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.

女士們、先生們，歡迎參加 DexCom 第四季和 2023 財年財報電話會議。我叫艾比，我是今天電話的接線生。 （操作員說明）謹此提醒，會議正在錄製中。

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

我現在將把電話轉給財務和投資者關係副總裁 Sean Christensen。你可以開始了。

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

謝謝艾比，歡迎參加 DexCom 第四季和 2023 財年財報電話會議。

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.

我們的議程由 DexCom 董事長、總裁兼執行長 Kevin Sayer 開始，他將總結我們最近的亮點和正在進行的策略舉措，然後由我們的財務長 Jereme Sylvain 進行財務回顧和展望。在我們準備好的發言之後，我們將開始徵集您的問題。到時候，我們要求分析師只問一個問題，這樣我們就可以為今天參與的每個人提供一個機會。請注意，DexCom 投資者關係網站的活動和簡報頁面上也提供了與我們第四季和 2023 財年業績相關的幻燈片。

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，讓我們回顧一下我們的安全港聲明。我們將在今天的電話會議中發表的一些聲明可能構成前瞻性聲明。這些陳述反映了管理層對未來事件、策略、競爭、產品、營運計劃和績效的意圖、信念和期望。本簡報中包含的所有前瞻性陳述均根據DexCom 目前掌握的資訊在本新聞稿發布之日作出，受到各種風險和不確定性的影響，實際結果可能與前瞻性陳述中的預期存在重大差異。

The factors that could cause actual results to differ materially from those expressed or implied by any of these forward-looking statements are detailed in DexCom's annual report on Form 10-K, 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這些前瞻性陳述明示或暗示的結果有重大差異的因素詳見 DexCom 表格 10-K 年度報告、最新表格 10-Q 季度報告以及其他向證券公司提交的文件和交易委員會。除法律要求外，我們不承擔在本簡報發布之日後更新任何此類前瞻性陳述或使這些前瞻性陳述與實際結果保持一致的義務。

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，在電話會議期間，我們將討論某些未依照公認會計準則（GAAP）制定的財務指標，涉及我們的非公認會計準則和現金績效。除非另有說明，所有對財務指標的引用均以非公認會計原則為基礎。不應孤立地考慮此附加資訊的呈現，也不應將其視為結果的替代品或優於根據 GAAP 準備的結果。請參閱我們的收益發布中的表格以及第四季度和財年收益演示中的幻燈片，以了解這些指標與其最直接可比較的公認會計準則財務指標的對帳情況。

Now I will turn it over to Kevin.

現在我將把它交給凱文。

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

謝謝肖恩，也謝謝大家加入我們。

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.

2023 年對 DexCom 來說是令人難以置信的一年，我想先回顧一下我們的一些主要成就。在新客戶開工率又創歷史新高的推動下，總收入有機成長了 24%。與去年相比，這意味著我們的有機收入成長超過 7 億美元，因為我們透過最近的覆蓋範圍擴大和 DexCom 的 CGM 系統的性能建立了強勁的商業勢頭。

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，我們的 DexCom 用戶群增加了超過 60 萬名，到年底全球客戶數量約 230 萬人。重要的是，我們再次實現了這種成長水平，同時提高了營運規模和效率。這裡的一個重要里程碑是我們的馬來西亞製造工廠在年中左右開業。該工廠的產量正在迅速增加，該團隊的產量已經與我們更成熟的美國工廠相當。該設施將有助於支持我們未來幾年的成長和成本目標。

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.

作為衡量我們在2023 年取得成功的標準，我們不僅在第四季度實現了10 億美元的收入，還實現了當年10 億美元的調整後EBITDA，並創造了創紀錄的自由現金流水平，與2022年相比成長了近70%。我們建立了一種提前幾年關注的嚴格成本文化，在利潤成長方面取得了適當的平衡，同時仍對支持我們重大成長機會的途徑進行策略性投資。

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 年將成為我們公司歷史上最具變革性的年份之一。我們向多個新市場推出了 G7 和 Dexcom ONE，顯著擴大了我們的全球覆蓋範圍，並推進了關鍵技術和臨床工作，這將為 DexCom 的未來奠定基礎。這一切始於 2 月 G7 在美國的推出。 G7 是迄今為止推出的最準確的 CGM，市場對 G7 的反應非常好。客戶和臨床醫生對新的外形尺寸、產品性能和易用性感到非常興奮，付款人也認識到 G7 提供的明確價值主張，因此立即建立了承保範圍。

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.

該產品上市後，我們立即開始看到處方模式發生了變化。當我們完成公司史上最大規模的覆蓋範圍擴展時，這種趨勢變得更加明顯。 4 月中旬，醫療保險覆蓋範圍涵蓋僅使用基礎胰島素的 2 型糖尿病患者，以及某些有低血糖風險的不使用胰島素的個人。透過這項決定以及隨後迅速對基礎市場進行的廣泛商業覆蓋，我們實際上使美國的報銷人口增加了一倍。這徹底改變了美國的市場格局。

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. 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.

憑藉更廣泛的覆蓋範圍和大大簡化處方流程的新產品，我們吸引了大量新的臨床醫生加入我們的生態系統。事實上，到 2023 年，我們的處方醫生基礎擴大了約 40%，我們不會就此止步。我們一直都知道，隨著我們業務的發展，初級保健管道將變得越來越重要。我們的商業團隊近年來所做的大部分工作都是針對這個市場量身定制的。我們現在看到了這項努力的直接結果，因為我們 70% 以上的新劇本是由初級保健醫生編寫的。這些關係不僅對於幫助我們涵蓋數百萬尚未開始 CGM 的胰島素使用者至關重要，而且對於幫助數千萬患有更廣泛的 2 型糖尿病、糖尿病前期及其他疾病的人也至關重要。

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 年取得的成功以及這些未來機會的巨大程度，我們很高興今年繼續對美國銷售團隊進行投資。當我們與處方者合作時，我們就贏了。現在我們需要繼續擴大處方者群體。

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.

我們已經看到越來越多的臨床醫生希望儘早將 Dexcom CGM 納入患者的護理計劃，因為他們認識到我們在推動行為改變、可持續結果和更大責任方面的獨特能力。這就是為什麼我們很高興在今年夏天晚些時候推出我們的最​​新產品 Stelo。 Stelo 將是第一個專門為不使用胰島素的 2 型糖尿病患者設計的 CGM。利用我們領先的感測器平台，我們建立了適合該族群需求的客製化軟體體驗。

Stelo will feature a 15-day wear time and launches 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 將具有 15 天的佩戴時間，並推出現金支付產品，同時我們與付款人一起建立更廣泛的覆蓋範圍。目前正在進行多項試驗，我們將繼續添加越來越多的證據，證明 DexCom 具有為所有糖尿病患者帶來更大健康和經濟成果的獨特能力。 Stelo 的推出也提供了一個很好的機會，讓我們可以透過大量的真實世界數據來支持我們的證據，因為我們看到了產品對我們客戶的影響。我們在 2023 年第四季向 FDA 提交了 Stelo 申請，這使我們預計將在今年夏天備受期待的上市。

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不斷成長，我們可以更深入地了解我們公司的未來潛力。我們建立了一個可以客製化的平台技術，為不同人群提供創意的解決方案。我們重新設計的軟體基礎設施是其中的關鍵組成部分，因為它可以實現更快的迭代和更好的連接性。

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.

連接性一直是 DexCom 的獨特優勢。隨著我們最近向 FDA 提交的直接觀看申請和新的 G7 泵集成，我們正在進一步提升這一領導地位。我們也將繼續創新我們的硬體技術，目前我們的重點是在我們所有的產品中推出長期磨損感測器。

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.

當我們看到擺在我們面前的重大機會時，我們一如既往地興奮不已。正如我在去年夏天的投資者日上所說，我們才剛開始。

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

現在，我將把它交給傑里姆，以審查第四季度的財務狀況。傑雷姆？

Thank you, Kevin.

謝謝你，凱文。

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.

提醒一下，除非另有說明，今天提出的財務指標將在非公認會計原則的基礎上進行討論。您可以在今天的收益報告以及我們的投資者關係網站上找到 GAAP 的調整表。

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 年第四季度，我們報告的全球收入為 10.35 億美元，而 2022 年第四季為 8.15 億美元，報告成長 27%，有機成長 26%。提醒一下，我們對有機收入的定義不包括貨幣以及過去 12 個月內獲得或剝離的非 CGM 收入。

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.

美國第四季營收總額為 7.69 億美元，而 2022 年第四季為 6.06 億美元，成長 27%。在 G7 的持續成功和近幾個月我們顯著改善的准入條件下，我們美國業務的勢頭持續增長。事實上，隨著我們的營收連續第三季加速，我們在美國實現了自 2021 年初以來最快的季度成長率。

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.

第四季國際營收成長 27%，總計 2.65 億美元。第四季國際有機收入成長 23%。我們在國際業務中繼續表現出色，並在第四季度再次佔據份額，因為我們的全球訪問工作和產品組合策略幫助擴大了我們在許多市場的影響力。

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.

我們第四季的毛利為6.64 億美元，佔營收的64.2%，而2022 年第四季佔營收的66.7%。毛利率年減是預料之中的，因為G7 在我們產品中所佔的比例要大得多，而且與一年前相比，第四季度的客戶結構。提醒一下，目前 G7 的成本狀況比 G6 更高，但我們預計隨著 G7 生產線銷量的增加，這種情況將在未來幾季發生變化。隨著規模的擴大，我們繼續預期 G7 的利潤狀況將優於 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 年第四季的營運費用為 4.21 億美元，而 2022 年第四季的營運費用為 3.72 億美元。本季再次證明了我們對支出嚴格遵守和深思熟慮的承諾。本季我們的營運費用成長率是營收成長率的一半，與去年相比，我們的營運費用槓桿率提高了近 500 個基點。這使得我們的營運支出槓桿率連續 8 個季度年增至少 250 個基點。

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. We remain in a great financial position, closing the year with greater than $2.7 billion of cash and cash equivalents.

2023 年第四季營業收入為2.427 億美元，佔營收的23.5%，而2022 年同期為1.721 億美元，佔營收的21.1%。調整後EBITDA 為3.215 億美元，佔營收的31.1%，而2022 年第四季的營業收入為 3.215 億美元，佔營收的 31.1%。2.371 億美元，佔 2022 年第四季營收的 29.1%。第三季淨利為 2.028 億美元，即每股 0.50 美元。我們的財務狀況依然良好，年底現金和現金等價物超過 27 億美元。

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 view 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.

擁有財務靈活性使組織能夠利用機會。舉個例子，我們執行了第三季業績中提到的 5 億美元加速股票回購計畫。透過這筆交易，我們能夠抵消與 2023 年到期轉換相關的剩餘稀釋，同時以我們認為具有吸引力的價格購買我們的股票。正如 Kevin 之前提到的，隨著我們的業務不斷擴大規模並提高效率，我們的自由現金流在 2023 年成長了 70%。隨著我們的現金流狀況持續成長，它只會增加我們顯著的財務靈活性。這使我們能夠繼續投資有意義的有機成長機會，同時持續評估資本的策略用途。

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.

轉向 2024 年指導。正如我們上個月所說，我們預計總收入將在 41.5 億美元至 43.5 億美元之間，全年有機成長 16% 至 21%。本指南假設美國 2 型基礎人群持續保持成長勢頭，G7 平台上的 Dexcom ONE 將擴展到新的地區，並於 2024 年夏季推出 Stelo。它還假設剝離我們的非糖尿病患者本季度澳大利亞和新西蘭的分銷業務，2023 年收入約3,000 萬美元。

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.

從利潤率角度來看，我們預計全年非 GAAP 毛利率將在 63% 至 64% 之間。營業利潤率約 20%，調整後 EBITDA 約 29%。我們的毛利率指引反映了我們客戶群中從 G6 到 G7 的持續轉變，以及該過程帶來的相關規模。在低於毛利率的情況下，我們將在 2024 年繼續非常勤奮地支出，同時對多種成長機會進行策略性投資。

With that, I will pass it back to Kevin.

這樣，我會將其傳回給凱文。

Thanks, Jereme.

謝謝，傑雷姆。

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

我現在想開啟問答環節。肖恩？

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，凱文。提醒一下，我們要求觀眾此時只提出一個問題，然後在必要時重新進入隊列。艾比，請提供問答說明。

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

（操作員說明）我們將回答摩根大通的 Robbie Marcus 提出的第一個問題。

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?

我將第二次祝賀這個季度的表現非常好。我想將兩個想法結合在一起。首先是我們在第四季看到的龐大營業利潤率，遠高於華爾街。在幻燈片簡報中，您可以看到有關 15 天感測器進展的幻燈片。這裡的問題實際上是，一，G 系列 15 天感測器何時獲得批准的時間範圍有任何更新嗎？如何真正思考這可以將您在這裡提出的良好營業利潤率、明年的指導目標以及未來真正可以帶到什麼地方？

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，羅比，這是凱文。我將採用 15 天的感測器計時，然後 Jereme 可以談論這些數字以及對未來營運利潤率的影響。

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.

正如我們今年稍早所說，我們正在對感測器的一些基本科學變化進行臨床測試和科學評估，這將使其在 15 天的時間內更加可靠。我們做得如此出色的原因之一是兩件事：我們的感測器的準確性以及感測器隨時間的推移的性能，但結合人們期望從感測器獲得一定天數的事實，我們提供了我們告訴他們我們要做的。我們希望確保 15 天的體驗與我們現在提供的 10 天的體驗一樣好。因此，我們正在科學基礎上做出一些細微的改變。我們將進行一項臨床研究，並將其歸檔，我們當然希望獲得批准。但目前，我們仍在評估一些技術。在我們提交之前​​，我們確實不會提供太多的信息，而且我們看到我們正在走向批准。

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。然後，對於您關於營業利潤率的長期問題，迄今為止，我們做得非常好，在我們的營業利潤率範圍內創造了槓桿和機會。儘管我們在營收方面做出了一些管道組合變化，但基於我們圍繞價值設計所做的大量工作以及許多我們已經能夠達到的規模。但是，當你考慮 15 天時，它為我們提供了一個真正的巨大機會，讓我們考慮毛利率和營業利潤率的槓桿作用，而且還提供了在可盈利領域發展業務的機會，這可能會有點10天的產品更具挑戰性。

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，這絕對是組織中正在進行的第一大努力。它確實為我們提供了很大的靈活性：a 繼續發展業務；或b，隨著時間的推移，實現世界一流的營業利潤。所以我認為從長遠來看，那裡有很多機會。我們還沒準備好具體說明那是什麼。我們顯然已經給了 2025 年 LRP。我們將執行這一點，但我確實認為這為該公司提供了真正的長期機會，可以回饋股東並利用全球機會。

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

我們將回答瑞銀集團的丹妮爾‧安塔菲 (Danielle Antalffy) 提出的下一個問題。

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?

祝賀今年取得了非常強勁的成績。很高興看到。我要問的問題是——我們聽到了更多關於市場上潛在競爭的消息。 Kevin，如果您能為我們強調一下 DexCom 建立的競爭護城河，我會很高興的。顯然，我們不太了解這個競爭對手計劃向市場推出什麼產品。那麼，也許您可以強調一下您認為 DexCom 從競爭角度來看處於什麼位置，以及您的份額在這方面的防禦力如何？

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. 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.

不，我很欣賞這個問題。首先也是最重要的，我們可以從核心技術和我們作為一家公司所擁有的基本信念開始。我們中心的表現是無與倫比的。例如，我們擁有超過 100 萬年的歷史，擁有取得了良好成果的 AID 系統以及表現出色的患者。我們的平台建立在連結性的基礎上。這是我與工程師討論過的功能之一，並且有些抱怨，因為它花了很多時間設計。我們最多可以同時連接 3 台設備。這是我們的競爭對手尚未在其平台中引入的連接類型，這對我們的患者來說非常重要。例如，這就是我們剛剛向 FDA 提交直接觀看功能的原因。

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.

今天，我們的競爭對手在看待我們時所考慮的另一件事是，他們認為這就是我們將要停留的地方。不是。當然，我們在技術方面、更好的連接通訊、軟體投資等各個方面都進行了新的努力。在過去的幾年裡，我們必須從一家真正的醫療設備軟體公司發展成為世界一流的軟體組織。這對我們來說是一個進步，也是一項巨大的投資。因此，我們研究了可以讓自己變得更強大的投資領域，並在那裡進行了投資。

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.

現在是技術方面。這是這個的另一部分。在過去的三年裡，我們花費了數億美元，在美國建立並運作了全自動工廠，並在馬來西亞開設了年中的新工廠，這是一個巨大的設施。但我們在那裡建造了這些自動化生產線，我們剛剛在愛爾蘭開工建設下一個世界級工廠，該工廠將於 2026 年開業。未來 CGM 業務需要投入巨額投資，特別是我們現在看到的規模和性能。我們已經進行了這些投資，做了這些事情，並作為一家公司不斷發展。

So we think we're very well positioned, and 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.

所以我們認為我們處於非常有利的位置，我們將看看其他人的表現。但我們很舒服。好吧，讓我再說一遍，我們從來都不舒服。但我們相信我們做了所有正確的事。

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

我們將回答富國銀行拉里·比格爾森 (Larry Biegelsen) 提出的下一個問題。

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?

我想專注於 Stelo。我認為，您預計該產品將為您 24 年的增長增加約 100 個基點，即 6 個月內幾乎達到 4000 萬美元。所以這對半年來說是一個相當健康的數字。凱文，是什麼讓您對這次發布充滿信心？隨著時間的推移，這個產品會有多大？利潤影響是什麼？

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.

拉里，謝謝你的提問。我們的指導價為 1%。此次發布的目的是將該產品發佈到這裡並進行學習。當我們看到這 1% 的收入數字時，我們當然有建構和支持這一數字的模型。我們相信，為 2 型非胰島素使用者和其他人設計這款產品，我們的目標是正確的細分市場。

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.

我們在 Stelo 方面最重要的經驗是學習和推廣它，並開始開發和發展這個新市場。我們相信，隨著時間的推移，該產品將成為我們業務中非常非常大的一部分，而這可能是我們市場中非常大的一部分。今年的發布主要是為了學習。我們有一個針對這 1% 的模型。我很想超越它。但如果我們吸取了所有需要學習的教訓，這也不會影響我們公司和我們的指導。因此，最重要的是讓產品上市並學到更多。

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. 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.

關於你關於利潤的問題，我們不一定是從毛利率的角度來談論它。拉里，當我們開始發布更多細節時，這就會及時到來。從營業利潤率來看，是的，這是我們要投資的東西。因此，當你從公司整體利潤率角度考慮時，當然，當我們對此進行投資並投資推出它時，將會有一些銷售和行銷，但這是我們今年要做的投資。我們將對這個產品進行投資，因為我們相信未來，而且我們將這樣做並且仍然擴大公司的營業利潤率。因此，您可以放心，我們將非常非常謹慎和衡量我們如何投資我們的資金，但要知道這是我們作為一個組織預留的投資的一部分，同時再次提高盈利能力。

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

我們將回答 Matthew Blackman 和 Stifel 提出的下一個問題。

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, anyway 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?

也許對於 Kevin 和 Jereme，您顯然提到了銷售團隊和 PCP 管道。您能否至少在今天提醒我們，您的 PCP 銷售人員涵蓋範圍是怎樣的？更重要的是，凱文，請聽聽您關於投資的評論，無論如何，今年要在該頻道中逐步增量？就支出規模、支出時間而言，這意味著什麼？您希望透過這些投資或任何其他方式來增加多少覆蓋範圍來實現您想要實現的目標？

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.

是的。謝謝你的提問，馬特。因此，當您考慮投資時，我們將擴大銷售團隊。今天，我們有大量的報導。這是數以萬計的初級保健醫生，並且主要是整個內分泌科醫生領域。但當你開始考慮擴大基礎覆蓋範圍時，我們面前的機會肯定是 Stelo 即將出現，我們發現有一個繼續擴大的機會。眾所周知，CGM，特別是 Dexcom CGM，可以在人們控製糖尿病方面發揮非常重要的作用。我們知道擁有這些呼叫點很有幫助。

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.

所以我們要擴大規模，你可以看看LinkedIn上的金額。就其大小而言，那裡還有很多空缺。因此，我們將擴大我們的銷售隊伍，我們將獲得更多的覆蓋範圍。

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 的推薦人現在就在那裡，所以你會看到我們在第一季進行招募。顯然，與這些代表相關的滿載負擔將在今年下半年發生，即第二季到第四季。這就是如何思考它的節奏。但同樣，這一切都在我們提供的整體指導中考慮到了，即 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.

因此，期望它成為我們圍繞在業務中創造槓桿並在我們需要的地方進行投資所做的典型工作的一部分。但如果你考慮的是全年的節奏，預計招募將在第一季進行。然後讓人們在今年的剩餘時間裡增加並成為我們第二季度運行率的一部分。

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

我們將接受 BTIG 的 Marie Thibault 提出的下一個問題。

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.

我想問一個關於國際的問題。我想您已經提醒我們，您將出售澳洲的非 CGM 業務，並直接進入日本。想要了解第一季與今年剩餘時間的節奏？另外，您對 Dexcom ONE 平台上的 G7 有何評論？這只是一個全面的國際問題。

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.

當然。謝謝，瑪麗。我們將為您提供一些背景資訊。因此，非 CGM 業務實際上已經消失了。這就是為什麼我們一直很樂意將其拿出來並與有機討論它。所以這個季度，你可以期待——我們去年談到了 300 萬美元左右。算起來，你可以按季度進行分配。到目前為止，大部分情況都已經解決了。

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 and 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.

所以想一想，在本季度，日本肯定也發生了類似的事情。我們在第四季度討論過它實際上為零。我預計第一季會有類似的貢獻。然後，當我們開始在第二季度開始處理該業務或該業務時，並期望它開始做出貢獻，因為我們在這一年中恢復了該業務。所以這些確實是國際性的時機。因此，就我們的過渡而言，第一季將是最重的負擔。

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 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.

由於它與 G7 上的 Dexcom ONE 有關，好消息是，我認為我們幾天前發布了它，4 個國家已經推出。這樣就出來了。今天它就在那裡。這四個國家是我們的首次嘗試，我們從這些國家的早期採用者那裡得到了很好的回饋。預計我們將在這一年以 G7 外形規格推出 Dexcom ONE。因此，我預計會有更多關於我們推出產品的地點和時間的新聞稿，但預計這種情況將在一年內真正發生，這讓我們再次對Dexcom ONE 的增長充滿信心，相信Dexcom ONE 的增長確實令人難以置信長期的司機。

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

我們將回答傑夫·約翰遜和貝爾德提出的下一個問題。

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?

也許只是把它放在國際點上。我認為這是一段時間以來我們第一次看到國際成長低於美國成長。如果我回顧過去幾個季度，我認為有機成長率已經達到了 40%、30%、23%。請協助我們了解 2024 年國際經濟成長與美國經濟成長可能會出現什麼情況？我們會期望它們彼此相似嗎？國際航班是否因任何原因繼續放緩？當我想到歐洲發生的一些競爭性援助批准時，尤其是你們的一個——具有競爭性的 CGM。您如何看待 AID 方面可能安裝的基礎的穩定性與新 AID 系統的獲勝率？

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 way 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.

謝謝，傑夫。當你想到節奏時－謝謝你提出關於國際比賽的問題。當你思考這一年的節奏時，第四季肯定是受到一些不同因素的推動——或者說，我想，我會說，是受到一些不同因素的推動。我們之前討論過一些關於日本業務的問題，實際上，當我們進行轉型時，收入實際上為零。因此，本季出現負成長。

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. 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.

然後非糖尿病業務真的很平淡。因此，當你想到該企業在歷史上是相當重要的成長者時，這些都會讓你失望。當你開始排除這些因素時，我們仍然成長得很好。事實上，我們今天經營的所有核心業務（英國、德國、澳洲等）在第二季、第三季和第四季之間都持續相對穩定地成長。只是有一些潮起潮落。但在大多數情況下，這些都應該表現良好。

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.

那你想一想這對未來意味著什麼？我們沒有改變我們的立場，即到 2025 年底，OUS 業務、國際業務佔收入的比例將比現在更大，約為 2/3、1/3，而今天的比例更像是 70 -30 或72- 28。因此，我認為總體而言，預計擁有所有機會的國際業務（當然還有我們今天的滲透率不足）在未來幾年的成長速度將超過美國業務。

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.

這並不是說我們不太看好美國業務。聽著，如果我們能在這兩方面都表現出色，我們就會在這兩方面都做工作。但至少我們的 LRP 中有這樣的內容。

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.

當您想到競爭性系統和援助時，我們對我們所提供的服務充滿信心。我們的產品，有許多不同的原因讓我們相信我們的產品在這個領域很特別。凱文之前提到過有關藍牙連接的一些內容。我只是給你舉個例子。人們可以在使用我們的產品時使用泵，可以與手機通話，也可以使用直接觀看的應用程式。沒有其他人可以提供這一點。我們是唯一能夠做到這一點的人。坦白說，當你想到這個人群時，他們確實需要並且值得獲得管理糖尿病的技術，我們相信這是一個差異化因素，而且是一個有意義的差異化因素。

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.

除此之外，我們在這些系統上進行了數百萬年的編譯，我們非常有信心，當我們坐在醫生面前時，我們坐在內分泌學家面前，我們坐在父母面前，對於需要援助系統的孩子，我們相信我們是您的選擇。我們將繼續戰鬥，並確保這一訊息繼續傳播出去。但當我們想到國際商業書籍時，我們仍然非常有信心，即使在推出競爭性系統後，我們也會在那裡做得非常好。

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

我們將回答馬特泰勒和傑弗里斯提出的下一個問題。

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?

我希望您能向我們介紹今年我們預計會看到的數據節奏，不僅是您之前提到的，可能來自您或研究人員的 GLP-1 數據。然後，在 Stelo 上，我們是否會在即將舉行的會議上看到任何相關內容，或者在發布之前、期間或之後從您那裡看到任何內容？

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，這是凱文。我會接受的。我們真的不需要 Stelo 的臨床試驗來獲得該產品的批准。有大量關於使用連續血糖監測的數據，特別是 2 型糖尿病領域的 DexCom 系統，研究人員將在接下來的幾個月內發布這些數據。我們將參考這一點，並與您討論這一點。

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 or 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——我們很清楚這些數據是從哪裡得出的，因為我們在所有研究中都看到患者有更好的結果或更健康。我們最終節省了系統資金。這些就是我們希望隨著時間的推移與 Stelo 一起實現的成果。再一次，關於 GLP-1，正在進行的研究非常多。有研究顯示 CGM 是一個要素。

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，我們希望這些研究在發表時能夠證明我們之前討論過的同樣的事情，即使用 CGM 和 GLP-1 比不使用 CGM 的研究能提供更好的結果。我們隨著時間的推移發表的那些研究，我們無法控制那些調查人員。但我們預計今年會有良好的數據。

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

我們將回答美國銀行 Travis Steed 的下一個問題。

I guess I wanted to understand a little bit more, Kevin, if you could give some more clarity on how you think of 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?

我想我想了解更多一點，凱文，你能否更清楚地說明你對 Stelo 未來幾年的報銷途徑的看法？您認為需要什麼才能為該產品開放報銷？如果以更傳統的方式進行報銷，您認為會是什麼樣子，或者您認為可以像 UnitedHealthcare 的 Levels 計劃那樣一次性完成？

Our goal is to do this in a more traditional -- for 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.

我們的目標是以更傳統的方式做到這一點——時間。正如我們之前所說，我們將推出現金支付產品，並提供現金支付選項，即人們可以進入並購買該產品的現金支付。我們將隨著時間的推移累積這些用戶的數據。我們將再次從我們看到的臨床試驗中累積數據，並最終為該產品建立報銷案例。

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.

我認為隨著時間的推移，我們當然希望參加CMS，並讓接受胰島素治療的2 型糖尿病患者在某個時間點得到該群體的承保，因為我們的目標是在醫療保健系統上花費更少的錢，我們是少數能夠實現這種性質的技術之一。因此，我們認為它更加傳統，並且隨著時間的推移與付款人和各個政府機構合作。

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 can be -- the partnerships and the relationships can be the only way.

我們將繼續支持這些計劃，我們很高興為他們提供支持並成為他們的合作夥伴。但我認為隨著時間的推移，我們需要有一個更傳統的報銷途徑。這可能是——夥伴關係和關係可能是唯一的途徑。

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.

最重要的是，我們將繼續圍繞 Stelo 開發我們的工具。我們推出的第一代將是我們的第一遍應用程式。在該產品的前 24 個月內，我們將進行多次迭代。它確實使它成為一個更具吸引力和吸引力的產品，並引導人們獲得更好的體驗。因此，請繼續關注我們在接下來的 12 個月內在這方面要說的內容。這將會非常令人興奮。

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

我們將回答花旗集團 Joanne Wuensch 的下一個問題。

Nice quarter. A couple of questions, two 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?

不錯的季度。幾個問題，兩個相關的問題。您能給我們一些稅收方面的指導以及如何考慮淨利息支出嗎？然後，讓我覺得更有趣的是，我認為你們的 LRP 是 21% 的營業利益率。這是您連續第二個季度超越該數字。那麼為什麼 21% 仍然是正確的數字呢？

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。那我們將從稅收開始。我認為今年，我們的比例下降到接近 26% 的範圍。雖然我們不一定逐年指導稅收，但目標是在未來 3 到 5 年內降至 20 左右。因此，我預計隨著我們制定的稅收結構的發展，它將每年繼續下降。

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.

就淨利息收入而言，其中一些——這是其中之一——有點困難，但只是考慮到利率隨著時間的推移而變化。但很簡單，考慮到我們的皈依者，我們的現金利息成本相當低。所以你基本上可以看一下資產負債表上的現金，將其乘以大約 4%。這會讓你了解這一年的情況。同樣，隨著利率隨時間的變化，我們必須及時向您通報最新情況。但這是另一種思考方式。

And then from an operating margin perspective, we gave the 2025 LRP. That's a 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 as we are ahead. And so that's a good spot to be in, and we'll continue to do so.

然後從營業利益率的角度來看，我們給了2025年的LRP。那是21%。你的觀點是有效的。如果你看我們今年的指南，毛利率為20%，毛利率為63% 至64%，如果我們堅持到2025 年毛利率為65%（這絕對是我們的信念），那麼你已經在21 歲了保證金的%。所以我完全理解數學。這只是意味著我們領先了。我們的 LRP 已經領先，但目前我們不一定願意更新它。我們會挺身而出，並在未來的某個時候更新它。但我認為這是一件好事。喬安妮，我們已經圍繞這個問題做了很多工作，圍繞著精益化並確保我們在業務中發揮槓桿作用。好消息是我們正在前進。所以這是一個很好的位置，我們將繼續這樣做。

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.

另外一個可能需要注意的是，我認為值得注意的年份很重要。我想你問了一些關於這一年的問題，以及為什麼我們會在這一年。今年我們對該組織進行了一些良好的投資。我們正在推出 Stelo，我們談到這是對該業務的一項重大投資。我們確實圍繞著我們的銷售隊伍做了很多工作。如果你還記得的話，幾年前，我們做了一些工作來解決這個問題，並且我們在保證金方面後退了一步。我們將做這一切，並繼續前進。

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.

今年我們將直接前往日本。這是我們正在投資的另一件事。然後凱文提到的所有圍繞臨床工作的工作都是我們圍繞繼續改進我們的產品所做的。我們將進行所有這些投資，並仍然實現營業利潤率的擴大。所以我認為這只是向您展示，我們正在這裡建立槓桿。但我認為您可以看到我們正在建設，並且您可以長期依賴我們繼續推動業務。

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

我們將回答馬修·奧布萊恩和派珀·桑德勒提出的下一個問題。

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?

從國內表現來看，23 年後半年以兩年為基礎，出現了明顯的加速。我特別想知道這是否只是基礎的幫助。看起來加速度高達 200、也許 250 個基點。這是國內加速的主要貢獻者嗎？就今年營收的基礎貢獻而言，我們該思考什麼？就美國 CGM 的基本採用而言，我們現在是否正在改變？

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 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。這是一個好問題。也許讓我簡單說明一下我們如何考慮該指南。正如您所看到的，今年下半年的表現，很大程度上與成為最準確的傳感器有關，以 G7 外形尺寸發布，當然還有基礎覆蓋範圍。因此，當您考慮一下時，您可以在查看腳本資料時看到所佔份額，我們正在獲取份額。擁有感測器——市場上最先進的感測器就是驅動器。這就是分享。

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.

現在，在這些空間中，毫無疑問，basal 是一個貢獻者。隨著該類別的擴大以及我們在該類別中佔據的份額，這確實對總數有所貢獻。所以你是對的，basal 是個貢獻者，但它與我們獲取份額的關係與品類擴張的關係同樣重要。因此，請將兩者視為貢獻者。

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.

當你想到 2024 年時，我們已經討論了一些關於整體採用率的問題，今年下半年的採用率每年約為 9% 至 10%。該指南假設該比例約為 8%。所以我認為你可以假設情況就是如此。我們的長期計劃更像是每年 6% 到 7%。因此，我們看到 basal 的進展速度比我們的長期計劃更快。最棒的是，隨著我們繼續佔據份額，並且該類別的成長速度比預期快一點，這將有助於做出長期貢獻。

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.

希望這能為您提供一些關於我們如何看待基礎的背景資訊。它絕對是一個貢獻者。我不想誇大這一事實，因為坦白說，我們的密集型胰島素業務繼續表現得非常非常好，而且您也看到我們在那裡佔據了份額。

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.

我只是補充一下傑里姆的評論，馬特。如果你看看今年下半年，那就是 G7 推出的時候。 G7 的推出和我們的成長加速有直接關係。這確實是一個重要的事件。另一件事，正如您所看到的結果一樣，這再次支持了我們在美國的現場銷售擴張方面所做的事情。

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的時間與那些不像過去那樣熟悉我們的技術的醫生在一起。正如我之前在電話中所說，當我們呼籲某人時，我們就贏了。我們做得很好。所以我們需要更多的電話。考慮到我們看到的加速發展以及下半年發生的好事，我們需要更多的腳步和更多的聲音。所以這一切都很好地融合在一起。

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

我們將回答瑪格麗特·安德魯和威廉·布萊爾提出的下一個問題。

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.

我想也許可以恢復不使用胰島素。當我們運行我們的市場模型時，非胰島素的採用似乎已經顯著增加，可能對您以及過去幾年的市場都是如此。再說一次，我們的數字可能並不完美，但美國的市場可能不會達到 100 萬用戶，今年可能會達到這個數字，而且這是一個相當大的數字。

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，第一，這些有意義的病人是否已經在 2023 年加入 DexCom 了？是什麼推動了這一點？回到Stelo 每年4000 萬美元的指導，我們顯然可以對ASP 或患者增加做出一些假設，但無論這些輸入是什麼，它很快就會讓你在2025 年達到2 億美元以上的銷售額，這是一個鏈中相當有意義的一塊。所以我想——這是正確的嗎？為什麼它可能是對的，也可能是錯的？與您在 23 年提供的初始 LRP 相比，其中有多少可以增量？

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.

傑里姆可能比我更詳細。這是我們今天業務的一部分，瑪格麗特。我們的產品確實有一些非胰島素使用者。我們有一些計劃實際上涵蓋了 CGM 的非胰島素使用者。我們在那裡看到了美妙的體驗。我們也沒有積極的現金支付計劃，但仍然有現金支付計劃，非胰島素用戶可以透過藥房和傳統 DME 以外的一些非常傳統的分銷管道獲得我們的產品。因此，其中一些人購買了連續血糖監測 (CGM) 並將其用於非胰島素治療，我們將繼續支持這些計劃。但這並不是我們業務的重要組成部分。它並不是我們成長的巨大推動力。它有所增長，但百分比並不顯著。

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，我們當然再次給了 2024 年 1% 的指導，並且我們致力於實現這一目標。這當然是我們的預測和指導。我們最致力於學習，因為我們真正感興趣的是 2 億美元這樣的數字，就像您所說的 2025 年，並​​在那裡定位合適的產品。

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 growing 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.

在定價和如何推出該產品方面，我們將擁有巨大的靈活性，因為這是一個現金支付計劃。而且它沒有針對當前我們有報銷的人群以及我們的產品得到報銷的人群進行標記。因此，我們相信我們將再次擁有靈活性來發展這一點。並實現獲利成長。同樣，我們有一個為期 15 天的產品進入該市場。所以我們的銷貨成本將會更低。隨著它的推出，我們正在圍繞它開發很多東西。正如您所看到的，我們確實正在改變業務模式來為此類個人提供服務，而不是我們迄今為止所服務的個人。我們將提供不同的體驗，我們一定會全面滿足他們的需求。因此，隨著時間的推移，我們看好它，到 2025 年它可能會是一個非常大的數字。這就是我們的計劃。

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

我們將回答傑森貝德福德和雷蒙德詹姆斯提出的下一個問題。

Just on gross margin, I think we came in the last year thinking gross margin would be lower in the second half. It wasn't. I'm guessing revenue levels play 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?

就毛利率而言，我認為去年我們認為下半年毛利率會更低。事實並非如此。我猜收入水平在那裡發揮了作用。但除了價格和產品組合之外，還有哪些因素影響 24 年的毛利率？然後，正如一個相關問題，您對馬來西亞有一些令人鼓舞的評論，我想您也提到了這一點，但我們在什麼時候看到馬來西亞和七國集團開始對毛利率產生積極影響？

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 the G7 today. And still a majority of our users, our legacy base still sit on the G6 system.

傑森，謝謝你的提問。去年，當我們對利潤率做出假設時，假設是 G6 向 G7 的過渡。我們有一系列假設。但假設 G6 到 G7 的過渡可能會更早一些。其中一些與 AID 系統上市的時間和覆蓋範圍以及隨著時間的推移如何發展有關。所以花了更長的時間。結果，我們在利潤率方面表現出色，今天生產 G7 的成本又回到了 G6。我們的大多數使用者、我們的傳統基礎仍然使用 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, Jason, 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 和與 G7 整合的 Control-IQ 的推出，顯然，在第一季後半段與 Omnipod 5 的有限發布，以及今年晚些時候的發布，我們確實相信基礎開始快點過去。因此，傑森，隨著這種情況發生，您將在今年年初從較低成本轉向較高成本產品。因此，這就是為什麼利潤會隨其變化。

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 now to '24 and then, of course, then bodes well as we move into 2025 and beyond.

現在，在今年下半年，假設基礎轉變和我們的模型表明，在這一年中，這應該會發生。平衡應該先平衡然後向有利於七國集團的方向傾斜。這使我們在今年結束時處於 G7 應該處於的位置，隨著時間的推移，我們將不得不向您提供基數的更新，但它應該低於 G6，在這一點上，它應該是增值的。這將是現在到 24 年的退出率，當然，這也是我們進入 2025 年及以後的好兆頭。

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.

這就是最大的推動力。只是這個基礎轉變什麼時候會發生。當它發生時，我們什麼時候才能達到這種成本平衡。所以，我們再次認為這會在 2023 年下半年發生。但它沒有發生。結果，我們在 2023 年的表現優於其他國家。可能將於 2024 年上半年在這裡舉行。

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

我們將接受 Canaccord Genuity 的 Will Plovanic 提出的下一個問題。

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 the 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。只是一種後續行動。當你觀察業務的成長和 Matt O'Brien 的問題時，只是試圖獲得一種顏色、粒度（如果可能的話），但來自基礎、低、密集和 1 型的貢獻，只是它正在向那個方向轉變。這些天的訂單更多的是基礎型和低劑量型以及強化型2型，這真的是新患者的成長嗎？如果是這樣，當你繼續前進時，我們應該如何考慮這種節奏？

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。我的意思是，如果你至少考慮到 2024 年，到 2024 年，新患者或至少來自新患者的收入的主要貢獻者仍然是強化胰島素，即 1 型和 2 型胰島素強化患者。這仍然是這兩者的組合佔全年新收入的大部分。

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 正在迎頭趕上，basal 正在迎頭趕上，但那些仍然屬於我們核心業務的人實際上仍然在推動基礎業務。現在隨著時間的推移，我們確實期望基礎的，因為有更多的人做得非常非常好。當我們進入 2025 年及之後，隨著距離的臨近，我們將不得不為您提供更多更新資訊。

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.

非常看好 basal 的長期機會。但至少想想2024 年，我們的核心業務實際上仍然在推動很大的成長，在basal 領域有明顯的長期機會，然後就你的觀點而言，hypo，坦白說，貢獻率仍然很低，然後是Stelo 類型也上線了。所有這些都是 2025 年及以後的真正機會。

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

我們將回答沃爾夫研究公司的邁克爾·波拉克提出的下一個問題。

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've 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?

我想詢問 Kevin 的後續情況，您對之前關於 15 天和時間安排問題的答复。我聽說在我們提交文件並找到批准途徑之前，我們不會提供太多的資訊。似乎有人認為 Stelo 是今年為期 15 天的開胃菜，也許會在 2025 年進行更廣泛的推廣。我不想——我不是在問你確定時間，但 2025 年是否會影響更廣泛的 15 天過渡期？或者所有這些測試和創新可能需要更長的時間嗎？

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.

我們想盡可能快地走。如果按照我的時間安排，那就是昨天了。 Stelo 15 天是這方面的入門，因此我們可以在這些使用者使用它時學習和收集數據，特別是使用我們目前的感測器配置。當我們經歷我們正在進行的技術變革時，當我們撥入我們將在最終產品中添加的那些功能時，我們將開始一項關鍵的試驗，我們會繼續，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 intent and difficult as it was, with the last product, things such as security and Bluetooth and stuff. We worked through all those issues already.

我們現在的處境與 G7 不同，我們提交了一個全新的系統，擁有全新的硬體、新功能、新的生產線、新的供應商，一切都是新的。這個為期 15 天的產品，我們是在與目前 G7 相同的平台上建構的。因此，從完成、關鍵到歸檔的時間不會像上一個產品（例如安全性和藍牙之類的東西）那樣刻意和困難。我們已經解決了所有這些問題。

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.

所以現在，我們正在真正完善科學並達到 15 天，並達到患者對我們期望的可靠性和品質水準。我們不認為這是一個極端的——我認為「25」是一個合理的假設，但我不會給你一個結束日期，因為有太多的變數。但我們肯定會沿著這種速度前進，然後我們會看到我們的著陸點，並在此過程中為您提供更多更新。我只是——歸檔事情或開始做事情。對我們來說重要的是把事情做好。這些也應該是您的里程碑。所以，我們會及時通知您，但這就是我們的情況。

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

我們將回答 Chris Pasquale 和 Nephron 提出的下一個問題。

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。想問一些有關 Dexcom ONE 及其進展的問題。我想您曾說過您預計它會佔 23 年國際新病人數的 30% 左右。好奇這是否是您最終的結局，以及您預計 24 年新患者的哪一部分開始？

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，克里斯。謝謝你的提問。是的，我們做到了——我們原以為到 2023 年，美國以外地區的新患者數量將佔到 1/3 左右。實際情況更接近新患者數量的 1/4 左右。所以稍微落後一點。有些招標需要更多的時間才能進行，所以這對我們來說仍然是非常好的一年，但有點落後於我們年初的水平，至少在預期方面是如此。

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，我們預計它的貢獻率將更高、更大。所以如果你想想去年，情況一定就是這樣。那是在 G6 外形規格上。顯然，我們對 2024 年以 G7 外形規格以及我們已經推出的 4 個國家/地區推出感到非常興奮。因此，我們的期望是更大的百分比，雖然我們不一定給出這個數字，但預計它會規模更大，該團隊希望到2024 年美國境外新患者的比例更大。

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

我們將接受 TD Cowen 的 Josh Jennings 提出的下一個問題。

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 ?

我只是希望詢問有關 2 型非胰島素低血壓症的後續情況——已覆蓋的低血壓指徵。我們認為它的移動速度不會像 2 型 basal 一樣快。但我認為你們談到了在美國有比 2 型基礎患者機會更大的患者機會。在滲透該指示方面有什麼瓶頸嗎？您如何看待未來對「24」、「25」、「26」的更深入滲透？

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，喬許。坦白說，這個領域已經消失了。我們知道這將是一個挑戰。這是一個很大的機會，但需要更多的時間來提高意識，並在醫生面前讓人們知道，嘿，聽著，如果您發生過低血壓事件，那麼您確實符合資格。順便說一下，以下是如何記錄它。

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.

所以它肯定比基礎慢。 2023 年，這並不是一個真正的實質貢獻者。然而，我們所知道的是，我們的商務長 Teri 和她的團隊非常非常專注於宣傳。確保人們了解他們是否患有低血壓事件，這項技術可以提供幫助，並且可以幫助改變這種狀況，並且他們確實符合資格並且可以獲得報銷。因此，它正在處理該訊息傳遞，並確保我們走出去並了解這些事件正在發生的地方。也就是說，無論你相信與否，理解如何識別這些事件何時發生，以便我們能夠在這些人面前走出來是一個挑戰，但我們正在努力解決這個問題。我們有關於這方面的良好數據。然後確保我們讓為這些患者提供服務的醫生了解文件的要求，以便他們有資格獲得報銷。

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.

因此，還有一些工作要做，但有一個團隊非常非常專注地工作。確保我們確實武裝我們的銷售隊伍，然後為社區提供幫助其更快發展所需的資訊。我認為這對我們來說是一個很大的機會，但我認為這個機會需要更長的時間才能滲透。所以就你的觀點而言，我認為這是一個驅動因素 - 2024 年這裡有一點驅動因素，當然是 2024 年的一個機會，但我認為它會繼續緩慢發展。但從長遠來看，我們確實認為隨著時間的推移，這是一個有意義的貢獻者。

I'd just add to that, it feeds to the sales force investment we're making in the states. 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.

我想補充一點，它有助於我們在各州進行的銷售團隊投資。我們需要教育醫生和患者。一旦你找到了一群在這個領域取得積極成果的人，他們回到醫生那裡並開始進行這些對話，事情就會變得更容易。但為了做到這一點，我們必須做很多工作，而且我們需要更多的人來做到這一點。

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

我們將回答 Leerink Partners 的 Mike Kratky 提出的下一個問題。

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?

一項在基礎上澄清一項。您之前曾討論過根據您在胰島素密集型 2 型患者中看到的軌跡來確定基礎人群中的滲透率。根據您今天的情況以及您對未來幾年的展望，您如何描述這種比較？

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。是的。因此，在我們的長期指南中，我們討論了基礎，實際上是美國總人口的 6 到 7 個百分點的採用率。我將從美國開始，因為在國際上，有一個覆蓋範圍。當我們在那裡進行報道時，就會有機會。但我們在 2025 年 LRP 中討論過這一點。

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 a middle between those two, 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.

在我們的前幾個季度，我們看到它反映了你的問題，我應該說，它反映了 2 型密集型，滲透率約為 9% 至 10%。我們的指南（至少到 2024 年）假設介於兩者之間，即 8%。我們已經有幾個季度了。這是非常非常積極的，但我們也希望確保在提供指導時保持謹慎。這就是為什麼我們假設 2024 年滲透率約為 8%。

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，如果它反映了我們在 2023 年下半年看到的情況，那麼就有機會跑贏大盤。顯然，我們正在追蹤 LRP，我認為這對整個業務來說都是一個積極的信號。但同樣，我們的指導滲透率是 8%。希望這對您有幫助。

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

我們將回答史蒂夫·利希特曼和奧本海默提出的下一個問題。

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 expand as you go after this large non-insulin group?

Kevin，您在先前的問題中提到了 Stelo 的不同商業模式。我們該如何看待上市可能會是什麼樣子？它是否具有 Dexcom ONE 更直接面向患者的感覺？當您追隨這個龐大的非胰島素群體時，分母確實會擴大，您是否需要在後台支援方面進行重大投資？

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.

這是一個很好的問題，也是我們公司內部討論和會議的一個非常相關的議題。我們正在非常多地評估非常有效的方法來服務如此龐大的患者群體，並且在我們建立這些模型時，與那些長期使用胰島素的患者群體相比，這些患者群體與我們的互動可能會有所不同。

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，我們正在研究與我們今天所做的不同的分銷模式。這樣我們就可以最有效地將產品提供給人們。再說一次，從現金支付開始，給我們一些機會做一些與過去略有不同的事情。所以你必須繼續關注這一點。這是一個非常深思熟慮的問題，並且與這裡每天發生的一切非常一致。

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

我們將接受巴克萊銀行馬特·米克西奇的最後一個問題。

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? So G7 exceeds 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.

因此，當您推動 G7 成為您業務的更大組成部分時，請對利潤率和某種組合進行後續追蹤。您之前提到過，我認為我們了解 G7 銷量的不斷增加，隨著時間的推移，該產品線的毛利率和盈利能力不斷提高。只是想知道您是否可以分享我們應該如何考慮長期目標？換句話說，G7 現在更有利可圖。你們現在是否有 G6 的利潤更高，而不僅僅是這些產品線的成熟度？所以 G7 超越了這一點。 Stelo 落後 G7 嗎？ Dexcom ONE 與 G7 是否有類似的線索，也許只是對中長期發展方向的一些方向感會在您提高這些銷量時非常有幫助。

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.

是的。所以也許我要討論的是我們如何考慮產品的成本。然後我認為從這裡開始，我們可以從這個角度來思考如何看待利潤。我可能會對服務模式進行一些評論，我認為這也很重要，因為這將有助於提高營運利潤。

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.

因此，當你考慮 G7 時，只考慮產品本身，截至今天，它的成本比 G6 更高。因此，我們預計今年的情況最終會發生轉變。當你讓你的模型有點彎曲或有點佈局時，我們預計感測器會降到 10 美元，無論是 10 天還是 15 天，因為我們從 2025 年 LRP 到 2026 年初。您對我們將在哪裡了解每個感測器的成本有某種感覺。

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 cost 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、硬體的成本都差不多，無論是 Stelo、Dexcom ONE 還是 G 系列。最終改變它的是支援模型、軟體、支援、研發、投資，當然還有服務模型。因此，當你考慮我們在 G 系列中投入的所有工作時，G 系列將擁有最高的報銷，但它也將擁有最高的服務模式，然後是軟體和其他方面的最大投資。 Dexcom ONE 是一種稍微不同的服務模式。因此，我們能夠減少與某些保固相關的負擔，以及隨之而來的支援成本。 Stelo 的外形尺寸為 15 天。因此，從毛利率的角度來看，當你隨著時間的推移思考這個問題時，這會很有幫助。

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.

所以我認為這就是考慮成本狀況的方法。目前我們還沒有推出 Stelo 的價格，所以目前我們無法給您具體的保證金。否則，我們的想法可能就很明顯了。但隨著時間的推移，隨著結果的出現，我認為這將有助於調整模型。我認為，當你考慮一個 15 天的產品時，這裡有真正的機會，從 Stelo 開始。但隨著時間的推移，這一點逐漸滲透到 Dexcom ONE 和 G 系列中。同樣，這些產品線中存在一些真正的機會來繼續提高獲利能力，因此有更多的槓桿。

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.

所以我認為所有這些都有槓桿。我希望這能為您提供一些背景資訊。我意識到我不會為您提供每一款產品的損益表，但至少它為您提供了有關硬體成本的一些背景信息，並且我們對運營支出成本和服務模式進行了區分，當然還有每一款產品的佩戴天數。

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

女士們、先生們，此時此刻，我想將電話轉回給凱文·塞耶先生（Kevin Sayer）致閉幕詞。

Thank you very much.

非常感謝。

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 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.

在這些財報電話會議期間，很容易談論百分比和利潤率以及未來技術、財務指導、競爭對手以及一系列重要的引人入勝的話題。但在今天結束時，我真的想專注於 2023 年，這確實是我們歷史上最非凡的一年。讓我們再次回顧一下這些數字：7 億美元的有機收入成長、超過10 億美元的EBITDA、我們的活躍用戶群中的60 萬個新客戶、毫不猶豫地在亞洲建立了一家工廠，當然還有在全球推出我們的G7 產品世界。雖然一流的技術是這些成就的基礎和基礎，但如果沒有傑出的人才超越，就不可能實現這一目標。因此，在 2023 年即將結束之際，我想感謝我們——我想是的，我們現在在全球擁有超過 10,000 名 DexCom 員工，他們做得非常好。謝謝大家。

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

女士們、先生們，今天的電話會議到此結束。我們感謝您的參與。您現在可以斷開連線。