對話仍然太早？

It's not too early for the conversation. It is too early for the implementation. But we have long been of the position that we are quite willing to go at risk with the payer opportunity to say to the payer, set forth your strategy or the patient group that you would like us to address, and that we are willing to, like I said, go at risk.

現在談這個不算太早；但要落地執行還太早。不過我們長期以來的立場是：對於與支付方（payer）的機會，我們非常願意承擔風險，去對支付方說，請提出你們的策略或你們希望我們服務的病患族群，而我們願意——如我所說——承擔風險。

And along with that in the end, if we save the payer system money, we want to this share in the savings. I think that's what is eventually going to happen, you're going to first see it at the physician level from payment; they're going to get paid for success.

而且最終，如果我們為支付方體系省下了錢，我們也希望能分享這些節省。我認為這終究會發生；你會先在醫師端看到這種按支付的模式——他們會因為成功而獲得報酬。

But I am of a belief, personally, that the industry that is addressing this population are also going to have to have some skin in the game in the future as part of this whole payment structure. And I do believe -- and it's pretty clear that to use A1C as a criteria, every study that you have ever seen, to my knowledge, that is not probably meta-analysis, but in direct studies, demonstrate a significant reduction in A1C, depending upon the patients entering baseline, but reduction in A1C with the utilization of CGM versus any other technology within the diabetes space.

但我個人相信，未來在這種整體支付架構下，服務這個族群的產業也必須投入一些「利害關係」（skin in the game）。而且我也相信——而且很清楚——如果以 A1C 作為標準，據我所知，你看過的每一項研究（可能不包含統合分析 meta-analysis，但在直接研究中）都顯示：使用 CGM 相較於糖尿病領域的任何其他技術，都能顯著降低 A1C；降幅會依病患進入時的基線而不同，但確實能降低 A1C。

So I do see that as something coming forward, and we are happy to be part of that equation. I think it's a great opportunity for us then to really showcase what we can do with that environment. But it's literally at a discussion stage, not at an implementation stage.

所以我確實看到這會逐步到來，而我們也很樂意成為這個方程式的一部分。我認為這對我們是很好的機會，能在那樣的環境中真正展現我們能做到什麼。但目前確實還在討論階段，還不是執行階段。

That said, and I will diverse just for second, and that is in the hospital market, and why I get so excited about G4 is good enough to be in the hospital, and some of the attributes that Kevin talked about will drive it even further. That market is clearly one in which, if there is recidivism of a patient, then the hospital doesn't get paid.

話雖如此，我先岔開一下，談到醫院市場；這也是為什麼我對 G4 如此興奮——它的表現已經好到可以用在醫院，而 Kevin 提到的一些特性會讓它走得更遠。那個市場很明顯地是：如果病患再度入院（recidivism），醫院就拿不到錢。

So they already are experience that pushback from the government, and there is a lot of dialogue that is going on at the endocrinology level about trying to achieve a certain level, not only of A1C but actual recording of average glucose levels in order to keep them between a certain bandwidth where they started to allow that to ease up to around 180, and now some of the criteria says we want these patients back closer to 140. So the dilemma is, how do you get them to 140 without starving them, basically, while they are in the hospital? And that is actually a very active dialogue that is being communicated amongst the endocrinology population, and that is where we fit in quite easily. ¶ There's no better way to get a patient to 140, keep them north of 80 but below 140, than with CGM. You don't have to really worry about what they're eating; the last thing you want to do is starve a patient in a hospital setting just to achieve some artificial level of glycemic control.

所以他們已經在承受政府端的反向壓力，而且在內分泌科層級有大量對話，討論如何達到某個水準——不只是 A1C，還包括實際記錄平均血糖值——以便把它們維持在某個區間內。他們一開始曾允許放寬到大約 180，而現在有些標準又說希望把這些病患拉回更接近 140。所以兩難在於：在病患住院期間，你要怎麼把他們降到 140、又不至於基本上把他們餓著？這其實是內分泌科族群之間非常活躍的討論，而我們很容易就能切入。 ¶ 沒有比 CGM 更好的方式，能把病患拉到 140，並讓他們維持在 80 以上但低於 140。你不需要太擔心他們吃了什麼；你最不希望做的，就是在醫院環境中為了達到某個人為的血糖控制水準而讓病患挨餓。

Thank you. Thank you for the thorough response.

謝謝。謝謝你詳盡的回覆。

And at this time, I'm showing no further questions.

此刻我這邊顯示沒有其他問題了。

Thank you, everyone. Obviously an exciting call for us, and I always have this reflection as I transition to this new role. So here's my reflection for today.

謝謝各位。對我們來說這顯然是一場令人振奮的電話會議，而當我轉換到這個新角色時，我總會有一些反思。以下是我今天的反思。

Look at statistics, and today 1 in 10 adults in the US has diabetes, and it is projected that 1 in 3 will have diabetes by the year 2050. So according to the pharmaceutical research and Manufacturers of America Association, US biopharmaceutical research companies are currently developing 180 new medicines for diabetes.

看看統計數據：今天美國每 10 位成人就有 1 位患有糖尿病，並預估到 2050 年，每 3 位就會有 1 位患有糖尿病。根據美國藥品研究與製造商協會（Pharmaceutical Research and Manufacturers of America Association），美國生物製藥研發公司目前正在開發 180 種新的糖尿病藥物。

You know the cost to bring a new medicine from concept to reality is well over $1 billion. And yet today, here is DexCom with tools in the field that improve, there again, glycemic variability. We don't need drugs, we already do it.

你知道，把一種新藥從概念帶到實際落地的成本遠遠超過 10 億美元。然而今天，DexCom 已經有在市場上的工具，能改善——再次強調——血糖變異性。我們不需要藥物，我們已經做到了。

So we feel that we are extremely well placed to expand on our opportunities. As Kevin mentioned in his comments, do you hear us talk about how accurate we are today? You hear us talk about the ability to expand connectivity and convenience, and that is driving right into the sweet spot of this expansion of diabetes care.

因此我們認為，我們在擴大機會方面的位置極佳。正如 Kevin 在評論中提到的，你有聽到我們談今天的準確度有多高嗎？你也聽到我們談擴大連線性與便利性的能力，而這正好切入糖尿病照護擴張的甜蜜點。

We have tools and are developing tools, not research so much, but as developmental tools, because we have already done the research to get a highly accurate sensor. Now we can expand on that to make things simple to use by a much larger audience.

我們有工具，也正在開發工具——與其說是研究，不如說是開發型工具——因為我們已經完成研究，取得高準確度的感測器。現在我們可以在此基礎上延伸，讓更廣大的使用者更容易上手。

So I am thrilled about the prospects. Obviously we had to get to cash flow positive and ultimately to profitable. But, until that day arrives and we are certainly at a pace, we now have the leverage to expand our capability to a much larger market.

所以我對前景感到非常振奮。顯然我們必須先達到現金流轉正，並最終實現獲利。但在那一天到來之前——而我們確實正以一定的速度前進——我們現在已具備槓桿，能把我們的能力擴展到更大的市場。

So with that I will sign off, and say thank you.

那麼我就先到這裡，並說聲謝謝。

And thank you ladies and gentlemen. This concludes today's conference. Thank you for your participation, and you may now disconnect.

也謝謝各位女士先生。今天的會議到此結束。感謝各位的參與，您現在可以斷線。