德康醫療 (DXCM) 2019 Q1 法說會逐字稿

Welcome to the DexCom First Quarter 2019 Earnings Release Conference Call.

歡迎參加 DexCom 2019 年第一季度收益發布電話會議。

My name is Adrian, and I'll be your operator for today's call.

我的名字是阿德里安，今天我將擔任您的接線員。

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

（操作員說明）請注意，會議正在錄製中。

I'll now turn the call over to Matt Dolan.

我現在將把電話轉給馬特·多蘭。

Matt Dolan, you may begin.

馬特·多蘭，你可以開始了。

Thank you, operator, and welcome to DexCom's First Quarter 2019 Earnings Call.

謝謝運營商，歡迎參加 DexCom 的 2019 年第一季度財報電話會議。

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

我們的議程從 DexCom 的董事長、總裁兼首席執行官 Kevin Sayer 開始，他將提供本季度的總結；隨後是我們的執行副總裁兼首席財務官昆汀布萊克福德的財務審查和展望；然後是我們的戰略和企業發展執行副總裁史蒂夫·帕切利的戰略更新。

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

在我們準備好的評論之後，我們將打開電話詢問您的問題。

(Operator Instructions) Please note that there are also slides available related to our first quarter performance on the DexCom Investor Relations website on the Events & Presentations page.

（操作員說明）請注意，在 DexCom 投資者關係網站的活動和演示頁面上，也有與我們第一季度業績相關的幻燈片。

With that, let's review our Safe Harbor.

有了這個，讓我們回顧一下我們的安全港。

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

我們將在今天的電話會議中做出的一些陳述可能構成前瞻性陳述。

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

這些陳述反映了管理層對未來事件、戰略、競爭、產品、運營計劃和績效的意圖、信念和期望。

All forward-looking statements included in this presentation are made as of the date hereof based on information currently available to DexCom and are subject to various risks and uncertainties, and actual results could differ materially from those anticipated in the forward-looking statements.

本演示文稿中包含的所有前瞻性陳述均基於 DexCom 目前可獲得的信息作出，並受到各種風險和不確定性的影響，實際結果可能與前瞻性陳述中的預期存在重大差異。

The factors that could cause actual results to differ materially from those expressed or implied by any of these forward-looking statements are detailed in DexCom's Annual Report on Form 10-K, quarterly reports on Form 10-Q and other filings with the Securities and Exchange Commission.

DexCom 的 10-K 表格年度報告、10-Q 表格的季度報告以及其他提交給證券交易的文件中詳細說明了可能導致實際結果與這些前瞻性陳述中任何明示或暗示的結果存在重大差異的因素委員會。

Except as required by law, we assume no obligation to update any such forward-looking statements after the date of this presentation or to conform these forward-looking statements to actual results.

除法律要求外，我們不承擔在本演示文稿發布之日後更新任何此類前瞻性陳述或使這些前瞻性陳述符合實際結果的義務。

Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP with respect to our non-GAAP and cash-based results.

此外，在電話會議期間，我們將討論某些尚未根據 GAAP 編制的關於我們的非 GAAP 和基於現金的業績的財務措施。

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

除非另有說明，否則所有對財務指標的引用均以非公認會計原則為基礎。

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.

不應孤立地考慮提供此附加信息或作為結果的替代品或優於根據公認會計原則編制的結果。

Please refer to the tables in our earnings release in the Investor Relations portion of our website for a reconciliation of these measures to the most directly comparable GAAP financial measure.

請參閱我們網站投資者關係部分的收益發布中的表格，以了解這些措施與最直接可比的 GAAP 財務措施的對賬。

Now I will turn the call over to Kevin.

現在我將把電話轉給凱文。

Thank you, Matt, and thank you, everyone, for joining us.

謝謝你，馬特，謝謝大家加入我們。

We are off to a great start in 2019 with much of the momentum that we experienced in 2018 continuing into our first quarter.

我們在 2019 年有了一個良好的開端，我們在 2018 年經歷的大部分勢頭一直持續到第一季度。

First quarter revenues grew to $280 million, a 52% increase over the first quarter of 2018.

第一季度收入增長至 2.8 億美元，比 2018 年第一季度增長 52%。

Once again, this strong performance was broad-based, as increased volumes in both our U.S. and OUS businesses drove results above our expectations, even as we absorbed the pricing headwinds that we have anticipated.

再一次，這種強勁的表現是廣泛的，因為我們的美國和 OUS 業務量的增加推動了超出我們預期的結果，即使我們吸收了我們預期的定價逆風。

We have spent years developing our innovative technology and demonstrating real-world clinical outcomes.

我們花了數年時間開發我們的創新技術並展示真實世界的臨床結果。

And as awareness builds, demand for DexCom CGM is very strong among both new and existing patients.

隨著意識的增強，新患者和現有患者對 DexCom CGM 的需求都非常強烈。

We remain confident that the company is well positioned to drive towards our long-term targets.

我們仍然相信，該公司有能力實現我們的長期目標。

Particularly, as we expand the rollout of G6 and improve access to CGM.

特別是，隨著我們擴大 G6 的推出並改善對 CGM 的訪問。

With this growing demand in mind, we are on track to meet our goal of doubling our G6 capacity by the end of 2019.

考慮到這種不斷增長的需求，我們有望實現到 2019 年底將 G6 產能翻番的目標。

From a cost perspective, we are demonstrating good expense control with revenue growth outpacing the increase in operating expense growth by more than 2x.

從成本的角度來看，我們展示了良好的費用控制，收入增長超過了運營費用增長的 2 倍以上。

We continue to believe that patient outcomes demonstrate the true value of a CGM.

我們仍然相信，患者的結果證明了 CGM 的真正價值。

In the first quarter, we showed real-world data that demonstrates the effectiveness of our Urgent Low Soon alert in the G6, which provides an actionable warning in advance of a dangerous hypoglycemic low.

在第一季度，我們展示了真實世界的數據，這些數據證明了我們在 G6 中的緊急低血糖警報的有效性，該警報在危險的低血糖低之前提供了可操作的警告。

Not only have we seen a further decrease in hypoglycemia among G6 users with this feature, but this has been achieved regardless of a user's frequency of screen views.

我們不僅看到使用此功能的 G6 用戶的低血糖症進一步降低，而且無論用戶瀏覽屏幕的頻率如何，這一點都已實現。

We also show the correlation between users of DexCom SHARE and Follow apps and better timing range for children and adolescents with diabetes.

我們還展示了 DexCom SHARE 和 Follow 應用程序用戶之間的相關性，以及糖尿病兒童和青少年更好的時間範圍。

Once again highlighting the importance of this feature to our user base.

再次強調此功能對我們用戶群的重要性。

It is outcomes such as these that have contributed to DexCom's great reputation among clinicians and allow us to capitalize on the increasing global awareness around CGM technology.

正是這些成果為 DexCom 在臨床醫生中的良好聲譽做出了貢獻，並使我們能夠利用全球對 CGM 技術日益提高的認識。

The kind of demand we are experiencing can also bring certain challenges.

我們正在經歷的這種需求也會帶來某些挑戰。

This is especially the case in the first quarter of every year as we must reconfirm benefits and document clinical necessity for each patient.

每年第一季度尤其如此，因為我們必須重新確認每位患者的益處並記錄臨床必要性。

The process can be burdensome at times with our teams going back-and-forth with clinicians and payers on the patient's behalf.

這個過程有時會很繁重，因為我們的團隊代表患者與臨床醫生和付款人來來回回。

To our customers, we understand the fundamental importance of DexCom CGM in your life and are working around the clock to make sure that you are cared for.

對於我們的客戶，我們了解 DexCom CGM 在您生活中的根本重要性，並日以繼夜地工作以確保您得到照顧。

We saw improvement in our ability to meet demand and serve our customers as the quarter progressed and believe that the initiatives that we introduced to expand our customer's volume per structure are progressing well, with several areas showing meaningful productivity improvements.

隨著本季度的進展，我們看到我們滿足需求和為客戶服務的能力有所提高，並相信我們為擴大每個結構的客戶數量而採取的舉措進展順利，幾個領域顯示出有意義的生產力提高。

Considering the significant level of demand for DexCom CGM and the strength of our first quarter, we are very pleased to be able to increase our revenue outlook for 2019.

考慮到對 DexCom CGM 的巨大需求和我們第一季度的實力，我們很高興能夠提高 2019 年的收入前景。

I will now turn the call over to Quentin who will provide detail on this outlook as well as a review of our financials.

我現在將把電話轉給昆汀，他將提供有關這一前景的詳細信息以及對我們財務狀況的審查。

Thank you, Kevin.

謝謝你，凱文。

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

提醒一下，除非另有說明，否則我今天討論的財務指標將在非公認會計原則的基礎上呈現。

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

可以在今天的收益發布以及我們的 IR 網站上找到與 GAAP 的對賬。

Today, we reported worldwide revenue of $280.5 million for the first quarter of 2019 compared to $184.4 million for the same quarter in 2018, representing growth of 52% on a reported basis and 53% on a constant currency basis or $96 million of absolute dollar growth.

今天，我們報告 2019 年第一季度的全球收入為 2.805 億美元，而 2018 年同一季度為 1.844 億美元，按報告基礎計算增長 52%，按固定匯率計算增長 53%，或絕對美元增長 9600 萬美元.

Clearly, the growing awareness for CGM has continued into the New Year.

顯然，對 CGM 日益增長的認識一直持續到新年。

Geographically, U.S. and international revenues both demonstrated strong growth of 45% and 79%, respectively, over the first quarter of 2018.

從地域上看，2018 年第一季度美國和國際收入均表現出強勁增長，分別為 45% 和 79%。

International revenues grew 86%, excluding the impact of currency, at least 25% of total company revenues in the first quarter, representing a high-water mark for the business and tracking towards the long-term expectations that we highlighted at our Investor Day late last year.

剔除匯率影響，國際收入增長 86%，至少佔第一季度公司總收入的 25%，代表該業務的高水位線，並符合我們在投資者日後期強調的長期預期去年。

We have seen continued success in shifting to the pharmacy channel consistent with our expectations at the start of the year, and we will continue to prioritize this initiative as we seek to drive improved access to DexCom CGM.

我們已經看到在轉向藥房渠道方面繼續取得成功，這與我們在今年年初的預期一致，我們將繼續優先考慮這一舉措，因為我們尋求改善對 DexCom CGM 的訪問。

Our first quarter gross profit was $168.8 million or 60.2% of sales.

我們第一季度的毛利潤為 1.688 億美元，佔銷售額的 60.2%。

The sequential decline from the fourth quarter of 2018 was consistent with what we have seen in prior years.

自 2018 年第四季度以來的連續下降與我們往年的情況一致。

Relative to the first quarter of 2018, gross margin was negatively impacted by incremental investments to scale infrastructure as we drive significant capacity expansion in 2019 and the continued shift in our mix towards the U.S. pharmacy and International business.

相對於 2018 年第一季度，由於我們在 2019 年推動顯著產能擴張，以及我們繼續向美國藥房和國際業務轉變，毛利率受到增加投資以擴大基礎設施規模的負面影響。

As demand continues to exceed expectations, we're accelerating investments to increase capacity, which is putting some additional pressure on gross margins.

隨著需求繼續超出預期，我們正在加快投資以增加產能，這給毛利率帶來了一些額外的壓力。

We now expect gross margins for the year of 64% to 65% as we speed up our capacity ramp to meet the growing demand.

隨著我們加快產能提升以滿足不斷增長的需求，我們現在預計今年的毛利率為 64% 至 65%。

We remain confident in our ability to bring cost out of the system as the year progresses and over the long term, beginning with the introduction of our new G6 transmitter and continued to implementation of automation into the manufacturing process, which will allow us to exit the year with gross margins approaching 70%.

隨著時間的推移和長期的發展，我們仍然有信心從系統中降低成本，從引入我們的新 G6 變送器開始，並繼續在製造過程中實施自動化，這將使我們能夠退出年毛利率接近70%。

These improvements provide us with the strategic flexibility to be proactive with payers and to navigate future uncertainties in the pricing environment as we continue to push for greater access to CGM.

這些改進為我們提供了戰略靈活性，可以主動與付款人打交道，並在我們繼續推動更多使用 CGM 的過程中應對定價環境中的未來不確定性。

Operating expenses were $176.4 million for the first quarter 2019 compared to $147.6 million in the same period last year.

2019 年第一季度的運營費用為 1.764 億美元，而去年同期為 1.476 億美元。

This reflects an increase of 20% year-over-year and compares favorably to our 52% revenue growth in the quarter, resulting in significant operating expense leverage from the prior year.

這反映出同比增長 20%，與我們本季度 52% 的收入增長相比是有利的，從而導致比上一年顯著的運營費用槓桿。

Operating loss was $7.6 million in the first quarter of 2019 compared to $28.7 million in the same quarter of 2018.

2019 年第一季度的經營虧損為 760 萬美元，而 2018 年同期為 2870 萬美元。

Our improved operational discipline resulted in a 1,290 basis point improvement in operating margins from the prior year.

我們改進的運營紀律使營業利潤率比上一年提高了 1,290 個基點。

Adjusted EBITDA was $26.1 million or 9.3% of revenue for the first quarter compared to $4.5 million or 2.4% of revenue for the first quarter of 2018.

第一季度調整後 EBITDA 為 2610 萬美元，佔收入的 9.3%，而 2018 年第一季度為 450 萬美元，佔收入的 2.4%。

As we said throughout 2018, we believe that there is an opportunity to drive significant operating leverage toward our long-term targets and both of our first quarter adjusted EBITDA and operating margin reflect great progress towards these goals.

正如我們在整個 2018 年所說的那樣，我們相信有機會推動顯著的經營槓桿朝著我們的長期目標邁進，我們第一季度調整後的 EBITDA 和營業利潤率都反映了朝著這些目標取得的巨大進展。

However, we are not pursuing this leverage at the expense of the growth in our business.

然而，我們並沒有以犧牲我們的業務增長為代價來追求這種影響力。

We remain confident in the opportunity that lies ahead, not only for our core business, but also the application of CGM technology to new markets.

我們對未來的機會充滿信心，不僅是我們的核心業務，還有 CGM 技術在新市場的應用。

We will continue to invest in these initiatives, our R&D pipeline and other strategic opportunities in order to maximize DexCom's long-term potential.

我們將繼續投資於這些舉措、我們的研發管道和其他戰略機會，以最大限度地發揮 DexCom 的長期潛力。

Our net loss was $4.6 million or $0.05 per share and our balance sheet remains strong having ended the quarter with approximately $1.4 billion in cash and equivalents and no borrowing against our $200 million revolving line of credit.

我們的淨虧損為 460 萬美元或每股 0.05 美元，我們的資產負債表仍然強勁，在本季度末擁有約 14 億美元的現金和等價物，並且我們的 2 億美元循環信貸額度沒有借款。

As mentioned, we continue to prioritize investment into our capacity expansion initiatives and automation of manufacturing, which led to $39 million of CapEx in the first quarter.

如前所述，我們繼續優先投資於我們的產能擴張計劃和製造自動化，這導致第一季度的資本支出為 3900 萬美元。

Looking at the remainder of the year, given the strength of our first quarter performance and the growing demand that we are seeing for DexCom real-time CGM, we are increasing our full year revenue expectations by $75 million, and now anticipate total revenue of approximately $1.25 billion to $1.3 billion for the year, reflecting reported growth of 21% to 26%.

展望今年剩餘時間，鑑於我們第一季度的強勁表現以及我們看到對 DexCom 實時 CGM 不斷增長的需求，我們將全年收入預期提高了 7500 萬美元，現在預計總收入約為全年 12.5 億至 13 億美元，反映報告的增長 21% 至 26%。

As I mentioned previously, we anticipate full year gross margins to approximate 64% to 65% for 2019, showing meaningful improvement in the back half of the year as we look to exit the year approaching 70%.

正如我之前提到的，我們預計 2019 年全年毛利率將約為 64% 至 65%，隨著我們希望在今年接近 70% 的情況下退出，顯示出下半年的顯著改善。

We now expect operating margins of approximately 6% and remain comfortable with our original target of adjusted EBITDA margins of approximately 18%.

我們現在預計營業利潤率約為 6%，並且對我們最初調整後的 EBITDA 利潤率約為 18% 的目標感到滿意。

Our restructuring efforts associated with setting up operations in the Philippines are progressing well with nearly 200 employees now on the ground in Manila.

我們與在菲律賓開展業務相關的重組工作進展順利，目前在馬尼拉有近 200 名員工。

We have been extremely pleased with early indications demonstrating significant efficiency and scaling benefits.

我們對早期跡象顯示出顯著的效率和規模效益感到非常滿意。

We now expect the restructuring-related costs to come in at approximately $15 million to $20 million, with the majority in the first half and now slightly below our original estimates.

我們現在預計與重組相關的成本約為 1500 萬至 2000 萬美元，其中大部分在上半年，現在略低於我們最初的估計。

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

有了這個，我現在將把電話轉給史蒂夫進行戰略更新。

Thank you, Quentin.

謝謝你，昆汀。

As our first quarter performance indicates, global awareness and demand for real-time CGM continues to increase dramatically, not only in the U.S., but also in international markets like Germany, the U.K. and Australia.

正如我們第一季度的業績所表明的那樣，全球對實時 CGM 的認識和需求繼續急劇增加，不僅在美國，而且在德國、英國和澳大利亞等國際市場也是如此。

In February, DexCom stood front and center at the annual Advanced Technologies & Treatments for Diabetes or ATTD conference, with DexCom product utilized in numerous clinical studies and presentations from key leaders in the diabetes community.

2 月，DexCom 站在年度糖尿病先進技術和治療或 ATTD 會議的前沿和中心，DexCom 產品用於糖尿病社區主要領導者的眾多臨床研究和演講中。

As anyone in attendance can attest, there is genuine excitement toward our efforts around Decision Support, app enhancement and of course, the G6 platform.

正如在場的任何人都可以證明的那樣，我們在決策支持、應用程序增強，當然還有 G6 平台方面所做的努力令人非常興奮。

The global rollout of G6 remains a key strategic objective in 2019.

G6 的全球推廣仍然是 2019 年的關鍵戰略目標。

As Kevin noted, we are doubling G6 capacity by the end of 2019.

正如 Kevin 所說，到 2019 年底，我們的 G6 產能將翻一番。

Given the level of performance and ease-of-use that the G6 system brings, we expect G6 to continue to function as a platform product for DexCom for many years to come, even in certain markets beyond the launch of our next-gen G7 product.

鑑於 G6 系統帶來的性能水平和易用性，我們預計 G6 將在未來許多年繼續作為 DexCom 的平台產品發揮作用，即使在我們推出下一代 G7 產品之後的某些市場中也是如此.

Yet as we push the rollout and production of G6, our teams are also making significant progress towards finalizing G7, and we remain on track for a late 2020 or early 2021 initial launch.

然而，隨著我們推動 G6 的推出和生產，我們的團隊也在最終確定 G7 方面取得了重大進展，我們仍有望在 2020 年末或 2021 年初首次發布。

As a reminder, G7 will be an entirely new sensor platform for DexCom.

提醒一下，G7 將成為 DexCom 的全新傳感器平台。

One that meets the iCGM standards and further extends our leadership with a significantly reduced form factor and extended wear in a fully disposable one-piece wearable.

一款符合 iCGM 標準並進一步擴展我們的領導地位的產品，其外形尺寸顯著減小，並且在完全一次性的一體式可穿戴設備中具有更長的耐磨性。

Strong, therapeutic, cost-saving outcomes utilizing CGM continue to present themselves across the health care landscape.

使用 CGM 的強大、治療性、節省成本的結果繼續在醫療保健領域展示自己。

For several quarters, we have discussed CGM usage in non-intensive type 2 diabetes, prediabetes, gestational diabetes, broad potential deployment in the hospital and application in overall wellness.

幾個季度以來，我們討論了 CGM 在非強化 2 型糖尿病、前驅糖尿病、妊娠糖尿病、醫院中廣泛的潛在部署以及在整體健康中的應用。

While it is now time for an increased focus in investment in these areas, particularly since we know that these opportunities will require completely different business models and distribution channels, in order to lead this effort, I'm pleased to announce that we have pointed Matt Dolan as General Manager of New Markets.

雖然現在是時候更加關注這些領域的投資了，特別是因為我們知道這些機會將需要完全不同的商業模式和分銷渠道，為了領導這項工作，我很高興地宣布，我們已經指出了馬特Dolan 擔任新市場總經理。

As many of you are already aware through his involvement with our Investor Relations and Corporate Development Efforts, Matt is a great leader and we are confident that he and his dedicated team are the right people to guide these key growth initiatives for DexCom.

正如你們中的許多人通過參與我們的投資者關係和企業發展工作已經意識到的那樣，Matt 是一位偉大的領導者，我們相信他和他的敬業團隊是指導 DexCom 這些關鍵增長計劃的合適人選。

Turning back to our core business.

回到我們的核心業務。

We have proven ourselves to be early advocates of the principle of interoperability and patient choice, having established partnerships with multiple insulin delivery players, and we will continue to leverage the iCGM designation.

我們已經證明自己是互操作性和患者選擇原則的早期倡導者，與多家胰島素輸送公司建立了合作夥伴關係，我們將繼續利用 iCGM 的稱號。

We are seeing significant progress from these collaborations and look forward to the launch of a few of these connected products over the next 12 months.

我們看到這些合作取得了重大進展，並期待在未來 12 個月內推出其中一些互聯產品。

We are especially thrilled for our patients as these innovative products stand ready to minimize the burden of diabetes management.

我們為我們的患者感到特別興奮，因為這些創新產品已準備好將糖尿病管理的負擔降至最低。

And we are proud that DexCom stands at the center of this progress.

我們為 DexCom 站在這一進步的中心而感到自豪。

With that, I will pass it back to Kevin.

有了這個，我會把它傳回給凱文。

Thanks, Steve.

謝謝，史蒂夫。

This is obviously an exciting time to work at DexCom.

這顯然是在 DexCom 工作的激動人心的時刻。

Not only are we working hard to bring our technology to the increasing number of people with diabetes who see the benefit of real-time CGM, but we are very actively exploring possible applications of our sensor technology to additional populations.

我們不僅在努力將我們的技術帶給越來越多的糖尿病患者，他們看到了實時 CGM 的好處，而且我們還在非常積極地探索我們的傳感器技術在更多人群中的可能應用。

My personal expectations for our New Markets group are very high.

我個人對我們新市場團隊的期望非常高。

We need to gather as much clinical and cost-based evidence as possible with our G6 platform so that we are truly prepared to attack these markets in a big way with G7.

我們需要通過我們的 G6 平台收集盡可能多的臨床和基於成本的證據，以便我們真正準備好通過 G7 大舉進攻這些市場。

In the meantime, we are capitalizing on the continued momentum in our core business, leading to a significant increase in our annual revenue guidance.

與此同時，我們正在利用核心業務的持續發展勢頭，大幅提高我們的年度收入指引。

With this success, we have put everybody on the DexCom team to roll out in the first quarter, from the commercial team, to manufacturing, to customer support, to R&D and beyond.

憑藉這一成功，我們讓 DexCom 團隊的每個人都在第一季度推出，從商業團隊到製造、到客戶支持、到研發等等。

We know you have worked incredibly hard, and we thank you.

我們知道您工作非常努力，我們感謝您。

In summary, we are pleased with DexCom's performance to start the year and believe that we are well positioned for another great year of revenue growth, technology advancement and increasing profitability.

總而言之，我們對 DexCom 年初的表現感到滿意，並相信我們已做好準備迎接另一個收入增長、技術進步和盈利能力提高的偉大年份。

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

我現在想打開問答電話。

Matt?

馬特?

Thank you, Kevin.

謝謝你，凱文。

(Operator Instructions) Operator?

（操作員說明）操作員？

(Operator Instructions) Our first question comes from Jayson Bedford from Raymond James.

（操作員說明）我們的第一個問題來自 Raymond James 的 Jayson Bedford。

I'll ask my question and related follow-up upfront here.

我會在這裡提前問我的問題和相關的後續行動。

First, Quentin, just implied in the initial guidance was about $100 million in assumed pricing headwinds due to the mix in the pharmacy, international, et cetera.

首先，昆汀在最初的指導中暗示，由於藥房、國際等領域的混合，假設的定價逆風約為 1 億美元。

Is that what's still baked into the new guidance?

這仍然是新指南中的內容嗎？

And then second, in terms of the move to the pharmacy I realize the inherent benefits for existing users migrating to what should be a lower-cost setting.

其次，就遷移到藥房而言，我意識到現有用戶遷移到應該是低成本環境的內在好處。

But receiver growth continues to be quite strong.

但接收器的增長仍然相當強勁。

So my question is, do you think the move to the pharmacy has stimulated incremental growth in new patient adds?

所以我的問題是，你認為搬到藥房是否刺激了新患者增加的增量增長？

And any color that you could provide around the pharmacy dynamic in the quarter would be great.

您可以在本季度為藥房動態提供的任何顏色都很棒。

Sure.

當然。

So yes, Jason, to your point, the $100 million that we talked about on the initial call for the year setting the original expectations, that's still consistent with how we think about it over the course of the year.

所以，是的，傑森，就你的觀點而言，我們在最初的年度呼籲中談到的 1 億美元設定了最初的預期，這仍然與我們對這一年的看法一致。

So no change there.

所以那裡沒有變化。

Obviously, we've got a concerted effort in place to move to the pharmacy channel, and that's playing out about just like we anticipated that it would.

顯然，我們已經齊心協力轉移到藥房渠道，這就像我們預期的那樣正在發揮作用。

Your point on new patient growth, I am certain that the pharmacy channel makes access more easy and more convenient for folks.

您對新患者增長的觀點，我確信藥房頻道使人們更容易和更方便地訪問。

I'm certain that's a part of the driver.

我確定這是驅動程序的一部分。

And when you look at the overall growth in the company, there is no question that the primary driver of our growth is new patient volume.

當您查看公司的整體增長時，毫無疑問，我們增長的主要驅動力是新患者數量。

So I am sure it's connected.

所以我確定它是連接的。

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

我們的下一個問題來自美國銀行的 Travis Steed。

Just looking at your Q1 revenue, it seems typical seasonality, so that's 20% Q1 for the full year.

僅查看您的第一季度收入，這似乎是典型的季節性，因此全年第一季度的收入為 20%。

Just trying to think about -- that suggested $100 million more than you're guiding to for 2019.

只是想一想——這表明比你 2019 年的指導要多出 1 億美元。

So is that just the typical conservatism that you have?

那麼這只是你所擁有的典型保守主義嗎？

Or is there anything else we should consider as we model out 2019?

或者在我們為 2019 年建模時，我們還應該考慮其他什麼？

I think the right way to think about it, and I know we talked about 20% back on the last call.

我認為這是正確的思考方式，我知道我們在上次通話時談到了 20% 的回報。

I think a few things came through in the quarter.

我認為本季度發生了一些事情。

We talked about the strength in the fourth quarter being really driven by new patient additions that came in late in the quarter.

我們談到了第四季度的實力真正受到本季度末新增患者的推動。

Now if you recall, at that point in time, we had shared that we expected those folks may be back with their next reorder really early in the second quarter.

現在，如果您還記得，在那個時間點，我們曾分享過，我們預計這些人可能會在第二季度初重新訂購他們的下一次訂單。

We saw a lot of that end up coming through in the month of March was a bit ahead of our expectation, a great signal and great outcome.

我們看到在 3 月份完成的很多事情都超出了我們的預期，這是一個很好的信號和很好的結果。

But at the end of the day, that was a bit of the upside surprise.

但歸根結底，這有點令人驚訝。

I think the other thing to keep in mind just around seasonality is that, as we continue to move more into the pharmacy channel, and as we continue to see the OUS business become a bigger part of the overall business, and as that Medicare continues to grow faster than the commercial business, all of those have very different seasonal patterns to them, generally, which might have more revenue early in the year.

我認為圍繞季節性要記住的另一件事是，隨著我們繼續更多地進入藥房渠道，並且隨著我們繼續看到 OUS 業務成為整體業務的更大一部分，並且隨著醫療保險繼續增長快於商業業務，所有這些都具有非常不同的季節性模式，一般來說，它們可能在年初有更多的收入。

So we're just trying to be thoughtful around all of those different dynamics in the business, as we set expectations for the full year.

因此，當我們為全年設定預期時，我們只是試圖對業務中所有這些不同的動態進行深思熟慮。

Surely not trying to signal anything.

當然不是試圖發出任何信號。

We know what your math would indicate that you laid out, but we're just being mindful of some of the shifts in the mix of the business.

我們知道您的數學將表明您的佈局，但我們只是注意業務組合的一些變化。

All right.

好的。

No, that's helpful.

不，這很有幫助。

And then I want to make sure I heard you correctly.

然後我想確保我沒聽錯。

You're exiting the year with 70% roughly gross margins?

你今年以大約 70% 的毛利率退出？

Just kind of give us a little bit more info on how you're going to get there.

只是給我們一點關於你將如何到達那裡的更多信息。

And is that sustainable into next year?

這是否可持續到明年？

And also does it give you a little bit more flexibility on pricing, if needed?

如果需要，它是否也讓您在定價方面更加靈活？

Yes.

是的。

So I think this is -- the 70% ability to get into that number by the end of the year is in line with the plans that we've always had around our gross margins progression into the future.

所以我認為這是——到今年年底達到這個數字的 70% 的能力符合我們一直圍繞未來毛利率發展的計劃。

You go back to our Investor Day and we laid out the path that arguably could take us up north of 70%, and then you have the headwinds that continue to play in with the revenue per patient, mix challenges that we envision as we continue to move into the pharmacy or OUS becomes more significant.

你回到我們的投資者日，我們制定了可以說可以使我們上升到 70% 以上的道路，然後你會遇到繼續影響每位患者收入的逆風，混合我們設想的挑戰，因為我們繼續進入藥房或 OUS 變得更加重要。

So there's nothing out of the ordinary here.

所以這裡沒有什麼不尋常的地方。

It's right in line with what we've planned to be able to do.

這正好符合我們計劃能夠做的事情。

The big enabler for us, and we've talked about this lower cost design transmitter for some time now, you're going to see that start to play through in the fourth quarter.

對我們來說是最大的推動者，我們已經討論了這種低成本設計發射器一段時間了，你會看到它在第四季度開始發揮作用。

So the teams have done an incredible job of designing cost out of the system.

因此，團隊在設計系統成本方面做得非常出色。

We'll start to produce that in the back half of the year.

我們將在今年下半年開始生產。

You'll actually see it start to get produced in the third quarter.

您實際上會看到它在第三季度開始生產。

That will get hung up in inventory a bit.

這會有點掛在庫存中。

We'll start to sell through it in the fourth quarter, and the benefit will start to play through.

我們將在第四季度開始通過它進行銷售，並且收益將開始發揮作用。

So it's in line with the plans that we've had.

所以這符合我們的計劃。

I think in terms of next year, I would just tell you, let's stick in the mid-60s at this point in time.

我認為就明年而言，我只想告訴你，讓我們在這個時間點停留在 60 年代中期。

I think it absolutely gives us the flexibility to continue to navigate the pricing environment and do what we need to do to ultimately generate the most significant growth for the company.

我認為這絕對讓我們能夠靈活地繼續在定價環境中導航，並做我們需要做的事情，最終為公司帶來最顯著的增長。

But it's these kind of things that give us the strategic opportunities to be flexible on how we think about positioning ourselves.

但正是這些事情給了我們戰略機會，讓我們可以靈活地考慮如何定位自己。

And our next question comes from Robbie Marcus with JPMorgan.

我們的下一個問題來自摩根大通的 Robbie Marcus。

Congrats on the great quarter.

祝賀偉大的季度。

I want to address the question that's been impacting the stock and clearly, top of mind for investors lately, and that's the potential impending approval of your competitor's Libre 2.0 (sic) [Libre 2] product.

我想解決一個影響股票的問題，而且很明顯，這是投資者最近最關心的問題，那就是你的競爭對手的 Libre 2.0 (sic) [Libre 2] 產品可能即將獲得批准。

And there's a lot of questions out there about, what does it look like?

那裡有很多問題，它看起來像什麼？

Does it get iCGM?

它有 iCGM 嗎？

And how those alerts and alarms will compare as a product versus G6 today and eventually G7?

這些警報和警報將如何作為產品與今天的 G6 以及最終的 G7 進行比較？

So I'd love to get your thoughts here.

所以我很想在這裡得到你的想法。

And any clarity or insight you can give us would be much appreciated?

您能給我們提供的任何清晰或見解將不勝感激？

Robbie, this is Kevin, I'll take that one.

羅比，這是凱文，我要那個。

Thanks.

謝謝。

Let's go back a bit, it was about a year ago at this time that we talked about the iCGM standards for the first time.

讓我們回過頭來，大約一年前的這個時候，我們第一次談到了 iCGM 標準。

And we remain very bullish on the fact that the FDA did give us guidance and standards by which we can develop products in the future that will be safe and in the best interest of our patient.

我們仍然非常看好 FDA 確實為我們提供了指導和標準，我們可以在未來開發出安全且符合患者最大利益的產品。

And we stand by that.

我們堅持這一點。

We've wanted standards and guidance for years so we know what the bar is to shoot at, and we actively look at that.

多年來，我們一直需要標準和指導，因此我們知道要達到什麼標準，並且我們會積極研究這一點。

We never assumed when we started this process that we would be the only iCGM company in the world, that eventually others would up their game to get that approval.

當我們開始這個過程時，我們從未想過我們將成為世界上唯一的 iCGM 公司，最終其他人會努力獲得批准。

And in the event that Abbott does get approval on the iCGM standards, that's -- they've obviously provided enough clinical evidence to do so with the FDA.

如果雅培確實獲得了 iCGM 標準的批准，那就是——他們顯然已經向 FDA 提供了足夠的臨床證據。

If you look back at the history of our company, and we were reminiscing about this today as we were preparing for the call, ever since I've been here, we've always had a competitive offering from another company in the field that claim to be as good as a DexCom.

如果你回顧我們公司的歷史，我們今天在準備電話會議時回憶起這件事，自從我來到這里以來，我們一直有來自該領域另一家公司的有競爭力的產品聲稱和 DexCom 一樣好。

But you'll notice, the claims of those companies have always been, we're as good as a DexCom.

但你會注意到，這些公司一直聲稱，我們和 DexCom 一樣好。

Never as good as somebody else.

永遠比不上別人。

We're as good as a DexCom.

我們和 DexCom 一樣好。

Real life use in field has proven over and over again that our technology leads the way.

現場的實際使用一次又一次地證明我們的技術處於領先地位。

And that our actual real-world clinical performance, on-body and on-patients, has always been the best and has always survived and given us the position to do that.

而且我們實際的真實世界臨床表現，無論是在身體上還是在病人身上，一直是最好的，並且一直存活下來，並讓我們有能力做到這一點。

We're very confident that our product will remain top-of-the-line and will do -- and will be extremely well received.

我們非常有信心，我們的產品將保持領先地位，並且會做到——而且會受到極大的歡迎。

We have not seen a lot of Libre 2 in Europe where it's been launched, so we don't have a lot of answers.

我們在歐洲沒有看到很多 Libre 2 已經發布，所以我們沒有很多答案。

And we're not going to speak to the characteristics of their product.

我們不會談論他們產品的特性。

We know a lot about ours.

我們對我們的了解很多。

We have enhancements coming for G6 over the course of the year that will make it an even better product offering and over time as we offer Decision Support and other things for our patients.

隨著我們為患者提供決策支持和其他服務，我們將在一年中為 G6 提供增強功能，使其成為更好的產品供應。

We intend to have the best experience that a patient could possibly have with G6.

我們打算為患者提供 G6 可能擁有的最佳體驗。

When we move to G7 and its size advantage, the body wearable, the one-piece component where we don't have to put a transmitter in the system anymore.

當我們轉向 G7 及其尺寸優勢時，身體可穿戴，我們不再需要在系統中放置發射器的一體式組件。

The lightweight nature of it.

它的輕量級特性。

And many of you know, I wear the G7 quite a bit now as I've always been a sensor snob, it is a patient experience, it's a bigger leap than from G5 to G6 has been in our previous history.

你們中的許多人都知道，我現在經常佩戴 G7，因為我一直是傳感器勢利小人，這是一種耐心的體驗，比我們以前的歷史上從 G5 到 G6 的飛躍更大。

So we know that product will be wildly competitive and have all the features and benefits of the current G6 system and more.

因此，我們知道該產品將極具競爭力，並具有當前 G6 系統的所有功能和優勢等等。

So we -- our pipeline is fabulous.

所以我們 - 我們的管道非常棒。

It's a great market opportunity and there's room for a number of participants and a number of products, not just one.

這是一個巨大的市場機會，有許多參與者和許多產品的空間，而不僅僅是一個。

That's really clear.

這真的很清楚。

I appreciate the thoughts, Kevin.

我很欣賞這些想法，凱文。

And then just a follow-up.

然後只是跟進。

Maybe not too far off of this, but can you give us some flavor of what your discussions with payers are like.

也許與此相差不遠，但是您能否給我們一些關於您與付款人討論的情況。

Are the payers focused on cost avoidance of diabetes, adverse events and improving patient outcomes?

付款人是否專注於避免糖尿病、不良事件和改善患者預後的成本？

Or are they just simply focused on moving reimbursement to the lowest-cost dominator?

或者他們只是簡單地專注於將報銷轉移到成本最低的支配者身上？

I appreciate it.

我很感激。

It depends on the meeting and it depends on the payer.

這取決於會議，取決於付款人。

We have been very successful in our payer discussions over the past several months and have had wins on numerous payer discussions.

在過去的幾個月裡，我們在付款人討論中非常成功，並在眾多付款人討論中取得了勝利。

For example, Cigna just gave us pharmacy coverage and pharmacy benefit.

例如，Cigna 剛剛為我們提供了藥房保險和藥房福利。

We do not issue press releases every time we have a win because that's our job, that's normal course of business for us.

我們不會在每次獲勝時發布新聞稿，因為這是我們的工作，這對我們來說是正常的業務流程。

But we have great coverage there and some local payers and pharmacy coverage.

但是我們在那裡有很好的覆蓋範圍以及一些當地的付款人和藥房覆蓋範圍。

We do spend a lot of time discussing outcomes and educating payers.

我們確實花了很多時間討論結果和教育付款人。

And I think over time, as we get more data and as we can build a better case, we can get those type of contracts in place.

而且我認為隨著時間的推移，隨著我們獲得更多數據並且我們可以建立更好的案例，我們可以製定這些類型的合同。

I would put the onus for that back on us rather than on the payers.

我會把責任歸還給我們，而不是付款人。

We just need better measurables and better data.

我們只需要更好的可衡量性和更好的數據。

It's taken us years to develop that clinical evidence.

我們花了數年時間才開發出這些臨床證據。

The DIaMonD study that we talked about for the first time a couple of years ago was really our first endeavor to do that.

幾年前我們第一次談到的 DIAMonD 研究確實是我們第一次嘗試這樣做。

And now with all this data coming to our servers, to our mobile platforms, we believe we'll be able to make some very strong real-world evidence just from our patients as we look at time and range statistics, and compliance with the system and how well they do on hypo avoidance.

現在，隨著所有這些數據進入我們的服務器，進入我們的移動平台，我們相信，當我們查看時間和範圍統計數據以及對系統的遵守情況時，我們將能夠僅從我們的患者那裡獲得一些非常有力的真實證據以及他們在避免低水平方面的表現如何。

I gave an example in my prepared remarks of the predictive alert that we have in the G6 system and how we're seeing a significant reduction in hypoglycemia because of that alert.

我在準備好的評論中舉了一個例子，說明我們在 G6 系統中擁有的預測性警報，以及我們如何看到由於該警報而顯著減少的低血糖症。

That type of evidence is something we really haven't presented in the past, and we will do that going forward now that we have so much data from the mobile systems.

這種類型的證據是我們過去真正沒有提出的，現在我們將繼續這樣做，因為我們擁有來自移動系統的大量數據。

We're very comfortable playing in that realm because we know the outcomes that our device provides to patients are outstanding.

我們在那個領域玩得很舒服，因為我們知道我們的設備為患者提供的結果非常出色。

And our next question comes from Danielle Antalffy from Leerink.

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

Congrats on a really good quarter.

祝賀一個非常好的季度。

Just a question, and this is sort of following up on the question around the impact of a competitor potentially getting iCGM.

只是一個問題，這是對有關競爭對手可能獲得 iCGM 的影響的問題的跟進。

But just curious if you can give any color directionally or what have you on the percent of your installed base domestically today and/or new patient adds that are MDI versus pumpers?

但只是好奇您是否可以定向提供任何顏色，或者您在當今國內安裝基數的百分比和/或新患者添加的 MDI 與泵機之間有什麼關係？

I think historically you've said, the majority of the patients coming on to the DexCom are MDI and not actually pumpers.

我認為從歷史上看，您曾說過，大多數進入 DexCom 的患者是 MDI，而不是真正的抽吸者。

Anything you can say to that?

你有什麼可以說的嗎？

The majority of our new adds now are MDI patients, Danielle, by a reasonable margin.

現在，我們的大多數新成員都是 MDI 患者，Danielle，在合理的範圍內。

As we're getting a much larger patient base, we're going over into those who are not on the pump systems for more of the new adds.

隨著我們獲得更大的患者群，我們將研究那些不在泵系統上的人，以獲得更多新的補充。

But I anticipate, as our partners get new systems out, that we will see significant growth in that segment as well as these systems do more than just deliver insulin but actually have algorithms that can improve outcomes.

但我預計，隨著我們的合作夥伴推出新系統，我們將看到該領域的顯著增長，而且這些系統不僅僅提供胰島素，而且實際上擁有可以改善結果的算法。

Right now our new patient adds are primarily MDI patients.

目前，我們新增的患者主要是 MDI 患者。

That's most of them.

這是他們中的大多數。

Got it.

知道了。

Okay.

好的。

That's helpful.

這很有幫助。

And then just a question on the G7, and I want to make sure I'm understanding correctly how pricing is going to change with G7.

然後只是一個關於 G7 的問題，我想確保我正確理解 G7 的定價將如何變化。

I know you guys haven't sort of outlined your go-to-market strategy per se, but I think you've said in the past that at some point, you're expecting to be at -- well, tell me if this is correct.

我知道你們本身並沒有概述你們的上市策略，但我認為你們過去曾說過，在某個時候，你們預計會在——好吧，告訴我這是否是正確的。

Are you expecting to eventually be pricing at parity with the competition as we look down -- further down the line to G7 and beyond?

當我們往下看時，您是否期望最終定價與競爭對手持平 - 進一步下降到 G7 及以後？

Or do you think that even with G7, you'll still be pricing at a premium?

還是您認為即使使用 G7，您仍然會以溢價定價？

I'm not going to outline all the specific details regarding that.

我不會概述有關此的所有具體細節。

But here is our strategy and here's how we look at that.

但這是我們的戰略，也是我們看待它的方式。

We look at the annual revenue per patient per year and what is the appropriate amount to charge a patient.

我們會查看每位患者每年的年收入以及向患者收取的適當金額。

For example, as we've gone from G7 to G6, that's how we look at that product offering as annual revenue per year rather than pricing on the individual components.

例如，當我們從 G7 升級到 G6 時，這就是我們如何將產品視為每年的年收入，而不是單個組件的定價。

With respect to how we price G7, there's a lot of variables involved here.

關於我們如何為 G7 定價，這裡涉及到很多變數。

If we have Decision Support tools that lead to better outcomes, does that justify a premium, does it not?

如果我們擁有能夠帶來更好結果的決策支持工具，這是否可以證明溢價是合理的，不是嗎？

I think we'll have to see it over time.

我認為隨著時間的推移我們將不得不看到它。

What's most important for the investment community to know is from a cost basis, we have a lot of flexibility with G7.

對於投資界來說，最重要的是從成本基礎上了解，我們在 G7 方面有很大的靈活性。

We designed that product for manufacturing.

我們設計了用於製造的產品。

We designed that to be a lower cost product offering than we have today, particularly with the extended wear.

我們將其設計為比我們現在提供的成本更低的產品，特別是在長時間佩戴的情況下。

We're prepared for what the market will do, but we will study this at great length and have a very detailed go-to-market strategy before we go, but I can't commit to anything specifically now.

我們已經為市場將要做什麼做好了準備，但我們會詳細研究這一點，並在我們開始之前製定一個非常詳細的市場進入戰略，但我現在不能具體承諾任何事情。

We're very optimistic about all the directions we can go.

我們對我們可以走的所有方向都非常樂觀。

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

我們的下一個問題來自 Piper Jaffray 的 JP McKim。

I wanted to ask, one, just, Kevin, you made a comment that you -- that I think you're wearing a G7 now.

我想問，一個，只是，凱文，你評論說你 - 我認為你現在穿著 G7。

So it feels a little more real me.

所以感覺我更真實一點。

And so I don't know, maybe initial thoughts on it, and then, will we see a trial start for G7 this year?

所以我不知道，也許是最初的想法，然後，今年我們會看到 G7 的試驗開始嗎？

Or is that still something that will happen in 2020?

還是這仍然會在 2020 年發生？

Look, we run trials with G7 all the time.

看，我們一直在用 G7 進行試驗。

But they're small trials that we're gathering data to learn and fine-tune the features of the system.

但它們是我們正在收集數據以學習和微調系統功能的小型試驗。

With respect to the experience, the regulatory people are probably going to kill me if the legal guy doesn't first, but it really is spectacular.

就經驗而言，如果法律人不先，監管人員可能會殺了我，但這真的很壯觀。

The wearable is pretty much nonexistent on your body.

可穿戴設備在您的身體上幾乎不存在。

As I look at projects we've started and innovation that we've attempted during my term at this company, this is the biggest leap we've ever taken.

當我回顧我在這家公司任職期間我們已經啟動的項目和我們嘗試過的創新時，這是我們所取得的最大飛躍。

And it's a huge leap.

這是一個巨大的飛躍。

And kudos to all the people involved in it because if I were to design what I'd hope CGM would have been when I started in this business, 25 years ago this week, I would have designed this.

對所有參與其中的人表示敬意，因為如果我要設計我希望 CGM 在我開始從事這項業務時的樣子，25 年前的這個星期，我會設計這個。

And so we're finally here.

所以我們終於到了。

That's really helpful.

這真的很有幫助。

And then maybe just on -- if I could ask one on just the non-intensive programs.

然後也許只是——如果我可以問一個關於非密集課程的問題。

There are several trials that we should see some data at ADA around.

有幾項試驗我們應該在 ADA 上看到一些數據。

I mean either Matt or Kevin, like how do you -- how do you define success in those trials?

我的意思是馬特或凱文，就像你一樣 - 你如何定義這些試驗中的成功？

Is it -- are payers really keen on recent amount of medications or are they'd sort of give the time, the range of the metrics?

是 - 付款人真的熱衷於最近的藥物數量，還是他們願意付出時間，衡量指標的範圍？

Or -- I guess, how do you -- how should we look at those trials as successful?

或者——我想，你怎麼看——我們應該如何看待這些試驗是成功的？

Yes.

是的。

I would say, you have to take the individual markets and kind of look market-by-market.

我會說，你必須採取個別市場和逐個市場的外觀。

So certainly, in the non-insulin-using, non-intensive type 2 market, reduction of drug cost is paramount, right?

所以當然，在非胰島素使用、非密集型 2 型市場中，降低藥物成本是最重要的，對吧？

In the hospital, things like length of stay -- reduce nursing time is important but reducing length of stay, getting people out of the ICU down to a step-down ward, into the general ward and out of the hospital.

在醫院裡，諸如住院時間之類的事情——減少護理時間很重要，但減少住院時間，讓人們離開 ICU 到降級病房，進入普通病房並離開醫院。

And actually, as important these days, prevention of hypoglycemia in a hospital setting is becoming increasingly important, it's on CMS's radar as a key metric for hospitals.

實際上，如今同樣重要的是，在醫院環境中預防低血糖症變得越來越重要，它作為醫院的關鍵指標在 CMS 的雷達上。

So reduction of hypoglycemia is going to be important going forward in that market.

因此，在該市場中，減少低血糖將變得很重要。

Gestational diabetes, we're still early in exploring opportunities there.

妊娠糖尿病，我們仍在早期探索那裡的機會。

I'd love to tell you that at some point, the CGM session will actually replace the oral glucose tolerance test.

我很想告訴你，在某個時候，CGM 會議實際上將取代口服葡萄糖耐量測試。

That's going to take some time and effort and some clinical trial work on our part.

這將需要一些時間和精力以及我們的一些臨床試驗工作。

So there's no kind of one size fits all in the new markets' development opportunities, but Matt has developed and will continue to develop a pretty robust team to tackle all these markets.

因此，在新市場的發展機會中，沒有一種萬能的方案，但馬特已經發展並將繼續發展一支非常強大的團隊來應對所有這些市場。

And clearly, over the next several years, 3- to 5-year time horizon, those markets becoming increasingly important for us.

顯然，在接下來的幾年，3 到 5 年的時間範圍內，這些市場對我們來說變得越來越重要。

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

我們的下一個問題來自摩根士丹利的大衛劉易斯。

Just 2 from me.

我只有2個。

Quentin, just want to come back to the gross margins.

昆汀，只想回到毛利率。

I appreciate your commentary about the 70% for the back half of the year and mid-60s next year.

我很欣賞你對今年下半年和明年 60 年代中期 70% 的評論。

But if I take the LRP, which obviously as you're aware with 65% in 2023.

但是，如果我採用 LRP，您顯然知道，到 2023 年將達到 65%。

Scaling and innovation, about 700 basis points of that.

規模化和創新，大約 700 個基點。

So it actually feels like both of those factors are playing a pretty powerful role on the back half of '19.

所以實際上感覺這兩個因素在 19 年的後半段都扮演著非常強大的角色。

So is it safe to assume the 65% 2023 number, given you're seeing earlier scaling and innovation is a -- is now a conservative number and we should think about that number being kind of materially higher?

那麼假設 2023 年的 65% 數字是否安全，因為您看到早期的擴展和創新是一個 - 現在是一個保守的數字，我們應該認為這個數字會更高一些？

Yes.

是的。

I don't want to get out to 5 years out from now and talk about whether it's conservative or aggressive.

我不想走出 5 年後談論它是保守的還是激進的。

I think what we tried to lay out for you is that we have very clear lines of sight to some very specific improvement efforts that will drive the gross margin higher over time.

我認為我們試圖為您展示的是，我們對一些非常具體的改進工作有非常明確的看法，這些工作將隨著時間的推移提高毛利率。

What becomes a bit more of a variable that we're prepared to be able to address is the revenue per patient headwind.

我們準備解決的更多變量是每位患者逆風的收入。

And as the mix shifts between different channels, we're going to have more than enough leverage flowing through the COGS profile of our business to be able to address that very aggressively and still produce a very attractive gross margin profile.

隨著不同渠道之間的組合轉變，我們將有足夠的槓桿作用通過我們業務的 COGS 配置文件，以便能夠非常積極地解決這個問題，並且仍然產生非常有吸引力的毛利率配置文件。

So we're happy with where things are at.

所以我們對事情的進展感到滿意。

The lower-cost transmitter coming in the back half of this year has always been something that we planned for and knew that we'd see a nice benefit from.

今年下半年推出的低成本發射機一直是我們計劃好的，並且知道我們會從中受益匪淺。

To Kevin's point earlier, you're going to see an incremental benefit coming from G7 as well as that's been designed to be even more cost-effective.

對於凱文早些時候的觀點，您將看到 G7 帶來的增量收益，並且其設計旨在更具成本效益。

So there's a lot of nice levers in front of us that give us the opportunity to combat some of the headwinds that might be out there.

所以我們面前有很多不錯的槓桿，讓我們有機會對抗可能存在的一些逆風。

Okay.

好的。

And just a quick follow-up on just the pharmacy benefit, the peridynamics, can you just update us, Steve, maybe on where you are into the pharmacy benefit coverage.

只需快速跟進藥房福利，近場動力學，您能否更新我們，史蒂夫，也許您在藥房福利範圍內的位置。

I think it was 50% last quarter.

我認為上個季度是 50%。

And more specifically, a lot has been made, sort of, inter-quarter about first provider or primary provider relationships.

更具體地說，關於第一供應商或主要供應商關係的季度間已經做了很多。

Can you just sort of talk about whether preferential provider or formerly relationships are having any impacts on U.S. demand?

您能否談談優惠供應商或以前的關係是否對美國需求產生任何影響？

And sort of how you see the future of preferred provider relationships in the channel, so the who you are in mix and we would say I'm preferred provider?

以及您如何看待渠道中首選提供商關係的未來，那麼您是誰，我們會說我是首選提供商？

I'll answer the second part of that question first, which the answer is no.

我將首先回答該問題的第二部分，答案是否定的。

I mean we've seen some isolated instances of companies trying to negotiate for preferred status, but that's certainly not something we're seeing as a trend as we move to the pharmacy benefit.

我的意思是，我們已經看到了一些孤立的公司試圖通過談判獲得優先地位的例子，但這肯定不是我們看到的趨勢，因為我們轉向了藥房福利。

As for commercial lives under coverage, we're certainly north of 50%.

至於覆蓋範圍內的商業生活，我們肯定在 50% 以上。

We haven't given a more granular number than that, and we're still not processing -- in terms of our commercial business, we're not processing close to 50% through the pharmacy channel at this point.

我們沒有給出比這更細化的數字，而且我們仍然沒有處理——就我們的商業業務而言，目前我們沒有通過藥房渠道處理接近 50% 的數據。

We're working hard to move more and more patients into that channel.

我們正在努力讓越來越多的患者進入該渠道。

So when we say we have north of 50% of the commercial lives covered, we're certainly still not processing 50%.

因此，當我們說我們覆蓋了超過 50% 的商業生命時，我們當然還沒有處理 50%。

And our next question comes from Joanne Wuensch from BMO Capital Markets.

我們的下一個問題來自 BMO Capital Markets 的 Joanne Wuensch。

Very nice quarter.

非常好的季度。

Two questions really.

真的是兩個問題。

At the ADA meeting in June, can you give us a feel for what we should be looking for there?

在 6 月份的 ADA 會議上，您能告訴我們我們應該在那裡尋找什麼嗎？

Yes.

是的。

Steve, why don't you take that one?

史蒂夫，你為什麼不拿那個？

Yes.

是的。

I mean I would say the most exciting data set, if you will, that we hope to see at ADA will be really a combined data set together with Tandem, where we should get a, at least, a first peak if not a full-blown view of the iDCL data.

我的意思是說，如果你願意的話，我們希望在 ADA 上看到的最令人興奮的數據集將是一個與 Tandem 組合在一起的數據集，我們應該得到一個，至少，第一個峰值，如果不是一個完整的—— iDCL 數據的爆炸視圖。

So that's -- again, that's Tandem's X2 pump with the DexCom G6 and the DexCom/type 0 algorithm running a hybrid close loop systems.

這就是——再一次，那是 Tandem 的 X2 泵，帶有 DexCom G6 和運行混合閉環系統的 DexCom/type 0 算法。

So that's probably the highlight for us and for Tandem collectively at ADA.

所以這可能是我們和 ADA 的 Tandem 集體的亮點。

There will be a number of additional kind of poster and some podium presentations, but from a data perspective that's really what we're looking forward to.

將會有一些額外的海報和一些講台演示，但從數據的角度來看，這確實是我們所期待的。

Yes.

是的。

I'd just add.

我只是補充。

The other thing, Joanne, that we're going to continue to see is anybody who stands up to speak starts talking about CGM.

Joanne，我們將繼續看到的另一件事是，任何站出來發言的人都會開始談論 CGM。

Every outcome, every trial, everything going on, CGM is clearly becoming the standard of evaluation -- of evaluating diabetes care across the board.

每一個結果，每一個試驗，每件事，CGM 顯然正在成為評估標準——全面評估糖尿病護理。

And I believe that trend is going to continue at ADA, and you will see CGM pretty much interwoven everywhere with everything that's done.

而且我相信這種趨勢將在 ADA 繼續下去，你會看到 CGM 幾乎與所做的一切交織在一起。

That's helpful.

這很有幫助。

And then my second question has to do with the OUS market.

然後我的第二個問題與 OUS 市場有關。

Growth was strong there again this quarter, and I'm just trying to get an idea of sustainability and into what other regions you might be looking to venture into?

本季度那裡的增長再次強勁，我只是想了解可持續性以及您可能希望涉足的其他地區？

You were talking about the OUS market?

你說的是OUS市場？

internationally, yes?

國際，是嗎？

Yes.

是的。

Clearly, the growth was strong there, and I think, you look at overall adoption of CGM in that overall marketplace is probably still sub-10% in terms of the long range opportunities.

顯然，那裡的增長很強勁，而且我認為，就長期機會而言，CGM 在整個市場中的整體採用率可能仍低於 10%。

And so there's a huge amount of runway that continues to exist in front of us.

所以有大量的跑道繼續存在於我們面前。

And our core markets continue to drive the primary growth for us today.

我們的核心市場今天繼續推動我們的主要增長。

Germany was another standout performer in the quarter leading the way for us.

德國是本季度另一個出色的表現，為我們領先。

But there is significant other new markets that are coming online.

但還有其他重要的新市場正在上線。

We just saw significant growth coming out of the Nordic markets, for example.

例如，我們剛剛看到北歐市場出現顯著增長。

We saw incremental reimbursement approved in Australia that allowed significant amount of contribution over the course of later part of this year and into next year.

我們看到澳大利亞批准了增量報銷，允許在今年晚些時候和明年進行大量捐款。

And then you get into some of the Asian markets, where we haven't started to see the contribution yet, but expect nice tailwinds coming out of Japan and Korea, for example.

然後你進入一些亞洲市場，我們還沒有開始看到貢獻，但期待來自日本和韓國的良好順風，例如。

So there are several new market opportunities, or even markets that we're in today, that it is growing at incredible rates, in paces of growth and a relatively untapped market opportunity.

因此，有幾個新的市場機會，甚至是我們今天所處的市場，它正在以令人難以置信的速度、增長速度和相對未開發的市場機會增長。

So I think there's several channels for overall growth in that international business that -- to get it to the point where in our long-range plans, we talked about it being closer to 30%, 35% of the overall business, which means it's going to be growing faster than the U.S. business.

因此，我認為國際業務的整體增長有幾個渠道——為了達到我們的長期計劃，我們談到它接近整體業務的 30%、35%，這意味著它是將比美國業務增長更快。

I think there's a lot of channels that will continue to make that available to us.

我認為有很多渠道將繼續為我們提供這些服務。

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

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

So first one from me is more a bigger picture prospective because we've now seen several quarters of strong patients growth.

因此，我的第一個更具前瞻性，因為我們現在已經看到了幾個季度的強勁患者增長。

So what I'm curious about is whether you guys are seeing a change in prescription patterns in the market?

所以我很好奇的是你們是否看到市場上處方模式的變化？

Whether it's endos or patients, and irrespective more of pharmacy or G6, but is CGM really becoming widely expected and a go-to from those type 1 patients?

無論是endos還是患者，也不管更多的是藥房還是G6，但CGM真的被廣泛期待並成為那些1型患者的首選嗎？

Margaret, this is Kevin.

瑪格麗特，這是凱文。

I believe it's becoming much more widely accepted and prescription patterns are rising across the board.

我相信它正變得越來越被廣泛接受，並且處方模式正在全面上升。

That -- it's just becoming the tool of the manager insulin delivery.

那 - 它只是成為經理胰島素輸送的工具。

And it's not -- while it is becoming a tool and more accepted, penetration rates are still not at the point where we need to step back and worry.

事實並非如此——雖然它正在成為一種工具並被更多人接受，但滲透率仍然沒有達到我們需要退後一步擔心的地步。

In the type 1 market, we think the penetration rates in the U.S. are still in the 30% range across the board.

在 1 類市場中，我們認為美國的滲透率仍處於 30% 的範圍內。

And type 2 intensive insulin using is still not that big a number either.

使用 2 型強化胰島素的數量也不是很大。

So over time, there's plenty of market runway here to continue to go on the international front.

因此，隨著時間的推移，這裡有大量的市場跑道可以繼續走在國際前沿。

Penetration rates in the intensive population are close to being at that high.

密集人口的滲透率接近於如此高的水平。

But we think it is much more accepted than it was before.

但我們認為它比以前更容易接受。

And we think G6 has had a very positive impact for us in these new markets because it's much easier to use.

我們認為 G6 在這些新市場對我們產生了非常積極的影響，因為它更易於使用。

There's no calibration feature, the easier insertion, the direct-to-phone connectivity.

沒有校準功能，更容易插入，直接連接到電話。

All the things we've built into G6 were designed to drive this market and we're seeing the benefits of that as we go forward.

我們在 G6 中構建的所有東西都是為了推動這個市場而設計的，我們在前進的過程中看到了它的好處。

And so just to follow up on that.

所以只是為了跟進。

It seems like you guys have got nice improvements.

看來你們有很好的改進。

So the endos saw selecting patients that they think that will see the most benefits from that.

因此，endos 選擇了他們認為會從中受益最多的患者。

And what else maybe do you need, I know you mentioned new connected product launches this year.

你可能還需要什麼，我知道你提到了今年推出的新連接產品。

I don't know if those are digital software or hardware?

不知道是數字軟件還是硬件？

It's interesting.

這真有趣。

I just spent some time with several of the folks from the field.

我剛剛和該領域的幾個人呆了一段時間。

And I would tell you, a lot of this varies territory to territory.

我會告訴你，很多這樣的地區因地區而異。

It varies practice to practice still.

仍然練習不同的練習。

There is not a standard guideline where all the doctors are identifying different patients and having different criteria.

沒有一個標準的指導方針，所有的醫生都在識別不同的病人並有不同的標準。

I would say like anything, that it's changing rapidly.

我想說的是，它正在迅速變化。

When I first went out on the field, when I started here, the only patient recommended for CGM was a pumper.

當我第一次上場時，當我從這裡開始時，唯一推薦給 CGM 的病人是一名抽水機。

I would ask doctors, who do you put on CGM?

我會問醫生，你給誰做 CGM？

They'd say somebody with a pump is where we start.

他們會說有泵的人是我們開始的地方。

That certainly is not the case anymore.

現在肯定不是這樣了。

And so it varies across the board, but it is much more prevalent than it used to be.

所以它全面變化，但它比以前更加普遍。

There's still plenty of room.

空間還是很大的。

And our next question comes from Jeff Johnson from Baird.

我們的下一個問題來自 Baird 的 Jeff Johnson。

Kevin, I want to go back and ask you a question on the MDI versus pump mix that was talked about earlier.

凱文，我想回過頭來問你一個關於 MDI 與之前討論過的泵混合的問題。

Especially within the MDI category, are you seeing any change in that patient base?

特別是在 MDI 類別中，您是否看到該患者群有任何變化？

Are you winning any competitive converts there?

你在那裡贏得了任何有競爭力的皈依者嗎？

Or are those all native first-time users of CGM that you're winning on that MDI side?

或者那些都是你在 MDI 方面贏得的 CGM 的本地首次用戶？

I don't have a good piece of data here.

我這裡沒有很好的數據。

Yes, I would say -- I would say, anecdotally, just honestly coming out of our national sales meeting and talking to our field force, who really they're on the front line, that you hear anecdotal stories that yes, people would try Libre and then if they are content with an on-body experience, with a sensor experience that they do migrate to a DexCom, but we don't have any real metrics to kind of give you as to what sort of conversion rate we have on Abbott to DexCom.

是的，我會說 - 我會說，有趣的是，我會說，只是誠實地從我們的全國銷售會議上出來並與我們的現場人員交談，他們真的在前線，你聽到的軼事故事是的，人們會嘗試Libre，然後如果他們滿足於身體體驗，他們確實遷移到 DexCom 的傳感器體驗，但我們沒有任何真正的指標可以告訴你我們有什麼樣的轉化率雅培到 DexCom。

With respect to Medtronic, they've launched a standalone system, but we -- honestly, we just don't do that system out in the marketplace at all.

至於美敦力，他們已經推出了一個獨立的系統，但我們——老實說，我們根本不會在市場上推出這個系統。

Yes.

是的。

Fair enough.

很公平。

And then on Medicare, I just -- we didn't get much color on that this quarter.

然後在醫療保險上，我只是 - 我們在本季度沒有得到太多的色彩。

Any update there on stick rates, on demand trends, things like that.

那裡有任何關於固定利率、需求趨勢等的更新。

I know G6 is pushed till later this year in that channel.

我知道 G6 在那個頻道被推到今年晚些時候。

Has that been impacting near-term demand?

這是否影響了近期需求？

Just any updates would be helpful?

任何更新都會有幫助嗎？

Yes.

是的。

No change in trends there, Jeff.

傑夫，那裡的趨勢沒有變化。

I would say our stick rates remain very, very high.

我想說我們的堅持率仍然非常非常高。

I mean we're incredibly encouraged by what we're seeing there.

我的意思是，我們對在那裡看到的東西感到難以置信的鼓舞。

And the new patient funnel continues to be very full.

新的患者漏斗仍然非常滿。

So pushing the G6 launch out into later in the year has not impacted any trends that we've seen in that Medicare business right now.

因此，將 G6 的推出推遲到今年晚些時候並沒有影響我們目前在醫療保險業務中看到的任何趨勢。

And our next question comes from Doug Schenkel from Cowen.

我們的下一個問題來自 Cowen 的 Doug Schenkel。

This is Ryan on for Doug.

這是道格的瑞恩。

And first off, Matt, congrats on the new role.

首先，馬特，祝賀新角色。

You referenced G6 enhancements coming this year earlier in the call and talked about new algorithms on the last quarterly call.

您在電話會議中提到了今年早些時候推出的 G6 增強功能，並在上一個季度電話會議上談到了新算法。

Can you provide any more details, should we expect the new algorithm to noticeably improve the performance metrics of G6 during 2019?

您能否提供更多細節，我們是否應該期待新算法在 2019 年顯著提高 G6 的性能指標？

And then should we expect extended wear for G6 during 2019?

那麼我們是否應該期待 G6 在 2019 年延長磨損？

You know what, let us -- we're going to keep that close to the vest and not lay out the -- the road map.

你知道嗎，讓我們 - 我們將保持接近背心而不是佈置 - 路線圖。

In the U.S., I can tell you in 2019, we don't expect extended wear for the G6 in 2019.

在美國，我可以在 2019 年告訴你，我們預計 2019 年 G6 不會延長磨損。

The decisions that we are making around things that would require extensive trials of that nature are very interesting.

我們圍繞需要對這種性質進行廣泛試驗的事情做出的決定非常有趣。

Do we commit those resources to G6?

我們是否將這些資源提交給 G6？

Or do we commit those resources to accelerating G7?

還是我們將這些資源用於加速 G7？

And in many cases, we're choosing the G7 acceleration over that.

在很多情況下，我們會選擇 G7 加速。

But there are new features coming out in the fall on G6, and we'll kind of wait a while before we lay what all those are out to everybody.

但是秋季 G6 會推出一些新功能，我們會稍等片刻，然後再向大家展示所有這些功能。

And your next question comes from Chris Pasquale from Guggenheim.

您的下一個問題來自古根海姆的 Chris Pasquale。

I just want to follow up on the comment about the gross margin, Quentin, and why we shouldn't assume that 70% is a good number going forward?

我只想跟進關於毛利率的評論，昆汀，為什麼我們不應該假設 70% 是一個很好的數字？

I'm assuming some of that has to do with the continuation of the pharmacy dynamic next year.

我假設其中一些與明年藥房動態的延續有關。

But just kind of flush out how much you have to sort of swim upstream to maintain margins in the mid-60s?

但是，您需要多少逆流而上才能保持 60 年代中期的利潤率？

And what you're thinking about over the next, call it, 18 months?

接下來你在想什麼，稱之為 18 個月？

Yes.

是的。

Without getting into specifics around 2020, maybe I'll just point you to one of the dynamics that we feel in the business right now, which is somewhat considerable to what we saw last year as well.

在不涉及 2020 年左右的細節的情況下，也許我只會向您指出我們目前在業務中感受到的一種動態，這與我們去年看到的情況相比也相當可觀。

For the full year, when we set margin expectations, we talked about there being roughly a 200 basis point headwind relative to the revenue per patient impact of moving into some of these other channels, both pharmacy and OUS.

對於全年，當我們設定利潤率預期時，我們談到相對於進入其他一些渠道（包括藥房和 OUS）對每位患者的收入影響而言，存在大約 200 個基點的逆風。

I think based upon what we know at that point in time, that's probably the right way to continue to think about that headwind as we roll into next year.

我認為根據我們當時所知道的情況，這可能是在我們進入明年時繼續考慮逆風的正確方法。

Clearly, we'll refine that as we learn more as we exit the year.

顯然，隨著我們在今年結束時了解更多信息，我們將對其進行改進。

But they start to push up into the 70s with the lower-priced transmitter.

但他們開始使用價格較低的發射器進入 70 年代。

It clearly gives us opportunities to be more thoughtful around pricing strategies into the future.

它顯然讓我們有機會對未來的定價策略進行更深思熟慮。

So that's why I come back into the mid-60s for the time being.

所以這就是我暫時回到 60 年代中期的原因。

But in terms of the pressure we're feeling from mixed channel, a couple of hundred basis points right now is what we're seeing.

但就我們從混合渠道感受到的壓力而言，我們現在看到的是幾百個基點。

So you can model from there where you want.

因此，您可以從那裡建模。

But I still think the mid-60s is right way to think about it over the long term.

但我仍然認為 60 年代中期是從長遠來看的正確方式。

That's helpful.

這很有幫助。

And then on the new markets, I'm assuming it's going to be a little while before we see some real data in some of these new indications.

然後在新市場上，我假設我們還需要一段時間才能在其中一些新跡像中看到一些真實數據。

But at this point, is there a lead candidate that you guys think is most promising or that you think you want to go after first?

但是在這一點上，有沒有你們認為最有前途的主要候選人，或者你認為你想先追求的領先候選人？

I would say, we're -- look, we're already commercial to some extent in the non-intensive type 2. I mean we've characterized some of the work we're doing, particularly with UnitedHealthcare as pilot studies, but we're talking about multiple thousands of patients.

我想說，我們 - 看，我們已經在某種程度上在非密集型 2 中商業化了。我的意思是我們已經描述了我們正在做的一些工作，特別是與 UnitedHealthcare 作為試點研究，但是我們談論的是成千上萬的患者。

So there are large pilot studies.

所以有大量的試點研究。

With respect to the work being done by United, Onduo, et cetera, you're not going to see any data.

至於 United、Onduo 等正在做的工作，你不會看到任何數據。

In fact, they hold some of the findings and the learnings there to be highly proprietary, so they're not going to share that with anybody.

事實上，他們認為其中的一些發現和學習是高度專有的，所以他們不會與任何人分享。

To the extent we run a more formalized clinical protocol for a hospital indication or a gestational indication or something like that, that data may become available.

如果我們為醫院適應症或妊娠適應症或類似的東西運行更正式的臨床方案，那麼這些數據可能會變得可用。

But right now, I don't think we have any plans to -- really, to tip our hat to our potential competitors in those markets as well.

但現在，我不認為我們有任何計劃——真的，向我們在這些市場的潛在競爭對手致敬。

And our next question comes from Raj Denhoy from Jefferies.

我們的下一個問題來自 Jefferies 的 Raj Denhoy。

Just really wanted to ask about the leverage, the middle of the income statement you guys are talking about.

只是真的想問一下槓桿，你們正在談論的損益表的中間部分。

And I appreciate the comments on the increase to the folks in the Philippines now.

我很欣賞現在對菲律賓人民增加的評論。

So a couple of questions there.

所以有幾個問題。

One is, if you think about the environment getting potentially more competitive.

一是，如果您考慮到環境可能變得更具競爭力。

One of the concerns is that, customer service for you guys has always been such a really strong suit and as you move that now offshore and how you maintain that?

一個令人擔憂的問題是，為你們提供的客戶服務一直是一個非常強大的套裝，當你現在將它轉移到海外時，你如何保持它？

And so I'm curious if you have any kind of really data or anything you can offer in terms of how that transition is going.

所以我很好奇你是否有任何真正的數據或任何你可以提供的關於過渡如何進行的東西。

Yes.

是的。

Raj, we've been incredibly impressed by the team that's being built over there.

Raj，我們對在那裡建立的團隊印象深刻。

And we pay very close attention to, not only quantitative assessment and performance metrics, but also qualitative.

我們非常關注，不僅定量評估和績效指標，而且定性。

And so we try to take the opportunity with every single patient as they work with our folks over there to get feedback from them on how the calls went and what we can do better.

因此，我們試圖抓住每一位患者的機會，因為他們與我們那邊的人一起工作，從他們那裡獲得關於電話如何進行以及我們可以做得更好的反饋。

And I can tell you out of the gate, our qualitative scores are higher than what we've seen in our domestic teams.

而且我可以告訴你，我們的定性分數比我們在國內團隊中看到的要高。

So we're seeing great results and something that we're paying very close attention to.

所以我們看到了很好的結果以及我們非常關注的事情。

From an efficiency perspective, we've been beyond, to be quite honest, what we anticipated we might be able to recognize in the early stages there.

從效率的角度來看，老實說，我們已經超越了我們在早期階段可能能夠認識到的預期。

You look at some of the work coming out of our customer advocacy or complaints area, our tech support and other back-office functions, and the efficiencies are significant that lead us to believe that it's going to make it much easier to scale, much more quickly and clearly, more effectively.

你看看我們的客戶宣傳或投訴領域、我們的技術支持和其他後台職能部門所做的一些工作，效率顯著，讓我們相信它會讓擴展變得更容易，更多快速、清晰、更有效。

So we couldn't be more encouraged by what we're seeing out of that effort there.

因此，我們從那裡的努力中看到的結果讓我們倍受鼓舞。

I believe that over time, that becomes a real strategic asset to this company and allows us to be more aggressive in how we think about other strategic opportunities in markets we might want to pursue.

我相信，隨著時間的推移，這將成為這家公司真正的戰略資產，並使我們能夠更加積極地思考我們可能想要追求的市場中的其他戰略機會。

Or how we just compete in the local markets that we're in already.

或者我們如何在我們已經在的當地市場中競爭。

So very encouraged by what we're seeing there.

我們對在那裡看到的東西感到非常鼓舞。

And your next question comes from Ravi Misra from Berenberg Capital.

您的下一個問題來自 Berenberg Capital 的 Ravi Misra。

So my first one is again on gross margins.

所以我的第一個又是毛利率。

Just hoping, Quentin, maybe you could give us a little bridge between the first quarter and fourth quarter ramp?

只是希望，昆汀，也許你能給我們在第一季度和第四季度坡道之間架起一座小橋？

And then on the first quarter, what are the headwinds that showed up in that margin that are going to fall away, maybe break it down versus year-over-year versus mix-shift or underutilized overhead?

然後在第一季度，出現在該利潤率中的哪些不利因素將會消失，可能會與同比、混合轉移或未充分利用的開銷進行分解？

Ravi, when you're talking fourth quarter, you're talking about from Q1 this year to Q4 of '19?

拉維，當您談論第四季度時，您指的是從今年第一季度到 19 年第四季度？

Right.

正確的。

Yes, exactly.

對，就是這樣。

Sure.

當然。

So I think -- let me just talk year-over-year real fast, Q1-to-Q1 around some of the headwinds that we had.

所以我認為 - 讓我圍繞我們遇到的一些不利因素，逐年快速地談論第一季度到第一季度。

There was about 200 basis points of impact related to the continued shift towards pharmacy, and the OUS business being a bigger part of the overall contribution.

繼續向藥房轉移帶來了大約 200 個基點的影響，而 OUS 業務在整體貢獻中佔比更大。

And then there's about 200 basis points associated with really our focus on doubling capacity.

然後有大約 200 個基點與我們真正關注產能翻倍相關。

And we talked about the fact that with the demand being beyond what we had anticipated, we're accelerating some of that spend.

我們談到了這樣一個事實，即由於需求超出了我們的預期，我們正在加速其中的一些支出。

So we pulled some of that forward.

所以我們向前推進了一些。

Not all of that is capitalizable or inventoriable, and so it's run through the P&L a bit earlier than what we had anticipating.

並非所有這些都是可資本化或可庫存的，因此它比我們預期的要早一點通過損益表。

So I think you'll see Q1 will be that low-water mark.

所以我認為你會看到第一季度將是那個低水位線。

I think you'll start to see it improve a bit in Q2 and see some real improvement in Q3 and onto Q4.

我認為你會開始看到它在第二季度有所改善，並在第三季度和第四季度看到一些真正的改善。

And really what drives that, in Q3, you're going to start to get just the benefit of levering the fixed overhead that we put in place right now to design the automated manufacturing capabilities.

真正推動這一點的是，在第三季度，您將開始受益於利用我們現在為設計自動化製造能力而設置的固定開銷。

In Q4, while you're getting some of the benefit of that leverage or the fixed overhead, you're really going to start to get the play-through of the benefit on the low-cost transmitter.

在第 4 季度，當您從該槓桿或固定開銷中獲得一些好處時，您將真正開始在低成本發射器上獲得好處。

So hopefully that gives you a bit of a bridge over the course of the year in terms of what the contributing factors are.

因此，希望這可以在一年中為您提供一些影響因素的橋樑。

But I think for us, we can see a clear line of sight of getting close to that 70% range as we exit the year.

但我認為，對於我們來說，我們可以清楚地看到在今年結束時接近 70% 的範圍。

Great.

偉大的。

I can add some follow-ups offline.

我可以離線添加一些後續。

And then my second question is, just around type 2 usage and kind of some of the commentary you had around moving patients from the ward -- from ward to ward, just curious, what's the take on the proposed rule changes around new technology add-on payments?

然後我的第二個問題是，關於第 2 類的用法和一些關於將患者從病房轉移到病房的評論——從一個病房到另一個病房，只是好奇，對圍繞新技術添加的擬議規則變化有何看法-付款？

I mean do you see a space for your CGM products to fit into that designation?

我的意思是您是否認為您的 CGM 產品有適合該名稱的空間？

And what could that mean from a reimbursement or payment perspective?

從報銷或付款的角度來看，這意味著什麼？

Yes.

是的。

Absolutely, and particularly in the hospital setting, as I mentioned, CMS has a renewed focus and has identified hypoglycemia in the inpatient setting as a huge problem.

當然，尤其是在醫院環境中，正如我所提到的，CMS 重新關注並確定住院環境中的低血糖是一個巨大的問題。

And so you're not going to detect hypoglycemia with finger sticks, even if you're taking a couple of finger sticks an hour, right?

所以你不會用手指棒檢測低血糖，即使你一個小時用幾次手指棒，對吧？

So I think that the CGM plays perfectly into that environment.

所以我認為 CGM 非常適合那種環境。

And we've long known that recurring hyperglycemia in the hospital as a problem leads to reduced healing times.

而且我們早就知道，醫院中反復出現的高血糖症會導致癒合時間縮短。

We can get CGM put on this -- the idea would be to get CGM put on these patients potentially pre-op, get them into the hospital with the sensor already on, get their blood sugar under control before a procedure and get them in and out of the hospital as quickly as possible.

我們可以把 CGM 放在上面——這個想法是讓 CGM 放在這些患者身上盡快出院。

So yes, we think there's great application here.

所以是的，我們認為這裡有很好的應用。

We think also the disposable nature of G7 is the perfect product opportunity there.

我們還認為 G7 的一次性性質是那裡完美的產品機會。

And our next question is from Matt Taylor from UBS.

我們的下一個問題來自瑞銀的馬特泰勒。

So I wanted to ask, Quentin, a question, see if you could give us a little bit more detail on what changes here sequentially in terms of some of the assumptions that are embedded in the revenue guidance for the year?

所以我想問昆汀一個問題，看看你是否可以更詳細地告訴我們關於今年收入指導中嵌入的一些假設的順序變化？

You did address a little bit of this in the earlier question about the pricing headwinds, but can you just give us a sense for what has changed?

您在之前關於定價逆風的問題中確實解決了一些問題，但是您能否讓我們了解發生了什麼變化？

And if you could provide broad strokes on the different components, that would be helpful?

如果您可以對不同的組件提供廣泛的筆觸，那會有所幫助嗎？

Yes.

是的。

I think -- it's really quite simple.

我認為——這真的很簡單。

To be honest with you, it's not a lot of different moving pieces.

老實說，這不是很多不同的移動部分。

It comes down to new patient volume more than anything else.

它歸結為新的患者數量比其他任何事情都重要。

I think the demand that we continue to see in the business coming off at Q4 and the strong Q1 continues to increase our confidence in the adoption of the technology in the marketplace, and so it's really new patient volumes that are driving the incremental growth.

我認為我們在第四季度繼續看到的業務需求和強勁的第一季度繼續增加我們對市場採用該技術的信心，因此真正推動增量增長的是新的患者數量。

I think that you'll see a lot of that come through on the commercial business through the pharmacy channel.

我認為您會通過藥房渠道在商業業務中看到很多內容。

From our experience, we believe that's where the majority ends up showing up, and then the international business is a bit strong as well.

根據我們的經驗，我們相信這是大多數人最終出現的地方，然後國際業務也有點強勁。

So those 2 channels are the primary drivers.

所以這兩個渠道是主要驅動力。

And at the end of the day, it's all new patient volumes that are driving it.

歸根結底，推動它的是所有新的患者數量。

The pricing assumption, I talked about earlier, no change in terms of the $100 million headwind.

我之前談到的定價假設在 1 億美元的逆風中沒有變化。

Okay.

好的。

And then maybe just a follow-up with the Head of New Markets here or just for the team, can you talk about which of the new markets you think is really going to be able to bear fruit for the company in the near term?

然後也許只是在這裡與新市場負責人的跟進，或者只是為了團隊，你能談談你認為哪些新市場真的能夠在短期內為公司帶來成果嗎？

Anything that you can share on the strategy there that's changed since -- you talked about some of the things at Investor Day?

您可以分享關於自那以後發生變化的策略的任何內容 - 您在投資者日談到了一些事情？

This is Kevin.

這是凱文。

I'll take that.

我會接受的。

I'm not as concerned about bearing fruit on the revenue side, as I am building a long-term case.

我並不擔心在收入方面取得成果，因為我正在建立一個長期案例。

So our efforts this year go -- as we rolled this stuff out, as I said earlier in my prepared remarks, are to develop the outcomes, the cost base evidence that show these are markets where we're going to save patient's money and deliver better outcomes.

所以我們今年的努力——正如我之前在準備好的評論中所說，當我們推出這些東西時，是為了開發結果，成本基礎證據表明這些市場是我們將節省患者的錢並提供更好的結果。

So it will be largely developing that evidence in those business models, establishing the relationships we need to go distribute into these markets and taking some steps like that over 2019 and early 2020.

因此，它將在很大程度上發展這些商業模式中的證據，建立我們需要進入這些市場的關係，並在 2019 年和 2020 年初採取類似的步驟。

And then when we roll out G7, we expect to roll that out to these other places as well.

然後，當我們推出 G7 時，我們也希望將其推廣到其他地方。

And that becomes more of a commercial thing right now.

現在這更像是一種商業行為。

And again, I will echo something that Steve said earlier.

再一次，我將重複史蒂夫早些時候所說的話。

We haven't just been sitting around on this and not working.

我們不只是坐在那里而不工作。

We've had some of our best people working on these efforts for quite some time.

我們已經讓一些最優秀的人從事這些工作已經有一段時間了。

Now what we've done is formalized the structure and said, you guys have a home, you have a group, you have some goals, go get this done.

現在我們所做的是將結構正式化，並說，你們有一個家，你們有一個小組，你們有一些目標，去完成這件事。

And we're going to start measuring that progress more, rather than just as projects.

我們將開始更多地衡量這一進展，而不僅僅是項目。

And that's what we're expecting in the near-term.

這就是我們在短期內所期望的。

And our next question comes from Steve Lichtman from Oppenheimer.

我們的下一個問題來自 Oppenheimer 的 Steve Lichtman。

Kevin, on intensive type 2s, where do you think we're at penetration-wise today?

凱文，在密集型 2 上，你認為我們今天的滲透率在哪裡？

And any updated color on your discussions with commercial payers and expanding access to those patients?

以及您與商業付款人的討論以及擴大對這些患者的訪問的任何更新顏色？

We continue to pursue that with the payers and certainly, using the CMS ruling as a basis for that.

我們將繼續與付款人一起追求這一點，當然，以 CMS 裁決為基礎。

It gives us a very good start.

它給了我們一個很好的開始。

I don't think penetration is very deep there right now.

我不認為現在那裡的滲透很深。

I can give you a number, I think it's less than 10%, in general.

我可以給你一個數字，我認為一般來說不到 10%。

However, a lot of those type 2 intensive patients are Medicare patients.

然而，很多那些 2 型重症患者是醫療保險患者。

And as we launch -- as we look at launching G6 into Medicare later in the year, for example, we think we have an opportunity to grow that significantly, and that's a nice opportunity for us going forward in the future.

當我們推出時——例如，當我們考慮在今年晚些時候將 G6 引入醫療保險時，我們認為我們有機會顯著增長，這對我們未來來說是一個很好的機會。

I can tell you that the type 2 intensive patients on the system, Quentin referred to the stickiness of our Medicare patients.

我可以告訴你，系統上的 2 型重症患者，昆汀提到了我們醫療保險患者的粘性。

It's been extremely good so far.

到目前為止，情況非常好。

So they're getting very good outcomes, those who use it.

所以他們得到了非常好的結果，那些使用它的人。

So we're happy with it.

所以我們對此很滿意。

It is a tremendous opportunity for us.

這對我們來說是一個巨大的機會。

And I -- we look forward to more coverage.

我 - 我們期待更多的報導。

It's a chore.

這是一件苦差事。

Getting the insurance companies to pay more and spend more money is never simple.

讓保險公司多付錢、多花錢絕非易事。

Got it.

知道了。

And then, you also talked about the positive results you're seeing from the predictive hypo alerts.

然後，您還談到了您從預測性低警報中看到的積極結果。

When do you think we could see data aggregated and published around the benefits there?

您認為我們什麼時候可以看到圍繞那裡的好處匯總和發布的數據？

I believe, Steve, that our predictive hypo alert paper was presented at ATTD.

我相信，史蒂夫，我們的預測性低警報論文是在 ATTD 上發表的。

So that's already out, the G6 system, the patients that experience less hypoglycemia with the predictive alert.

所以這已經是 G6 系統了，患者在預測性警報下出現的低血糖症較少。

And our next question comes from Suraj Kalia from Northland Securities.

我們的下一個問題來自 Northland Securities 的 Suraj Kalia。

Congrats on a great quarter.

祝賀一個偉大的季度。

So Quentin, a lot of my questions have been asked.

所以昆汀，我的很多問題都被問到了。

Maybe I'll just kind of lump both my questions into one.

也許我會把我的兩個問題合二為一。

And forgive me if you all have mentioned this on the call.

如果你們都在電話中提到了這一點，請原諒我。

What are the expectations for U.S. versus OUS contribution in FY '19?

對 19 財年美國與 OUS 的貢獻有何期望？

I'd love to get some perspective on how you'll see the margins for these 2 different buckets.

我很想了解您將如何看待這兩個不同存儲桶的邊距。

I mean roughly speaking, the math tells me that roughly $400 million -- a little over $400 million would be OUS, the remaining would be U.S. Maybe you can kind of parse out for as what the -- how we should think about this?

我的意思是粗略地說，數學告訴我大約 4 億美元——略高於 4 億美元將是 OUS，剩下的將是美國。也許你可以分析一下——我們應該如何看待這個問題？

How the gross margins for the different buckets would be?

不同桶的毛利率如何？

And finally, this transmitter that is expected to bump up gross margins to 70% in Q4, what is the incremental gross margins contribution from this transmitter?

最後，這個發射器預計將在第四季度將毛利率提高到 70%，這個發射器的增量毛利率貢獻是多少？

I'd love to get some color, if possible?

如果可能的話，我想得到一些顏色？

Sure.

當然。

So in terms of U.S. versus OUS split, on the full year, our OUS business is expected to grow in the mid- to high-30s range, which -- the U.S. business is growing in the teens, the 20%-or-so.

因此，就美國與 OUS 的拆分而言，全年，我們的 OUS 業務預計將在 30 多歲的中高段範圍內增長，其中 - 美國業務正在以 20% 左右的速度增長.

That's about what we've expected on the course of the full year.

這就是我們對全年的預期。

We haven't given specific gross margin data points on the U.S. or OUS business and we're not going to put that out there.

我們沒有給出關於美國或 OUS 業務的具體毛利率數據點，我們不會把它放在那裡。

And that shifts, honestly, quarter-to-quarter just based upon the mix of the revenue within say, OUS, where you've got a direct marketing, you've got a distributor business as well.

老實說，這只是根據 OUS 內部的收入組合，每季度都會發生變化，你有一個直接營銷，你也有一個分銷商業務。

So it just fluctuates based upon the mix.

所以它只是根據混合而波動。

But we haven't put those data points out there, nor are we going to right now.

但是我們還沒有把這些數據點放在那裡，我們現在也不會。

In terms of the incremental benefit associated with the transmitter, the G6 low-cost transmitter, without giving you the exact specific cost differential, we can tell you it's more than 50% cheaper than what the G6 existing transmitter is today.

就與發射器相關的增量收益而言，G6 低成本發射器，在沒有給您確切的具體成本差異的情況下，我們可以告訴您它比現在的 G6 現有發射器便宜 50% 以上。

So in terms of orders of magnitude, I think that it's clearly a very significant benefit for us that drives the overall improvement in the gross margin in that fourth quarter time frame we've talked about.

因此，就數量級而言，我認為這對我們來說顯然是一個非常重要的好處，它推動了我們所討論的第四季度時間框架內毛利率的整體改善。

And that concludes the question-and-answer session.

問答環節到此結束。

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

我現在將把電話轉回給 Kevin Sayer 以作最後評論。

Thank you very much, and thanks, everyone, for being on the call today.

非常感謝大家，感謝大家今天接聽電話。

I actually wanted to stop the call at 52% growth and $95 million-plus in incremental revenue over Q1 of last year, but we decided we would keep going.

實際上，我想在去年第一季度的 52% 增長和 9500 萬美元以上的增量收入中停止通話，但我們決定繼續前進。

Much of the discussion around this call and recent months has focused upon 2 things: The pricing environment and anticipated competitive offerings in the space.

圍繞這次電話會議和最近幾個月的大部分討論都集中在兩件事上：定價環境和該領域預期的競爭產品。

And I think too often we forgot one thing.

而且我認為我們經常忘記一件事。

This market opportunity is huge.

這個市場機會是巨大的。

It is extremely large, not only in the intensive insulin space, but ultimately, in the type 2 space and the other areas, so we're looking at all the way down to health and wellness.

它非常大，不僅在密集型胰島素領域，而且最終在 2 型領域和其他領域，所以我們一直在關注健康和保健。

We continue to see people now buying our system, getting a prescription because they want to manage their nutrition on the side and they're paying cash and using it, but seeing some very interesting things.

我們繼續看到人們現在購買我們的系統，獲得處方，因為他們想要管理他們的營養，他們支付現金並使用它，但看到了一些非常有趣的東西。

We truly see today when CGM, in multiple configurations and forms, becomes a very useful tool across all of health care and truly the standard of care in the intensive management of diabetes.

今天，我們真正看到 CGM 以多種配置和形式成為所有醫療保健中非常有用的工具，並真正成為糖尿病強化管理中的護理標準。

With respect to pricing, our channel and payer teams are doing very well at DexCom.

在定價方面，我們的渠道和付款人團隊在 DexCom 做得很好。

I talked earlier about the recent win with Cigna.

我早些時候談到了最近與 Cigna 的勝利。

We are -- we're hitting on all cylinders here and that team has gone very well.

我們是——我們在這裡全力以赴，那支球隊進展順利。

Given the size of the opportunity with respect to the competitive environment, I said earlier, we didn't expect to remain the sole voice of CGM forever.

鑑於競爭環境的機會規模，我之前說過，我們沒想到永遠是 CGM 的唯一聲音。

We always knew others would come.

我們一直都知道其他人會來。

An increased awareness generated by all parties move patients to the technology that best meets their needs.

各方提高了意識，使患者轉向最能滿足其需求的技術。

And that technology remains DexCom.

而這項技術仍然是 DexCom。

With G6, our planned enhancements coming later this year; our next-gen G7 offering, and the technologies that will be following that, we expect to be the leader in this industry, in this the space for a very long time.

對於 G6，我們計劃在今年晚些時候推出增強功能；我們的下一代 G7 產品，以及隨之而來的技術，我們希望在這個領域成為這個行業的領導者很長一段時間。

Thanks again everybody and have a great day.

再次感謝大家，祝您有美好的一天。

Thank you, ladies and gentlemen.

謝謝你們，女士們，先生們。

This concludes today's conference call.

今天的電話會議到此結束。

Thank you for participating, and you may now disconnect.

感謝您的參與，您現在可以斷開連接。