德康醫療 (DXCM) 2022 Q4 法說會逐字稿

Ladies and gentlemen, welcome to the Dexcom Fourth Quarter 2022 Earnings Release Conference Call. My name is Abby, and I will be your operator for today's call. (Operator Instructions) As a reminder, the conference is being recorded.

各位女士、先生，歡迎參加 Dexcom 2022 年第四季財報發布電話會議。我是 Abby，將擔任今天會議的接線員。（接線員指示）提醒各位，本次會議將被錄音。

And I will now turn the call over to Sean Christensen, Vice President of Finance and Investor Relations. Sean, you may begin.

現在我將把電話交給財務與投資人關係副總裁 Sean Christensen。Sean，請開始。

Thank you, Abby, and welcome to Dexcom's Fourth Quarter 2022 Earnings Call. Our agenda begins with Kevin Sayer, Dexcom's Chairman, President and CEO, who will summarize our recent highlights and ongoing strategic initiatives; followed by a financial review and outlook from Jereme Sylvain, our Chief Financial Officer. Following our prepared remarks, we will open the call up for your questions. (Operator Instructions)

謝謝你，Abby，也歡迎各位參加 Dexcom 2022 年第四季財報電話會議。我們的議程將先由 Dexcom 董事長、總裁暨執行長 Kevin Sayer 開場，總結近期亮點與持續推動的策略性計畫；接著由我們的財務長 Jereme Sylvain 進行財務回顧與展望。在我們的準備稿結束後，將開放各位提問。（接線員指示）

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

請注意，Dexcom 投資人關係網站的「活動與簡報」頁面亦提供與我們第四季表現相關的投影片。

With that, let's review our safe harbor statement. Some of the statements we will make in today's call may constitute forward-looking statements. These statements reflect management's intentions, beliefs and expectations about future events, strategies, competition, products, operating plans and performance. All forward-looking statements included in this presentation are made as of the date hereof based on information currently available to Dexcom, are subject to various risks and uncertainties, and actual results could differ materially from those anticipated in the forward-looking statements.

接下來，我們先說明安全港聲明。今天電話會議中我們所做的部分陳述可能構成前瞻性陳述。這些陳述反映管理層對未來事件、策略、競爭、產品、營運計畫與績效的意圖、信念與預期。本簡報中所有前瞻性陳述均以本簡報日期為準，係基於 Dexcom 目前可得資訊作出，並受多項風險與不確定性影響，實際結果可能與前瞻性陳述所預期者有重大差異。

The factors that could cause actual results to differ materially from those expressed or implied by any of these forward-looking statements are detailed in Dexcom's annual report on Form 10-K, most recent quarterly report on Form 10-Q and other filings with the Securities and Exchange Commission. Except as required by law, we assume no obligation to update any such forward-looking statements after the date of this presentation or to conform these forward-looking statements to actual results.

可能導致實際結果與任何此等前瞻性陳述所明示或暗示內容產生重大差異的因素，已詳載於 Dexcom 的 Form 10-K 年度報告、最近一期 Form 10-Q 季度報告及其他向美國證券交易委員會提交的文件中。除法律要求外，我們不承擔在本簡報日期後更新任何此等前瞻性陳述，或使其與實際結果一致的義務。

Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP with respect to our non-GAAP and cash-based results. Unless otherwise noted, all references to financial metrics are presented on a non-GAAP basis. The presentation of this additional information should not be considered in isolation or as a substitute for results or superior to results prepared in accordance with GAAP. Please refer to the tables in our earnings release and the slides accompanying our fourth quarter earnings presentation for a reconciliation of these measures to their most directly comparable GAAP financial measure.

此外，在本次電話會議中，我們將討論若干未依 GAAP 編製的財務衡量指標，涉及我們的非 GAAP 與以現金為基礎的結果。除非另有說明，所有財務指標之引用均以非 GAAP 基礎呈現。此額外資訊之呈現不應被孤立看待，亦不應作為依 GAAP 編製結果之替代，或被視為優於依 GAAP 編製之結果。請參閱我們的財報新聞稿表格及隨第四季財報簡報附上的投影片，以取得這些衡量指標與其最直接可比之 GAAP 財務衡量指標的調節表。

Now I will turn it over to Kevin.

現在我把時間交給 Kevin。

Thank you, Sean, and thank you, everyone, for joining us. I'd like to start by reviewing some of Dexcom's key accomplishments in 2022. Total revenue grew 20% on an organic basis driven by another year of record new customer starts. This translates into more than $475 million of organic revenue growth compared to last year as we saw another step forward for CGM awareness and Dexcom brand loyalty. We added nearly 450,000 Dexcom users to our base in 2022 and ended the year with close to 1.7 million customers globally. Our team did a great job generating this customer engagement and growth while simultaneously enhancing the scale and efficiency of our organization.

謝謝你，Sean，也謝謝各位參與。我想先回顧 Dexcom 在 2022 年的一些關鍵成就。總營收在有機基礎上成長 20%，主要由再創新高的新客戶啟用量所帶動。這相當於相較去年超過 4.75 億美元的有機營收成長，反映 CGM 認知度再上層樓以及 Dexcom 品牌忠誠度提升。2022 年我們的用戶基礎新增近 45 萬名 Dexcom 使用者，年底全球客戶接近 170 萬名。我們的團隊在提升客戶參與度與成長的同時，也同步強化了組織的規模與效率。

Our operations team demonstrated world-class performance this year, ensuring adequate supply in a difficult macro environment and providing on-time delivery rates of greater than 99%. We drove over 500 basis points of operating expense leverage in 2022 despite broad inflationary pressure. This was not the result of reactionary cost cutting. Instead, it reflects decisions made years ago at our company to foster a culture of cost discipline as we grow.

我們的營運團隊今年展現世界級表現，在艱困的總體環境下確保供應充足，並提供超過 99% 的準時交付率。儘管面臨廣泛的通膨壓力，我們在 2022 年仍推動營運費用槓桿改善超過 500 個基點。這並非反應式的成本削減所致，而是反映我們公司多年前所做的決策：在成長過程中培養成本紀律的文化。

From a strategic perspective, we will look back at 2022 as a pivotal year for our company. We advanced several of our most important initiatives, including multiple new product launches, significant access wins, new market development and a further extension of our market-leading performance in connectivity. Everything we achieved this past year helps build a foundation for years of sustainable growth ahead.

從策略角度來看，回顧 2022 年將是我們公司的關鍵轉折點。我們推進了多項最重要的計畫，包括多個新產品上市、重大的給付/准入成果、新市場開發，以及在連結性方面進一步擴大我們的市場領先表現。我們在過去一年所達成的一切，都為未來多年可持續的成長奠定基礎。

For example, in October, CMS published a proposed local coverage determination that would meaningfully expand access to CGM technology for the Medicare population. This proposal would broaden coverage to include people with type 2 diabetes using basal insulin only as well as certain non-insulin-using individuals that experience hypoglycemia. This result was led by the publication of Dexcom's MOBILE study and furthered by a strong partnership with the diabetes community. We heard broad support and enthusiasm from key stakeholders during the comment period and expect the ruling to be finalized in the coming months.

例如在 10 月，CMS 發布了一項擬議的地方給付決定（local coverage determination），將可大幅擴大 Medicare 人群對 CGM 技術的可及性。該提案將擴大給付範圍，納入僅使用基礎胰島素（basal insulin）的第二型糖尿病患者，以及部分未使用胰島素但會發生低血糖的個體。此成果由 Dexcom 的 MOBILE 研究發表所帶動，並在與糖尿病社群的強力合作下得以推進。我們在意見徵詢期間聽到關鍵利害關係人廣泛的支持與熱忱，並預期該裁定將在未來數月內定案。

As a reminder, we size the basal-only type 2 population at 3 million people in the United States. Between this Medicare ruling and broader commercial coverage, which we expect to follow shortly, this population has the potential to nearly double our addressable reimbursed market in the United States.

提醒各位，我們估計美國僅使用基礎胰島素的第二型糖尿病族群規模為 300 萬人。透過這項 Medicare 裁定以及我們預期不久後將跟進的更廣泛商業保險給付，該族群有潛力使我們在美國可獲給付的可服務市場幾乎倍增。

Outside the United States, our team has been equally focused on building greater access. We drove many positive coverage decisions from Mobile payers over the course of 2022. These access wins were in response to the strong clinical evidence we continue to generate as well as the introduction of our portfolio strategy in many of these markets.

在美國以外，我們的團隊同樣專注於建立更高的可及性。2022 年期間，我們推動了許多來自 Mobile 付費方的正面給付決策。這些准入成果是對我們持續產出之強勁臨床證據的回應，也受益於我們在多個市場導入產品組合策略。

2022 was the first time that we brought multiple Dexcom products to a single market, and this strategy has enabled us to significantly extend our reach. By offering multiple products, we can provide a unique value proposition that meets the specific needs of our diverse base of customers, clinicians and payers.

2022 年是我們首次在單一市場導入多款 Dexcom 產品，而此策略使我們得以顯著擴大觸及範圍。透過提供多種產品，我們能提出獨特的價值主張，以滿足多元客群、臨床醫師與付費方的特定需求。

A great example is in the U.K., where Dexcom ONE was added to the national formulary for all people with intensively managed diabetes. Collectively, our international access initiatives have helped us expand our reimbursed coverage by 3.5 million lives over the past 18 months.

一個很好的例子是在英國，Dexcom ONE 被納入國家處方集（national formulary），適用於所有接受密集管理之糖尿病患者。整體而言，我們的國際准入計畫在過去 18 個月已協助我們將可獲給付的覆蓋人數擴大 350 萬人。

2022 will also be remembered as the year of G7. We received both CE Mark and FDA regulatory clearance for G7 and initiated a full launch outside the United States. The feedback from our customers has been everything we'd hope for. We are hearing consistent praise for the new features, such as the 60% smaller form factor, shorter warm-up period and more engaging and consumer-friendly app.

2022 年也將被記為 G7 之年。我們取得 G7 的 CE Mark 與 FDA 監管核准，並在美國以外啟動全面上市。客戶回饋完全符合我們的期待。我們持續聽到對新功能的高度讚賞，例如體積縮小 60%、更短的暖機時間，以及更具互動性、對消費者更友善的 App。

Perhaps the most encouraging is that 97% of initial users surveyed have found G7 easy to use. We designed this product to simplify the lives of our customers, and we are thrilled to see that emphasis resonating. All of this leaves us incredibly excited to bring G7 to the U.S. In fact, we began shipping this week into our U.S. distribution channels to support our rollout.

或許最令人振奮的是，受訪的初期使用者中有 97% 認為 G7 易於使用。我們設計這項產品的目的就是簡化客戶生活，而看到這項重點引起共鳴，我們感到非常欣喜。這一切都讓我們對將 G7 帶到美國市場感到無比興奮。事實上，我們本週已開始出貨至美國的配送通路，以支援我們的推廣上市。

We have quickly ramped up production capacity to support the launch with our automated G7 lines already capable of producing more than 100,000 sensors a day. We want to get G7 into the hands of as many people as possible. So in conjunction with our launch, we've established a bridge program to simplify access for our early adopters. This program will provide new and existing customers access to G7 immediately and allow us to go to market in a broad and expedited manner.

我們已迅速提升產能以支援上市，目前自動化的 G7 產線每天已可生產超過 100,000 個感測器。我們希望讓盡可能多的人能使用 G7。因此，配合上市，我們建立了一項銜接計畫（bridge program），以簡化早期採用者的取得流程。該計畫將讓新舊客戶都能立即取得 G7，並使我們能以更廣泛且加速的方式推向市場。

Behind the scenes, we continue to advance our discussions with payers to build reimbursement. Our conversations have progressed very well, and we are well on track with our G7 coverage plans.

在幕後，我們持續推進與付費方的討論以建立給付。我們的對話進展非常順利，G7 的給付覆蓋計畫也正按進度推進。

More importantly, we are not going to be bashful about what we think of this product. G7 is the new gold standard in diabetes technology. This is the most accurate, easy-to-use and accessible CGM ever produced, and we want to share this message with the world. As a result, we will be releasing our second-ever Super Bowl commercial this Sunday. We're again teaming up with one of our most recognizable Dexcom warriors, Nick Jonas, to announce the G7 is here.

更重要的是，我們不會對我們對這項產品的看法有所保留。G7 是糖尿病科技的新黃金標準。這是迄今為止最精準、最易用、且最容易取得的 CGM，我們希望把這個訊息分享給全世界。因此，我們將在本週日推出我們史上第二支超級盃廣告。我們再次與最廣為人知的 Dexcom 勇士之一 Nick Jonas 合作，宣布 G7 來了。

This is a great opportunity to connect not only with our loyal G6 users but with the millions of people with diabetes that still do not use CGM. We want these individuals, their caregivers and their loved ones to know that Dexcom can help them live healthier lives.

這是一個絕佳機會，不僅能與我們忠誠的 G6 使用者連結，也能觸及數以百萬計仍未使用 CGM 的糖尿病患者。我們希望這些人、他們的照護者以及親友都能知道，Dexcom 能幫助他們過上更健康的生活。

With that, I'll turn it over to Jereme for a review of the fourth quarter financials. Jereme?

接下來，我把時間交給 Jereme，請他回顧第四季財務表現。Jereme？

Thank you, Kevin. As a reminder, unless otherwise noted, the financial metrics presented today will be discussed on a non-GAAP basis. Reconciliations to GAAP can be found in today's earnings release as well as on our IR website.

謝謝你，Kevin。提醒一下，除非另有說明，今天所呈現的財務指標將以非 GAAP 基礎進行討論。與 GAAP 的調節表可在今日的財報新聞稿以及我們的投資人關係（IR）網站上查閱。

For the fourth quarter of 2022, we reported worldwide revenue of $815 million compared to $698 million for the fourth quarter of 2021, representing growth of 20% on an organic basis. As a reminder, our definition of organic revenue excludes currency in addition to non-CGM revenue acquired in the trailing 12 months.

2022 年第四季，我們全球營收為 8.15 億美元，相較 2021 年第四季的 6.98 億美元，以有機基礎計算成長 20%。提醒一下，我們對有機營收的定義，除排除匯率影響外，也排除過去 12 個月內收購的非 CGM 營收。

U.S. revenue totaled $606 million for the fourth quarter compared to $517 million in the fourth quarter of 2021, representing growth of 17%. Our recent momentum in the U.S. continued into Q4 as we delivered another strong quarter of volume growth and solid new customer starts.

第四季美國營收合計 6.06 億美元，相較 2021 年第四季的 5.17 億美元，成長 17%。我們近期在美國的動能延續至第四季，交出另一個強勁的出貨量成長季度，且新客戶啟用表現穩健。

We were very encouraged by the prescribing trends we saw in the fourth quarter, and we closed the year with around 75% of our commercial scripts going through the pharmacy channel. This represents the endpoint of a multiyear channel journey. And we believe our current structure maximizes access for our users as the most covered CGM and supports greater customer choice in how they access the most accurate CGM.

我們對第四季看到的處方趨勢感到非常振奮，並以約 75% 的商業處方量透過藥局通路作為年度收官。這代表我們多年通路轉型旅程的終點。我們相信目前的架構，作為覆蓋最廣的 CGM，能最大化使用者的可近性，並支持客戶在取得最精準 CGM 的方式上有更大的選擇。

International revenue grew 15%, totaling $209 million in the fourth quarter. International organic revenue growth was 27% for the fourth quarter. We continue to take share in international markets as the introduction of new products and access wins over the past year leave us in a wonderful position to compete for new users.

國際營收成長 15%，第四季合計 2.09 億美元。第四季國際有機營收成長為 27%。我們持續在國際市場擴大市占；過去一年新產品導入與取得給付/覆蓋的進展，使我們處於極佳位置，得以競逐新使用者。

For example, in response to the sizable U.K. coverage decision we received last August, our revenue growth has accelerated over the past 2 quarters in that region. Even though this was already one of our largest OUS markets, there has been a clear uptick in demand following this broad expansion of access.

例如，因應我們去年 8 月收到英國大規模的給付/覆蓋決策，該地區過去 2 個季度的營收成長已加速。即使那裡原本就是我們最大的海外（OUS）市場之一，在這次廣泛擴大可近性之後，需求明顯上升。

Our fourth quarter gross profit was $544 million or 66.7% of revenue compared to 67.7% of revenue in the fourth quarter of 2021. Foreign currency was an 80 basis point negative impact on gross margin in the quarter. Operating expenses were $372 million for the fourth quarter of 2022 compared to $461 million in the fourth quarter of 2021.

第四季毛利為 5.44 億美元，或占營收 66.7%，相較 2021 年第四季占營收 67.7%。本季外匯對毛利率造成 80 個基點的負面影響。2022 年第四季營業費用為 3.72 億美元，相較 2021 年第四季的 4.61 億美元。

You may recall that in the fourth quarter of 2021, we recognized an $87 million expense associated with the contingent milestone under the 2018 collaboration and license agreement with Verily Life Sciences. Absent this, our operating expenses for the fourth quarter of 2022 would have been relatively flat year-over-year. This represents another quarter of very disciplined cost management as we generated 800 basis points of OpEx leverage.

各位或許記得，2021 年第四季我們認列了 8,700 萬美元費用，與 2018 年與 Verily Life Sciences 簽訂的合作與授權協議下的或有里程碑相關。若不計此項，2022 年第四季的營業費用年對年將大致持平。這也代表我們又一季非常嚴謹的成本管理，帶來 800 個基點的 OpEx 槓桿。

Operating income was $172.1 million or 21.1% of revenue in the fourth quarter of 2022 compared to $12 million or 1.7% of revenue in the same quarter of 2021. Even excluding the Verily charge from 2021, this highlights incredibly strong operating expense leverage in our current year, which more than offsets our step backwards in gross margin.

2022 年第四季營業利益為 1.721 億美元，或占營收 21.1%，相較 2021 年同季的 1,200 萬美元、占營收 1.7%。即使排除 2021 年的 Verily 費用，這也凸顯我們本年度極為強勁的營業費用槓桿，足以抵銷毛利率下滑的影響。

Adjusted EBITDA was $237.1 million or 29.1% of revenue for the fourth quarter compared to $67.3 million or 9.6% of revenue for the fourth quarter of 2021. Net income for the fourth quarter was $136.3 million or $0.34 per share.

第四季調整後 EBITDA 為 2.371 億美元，或占營收 29.1%，相較 2021 年第四季的 6,730 萬美元、占營收 9.6%。第四季淨利為 1.363 億美元，或每股 0.34 美元。

We remain in a great financial position, closing the quarter with approximately $2.5 billion worth of cash and cash equivalents. This cash level provides organizational flexibility to support our organic growth opportunity and assess strategic uses of capital on an ongoing basis, such as the accelerated share repurchase program we executed in 2022 and ongoing development of our Malaysia manufacturing facility.

我們的財務狀況依然非常穩健，季末現金及約當現金約 25 億美元。此一現金水位為組織提供彈性，以支持我們的有機成長機會，並持續評估資本的策略性運用，例如我們在 2022 年執行的加速庫藏股回購計畫，以及馬來西亞製造廠的持續開發。

Turning to 2023 guidance. As we stated last month. We anticipate total revenue to be in the range of $3.35 billion to $3.49 billion, representing growth of 15% to 20%. This reflects another year of strong underlying volume growth, which will again exceed our revenue growth rate for the year.

接著談 2023 年財測。如同我們上個月所述，我們預期總營收將落在 33.5 億至 34.9 億美元區間，代表成長 15% 至 20%。這反映又一年強勁的基本出貨量成長，而該出貨量成長率今年仍將再次高於我們的營收成長率。

To help provide some insight into the makeup of our guidance this year, we recently provided some additional color around our expectations. First, earlier on this call, Kevin discussed our plans to support our initial G7 customers with a bridge program. We expect this program to impact our revenue per customer early in the year as we provide G7 access at an affordable cash rate as we build reimbursement. We expect this impact to narrow over the course of the year as broader coverage is secured.

為了協助各位更了解今年財測的組成，我們近期也補充了一些細節。首先，在本次電話會議稍早，Kevin 談到我們將以銜接（bridge）計畫支援首批 G7 客戶。我們預期，隨著我們在建立給付/報銷的同時，以可負擔的自費價格提供 G7 使用權，該計畫將在年初影響每位客戶的營收。我們預期，隨著取得更廣泛的覆蓋，這項影響將在全年逐步縮小。

Internationally, we estimate that around 1/3 of our new customer starts will come in through the Dexcom ONE platform. Therefore, this business will start to have a more material impact on numbers this year as that customer base builds.

在國際市場方面，我們估計約 1/3 的新客戶啟用將透過 Dexcom ONE 平台導入。因此，隨著客戶基礎擴大，這項業務今年將開始對數字產生更實質的影響。

For the type 2 basal opportunity, we anticipate CMS reimbursement to be finalized for this population by midyear and begin contributing to our results in the second half of 2023. We expect this population to contribute approximately 1% of our total revenue in 2023.

就第二型糖尿病基礎胰島素（type 2 basal）機會而言，我們預期 CMS 對此族群的報銷將在年中前定案，並於 2023 年下半年開始對我們的業績做出貢獻。我們預期該族群在 2023 年約貢獻我們總營收的 1%。

Turning to margins. We expect gross profit margin to be in the range of 62% to 63%. This assumed year-over-year decline is primarily related to the impact of the broader G7 launch. As with any launch, we will initially be running at lower production volumes, and it will take some time for our new manufacturing lines to scale. Importantly, this is a temporary dynamic, and we still expect G7 product costs to be less than G6 at scale.

接著談毛利率。我們預期毛利率將落在 62% 至 63% 區間。此一年對年下滑主要與更廣泛的 G7 上市所帶來的影響有關。如同任何產品上市初期，我們一開始的生產量會較低，而新的製造產線需要一些時間擴產。重要的是，這是暫時性的動態；在規模化後，我們仍預期 G7 的產品成本將低於 G6。

Despite the step backwards in gross margin, we are guiding for operating margins to be relatively flat year-over-year at 16.5%, which reflects another 150 to 250 basis points of operating expense leverage in 2023. This is the result of ongoing cost initiatives at our organization, which continue to drive leverage even as we allocate greater investment to support our global commercial infrastructure and G7 launch. Finally, we expect adjusted EBITDA margins of approximately 26% in 2023.

儘管毛利率有所回落，我們對營業利益率的指引為年對年大致持平、約 16.5%，反映 2023 年將再取得 150 至 250 個基點的營業費用槓桿。這是我們持續推動成本措施的成果；即使我們加大投資以支持全球商業基礎建設與 G7 上市，仍能持續帶來槓桿。最後，我們預期 2023 年調整後 EBITDA 利潤率約為 26%。

With that, I will pass it back to Kevin.

接下來，我把時間交還給 Kevin。

Thanks, Jereme. To summarize, we are incredibly excited about the opportunity ahead with G7, and we're rolling out product to our distributors as we speak, and we're ready for a big launch in the U.S.

謝謝你，Jereme。總結來說，我們對 G7 帶來的前景機會感到無比興奮；我們正把產品交付給經銷商，並已準備好在美國進行一場大型上市。

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

我現在想開放電話會議進入問答環節。Sean？

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

謝謝你，Kevin。（接線員指示）Abby，請提供問答說明。

(Operator Instructions) We will take our first question from Jeff Johnson with Baird.

（接線員指示）我們的第一個問題來自 Baird 的 Jeff Johnson。

Let me ask you just a 2-part question on G7, if I could. Kevin, on your website, you talk about adding more commercial coverage for G7 every day. I guess, could you give us a number of what percentage of covered lives or lives are covered currently in the commercial channel for G7 and where you expect that to go maybe over the next quarter or 2?

如果可以的話，我想就 G7 問兩個部分的問題。Kevin，你們網站上提到每天都在為 G7 增加更多商業保險覆蓋。我想請問，目前在商業通路中，已覆蓋的人口（covered lives）比例大約是多少？以及你預期在接下來 1 到 2 個季度會提升到什麼程度？

And I think Libre 3 has now been in the pharmacy channel for about 4 months or so in the U.S. Obviously, your business looks like it's probably safe with the AID users in the Medicare channel. But for your stand-alone T1 users, have you seen any change in your attrition rate? Anything as we kind of look at that Libre 3 versus G6 dynamic that has changed in the last few months that Libre 3 has been out there?

另外，我想 Libre 3 在美國藥局通路已經上市大約 4 個月左右。顯然，在 Medicare 通路的 AID 使用者方面，你們的業務看起來應該相對安全。但對於你們的獨立型第一型糖尿病（T1）使用者，你們是否看到流失率有任何變化？在過去幾個月 Libre 3 上市後，從 Libre 3 對 G6 的競爭態勢來看，有沒有任何改變？

Thanks, Jeff. Yes, I appreciate that. This is Jereme. So to your question on coverage, we're still in the throes of the commercial DME and the Medicare coverage. We talked about on G7 taking about 90 days.

謝謝你，Jeff。是的，感謝提問。我是 Jereme。就你關於覆蓋的問題而言，我們目前仍在推進商業 DME 與 Medicare 的覆蓋流程。我們先前談到，G7 大約需要 90 天。

But on the pharmacy side, we're actually a little bit ahead of schedule. Kevin referenced, we're well on track to the point where I talked about, about a $30 million-ish hit in Q1 as a result of our bridge program. That number is more like $15 million now, and that's because some of those pharmacy contracts are coming in earlier. So we are making great progress, and we continue to get that every day. And the signs lead to more and more contracts coming over, maybe even ahead of schedule.

但在藥局端，我們其實進度略超前。Kevin 提到，我們正穩步朝我所說的方向前進，也就是因銜接計畫在第一季造成約 3,000 萬美元左右的影響。現在這個數字更接近 1,500 萬美元，因為部分藥局合約更早到位。所以我們進展非常順利，而且每天都在取得進展。各種跡象顯示會有越來越多合約轉入，甚至可能早於原先時程。

In terms of the question then on competitive dynamics, maybe I can start and then Kevin will obviously have a few thoughts there. We had a record new patient start in Q4. If that gives you any context to we had another solid new patient quarter. So while we have seen competitive product out there, we continue to do very, very well with G6 to the point where we have seen incredible strength there. And that's, of course, on the heels of a G7 launch, which as we referenced, is coming out here in the next coming days.

就競爭態勢這個問題而言，也許我先開始，然後 Kevin 顯然也會有一些想法。我們在第四季創下新病患啟用的紀錄。如果這能提供一些背景，我們又迎來另一個穩健的新病患季度。因此，雖然我們確實看到市場上有競品，我們在 G6 上仍持續表現非常、非常出色，強勁到令人難以置信。當然，這也是在 G7 上市的基礎之上；如我們先前提到的，G7 將在接下來幾天內推出。

Kevin, I don't know if you have anything else to add there.

Kevin，我不知道你是否還有什麼要補充的。

No. I would tell you what we're also hearing is a great deal of excitement from our user base for G7. So with respect to your question regarding how our G6 users doing, they're very anxious to get G7 and very excited to go. So we're feeling good about where we are right now.

沒有。我想告訴你的是，我們也聽到使用者社群對 G7 有非常高的期待與興奮。所以就你問到我們 G6 使用者的狀況而言，他們非常迫不及待想用到 G7，也非常期待開始使用。因此，我們對目前的狀況感到很有信心。

We will take our next question from Larry Beigelsen with Wells Fargo.

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

Kevin, I wanted to ask about the ramp in the type 2 basal population. I think people were a little surprised you only expected 1% growth contribution in '23. I guess, that would be about $60 million on an annual run rate. At the last investor meeting, you said you expect $700 million in revenues in 2025 from sources other than insulin-intensive patients, and I think this was mostly type 2 basal. So the question is, do you still expect $700 million by 2025 from these non-intensive sources? And how do you see the ramp in the type 2 basal population?

Kevin，我想問一下第二型糖尿病基礎胰島素（basal）族群的放量（ramp）。我想大家有點意外，你們只預期 2023 年帶來 1% 的成長貢獻。我猜那大約相當於年化 run rate 約 6,000 萬美元。在上次投資人會議上，你們說預期 2025 年來自非胰島素密集型病患來源的營收可達 7 億美元，而我認為這主要是第二型 basal。問題是：你們仍然預期到 2025 年這些非密集型來源可達 7 億美元嗎？以及你們如何看待第二型 basal 族群的放量速度？

Well, Larry, our -- I'm going to talk for a bit. I'll turn it over to Jereme. Our initial estimates, it's 1% of our total revenues would come from that. And that's a reasonably sized number. We plan for July, second half of the year, approval and rolling it out from there. It may go faster than that, but we've been conservative in our estimates, and we will make every attempt to beat those.

Larry，我們——我先講一會兒，之後交給 Jereme。我們最初的估算是，這部分將占我們總營收的 1%。那是一個相當可觀的數字。我們規劃在 7 月、也就是下半年取得核准並從那時開始逐步推廣。進展可能會比這更快，但我們在估算上採取保守態度，並會盡一切努力超越這些目標。

As we look out to 2025, that non-intensive insulin space is not just basal users. We believe our CGM product will be very valuable amongst a number of markets in the type 2 space and also in metabolic health. So it's not just basal users there. It's a lot more than that. And many of the basal users, as you well know, move up to be intensive insulin users as well. So we view that population as moving and shifting with us as they go.

展望 2025 年，非密集型胰島素市場不只是 basal 使用者。我們相信，我們的 CGM 產品在第二型糖尿病的多個細分市場以及代謝健康領域都會非常有價值。所以不僅僅是 basal 使用者，遠不止於此。而且如你所知，許多 basal 使用者也會進一步轉為胰島素密集型使用者。因此我們把這個族群視為會隨著我們一起移動與轉換，伴隨他們的治療進程而變化。

Jereme, you have anything else to add?

Jereme，你還有什麼要補充的嗎？

Sure. Yes. Larry, so the $60 million number you're referencing would assume, say, everybody started on July 1 and they went through the end of the year. The reality is that some folks will start in July, some folks will start in December. And so really, the exit velocity is much higher than that on a run rate perspective.

當然。是的，Larry，你提到的 6,000 萬美元數字是假設例如所有人都在 7 月 1 日開始，並一路用到年底。實際情況是，有些人會在 7 月開始，有些人會在 12 月才開始。因此從 run rate 的角度來看，期末的退出速度（exit velocity）要高得多。

If you were to blend it, average it over the course of the year, you're really only getting 3 months of revenue contribution. And so you kind of do the math there, and the exit rate is a little bit higher than I think what you're implying. So we are really, really bullish on it.

如果你把它混合、用全年平均來看，你實際上只得到大約 3 個月的營收貢獻。所以你可以自己算一下，期末的退出率會比你暗示的略高一些。因此我們對此非常、非常看好。

But it is a recurring revenue business. So what we need to do is get those -- get that coverage out there, get the scripts in. And so, look, I understand the question. It's a big, big market with a big, big opportunity. We plan on playing in it, and we plan on playing it in a big way. But obviously, we want to be prudent around guidance. And certainly, if things go better than that, then we'll always try to do so. We'll report back to everybody.

但這是一個經常性收入（recurring revenue）的生意。所以我們需要做的是把——把那個給付覆蓋（coverage）鋪出去，把處方（scripts）開進來。所以，聽著，我理解這個問題。這是一個非常、非常大的市場，也有非常、非常大的機會。我們計畫參與其中，而且要以很大的規模參與。但顯然，我們在財測指引上希望保持審慎。當然，如果事情進展得比這更好，我們也會努力做到。我們會再向大家回報。

We will take our next question from Margaret Kaczor with William Blair.

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

I wanted to maybe take Larry's question a step further and just kind of talk about the potential pace of adoption within type 2 basal, maybe not just this year, but really more over an 18-month, 24-month period? And is it fair at all to compare it to, I guess, what attritional type of insulin diabetic population is? Is it going to be easier, harder, I guess, to drive adoption or are there guardrails on penetration?

我想把 Larry 的問題再往前推一步，談談第二型 basal 內部的潛在採用速度（pace of adoption），也許不只是今年，而是更著眼於 18 個月、24 個月的期間？另外，把它拿來和我猜所謂的「自然流失型」（attritional）的胰島素糖尿病族群相比，這樣的比較公平嗎？推動採用會更容易、更困難嗎？或者在滲透率上是否有一些護欄（guardrails）？

And then just because you brought up metabolic health to non-insulin diabetics, 2025 is just around the corner. So should we expect, I guess, a more meaningful impact from here as early as next year?

然後，因為你提到了代謝健康、也就是非胰島素糖尿病族群，2025 年其實已經近在眼前。所以我們是否應該預期，最早從明年開始就會看到更有意義的影響？

Yes. So let me start on the base, and then I can turn it over to Kevin from that perspective. And so the ramp in basal is going to be a bit interesting. We'll give you kind of the way we think about it. Think about it as -- I generally start with type 2 intensive, and you think about that ramp and you think about coverage and how that takes place. And if the coverage takes place over a similar time, you'd expect a relatively similar ramp.

是的。我先從 basal 這部分開始，然後我可以從這個角度把問題交給 Kevin。basal 的放量會有點有趣。我們跟你分享一下我們的思考方式。可以這樣想——我通常先從第二型胰島素密集型（type 2 intensive）開始，你去想那個放量曲線，以及給付覆蓋如何展開。如果給付覆蓋在相近的時間內完成，你會預期看到相對類似的放量。

Now I'd caveat that by saying there's more awareness today. And hence, the Super Bowl commercial is a good opportunity for us to continue to raise that awareness. However, the place in which the basal patients cede is a wider swath of physicians.

不過我要補充的是，現在市場的認知度更高。因此，超級盃廣告對我們而言是持續提升認知度的一個好機會。然而，basal 病患所涵蓋的醫師範圍更廣。

And so we don't have an exact crystal ball here. If you're using prior analogs, the best analog is type 2 intensive would be about the adoption rate. But I think as time moves on, we'll be able to give you a little bit more color. But that's kind of our best crystal ball.

所以我們沒有一個精準的水晶球。如果要用過去的類比，最好的類比是第二型胰島素密集型的採用率大致可作為參考。但我想隨著時間推進，我們能提供更多細節。不過這大概就是我們目前最好的「水晶球」。

And then maybe, Kevin, if you want to give just some general thoughts about metabolic health and the opportunities there.

然後也許，Kevin，如果你願意的話，請就代謝健康以及那裡的機會談一些整體看法。

No. As we look out to the future, Margaret, particularly with our easy-to-use G7 platform that we're launching today, we believe our future is very bright as we deal with metabolic health. We've changed our mission statement to help people control their health, not just diabetes anymore.

好的。Margaret，展望未來，特別是我們今天推出的、易於使用的 G7 平台，我們相信在代謝健康領域，我們的前景非常光明。我們已經調整了使命宣言，目標是幫助人們掌控自己的健康，不再只侷限於糖尿病。

We continue to see very positive results from several programs who are using sensors to assist people in these endeavors. And over time, and particularly with type 2 management and all the type 2 drug alternatives on the horizon, we believe CGM becomes a very important part of that health equation. And we're continuing to work on product offerings and business models. So it will be differentiated from what we do today and geared towards that population.

我們持續看到有幾個計畫在使用感測器來協助人們達成這些目標，並且取得非常正面的成果。隨著時間推進，特別是在第二型糖尿病管理，以及未來各種第二型用藥替代方案陸續出現的背景下，我們相信 CGM 會成為健康方程式中非常重要的一環。我們也持續在產品方案與商業模式上投入。因此，它會與我們今天所做的有所區隔，並更貼近那個族群的需求。

We're really excited about the opportunity. And it will continue to mature over 2023, and then we'll see what happens in 2024. We've got a lot of basal patients to reach first. So let's go after them, and then we'll continue to move to the other areas as well.

我們對這個機會感到非常興奮。它會在 2023 年持續成熟，然後我們再看看 2024 年會如何發展。我們首先還有很多 basal 病患需要觸及。所以先把他們拿下，然後我們也會持續往其他領域推進。

And we will take our next question from Robbie Marcus with JPMorgan.

接下來我們的下一個問題來自 JPMorgan 的 Robbie Marcus。

Congrats on a nice quarter. Wanted to ask about the European or OUS experience. And it looks like you're gaining share, you're doing well. How much of that is being driven by G7? And what's the feedback there? And any head-to-head color you could give us versus Libre 3 in the markets where it participates? And then also sort of same question on Dexcom ONE and the impact you're seeing there.

恭喜這是一個不錯的季度。我想問一下歐洲或美國以外（OUS）的經驗。看起來你們正在提升市占、表現很好。其中有多少是由 G7 推動的？那邊的回饋如何？在有參與的市場中，你們能否提供一些與 Libre 3 正面比較（head-to-head）的資訊？另外也想問同樣的問題：Dexcom ONE 以及你們在那裡看到的影響是什麼？

I will start off. With respect to the sales and the revenue numbers, G7 and Dexcom ONE are still early enough in their launch life cycle that while they're additive, they're not what's driving a lot of the adoption, a lot of the growth that we've seen in European markets. A lot of that's been what we've established with G6, the additional coverage that we've obtained, as I talked about in the prepared remarks, in 18 months, we've added 3.5 million more reimbursed lives.

我先回答。就銷售與營收數字而言，G7 和 Dexcom ONE 的上市週期仍處於相對早期，因此雖然它們有增量貢獻，但並不是推動歐洲市場大量採用與成長的主要因素。那裡的成長很大一部分來自我們以 G6 建立的基礎，以及我們取得的額外給付覆蓋；正如我在事先準備的發言中提到的，在 18 個月內，我們新增了 350 萬名可獲得給付的受保人（reimbursed lives）。

That being said, initial response to G7 has been everything we'd hoped for. People love the app. They love the receiver. Again, in many of these markets, the receiver is a very, very strong tool. My most recent conversation with the G7 user focused completely around the 0.5-hour warm-up. A 0.5-hour warmup has eliminated 90 minutes of the longest 2 hours of somebody's life who ever used the G6.

話雖如此，G7 的初期反應完全符合我們的期待。大家喜歡這個 App，也喜歡接收器（receiver）。同樣地，在許多這些市場中，接收器是一個非常、非常強的工具。我最近一次與 G7 使用者的對話，完全聚焦在 0.5 小時的暖機時間（warm-up）。0.5 小時的暖機，等於消除了曾經使用 G6 的人生命中最漫長的 2 小時裡的 90 分鐘。

And certainly, in the comparative front compared to the hour warm-up, again, it is a much better experience. The majority of our G6 users are new to Dexcom. They're not Dexcom upgrade -- I mean G7 users, I apologize. The majority of our G7 users are new to Dexcom. Some of them come from the competition. Some of them have not used CGM before, but they're all finding it very easy to use and having great experiences. So we're very happy with the product to this point in time. We've done very well.

而且當然，從比較的角度來看，相較於一小時的暖機時間，這同樣是更好的體驗。我們的大多數 G6 使用者都是 Dexcom 的新用戶。他們不是 Dexcom 的升級用戶——我是說 G7 使用者，抱歉。我們的大多數 G7 使用者都是 Dexcom 的新用戶。有些人是從競品轉過來的。有些人以前沒有使用過 CGM，但他們都覺得非常容易上手，且體驗非常好。所以截至目前我們對這個產品非常滿意。我們做得非常好。

We will take our next question from Joanne Wuensch with Citibank.

我們的下一個問題來自花旗銀行（Citibank）的 Joanne Wuensch。

So I'd like to spend just a minute on the gross margin and how you anticipate those ramping throughout the year. And then while I know we're sort of early to think -- be thinking about 2024, I do think people are looking at that as sort of a more normalized margin rate, and if you could sort of shed any light on how to think about that.

我想先花一點時間談談毛利率，以及你們預期毛利率在今年會如何逐步提升。然後，雖然我知道現在談——思考 2024 年可能還算早，但我確實認為大家把 2024 年視為較為正常化的毛利率水準；如果你們能提供一些線索，讓我們知道該如何看待那個水準。

Sure. Thanks, Joanne. Appreciate that. And you start off with, obviously, the fourth quarter. We had a really strong gross margin. I think it's a demonstration of what's to come with what our teams can do when you give them time with a new product launch.

當然。謝謝你，Joanne。很感謝你的提問。先從第四季開始說起，我們的毛利率非常強勁。我認為這展示了未來的潛力：當你給團隊時間去消化一個新產品上市時，我們的團隊能做到什麼。

So I think as you think about the year, the cadence for 2023, we do expect in the first half of the year margins to be a little bit lower. And that's because of, as Kevin referenced earlier, the bridge program. Certainly, that has an impact. But most importantly, it's the launch of G7. Volumes won't be at where they would have been, say, in a more mature launch, and we'll still be going through some of those early manufacturing scrap and yield challenges we always see.

所以當你思考 2023 年全年的節奏時，我們確實預期上半年毛利率會稍微低一些。原因是，如 Kevin 先前提到的，過渡（bridge）計畫當然會帶來影響。但更重要的是 G7 的上市。出貨量不會像更成熟的上市階段那樣高，而我們也仍會經歷一些早期製造的報廢與良率挑戰，這是我們一向會看到的情況。

But what we've proven time and time again is if you give our engineering and R&D team time with these lines, they continue to get yields better over time. And so our expectation is as we start to exit the year in 2023, we start to come closer back to that long-term guide of 65% gross margins.

但我們一次又一次證明，只要給我們的工程與研發團隊時間在這些產線上持續優化，良率就會隨時間改善。因此，我們的預期是，當 2023 年接近年底時，我們會逐步回到長期指引的 65% 毛利率水準。

And there's nothing longer term structurally that we don't believe, especially as G7 gets to scale, that gets us back to those long-term guides that we've originally provided. So we'll continue to work towards that. Think about 2023 as the first half of the year as a little bit lower. As we ramp up those lines in the back half, you start to tackle some of that absorption of those fixed overheads.

而且從更長期、結構性的角度來看，我們不認為有任何因素會阻礙我們——尤其當 G7 規模化之後——回到我們原先提供的長期指引水準。因此我們會持續朝那個方向努力。可以把 2023 年想成上半年稍低；下半年隨著產線爬坡，你就會開始處理固定製造費用的吸收（absorption）。

We will take our next question from Matthew O'Brien with Piper Sandler.

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

Just on the bridging program, can you tease out a little bit more, maybe, Jereme, on expectations there? I think you had said $20 million to $30 million. You said you're trending better than that for Q1, which is great to hear. But I don't think you ever said how much the bridging program is going to cost you for the full year. It seems like it's going to be even better than expected overall versus maybe what you were thinking starting off '23.

關於過渡計畫（bridging program），你能不能再多拆解一點、也許 Jereme，談談你們的預期？我記得你說過是 2,000 萬到 3,000 萬美元。你也說第一季的趨勢比那更好，這很令人高興。但我不覺得你們有說過這個過渡計畫全年會花多少成本。看起來整體上可能會比原先在 2023 年初所想的還要更好。

But then also bridging is supposed to be more of a headwind on the gross margin side, too. And if it's less of a headwind, maybe that helps out the gross margin profile a little bit more, maybe sooner than expected. So I'm just wondering like based on all these things on the bridging program specifically being better than expected, should we start to creep up a little bit more as far as our expectations for top line growth and then even gross margins for the full year?

另外，過渡計畫在毛利率端也應該是比較偏逆風。如果逆風變小，也許會讓毛利率走勢更好一些，甚至比預期更早。所以我想問的是：基於這些因素，尤其是過渡計畫表現優於預期，我們是否應該開始把對全年營收成長、甚至全年毛利率的預期稍微往上調？

Sure. Yes. I don't think we're at a point where we'd necessarily change our guidance. But let me take your question head on, which is in isolation, what does this do? So certainly, what the bridging program, what this effectively means is we have contracts in place a little bit more ahead of when we ultimately expected. And so ASPs will be a little bit higher, and that's as a result of most folks going through coverage as opposed to the bridging program.

當然。是的。我不認為我們現在會因此改變指引。不過我直接回答你的問題：如果單獨看這件事，它帶來什麼影響？過渡計畫的意義在於，我們比原先預期更早就把一些合約談妥並到位。因此 ASP（平均銷售價格）會稍微高一些，因為大多數人是透過保險給付（coverage）流程，而不是透過過渡計畫。

So that does a couple of things. Certainly, it does help revenue and it does help margin. That all being said, we're not changing guidance for the year. But I think what this does mean is, one, it's a great thing for patients who want to access the product. We talked about coverage being a key strategy. That's wonderful. It does help longer term for those margin profiles. And while I wouldn't necessarily guide you outside of our ranges, you are correct. It does help on revenue and gross margin on the full year.

這會帶來幾件事：確實有助於營收，也有助於毛利率。儘管如此，我們不會改變全年指引。但我認為這代表：第一，對想要取得產品的病患來說是好事。我們談到給付覆蓋是關鍵策略，這很棒。長期而言也有助於毛利率結構。雖然我不會在我們的區間之外額外給你指引，但你說得沒錯：它確實會對全年營收與毛利率帶來正面幫助。

And the other question was how much for the full year. We expected a majority of it, almost all of the $20 million, $30 million, in the first quarter. We do expect a nominal amount in Q2. We haven't expected any of it beyond Q2. Really, a majority of your concern would be in Q1.

至於你問全年會是多少，我們原本預期其中的大部分、幾乎全部的 2,000 萬到 3,000 萬美元會發生在第一季。我們預期第二季會有名目上（nominal）的少量。我們不預期第二季之後還會有。真正需要擔心的主要是在第一季。

And we will take our next question from Marie Thibault with BTIG.

我們的下一個問題來自 BTIG 的 Marie Thibault。

Congrats on a strong quarter. Wanted to ask a little bit more on kind of the backlog around the Medicare decision making. I'm very curious how physicians and patients, how aware they are of that decision, whether we might see a bolus of patients sort of come on once that Medicare coverage took place.

恭喜本季表現強勁。我想再多問一點關於 Medicare 決策制定相關的積壓（backlog）情況。我很好奇醫師與病患對那項決定的認知程度有多高，以及一旦 Medicare 給付生效後，我們是否可能看到一波病患大量加入。

Thanks for the question. It will be up to us to drive awareness in that community to make sure people are aware of that decision. There will certainly be those very familiar with Dexcom and with continuous glucose monitoring will be aware of it and will pick it up quickly. But it will be up to us to drive awareness in both communities. the physicians and users of the product to go and ask for it and to create that environment. So we're not going to sit back and wait. We're going to have to push.

謝謝你的問題。我們必須在那個社群中推動認知，確保大家知道那項決定。當然，那些非常熟悉 Dexcom、也熟悉連續血糖監測的人會知道，並且會很快採用。但我們需要在兩個社群——醫師以及產品使用者——都去推動認知，讓他們去主動詢問並營造那樣的環境。所以我們不會坐等，我們必須推進。

We'll take our next question from Travis Steed with Bank of America.

我們的下一個問題來自美國銀行（Bank of America）的 Travis Steed。

So U.S. growth the last couple of quarters has been around 17%. So second half of the year, I think, was record patient growth for both quarters. So trying to think about ex the contra (inaudible) for the bridge program if we should be seeing an acceleration here in the first quarter and the U.S. growth specifically and how that builds over the course of the year. And then on the Super Bowl ad, what kind of impact did you see on U.S. new patient starts last time you did that?

美國市場過去幾季的成長大約在 17% 左右。下半年我認為兩季都是創紀錄的病患成長。所以我在想，如果把過渡計畫的抵減（contra）（聽不清）因素排除掉，我們是否應該在第一季看到加速，特別是美國的成長，以及這種成長在全年會如何逐步建立。另外，關於超級盃廣告，上次你們這麼做時，對美國新病患啟用（new patient starts）帶來了什麼樣的影響？

Sure. Yes. So I'll start with how we're thinking about Q1. And the way we've generally thought about Q1 is in terms of full year contribution, absent any sort of bridging program, to be a very similar contributor as a percentage of total year revenue in the first quarter. So that's total company, not just U.S. total company.

好的。是的。我先從我們如何看待第一季開始。我們一般看待第一季的方式是：在沒有任何過渡計畫的情況下，第一季對全年營收的貢獻占比，會與以往相當類似。這是以全公司來看，不只是美國；是全公司。

And then you add the bridging program and then you pull it down from there. And that's generally how we think about the quarter, which is just an indication of continued strong new patient growth. Clearly, we'll be working through driving new patients and driving growth over the course of the year.

然後再把過渡計畫加進來，接著從那裡往下調。這大致就是我們看待這一季的方式，也就是持續強勁的新病患成長的指標。很明顯地，我們會在全年持續推動新病患與成長。

In terms of the Super Bowl and then how to think about the Super Bowl and how that contributes, last time we did it, there were hundreds and hundreds of thousands of inbound leads. Not all of those obviously translated into patients, but there was a lot of interest.

至於超級盃，以及如何看待超級盃的貢獻，上次我們做的時候，有數十萬、數十萬的主動詢問線索（inbound leads）。當然不是全部都轉化為病患，但確實引發了很大的興趣。

One of the challenges, though, if you rewind the clock a couple of years, is there wasn't as much coverage there. And so I think what we're hoping this time around is, one, the awareness is the most important thing. And the awareness, as that gets out there, will be very, very helpful.

不過，如果你把時間倒回兩年前，其中一個挑戰是當時的給付覆蓋沒有那麼多。所以我認為這次我們希望的是：第一，最重要的是提升認知。當認知擴散出去，會非常、非常有幫助。

But as coverage starts to come through and we have this bridging program in place, it's a real opportunity to take advantage of it. We're not ready to give exact patient numbers out there other than to say that the return on capital is a very strong investment. And so you should expect we do that math before we sign up for this. And we wouldn't be doing if we didn't expect a return on investment that was commensurate with what you and we would expect.

但隨著給付覆蓋逐步到位，而且我們也有這個過渡計畫，這是一個真正可以把握的機會。我們還沒準備好提供精確的病患數字；只能說資本報酬（return on capital）是一項非常強的投資。因此你應該預期我們在簽下這個案子之前會先算清楚。我們不會在不預期投資報酬（return on investment）能符合你我期待的情況下去做。

We will take our next question from Jayson Bedford with Raymond James.

我們的下一個問題將由 Raymond James 的 Jayson Bedford 提出。

Just maybe an OpEx question. It looks like it's a bit bigger of a step up implied in '23. I know the Super Bowl ad is a contributor. But just wondering if you can comment on what are the sources of the OpEx growth and maybe hit on any planned changes to the sales force in support of G7.

我想問一個可能關於營運費用（OpEx） 的問題。看起來在 2023 年隱含的增幅更大一些。我知道超級盃廣告是一個因素。但想請你們評論一下 OpEx 成長的來源是什麼，以及是否能談談為了支援 G7，對銷售團隊是否有任何規劃中的調整。

Thanks, Jayson. This is Kevin. I'll take it, rather big picture. We'll continue to invest in R&D. Our spend will grow some but not as rapidly as it has in other years. And quite honestly, as a percentage of revenue, it's probably come down a little bit.

謝謝你，Jayson。我是 Kevin。我來回答，先從比較宏觀的角度說。我們會持續投資研發（R&D）。支出會有所成長，但不會像其他年份那樣成長得那麼快。坦白說，作為營收的百分比，它可能也已經略微下降。

Same with -- on the G&A side, we'll continue to invest in infrastructure and build things out for our continued growth. But a lot of that investing has been done. Our biggest dollar investment, our biggest increases are going to be on the commercial side and in all areas, create awareness in the sales force, marketing across the board, we'll be spending on the commercial side. Those expenditures will -- could adjust and move over the course of the year as we learn more. We've always been very adept at channeling those dollars where they can be the most effective.

在一般與行政（G&A）方面也是一樣，我們會持續投資基礎建設，並為持續成長擴建相關能力。但其中很多投資已經完成。我們以金額計最大的投資、最大的增幅，將會在商業端；在各個面向提升能見度，包括銷售團隊的認知、行銷等全面投入，我們會在商業端加大支出。這些支出會——也可能在一年當中隨著我們學到更多而調整與移動。我們一向很擅長把這些資金導向最有效的地方。

We're analyzing some of that now. We certainly have a plan, but we've never been afraid to deviate from it if it makes more sense. And so we're looking at all those things. A lot of international investment this year, quite honestly, as a percentage of our investment. International is getting a bigger piece of it than they have in the past because we really look at these opportunities. We've got G7 and several of these companies combined with the Dexcom launch and all those covered lives we've added. We think there's great growth opportunities over there, but we've got to invest in that infrastructure.

我們目前正在分析其中一些項目。我們當然有計畫，但如果偏離計畫更合理，我們也從不害怕調整。因此我們正在檢視所有這些事情。坦白說，今年國際市場的投資占比會更高。相較過去，國際市場會分到更大的一部分，因為我們確實看到了這些機會。我們有 G7，以及其中幾家公司，再加上 Dexcom 的上市，以及我們新增的所有受保人數（covered lives）。我們認為那邊有很好的成長機會，但我們必須投資相關的基礎建設。

Yes. And just to kind of add to that one, Jayson, just to give you some context. We launched outside the U.S. with Dexcom ONE and G7, call it, in the first couple of phases. But we have more phases to go. And so we're going to make the marketing push obviously with G7 in the U.S, but there's also a second phase of G7 launchings outside the U.S. and a second and third phase of Dexcom ONE outside the U.S. So sales and marketing is really where we want to put our investment, and we'll get leverage elsewhere. But hopefully, that gives you kind of some context for how we're thinking about that spend in 2023.

是的。再補充一下，Jayson，提供一些背景。我們在美國以外的市場推出 Dexcom ONE 和 G7，大概分成前幾個階段。但我們還有更多階段要走。因此我們會在美國針對 G7 進行行銷推進，但在美國以外也會有第二階段的 G7 上市，以及 Dexcom ONE 在美國以外的第二與第三階段。因此，銷售與行銷才是我們希望投入資源的地方，而其他部分我們會取得槓桿效益。希望這能讓你更了解我們如何思考 2023 年的支出。

And we will take our next question from Matt Taylor with Jefferies.

我們的下一個問題將由 Jefferies 的 Matt Taylor 提出。

So I just want to get some thoughts on gross margin longer term. I know you touched on this year. And obviously, with the new product launch, there's some initial depression, and then you get spring loaded with leverage over time. So help us think about G7 over the next couple of years. Does that expand? How can that impact gross margins with and without the potential for a longer wear label?

我想請教一些關於長期毛利率的看法。我知道你們談到了今年的情況。顯然，新產品上市初期會對毛利率造成一些壓力，之後隨著時間推移會透過規模槓桿而改善。請協助我們思考未來幾年 G7 的情況：毛利率會擴張嗎？在可能取得更長配戴天數標示（longer wear label）與否的情境下，對毛利率會有什麼影響？

Yes. I can start there. You're 100% right. I mean, obviously, there's the levers to get the actual cost of the product, and we've been very transparent about it. We want to get to basically $1 per day and a 10-day sensor or a $10 sensor. And then we want to go even beyond that. But that has always been kind of our public goal.

好的。我可以先回答。你說得完全正確。顯然，我們有一些槓桿可以降低產品的實際成本，而且我們一直很透明。我們希望基本上達到每天 1 美元，也就是 10 天感測器約 10 美元的水準，然後我們還希望能再更進一步。但這一直是我們對外公開的目標。

Then, of course, as you move to a 15-day sensor, that cost is spread out over a longer period. So we have intentions over the long haul of doing all of that. Now the math, if you do that, would indicate there's some real opportunities in gross margin even beyond potential long-term guide.

接著，當你把感測器延長到 15 天時，成本就會分攤到更長的期間。因此從長期來看，我們確實有意圖做到這些。若以數學來看，這代表毛利率存在一些真正的機會，甚至可能超過長期指引所暗示的水準。

The one thing we want to be mindful of is we don't want to shortchange ourselves and other opportunities to either partner or otherwise over the long haul. So while the long-term guide remains intact, there are certainly levers and opportunities for us to do well there. And so I think you're hitting on all the right points.

我們想留意的一點是，我們不希望在長期上低估自己，以及其他機會——不論是合作夥伴關係或其他方式。因此，雖然長期指引仍然維持不變，但我們確實有槓桿與機會在那方面表現得很好。我認為你提到的點都很到位。

That all being said, we really hold to that long-term 65% gross margin. That's what we'll work to. And if there's other opportunities to get fill you in on some other things we're doing in the future, we'll certainly do so.

話雖如此，我們仍然堅持長期 65% 的毛利率目標。這是我們會努力達成的。如果未來有其他機會，讓我們能向你補充一些我們正在做的事情，我們也一定會分享。

We will take our next question from Mathew Blackman with Stifel.

我們的下一個問題將由 Stifel 的 Mathew Blackman 提出。

Jereme, just curious, I appreciate all the inputs that you gave us that roll up to the 15% to 20% guide. I'm just curious, have you contemplated in that 15% to 20% range any competitive pressures in the event that your competitor gets approved to integrate with a pump sometime in 2023?

Jereme，我想確認一下，感謝你提供所有彙整到 15% 到 20% 指引的各項因素。我只是好奇，在 15% 到 20% 這個區間內，你們是否已經把競爭壓力納入考量——例如若競爭對手在 2023 年某個時間點獲准與胰島素幫浦整合？

Yes. Thanks for the question, Matt. Yes, we do. We've considered all of that when providing that guidance. I mean, when we think about all the competitive pressures and then we think about all the opportunities ahead of us, we consider all that in the guidance.

是的。謝謝你的問題，Matt。是的，我們有。我們在提供該指引時已經把這些都納入考量。當我們思考所有競爭壓力，同時也思考我們面前的所有機會時，我們都把這些反映在指引中。

And you are right, there is the potential out there, at least according to some of the commentary, that there could be some potential pressure out there. I would say that we've contemplated it. At the same time, we feel very confident in our product offering and what it ultimately does, how it integrates and the safety features that people rely on our product for the accuracy, the ease of use. So I think we feel very confident about it. But yes, we did contemplate that in our guide.

你說得沒錯，至少根據一些評論，確實存在某種可能的壓力。我會說我們已經考慮過。同時，我們對我們的產品方案以及它最終能做到的事情非常有信心：它如何整合，以及人們依賴我們產品的安全功能——包括準確度、易用性。因此我認為我們非常有信心。但是的，我們在指引中確實已經考慮了這點。

We will take our next question from Chris Pasquale with Nephron.

我們的下一個問題將由 Nephron 的 Chris Pasquale 提出。

Love the update on how you guys are thinking about price. You said in the past, your U.S. channel mix could start to stabilize once you hit 75% of the pharmacy. You're there now. But you also have D1 making a bigger portion of the OUS starts, which I would imagine might pull down your international ASP a bit. So can you tell us what impact price had on revenue in '22 and then how you're thinking about the potential impact this year?

我很喜歡你們對定價思考方式的更新。你們過去曾說，一旦美國通路組合中藥局（pharmacy）占比達到 75%，就可能開始趨於穩定。你們現在已經到了。但你們也讓 D1 在美國以外（OUS）的新啟用占比變得更大，我想這可能會把你們的國際 ASP 拉低一些。所以你能否說明價格在 2022 年對營收造成了什麼影響，以及你們如何看待今年可能的影響？

Yes. So we'll talk about 2022 since we gave kind of a guide there, which was around $200 million in the U.S. and around $50 million outside the U.S. And the full year of 2022 was generally in line with that. It was, I think, just south of $200 million in the U.S. and just south of $50 million outside the U.S. So basically right in line with that.

好的。我們先談 2022 年，因為我們當時給過一個指引：美國約 2 億美元，美國以外約 5,000 萬美元。2022 全年整體而言大致符合該指引。我記得美國略低於 2 億美元，美國以外略低於 5,000 萬美元，所以基本上就是與之相符。

So I think you can feel good about what guidance we gave there.

因此我認為你可以對我們當時給的指引感到放心。

Going forward, the expectation is in the G Series, that delta -- that price-volume delta starts to come down over time. What we would expect to see is -- and we're not going to give a specific number for 2023 since most of that migration is done, but we will have to lap the 2022 migration. And then if there's drift, say, 75 say drifts to 80, you wouldn't expect material moves there. But those are all things we've contemplated in those figures.

往前看，在 G 系列中，那個差異——也就是價格/量（price-volume）的差異——會隨時間開始下降。我們預期會看到的是——由於大部分的轉換已經完成，我們不會提供 2023 年的具體數字，但我們必須與 2022 年的轉換效應相比（lap）。之後如果還有些微漂移，例如 75% 漂移到 80%，你不會預期會有重大的變動。但這些都是我們在那些數字中已經考慮過的因素。

To your point, and I think you're hitting out the way we model the business, we model the business as a G Series and a Dexcom ONE. And I would suggest you do that going forward. And then to your point, Dexcom ONE modeled as a percentage of total business will allow you to then understand the contributions to ASP there, which is why it was important for us to give you our expectation of new patient starts in 2023 that 1/3 of them outside the U.S. will be on Dexcom ONE. So I think the way you're thinking about the model is exactly the way we model it internally, and that's the way I'd go about doing that for 2023 and beyond.

如你所說，而且我認為你點出了我們建模業務的方式：我們把業務分成 G 系列與 Dexcom ONE 來建模。我也建議你未來用同樣方式。然後如你所說，把 Dexcom ONE 作為整體業務的占比來建模，就能理解它對 ASP 的貢獻；這也是為什麼我們要向你們提供 2023 年新病患啟用的預期：在美國以外的新啟用中，有 1/3 會使用 Dexcom ONE。我認為你思考模型的方式，正是我們內部建模的方式，而這也是我建議你在 2023 年及之後採用的方法。

And we will take our next question from Kyle Rose with Canaccord.

我們的下一個問題將由 Canaccord 的 Kyle Rose 提出。

I wanted to ask an additional question just on the commercial strategy moving forward. I understand the DTC advertising, and you doubled the sales force a few years ago. But just as you prepare for basal approval in the U.S., how does the focus or the call point of the actual sales force need to change? Do you need to make additional investments in people? Just help us understand how the targeting goes moving forward.

我想就未來的商業策略再追問一個問題。我理解你們的 DTC（直接面向消費者）廣告，而且你們在幾年前把銷售團隊規模加倍。但當你們正準備在美國取得基礎胰島素適應症的核准之際，實際銷售團隊的重點或拜訪對象需要如何調整？你們是否需要在人員方面做額外投資？請協助我們理解未來的目標客群鎖定會如何推進。

Yes. This is Kevin. I'll take that. Jereme gave us a bit of color earlier. 75% of our calls already by our U.S. sales force are in the PCP arena. And I think you'll continue to see that expand as our team spends more of their time addressing that marketplace, at the same time, not ignoring the places where we've been so successful in the past with the intensive management diabetes. So we will look at that structure in great detail.

是的。我是 Kevin。我來回答。Jereme 先前已提供一些背景。我們美國銷售團隊目前 75% 的拜訪已經是在 PCP（基層照護醫師）領域。我認為你們會持續看到這個比例擴大，因為我們的團隊會投入更多時間來面向那個市場；同時，我們也不會忽視過去在強化型糖尿病管理領域讓我們非常成功的那些場域。因此，我們會非常仔細地檢視那個組織架構。

On a geographical basis, even within the U.S., there may be some places where we need to expand geographically versus large expansion across the entire country. We'll analyze that in great detail as we go. We're in the process of doing that now. We just brought on a new Chief Commercial Officer, as many of you will remember, in early January. And she's deep in the middle of that today as we manage those thoughts and the launch and everything else going on. But we'll look at it very strongly.

從地理分布來看，即使在美國境內，也可能有一些地區需要做地理上的擴張，而不是在全國範圍內大幅擴編。我們會在推進過程中非常仔細地分析。我們現在正在進行這項工作。大家可能記得，我們在 1 月初剛聘任了一位新的首席商務長（Chief Commercial Officer）。她目前正深入參與其中，協助我們在管理這些想法、上市推進以及其他所有進行中的事項。但我們會非常嚴肅、強力地評估。

We will take our next question from Steve Lichtman with Oppenheimer.

接下來我們將接聽 Oppenheimer 的 Steve Lichtman 的提問。

Question on Dexcom ONE outlook. Can you talk about any major new geographic regions you expect to roll out the platform this year? And should we expect to see any movement in bringing Dexcom ONE onto the G7 platform this year? Or is that a longer-term play?

關於 Dexcom ONE 的展望問題。你們能否談談今年預期會在任何主要的新地理區域推出這個平台？另外，今年我們是否應該期待 Dexcom ONE 會轉到 G7 平台上？還是這會是更長期的布局？

Yes. It's a fair question. Let me just say, we're not necessarily going to give the playbook as to what countries we are going into. Now we have launched recently in Croatia, Romania and Greece for Dexcom ONE. That is out there now. So hopefully, that gives you some context, but we will be launching in more countries.

是的。這是個合理的問題。我先說，我們不一定會公開提供我們將進入哪些國家的作戰手冊。不過，我們最近已在克羅埃西亞、羅馬尼亞與希臘推出 Dexcom ONE。現在已經上線了。希望這能提供一些脈絡，但我們也會在更多國家推出。

But rather than give the playbook publicly, we'll let our commercial team execute that and give you that feedback. But just know, we will go into more countries. So hopefully, that gives you at least some context. We will go.

但與其公開給出作戰手冊，我們會讓商業團隊去執行，並再向各位回饋。只要知道，我們會進入更多國家。希望這至少能提供一些脈絡。我們會推進。

In terms of the movement from Dexcom ONE to the G7 form factor, we are absolutely going to be moving to that factor. It's going to take a little bit of time, and the reason it's going to take a little bit of time is, as we get economies of scale on G6, which we have today across the existing user base as well as Dexcom ONE as well as a lot of opportunity for new users on G7, we want to make sure we prioritize G7 and that form factor for those patients coming on to therapy on the G Series.

至於從 Dexcom ONE 轉到 G7 的外形規格（form factor），我們絕對會往那個方向移轉。這會需要一點時間；之所以需要時間，是因為當我們在 G6 上取得規模經濟（我們目前已在既有用戶、Dexcom ONE，以及 G7 上大量新用戶的機會上做到），我們要確保把 G7 以及那個外形規格的優先順序，放在那些開始使用 G 系列治療的病患身上。

Make no mistake, though, as soon as possible, right after that, we will be moving Dexcom ONE to that G7 form factor. Stay tuned. We'll have some updates as the years progress on. But you're thinking about it the right way. We will move there in relatively short order.

不過請不要誤會：在可行的最短時間內、緊接著之後，我們就會把 Dexcom ONE 移轉到 G7 的外形規格。敬請期待。隨著年度推進，我們會提供一些更新。但你的理解方向是對的。我們會在相對短的時間內完成移轉。

We will take our next question from Josh Jennings with Cowen.

接下來我們將接聽 Cowen 的 Josh Jennings 的提問。

I was hoping to follow up on the pricing question. And I'm not sure if you've given a recent update just on how investors should think about the average reimbursement Dexcom receives in the U.S. for a G6 or a G Series patient.

我想追問一下定價的問題。我不確定你們最近是否有更新過，投資人應該如何看待 Dexcom 在美國針對 G6 或 G 系列病患所收到的平均給付（average reimbursement）。

And then just a follow-up on that is, will that change with the G7 introduction for one? And then two, is it important the share shifts in the pump market just considering the reimbursement Dexcom gets to the DME channel with the Tandem pump versus the pharmacy channel with the Insulet pump?

另外再追問：第一，隨著 G7 的導入，這個數字會改變嗎？第二，考量 Dexcom 透過 Tandem 幫浦在 DME（耐用醫療設備）通路取得給付、以及透過 Insulet 幫浦在藥局通路取得給付，幫浦市場的市占移轉是否重要？

Yes. It's a good question. Look, I think the way to think about the ASP is it's really more about channel than it is about version. And so as you think about where folks and who folks -- who gets access, the general way to think about it is Medicare, which is publicly out there, I think after the increase, it's around $250 a month. There's a delta there which goes to the distributor who ultimately fulfills that. So the net price to us is south of that. But ultimately, that would be our price in that range.

是的。這是個好問題。你看，我認為思考 ASP（平均銷售單價）的方式，與其說取決於產品版本，不如說更取決於通路。因此，當你思考人們在哪裡、以及哪些人——哪些人能取得使用權時，一般來說可以這樣理解：Medicare（這是公開資訊）在調升後，我想大約是每月 250 美元左右。這中間有一個差額會給到經銷商，最終由他們負責履約配送。因此，我們的淨價會低於那個數字。但最終，我們的價格大致會落在那個區間。

That's publicly available. Generally, commercial DME is higher than that and pharmacy is lower than that number. And so that's the way to think about it. In terms of then how ASP moves over time, think about it less of generation of product and think about it more as where folks want to get their product. And so I think you're thinking about it the right way.

這些都是公開可得的資訊。一般而言，商業保險的 DME 通路會高於那個水準，而藥局通路會低於那個數字。因此可以用這種方式來理解。至於 ASP 隨時間如何變動，與其用產品世代來思考，不如更多從人們希望透過哪個通路取得產品來思考。所以我認為你的思考方向是對的。

As we talked about, 75% of our lives covered in commercial. 75% of those patients, those patients obviously then come through at a lower price point. If that drifts to, say, 80%, you could see that having a potential tick on there. Again, most of that is behind us, but that's the way to think about the split there.

如同我們提到的，在商業保險中，我們覆蓋的 75% 受保人（lives covered）中，有 75% 的病患顯然會以較低的價格點進來。如果這個比例漂移到例如 80%，你可能會看到 ASP 有潛在的小幅變動。再次強調，這其中大部分影響已經在我們身後了，但這就是理解其分拆（split）的方式。

And then in terms of pump partners and how folks ultimately access it, it really depends again consumer preference. You're right, Tandem is generally accessed through the DME and Insulet's generally access to the pharmacy. So it makes sense that folks get their CGMs through that channel.

至於幫浦合作夥伴以及人們最終如何取得產品，仍然取決於消費者偏好。你說得對，Tandem 一般是透過 DME 取得，而 Insulet 一般是透過藥局取得。因此人們透過相同通路取得他們的 CGM（連續血糖監測）是合理的。

That all being said, it's ultimately consumer preference. And we believe the consumer experience through the pharmacy is great. We have some really great DME partners. They do a wonderful job fulfilling product through that DME channel. And so we believe that, that folks can be fulfilled either way.

話雖如此，最終仍是消費者偏好。我們相信透過藥局的消費者體驗很棒。我們也有一些非常優秀的 DME 合作夥伴，他們透過 DME 通路履約配送產品做得非常出色。因此我們相信，不論哪一種方式，人們都能順利取得產品。

Great. If I could sneak in just a quick follow-up. Just thinking about your CGM platform attached to pumps, is there a premium reimbursement that Dexcom receives in that scenario versus standalone? Or is it all consistent across the board? It just depends on the channel, as you said?

很好。如果我可以再插問一個很快的追問。就你們與幫浦綁定的 CGM 平台而言，在那種情境下 Dexcom 取得的給付是否會比單獨使用（standalone）更高、存在溢價？還是說整體都一致，只是如你所說取決於通路？

No. Right now, there's one class of CGM products, and reimbursement is consistent across the board.

不。目前 CGM 產品只有一個類別，給付在各方面都是一致的。

We will take our next question from Cecilia Furlong with Morgan Stanley.

接下來我們將接聽 Morgan Stanley 的 Cecilia Furlong 的提問。

I was hoping to follow up. You talked, though, the last quarter just about rolling out cash pay models in the U.S. Just curious if you could provide more color as you're thinking about that opportunity today. And then for 2023, specifically, how we should think about potential incremental contributions from that?

我想追問一下。你們在上一季談到在美國推出現金自費（cash pay）模式。想請問你們目前如何看待這個機會，能否提供更多細節？另外，針對 2023 年，這項模式可能帶來的增量貢獻，我們應該如何思考？

You bet. This is Kevin. I'll take it. Big picture, our cash pay program for G7 to start with is going to be our bridging program. And people will be able to pay cash for G7 that way. Ultimately, as we get access and coverage of G7, when people's co-pays will be significantly lower than the bridging program cost, we'll phase that out and have a cash pay program on G7 that individuals will be able to access.

當然可以。我是 Kevin。我來回答。從大方向來看，我們針對 G7 的現金自費方案一開始會是我們的過渡（bridging）方案。人們可以透過那個方式以現金購買 G7。最終，當我們取得 G7 的可近性與給付覆蓋後，當人們的自付額（co-pay）會顯著低於過渡方案的成本時，我們會逐步退出該過渡方案，並在 G7 上提供一個個人可使用的現金自費方案。

We continue our cash pay program on G6, but that is not a major portion of our revenues. It's just a piece of them. We do this to create access primarily where people's insurance doesn't cover it, and they can't get access through the federal or the other governmental channels as well. It's not a huge percentage of our revenues. We need to continue to be cognizant of it and address those patients' needs. And that's why we have it there.

我們也會持續在 G6 上提供現金自費方案，但那不是我們營收的主要部分，只是其中一部分。我們這麼做主要是為了在某些人的保險不涵蓋、且他們也無法透過聯邦或其他政府通路取得時，創造可近性。這不是我們營收中的很大比例。我們需要持續留意並滿足那些病患的需求，這也是我們保留該方案的原因。

Next question from Matt Miksic with Barclays.

下一題來自 Barclays 的 Matt Miksic。

If I could, just 2 quick follow-ups on some of the topics that were covered earlier. So on ramping production for G7 to the gross margins and the impact and improving on scrap rates and all that. And just wondering, by the end of the year, we're sort of hitting what you say about your manufacturing and sort of representative margins maybe in the facilities that you have.

如果可以的話，我想就先前提到的一些主題做兩個快速追問。第一個是關於 G7 的產能爬坡對毛利率的影響，以及改善報廢率（scrap rates）等。我想問的是，到今年年底，我們是否大致會達到你們所說的製造端、以及你們現有廠房可能代表性的毛利水準？

And the other was just on the comment you had on contemplation or competition on the pump integration front this year. And if that were not to come, I'm just wondering, not to put you in a tough spot or anything like that or credit margin the guidance range. But if that were not to come, does that -- is that sort of a slight tailwind to the -- to the top end of your guided range or how to think about that?

第二個是關於你們提到今年在幫浦整合方面可能出現的考量或競爭。如果那件事沒有發生，我想問（不是要讓你為難或什麼，也不是要去挑戰你們指引區間的可信度），如果那沒有發生，是否會對你們指引區間的上緣形成一點順風（tailwind）？我們應該如何理解？

This is Kevin. I'll take that bigger picture. Jereme has been very familiar with the numbers, but I'll give you a bit of my perspective. With respect to no competition in the pump integration point, we may pick up more, we may not. What I do know is everybody using those pumps integrated systems right now uses a Dexcom. And they're achieving remarkable results with the technology we've developed over the years, and we'll continue to receive such.

我是 Kevin。我來談談更宏觀的面向。Jereme 對這些數字非常熟悉，但我提供一些我的觀點。就幫浦整合端沒有競爭這件事而言，我們可能會多拿一些，也可能不會。我所知道的是，目前使用那些幫浦整合系統的人都在使用 Dexcom。而且他們透過我們多年來開發的技術，正取得顯著的成果，我們也將持續獲得這樣的成果。

It is our position that the experience that they're going to have with algorithms based upon Dexcom's CGM that have been developed through the data and the performance of our sensor will continue to make us the leader in that space regardless of who the competing sensor is. And so we're very confident there that we will continue to have a very strong product offering going forward.

我們的立場是：他們將會在基於 Dexcom CGM 的演算法上獲得的體驗——這些演算法是透過我們感測器的數據與效能所開發——將持續讓我們在該領域保持領先，不論競爭的感測器是誰。因此我們對此非常有信心，未來我們仍將持續提供非常強勁的產品組合。

With respect to the margin change over the course of the year, there's a couple of factors in there. Obviously, Jereme has talked about the bridging program in the first half of the year bringing margins down a bit because the revenue per patient will be a bit lower there when we start. But as we see that pick up, we'll pick that up on the revenue side. Then you have basal come in, and Medicare reimbursement is strong. So that will help on pricing.

至於全年毛利率的變動，裡面有幾個因素。顯然 Jereme 已談到上半年橋接計畫（bridging program）會讓毛利率稍微下降，因為一開始每位病患的收入會略低。但隨著我們看到其帶動的成長，我們會在收入端把它補回來。接著 basal 會進來，而 Medicare 的給付很強勁，因此在定價上會有所助益。

The flip side of that is it's sometimes lost on folks, everything we do with G7 is different. All these lines are completely different. All the capacity is different. But the only thing that's the same is we're building in Arizona, and we're building it in San Diego. And that's not going to be the same for a good portion of the year because we expect the factory in Malaysia to be up and running in the second half and producing product there.

另一方面，有時大家會忽略的是，我們在 G7 上做的每一件事都不同。所有這些產線都完全不同，所有產能也都不同。唯一相同的是，我們在亞利桑那州建廠，也在聖地牙哥建廠。但在今年相當一段時間內也不會完全一樣，因為我們預期馬來西亞工廠將在下半年投產並在那裡生產產品。

So you have a number of variables with respect to scrap, with respect to purchasing components, with respect to how these lines run as we get them up and running and functioning at full speed versus where they are today and then bringing on a new factory. We have tried to contemplate every one of those variables as we've started, and we'll update you as to how things are going as time goes on.

因此你會看到許多變數：報廢（scrap）、零組件採購、這些產線在我們把它們建置完成並以滿速運轉時的運行狀況（相較於目前的狀態），以及再加入一座新工廠。我們在起步時已嘗試把每一個變數都納入考量，並會隨著時間推移向各位更新進展。

But whenever you do a product launch, particularly when this significant because when we did our last big G6 product launch, we had similar margin activity, but it was on a much smaller scale because we're so much bigger than we were before, there's just more variables that we have to plan for.

但每當你進行產品上市，尤其是像這次這麼重大的上市——我們上一次大型的 G6 產品上市時，也有類似的毛利率波動，但規模小得多——因為我們現在比以前大得多，所以需要規劃的變數也更多。

We've tried to be conservative and thoughtful in our guidance based on the performance we expect of our teams. We also expect our teams to be better than this too. We don't ever lower the bar for them, as they will tell you. But we've looked at all -- every one of those things and contemplating that, and we meet on this literally every day to make sure we're covering all of our bases. This launch is really important to us as are our margins. But it's really important to get product out to all the users that want it.

我們已根據團隊預期的表現，在指引上力求保守且周全。我們也期待團隊能做得比這更好。我們從不為他們降低標準，他們也會這麼告訴你。我們已把所有——每一項因素都看過並納入思考，而且我們幾乎每天都在開會，確保把所有面向都涵蓋到。這次上市對我們非常重要，我們的毛利率也同樣重要。但更重要的是，將產品交付給所有想要使用的使用者。

And we will take our last question from Michael Polark with Wolfe Research.

接下來我們將請 Wolfe Research 的 Michael Polark 提出最後一個問題。

I just wanted to follow up on first quarter to make sure I have my modeling square. Jereme, I heard in response to prior question using the full year guide, you're thinking about 1Q consistent with seasonal patterns. The last 3 years, I have 21% of full year revenue in the first quarter. If I use the midpoint of your range this year, that's $720 million. But then you made the comment about the bridge program down from there. So that would be another, say, $15 million or $20 million for the quarter. So I'd be at $700 million or $705 million. Have I put this together correctly? If not, can you help?

我想追問一下第一季，確認我的模型是否正確。Jereme，我聽你在回應前一個問題時以全年指引為基礎，認為 1Q 會符合季節性模式。過去 3 年，我的數據顯示第一季約占全年營收的 21%。如果我用你們今年區間的中點，那就是 7.2 億美元。但你又提到橋接計畫會讓它再往下。因此該季可能再少個 1,500 萬或 2,000 萬美元。那我就會落在 7 億或 7.05 億美元。我這樣組合是否正確？如果不是，你能幫我釐清嗎？

Sure. Yes. I mean you're not far directionally off. I mean you are right, we do expect the Q1 contribution and really the sequential decline from Q4 into Q1 to be very similar to what you've seen in the past. And so that will help you get a little bit closer as you think about sequential decline as well from Q4 into Q1. That will put you into a ballpark.

當然。是的。你的方向其實差不多。你說得對，我們確實預期第一季的貢獻，以及從第四季到第一季的連續下滑幅度，會與你過去看到的情況非常相似。因此，當你思考從 Q4 到 Q1 的連續下滑時，這會幫助你更接近。這會讓你落在一個大致的區間。

And then from there, you're right. We updated our number. It's about $15 million now as a result of the bridging program as opposed to the $20 million to $30 million. But that will get you in the ballpark. You're not far off, but there's probably a little bit of tweaking to do around the edges there. But use that 21% contribution, but think also 10% sequential. Those little rounding differences ultimately matter in there. Hopefully, that gives you the context you need though.

然後從那裡開始，你也說得對。我們更新了數字，因橋接計畫的影響現在大約是 1,500 萬美元，而不是 2,000 萬到 3,000 萬美元。但這會讓你落在合理範圍內。你差得不遠，但邊邊角角可能還需要稍微微調。不過可以用 21% 的貢獻率，同時也要考慮約 10% 的連續變動。這些四捨五入的小差異最後都會影響結果。希望這能提供你需要的背景。

And ladies and gentlemen, with no further questions at this time, I will turn the call back to Kevin Sayer for any additional or closing remarks.

各位女士、先生，若此刻沒有進一步問題，我將把電話交回 Kevin Sayer，請他做任何補充或結語。

Thank you very much, and thanks, everybody, for joining us today. We spent a lot of time in our fourth quarter call talking about 2023. I want to just step back again and thank all of our great people here at this company for their hard work in a year where we delivered on our revenue targets, we controlled our costs. At the same time, we've advanced our technologies, our infrastructure, and we've advanced coverage and accessibility for our product all over the world to enhance people's lives.

非常感謝，也謝謝各位今天加入我們。我們在第四季電話會議花了很多時間談 2023 年。我想再退一步，感謝公司裡所有優秀同仁在這一年裡的辛勤付出：我們達成了營收目標，也控制了成本。同時，我們推進了技術與基礎設施，並在全球各地提升了我們產品的給付覆蓋與可近性，以改善人們的生活。

But we are very excited for this launch. This is my fourth major launch here at Dexcom. And every single time, it's taken our company to another level. The first time was G4, and that was when accuracy really came to bear. And we truly established what accuracy standard should be for CGM, and we will remain the most accurate system in the world. G7 is going to be a better experience than G6.

但我們對這次上市感到非常興奮。這是我在 Dexcom 的第四次重大上市。每一次都讓公司提升到另一個層級。第一次是 G4，那是準確度真正開始發揮影響的時候。我們確立了 CGM 準確度應有的標準，而我們也將持續是全球最準確的系統。G7 將帶來比 G6 更好的使用體驗。

Every time we try to make the product easier to use, and this is the biggest ease-of-use advancement we've ever had as we look at the responses from our users so far. And as always, we will make this product as accessible as we can. Dexcom has always been the most accessible brand CGM as far as coverage, and we will continue to do so. That's our commitment to drive that very hard for our end users.

每一次我們都努力讓產品更容易使用；而從目前使用者的回饋來看，這次是我們有史以來在易用性上最大的進步。一如既往，我們會盡可能讓這項產品更容易取得。就給付覆蓋而言，Dexcom 一直是最具可近性的 CGM 品牌，我們也會持續如此。這是我們對終端使用者的承諾，我們會非常努力推動。

It is going to be a busy and great 2023. I am very confident we'll be sitting here a year from now and I'll be able to say the same things. Thanks, everybody, and have a great day.

2023 年將會非常忙碌且精彩。我非常有信心，一年後我們再坐在這裡時，我仍能說出同樣的話。謝謝各位，祝大家有美好的一天。

Thank you, ladies and gentlemen. This concludes today's conference call. We thank you for your participation.

謝謝各位女士、先生。今天的電話會議到此結束。感謝各位的參與。