德康醫療 (DXCM) 2024 Q2 法說會逐字稿

Welcome to the Dexcom second quarter 2024 earning release conference call.

歡迎參加 Dexcom 2024 年第二季財報發布電話會議。

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

我叫艾比，我將擔任您今天通話的接線生。

(operator instructions) As a reminder, the conference is being recorded.

（操作員說明） 請注意，會議正在錄製中。

I will now turn the call over to Sean Christensen.

我現在將把電話轉給肖恩·克里斯滕森。

You may begin.

你可以開始了。

Thank you, Abby, and welcome to Dexcom's second quarter 2024 earnings call.

謝謝艾比，歡迎參加 Dexcom 的 2024 年第二季財報電話會議。

Our agenda begins with Kevin Sayer, Dexcom's Chairman, President and CEO, who will summarize our recent highlights and ongoing strategic initiatives, followed by financial review and outlook from Jeremy Sylvain, our Chief Financial Officer.

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 Jeremy Sylvain 進行財務回顧和展望。

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

在我們準備好的發言之後，我們將開始電話詢問您的問題。

At that time, we ask analysts to limit themselves to one question each so we can provide an opportunity for everyone participating today.

屆時，我們要求分析師每個人只回答一個問題，這樣我們就可以為今天參與的每個人提供一個機會。

Please note that there are also slides available related to our second quarter 2024 performance on the Dexcom Investor Relations website on the Events and Presentations page.

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 2024 年第二季業績相關的幻燈片。

With that, let's review our Safe Harbor statement.

接下來，讓我們回顧一下我們的安全港聲明。

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

我們將在今天的電話會議上發表的一些聲明可能構成前瞻性聲明。

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

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

All forward looking statements included on this call 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.

本次電話會議中包含的所有前瞻性陳述均基於Dexcom 目前掌握的信息，截至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.

Dexcom 的 10-K 表格年度報告、10-Q 表格最新季度報告以及其他向公司提交的文件中詳細介紹了可能導致實際結果與任何這些前瞻性陳述中明示或暗示的結果存在重大差異的因素。交易委員會。

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

除法律要求外，我們不承擔在本次電話會議之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.

此外，在電話會議期間，我們將討論某些未依照公認會計原則所準備的財務措施。

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

除非另有說明，本次電話會議中所有提及的財務指標均基於非公認會計原則（Non-GAAP）。

This non-GAAP information should not be considered in isolation or as a substitute for results or superior to results prepared in accordance with GAAP.

此非 GAAP 資訊不應被孤立地考慮，也不應被視為結果的替代品或優於根據 GAAP 準備的結果。

Please refer to the tables in our earnings release and the slides accompanying our second quarter earnings call for a reconciliation of these measures to their most directly comparable GAAP financial measure.

請參閱我們的收益發布中的表格以及第二季度收益電話會議隨附的幻燈片，以將這些指標與其最直接可比較的公認會計準則財務指標進行調節。

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。

Before we begin discussing Q2 results, let me state that overall category demand remains strong, and awareness of the value of CGM across the metabolic health spectrum continues to accelerate.

在我們開始討論第二季的結果之前，我要指出的是，整體品類需求仍然強勁，並且對 CGM 在整個代謝健康領域的價值的認識不斷增強。

This trend was evident at the recent American Diabetes Association Conference, which featured Dexcom's largest evidence to-date in the non-insulin type 2 space.

這一趨勢在最近舉行的美國糖尿病協會會議上表現得很明顯，會上 Dexcom 展示了迄今為止在非胰島素 2 型領域的最大證據。

DexCom research demonstrated significant A1C reduction in multiple studies, as well as real-world evidence showing a time-in-range increase of greater than four hours per day for nearly 4,000 customers using Dexcom CGM at one year.

DexCom 研究表明，多項研究顯示 A1C 顯著降低，且現實世界的證據顯示，使用 Dexcom CGM 一年後，近 4,000 名客戶每天的時間範圍增加超過四個小時。

We are leveraging several pathways of evidence generation to ensure that we are maximizing our market opportunity into the future, as our CGM systems become increasingly tailored to the unique needs of each customer.

隨著我們的 CGM 系統越來越適合每位客戶的獨特需求，我們正在利用多種證據產生途徑來確保我們能夠最大限度地利用未來的市場機會。

Despite the positive progress on these fronts, we saw three near-term trends emerge over the course of the second quarter that drove results below our expectations.

儘管在這些方面取得了積極進展，但我們看到第二季度出現了三個近期趨勢，導致結果低於我們的預期。

First, as we worked through our US salesforce realignment expansion, we have seen our share of new customers fall short of our expectations despite still strong absolute customer additions.

首先，當我們對美國銷售隊伍進行重組擴張時，我們發現，儘管絕對客戶增加量仍然強勁，但我們的新客戶份額仍低於我們的預期。

Second, our US revenue per customer has stepped down faster than expected based on two primary drivers, rebate eligibility and channel mix.

其次，基於折扣資格和通路組合這兩個主要驅動因素，我們在美國的每位客戶收入下降速度快於預期。

With G7 coverage emerging faster than expected, we realized greater rebate eligibility relative to initial expectations and compared to 2023 levels.

隨著 G7 覆蓋範圍的出現速度快於預期，我們意識到相對於最初預期和 2023 年的水平，折扣資格更高。

While we believe this enhanced G7 coverage has helped facilitate new customer starts as mentioned above, the pace of these stars did not allow us to offset the temporary impact from this rebate eligibility.

雖然我們相信，如上所述，G7 覆蓋範圍的擴大有助於促進新客戶的啟動，但這些明星的步伐並沒有讓我們抵消此回扣資格的暫時影響。

We expect the impact of this rebate eligibility dynamic will reach its peak in the third quarter, and Jereme will provide specific color on the Q3 expectations shortly.

我們預計這種回扣資格動態的影響將在第三季達到頂峰，Jereme 很快就會提供有關第三季預期的具體資訊。

Beyond the transitory G7 eligibility dynamic, we also saw revenue per customer impacted by US channel mix dynamics.

除了短暫的 G7 資格動態之外，我們還看到每位客戶的收入受到美國通路組合動態的影響。

US customer growth has remained strong in our pharmacy business as we expand our reach into primary care and type 2 diabetes more broadly.

隨著我們更廣泛地將業務範圍擴大到初級保健和 2 型糖尿病，我們的製藥業務的美國客戶成長仍然強勁。

However, our growth in the DME channel has trailed our plan.

然而，我們在 DME 通路的成長卻落後於我們的計畫。

The DME distributors remain important partners for us in our business, and we've not executed well this quarter against these partnerships.

DME 經銷商仍然是我們業務中的重要合作夥伴，本季我們在這些合作夥伴關係方面的執行情況不佳。

We need to refocus on those relationships.

我們需要重新關注這些關係。

Finally, our international performance was also lighter than expectations in the quarter.

最後，我們本季的國際業績也低於預期。

While we delivered strong performance in some of our core markets, such as the UK and France, we saw category growth soften in certain geographies as type 1 penetration advances in these regions.

雖然我們在英國和法國等一些核心市場取得了強勁的業績，但隨著 1 類滲透率在這些地區的進步，我們發現某些地區的品類成長放緩。

We continue to see a significant runway ahead across our international footprint, particularly as we drive greater access for people with type 2 diabetes.

我們繼續看到我們的國際足跡有一個重要的跑道，特別是當我們為第 2 型糖尿病患者提供更多服務時。

To account for these trends and appropriately reflect our base assumption, we've lowered our full year revenue guidance to 11% to 13% organic growth.

為了考慮這些趨勢並適當反映我們的基本假設，我們將全年收入指引下調至 11% 至 13% 有機成長。

We have higher expectations for our business than what we experienced this quarter.

與本季相比，我們對業務的期望更高。

We believe we have an incredible product, an incredible future pipeline and an unparalleled market opportunity.

我們相信我們擁有令人難以置信的產品、令人難以置信的未來產品線和無與倫比的市場機會。

We also have a great team capable of leading this market.

我們也擁有一支能夠領導這個市場的優秀團隊。

But I expect more for myself and more from my team going forward.

但我對自己和我的團隊未來的期望更高。

So what are we doing to enhance our competitive position and reestablish momentum?

那麼，我們正在採取哪些措施來增強我們的競爭地位並重新建立動力呢？

It starts with our product portfolio, which we continue to strengthen to put our field sales team in a great position with clinicians.

首先是我們的產品組合，我們不斷加強產品組合，使我們的現場銷售團隊在臨床醫生中處於有利地位。

In the second quarter, we expanded our direct-to-Apple Watch connectivity with G7, launching in the US and several additional international markets with this feature that has been among our most requested for several years.

第二季度，我們透過 G7 擴展了與 Apple Watch 的直接連接，在美國和其他幾個國際市場推出了這項功能，多年來一直是我們最需要的功能之一。

We expanded the international launch of the Dexcom ONE plus system, now reaching 18 international markets with our smaller G7 form factor for our Dexcom ONE users.

我們擴大了 Dexcom ONE plus 系統的國際發布範圍，現已為 Dexcom ONE 用戶提供更小的 G7 外形尺寸，涵蓋 18 個國際市場。

We've built upon the performance of G7, making it even better.

我們以 G7 的性能為基礎，使其變得更加出色。

This includes a continuation of our monthly cadence of software updates, which included the second quarter additions of medication logging and the ability to ingest activity data into our G7 app.

這包括繼續我們每月的軟體更新節奏，其中包括第二季度增加的藥物記錄以及將活動數據提取到我們的 G7 應用程式中的功能。

We've introduced a stronger adhesive to support our customers into the summer months, and we expanded the G7 Bluetooth connectivity range by more than 65%.

我們推出了更強的黏合劑來為客戶提供夏季支持，並將 G7 藍牙連接範圍擴大了 65% 以上。

We advanced Dexcom CGM leadership in the ID space with the launches of G7 integrations with Tandem's Mobi system and Insulet's Omnipod 5.

透過推出與 Tandem 的 Mobi 系統和 Insulet 的 Omnipod 5 整合的 G7，我們提升了 Dexcom CGM 在 ID 領域的領導地位。

We've strengthened our existing products while preparing for the most expansive product launch in our company's history with the upcoming August launch of Stelo.

我們增強了現有產品，同時為公司歷史上最廣泛的產品發布做好準備，即將於 8 月推出 Stelo。

We are seeing the demand for CGM build in the non-insulin space and consumer use and believe that we've created a unique and engaging system to drive people to better metabolic health outcomes.

我們看到非胰島素領域和消費者使用對 CGM 的需求不斷增加，並相信我們已經創建了一個獨特且引人入勝的系統來推動人們獲得更好的代謝健康結果。

Our team has worked hard to build a scalable service model for Stelo that will be great for our customers, including the e-commerce experience, seamless delivery through Amazon fulfillment, insightful product features, digital support options, and much more to come.

我們的團隊努力為 Stelo 建立一個可擴展的服務模型，這對我們的客戶來說非常有利，包括電子商務體驗、透過亞馬遜履行的無縫交付、富有洞察力的產品功能、數位支援選項等等。

We'll offer both single purchase opportunities as well as discounted subscriptions that bring the monthly costs below $100.

我們將提供單次購買機會以及折扣訂閱，使每月費用低於 100 美元。

Stelo will be a full launch on stelo.com, and we continue to expect approximately 1% of revenue contribution in 2024.

Stelo 將在 stelo.com 上全面推出，我們繼續預計 2024 年將貢獻約 1% 的收入。

We are committed to personalized approaches to metabolic health management through updates like these.

我們致力於透過此類更新來實現代謝健康管理的個人化方法。

This is what will enable us to capture greater share and maintain high rates of retention and utilization across our customer base.

這將使我們能夠在客戶群中獲得更大的份額並保持較高的保留率和利用率。

We feel that our expanded US sales force positions us very well to reignite our growth opportunity now and well into the future.

我們認為，我們擴大的美國銷售團隊使我們能夠很好地重新點燃我們現在和未來的成長機會。

We have the ability to dive deep into the technological leadership that Dexcom provides for diabetes specialty practices.

我們有能力深入了解 Dexcom 為糖尿病專業實踐提供的技術領先地位。

We have also expanded our reach and ability to highlight the simplicity of our platform and how it fits into a busy primary care practice.

我們還擴大了我們的覆蓋範圍和能力，以突出我們平台的簡單性以及它如何適應繁忙的初級保健實踐。

We have the advantage of better coverage and the lowest out-of-pocket cost for the insulin population and soon to be enhanced by the simplicity of this Stelo OTC platform.

我們的優勢是為胰島素人群提供更好的覆蓋範圍和最低的自付費用，並且很快將透過 Stelo OTC 平台的簡單性得到增強。

As we take significant steps to broaden our addressable market well into the future with Stelo and our expanded US sales force, we are also working hard to ensure simplified access to our systems in the markets we serve.

在我們採取重大措施，透過 Stelo 和擴大的美國銷售團隊將我們的潛在市場拓展到未來的同時，我們也在努力確保在我們所服務的市場中簡化對我們系統的存取。

In the second quarter, our team worked with the CDC to create new ICD-10 diagnostic codes for problematic hypoglycemia.

第二季度，我們的團隊與 CDC 合作，為有問題的低血糖創建了新的 ICD-10 診斷代碼。

These codes, which were published in May and go into effect in October, can simplify the process of documenting hypoglycemic events that qualify non-insulin users for CGM coverage.

這些規範於 5 月發布並於 10 月生效，可以簡化記錄低血糖事件的過程，使非胰島素使用者有資格獲得 CGM 承保。

Our international market expansion efforts also progress in the second quarter as we received coverage in France for people with type 2 diabetes on basal insulin and began serving these customers in June.

我們的國際市場擴張工作在第二季度也取得了進展，我們在法國獲得了基礎胰島素 2 型糖尿病患者的保險，並於 6 月開始為這些客戶提供服務。

We also transitioned to direct sales in Japan at the outset of the quarter and look forward to taking control of our commercial efforts in that crucial market.

我們還在本季初轉向日本的直銷，並期待控制我們在這個關鍵市場的商業工作。

To summarize, our second quarter performance and 2024 outlook are not up to our standards and we look forward to better capitalizing on our opportunity as we move forward.

總而言之，我們第二季度的業績和 2024 年的前景未達到我們的標準，我們期待在前進的過程中更好地利用我們的機會。

With that, I'll turn it over to Jereme.

這樣，我就把它交給 Jereme。

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.

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。

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

您可以在今天的收益報告以及我們的投資者關係網站上的幻燈片中找到 GAAP 的調整表。

For the second quarter of 2024, we reported worldwide revenue of $1.004 billion compared to $871.3 million in the second quarter of 2023, representing growth of 15% on a reported basis and 16% on an organic basis.

2024 年第二季度，我們報告的全球收入為 10.04 億美元，而 2023 年第二季度為 8.713 億美元，報告成長 15%，有機成長 16%。

As a reminder, our definition of organic revenue excludes the impact of foreign exchange in addition to non-CGM revenue acquired or divested in the trailing 12 months, US revenue totaled $732 million for the second quarter compared to $617 million in the second quarter of 2023, representing growth of 19%.

提醒一下，我們對有機收入的定義不包括外匯的影響以及過去 12 個月內收購或剝離的非 CGM 收入，第二季度美國收入總計 7.32 億美元，而 2023 年第二季度為 6.17 億美元，增長19%。

As Kevin mentioned, we experienced lower than expected new customer starts in conjunction with our sales force expansion and realignment, particularly in the DME channel, as well as a near-term impact from pharmacy eligibility changes, which lowered our revenue per customer relative to our expectation.

正如Kevin 所提到的，隨著我們的銷售團隊擴張和重組，特別是在DME 管道，以及藥房資格變化的近期影響，我們的新客戶數量低於預期，這降低了我們每個客戶的收入相對於我們的收入。

Together, these dynamics adversely impacted our revenue this quarter by approximately $40 million as compared to our internal estimates.

與我們的內部估計相比，這些動態對我們本季的營收產生了約 4000 萬美元的不利影響。

Based on the compounding effect of these lower second quarter new customer starts, we also expect our growth rate in the back half of the year to be impacted.

基於第二季新客戶開工率下降的複合效應，我們預期下半年的成長率也會受到影響。

To offset this.

為了抵​​消這一點。

Our team is working aggressively to improve our execution and deliver the higher market share levels that we believe our product deserves.

我們的團隊正在積極努力提高我們的執行力，並提供我們認為我們的產品應得的更高的市場份額。

International revenue grew 7% totaling $272 million in the second quarter.

第二季國際營收成長 7%，總計 2.72 億美元。

International organic revenue growth was 10% for the second quarter.

第二季國際有機收入成長 10%。

While we anticipated our international growth to slow this quarter as we lapped our very strong performance from Q2 2023, our results came in lighter than expected.

儘管我們預計本季的國際成長將放緩，因為我們的業績較 2023 年第二季非常強勁，但我們的業績卻低於預期。

Our miss on new customers impacted us by approximately $10 million on the quarter.

本季我們錯過新客戶為我們帶來了約 1000 萬美元的影響。

Our international performance can often ebb and flow based on coverage decision and distributor purchases, but as Kevin mentioned, there remains a long runway ahead for Dexcom CGM globally.

我們的國際業績經常會根據覆蓋決策和分銷商採購情況而起伏不定，但正如 Kevin 所提到的，Dexcom CGM 在全球範圍內還有很長的路要走。

We continue to invest in infrastructure to expand our geographical presence, provide compelling evidence to expand market access in new segments of key markets, and leverage our product portfolio to meet the unique needs of various customers and health systems.

我們繼續投資基礎設施以擴大我們的地理分佈，提供令人信服的證據以擴大關鍵市場新領域的市場准入，並利用我們的產品組合來滿足各種客戶和衛生系統的獨特需求。

Our second quarter gross profit was $638.1 million or 63.5% of revenue, which was in line with the 63.5% of revenue we delivered in the second quarter of 2023.

我們第二季的毛利為 6.381 億美元，佔營收的 63.5%，這與我們在 2023 年第二季交付的營收的 63.5% 一致。

We continued to see further migration of our customer base from G6 to G7 in the second quarter as we finalize new pump integrations and transition Dexcom one to the G7 form factor.

隨著我們最終完成新的泵浦整合並將 Dexcom one 過渡到 G7 外形尺寸，我們繼續看到我們的客戶群在第二季度從 G6 進一步遷移到 G7。

Between its ongoing customer transition and continued ramp up of our high-volume manufacturing facilities in Mesa and Malaysia, we are making steady progress towards our long-term cost targets.

在持續的客戶轉型以及我們在梅薩和馬來西亞的大批量生產設施的持續增加之間，我們正在朝著我們的長期成本目標穩步前進。

Operating expenses were $442.7 million for Q2 of 2024, compared to $395.1 million in Q2 of 2023.

2024 年第二季的營運費用為 4.427 億美元，而 2023 年第二季的營運費用為 3.951 億美元。

Operating income was $195.4 million or 19.5% of revenue, in the second quarter of 2024, compared to $158.4 million or 18.2% of revenue, in the same quarter of 2023.

2024 年第二季的營業收入為 1.954 億美元，佔營收的 19.5%，而 2023 年同一季度的營業收入為 1.584 億美元，佔營收的 18.2%。

Adjusted EBITDA was $283.9 million or 28.3% of revenue for the second quarter, compared to $232.6 million or 26.7% of revenue for the second quarter of 2023.

調整後 EBITDA 為 2.839 億美元，佔第二季營收的 28.3%，而 2023 年第二季為 2.326 億美元，佔營收的 26.7%。

Net income for the second quarter was $174.3 million or $0.43 per share.

第二季淨利為 1.743 億美元，即每股 0.43 美元。

We remain in a great financial position, closing the quarter with greater than $3.1 billion of cash and cash equivalents.

我們的財務狀況依然良好，本季末現金和現金等價物超過 31 億美元。

And based on our strong cash position, consistent free cash flow generation and ongoing growth opportunities, we are announcing an authorization for a share repurchase program of up to $750 million.

基於我們強大的現金狀況、持續的自由現金流產生和持續的成長機會，我們宣布授權高達 7.5 億美元的股票回購計畫。

Turning to guidance.

轉向指導。

Starting with full year 2024, we are decreasing our revenue guidance to a range of $4.0 billion to $4.05 billion, representing organic growth of 11% to 13% for the year.

從 2024 年全年開始，我們將營收指引下調至 40 億美元至 40.5 億美元的範圍，即全年有機成長 11% 至 13%。

As mentioned earlier, the compounding effect of our slower than expected new customer growth in the US DME channel and international business, as well as increased pharmacy eligibility, resulted in the need to recalibrate the guide.

如前所述，美國 DME 通路和國際業務的新客戶成長低於預期以及藥房資格增加的複合效應導致需要重新調整指南。

Our updated guidance reflects these dynamics and assumes a longer ramp in productivity in our US sales force.

我們更新的指導反映了這些動態，並假設我們美國銷售團隊的生產力將持續成長。

For margins, we are reducing our non-GAAP gross profit margin guidance to approximately 63% while maintaining our prior guidance on non-GAAP operating margin and adjusted EBITDA at approximately 20% and 29%, respectively.

對於利潤率，我們將非 GAAP 毛利率指引降低至約 63%，同時維持先前對非 GAAP 營業利潤率和調整後 EBITDA 的指引，分別約為 20% 和 29%。

In addition to our annual guidance, we are providing two additional data points to help investors and analysts understand some of the unique elements impacting our revised guidance in 2024.

除了我們的年度指導之外，我們還提供了兩個額外的數據點，以幫助投資者和分析師了解影響我們 2024 年修訂指導的一些獨特因素。

First, the impact to new patients from our sales force initiative, combined with our revenue per customer trends that Kevin detailed, will change the historical seasonality pattern that we have typically experienced.

首先，我們的銷售隊伍計畫對新患者的影響，加上凱文詳細介紹的每位客戶的收入趨勢，將改變我們通常經歷的歷史季節性模式。

These impacts are expected to reach their peak in the third quarter, with total revenue expected to be between $975 million to $1 billion.

這些影響預計將在第三季達到頂峰，總收入預計在 9.75 億美元至 10 億美元之間。

In conjunction with this revenue outlook, we thought would be helpful to provide a midyear update on our global active customer base, which we now estimate to be between $2.5 million and $2.6 million.

結合這一收入前景，我們認為提供有關我們全球活躍客戶群的年中最新資訊將很有幫助，我們現在估計該客戶群在 250 萬美元至 260 萬美元之間。

This represents strong growth over where we finished 2023, though the growth percentage has decelerated slightly.

儘管成長百分比略有下降，但與 2023 年結束時相比，這表明增長強勁。

Our hope is These updates will provide additional visibility as our team works to implement several of the areas of focus that we have aligned on over the past month and as our sales force continues to ramp their efficiency.

我們希望這些更新能提供額外的可見性，因為我們的團隊致力於實施我們在過去一個月中協調一致的幾個重點領域，而我們的銷售人員繼續提高效率。

With that, we can open up the call for Q&A.

這樣，我們就可以發起問答環節了。

Sean?

肖恩？

Thank you, Jeremy.

謝謝你，傑瑞米。

As a reminder, we ask our audience to limit themselves to only one question at this time and then re-enter the queue if necessary.

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。

Abby, please provide the Q&A instructions.

艾比，請提供問答說明。

(operator instruction)

（操作員指令）

Robbie Marcus, JPMorgan.

羅比馬庫斯，摩根大通。

Thanks.

謝謝。

I Have a lot more than one, but I'll keep it to one.

我有不只一件，但我會保留一件。

Guidance moving down about $400 million, so I appreciate a few million here or there, but I mean, this is such a step change in the business and the outlook and the trends.

指導意見下降了約 4 億美元，所以我讚賞這裡或那裡的幾百萬美元，但我的意思是，這是業務、前景和趨勢的一個階躍變化。

You know, MedTech companies split sales forces all the time and grow them.

您知道，醫療科技公司一直在拆分銷售人員並擴大其規模。

You've done it multiple times.

你已經做過很多次了。

I'm just kind of in shock at how big of a disruption and a downward guide is on US sales force expansion?

我只是對美國銷售團隊擴張受到如此大的干擾和下行指導感到震驚？

I feel like there has to be more going on.

我覺得還需要發生更多事。

Maybe you could give us more color into, are basal patients using it less?

也許您可以給我們更多的信息，基礎患者使用它的次數是否較少？

Are you seeing GLP-1 fears pop up and in Type 2 patients not starting on therapy as much?

您是否發現第 2 型患者突然出現對 GLP-1 的恐懼，而沒有開始接受治療？

Are you seeing, Abbott and Medtronic take a lot more share?

你看到了嗎，雅培（Abbott）和美敦力（Medtronic）佔據了更多份額？

I feel like there's just, we need more explanation for the third and fourth quarter guidance cut behind it.

我覺得我們需要對第三季和第四季指引的削減做出更多解釋。

Thanks a lot.

多謝。

Thanks, Robbie.

謝謝，羅比。

I appreciate the question and understand your position.

我很欣賞這個問題並理解你的立場。

Let me start with, let's go back to the numbers and the things we talked about in our script.

首先，讓我們回到腳本中討論的數字和內容。

We're short a large number of new patients as to where we thought we would be at this point in time, and Jeremy can provide you with the numbers as to what the new patient constitute.

我們目前還缺少大量新患者，傑里米可以向您提供有關新患者組成的數據。

There is a combination of things as far as the new patient shortage.

就新患者短缺而言，存在多種因素。

Obviously, disruptive on the disruption on the sales force expansion side.

顯然，這對銷售團隊擴張方面的破壞具有破壞性。

This was a different expansion for us than other ones and other ones we've done, we literally took territories and just divided them geographically.

這對我們來說是一次與其他擴張和我們做過的其他擴張不同的擴張，我們確實佔領了領土，只是在地理上劃分了它們。

In this time, we changed roles.

這一次，我們改變了角色。

We changed positions people called on.

我們改變了人們呼籲的立場。

It was a much more disruptive expansion we've had in the past, and that did lead to a lot of disruption, particularly at the beginning of the quarter.

這是我們過去經歷過的更具破壞性的擴張，這確實導致了很多破壞，特別是在本季初。

We saw things getting better towards the end.

我們看到事情到最後變得更好了。

With respect to the other factors, as far as market share, we said we've lost market share in the DME channel.

至於其他因素，就市場佔有率而言，我們說我們在DME通路失去了市場佔有率。

While we've done well in the pharmacy channel, as you can all see by scripts and scripts that are filled in the pharmacy on the DME side, we've lost share, and that that has hurt us.

雖然我們在藥房管道做得很好，正如大家可以透過 DME 端藥房中填寫的腳本和腳本看到的那樣，但我們失去了份額，這對我們造成了傷害。

And again, that is patients, it's including new patients, but it also, as we're losing in that category, we're also losing the customers who have the highest annual revenue per year as a patient.

再說一遍，那就是患者，它包括新患者，但隨著我們在這一類別中的流失，我們也失去了作為患者每年收入最高的客戶。

So you're losing those.

所以你正在失去那些。

And then some of those patients, even though we've lost share in the DME channel, have shipped to the pharmacy, but that is at a lower revenue per year number.

然後，儘管我們失去了 DME 管道的份額，其中一些患者仍已將產品運送到藥房，但每年的收入較低。

The last piece of this is rebate eligibility.

最後一部分是回扣資格。

And again, we expected G7 to have rebat eligibility over schedule that was literally twice as fast as G6.

再次，我們預計 G7 將按計劃獲得回扣資格，速度實際上是 G6 的兩倍。

It's been three times faster, G7 got to fall rebate very quickly, quicker than we had planned.

速度快了三倍，G7 很快就得到了回扣，比我們計劃的要快。

So all those things added together, while they had somewhat of an effect on Q2, they have a longer range effect on the rest of the year.

因此，所有這些因素加在一起，雖然對第二季度產生了一定影響，但對今年剩餘時間產生了更長期的影響。

So we added those all those things together, and that's how we came up with our guide.

因此，我們將所有這些內容加在一起，這就是我們提出指南的方式。

I'll let Jeremy came up with more, if you want to add to that.

如果你想補充的話，我會讓傑里米想出更多的。

Yeah.

是的。

So to give some context to the numbers, you're right, Robbie.

因此，為了給這些數字提供一些背景信息，你是對的，羅比。

At the top end of guidance, about a $300 million decline.

以指導上限計算，減少約 3 億美元。

In Kevin's prepared remarks, we talked about $50 million really impacting the second quarter.

在 Kevin 準備好的演講中，我們談到了 5000 萬美元對第二季的真正影響。

Those end up playing out to be a little bit larger as you expand those over the course of the year.

當你在一年中擴大這些規模時，這些最終會變得更大一些。

So to give you some context, the new patient missing Q2, which we expect it to drag out into Q3 as we kind of navigate through those changes, both in the US and outside the US.

因此，為了給您一些背景信息，新患者錯過了第二季度，我們預計它會拖到第三季度，因為我們正在經歷這些變化，無論是在美國還是在美國以外。

We have some new patient misses there.

我們那裡有一些新的病人漏診。

That's about $125 million on the year of that impact

受影響當年的損失約 1.25 億美元

The channel mix and really the loss of share in DME, that's a big one for us, and that's $100 million over the course of the year.

通路組合以及 DME 份額的損失，這對我們來說是一個重大損失，全年損失達 1 億美元。

Certainly impacted Q2, but we expect it to impact the rest of the year as well, as those that essentially work into four quarters.

當然會影響第二季度，但我們預計它也會影響今年剩餘時間，就像那些基本上持續到四個季度的情況一樣。

And then the rebate eligibility happened again quicker than we would have expected.

然後，回扣資格再次發生的速度比我們預期的要快。

Again, potentially you get there.

再說一次，你有可能到達那裡。

It happened quicker than we expected.

事情發生得比我們預想的還要快。

That's about $75 million.

這大約是 7500 萬美元。

So we have those up.

所以我們已經做好了。

That's about the $300 million that you see.

這大約是你看到的 3 億美元。

Certainly not something we're happy about, but in full transparency, we needed to make sure what we saw as we closed out the second quarter, we're transparent about what the impact is for the balance of the year.

當然這不是我們高興的事情，但在完全透明的情況下，我們需要確保我們在第二季結束時所看到的情況，我們對今年剩餘時間的影響保持透明。

Larry Biegelsen, Wells Fargo.

拉里·比格爾森，富國銀行。

Good afternoon.

午安.

Thanks for taking the question.

感謝您提出問題。

That was a super helpful review of the issues.

這是對這些問題的非常有用的回顧。

Maybe, Kevin, if you could go through kind of what you're doing to address each of those issues, when you think they'll be resolved.

也許，凱文，如果你能在你認為這些問題會解決的時候，經歷你正在做的事情來解決這些問題。

It's not clear to me, for example, losing share in the DME channel, why that's happening and how you reverse that.

例如，我不清楚 DME 通路的份額下降、為什麼會發生這種情況以及如何扭轉這種情況。

Just lastly, you have an LRP out there for 25.

最後，你有一個 25 美元的 LRP。

Is that still valid?

這仍然有效嗎？

Thanks for taking the questions.

感謝您提出問題。

Yeah, let me start with the LRP. for 25.

是的，讓我從 LRP 開始。 25。

Yes, we believe our LRP for '25 is valid, but our revenue will probably come in closer to the lower end of the range rather than the upper end of the range, as we sit here today.

是的，我們相信 25 年的 LRP 是有效的，但正如我們今天坐在這裡的那樣，我們的收入可能會更接近該範圍的下限，而不是該範圍的上限。

But we've achieved incredible progress on the P&L side, our burning margin and EBITDA side, our gross profit side on that LRP.

但我們在損益表、燃燒利潤和 EBITDA 以及 LRP 的毛利方面取得了令人難以置信的進步。

So from a P&L perspective, we're definitely hitting our goals on the LRP side.

因此，從損益角度來看，我們肯定正在實現 LRP 方面的目標。

As far as fixing all these things and what fixes we have in place, obviously, it's going to be a bit of a process.

顯然，就修復所有這些問題以及我們已經採取的修復措施而言，這將是一個過程。

On the rebate eligibility front, we believe that caps out in Q3, and we plan for this to cap out in Q4.

在回扣資格方面，我們認為這一點將在第三季度達到上限，並且我們計劃在第四季度達到上限。

It's just happened a couple of quarters earlier than we planned.

它只是比我們計劃的提前了幾個季度。

So that is very much a temporary thing and accelerated.

所以這在很大程度上是暫時的事情並且是加速的。

With respect to DME market share, one of the factors that has actually happened that created part of this several of the Medicare Advantage programs went to pharmacy reimbursement.

就 DME 市場份額而言，造成這幾個 Medicare Advantage 計劃一部分的因素之一是藥房報銷。

So patients who are being served by the DME channel shifted to the pharmacy, and that is a piece of our lost DME share.

因此，接受 DME 通路服務的患者轉向了藥房，這是我們失去的 DME 份額的一部分。

I can't quantify exactly how much, but that some of it.

我無法具體量化多少，但可以確定其中的一些。

Adding to that, we need to refocus on those relationships.

除此之外，我們需要重新關注這些關係。

We need to do better and we will talk with them.

我們需要做得更好，我們會與他們交談。

We have some plans and some things in place to start off there.

我們有一些計劃和一些事情可以從那裡開始。

But it's early.

但現在還早。

We have to implement them.

我們必須實施它們。

And again, DME data is really the last piece of the puzzle as far as our revenues.

再說一次，DME 數據確實是我們收入的最後一塊拼圖。

As far as where we get it by the end of the year, just given the data sources that we all look at, it's not as simple as the scripts on the pharmacy side.

就我們到年底得到的數據而言，僅考慮到我們大家都在查看的數據來源，它並不像藥房方面的腳本那麼簡單。

So we are addressing that.

所以我們正在解決這個問題。

We will put more emphasis and time there.

我們將更加重視並投入更多時間。

We'll send more customers through that channel and do better by those guys.

我們將透過該管道發送更多客戶，並讓這些人做得更好。

So we'll keep looking.

所以我們會繼續尋找。

On the international front, another piece to remember, we've got a few things going on there.

在國際方面，另一件事要記住，我們在那裡發生了一些事情。

Timing of some of the tenders affects the numbers.

一些招標的時間安排會影響數字。

There are some tenders that kick in 1, July that will help on the international growth, and that will be helpful there.

有一些招標將於 7 月 1 日開始，這將有助於國際成長，這將有幫助。

We're also looking for type 2 expansion, as I said on the call.

正如我在電話中所說，我們也在尋找 2 類擴充。

We just got basal coverage in France as kicking in.

我們剛剛在法國得到了基礎報道。

We know some of the other countries are moving towards basal coverage very quickly, and we can play there with our Dexcom one plus product, Dexcom one plus is still early in the game, and we're seeing that begin to pick up.

我們知道其他一些國家正在非常迅速地實現基礎覆蓋，我們可以在那裡使用我們的 Dexcom 一加產品，Dexcom 一加仍處於遊戲早期，我們看到它開始回升。

So there are a number of levers to pull and everything's working on, Larry.

因此，拉里，有很多槓桿可以拉動，一切都在進行中。

I can't quantify each one of them, but suffice to say we're not just sitting here.

我無法量化其中每一項，但足以說明我們不只是坐在這裡。

All right, Jeremy, you want to answer that?

好吧，傑里米，你想回答這個問題嗎？

Yeah.

是的。

And then maybe below the hood a little bit in terms of how we allocate the investment dollars, Larry.

然後也許是關於我們如何分配投資資金的一些幕後，拉里。

We are reprioritizing and re-allocating investments to where we know that it ultimately drives the most bang.

我們正在重新確定投資的優先順序並將投資重新分配到我們知道最終能產生最大影響的領域。

So the team is working on that diligently in terms of refocusing on where those dollars and those efforts go.

因此，團隊正在努力解決這個問題，重新專注於這些資金和努力的去向。

So not giving the specifics, just given the competitive nature of it, but rest assured there are changes being made underlying the business to ensure that we get back on top of our new patients.

因此，我們不提供具體細節，只是考慮到其競爭性質，但請放心，我們正在對業務進行基礎更改，以確保我們重新掌控新患者。

Jeff Johnson, Baird.

傑夫·約翰遜，貝爾德。

Thank you.

謝謝。

Good afternoon, guys.

下午好，夥計們。

Kevin, maybe following up on your DME comments, you say you need to maybe work on some relationship there.

凱文，也許跟進你的 DME 評論，你說你可能需要在那裡建立一些關係。

Any color you can give there, and not to air dirty laundry. but I guess in one of our DME checks here recently, we kind of one off the conversation, but it heard that, maybe some of the comments you made about CMS changes and who would bear the brunt of the any kind of reimbursement change in 2026 or 2027 would maybe be borne more by DME the new guys.

你可以在那裡提供任何顏色，但不要讓髒衣服晾乾。但我想在我們最近的一次 DME 檢查中，我們有點結束了對話，但它聽說，也許您對 CMS 更改發表了一些評論，以及誰將首當其沖地接受 2026 年任何形式的報銷更改或者2027年可能會更多由DME新人承擔。

Is it things like that, that kind of strained some relationships?

是不是這樣的事情，讓一些關係變得緊張？

What else might have strained relationships?

還有什麼可能導致關係緊張？

And have there been any kind of formulary changes or anything in DME where they have just wholeheartedly moved patients too to Abbott, and it's going to be harder for you to get those patients back going forward?

DME 是否有任何形式的處方變化或任何變化，他們全心全意地將患者轉移到 Abbott，而您以後要讓這些患者回來會變得更加困難？

Thank you.

謝謝。

I don't think there's been anything formulary or systematic along those lines.

我認為在這些方面沒有任何規定或系統的東西。

I think I need to take-- I'll let Jeremy take some more details, but let me move you guys back a little bit in time.

我想我需要——我會讓傑里米了解更多細節，但讓我把你們的時間拉回來一點。

When we started this journey journey down pharmacy coverage, we had as a company, zero relationships in the pharmacy channel.

當我們開始藥品覆蓋範圍的旅程時，作為一家公司，我們在藥品管道中的關係為零。

We worked very hard to develop those relationships because, as you can all see by our numbers and our largest competitor's numbers, that is where a large portion of the business has moved at this point in time.

我們非常努力地發展這些關係，因為正如你們從我們的數據和我們最大的競爭對手的數據中看到的那樣，這就是目前大部分業務已經轉移的地方。

We put a tremendous amount of effort there because we'd never been there before.

我們在那裡付出了巨大的努力，因為我們以前從未去過那裡。

We didn't have any infrastructure.

我們沒有任何基礎設施。

We didn't have other products there.

我們那裡沒有其他產品。

We didn't have relationships there.

我們在那裡沒有關係。

I think in creating and building those relationships.

我認為創造和建立這些關係。

We ignored other relationships that were very important to us more than we should have.

我們忽略了其他對我們來說非常重要的關係，這些關係超出了我們應有的範圍。

And so we need to balance that a little better and make sure that our customers get their product through a source that's easy, efficient and economical for them.

因此，我們需要更好地平衡這一點，並確保我們的客戶透過對他們來說簡單、高效且經濟的來源來獲得他們的產品。

We felt to a large extent, we are doing that, but we think we need to do more.

我們在很大程度上感覺到我們正在這樣做，但我們認為我們需要做得更多。

Jeremy, you want to take some more on that?

傑里米，你想再了解嗎？

No, that's it.

不，就是這樣。

And Jeff, to your comment on if there's any CMS changes in terms of reimbursement down there, we certainly did not say that.

Jeff，對於您關於 CMS 在報銷方面是否有任何變化的評論，我們當然沒有這麼說。

I think that was maybe a competitor that said that.

我認為這可能是競爭對手說的。

What we had said was we're partners, and so if there's any changes in CMS reimbursement and as partners, we would look at it as partners.

我們說過我們是合作夥伴，所以如果 CMS 報銷和作為合作夥伴有任何變化，我們都會以合作夥伴的身份來看待它。

And that would be our expectation going forward.

這將是我們對未來的期望。

So that was not how we positioned it.

所以這不是我們的定位。

But nevertheless, to the extent that those have caused frayed relationships, as Kevin alluded to, we would pay more attention to if irrespective.

但儘管如此，正如凱文所提到的那樣，就這些問題造成的關係緊張而言，我們無論如何都會更加關注。

Understood.

明白了。

Thank you.

謝謝。

Margaret Andrew, William Blair.

瑪格麗特·安德魯，威廉·布萊爾。

Hey, good afternoon, guys.

嘿，下午好，夥計們。

Thanks for taking the questions.

感謝您提出問題。

I guess I just wanted to follow-up and be clear on the dynamics on the guidance increase.

我想我只是想跟進並明確指導增加的動態。

The way you described it maybe wasn't super clearly, at least for me.

您描述的方式可能不太清楚，至少對我來說。

Are you assuming and continuing to assume lower new patient ads for the rest of the year?

您是否假設並繼續假設今年剩餘時間新病患廣告會減少？

Or was that kind of new patient missing Q2 alone driving $125 million decrease for the year?

或者僅僅是缺少第二季度的新患者就導致了今年 1.25 億美元的減少？

And then, continuing on that thread, are you seeing any change in some of those new patient ad dynamics or rep productivity on a month-by-month basis that would maybe give you that confidence in recovery?

然後，繼續這個主題，您是否看到一些新的患者廣告動態或代表生產力逐月發生任何變化，這可能會讓您對康復充滿信心？

If that is what you're assuming?

如果這就是你的假設？

Thanks.

謝謝。

Yeah, it's a good question.

是的，這是一個好問題。

Let me start on that.

讓我開始吧。

So Margaret, the answer is we do expect to see disruption continue into the third quarter, and that's one of the reasons why you're seeing the impact.

瑪格麗特，答案是我們確實預計中斷會持續到第三季度，這也是您看到影響的原因之一。

It's really a bit of a cumulative impact.

這確實是一個累積的影響。

Obviously, Q2 was a big impact.

顯然，第二季的影響很大。

We've sized it in terms of patient.

我們根據病人的情況來衡量它的大小。

It was a pretty sizable disruption relative expectations.

相對預期而言，這是一個相當大的破壞。

It was around 70,000 patients.

約有 70,000 名患者。

So it was a pretty big number.

所以這是一個相當大的數字。

Obviously, that rolls through for the rest of the year.

顯然，這將持續到今年剩餘時間。

But we do expect it to take a little bit time to recover that.

但我們確實預計需要一點時間才能恢復。

And so there will be there.

所以那裡就會有。

We have lowered the patient expectations into Q3.

我們已將患者期望降低到第三季。

And then into Q4 with our expectation as we start to get to back to where we were.

然後進入第四季度，我們開始回到原來的狀態。

But think about it as a quarter delay effectively, as a result of some of this disruption on our longer-term plans.

但實際上，這實際上是一個季度的延遲，因為我們的長期計劃受到了一些幹擾。

And so when you run those numbers, plus you run some expected numbers here in Q three on in disruption relative to expectation, that's ultimately how you get to the figures.

因此，當您計算這些數字時，再加上第三季度中相對於預期的干擾的一些預期數字，這就是您最終獲得這些數字的方式。

In terms of improvement over the course of time, ultimately, you do expect to see that.

就隨著時間的推移而取得的進步而言，最終，您確實希望看到這一點。

And we've seen some of that over that over time.

隨著時間的推移，我們已經看到了其中的一些情況。

Now, we always expected perhaps a little bit of disruption and some recovery.

現在，我們總是期望可能會出現一點破壞和一些復甦。

I would say the disruption is bigger than we would have anticipated.

我想說，這種破壞比我們預期的還要大。

And the recovery is there.

復甦就在那裡。

But when the disruption is bigger than anticipated, even as you have some of that recovery, again, you were a quarter behind where you'd expect to be.

但是，當破壞程度超出預期時，即使您已經實現了一些復甦，您仍然比預期落後了四分之一。

And I expect that to play out as we as we kind of exit the year.

我預計這將在我們今年結束時發揮作用。

So we revised that.

所以我們對此進行了修改。

We've included that in the guidance high level.

我們已將其納入高級指導中。

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

凱文，我不知道你還有什麼要補充的嗎？

No, I think that's good.

不，我認為這樣很好。

Travis Steed, Bank of America.

特拉維斯·斯蒂德，美國銀行。

I guess maybe could you just kind of explain what is the rebate eligibility, what it is, what it means, Kind of why it's temporary, why that happened?

我想也許你能解釋一下什麼是回扣資格，它是什麼，它意味著什麼，為什麼它是暫時的，為什麼會發生這種情況？

I think a lot of confusion on that aspect.

我認為在這方面有很多困惑。

And I don't know if something happened kind of late in the quarter.

我不知道本季末是否發生了一些事情。

It wss like you guys, I think we're comfortable the consensus in June.

就像你們一樣，我認為我們對六月的共識感到滿意。

So just wanted to ask, dose this all kind of come up late in the quarter?

所以只是想問一下，這一切都是在本季末出現的嗎？

Yeah, I can take that.

是的，我可以接受。

So when you think about rebate eligibility over time, you kind of get closer and closer to the 100% eligibility.

因此，隨著時間的推移，當您考慮回扣資格時，您會越來越接近 100% 的資格。

And it takes a little bit time.

這需要一點時間。

So plans, as they opt into coverage, opt in.

因此，當計劃選擇承保時，他們就選擇加入。

So we started to take place over G6, to a lesser extent, G5.

所以我們開始在 G6 上進行，在較小程度上，在 G5 上進行。

We weren't really in the pharmacy, then.

那時我們並不是真的在藥局。

We saw it take place over the course of G6.

我們看到它在 G6 期間發生。

And when we launched G7, we assumed it happened about twice as fast as G6.

當我們推出 G7 時，我們假設它的速度大約是 G6 的兩倍。

So the assumption is, as more and more folks get access.

所以我們的假設是，隨著越來越多的人獲得存取權限。

Therefore, more and more folks are moving through that program.

因此，越來越多的人正在參加該計劃。

Therefore, you're subject to more and more rebates.

因此，您將獲得越來越多的回扣。

And then the offset, of course, is by having more access, you have more volumes.

當然，抵消是透過擁有更多的存取權限，你擁有更多的數量。

As you can tell by our new patient numbers, we didn't have the volumes, but also the existing patient base was also subject to rebates.

從我們的新患者數量可以看出，我們沒有足夠的數量，而且現有的患者基礎也可以獲得回扣。

And so effectively, it's timing of price as you run through this is temporal, meaning you can only rebate up to your entire population and eventually gets there.

因此，實際上，當你經歷這個過程時，價格的時機是暫時的，這意味著你只能向整個人口進行回扣，並最終到達那裡。

But that's why it's a timing thing.

但這就是為什麼它是一個時機問題。

And it just happen, like Kevin was alluding to, three times as fast as G6, not two times as fast as G6.

就像 Kevin 提到的那樣，它的速度是 G6 的三倍，而不是 G6 的兩倍。

So that's a big piece there.

所以這是一個很大的部分。

In terms of the understanding of how the quarter was rolling up, you are correct.

就對本季如何滾動的理解而言，您是正確的。

It did it did roll up later into the second quarter.

確實如此，後來確實進入了第二季。

You can see our results in the second quarter, while not up to expectations, did not impact the quarter as much as it impacted the full year.

您可以看到我們第二季的業績雖然沒有達到預期，但對本季的影響沒有對全年的影響那麼大。

And obviously, that was driven by what you saw the dynamics that played through, really, the second quarter.

顯然，這是由你所看到的第二季的動態所驅動的。

Kevin was alluding to DME, where there's a big change in, let's say, his share and where we certainly missed.

Kevin 指的是 DME，他的份額發生了很大的變化，而我們肯定錯過了這一點。

And that data comes in a little delayed.

而且這些數據的到來有點延遲。

That's about a four to six week delay before we said.

比我們說的要晚大約四到六週。

So as we as we've tallied that data as we're moving into, really, the close of the quarter and into the weeks leading into the call, not only did it make us aware of certainly the impact on the quarter.

因此，當我們在進入季度末和電話會議前幾週對這些數據進行統計時，它不僅讓我們意識到對本季的影響。

It was really important for us then to reflect that in the guidance on the year.

對我們來說，在今年的指導中反映這一點非常重要。

And so a lot of that data, you're right.

這麼多數據，你是對的。

It obviously took place over the course of the quarter.

這顯然是在本季發生的。

We became aware of it, really as we closed out the quarter.

我們在本季結束時就意識到了這一點。

But that's why it's really important to get it in front of it for the guidance for the full year.

但這就是為什麼將其放在全年指導之前非常重要的原因。

Matt Taylor, Jefferies.

馬特泰勒，杰弗里斯。

Hi.

你好。

Thanks for taking a question.

感謝您提出問題。

I guess I wanted to ask if you could give a little more color, at least qualitatively, on when do you expect these issues to begin to heal, to rebound.

我想我想問您是否可以提供更多信息，至少在質量上，您預計這些問題何時開始癒合、反彈。

I don't know if you want to address them separately or together.

不知道你是想分開說還是一起說。

You've given the back half guidance.

你已經給了後半部指導。

But conceptually, what kind of impact this is going to have on the first half of 2025, when you're comping more normal periods?

但從概念上講，當您比較更正常的時期時，這將對 2025 年上半年產生什麼樣的影響？

And when do you think you're going to see the sales force really find its footing, the rebates kind of flush through?

你認為什麼時候才能看到銷售團隊真正站穩腳跟，回扣就會如期而至？

Maybe you could flesh that out a little bit more to help us model the future.

也許你可以進一步充實這一點，幫助我們模擬未來。

Yeah, I'll start.

是的，我要開始了。

And again, Jeremy, you can add more color.

再說一遍，傑里米，你可以添加更多顏色。

With respect to the rebates, this really caps in Q3, we had estimated in our own models that we would have full rebate eligibility by the fourth quarter of this year.

至於回扣，這在第三季確實是上限，我們在自己的模型中估計，到今年第四季我們將擁有完全的回扣資格。

It's just happened again, a couple of quarters faster than we had planned.

它又發生了，比我們計劃的要快幾個季度。

With respect to our field sales team and the disruption there, we believe we'll work through that in Q3 and early Q4.

關於我們的現場銷售團隊和那裡的干擾，我們相信我們將在第三季和第四季初解決這個問題。

And by the time we start 2025, this group should be clicking on all cylinders and things should go very well there.

到 2025 年開始時，這個團隊應該會全力以赴，一切都會順利進行。

Another thing that Jeremy talked about is reallocation and really examining where we're going to spend the dollars that we spend and the investments you're going to make to maximize the commercial effect of those.

傑里米談到的另一件事是重新分配，並真正檢查我們將在哪裡花費我們所花費的美元以及您將進行的投資，以最大限度地提高這些投資的商業效果。

Those programs and those decisions are being made now.

這些計劃和決定現在正在製定中。

We'll roll into Q3 into Q4.

我們將從第三季進入第四季。

And we believe will set us up nicely for 2025.

我們相信這將為 2025 年做好準備。

We're obviously not given 2025 guidance today.

今天我們顯然沒有得到 2025 年的指導。

But we feel by the end of the year, the things that we've talked about today, we should have worked through and we should have a very good idea as to where we're going in the future.

但我們覺得到今年年底，我們今天討論的事情應該已經解決，我們應該對未來的發展方向有一個很好的想法。

And Kevin alluded to it earlier.

凱文早些時候提到過這一點。

We talked about the question was, is how do you feel about the 2025 LRP and this is still valid?

我們討論的問題是，您對 2025 年 LRP 有何看法？

And again, we said, look, we feel it's still valid, albeit at the lower end of it, Matt.

我們再說一次，看，我們覺得它仍然有效，儘管處於低端，馬特。

So I think that gives you some context.

所以我認為這給了你一些背景資訊。

Obviously, this year is going to be impacted by these these these factors.

顯然，今年將受到這些因素的影響。

And as we work out of those and we work into next year, Kevin alluded to it, rebates shouldn't be an impact next year.

當我們解決這些問題並努力進入明年時，凱文提到，回饋不應該對明年產生影響。

So as we work out of it and as we give as we get to closer to the end of year, we'll give 2025 guidance but that help give you some context to our confidence as we move out of this year into next year and getting these things behind us.

因此，當我們解決這個問題時，當我們接近年底時，我們將給出 2025 年的指導，但這有助於為您提供一些背景信息，讓我們在從今年進入明年並取得進展時充滿信心。這些事情都在我們後面。

Tt shouldn't go unnoticed.

不應該被忽視。

Obviously, we're bullish on the business longer term, clearly not happy with the quarter and certainly not happy with the revised guide.

顯然，我們對長期業務持樂觀態度，顯然對本季不滿意，當然對修訂後的指南也不滿意。

So don't don't mistake it for that.

所以不要誤以為是這樣。

But we do are bullish on the business longer term, hence the $700 million share repurchase authorization.

但我們確實看好該業務的長期發展，因此獲得了 7 億美元的股票回購授權。

So hopefully, that helps Square or at least thinking about 2025..

希望這對 Square 有所幫助，或至少對 2025 年有所幫助。

Danielle Antalffy, UBS.

丹妮爾·安塔菲，瑞銀集團。

Just a question on this, the pharmacy component.

只是一個關於這個的問題，藥房部分。

And one of the sort of long-term risks here has always been that this becomes a more commoditized market.

這裡的長期風險之一始終是這將成為一個更商品化的市場。

You look at and finger sticks and blood glucose meters, and they're commoditized at this point.

你看看指尖採血筆和血糖儀，它們現在已經商品化了。

And when we hear things like, you know, rebates and pressure in the pharmacy, I just want to make sure I understand, is this a competitive dynamic in the pharmacy as well?

當我們聽到諸如藥房的回扣和壓力之類的事情時，我只是想確保我理解，這也是藥房的競爭動態嗎？

What's going on there?

那裡發生了什麼事？

And why is Q3 the peak?

為什麼第三季是峰值？

Where's the bottom, I guess from a pharmacy rebate perspective as you do broaden coverage?

當您擴大覆蓋範圍時，我想從藥房回扣的角度來看，底部在哪裡？

Because if this is going to be standard of care, which I still think it is, does that mean what price?

因為如果這將成為護理標準（我仍然這麼認為），那麼這意味著什麼價格？

And how should we be thinking about this over the long term?

從長遠來看，我們該如何思考這個問題？

Sorry, if I didn't make a ton of sense.

抱歉，如果我沒有說清楚的話。

No, it made perfect sense to me.

不，這對我來說非常有意義。

With respect to our overall pricing, our pricing within channels, when you look at it, the prices remains relatively consistent.

至於我們整體的定價，我們通路內的定價，你看，價格還是比較一致的。

What has happened in this quarter and what has happened now is more and more people have become eligible for rebates, hence bringing our value for per customer down.

本季發生的情況以及現在發生的情況是，越來越多的人有資格獲得回扣，從而降低了我們為每位客戶提供的價值。

This was the price that we assumed we would be targeting at the end of the fourth quarter, and we'd be rolling into '25 with.

這是我們假設第四季末的目標價格，並且我們將進入 25 年。

In other periods, we haven't had anything as severe as we have today, obviously, but our new patient growth number would be so high and our volumes would be so high.

顯然，在其他時期，我們沒有遇到像今天這樣嚴重的情況，但我們的新患者增長數量會如此之高，我們的治療量也會如此之高。

If something like this happen, we grew through it.

如果發生這樣的事情，我們就會透過它成長。

And so if a plan like this accelerate, our new patient numbers are so big, Danielle, that we managed through it in this quarter, you combine the two of them, the increase in the rebates, which gets again, to a net price very near what we'd expected and modeled.

因此，如果像這樣的計劃加速，我們的新患者數量如此之大，丹妮爾，我們在本季度完成了它，你將兩者結合起來，回扣的增加，這再次得到一個淨價非常接近我們的預期和模型。

That doesn't mean the bottom of the price is falling out on an overall basis in the channel.

這並不意味著價格在通道中總體上已經觸底。

It just means more people were subject to rebates than we had before, and we shifted patients from our more profitable DME channel over to that pharmacy.

這只是意味著比以前更多的人可以獲得回扣，並且我們將患者從利潤更高的 DME 管道轉移到了該藥房。

Through some, again, as I talked earlier, the three largest Medicare Advantage plans adopted pharmacy coverage this year.

正如我之前所說，透過一些措施，三大醫療保險優勢計畫今年都採用了藥局保險。

A lot of the Medicaid plans have gone to pharmacy coverage as well.

許多醫療補助計劃也涵蓋了藥局保險。

So those plants moving there necessitated a bit of that in a bit of those rebates are going up.

因此，那些搬到那裡的工廠需要一些回扣的增加。

So no, we don't believe we we don't believe we have a price falling out.

所以不，我們不相信我們的價格會下跌。

We believe what we do continues to provide tremendous value people and does a lot to improve, help save their lives and all the things we've talked about forever.

我們相信，我們所做的事情將繼續為人們提供巨大的價值，並為改善、幫助拯救他們的生命以及我們永遠談論的所有事情做出很大貢獻。

So this is still a very valuable component in somebody's health, and we'll continue to treat it as such.

因此，這對某人的健康來說仍然是一個非常有價值的組成部分，我們將繼續這樣對待它。

Joanne Wuensch, Citi Bank.

喬安妮‧文施 (Joanne Wuensch)，花旗銀行。

Good afternoon and thank you for taking the question.

下午好，感謝您提出問題。

I'm going to pivot a little to Stelo.

我將稍微轉向 Stelo。

It was 1% of your 24 revenue at one level and it's still 1% of the '24 revenue, which has been lowered by a couple of hundred million.

在某個層級上它是 24 年收入的 1%，而且仍然是 24 年收入的 1%，已經減少了數億。

Does it indicate your a change in your expectations for the year or anything that we should read into it?

這是否表明您對今年的期望發生了變化，或者我們應該對此進行解讀？

I'm just sort of a little curious about that and anything else that you can share as you think about building revenue?

我只是有點好奇這一點以及您在考慮增加收入時可以分享的其他內容嗎？

Thanks.

謝謝。

No, It's an Integer, and so the whole point there is yes, while the top has come down 1%, 43 versus 40, at the end of the day, it was all that kind of general contribution.

不，它是一個整數，所以重點是肯定的，雖然頂部下降了 1%，43 比 40，但最終，這都是一般性的貢獻。

So there was nothing insinuated by that, Joanne, it was it's just it rounded to that Integer.

所以喬安妮，這沒有任何暗示，它只是四捨五入到那個整數。

Matthew O'Brien, Piper Sandler.

馬修·奧布萊恩，派珀·桑德勒。

All right.

好的。

Good afternoon.

午安.

Thanks for taking the question.

感謝您提出問題。

And it is one question, but it's long enough, and I'll tie it all together.

這是一個問題，但它已經夠長了，我會把它們連在一起。

I promise.

我保證。

Just clearly, Kevin, your comment about next year's date in the LRP, you mean that 15% growth or do you mean $4.6 billion at the low end because of its 4.6 up of 4.57, that's 12% growth.

凱文，很明顯，您對 LRP 明年日期的評論是指 15% 的增長，還是指低端的 46 億美元，因為 4.6 比 4.57 上漲，即 12% 的增長。

And then within there, the low end of the range, 15% off of even a 12% number this year is a deceleration versus or is it easier comps, so there is deceleration still factored in there?

然後，在這個範圍的低端，今年甚至 12% 的數字下降 15% 是一個減速，還是更容易補償，所以那裡仍然有減速因素？

So what has changed get us from that kind of 17.5% growth we expect from you guys, typical growth rate guidance, to now this more like 15% or even lower?

那麼，是什麼變化讓我們從你們期望的 17.5% 的成長率（典型的成長率指導），變成了現在的 15% 甚至更低？

What's the difference there that we can really anchor onto?

我們真正可以錨定的差別是什麼？

Because that's, I think, the biggest challenge for the stock as we think about how it will trade tomorrow.

因為我認為，當我們考慮該股明天將如何交易時，這是該股面臨的最大挑戰。

Thank you.

謝謝。

Sure.

當然。

Maybe I can start with the maybe the next to your question.

也許我可以從你的問題的下一個開始。

I don't think it's necessarily guided to a number.

我認為這不一定是一個數字。

What we really tried to do is say, here's our LRP.

我們真正想做的是說，這是我們的 LRP。

It's still in play.

比賽仍在進行中。

When I say to the lower end, it's not necessarily the low end or a point estimate within there.

當我說低端時，它不一定是低端或其中的點估計。

It's really to give some context to, as we've already made plans and are looking at next year, we have some there's confidence in meeting that low end number.

這確實是為了提供一些背景信息，因為我們已經制定了計劃並正在考慮明年，我們有信心達到這個低端數字。

And so really that's really what the goal here is rather than the aesthetic guide number.

所以這確實是這裡的目標，而不是美學指導數字。

Now, your question then coming back to which is this year's growth, which the organic growth number, obviously 11% to 13% is lower than we've historically seen.

現在，你的問題又回到了今年的成長，有機成長數字，顯然 11% 到 13% 低於我們歷史上看到的。

Kevin's alluded to it a little bit in the script.

凱文在劇本中提到了一點。

This year, a little bit of what I would say is our execution, where I think we need to execute better on new patients and execute better in various channels.

今年，我想說的一點是我們的執行力，我認為我們需要對新患者執行得更好，在各個管道執行得更好。

And so that's something as a team we have to get our arms around.

因此，作為一個團隊，我們必須全力以赴。

This year was impacted by a quicker, as we mentioned, a quicker rebate dynamic and weaker than we expected.

正如我們所提到的，今年受到了更快的回扣動態的影響，而且比我們預期的要弱。

And that's part of it.

這就是其中的一部分。

Obviously, we lap that next year.

顯然，我們明年就會完成這個目標。

And you can only rebate 100% of your units.

而且您只能回饋 100% 的單位。

So obviously, it stops at some point.

很明顯，它會在某個時刻停止。

And so until that that piece of it will be transitory.

因此，在那之前，這一部分將是暫時的。

But I think the big key then is getting back to execution and execution on new patients and executing in the DME channel and making sure we have good partnerships there and executing on our channel mix.

但我認為最重要的關鍵是回到對新患者的執行和執行以及在 DME 管道中的執行，並確保我們在那裡擁有良好的合作夥伴關係並在我們的管道組合上執行。

Some that's really the work we have to do.

有些確實是我們必須做的工作。

And come back to that point, that's one of the reasons we had a little bit of a lapse here.

回到這一點，這就是我們在這裡出現一點失誤的原因之一。

And to the extent that we can get back to it, that allows us to look, I'll get back to what we hope is what our traditional performance has been.

在我們可以回到它的範圍內，讓我們看看，我會回到我們希望的傳統表現。

Marie Thibault, BTIG.

瑪麗蒂博，BTIG。

Hey, good afternoon.

嘿，下午好。

This is Sam on for Marie.

這是瑪麗的山姆。

Thanks for taking the questions here.

感謝您在這裡提出問題。

Maybe I can ask on the DME channel.

也許我可以在 DME 頻道上詢問。

I recall that when you guys are making that shift a few years ago, that volume mix would peak around 20%, I guess, is the right way to think about it closer to 15% now.

我記得幾年前，當你們進行這種轉變時，銷量組合將達到 20% 左右的峰值，我想，現在考慮接近 15% 是正確的方式。

And then as we think about more MA plan shifting of pharmacy, I mean, is there any risk that could go even lower?

然後，當我們考慮更多的 MA 計劃轉移藥房時，我的意思是，是否有任何風險可能會更低？

Thanks.

謝謝。

Taking the questions.

接受提問。

Yeah, we had always kind of got at least in the commercial channels, and we talked this is really more about the commercial channels.

是的，我們總是至少在商業管道中有所涉足，我們談到這實際上更多地與商業管道有關。

We had always assumed to be about 75, 25.

我們一直假設75歲、25歲左右。

That was kind of our crystal ball.

這就是我們的水晶球。

And as we got there, it started to skew a little bit more.

當我們到達那裡時，情況開始變得更加傾斜。

But it didn't drift off of that 75, 25 all that much.

但它並沒有偏離 75、25 太多。

However, this quarter, as we started to see really what I would say is loss of share, which for us in that channel is a bit unique and something we got to get our arms around.

然而，本季度，當我們開始真正看到我所說的份額損失時，這對於我們在該管道中來說有點獨特，我們必須抓住這一點。

The split in our business was a little more.

我們業務上的分歧更大一些。

It doesn't necessarily mean that the overall market split ultimately ends up that way.

這並不一定意味著整個市場的分裂最終會以這種方式結束。

But it does mean that the shift of our business certainly shifted that way.

但這確實意味著我們業務的轉變肯定會發生這種轉變。

And so does that number shift down to 85, 15?

那麼這個數字會降到 85、15 嗎？

Well, if we take share, no.

好吧，如果我們分享的話，不行。

And that's really on us.

這確實是我們的責任。

So let's get back to the execution question.

那麼讓我們回到執行問題。

We need to execute in that channel.

我們需要在該頻道中執行。

And that channel, it's a very important channel for us.

這個管道對我們來說是一個非常重要的管道。

And these are very important partners.

這些都是非常重要的合作夥伴。

And they serve a very, very important partnership to our customers.

他們為我們的客戶提供了非常非常重要的合作關係。

And so we've got to get back into that channel and make sure and that we're getting our fair share there.

因此，我們必須回到該管道並確保我們在那裡獲得公平的份額。

That's really the big driver.

這確實是最大的驅動力。

I'd also add, though, there has been a shift in government payer activity from the DME channel to the pharmacy.

不過，我還要補充一點，政府付款活動已從 DME 管道轉移到藥局。

That actually has happened.

這確實已經發生了。

And we have to figure out how much that has impacted, our DME mix versus pharmacy mix as well.

我們必須弄清楚這對我們的 DME 組合與藥品組合的影響有多大。

Mathew Blackman, Stifel.

馬修布萊克曼，史蒂菲爾。

Jeremy, I think I heard you mentioned that the new patient shortfall was something in the neighborhood of 70,000.

傑里米，我想我聽到你提到新的患者缺口約為 70,000 名。

Is there any way to tease that out?

有什麼辦法可以解決這個問題嗎？

I'm sure challenging by indication.

我確信透過指示來挑戰。

I mean, the DME share, while it sounds like it maybe is skewed more to basil patients potentially.

我的意思是，DME 份額，雖然聽起來可能更傾向於羅勒患者。

Is that fair?

這樣公平嗎？

And then what about on the sales force dislocation?

那麼銷售團隊的錯位又如何呢？

Just any help on sort of the difference pieces of the business?

只是對業務的不同部分有任何幫助嗎？

Yeah.

是的。

So the 70,000, the way to think about it is there's a good chunk of that is some OUS.

因此，這 7 萬人中，有很大一部分是 OUS。

And so there's a portion that's outside the United States.

所以有一部分是在美國以外的。

There's a portion that's inside the United States, and it's usually reflective of our patient base in total.

其中一部分位於美國境內，通常反映了我們患者群體的整體情況。

So you kind of have our splits there in the US really a lot of it is driven by the salesforce.

因此，在美國，我們的分歧實際上很大一部分是由銷售人員推動的。

Now, one of the challenges, of course, is the sales force services, all different indications.

當然，現在的挑戰之一是銷售人員服務，所有跡像都不同。

And so as you service all in different indications, you'd probably imagine if we're not doing well in the DME it gets back to your point.

因此，當您在不同的適應症中提供所有服務時，您可能會想像如果我們在 DME 中表現不佳，它就會回到您的觀點。

We're not doing wonderful in the basal space.

我們在基礎空間方面做得併不好。

That's a big piece of the DME, certainly DME, Medicare and in the patient base that they service.

這是 DME 的重要組成部分，當然是 DME、醫療保險以及他們所服務的患者群體。

So that's the way.

就是這樣。

It's really it's really hard to parse out by category.

確實很難按類別來解析。

But when we look into it and we say, gee, we're we're not doing we're not taking share in the DME space, you can presume that a lot of that is in that Medicare space.

但當我們調查它時，我們會說，哎呀，我們沒有做，我們沒有在 DME 領域分享，你可以假設其中很多都在醫療保險領域。

And I think it is fair to say that really across the board disruption, you can assume there's a little bit really across the board, but the biggest piece there, but the best way to put it.

我認為可以公平地說，真正全面的顛覆，你可以假設確實有一點全面的顛覆，但這是最大的部分，但也是最好的表達方式。

Yeah, I appreciate that.

是的，我很欣賞這一點。

Jayson Bedford, Raymond James.

傑森貝德福德，雷蒙德詹姆斯。

Just two quick ones.

就兩個快的。

Appreciate the color on the installed base, but can we assume there's no, there's been no real notable change in attrition?

欣賞安裝基礎上的顏色，但我們可以假設沒有，磨損沒有真正顯著的變化嗎？

And then just on the 3Q guidance, is there not a healthy contribution from Stelo in 3Q Or is the 40 million more fourth quarter weighted?

然後就第三季的指導而言，第三季 Stelo 是否沒有做出健康的貢獻，或者第四季增加的 4,000 萬是加權的嗎？

Yeah, Kevin.

是的，凱文。

This Stelo guidance, the Q3 contribution is not overly large.

根據 Stelo 的指導，第三季的貢獻並不算太大。

Most of the Stelo revenue as fourth quarter weighted as we, again, plan to launch Stelo in later August.

由於我們再次計劃在 8 月下旬推出 Stelo，因此第四季度的大部分 Stelo 收入都受到了影響。

So that is that's how that one works.

這就是它的工作原理。

With respect to attrition, our retention and attrition by patient category remains similar to what we had in our plans.

關於人員流失，我們按患者類別劃分的保留和人員流失仍然與我們計劃中的情況相似。

We know that our our Type 1 patient with an automated insulin delivery system is certainly our stickiest and patient with high utilization factors as we go down the acuity curve to people on MDI or basal users or even those who are not in non-insulin users.

我們知道，我們擁有自動胰島素輸送系統的 1 型患者無疑是我們最黏著且利用率高的患者，因為我們沿著敏銳度曲線向下延伸到 MDI 患者或基礎使用者，甚至非胰島素使用者。

Utilization goes down, but our retention numbers are still industry-standard by a very large margin.

利用率下降了，但我們的留存率仍然大幅達到業界標準。

And so we're still doing very well there.

所以我們在那裡仍然做得很好。

Steve Lichtman, Oppenheimer.

史蒂夫·利奇曼，奧本海默。

I wanted to ask again about the or the salesforce integration and just where you are today.

我想再次詢問有關銷售人員整合以及您今天的情況。

Are you seeing signs of stabilization now?

現在您看到穩定的跡象了嗎？

And what are you assuming on that front for the guide?

您對指南的這方面有何假設？

And then can you remind us what opportunities you see with this larger sales force that obviously can turn this into a positive ultimately?

然後您能否提醒我們，您在這支更大的銷售隊伍中看到了哪些機會，顯然可以最終將其轉化為積極的一面？

We are seeing things beginning to stabilize, but we're also seeing things slower than we had projected in our own internal models at the start of the year.

我們看到事情開始穩定，但我們也看到事情比我們年初在內部模型中預測的要慢。

And as we developed our guidance earlier, hence, as Jeremy said, the guidance coming down a bit.

正如傑里米所說，隨著我們更早地制定指導意見，指導意見有所下降。

So we are see seeing things begin to stabilize and they're stabilizing across different categories and geographies.

因此，我們看到事情開始穩定下來，而且在不同的類別和地區都在穩定下來。

I think the biggest thing to anticipate for us and one of the things class we missed in our plans, we sent a whole bunch of new reps and offices we've never called on before.

我認為對我們來說最值得期待的事情也是我們在計劃中錯過的事情之一，我們派出了一大堆我們以前從未拜訪過的新代表和辦公室。

And there's I get to know you period that we probably didn't estimate being long enough.

我認識你的那段時間我們可能沒有估計得夠長。

And so we're taking steps to assist our team in better interactions with those physicians and getting to know them and getting into trust and use Dexcom.

因此，我們正在採取措施幫助我們的團隊與這些醫生更好地互動，了解他們並建立信任並使用 Dexcom。

Somebody hasn't prescribed Dexcom, they've got to prescribe one to see how it goes.

有人沒有開 Dexcom，他們必須開一瓶看看效果如何。

And we've been going through that cycle during this quarter and we should be able to increase the prescription patterns of those new physicians a lot more going forward.

我們在本季度經歷了這個週期，我們應該能夠在未來更多地增加這些新醫生的處方模式。

But there was a lot of getting to know you, for lack of a better word, going on here in the second quarter as this group got out there.

但是，由於缺乏更好的詞，當這支球隊離開那裡時，在第二季度這裡發生了很多事情來了解你。

We'll have a lot more data at the end of third quarter.

我們將在第三季末獲得更多數據。

We saw better interactions in May and June, and we'll see how things go from here on out.

我們在五月和六月看到了更好的互動，我們將看看從現在開始事情會如何發展。

Thank you.

謝謝。

Mike Pollard, Wolfe Research.

麥克‧波拉德，沃爾夫研究中心。

Thank you.

謝謝。

I want to ask on your relationship with distributors and the concept of stocking.

我想問一下你們和經銷商的關係以及備貨的概念。

Last year obviously was a big year with the G7 launch and the basal coverage expansion and there's always a lot of stuff going on OUS.

去年顯然是重要的一年，G7 發布了，基礎覆蓋範圍擴大了，OUS 上總是有很多事情發生。

As you look back at '23 as the baseline for building '24, would you frame any of kind of setback as stocking last year that that kind of caused snafu in your modeling or this year?

當你回顧「23」作為建立「24」的基準時，你會把去年或今年的庫存挫折歸咎於去年或今年造成的混亂嗎？

If you can comment on inventory levels with key partners, as they're pretty observing a drawdown of inventory?

您是否可以對主要合作夥伴的庫存水準發表評論，因為他們非常觀察到庫存的減少？

If there's anything to frame around that.

如果有什麼可以圍繞這一點構建的。

I'd appreciate the color.

我很欣賞這個顏色。

Yeah, if anything, usually you have these challenges when you launch a product given inventory levels of the old and inventory levels of the new.

是的，如果有的話，當你推出一款產品時，考慮到舊產品的庫存水平和新產品的庫存水平，通常你會遇到這些挑戰。

In all fairness to our partners last year, they did a pretty good job of balancing G6 and G7 inventory levels as they went through their transition.

平心而論，去年我們的合作夥伴在轉型過程中在平衡 G6 和 G7 庫存水準方面做得相當不錯。

So we didn't have a whole lot in the prior year.

所以我們前一年沒有太多。

This year it's pretty normal.

今年的情況很正常。

And we have inventory levels that generally range in between pretty normal levels.

我們的庫存水準通常在相當正常的水準之間。

We keep an eye on what's in the channel and they always stay within this.

我們密切注意頻道中的內容，他們始終留在頻道內。

This really relatively tight band.

這個帶確實比較緊。

And when we keep it, we keep it in that band intentionally.

當我們保留它時，我們有意將其保留在該範圍內。

And so we've been in that band now, and we hope we generally stay in that band.

所以我們現在已經在這個樂團了，我們希望我們總體上留在這個樂團。

I don't I don't recall a time we've been outside that band, quite frankly.

坦白說，我不記得我們曾經離開過那個樂團。

And so nothing to call out specifically.

所以沒有什麼需要特別指出的。

The bigger issue, than I get you're getting at, the bigger issue would have been say last year during a window when you had a launch of G7 and folks were gearing up given not sure how much demand would come in.

更大的問題，比我所理解的你所理解的，更大的問題應該是去年的一個窗口期，當時你推出了 G7，人們正在做準備，因為不確定會有多少需求。

We didn't really have that last year.

去年我們確實沒有這樣的經驗。

And again, kudos to everybody that was holding inventory.

再次向所有持有庫存的人表示敬意。

They did a nice job.

他們做得很好。

Thank you.

謝謝。

Shagun Singh, RBC Capital Markets.

Shagun Singh，加拿大皇家銀行資本市場。

Great.

偉大的。

Thank you so much for taking the question.

非常感謝您提出這個問題。

Just a follow up on the sales force disruption here, you said it was more disruptive than historically because you changed roles.

只是對這裡銷售團隊中斷的後續行動，您說這比歷史上更具破壞性，因為您改變了角色。

So can you elaborate on that?

能詳細說明一下嗎？

And then you talked about physicians, changed physicians people are calling on.

然後你談到了醫生，人們呼籲更換醫生。

So is this are you referring to the PCP channel?

那您指的是PCP頻道嗎？

And then you also referred to longer time to productivity.

然後您也提到了更長的生產力時間。

Can you give us a sense of how long does it take to get fully productive?

您能否告訴我們需要多長時間才能充分發揮生產力？

It sounds like about two quarters or so because you said you expect them to be fully productive getting into 2025.

聽起來大約是兩個季度左右，因為您說過您希望他們在 2025 年之前能夠充分發揮生產力。

So is that the case?

那麼是這樣的嗎？

And then just finally, can you give us an update on the extended-wear?

最後，可以為我們介紹一下關於延長磨損的最新情況嗎？

Thank you.

謝謝。

I was waiting for a science question.

我在等一個科學問題。

So I'll start with extended wear.

所以我將從延長佩戴開始。

We've been committed to launching a 15 day product in 2025.

我們一直致力於在 2025 年推出為期 15 天的產品。

And we intend to.

我們打算這樣做。

Things are progressing well on that front.

這方面的事情進展順利。

Stelo will be a 15-day product as well.

Stelo 也將是為期 15 天的產品。

We will learn a great deal from Stelo with our launch and how that goes.

我們將從 Stelo 的發布以及進展中學到很多東西。

With respect to the sales team, again, that reorganization is much different than what we've done in the past.

就銷售團隊而言，這次重組與我們過去所做的有很大不同。

What we've done in the past is we would look at an area and the total sales volume in an area and the physicians there and kind of just divided up geographically and make various sub areas.

我們過去所做的就是查看一個地區、該地區的總銷量以及那裡的醫生，然後按地理劃分並劃分不同的子區域。

So the reps in those areas would call on endocrinologists and primary care physicians and primarily their efforts were focused on those that were high, the highest prescribers in that territory.

因此，這些地區的代表會召集內分泌科醫生和初級保健醫生，他們的工作主要集中在那些開藥率高的人，也就是該地區開藥率最高的醫生。

What we did this time is, we took our territories and we said, okay, we are going to have specialty reps.

這次我們所做的是，我們佔領了我們的領土，我們說，好吧，我們將有專業代表。

And one force who calls primary on the primarily on the high-prescribing physicians, endocrinologists and high-prescribing primary care doctors who are very familiar with the product and service them more in that type of role.

還有一股力量主要針對高處方醫生、內分泌科醫生和高處方初級保健醫生，他們非常熟悉該產品，並以此類角色為他們提供更多服務。

And that's one group of our sales force.

這就是我們的一組銷售人員。

Then we have more people who are prospecting who are going down and talking to more of PCPs who don't prescribe as much product, places where we have not been before.

然後，我們有更多的人正在尋找客戶，他們正在與更多的 PCP 交談，他們不會開出那麼多產品，我們以前從未去過的地方。

Because what we've noted in our data is we obviously don't win in offices we don't call on.

因為我們在數據中註意到，我們顯然不會在我們不拜訪的辦公室中獲勝。

And so we needed to get into those offices and develop relationships.

因此，我們需要進入這些辦公室並發展關係。

A lot of the time that that has been spent in the first, in this first quarter and going forward in Q3 is beginning to develop and cultivate those relationships so we can get prescriptions from those health care professionals.

在第一季、第一季以及第三季中花費的大量時間開始發展和培養這些關係，以便我們可以從那些醫療保健專業人員那裡獲得處方。

They need to learn to trust us, and they need to learn to, and have some experiences with our products.

他們需要學會信任我們，他們需要學會信任我們，並擁有我們產品的一些經驗。

So that is how that is going and that is why this is different.

事情就是這樣，這就是為什麼情況有所不同。

So we really did things differently than we've done in the past.

所以我們所做的事情確實與過去不同。

We believe over the long term is absolutely the right thing to do and we have confidence in this team that they'll work through this.

我們相信從長遠來看這絕對是正確的事情，我們對這個團隊充滿信心，他們會解決這個問題。

We believe it will start to turn, near the end, starting into Q4 and be in a very good position by 2025.

我們相信，從第四季開始，到 2025 年，情況將開始好轉，並處於非常有利的位置。

And that is the timeframe that we are looking at if things go fast or great, but that's how we model our business.

如果事情進展得很快或很好，這就是我們正在考慮的時間框架，但這就是我們建立業務模型的方式。

As Jeremy said earlier, we've decelerated our new patient number from what we had in our original models for Q3 as to what we have now.

正如傑里米早些時候所說，我們已經將新患者數量從第三季度原始模型中的數量減少到了現在的數量。

And we see things picking back up in Q4.

我們看到第四季情況有所回升。

As the group gets more.

隨著團體越來越多。

And so that's where it is.

這就是它所在的地方。

Thank you.

謝謝。

Bill Plovanic, Canaccord Genuity.

比爾‧普洛瓦尼克 (Bill Plovanic)，Canaccord Genuity。

Great.

偉大的。

Thanks for taking my questions.

感謝您回答我的問題。

I just wanted to ask, so the pharmacy is good.

我只是想問，藥局不錯。

DME is slowing.

DME 正在放緩。

Do you think this is potentially a slowdown in penetration into the Type 1 and Type 2 markets?

您認為這是否會導致 1 類和 2 類市場的滲透速度放緩？

You're hitting about 60% type 1, 40% type 2 in the US.

在美國，大約 60% 屬於第 1 型，40% 屬於第 2 型。

I mean, are you just starting to get a saturation point where each incremental market share market penetration Iis that much tougher to come by?

我的意思是，你是否剛開始達到飽和點，每個增量市場佔有率的市場滲透都變得更難實現？

Or do you think this, so it's a broader challenge or is this purely specific to sales force and DME and what have you?

或者您認為這是一個更廣泛的挑戰，或者這純粹是針對銷售人員和 DME 的，您有什麼？

It's a good question in the US, we don't think so.

在美國這是一個很好的問題，但我們不這麼認為。

There's still quite a bit of one way and we're still seeing the growth patterns relatively steady there.

仍然有相當多的單一途徑，而且我們仍然看到那裡的成長模式相對穩定。

If you look at the overall total market growth in the second quarter.

如果你看一下第二季的整體市場總成長。

I think what you can see is, if you add up all the various players, it's still very robust growth.

我認為你可以看到，如果你把所有不同的參與者加起來，它仍然是非常強勁的成長。

I think in our case, certainly in the DME in the DME channel, it was a share loss.

我認為就我們的情況而言，當然是在 DME 頻道的 DME 中，這是份額損失。

And I think we just held our own in the retail channel this quarter.

我認為本季我們在零售通路中保持了自己的地位。

And so and so that I don't necessarily know that I would say that.

如此這般，我不一定知道我會這麼說。

I think it's more about us getting getting in charge of really our go to market and making sure with our leading technology, we're getting fair share there.

我認為更多的是我們要真正掌控我們的市場走向，並確保憑藉我們的領先技術，我們在那裡獲得公平的份額。

As you zoom outside the US, as Kevin alluded to a little bit in the script, outside the US, it's really chunks of chunks of coverage and chunks of approval.

當你把目光轉向美國之外時，正如凱文在劇本中提到的那樣，在美國之外，這確實是大塊的報道和大塊的認可。

And while we got a bit of a chunk here in France, Basel, there are some chunks we are waiting on.

雖然我們在法國巴塞爾獲得了一些份額，但我們仍在等待一些份額。

And so it can slow a bit as an overall market.

因此，整個市場可能會稍微放緩。

I think you see it when you compare, when you combined results globally, there is a bit of a slowdown outside the US.

我認為，當你比較時，當你綜合全球結果時，你會看到這一點，美國以外的地區出現了一些放緩。

We don't think that it's a long-term issue because as chunks of approvals come in, you find that there's still certainly pent-up demand.

我們認為這不是一個長期問題，因為隨著大量批准的到來，你會發現肯定仍然有被壓抑的需求。

So really it's about coverage.

所以這實際上與覆蓋範圍有關。

And we are working on coverage in various different areas, both Type 2 intensive, certainly in Basel.

我們正在努力涵蓋各個不同領域，都是 2 類密集型領域，當然在巴塞爾。

And there's even some countries where we're still working on Type 1 coverage in some of the more emerging markets.

甚至在某些國家/地區，我們仍在一些新興市場中致力於 1 類覆蓋範圍。

So maybe outside the US, you see a temporal slowdown, but not in the US.

因此，也許在美國之外，你會看到暫時的放緩，但在美國卻沒有。

I think the US is still a very robust market.

我認為美國仍然是一個非常強大的市場。

We're still seeing diesel grow at the same rates that we expected as a total, the total category.

我們仍然看到柴油的成長速度與我們對整個類別的預期相同。

Still seeing the Intensive Insulin category is still growing well.

仍然看到強化胰島素類別仍然成長良好。

And obviously with, non-insulin opportunities with Stelo and the OTC products, I think it's a market that can continue to grow for some time.

顯然，隨著 Stelo 和非處方藥產品的非胰島素機會，我認為這是一個可以繼續成長一段時間的市場。

Yeah, I'll add to that.

是的，我會補充這一點。

You talking about a 60% penetration.

你說的是 60% 的滲透率。

I said several years ago, 80% per Type 1 insulin users.

我幾年前就說過，80% 的人是第 1 型胰島素使用者。

And I believe the same with Type 2 intensive insulin users.

我相信第 2 型強化胰島素使用者也是如此。

There is no reason somebody should be on a CGM.

沒有理由有人應該接受 CGM。

It's up to us to create the experience and the access structured, whereby everybody can get to it.

我們有責任創造一種體驗和結構化的存取方式，以便每個人都可以獲得它。

And those are the things we have to take on, Bill.

這些就是我們必須承擔的事情，比爾。

And I grew cherries Jeremy's comments.

傑里米的評論讓我種了櫻桃。

Our average this quarter focused on our execution a lot more than a market slowdown, it's up to us to be better.

我們本季的平均值更專注於我們的執行力，而不是市場放緩，這取決於我們是否做得更好。

Okay, thanks.

好的謝謝。

Chris Pasquale, Nephron.

克里斯·帕斯誇萊，尼弗龍。

Thanks.

謝謝。

I wanted to just clarify two points.

我只想澄清兩點。

One on the rebate issue.

一是關於回扣問題。

Do you need to anniversary that before revenue per patient becomes less of a drag?

您是否需要周年紀念日才能減少每位患者的收入負擔？

In other words, is that a period impact or is it a resetting the bar that then you have to lap before you get back to normal?

換句話說，這是一個時期的影響，還是一個重置標準，然後你必須跑一圈才能恢復正常？

And Jeremy, you touched on international briefly in the last question.

傑里米（Jeremy），您在上一個問題中簡要談到了國際。

Most of the focus thus far has been on US, but OUS also disappointed it.

到目前為止，大部分焦點都集中在美國，但 OUS 也令人失望。

Am I right in interpreting, you think that the slower growth there, it is more normal until you get some of these new coverages to come through.

我的解釋是否正確，您認為那裡的成長速度越慢，在您獲得一些新的報導之前，這是比較正常的。

That's really the going to be the catalyst for a reacceleration.

這確實將成為重新加速的催化劑。

Yeah.

是的。

So in terms of your rebate dynamic, I think we talked about it coming faster and because it's come faster, certainly here in the Q2 and to a lesser extent in Q1.

因此，就您的回扣動態而言，我認為我們討論過它會更快到來，因為它會更快到來，當然在第二季度，在第一季度的程度較小。

You'll lap it pretty darn early next year.

明年初你就會把它圈得很漂亮。

So we're going to lap it pretty darn quick.

所以我們要非常快地完成它。

Obviously, it's going to impact us at a more acute number.

顯然，這將對我們產生更嚴重的影響。

We expected it to be gradual over the course of this year into next year, which still would have been faster than G6.

我們預計它會從今年到明年逐步推進，但仍會比 G6 更快。

So to that point, it does it does help for next year's comps because we will lap and pretty darn quick.

所以到目前為止，它確實對明年的比賽有幫助，因為我們會跑得非常快。

In terms of the question on OUS, one of the things we've done historically, there is a market where we've taken share and obviously it's been growing.

就 OUS 的問題而言，我們歷史上做過的事情之一，我們已經佔據了一個市場份額，而且顯然它一直在增長。

In this quarter, I would say we didn't take share and that's the that's part of it.

在本季度，我想說我們沒有分享份額，這就是其中的一部分。

The other part then is in the chunks.

另一部分則成塊。

And so there's two opportunities there.

所以那裡有兩個機會。

Certainly, there's chunks of reimbursement which would help accelerated it.

當然，大量的報銷將有助於加速這一過程。

But our expectation with the product launches we've had and the quality of product that we have is to take share.

但我們對產品發布和產品品質的期望是搶佔市場份額。

And so I think there's two opportunities one is within our control, which is taking share.

所以我認為有兩個機會，一個是我們可以控制的，一個是搶佔份額。

And then the other is within the industry's control, which is coverage.

另外一個是行業可控範圍內的，那就是覆蓋範圍。

And we're going to execute on that, which we can control and certainly aid and helping the industry covered as well.

我們將執行這一點，這是我們可以控制的，當然也可以幫助和幫助所涵蓋的行業。

Thanks.

謝謝。

Matt Miksic, Barclays.

馬特·米克西奇，巴克萊銀行。

Hey, thanks so much for taking the question.

嘿，非常感謝您提出問題。

So there's a couple of things that I think investors are trying to pin down here and understand, given the announcement and the display changing trajectory here in the back half.

因此，考慮到後半部分的公告和顯示變化軌跡，我認為投資者正試圖確定並理解一些事情。

And the first is around this, the channel mix, indication mix and their indirect impact on pricing, maybe given that you're building out a field force growing into areas where you haven't traditionally called, as you talked about, potentially maybe the margin impact of that.

第一個是圍繞這一點，渠道組合、指示組合及其對定價的間接影響，也許考慮到您正在建立一支現場隊伍，發展到您傳統上沒有提到過的領域，正如您所說，可能是邊際影響。

But is that something where your channel mixes and these pricing factors have sort of set off on a new trajectory that and we now have to think about an equation that applies patient growth and price mix.

但是，您的通路混合和這些定價因素是否已經開啟了一條新的軌跡，我們現在必須考慮一個應用病患成長和價格組合的方程式。

What does that translate into growth over the next couple of years?

這對未來幾年的成長有何影響？

Should we be thinking differently about that?

我們應該對此有不同的思考嗎？

And then I guess the other just to cross it off the list, it doesn't sound like it's a factor is, it's just around competition.

然後我想另一個只是將其從清單中劃掉，這聽起來不像是一個因素，它只是圍繞著競爭。

Is there a shift, given the places where you're going into new accounts in the PCP channel or elsewhere?

考慮到您在 PCP 頻道或其他地方開設新帳戶的地方，是否存在變化？

Are you feeling like you're getting into slightly tougher competitive challenges?

您是否覺得自己正面臨稍微嚴峻的競爭挑戰？

It doesn't sound like it, but just if you could maybe cross that off the list and provide any color on the first that would be terrific.

聽起來不像，但如果你能把它從清單中劃掉並在第一個上提供任何顏色那就太棒了。

Thanks.

謝謝。

Yeah.

是的。

So I'll maybe go to crossing off the list.

所以我可能會去劃掉這個清單。

There's always competition.

競爭總是存在的。

And certainly, as we go into all of these categories, you're always going to have that.

當然，當我們進入所有這些類別時，你總是會遇到這樣的情況。

We've always had competition.

我們一直都有競爭。

So this is an area that's been, we've been competing on for some time.

所以這是一個我們已經競爭了一段時間的領域。

So I don't think that's necessarily a new dynamic when you when you expand the sales force, clearly your first call points, you've got to go through that.

所以我認為，當你擴大銷售隊伍時，這不一定是一個新的動態，顯然你的第一個呼叫點，你必須經歷這一點。

But this is no different than what we had in 2021 last time, we expanded the sales force we went into new locations is building familiarity.

但這與我們上次在 2021 年的情況沒有什麼不同，我們擴大了銷售隊伍，進入新地點，以建立熟悉度。

And yes, there's always competition, but that's not a new thing.

是的，競爭總是存在的，但這並不是什麼新鮮事。

So I think you can cross that off the list.

所以我認為你可以把它從清單上劃掉。

To your question then on mix, I did it in the US, I don't think the market has moved all that much.

對於你關於混合的問題，我在美國做到了，我認為市場變化不大。

I think it gets back to our performance within that market and we have to perform in those areas.

我認為這又回到了我們在該市場的表現，我們必須在這些領域表現出色。

And so when you talk about is this a new price year over year pure price, it hasn't really changed all that much.

因此，當你談論這是一個新的價格同比純價格時，它並沒有真正改變那麼多。

Certainly in the DME channel, it hasn't changed all that much.

當然，在 DME 通道中，它並沒有太大變化。

And when we talk about that often.

當我們經常談論這一點時。

But when you have less performance in your highest reimbursed channels and better performance in a lower reimbursed channel, we've always talked about DME being higher than pharmacy.

但是，當您在最高報銷管道中表現較差，而在較低報銷管道中表現較好時，我們總是談論 DME 高於藥房。

And then you don't outperform on new patients.

然後你就不會在新病人身上表現出色。

You kind of combine all those up.

你把所有這些結合起來。

That's what you really saw.

這才是你真正看到的。

So the opportunity is for us to get out there and get the new patients and get the new patients and all of the channels and the channels that we've been in and get our fair share in those channels.

因此，我們有機會走出去，吸引新患者，吸引新患者，以及我們已經進入的所有管道，並在這些管道中獲得公平的份額。

So I think that's the best way to think about it is, we can do it.

所以我認為最好的思考方式是，我們可以做到。

It's within our purview to go do so as opposed to necessarily a shifting in the market itself.

這樣做是在我們的職權範圍之內，而不是必然改變市場本身。

Thanks so much.

非常感謝。

This concludes the question and answer session.

問答環節到此結束。

I will turn the call to Kevin Sayer for closing remarks.

我將把電話轉給凱文·塞耶 (Kevin Sayer)，讓其致閉幕詞。

Well, thanks, everybody for participating today.

好的，謝謝大家今天的參與。

This is a tough call for us.

這對我們來說是一個艱難的決定。

I know it's a tough call for all of you have supported us.

我知道對於所有支持我們的人來說，這是一個艱難的決定。

We've provided the best view that we have going forward.

我們已經提供了我們未來的最佳視野。

We obviously will work hard to do better and provide you with more color and more things going forward.

我們顯然會努力做得更好，為您提供更多的色彩和更多的東西。

We are extremely excited for our Stelo launch later this quarter.

我們對本季稍後推出 Stelo 感到非常興奮。

And we certainly expect to hear from you as we do that.

我們當然希望在這樣做時收到您的來信。

I just want to also point out, we've talked a lot about our commercial team today.

我還想指出，我們今天談論了很多關於我們的商業團隊的事情。

They're fabulous.

他們太棒了。

They've done very well and they will rebound from this.

他們做得很好，他們會從中反彈。

I have every confidence they will.

我完全有信心他們會的。

When you have something like this, it's on everybody in the company.

當你遇到這樣的事情時，公司裡的每個人都會有責任。

It's not just on those guys.

這不僅僅是那些傢伙的事。

We're all going to get to put our heads down and focus more.

我們都將低下頭，更專注。

So you can count on that.

所以你可以信賴這一點。

Thank you very much for being with us today.

非常感謝您今天和我們在一起。

And we'll see you all soon.

我們很快就會見到大家。

Thank you, ladies and gentlemen.

謝謝你們，女士們、先生們。

This concludes today's conference.

今天的會議到此結束。

Thank you for participating.

感謝您的參與。

You may now disconnect.

您現在可以斷開連線。

Speakers, Please standby for your debrief.

各位發言者，請等候報告。