德康醫療 (DXCM) 2023 Q4 法說會逐字稿

Ladies and gentlemen, welcome to the DexCom Fourth Quarter and Fiscal Year 2023 Earnings 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 2023 年第四季暨全年財報電話會議。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. 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。您可以開始了。

Thank you, Abby, and welcome to Dexcom's Fourth Quarter and Fiscal Year 2023 Earnings Call.

謝謝你，Abby，也歡迎各位參加 Dexcom 2023 年第四季暨全年財報電話會議。

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. At that time, we ask analysts to limit themselves to one question so we can provide an opportunity for everyone participating today. Please note that there are also slides available related to our fourth quarter and fiscal year 2023 performance on the Dexcom Investor Relations website on the Events and Presentations page.

我們的議程首先由 Dexcom 董事長、總裁兼執行長 Kevin Sayer 開場，總結近期亮點與持續推進的策略性計畫；接著由我們的財務長 Jereme Sylvain 進行財務回顧與展望。在我們的準備發言結束後，將開放提問。屆時我們請分析師每人限問一題，以便讓今天所有與會者都有機會提問。另請注意，Dexcom 投資人關係網站的「活動與簡報」頁面上，亦提供與我們 2023 年第四季暨全年表現相關的投影片。

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，我們先回顧安全港聲明。我們在今天電話會議中所做的部分陳述，可能構成前瞻性陳述。這些陳述反映管理層對未來事件、策略、競爭、產品、營運計畫與績效的意圖、信念與預期。本簡報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上述任何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類前瞻性陳述，或使該等前瞻性陳述與實際結果一致的義務。

Additionally, during the call, we will discuss certain financial measures that have not been prepared in accordance with GAAP, with respect to our non-GAAP and cash-based results. 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 and fiscal year 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，所有財務指標之提及均以非 GAAP 基礎呈現。此額外資訊不應被孤立看待，亦不應作為依 GAAP 編製之結果的替代，或被視為優於依 GAAP 編製之結果。請參閱我們的財報新聞稿表格，以及隨附於第四季暨全年財報簡報的投影片，以取得這些衡量指標與最直接可比的 GAAP 財務衡量指標之調節表。

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. 2023 was an incredible year for Dexcom, and I'd like to start by reviewing some of our key accomplishments. Total revenue grew by 24% on an organic basis, driven by another year of record customer starts. This translates into more than $700 million of organic revenue growth compared to last year, as we built strong commercial momentum through recent coverage expansion and the performance of Dexcom's CGM systems.

謝謝你，Sean，也謝謝各位今天加入我們。2023 年對 Dexcom 而言是令人驚豔的一年，我想先回顧幾項關鍵成就。總營收以有機基礎成長 24%，主要受另一年創紀錄的新客戶啟用所帶動。相較去年，這相當於超過 7 億美元的有機營收成長；我們透過近期保險給付範圍擴大，以及 Dexcom CGM 系統的表現，建立了強勁的商業動能。

In 2023, we added over 600,000 Dexcom users to our base and ended the year with approximately 2.3 million customers globally. Importantly, we delivered this level of growth again while enhancing scale and efficiency of our operations. A key milestone here was the opening of our Malaysia manufacturing facility around midyear. Production at this site is ramping quickly, and the team is already delivering yields on par with our more established U.S. facilities. This facility will help support our growth and cost ambitions for years to come.

2023 年，我們新增超過 60 萬名 Dexcom 使用者，並在年底於全球擁有約 230 萬名客戶。重要的是，我們在再次達成此成長水準的同時，也提升了營運的規模與效率。其中一項關鍵里程碑，是我們約在年中啟用馬來西亞製造工廠。該廠產能正快速爬坡，團隊已交出與我們更成熟的美國廠區相當的良率。此工廠將在未來多年協助支撐我們的成長與成本目標。

As a measure of our success for 2023, we not only generated $1 billion in Q4 revenue, we also delivered $1 billion in adjusted EBITDA for the year and generated record levels of free cash flow, which is up nearly 70% compared to 2022. By establishing a disciplined cost culture that focuses years in advance, we are striking the right balance of margin progression while still investing strategically in pathways to support our significant growth opportunities.

作為我們 2023 年成功的衡量，我們不僅在第四季創造 10 億美元營收，也在全年達成 10 億美元的調整後 EBITDA，並創下自由現金流新高，較 2022 年成長近 70%。透過建立著眼於多年之前、具紀律的成本文化，我們在推動毛利率/利潤率提升的同時，仍能策略性投資於支持重大成長機會的途徑，取得了適當的平衡。

From a strategic perspective, 2023 will go down as one of the most transformational years in our company's history. We launched G7 and Dexcom ONE into multiple new markets, significantly expanding our global access and advancing key technical and clinical work that will provide the foundation for the future of Dexcom. This started with the rollout of G7 in the U.S. in February. G7 is the most accurate CGM ever launched, and the market's reception to G7 has been exceptional. Customers and clinicians have been thrilled with the new form factor, product performance and ease of use, and payers wasted no time establishing coverage as they recognize the clear value proposition that G7 provides.

從策略角度來看，2023 年將成為公司史上最具轉型意義的年份之一。我們在多個新市場推出 G7 與 Dexcom ONE，大幅擴大全球可及性，並推進關鍵技術與臨床工作，為 Dexcom 的未來奠定基礎。這一切始於 2 月在美國推出 G7。G7 是迄今推出過最精準的 CGM，而市場對 G7 的反應極為出色。客戶與臨床醫師對新的外型設計、產品效能與易用性都感到非常滿意；而付款方也迅速建立給付，因為他們認可 G7 所提供的明確價值主張。

We immediately started to see a change in prescribing patterns once this product reached the market. And this trend became even more pronounced as we completed the largest expansion of coverage in our company's history. In mid-April, Medicare coverage went live for people with type 2 diabetes using basal insulin only, as well as certain non-insulin-using individuals with hypoglycemia risk. Between this decision and the broad commercial coverage that quickly followed for the basal markets, we have effectively doubled our reimbursed population in the U.S. This has completely changed the market landscape in the U.S.

產品一上市，我們立刻看到處方行為出現變化。而當我們完成公司史上最大規模的給付範圍擴張後，這一趨勢更加明顯。4 月中旬起，Medicare 對僅使用基礎胰島素的第二型糖尿病患者，以及部分具有低血糖風險、未使用胰島素的個體，開始提供給付。在此決策以及隨後迅速跟進、涵蓋基礎胰島素市場的廣泛商業保險給付之下，我們在美國可獲得報銷的人口幾乎翻倍，徹底改變了美國的市場版圖。

With broader coverage available and a new product that greatly simplifies the prescribing process, we've attracted a sizable new cohort of clinicians to our ecosystem. In fact, in 2023, we expanded our prescriber base by approximately 40%, and we're not stopping there. We have always known that the primary care channel would become increasingly important as our business evolves.

在更廣泛的給付可用、且新產品大幅簡化開立處方流程的情況下，我們吸引了一大批新的臨床醫師加入我們的生態系。事實上，2023 年我們的開方醫師基礎擴大約 40%，而我們不會就此止步。我們一直知道，隨著業務演進，基層醫療（primary care）通路將變得愈來愈重要。

Much of the work our commercial team has done in recent years has been tailored to this market. And we are now seeing the direct result of that effort as more than 70% of our new scripts are being written by primary care physicians. These relationships are not only critical to help us reach the millions of insulin-using individuals who have not yet started on CGM, but also the tens of millions with broader type 2 diabetes, prediabetes and beyond.

我們商業團隊近年來所做的許多工作，都是為了這個市場量身打造。如今我們正看到這些努力的直接成果：超過 70% 的新處方由基層醫療醫師開立。這些關係不僅對我們觸及數以百萬計尚未開始使用 CGM 的胰島素使用者至關重要，也有助於我們觸及更廣泛的第二型糖尿病、糖尿病前期（prediabetes）乃至更多族群的數千萬人。

Based on the success of our team in 2023 and the magnitude of these future opportunities, we are excited to continue our investment in our U.S. sales force this year. When we have a presence with prescribers, we win. Now it is up to us to continue to expand that prescriber pool.

基於我們團隊在 2023 年的成功以及未來機會的龐大規模，我們很高興今年將持續加碼投資美國銷售團隊。當我們在開方醫師端建立能見度與存在感時，我們就能勝出。接下來就看我們如何持續擴大這個開方醫師池。

We are already seeing more clinicians want to incorporate Dexcom CGM earlier into patients' care plans as they recognize our unique ability to drive behavior change, sustainable outcomes and greater accountability. This is why we are thrilled to be introducing our newest product, Stelo, later this summer. Stelo will be the first CGM designed specifically for people with type 2 diabetes who are not on insulin. Leveraging our leading sensor platform, we have built a custom software experience that is tailored to the needs of this population.

我們已經看到更多臨床醫師希望在患者照護計畫中更早導入 Dexcom CGM，因為他們認知到我們具備獨特能力，可推動行為改變、可持續的結果，以及更高的責任歸屬。這也是為什麼我們非常期待在今年夏末推出最新產品 Stelo。Stelo 將是第一款專為未使用胰島素的第二型糖尿病患者所設計的 CGM。憑藉我們領先的感測器平台，我們打造了量身訂製的軟體體驗，以符合此族群的需求。

Stelo will feature a 15-day wear time and launch as a cash pay product while we build our case with payers for broader coverage. With several trials currently underway, we will continue to add to the growing body of evidence demonstrating Dexcom's unique ability to drive greater health and economic outcomes for all people with diabetes. The launch of Stelo also presents a great opportunity to bolster our evidence with a large collection of real-world data as we see the impact this product is having on our customers. We filed Stelo with the FDA in the fourth quarter of 2023, leaving us well on track for our highly anticipated launch this summer.

Stelo 將具備 15 天配戴時間，並在我們向付款方建立更廣泛給付的論證期間，以自費（cash pay）產品形式上市。目前已有多項試驗進行中，我們將持續累積日益增長的證據，證明 Dexcom 對所有糖尿病患者在健康與經濟成果上具備獨特的改善能力。Stelo 的上市也提供絕佳機會，透過大量真實世界資料的蒐集來強化我們的證據，並觀察此產品對客戶所帶來的影響。我們已於 2023 年第四季向 FDA 提交 Stelo 申請，使我們完全按計畫推進，迎接今年夏季備受期待的上市。

As our product portfolio continues to grow, it provides a greater glimpse into the future potential of our company. We have built a platform technology that we can customize to provide creative solutions for different populations. Our redesigned software infrastructure is a key component to this, as it enables much quicker iteration and greater connectivity.

隨著我們的產品組合持續擴大，也讓外界更清楚看見公司未來潛力。我們已建立一套平台技術，可依不同族群需求進行客製化，提供具創意的解決方案。我們重新設計的軟體基礎架構是其中的關鍵組成，因為它能支援更快速的迭代與更高的連結性。

Connectivity has always been a distinct advantage for Dexcom. And with our recent filing of direct-to-watch with the FDA and new G7 pump integrations, we are further advancing this leadership position. We will also continue innovating on our hardware technology, with our current efforts focused on launching an extended wear sensor across all of our product offerings.

連結性一直是 Dexcom 的明顯優勢。隨著我們近期向 FDA 提交「直接連接手錶（direct-to-watch）」申請，以及新的 G7 幫浦整合，我們正進一步鞏固並推進這一領導地位。我們也將持續在硬體技術上創新，目前的重點是於所有產品線推出延長配戴感測器。

As we look at the significant opportunity ahead of us, we are as excited as we've ever been. As I said at our Investor Day this past summer, we are just getting started.

展望我們眼前的重大機會，我們的興奮程度一如既往。正如我在去年夏天的投資人日所說，我們才剛剛開始。

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

接下來，我將把時間交給 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。提醒各位，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 2023, we reported worldwide revenue of $1.035 billion compared to $815 million for the fourth quarter of 2022, representing growth of 27% on a reported basis and 26% on an organic basis. As a reminder, our definition of organic revenue excludes currency in addition to non-CGM revenue acquired or divested in the trailing 12 months.

2023 年第四季，我們公布全球營收為 10.35 億美元，對比 2022 年第四季的 8.15 億美元；按報告口徑年增 27%，按有機口徑年增 26%。提醒各位，我們對有機營收的定義，除排除匯率影響外，也排除過去 12 個月內收購或處分的非 CGM 營收。

U.S. revenue totaled $769 million for the fourth quarter compared to $606 million in the fourth quarter of 2022, representing growth of 27%. Between the ongoing success of G7 and our significantly improved access in recent months, the momentum in our U.S. business continues to grow. In fact, we delivered our fastest quarterly U.S. growth rate since the beginning of 2021 as our revenue accelerated for the third quarter in a row.

第四季美國營收合計 7.69 億美元，對比 2022 年第四季的 6.06 億美元，年增 27%。在 G7 持續成功，以及我們近幾個月顯著改善的可及性（access）帶動下，我們美國業務的動能持續增強。事實上，隨著營收連續第三季加速成長，我們交出了自 2021 年初以來最快的單季美國成長率。

International revenue grew 27%, totaling $265 million in the fourth quarter. International organic revenue growth was 23% for the fourth quarter. We continue to execute very well across our international footprint and again took share in Q4 as our global access work and product portfolio strategy have helped broaden our reach in many markets.

第四季國際營收年增 27%，達 2.65 億美元。第四季國際有機營收成長為 23%。我們在國際版圖的執行持續表現出色，且在第四季再次提升市占；我們在全球可及性（access）方面的工作與產品組合策略，協助我們在許多市場擴大觸及範圍。

Our fourth quarter gross profit was $664 million or 64.2% of revenue, compared to 66.7% of revenue in the fourth quarter of 2022. This year-over-year decline in gross margin was expected, as G7 was a much larger percent of our product and customer mix in Q4 compared to a year ago. As a reminder, G7 has a higher cost profile than G6 today but we expect this to change in the coming quarters as we drive greater volume through our G7 lines. As it reaches scale, we continue to expect G7's margin profile to improve upon that of our G6 platform.

第四季毛利為 6.64 億美元，毛利率為營收的 64.2%，對比 2022 年第四季的 66.7%。這項毛利率的年減幅度在預期之內，因為相較一年前，第四季 G7 在我們的產品與客戶組合中占比大幅提高。提醒各位，G7 目前的成本結構高於 G6，但我們預期在未來幾季，隨著 G7 產線出貨量提升，這點將會改變。當規模效益逐步顯現時，我們仍預期 G7 的毛利結構將優於 G6 平台。

Operating expenses were $421 million for Q4 2023, compared to $372 million in Q4 of 2022. This quarter was another demonstration of our commitment to being disciplined and thoughtful with our spend. Our operating expenses grew at half the rate of revenue this quarter, and we delivered nearly 500 basis points of operating expense leverage compared to last year. This extended our streak to 8 straight quarters of at least 250 basis points of year-over-year OpEx leverage.

2023 年第四季營業費用為 4.21 億美元，對比 2022 年第四季的 3.72 億美元。本季再次展現我們在支出上維持紀律與審慎的承諾。本季營業費用的成長速度僅為營收的一半，且相較去年我們實現了接近 500 個基點的營業費用槓桿（OpEx leverage）。這也使我們連續 8 個季度達成至少 250 個基點的年對年 OpEx 槓桿。

Operating income was $242.7 million or 23.5% of revenue in the fourth quarter of 2023, compared to $172.1 million or 21.1% of revenue in the same quarter of 2022. Adjusted EBITDA was $321.5 million or 31.1% of revenue for the fourth quarter, compared to $237.1 million or 29.1% of revenue for the fourth quarter of 2022. Net income for the third quarter was $202.8 million or $0.50 per share.

2023 年第四季營業利益為 2.427 億美元，約占營收的 23.5%，對比 2022 年同期的 1.721 億美元、占營收 21.1%。第四季調整後 EBITDA 為 3.215 億美元，約占營收的 31.1%，對比 2022 年第四季的 2.371 億美元、占營收 29.1%。第三季淨利為 2.028 億美元，或每股 0.50 美元。

We remain in a great financial position, closing the year with greater than $2.7 billion of cash and cash equivalents. Having financial flexibility allows the organization to take advantage of opportunities. Case in point, we executed the $500 million accelerated share repurchase program mentioned on our Q3 results. Through this transaction, we were able to offset the remaining dilution related to our maturing 2023 converts, while purchasing our stock at what we viewed as an attractive price. As Kevin mentioned earlier, our free cash flow grew by 70% in 2023 as our business continues to scale and become more efficient. As our cash flow profile continues to grow, it only adds to our significant financial flexibility. This allows us to continue to invest behind our meaningful organic growth opportunity while assessing strategic uses of capital on an ongoing basis.

我們的財務狀況依然非常穩健，年底現金及約當現金超過 27 億美元。具備財務彈性讓組織能把握機會。舉例而言，我們已執行在第三季財報中提到的 5 億美元加速庫藏股回購（ASR）計畫。透過這筆交易，我們得以抵銷與 2023 年到期可轉債相關的剩餘稀釋，同時以我們認為具吸引力的價格買回公司股票。如 Kevin 先前提到，2023 年我們的自由現金流成長 70%，因為業務持續擴張並提升效率。隨著我們的現金流特性持續增強，也進一步提升我們顯著的財務彈性。這讓我們能在評估資本策略性運用的同時，持續投資於具意義的有機成長機會。

Turning to 2024 guidance. As we stated last month, we anticipate total revenue to be in the range of $4.15 billion to $4.35 billion, representing organic growth of 16% to 21% for the year. This guidance assumes continued momentum in the type 2 basal-only population in the U.S., the expansion of Dexcom ONE on the G7 platform into new geographies, and the launch of Stelo in the summer of 2024. It also assumes the divestiture of our non-diabetes distribution business in Australia and New Zealand this quarter, which represented around $30 million of revenue in 2023.

接著談 2024 年展望。如同我們上個月所述，我們預期總營收將落在 41.5 億至 43.5 億美元區間，代表全年有機成長 16% 至 21%。此指引假設美國第 2 型糖尿病僅使用基礎胰島素（basal-only）族群的動能延續、Dexcom ONE 在 G7 平台上擴展至更多新地理區域，以及 Stelo 於 2024 年夏季上市。同時也假設我們將於本季處分澳洲與紐西蘭的非糖尿病分銷業務；該業務在 2023 年約貢獻 3,000 萬美元營收。

From a margin perspective, we expect full year non-GAAP gross profit margin to be in a range of 63% to 64%, operating profit margin to be approximately 20%, and adjusted EBITDA of approximately 29%. Our gross margin guidance reflects the ongoing conversion from G6 to G7 within our customer base and the associated scale that comes with that process. Below gross margin, we'll continue to be very diligent with our spend in 2024, while investing strategically behind multiple growth opportunities.

就利潤率而言，我們預期全年非 GAAP 毛利率將落在 63% 至 64% 區間，營業利益率約為 20%，調整後 EBITDA 約為 29%。我們的毛利率指引反映客戶群持續由 G6 轉換至 G7，以及該轉換過程所帶來的規模效益。在毛利率以下的費用方面，2024 年我們將持續非常嚴謹地控管支出，同時針對多項成長機會進行策略性投資。

With that, I will pass it back to Kevin.

接下來我把時間交回給 Kevin。

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

謝謝你，Jereme。現在我想開放電話會議進入問答環節。Sean？

Thank you, Kevin. As a reminder, we ask our audience to limit themselves to only one question at this time and then reenter the queue if necessary. Abby, please provide the Q&A instructions.

謝謝你，Kevin。提醒各位，我們請聽眾此刻先限制為只提一個問題，如有需要可再重新排隊。Abby，請提供問答說明。

(Operator Instructions) And we will take our first question from Robbie Marcus with JPMorgan.

（接線員說明）我們的第一個問題來自 JPMorgan 的 Robbie Marcus。

I'll offer up for the second time congrats on a really good quarter. I wanted to tie 2 ideas together. The first is the great operating margins we saw in the fourth quarter, came in well above the Street. And in the slide deck presentation, you have the slide about making progress on the 15-day sensor. And the question here is really, one, any updates on the time frame of when that G-Series 15-day sensor will be approved? And how to really think about where that could take the good operating margins you put up here and what you've guided for next year, and where that could really take it in the future?

我第二次向各位道賀，這真的是非常出色的一季。我想把兩個想法串在一起。第一個是我們在第四季看到的優異營業利益率，明顯高於市場預期。而在簡報投影片中，你們有一頁提到 15 天感測器的進展。我的問題主要是：第一，關於該 G 系列 15 天感測器何時獲准，有沒有任何時間表更新？第二，該產品可能如何影響你們目前交出的良好營業利益率、以及對明年的指引，並在未來把營業利益率帶到什麼樣的水準？

Thanks, Robbie, this is Kevin. I'll take the 15-day sensor timing, and then Jereme can talk about the numbers and the effect on operating margins going forward.

謝謝你，Robbie，我是 Kevin。我先回答 15 天感測器的時程，接著 Jereme 可以談談數字以及對未來營業利益率的影響。

As we've said earlier this year, we're in the middle of clinical testing and scientific evaluation of some fundamental science changes to the sensor that will make it more reliable for that 15-day period. One of the reasons that we've done so well, 2 things: the accuracy of our sensor and the performance of our sensor over time, but combined with the fact people expect to get a certain amount of days from a sensor and we deliver what we tell them we're going to do. And we want to make sure that 15-day experience is every bit as good as the 10-day experience that we offer now. So we're making a few slight changes on a science basis. We'll run a clinical study, file that, and we certainly would expect to get approved. But right now, we're still evaluating some of the technologies. And we really won't provide a lot of color until we're filed and we see we're on a path towards approval.

如同我們今年稍早所說，我們正處於臨床測試與科學評估的中期，針對感測器做一些基礎科學層面的變更，以便在 15 天期間內更可靠。我們之所以能做得這麼好，有兩個原因：感測器的準確度，以及感測器隨時間的表現；再加上使用者期待感測器能提供一定天數，而我們能做到我們承諾的表現。我們希望確保 15 天的使用體驗，能與目前提供的 10 天體驗同樣出色。因此我們在科學層面做了一些小幅調整。我們會進行臨床研究、提交申請，並且我們當然預期能獲得核准。但目前我們仍在評估部分技術，在完成申請並確認正走在獲准的路徑之前，我們不會提供太多細節。

Yes. And then to your question longer term on operating margins, we've done a really nice job to date creating leverage and opportunities within our operating margin profile. And despite some of the moves in the channel mix changes we've made on the topline, we've been able to maintain a gross margin based on a lot of the work we've done around design to value and a lot of the scale that we've been able to achieve. But when you think about 15-day, it provides a real big opportunity for us to think about both leverage from a gross margin and then operating margin profile, but also opportunities to grow the business in areas profitably that maybe it would be a little bit more of a challenge with the 10-day product.

是的。至於你提到的長期營業利益率，我們迄今在營業利益率結構上創造槓桿與機會方面做得非常好。儘管在營收端我們做了一些通路組合（channel mix）的調整，但憑藉我們在價值導向設計（design to value）上的大量工作，以及已達成的規模效益，我們仍能維持毛利率水準。不過當你思考 15 天產品時，它為我們帶來非常大的機會：一方面可望在毛利率上帶來槓桿，進而改善營業利益率結構；另一方面也讓我們能在某些領域以更具獲利性的方式擴大業務，而若僅有 10 天產品，這些領域可能會更具挑戰。

So it is absolutely the #1 effort going on in the organization. It does provide us lots of flexibility to either, a, continue to grow the business; or b, deliver operating margins that can be world class over time. So I think longer term, there's a lot of opportunities there. We're not ready to particularly lay out what that is. We've obviously given our 2025 LRP. And we'll execute to that, but I do think it provides real long-term opportunities for this company to deliver back to shareholders and take advantage of opportunities globally.

因此，這絕對是組織內正在進行的首要（#1）工作。它確實為我們提供了很大的彈性：要麼（a）持續成長業務；要麼（b）隨著時間推進，交付可達世界級的營業利潤率。因此我認為從長期來看，這裡有很多機會。我們目前還沒有準備好特別去詳細說明那會是什麼。我們顯然已經提供了我們的 2025 LRP，而我們也會依此執行；但我確實認為，這為公司帶來真正的長期機會，能回饋股東，並把握全球性的機會。

We will take our next question from Danielle Antalffy with UBS.

我們的下一個問題來自 UBS 的 Danielle Antalffy。

Congrats on a really strong end to the year. It's great to see. I'm going to ask this question about -- we're hearing more about potential competition coming to market. And I would just love, Kevin, if maybe you could highlight for us the competitive moats that Dexcom has built. Obviously, we don't know much about what this competitor is planning to bring to market. So -- but maybe if you could just highlight where you think Dexcom is from a competition perspective and how defensible your share is here?

恭喜你們在年底交出非常強勁的表現，看到這樣的結果很棒。我想問一個問題——我們聽到市場上可能會有更多潛在競爭者進入。我很想請 Kevin 也許能為我們強調一下 Dexcom 所建立的競爭護城河。顯然，我們對這個競爭者計畫推出什麼產品所知不多。所以——但也許你可以談談你認為 Dexcom 從競爭角度目前處於什麼位置，以及你們在這裡的市占有多可防禦？

No, I appreciate that question. First and foremost, we can start with the core technology and the fundamental beliefs we've had here as a company. The performance of our centers has been unparalleled. We've got over 1 million years, for example, and AID systems with great outcomes and patients who have done very well there. We've built our platforms on connectivity.

不，我很感謝這個問題。首先，我們可以從核心技術以及我們作為一家公司一直以來的基本信念談起。我們感測器的表現一直是無可比擬的。舉例來說，我們已累積超過 100 萬年的使用經驗，並且在 AID 系統上帶來很好的結果，患者在那方面的表現也非常好。我們的平台是建立在連線能力之上。

One of the features that I've talked with the engineers about and kind of complained about because it took a lot of time to engineer, we can connect up to 3 devices at the same time. This is the type of connectivity that our competitors have not put into their platforms, and it's a feature that's very important to our patients, which is the reason, for example, why we just filed our direct-to-watch features with the FDA.

我曾和工程師討論過、也有點抱怨過的一個功能——因為它花了很多時間去工程化——就是我們可以同時連接多達 3 個裝置。這種連線能力是我們的競爭對手尚未放進他們平台的，而這對我們的患者非常重要；例如，這也是為什麼我們剛向 FDA 提交了我們的「直接連到手錶（direct-to-watch）」功能。

One of the other things our competition thinks about as they look at us today and they think this is where we're going to stay, we're not. We certainly have new pipeline efforts across all fronts on the technology side, better connectivity communications, software investments. We've had to evolve from being literally a medical device software company to being a world-class software organization over the past couple of years. And it has been an evolution for us and it's been a big investment. So we've looked at the areas to invest to make ourselves stronger and made investments there.

另外一件事是，競爭對手在看我們今天的狀態時，可能以為我們會停留在這裡——但我們不會。我們在技術端各個面向都有新的研發管線工作，包括更好的連線通訊、軟體投資。過去幾年，我們必須從本質上是一家醫療器材軟體公司，演進成為世界級的軟體組織。這對我們而言是一個演進，也是一項重大投資。因此我們檢視了需要投資以讓自己更強的領域，並在那些地方做了投資。

Now that's on the technology side. Here's the other piece of this. We've spent hundreds of millions of dollars over the past 3 years getting fully automated factories up and running both here in the United States and our new factory in Malaysia that opened midyear, and that is a tremendous facility. But we built out those automated lines there, and we just turned ground on what will be our next world-class factory over in Ireland that would open in 2026. There's a huge investment that has to be made to play in the CGM business going forward, particularly at the scale and the performance that we see now. And we've made those investments and done those things and evolved as a company.

以上是技術面。另一個部分是：過去 3 年，我們投入了數億美元，讓美國本土以及馬來西亞的新工廠（於年中啟用）都能建立並運轉完全自動化的工廠；那是一座非常出色的設施。我們在那裡建置了自動化產線；同時，我們也剛在愛爾蘭動工建設下一座世界級工廠，預計於 2026 年啟用。未來要在 CGM 業務中競爭，尤其是在我們目前所看到的規模與表現水準下，必須做出巨額投資。而我們已經做了這些投資、完成了這些事情，並且作為一家公司持續演進。

So we think we're very well positioned, and then we'll see where everybody else comes. But we're comfortable. Well, let me rephrase that, we're never comfortable. But we believe we've done all the right things.

所以我們認為自己處於非常有利的位置，接下來就看其他人會怎麼做。但我們很安心——嗯，我換個說法，我們從不會覺得安心。但我們相信我們做了所有正確的事情。

And we will take our next question from Larry Biegelsen with Wells Fargo.

接下來我們的下一個問題來自 Wells Fargo 的 Larry Biegelsen。

I wanted to focus on Stelo. You expect this product to add approximately, I think, 100 basis points to your growth in '24, which is almost $40 million in 6 months. So that's a pretty healthy number for only half a year. Kevin, what's informing your confidence in the launch? How big could this product be over time? And what are the margin implications?

我想聚焦在 Stelo。你們預期這個產品在 2024 年能為成長貢獻約 100 個基點，我想這相當於 6 個月接近 4,000 萬美元。所以對於只有半年的時間來說，這是個相當可觀的數字。Kevin，是什麼因素支撐你們對這次上市的信心？這個產品長期來看可能有多大？以及對利潤率有什麼影響？

Larry, thanks for the question. And we have guided at 1%. The purpose of this launch is to get this product out here and learn. And as we look at that 1% of revenue number, we certainly have models that build and support that. And we believe in designing this product for the type 2 non-insulin user and others that we're targeting the right segment to go after that.

Larry，謝謝你的問題。我們的指引是 1%。這次上市的目的，是把產品推出去並學習。當我們看這個 1% 的營收數字時，我們確實有建立並支持該數字的模型。我們也相信，將這個產品設計給第 2 型非胰島素使用者以及我們鎖定的其他族群，是在追求正確的目標客群。

Our most important experience with Stelo is learning and getting it out there and starting to develop and grow this new market. We're confident that this product over time can become a very, very large portion of our business and this can be a very large segment within our markets. This year's launch is all about learning, more than anything else. And we have a model for that 1%. I would love to exceed it. But if we learn all the lessons that we need to learn, this is not a back breaker for our company and our guidance either. So the most important thing is to get the product out there and to learn, more than anything else.

我們對 Stelo 最重要的經驗是學習：把它推出去，並開始開發與成長這個新市場。我們有信心，隨著時間推進，這個產品可以成為我們業務中非常、非常大的一部分，而這也可能成為我們市場中的一個非常大的區隔。今年的上市最重要的是學習，勝過其他一切。我們對那個 1% 有模型。我很希望能超過它。但如果我們學到所有需要學到的課題，這對公司以及我們的指引都不會造成致命影響。因此最重要的是把產品推出去並學習，勝過其他一切。

And then to your question on margin, we're not necessarily talking about it from a gross margin perspective. That will come in time, when we start to release more details around it, Larry. From an operating margin, yes, this is something we're going to invest in. And so when you think about it from an overall company margins, certainly, as we invest in this and we invest in launching it, there will be some sales and marketing, but it's an investment we're going to make this year.

至於你問到的利潤率，我們目前不一定從毛利率的角度來談。那會在之後、當我們開始釋出更多細節時再說，Larry。從營業利潤率來看，是的，這是我們會投資的項目。因此當你從公司整體利潤率來思考時，當然，隨著我們投資並推動上市，會有一些銷售與行銷費用，但這是我們今年會做的投資。

And we're going to make that investment in this product because we believe in the future, and we're going to do so and still expand operating margins as a company. So you can be safe that we're going to be very, very careful and measured about how we invest our dollars, but know that this is part of the investments we've set aside as an organization, while still again, improving profitability.

而我們會在這個產品上做投資，因為我們相信未來；同時我們也會這麼做，並且仍然讓公司擴大營業利潤率。所以你可以放心，我們在投資資金時會非常、非常謹慎且有節制；但也請理解，這是我們作為組織預留的投資之一，同時仍會持續提升獲利能力。

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

我們的下一個問題來自 Stifel 的 Matthew Blackman。

Maybe for Kevin and Jereme, you obviously mentioned sales force and the PCP channel. Can you just remind us, at least today, what kind of PCP sales force coverage you have? And then more importantly, sort of leaning into your comments, Kevin, about investing any way incrementally in that channel this year, what does that mean in terms of spend magnitude, spend timing? And how much more coverage are you expecting to add with these investments, or any other way to frame what you're trying to accomplish?

也許問 Kevin 和 Jereme：你們顯然提到了銷售團隊以及 PCP 通路。你們能否提醒我們，至少在目前，你們在 PCP 端的銷售團隊覆蓋大概是什麼規模？更重要的是，延伸你剛才的評論，Kevin，關於今年在該通路上逐步增加投資，這在支出規模、支出時點上代表什麼？你們預期透過這些投資能增加多少覆蓋，或用其他方式說明你們想達成什麼？

Yes. So thanks for the question, Matt. So when you think about the investment, we are going to expand that sales force. And today, we have a good amount of coverage. It's tens of thousands of primary care physicians and predominantly the entirety of the endocrinologist space. But as you start to think about basal coverage expanding, the opportunity ahead of us, certainly Stelo out on the horizon, we found there was an opportunity to continue to expand. And as we know, CGM, specifically Dexcom CGM, can play a very important role in how folks manage their diabetes. We know that having those call points is helpful.

好的。謝謝你的問題，Matt。談到投資時，我們將擴大那支銷售團隊。目前我們已有相當不錯的覆蓋：涵蓋數以萬計的基層照護醫師（primary care physicians），以及幾乎整個內分泌科醫師領域。但當你開始思考基礎胰島素（basal）覆蓋的擴張、我們面前的機會，當然還有地平線上的 Stelo，我們發現仍有機會持續擴大。正如我們所知，CGM，特別是 Dexcom CGM，能在民眾管理糖尿病的方式上扮演非常重要的角色。我們也知道，擁有這些拜訪觸點是有幫助的。

So we are going to expand, and you can take a look at LinkedIn for the amount. There's quite a few openings out there in terms of the size of it. So we'll expand our sales force and we will get more coverage.

所以我們會擴大，你可以看看 LinkedIn 上的職缺數量。就規模而言，目前有相當多的開缺。因此我們會擴編銷售團隊，並取得更高的覆蓋。

In terms of the cadence, the LinkedIn recs are out there right now, so you'll see us hire over the course of the first quarter. Obviously, then, the fully-loaded burden associated with those reps will take place over the back half of the year, so Q2 through Q4. So that's how to think about the cadence of that. But again, that's all contemplated in the overall guidance we've provided, the 20% operating margin.

就節奏而言，LinkedIn 的招募職缺現在就已經發布了，所以你會看到我們在第一季期間進行招募。當然，與這些業務代表相關的全額成本負擔會在下半年反映出來，也就是 Q2 到 Q4。因此可以用這樣的節奏來理解。不過再次強調，這些都已包含在我們提供的整體指引之中，也就是 20% 的營業利潤率。

So expect it as part of typical work that we do around creating leverage in the business and investing where we need to. But if you're thinking about it for a cadence over the course of the year, expect the hires to be made over the course of the first quarter and then for folks to ramp up and be part of our run rate really Q2 through the balance of the year.

所以請把它視為我們一貫的作法：在業務中創造槓桿，並在需要的地方投資。但如果你要以年度節奏來看，預期招募會在第一季完成，接著人員會逐步上手並在 Q2 到今年剩餘期間真正成為我們的常態運行（run rate）的一部分。

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

接下來我們將接聽來自 BTIG 的 Marie Thibault 的提問。

I wanted to ask a question here on international. I think you've reminded us that you'll be selling a non-CGM business in Australia and also going direct in Japan. Wanted to understand the cadence for Q1 versus the rest of the year. And also, any sort of comments you could make on G7 being on the Dexcom ONE platform? Just an all-around international question there.

我想在國際業務方面提一個問題。我想你們提醒過我們，你們將在澳洲出售一項非 CGM 業務，並且也會在日本改為直營。想了解第一季相較於今年其餘時間的節奏安排。另外，關於 G7 採用 Dexcom ONE 平台這件事，你們有任何評論嗎？這是一個整體性的國際業務問題。

Sure. Thanks, Marie. And we'll give you some context. So the non-CGM business, that effectively is gone at this point. So that's why we've been comfortable pulling it out and talking about it to organic. So this quarter, you can expect -- we talked about $30-ish million last year. The math on that, you can kind of do the allocation by quarter. That's out as of this point, for the most part.

好的。謝謝你，Marie。我們先提供一些背景。非 CGM 業務到目前為止基本上已經退出了。因此我們才會很有把握把它剔除，並在談到有機成長時將其排除。就本季而言，你可以預期——我們提過去年大約是 3,000 萬美元左右。這部分的數學你可以按季度自行分攤計算。到目前為止，這部分大多已經不在了。

And so think about that in the quarter, Japan certainly a similar type thing. We talked about it in Q4 being effectively nil. I'd expect a similar contribution in the first quarter. And then as we start to take that book of business or that business live in the second quarter, I expect it to start to contribute as we build that business back up over the course of the year. So those are really the international kind of timing. So Q1 will be the heaviest burden in terms of as we transition through that.

因此在本季來看，日本也是類似的情況。我們在第四季提到它基本上為零。我預期第一季也會有類似的貢獻。接著當我們在第二季開始把那本業務、或那項業務正式上線時，我預期它會開始貢獻，並在今年的過程中逐步把業務重新建立起來。這些就是國際業務在時點上的安排。因此第一季在我們進行轉換的過程中，負擔會是最重的。

As it pertains to Dexcom ONE on G7, great news is, I think we press released it a couple of days ago, 4 countries have launched. And so that has come out. It is now out there today. Those 4 countries are our first foray, and we're getting great feedback from early adopters within those countries. The expectation is we have a cadence of launches of Dexcom ONE on a G7 form factor really over the course of the year. So I'd expect a lot more press releases around where and when we're launching that, but expect that to really take place over the course of the year, which gives us a lot of confidence again in Dexcom ONE being a really incredible growth driver for the long term.

至於 G7 上的 Dexcom ONE，好消息是——我想我們在幾天前發了新聞稿——已有 4 個國家上市。這已經推出了，今天也已在市場上。這 4 個國家是我們的第一波嘗試，我們也從這些國家的早期採用者那裡獲得非常好的回饋。我們預期 Dexcom ONE 以 G7 外形規格推出的上市節奏會貫穿全年。因此我預期會有更多新聞稿說明我們在哪裡、何時推出；但請預期這會在全年逐步發生，這也再次讓我們對 Dexcom ONE 作為長期非常出色的成長驅動因素充滿信心。

We will take our next question from Jeff Johnson with Baird.

接下來我們將接聽來自 Baird 的 Jeff Johnson 的提問。

Maybe just keep it on that international point. I think this is the first quarter in a while we've seen international growth below the U.S. growth. And if I look back the last few quarters, I think you've gone 40%, 30%, 23% here on the organic growth rate. Just help us understand kind of where that international versus U.S. growth might settle out here in 2024. Would we expect them to be similar to each other? Does international continue to slow for any reason? And as I think about some of the competitive AID approvals that have happened over in Europe, especially with one of your -- with a competitive CGM, just how are you thinking about the stability of your maybe installed base on the AID side over there versus win rate for new AID systems there?

也許就延續國際這個主題。我想這是我們一段時間以來第一次看到國際成長低於美國成長。如果我回看過去幾季，我想你們的有機成長率大概是 40%、30%、這一季 23%。請幫我們理解一下，2024 年國際相對於美國的成長大概會落在什麼水準？我們是否應該預期兩者會相近？國際是否會因任何原因持續放緩？另外，當我想到歐洲那邊一些競爭性的 AID 核准，尤其是你們——與一個競爭對手的 CGM 相關的核准——你們如何看待在那邊 AID 端你們可能的既有裝機基礎的穩定性，以及在那邊新 AID 系統的贏單率？

Thanks, Jeff. So as you think about the cadence -- so thanks for the question on international. As you think about the cadence over the course of the year, certainly Q4 was buoyed by a few different -- or weighed down, I guess, I'd say, by a few different things. We talked a little bit about earlier about the Japan business, and really the revenues were effectively nil as we make that transition. And so that's a negative grower in the quarter. And then the non-diabetes business was really flat. And so when you think about the business being historically a pretty significant grower, those pull you down.

謝謝你，Jeff。談到節奏——也謝謝你關於國際的問題。當你思考全年節奏時，第四季確實受到幾個不同因素的支撐——或者我應該說，被幾個因素拖累。我們先前稍早談到日本業務，當我們進行轉換時，營收基本上為零。因此在該季它是負成長的因素。然後非糖尿病業務基本上是持平。當你想到這項業務過去一直是相當顯著的成長來源時，這些因素就會把整體拉低。

As you start to exclude those things, we are still growing quite well. In fact, all of the core businesses where we operate today, U.K., Germany, Australia, et cetera, all continue to grow relatively consistently between Q2, Q3, Q4. There are just some ebbs and flows. But for the most part, those all should do well.

當你開始把這些因素排除後，我們其實仍然成長得相當不錯。事實上，我們目前營運的所有核心市場——英國、德國、澳洲等等——在第二季、第三季、第四季之間都持續相對一致地成長。當然會有一些起伏，但大致上這些市場都應該表現良好。

So then you think about what does that mean going forward? We haven't changed our stance that the OUS business, the international business as a percentage of revenue by the end of 2025 will be bigger than it is today, about 2/3, 1/3, where that split today is more like 70-30 or 72-28. So I think on the whole, expect the international business with all of the opportunity out there, with certainly the underpenetration we have today, to grow faster than that of the U.S. business over the coming years. That's not to say that we're not incredibly bullish on the U.S. business. Look, if we can outperform on both of those, we'll do the work on both. But at least that's in our LRP.

那麼再來思考，這對未來意味著什麼？我們並沒有改變我們的立場：到 2025 年底，OUS 業務、也就是國際業務占營收的比重，將會比今天更大；大約會是 2/3、1/3，而目前的分拆更像是 70/30 或 72/28。整體而言，考量到海外的機會，以及我們目前的滲透率仍偏低，我認為未來幾年國際業務的成長速度應該會快於美國業務。這並不是說我們對美國業務不看好。你看，如果我們能在兩邊都超越預期，我們就會在兩邊都努力。但至少這是我們在 LRP（長期規劃）中的假設。

As you think about competitive systems and AID, we are highly confident in what we have to offer. Our product, there's multiple different reasons why we believe our product is special in that space. Kevin alluded to a little bit about it earlier around Bluetooth connectivity is one. I'll just give you an example there. Someone can be on a pump, can talk to their phone and can be on a direct-to-watch application, all while on our product. No one else can offer that. We are the only one that can do that. And as you think about this population, which really needs and deserves, quite frankly, the technology to manage their diabetes, we believe that, that is a differentiator and a meaningful differentiator going forward.

至於競爭系統與 AID，我們對我們能提供的方案非常有信心。我們的產品在那個領域之所以特別，有多個原因。Kevin 先前稍早提到其中一點：藍牙連線能力。我舉個例子：使用者可以在使用幫浦的同時，與手機連線，並且也能使用直連手錶的應用程式，而且全程都使用我們的產品。沒有其他人能提供這樣的能力。我們是唯一能做到的。當你想到這個族群——坦白說，他們確實需要也值得擁有用來管理糖尿病的科技——我們相信這會是一個差異化因素，而且是未來非常重要的差異化。

Add to that, the millions and millions of years that we're compiling on these systems, we feel highly confident that when we sit in front of a physician, we sit in front of an endocrinologist and we sit in front of a parent, a child that needs an AID system, we feel confident that we are the choice. We'll continue to battle and make sure that, that message continues to go out there. But as we think about that international book of business, we continue to feel very confident, even post launch of a competitive system, we'll do incredibly well there.

再加上我們在這些系統上累積的數以百萬計的使用年數（years），我們非常有信心：當我們坐在醫師面前、坐在內分泌科醫師面前，或坐在需要 AID 系統的家長與孩子面前時，我們有信心我們會是他們的選擇。我們會持續競爭並確保這個訊息能持續傳達出去。但當我們思考那本國際業務時，即使在競爭系統上市之後，我們仍然非常有信心我們會在那裡表現得非常好。

We will take our next question from Matt Taylor with Jefferies.

接下來我們將接聽來自 Jefferies 的 Matt Taylor 的提問。

I was hoping you could update us on the cadence of data that we could expect to see this year, not only around -- you mentioned before, GLP-1 data that could come from you or from investigators. And then also on Stelo, are we going to see anything on that at upcoming conferences or from you before, during or after the launch?

我希望你們能更新一下今年我們可以期待看到的數據發布節奏，不僅是——你們先前提到的，可能來自你們或研究者的 GLP-1 相關數據。另外也想問 Stelo，我們是否會在接下來的會議上看到任何相關內容，或在上市前、上市期間或上市後，由你們發布任何資訊？

No, this is Kevin. I'll take that. We don't really -- we don't need a clinical trial for Stelo as far as getting that product approved. There is a lot of data on use of continuous glucose monitoring, particularly Dexcom systems in this type 2 diabetes world that will be published by investigators over the course of the next several months. And we'll reference to that and we'll talk to you about that.

不，這是 Kevin，我來回答。就 Stelo 而言，為了讓該產品獲准，我們並不真的需要臨床試驗。關於連續血糖監測的使用——特別是 Dexcom 系統——在第二型糖尿病領域已有大量數據，接下來幾個月會由研究者陸續發表。我們會引用那些資料，也會就此與你們溝通。

We know -- we have a very good idea where this data comes out because we've seen in all our studies, patients have better outcomes, they're healthier, we end up saving the system money. And those are the outcomes that we're hoping to drive with Stelo over time. With respect to GLP-1s, again, the list of studies ongoing is very large. And there are studies where CGM is an element.

我們知道——我們非常清楚這些數據會呈現什麼，因為在我們所有研究中都看到：病人的結果更好、更健康，而我們最終也能為整個體系節省成本。這些就是我們希望 Stelo 隨時間推進所能帶來的結果。至於 GLP-1，同樣地，正在進行的研究清單非常龐大，其中也有研究把 CGM 作為其中一個要素。

Again, we expect those studies when they're published to demonstrate the same things that we've talked about before, that the use of the CGM with the GLP-1 provides a better result than a study without it. And those studies we published over time, we don't control those investigators. But we expect good data over the course of the year.

同樣地，我們預期這些研究在發表時會證明我們之前談過的相同結論：在使用 GLP-1 的情境下，搭配 CGM 的效果會優於不搭配 CGM 的研究。我們會隨時間引用那些已發表的研究；我們無法控制那些研究者，但我們預期今年全年會有不錯的數據出爐。

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

接下來我們將接聽來自美國銀行（Bank of America）的 Travis Steed 的提問。

I guess I wanted to understand a little bit more, Kevin, if you could give some more clarity on how you think a reimbursement pathway for Stelo could look over the next couple of years? What do you think is needed to open reimbursement up for that product and how you think that would look if it would be done in a more traditional way, or do you think it could be done kind of more one-off like the Levels program with UnitedHealthcare?

我想更深入了解一下，Kevin，你是否能更清楚說明你認為未來幾年 Stelo 的給付（reimbursement）路徑可能會是什麼樣子？你認為要讓該產品開啟給付需要哪些條件？以及你認為它會以較傳統的方式來完成，還是你認為它可能會以較一次性（one-off）的方式來完成，例如 UnitedHealthcare 的 Levels 計畫那樣？

Our goal is to do this in a more traditional [way over] time. As we've said earlier, we'll launch the product as a cash pay product and have a cash pay option, a cash pay that people can get into and purchase the product. We will accumulate data from those users over time. We'll accumulate data again from the clinical trials that we see out there and ultimately build a case for reimbursement for this product.

我們的目標是隨著時間推移，以更傳統的方式來做這件事。正如我們先前所說，我們會先以自費產品的形式推出，並提供自費選項，也就是讓人們可以選擇自費進入並購買該產品。我們會隨時間從這些使用者累積資料。我們也會從我們在外部看到的臨床試驗中再次累積資料，並最終建立本產品的給付（reimbursement）論證。

I think over time, we certainly expect to go to CMS and have people with type 2 diabetes who are on insulin covered at some point in time by that group because again, our goal is to spend less money in the health care system, and we're one of the few technologies that enables an outcome of that nature. So we see it being more traditional and working with payers and the various government agencies over time.

我認為隨著時間推移，我們當然預期會與 CMS 接洽，並在某個時間點讓使用胰島素的第二型糖尿病患者能夠由該單位納入給付，因為再次強調，我們的目標是讓醫療體系花更少的錢，而我們是少數能夠實現這類結果的技術之一。因此，我們認為這會更偏向傳統模式，並隨時間與支付方以及各類政府機構合作。

The programs we will continue to support, we're happy to support them and be partners with them. But I think over time, we need to have a more traditional reimbursement path. And that -- it can't be -- the partnerships and the relationships can't be the only way.

我們會持續支持這些計畫，我們很樂意支持並與他們成為合作夥伴。但我認為隨著時間推移，我們需要一條更傳統的給付路徑。而且——不能——合作夥伴關係與人脈關係不能是唯一的方式。

On top of that, we'll continue to develop our tools around Stelo. This first generation that we launch is going to be our first pass app. We will have numerous iterations over the course of the first 24 months of that product. It really makes it a much more inviting and engaging product and lead people to better experiences. So stay tuned for what we have to say on that front over the next 12 months. It's going to be very exciting.

此外，我們也會持續圍繞 Stelo 開發我們的工具。我們推出的第一代將是我們的第一版 App。在該產品推出後的前 24 個月內，我們會有多次迭代。這將使產品更具吸引力與互動性，並帶領人們獲得更好的體驗。因此，接下來 12 個月請持續關注我們在這方面的分享，會非常令人振奮。

And we will take our next question from Joanne Wuensch with Citi Group.

接下來我們將請花旗集團（Citi Group）的 Joanne Wuensch 提問。

Nice quarter. A couple of questions, 2 related ones. Can you sort of give us the guidance for tax and how to think about net interest expense? And then the one that strikes me as somewhat more interesting is, I think your LRP is for 21% operating margins and this is the second quarter in a row where you've bypassed that number, so why is 21% still the right number to be had?

這一季表現不錯。我有幾個問題，兩個相關的問題。你們能否提供稅率方面的指引，以及該如何看待淨利息費用？另外一個我覺得更有意思的是，我記得你們的 LRP（長期計畫）目標是 21% 的營業利益率，而你們已經連續第二季超過這個數字了，那為什麼 21% 仍然是合理的目標？

Sure. Yes. So we'll start with tax. I think this year, we kind of dropped down to closer to that 26% range. While we don't necessarily guide year-by-year to tax, the goal is over the course of the next 3 to 5 years to get down into the low 20s. So I would expect it to continue to come down every year as we grow into the tax structure that we've put in place.

當然。是的。我們先從稅率談起。我想今年我們大致降到接近 26% 的區間。雖然我們不一定會逐年提供稅率指引，但目標是在未來 3 到 5 年內降到 20% 出頭。因此，我預期隨著我們逐步適應已建立的稅務架構，稅率會每年持續下降。

In terms of net interest income, some of that -- it's one of those -- it's a bit of a difficult one, but just given where interest rate is going to go over time. But it's pretty straightforward that our cash interest cost is pretty low just given our converts. And so you can basically take a look at the cash on the balance sheet, multiply it by about 4%, and that gets you to about where you'd be for the year. Again, we'll have to keep you updated as interest rates change over time. But that's the other way to think about it.

至於淨利息收入，其中一部分——這算是比較難預測的項目，因為取決於利率隨時間的走向。但很直接的是，考量到我們的可轉債（converts），我們的現金利息成本相當低。所以你基本上可以看資產負債表上的現金，乘上大約 4%，就大致能得到全年會落在的水準。同樣地，隨著利率變動，我們也會持續向各位更新。但這是另一種思考方式。

And then from an operating margin perspective, we gave the 2025 LRP. That's at 21%. Your point is valid. If you take a look at our guide this year at 20% and our gross margin of 63% to 64%, if we hold true to our 65% gross margin in 2025, which is absolutely our belief, you're already there at 21% of margin. So I absolutely understand the mathematics. It just means we're ahead. We're ahead of our LRP, but we're not necessarily willing to update it at this point. We'll come forward and we'll update it at some point in the future. But I think it's a good thing. We've done a lot of work around this, Joanne, around getting lean and making sure we drive leverage into the business. And the great news is we are ahead. And so that's a good spot to be in, and we'll continue to do so.

然後就營業利益率而言，我們給出的 2025 年 LRP 是 21%。你的觀點是合理的。如果你看我們今年指引為 20%，毛利率為 63% 到 64%，若我們在 2025 年維持 65% 的毛利率——這絕對是我們的信念——那麼你在數學上已經可以推到 21% 的利益率。所以我完全理解這個計算。這只是代表我們進度超前。我們確實領先於 LRP，但目前不一定願意更新它。我們會在未來某個時間點再提出更新。不過我認為這是好事。Joanne，我們在這方面做了很多工作，讓組織更精實並確保把槓桿效益導入業務。好消息是我們走在前面，這是個很好的位置，我們也會持續這麼做。

One other maybe caveat just I think it's important to note on the year, I think you asked the question a little bit about the year and why are we on the year, we're making some good investments this year in the organization. We're launching Stelo, and we talked about that being a significant investment in the business. We're certainly doing a lot of work around our sales force. And if you recall, a few years ago, we did some work around that, and we took a step back on margin. We're going to do all that and still step forward.

另外也許補充一點提醒，我覺得對今年很重要。我想你問的部分也與今年為何如此有關：我們今年正在對組織做一些不錯的投資。我們正在推出 Stelo，我們也談到這會是對業務的一項重大投資。我們也確實在銷售團隊方面做了很多工作。如果你還記得，幾年前我們也做過一些調整，當時在利益率上曾經退一步。這次我們會做所有這些，同時仍然向前邁進。

We're going to go direct in Japan this year. That's another thing that we're making an investment in. And then all the work Kevin referenced around the clinical work that we're doing around continuing to improve our product. We're going to make all those investments and still deliver an expansion of operating margins. So I think it just goes to show you, we're building the levers in here. But I think you can see that we're building and that you can rely on us longer term to continue to drive that through the business.

我們今年會在日本採取直營模式。這也是我們正在投入的一項投資。然後還有 Kevin 提到的所有臨床相關工作，我們持續進行以不斷改善產品。我們會做所有這些投資，同時仍然交出營業利益率擴張。我想這只是顯示我們正在建立這些槓桿。但我認為你也看得到我們正在建構，而且長期而言你可以信賴我們會持續把這些推動到業務之中。

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

接下來我們將請 Piper Sandler 的 Matthew O'Brien 提問。

Looking at the domestic performance, there's been a clear acceleration in the back half of '23 on a 2-year stacked basis. And I'm wondering specifically if that's just basal that's helping there. It looks like it's as much as 200, maybe 250 basis points of the acceleration. Is that the primary contributor to the domestic acceleration? What should we think about in terms of basal contribution to the topline this year? And are we inflecting right now as far as basal adoption goes with CGM here in the States?

看國內市場表現，以兩年疊加（2-year stacked）的基礎來看，23 年下半年有明顯加速。我想特別問的是，這是否只是 basal（基礎胰島素）在推動？看起來加速幅度可能有 200、甚至 250 個基點。basal 是否是國內加速的主要貢獻者？今年 basal 對營收（topline）的貢獻應該如何看？以及就美國這邊的 CGM 而言，basal 的採用是否正在出現拐點？

Yes. It's a good question. Let me maybe just give some color as to how we're thinking about the guidance. As you see the performance in the back half of the year, a lot of that has to do with being the most accurate sensor, launching with the G7 form factor and then, of course, having the basal coverage there. And so when you think about it, and you can see the share taking when you look at the script data, we are taking share. And having the sensor -- the most advanced sensor on the market is the driver there. So that's taking share.

是的，這是個好問題。我先補充一些我們如何思考指引的背景。你看到下半年表現，其中很大一部分與我們是最準確的感測器、以 G7 的外形規格（form factor）推出，以及當然也包括 basal 的給付覆蓋有關。所以當你這樣思考，並且從處方資料（script data）看市占變化，你會看到我們正在取得市占。我們擁有市場上最先進的感測器是主要驅動因素，因此帶動我們取得市占。

Now within those spaces, basal is a contributor, no question. As that category expands and we take share within that category, that does contribute to the overall numbers. And so you are right, basal is a contributor, but it has as much to do with us taking share as it does with category expansion. So think about both of those as contributors.

而在這些領域中，basal 的確是貢獻者，毫無疑問。隨著該類別擴大、以及我們在該類別中取得市占，確實會對整體數字有所貢獻。所以你說得對，basal 是貢獻者，但它的影響同時來自我們取得市占，以及類別本身的擴張。請把這兩者都視為貢獻因素。

As you think about 2024, we've talked a little bit about the adoption rate, basal in total adopting in this back half of the year around 9% to 10% per year on a per annum basis. The guide assumes about 8% there. And so I think you can assume that was the case. Our long-range plan was more like 6% to 7% per year. So we are seeing basal going faster than what was in our long-range plan. And what's great about that is as we continue to take share and the category grows a little faster than expected, that will help contribute over the longer haul.

談到 2024 年，我們先前稍微提過採用率：今年下半年 basal 整體的採用大約以每年 9% 到 10% 的年化速度成長。我們的指引假設大約是 8%。所以你可以把它視為我們的假設。我們的長期計畫原本比較像是每年 6% 到 7%。因此我們確實看到 basal 的成長速度快於長期計畫中的假設。這很棒，因為當我們持續取得市占、且類別成長比預期更快一些時，長期而言將有助於貢獻成長。

So hopefully, that gives you some context to how we're seeing basal. It absolutely is a contributor. I don't want to overstate the fact though that -- basal because, quite frankly, our intensive insulin businesses continue to do really, really well, and you see us taking share there as well.

希望這能讓你更了解我們如何看待 basal。它絕對是貢獻者。不過我也不想過度強調——basal，因為坦白說，我們的強化胰島素（intensive insulin）業務仍然表現非常、非常好，你也看到我們在那裡同樣在取得市占。

I'd just add to Jereme's comments, Matt. If you look at the second half of the year, that's when G7 rolled out. There is a direct correlation to G7 launching and the acceleration of our growth. It really was an important event. And the other thing that -- just as a consequence of what you saw, again, this supports what we're doing in the U.S. with respect to our field sales expansion.

我再補充 Jereme 對你問題的回應，Matt。如果你看下半年，那正是 G7 推出的時間點。G7 上市與我們成長加速之間有直接的關聯，這確實是一個重要事件。還有另一點——作為你所看到結果的延伸，這也支持我們在美國針對外勤銷售擴張所做的事情。

We do need to spend more time with physicians who aren't as familiar with our technology as they would have been in the past. And as I said on the call earlier, where we call on somebody, we win. We do very well. So we need more calls. We needed more feet on the street and more voice, given the acceleration that we saw and the good things that we saw happen over the second half of the year. So it all flows together nicely.

我們確實需要花更多時間與那些不像過去那樣熟悉我們技術的醫師交流。正如我先前在電話會議上所說，我們只要去拜訪某個對象，就能拿下，我們表現得非常好。所以我們需要更多拜訪。我們需要更多外勤人員、更多聲量，因為我們看到加速的趨勢，以及下半年發生的那些正向進展。因此這一切都能很順暢地串在一起。

We'll take our next question from Margaret Andrew with William Blair.

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

I wanted to maybe spin back to non-insulin. When we kind of run our market models, non-insulin adoption seems to have meaningfully increased, probably for you as well as certainly for the market the last couple of years. And again, our numbers probably aren't perfect, but maybe the market's not at 1 million users in the U.S. Could get there this year, and that's a pretty sizable amount.

我想把話題拉回到非胰島素族群。當我們跑市場模型時，非胰島素的採用率在過去幾年似乎顯著提升，對你們而言可能也是如此，當然對整體市場更是如此。而且我們的數字可能不完美，但美國市場的使用者可能還沒到 100 萬人，今年有機會達到，而那是相當可觀的規模。

So I guess, one, are these meaningful patient adds to Dexcom already in 2023? And what drove that? And going back to the Stelo guidance of $40 million per year, we can obviously throw some assumptions around ASPs or patient adds, but regardless of what those inputs can be, it pretty quickly gets you to $200 million plus sales in 2025, which is a pretty meaningful chunk of the chain. So I guess -- is that correct? Why could it be right or wrong? And how much of that could be incremental to the initial LRP that you provided in '23?

所以我想問，第一，這些是否已在 2023 年為 Dexcom 帶來有意義的新增病患？是什麼驅動的？另外回到 Stelo 每年 4,000 萬美元的指引，我們當然可以對 ASP 或新增病患數做一些假設，但不管這些輸入值如何，很快就會推導出 2025 年超過 2 億美元的銷售額，這在整個版圖中是相當有意義的一塊。所以我想問——這樣的推論正確嗎？為什麼可能對或不對？以及其中有多少可能相對於你們在 2023 年提供的初始 LRP 屬於增量？

Jereme can probably get into more detail than me. It is a part of our business today, Margaret. We do have some non-insulin users for our product. We have some plans that actually cover non-insulin users for CGM. And we've seen -- had wonderful experiences there. We also have not an aggressive cash pay program, but a cash pay program nonetheless, where non-insulin users have access to our product through some very traditional distribution channels outside the pharmacy and outside traditional DME. So some of those individuals have purchased CGM and use it on the non-insulin front as well, and we continue to support programs. But it is not a remarkable chunk of our business. It has not been a tremendous driver of our growth. It has grown, but it hasn't been a significant percentage.

Jereme 可能可以比我更深入說明。Margaret，這確實是我們目前業務的一部分。我們的產品確實有一些非胰島素使用者。我們也有一些保險方案實際上會為非胰島素使用者的 CGM 提供給付，而我們在那方面的經驗非常好。我們也有一個現金自費方案，雖然不是很激進，但確實存在；非胰島素使用者可以透過一些非常傳統的通路取得我們的產品，這些通路不在藥局，也不在傳統 DME 之外。因此其中一些人購買了 CGM，並在非胰島素情境下使用，我們也持續支持相關方案。但這並不是我們業務中很顯著的一塊，並未成為我們成長的主要驅動力。它有成長，但占比並不高。

As we look going forward, certainly, again, we gave guidance of 1% for 2024, and we're committed to that. And that certainly is our forecast and what we've guided. We're most committed to learning because what we're really interested is a number like $200 million, like you're talking about for 2025, and to be positioned with the right product there.

展望未來，當然我們對 2024 年給出的指引是 1%，我們也會遵守這個承諾。那確實是我們的預測與我們所做的指引。我們最投入的是學習，因為我們真正感興趣的是你提到的那種數字，例如 2025 年 2 億美元，並且要以正確的產品定位來因應。

With respect to pricing and how to launch that product, we're going to have tremendous flexibility as this is a cash pay program. And it's not labeled for the current population where we have reimbursement and where we're reimbursed for our products. So we believe we'll have, again, flexibility to grow that and grow it profitably. So again, we have a 15-day product going into that market. So we will have lower COGS. And we're developing a lot of things around that as it rolls out. As you see, we really are changing the business model to serve this type of individual versus those we've served up to this point in time. We're going to offer a different experience and we'll definitely meet their needs across the board. So we're bullish on it over time, and it could be a very big number in 2025. That's what we're planning on.

就定價以及如何推出該產品而言，由於這是一個現金自費方案，我們將擁有極大的彈性。而且它並不是針對我們目前有保險給付、且我們的產品可獲得報銷的既有族群所標示的適應症。因此我們相信，我們將再次擁有彈性去擴大規模，並以獲利的方式成長。另外，我們有一個 15 天產品要進入該市場，因此我們的 COGS 會更低。我們也正在圍繞它推出時的各項配套進行開發。如你所見，我們確實正在改變商業模式，以服務這類個體，而不是我們迄今為止所服務的族群。我們會提供不同的體驗，並且會在各方面滿足他們的需求。因此我們長期看多，到了 2025 年它可能會是一個非常大的數字，這也是我們的規劃方向。

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

我們的下一個問題來自 Raymond James 的 Jayson Bedford。

Just on gross margin, I think we came into last year thinking gross margin would be lower in the second half. It wasn't. I'm guessing revenue levels played a part there. But outside of price and mix, what weighs on gross margin in '24? And then just as a related question, you had some encouraging comments on Malaysia, and I think you alluded to it, but at what point do we see Malaysia and G7 starting to have a positive impact on gross margin?

關於毛利率，我記得我們去年進入年度時原本以為下半年毛利率會更低，但結果並沒有。我猜營收水準在其中扮演了一部分角色。但撇除價格與組合之外，2024 年有哪些因素會壓抑毛利率？另外一個相關問題，你們對馬來西亞有一些令人鼓舞的評論，我想你們也提到過，但我們何時會看到馬來西亞與 G7 開始對毛利率產生正面影響？

Jayson, thanks for the question. Last year when we made the assumption on what the margin looked like, the assumption was the G6 to G7 transition. We had a range of assumptions. But the assumption was the G6 to G7 transition would take place perhaps a little bit earlier. And some of that had to do with timing of when the AID systems were available in the market and coverage, and how that goes over time. And so it took a little bit longer. And as a result, we outperformed on margin and it gets back to G6 cost less to make than G7 today. And still a majority of our users, our legacy base still sit on the G6 system.

Jayson，謝謝你的問題。去年我們在做毛利率假設時，主要假設是 G6 轉換到 G7。我們有一個假設區間，但當時的假設是 G6 到 G7 的轉換可能會更早發生一些。其中一部分與 AID 系統何時在市場上可用、以及給付覆蓋情況與其隨時間推進的節奏有關。因此實際上花了更久。結果就是我們在毛利率上表現優於預期，原因回到一點：目前 G6 的製造成本比 G7 低。而且我們的大多數使用者、我們的既有用戶基礎仍然在使用 G6 系統。

With the launch of Tandem and Control-IQ integrated with G7 and obviously, the limited launch with Omnipod 5 coming out here in the back half of Q1, and then obviously, a launch sometime later in the year, we do believe that base starts to move over quicker. And so what you have there is, as that takes place, Jayson, you have that shift from a lower cost to a higher-cost product weighing in the start of the year. And hence, that's why the margin goes where it goes.

隨著 Tandem 與 Control-IQ 整合 G7 的推出，以及 Omnipod 5 在第一季後半段的有限度上市，然後在今年稍晚某個時間點全面上市，我們確實相信用戶基礎會更快轉移。因此當這個轉移發生時，Jayson，你會看到從低成本產品轉向高成本產品的結構性變化在年初對毛利率造成壓力，也因此毛利率會呈現那樣的走勢。

Now in the back half of the year, assuming that base transitions, and our models show that over the course of the year, that should, the equilibrium should balance then tilt in the favor of G7. It puts us in a position exiting the year where G7 should be, and we'll have to give you updates on the base as the year progresses, but it should be lower than G6, within at that point, it should be accretive. And that would be the exit rate leading out of '24 and then, of course, then bodes well as we move into 2025 and beyond.

而在下半年，假設用戶基礎完成轉換，我們的模型顯示在一年之中，均衡點應該會先達到，接著再朝對 G7 有利的方向傾斜。這會讓我們在年底時處於一個位置：G7 的成本應該會——我們會在年度進行中就用戶基礎提供更新——但到那個時間點，G7 的成本應該會低於 G6，屆時就應該會具備增益效果。這將成為 2024 年結束時的退出率（exit rate），當然也為我們邁向 2025 年及之後奠定良好基礎。

So that's the big driver. It's just when does that base transition. And when it does, when do we have that cost kind of equilibrium. So again, we thought it was going to happen in the back half of 2023. It didn't take place. We outperformed there in 2023 as a result. Probably going to take place here in the first half of 2024.

所以最大的驅動因素就是：用戶基礎何時完成轉換，以及轉換後何時能達到成本上的均衡。再說一次，我們原本以為這會在 2023 年下半年發生，但並沒有，因此我們在 2023 年的毛利率表現優於預期。這件事大概會在 2024 年上半年發生。

And we will take our next question from Bill Plovanic with Canaccord Genuity.

接下來我們的下一個問題來自 Canaccord Genuity 的 Bill Plovanic。

Congratulations on the quarter. Just kind of a follow-up. Just trying to get a color, granularity if possible. As you look at the growth in the business and kind of to Matt O'Brien's question, but the contribution from basal, hypo, intensive and type 1, just is it kind of shifting to that order these days where it's more of the basal and hypo and the intensive type 2 is really the new patient growth? And then if so, how should we think about that cadence as you continue to move forward?

恭喜本季表現。我想追問一下，若可以的話想更具體了解一些。當你們看業務成長——也呼應 Matt O'Brien 的問題——在 basal、hypo、intensive 與第 1 型的貢獻上，現在是否正逐漸轉變成這樣的排序：basal 和 hypo，以及強化治療的第 2 型，才是新增病患成長的主要來源？如果是的話，隨著你們持續往前推進，我們應該如何看待這個節奏？

Yes. I mean if you think about 2024 at least, 2024, the main contributor to new patients or at least revenue from new patients is still going to sit in the intensive insulin, so the type 1 and type 2 insulin-intensive patients. And that still is where the combination of those 2 makes up a majority of the new revenue over the course of the year.

是的。至少以 2024 年來看，新增病患（或至少新增病患帶來的營收）的主要貢獻者仍會來自強化胰島素治療族群，也就是第 1 型與第 2 型的胰島素強化治療病患。這兩者合計仍將在全年新增營收中占據大多數。

Basal is catching up, and basal is doing a nice job of catching up, but those in still part of our core business is still actually driving the underlying business. Now over time, we do expect basal, given it's a larger population, to do very, very well. We'll have to give you more of an update as we get into 2025 and beyond as we get closer to that.

Basal 正在追趕，而且追趕得不錯，但我們核心業務的一部分仍然在推動基本盤。隨著時間推進，我們確實預期 basal 由於族群更大，會表現得非常、非常好。我們會在接近 2025 年及之後、並更接近那個時間點時，再提供更多更新。

So incredibly bullish on the long-term opportunity there with basal. But think about at least 2024, our core business is actually still driving a lot of the growth with obviously longer-term opportunities in basal and then to your point, hypo, which is, quite frankly, still a low contributor, and then with Stelo kind of coming online as well. All of those are real opportunities in 2025 and beyond.

所以我們對 basal 的長期機會非常看多。但至少就 2024 年而言，我們的核心業務仍在推動相當多的成長；而更長期的機會則在 basal，以及你提到的 hypo——坦白說目前貢獻仍偏低——再加上 Stelo 也將開始上線。這些在 2025 年及之後都是真正的機會。

We will take our next question from Michael Polark with Wolfe Research.

我們接下來的問題來自 Wolfe Research 的 Michael Polark。

I want to ask a follow-up on, Kevin, your response to the prior question on 15-day and timing. I heard we won't provide a lot of color until we're filed and see a path to approval. There kind of had been -- it seems like there was a thought that Stelo was kind of the appetizer this year for 15-day and maybe a broader rollout in 2025. And I don't want to -- I'm not asking you to pin down timing, but is 2025 a year where a broader transition to 15-day could be affected? Or might all this testing and innovation take a little longer?

我想就先前關於 15 天與時程的問題，追問一下你剛才的回覆，Kevin。我聽到的是，在我們完成申報並看到獲准的路徑之前，我們不會提供太多細節。之前似乎有一種想法是，Stelo 今年有點像 15 天產品的「開胃菜」，並可能在 2025 年進行更廣泛的推廣。我不想——我不是要你釘死時程，但 2025 年是否可能會受到影響而讓更大範圍轉向 15 天？或者這些測試與創新可能需要更久？

We would like to go as fast as possible. If it were on my time frame, it would be yesterday. Stelo at 15 days is a primer for that so we can learn and gather data from those users as they use it, particularly with our current sensor configuration. As we go through the technology changes that we're making, as we dial in on those features that we're going to put in the final product, we'll get a pivotal trial started and we'll go, but we're learning each and every day.

我們希望能盡可能快。如果照我的時間表，那應該是昨天就完成。Stelo 的 15 天是為此做的前導，讓我們能在使用者使用時學習並蒐集資料，特別是在我們目前的感測器配置下。隨著我們推進正在進行的技術變更、並把要放進最終產品的功能逐一調校到位，我們會啟動關鍵性試驗並往前走，但我們每天都在學習。

We are not in a position like we were with G7, where we're submitting an entire new system with completely new hardware and new features and new manufacturing lines, new suppliers, new everything. This 15-day product, we built on the same platform our current G7 is built. So the time from finishing and pivotal to filing is not going to be near as intense and difficult as it was with the last product, things such as security and Bluetooth and stuff. We worked through all those issues already.

我們不像當初 G7 那樣，是在提交一整套全新系統，包含全新的硬體、新功能、新製造產線、新供應商、全新的所有東西。這個 15 天產品是建立在與目前 G7 相同的平台上。因此，從完成到關鍵性試驗再到申報的時間，不會像上一代產品那樣緊繃且困難，例如資安、藍牙等問題；那些我們都已經處理過了。

So right now, it's really refining the science and getting to 15 days and getting that reliability and quality level that our patients expect from us. We don't view this as an extremely -- I think '25 is a reasonable assumption, but I'm not going to give you an end date as to when because there's too many variables. But we're certainly headed down a path along that type of speed and then we'll see where we land and give you more updates along the way. I just -- filing things or starting things, what's important to us is getting things done. And those should be your milestones as well. So we'll keep you posted, but that's where we are.

所以目前真正的重點是把科學再精煉，達到 15 天，並達到病患對我們期待的可靠性與品質水準。我們不把這視為一個極端——我認為 2025 年是合理的假設，但我不會給你一個截止日期，因為變數太多。不過我們確實正沿著那樣的速度路徑前進，接著看最後落點在哪裡，並在過程中提供更多更新。我只是——對我們而言，申報或啟動固然重要，但更重要的是把事情做成。而那些也應該是你們的里程碑。我們會持續向各位更新，但目前就是這樣。

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

我們接下來的問題來自 Nephron 的 Chris Pasquale。

Congrats on the quarter. Wanted to ask a couple of questions about Dexcom ONE and the progress there. I think you had said you expected it to account for about 30% of international new patient starts in '23. Curious if that's where you ended up and what portion of new patient starts you expect it to be in '24?

恭喜本季表現。我想問幾個關於 Dexcom ONE 以及其進展的問題。我記得你們曾說，預期它在 2023 年美國以外的國際新病患啟用中約占 30%。想了解最後是否達到那個水準，以及你們預期它在 2024 年的新病患啟用中會占多少比例？

Sure, Chris. Thanks for the question. Yes, we did -- we thought it was going to be about 1/3 of patient starts in 2023 outside the U.S. It was closer to about 1/4 of new patient starts. So a little bit behind there. Some of the tenders took a little bit more time to get on and -- so it was still a really good year for us, but a little bit behind where we had started the year, at least on the expectations.

當然可以，Chris，謝謝你的問題。是的，我們當時認為 2023 年在美國以外的新病患啟用中大約會占 1/3。實際上更接近約 1/4，所以稍微落後一些。有些標案（tender）上線花了更長時間——因此對我們來說仍然是非常好的一年，但相較於年初的預期，確實略為落後。

This year, we expect it to be more and a bigger contributor as a percentage. So if you think about last year, that was certainly the case. That was on the G6 form factor. Very excited about, obviously, coming out here on the G7 form factor here in 2024 and the 4 countries that we already launched in. So our expectation is a bit bigger percentage. While we haven't necessarily given that number, expect it to be bigger and the team wants it to be bigger as a percentage of new patients outside the U.S. in 2024.

今年我們預期它的占比會更高、貢獻也會更大。回想去年，那是以 G6 的外形規格（form factor）推出的。今年 2024 年我們非常期待能以 G7 的外形規格推出，而且我們已經在 4 個國家上市。因此我們的預期是占比會更大。雖然我們未必已經給出具體數字，但請預期它在 2024 年美國以外新病患中的占比會更高，團隊也希望它的占比能更高。

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

我們接下來的問題來自 TD Cowen 的 Josh Jennings。

I was hoping to just ask a follow-up on the type 2 hypo non-insulin -- hypo indication that has coverage. We didn't think it would move as fast as type 2 basal. But I think you guys talked about a bigger patient opportunity in the U.S. than the type 2 basal patient opportunity. Anything that's been a bottleneck in terms of penetrating that indication? And just how do you see a deeper penetration going forward into '24, '25, '26 ?

我想追問一下第二型糖尿病低血糖、非胰島素使用者——也就是已獲給付的低血糖適應症。我們原本不認為它會像第二型基礎胰島素（basal）那樣進展得那麼快。但我記得你們談到，在美國這個族群的病患機會甚至比第二型 basal 的病患機會更大。在滲透這個適應症方面，有沒有什麼瓶頸？以及你們如何看待在 2024、2025、2026 年進一步提高滲透率？

Yes. Thanks, Josh. It's an area that, in all candor, it's gone. And we knew this is going to be a bit of a challenge. It's a big opportunity, but it's going to take a little bit more time on awareness and getting in front of the physicians and letting folks know that, hey, look, if you've had a hypo event, you do qualify. And by the way, here's how to document it.

是的，謝謝你，Josh。坦白說，這個領域的進展確實如此。我們也知道這會是一個比較具挑戰性的項目。機會很大，但在提升認知、接觸醫師並讓大家知道「嘿，如果你曾發生低血糖事件（hypo event），你是符合資格的」，以及「順帶一提，該如何做文件紀錄」等方面，需要多一點時間。

So it has been certainly slower than basal. It's not been a real all that material contributor in 2023. What we do know, however, is Teri, our Chief Commercial Officer, and her team are very, very focused in getting the word out. And making sure that folks understand if they are suffering with hypo events, this technology can help and it can help change that and that they do qualify and there is reimbursement out there. And so it's working on that messaging and making sure that we get out there and understand where those events are taking place. That is, believe it or not, it is a challenge in understanding how to identify when those have took place so that we can get out in front of those folks, but we are working on it. We have good data around that. And then making sure we're making those physicians that are then serving those patients aware of what the requirements are for documentation so that they can qualify for reimbursement.

所以它確實比 basal 慢。2023 年它並不是非常重大的貢獻來源。不過我們知道的是，Teri（我們的首席商務長）和她的團隊非常、非常專注於把訊息傳遞出去，並確保大家理解：如果他們正受低血糖事件所苦，這項技術能提供幫助、能帶來改變；他們確實符合資格，而且也有可用的給付。因此我們正在打磨這些訊息，並確保我們走出去、了解這些事件發生在哪裡。信不信由你，要理解並辨識這些事件何時發生，其實是個挑戰，因為我們必須先能辨識，才能更早接觸到這些人，但我們正在處理。我們也有不錯的相關數據。接著要確保為這些病患服務的醫師了解文件紀錄的要求，讓病患能符合給付資格。

So there's some work to be done, but there's a team working very, very intently on it and making sure that we do arm our sales force and then arm the community with the information needed to help it grow faster. I think it's a big opportunity for us, but I think it's an opportunity that's going to take a little bit longer to penetrate. So to your point, I think it's a driver -- it's a driver a little bit here in 2024, certainly an opportunity in 2024, but I think it's going to continue to slow roll. But over the longer haul, we do think this is a contributor over time that can be meaningful.

所以還有一些工作要做，但有一個團隊正非常、非常投入地推進，確保我們能為業務團隊、也為社群提供所需資訊，讓它能更快成長。我認為這對我們是很大的機會，但也會是一個需要更長時間才能滲透的機會。所以如你所說，我認為它在 2024 年會帶來一些驅動力——在 2024 年當然是個機會，但我認為它會持續以較慢的節奏推進。不過從更長期來看，我們確實認為這會是一個隨時間推移、可能變得相當有意義的貢獻來源。

I'd just add to that, it feeds to the sales force investment we're making in the space. We need to educate physicians and patients. And once you get a population of people who have positive outcomes in this space and they go back to their doctors and those conversations start taking place, this becomes easier. But there's a lot of seeding that we have to do to do it, and we needed more feet on the street to do that.

我再補充一點，這也回到我們在這個領域增加業務人力投資。我們需要教育醫師與病患。一旦在這個領域累積出一群有正向結果的人，他們回到醫師那裡、開始有這些對話之後，事情就會變得更容易。但我們必須先做很多「播種」工作，因此我們需要更多第一線人員來完成這件事。

And we will take our next question from Mike Kratky with Leerink Partners.

我們接下來的問題來自 Leerink Partners 的 Mike Kratky。

One clarifying one on basal. You've previously talked about framing the penetration within basal population relative to the trajectory you saw in insulin-intensive type 2 patients. How would you characterize that comparison based on where you are today and also as you're looking out over the next few years?

我想釐清一個關於 basal 的問題。你們先前談過，會把 basal 族群的滲透率，拿來對照你們在胰島素密集治療的第二型糖尿病患者中看到的滲透軌跡。以你們目前的進展，以及展望未來幾年，你會如何描述這個比較？

Sure. Yes. So in our long-term guide, we had talked about basal effectively being about 6 to 7 points of adoption as a percentage of the total population here in the U.S. And I'll start with the U.S. because internationally, there's a coverage. As we work through coverage there, there's opportunities. But we had talked about that in our 2025 LRP.

當然可以。是的，在我們的長期指引中，我們談到 basal 在美國的採用率，大致相當於整體人口的約 6 到 7 個百分點。我先從美國談起，因為在國際市場方面，牽涉到給付覆蓋；當我們逐步推進那邊的給付覆蓋時，會有機會。我們在 2025 年的 LRP 中提到過這點。

In our first couple of quarters, we saw it mirror that, to your question -- to your point, I should say, that it was mirroring the type 2 intensive, which was about a 9% to 10% penetration rate. Our guide, at least for 2024, assumes the middle between those 2, 8%. We've got a couple of quarters under our belt. It's very, very positive, but we also want to make sure we're prudent when it comes to guidance. And so that's why we've assumed about an 8% penetration rate over the course of 2024.

在最初幾個季度，我們看到它如你所說——應該說，如你指出的——它的走勢與第二型胰島素密集治療族群相似，後者的滲透率大約是 9% 到 10%。而我們的指引，至少對 2024 年而言，是假設介於這兩者之間的中間值，也就是 8%。我們已經累積了幾個季度的經驗，表現非常、非常正面，但我們也希望在提供指引時保持審慎。因此我們才會假設 2024 年全年約 8% 的滲透率。

Obviously, if it mirrors that which we saw in the back half of 2023, there's opportunities to outperform. And clearly, we're tracking ahead of our LRP, which I think is both positive signals, I think, for the business in total. But again, our guidance has been 8% as a percent of penetration. Hopefully, that helps you.

顯然，如果它重現我們在 2023 年下半年所看到的情況，就有機會跑贏表現。而且很明顯，我們目前的進度領先於我們的 LRP，我認為這對整體業務而言都是正面的訊號。不過再次強調，我們的指引是以滲透率百分比計為 8%。希望這能對你有所幫助。

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

我們的下一個問題將由 Oppenheimer 的 Steve Lichtman 提出。

Kevin, you mentioned to an earlier question, different business models for Stelo. How should we think what the go-to-market could look like? Does it have a Dexcom ONE more direct-to-patient feel? And do you need to make any significant investments in back-office support as the denominator really expands as you go after this large non-insulin group?

Kevin，你在先前的問題中提到 Stelo 會有不同的商業模式。我們應該如何看待其上市策略（go-to-market）可能會是什麼樣子？它是否更像 Dexcom ONE 那種更直接面向病患（direct-to-patient）的方式？而且當你們鎖定這個龐大的非胰島素族群、分母大幅擴張時，是否需要在後台支援方面做任何重大投資？

That's a great question, and that is a very pertinent topic of discussion and meeting here within the walls of our company. We are very much evaluating very efficient ways to serve such a large patient group and a patient group that may interact differently with us than those who've been on insulin over time as we build those models out.

這是個很好的問題，而且也是我們公司內部在這裡非常切題、正在討論與開會的主題。我們正在積極評估以非常高效率的方式來服務這麼龐大的病患族群；而且隨著我們建立這些模式，這個族群與我們互動的方式，可能也會不同於那些長期使用胰島素的族群。

So we are looking at distribution models that appear different than what we are doing today so we can most efficiently get that product to people. And again, starting with cash pay, gives us some opportunities to do things a little different than we've done in the past. And so you'll have to stay tuned for that. It's a very thoughtful question and very much in line with everything that's going on here every day.

因此，我們正在研究看起來會不同於我們目前做法的通路/配送模式，以便能最有效率地把產品送到人們手中。而且再次強調，從自費（cash pay）開始，讓我們有一些機會以不同於過去的方式來做一些事情。所以你們還得持續關注。這是個非常周到的問題，也非常符合我們每天在這裡所進行的一切。

We will take our final question from Matt Miksic with Barclays.

我們將接受最後一個問題，由 Barclays 的 Matt Miksic 提出。

So one follow-up on margins and kind of mix as you drive G7 to be a bigger part of your business. You mentioned before, and I think we understand the ramping G7 volumes, improving gross margin and profitability of that product line over time. And just wondering if you could share maybe how we should think about the long term? Like in other words, G7 is more profitable now. Do you have a G6 more profitable now rather just the maturity of those lines? Does G7 exceed that? Does Stelo trail G7? Does Dexcom ONE with G7 kind of trail that? Maybe just some sense directionally of where those are headed over the intermediate and long term would be super helpful as you drive these volumes up.

那我就毛利率以及在你們推動 G7 成為業務更大部分時的產品組合再追問一下。你之前提到過，我想我們也理解，隨著 G7 出貨量爬坡，該產品線的毛利率與獲利能力會隨時間改善。我想請你分享一下我們應該如何看待長期走向？換句話說，G7 現在更賺錢嗎？G6 現在是否反而更賺錢，僅僅因為產品線更成熟？G7 會超過它嗎？Stelo 會落後於 G7 嗎？搭配 G7 的 Dexcom ONE 會不會也落後於它？如果你能就中期與長期這些產品大致的方向提供一些概念，當你們把量拉上去時，會非常有幫助。

Yes. So maybe what I'll talk about is how we're thinking about the cost of the product. And then I think from there, we can kind of make some calls on how we think about margin from that perspective. And I'll maybe comment a little bit on the service model, which I think is also important because that will help from the operating margin.

好的。所以我可能先談談我們如何看待產品成本。然後我想從那裡出發，我們就可以從那個角度對毛利率做一些判斷。我也會稍微評論一下服務模式，我認為這也很重要，因為它會影響營業利益率。

So as you think about the G7, just the product itself, as of today, it costs more than G6. And so that will eventually, we expect over the course of this year, flip. And as you kind of get your models kind of bent out or kind of laid out, we expect to get down to a $10 sensor, irrespective of whether it's 10 or 15 days, as we exit the 2025 LRP into early 2026. So that gives you some kind of feel for where we'll get to the cost of each sensor.

所以談到 G7，就產品本身而言，截至今天，它的成本高於 G6。因此我們預期在今年的過程中，這個情況最終會反轉。而且當你把各種模型調整到位或把它們鋪陳好之後，隨著我們在 2025 年 LRP 結束、進入 2026 年初，我們預期可以把感測器成本降到 10 美元，不論是 10 天或 15 天。這能讓你大致感受到我們將把每個感測器的成本降到什麼水準。

Now each sensor, the hardware is about the same cost, whether it's Stelo, whether it's Dexcom ONE or whether it's the G-Series. It's the support models, the software, the support, the R&D, the investment in it and then, of course, the service models that ultimately then change it. And so as you think about all of the work that we put into the G-Series, the G-Series will have the highest reimbursement, but it will also have the highest service model and then the most investment in software and otherwise. Dexcom ONE is a little bit more of a different service model. And thus, we are able to reduce the burden associated with some of the warranty and then the support costs that play into that. And then Stelo is in a 15-day form factor. And so that's helpful from a gross margin perspective as you think through that over time.

現在，每個感測器的硬體成本大致相同，不論是 Stelo、不論是 Dexcom ONE，或是不論是 G 系列。真正造成差異的是支援模式、軟體、支援、研發、相關投資，當然還有最終的服務模式，這些才會改變整體成本結構。因此，當你想到我們投入在 G 系列上的所有工作時，G 系列會有最高的給付/報銷（reimbursement），但同時也會有最高的服務模式成本，以及在軟體等方面最多的投資。Dexcom ONE 的服務模式則有些不同，因此我們能降低與部分保固以及支援成本相關的負擔。而 Stelo 是 15 天的產品規格（form factor），因此從毛利率角度來看，隨著時間推進，這會有所幫助。

So I think that's the way to think about the cost profile. We haven't launched the price of Stelo at this point, so we can't necessarily give you the specific margin at this point. Otherwise, maybe pretty obvious how we're thinking about it. But over time, as that comes out, I think it will help align the models. And I think there's real opportunities here as you think about a 15-day -- a 15-day product, starting with Stelo. But as that then makes its way through Dexcom ONE and the G-Series over time, again, more levers there where there are some real opportunities in those product lines to continue to drive profitability.

所以我認為這就是看待成本輪廓的方式。我們目前尚未公布 Stelo 的定價，因此此刻我們不一定能提供具體的毛利率。除此之外，我們的思考方式可能相當明顯。但隨著時間推進、當它推出之後，我認為這將有助於讓各種模式更一致。而且當你想到 15 天——以 Stelo 作為起點的 15 天產品時，這裡確實有很大的機會。但當它隨時間推進，逐步延伸到 Dexcom ONE 與 G 系列時，同樣會有更多槓桿，讓這些產品線在持續推動獲利能力方面出現一些真正的機會。

So I think there's levers across all of these. I hope that gives you some context. I realize I'm not giving you a P&L for each one of them, but at least it gives you some context at the hardware costs and we differentiate on the OpEx cost and service models and then, of course, the days of wearing each one.

所以我認為在所有這些產品上都有槓桿。我希望這能提供一些背景。我知道我沒有為每一個產品提供各自的損益表（P&L），但至少能讓你了解硬體成本的情況；而我們的差異化主要在營運費用（OpEx）成本與服務模式，當然還包括各產品的配戴天數。

And ladies and gentlemen, at this time, I would like to turn the call back to Mr. Kevin Sayer for closing remarks.

各位女士、先生，現在我想把電話會議交回給 Kevin Sayer 先生作結語。

Thank you very much. It's very easy during these earnings calls to talk about percentages and margins and future technologies, financial guidance, competitors, a whole host of important and engaging topics. But as we wrap up today, I really want to focus on 2023, which is truly the most remarkable year in our history. Let's review these numbers again, $700 million in organic revenue growth, more than $1 billion in EBITDA, 600,000 new customers in our active user base, standing up a plant in Asia without missing a beat and, of course, launching our G7 product all over the world. While best-in-class technology is foundational and fundamental to these types of accomplishment, it doesn't happen without exceptional people going above and beyond. So as we close out 2023, I want to thank our -- I guess we are, we're now more than 10,000 Dexcom employees around the world, incredibly well done. Thanks, everybody.

非常感謝。在這些法說會中，很容易去談百分比、毛利率、未來技術、財務指引、競爭對手，以及一大堆重要且引人入勝的主題。但在今天結束之前，我真的想把焦點放在 2023 年——這確實是我們歷史上最非凡的一年。讓我們再回顧一次這些數字：有機營收成長 7 億美元、EBITDA 超過 10 億美元、活躍用戶基礎新增 60 萬名客戶、在亞洲建立一座工廠且全程不失速，當然還有在全球各地推出我們的 G7 產品。雖然同級最佳的技術是這些成就的基礎與根本，但若沒有卓越的人才超越本分地付出，這些都不可能發生。因此，在 2023 年結束之際，我要感謝我們——我想我們現在在全球已經超過 10,000 名 Dexcom 員工，做得非常非常好。謝謝大家。

Ladies and gentlemen, this concludes today's call. We thank you for your participation. You may now disconnect.

各位女士、先生，今天的電話會議到此結束。感謝各位的參與。您現在可以掛線。