Executive Summary

Q1 2025 net sales were $17.64M, up 36% year-over-year; gross margin was 50.9% (down ~482 bps YoY) as pharmacy channel mix accelerated; adjusted EBITDA was -$15.54M; diluted EPS was -$0.93 .
Versus Wall Street consensus (S&P Global), revenue beat by ~$1.49M (actual $17.64M vs $16.15M*), while EPS missed (actual -$0.93 vs -$0.506*) and adjusted EBITDA was modestly better than consensus (-$15.54M vs -$17.92M*) — a mixed print with a top-line beat and EPS miss driven by opex growth and warrant revaluation .
Full-year 2025 guidance raised across revenue ($82–$87M, from $80–$85M), pharmacy mix (22–25% of new starts, from >20%), and gross margin (50–53%, from ≥50%), reflecting stronger demand and faster-than-expected pharmacy adoption .
Catalysts: accelerating pharmacy reimbursement (Prime Therapeutics formulary effective Feb 1), continued CGM integrations (Libre 3 Plus), sales force expansion (to 63 territories), and upcoming ADA investor event highlighting real-world outcomes and patch pump demo — all referenced as drivers of patient access and growth .

What Went Well and What Went Wrong

What Went Well

New patient starts rose 48% YoY to 3,853; installed base reached 19,151, with 71% of starts from MDI — evidence of market expansion beyond traditional pump users .
Pharmacy mix ramped to “low 20s” percent of new starts in Q1 (already exceeding prior “>20%” FY guidance), with management emphasizing the pay‑as‑you‑go model’s long-term accretion and reduced patient out-of-pocket costs; “we send every patient that we can through the pharmacy” .
Product and channel execution: Libre 3 Plus integration, Color iLet, Bionic Circle, and PBM formulary momentum (Prime Therapeutics effective Feb 1) supported demand and access, underpinning guidance raises .

What Went Wrong

Gross margin compressed to 50.9% from 55.7% in Q1 2024, primarily due to higher pharmacy mix on new patient starts, despite management’s longer-term margin confidence .
Operating expenses rose 66% YoY to $27.61M, driven by sales force expansion and public company costs, contributing to wider loss from operations (-$18.64M) and net loss (-$28.66M) .
Non-GAAP adjustments highlight volatility: change in fair value of warrant liabilities (-$12.45M) weighed on GAAP net loss; adjusted EBITDA deteriorated to -$15.54M vs -$7.81M in Q1 2024 .

Financial Results

Key P&L metrics (quarterly comparison)

Metric	Q1 2024	Q4 2024	Q1 2025	Q2 2025
Revenue ($USD Millions)	$12.933	$20.440	$17.639	$23.238
Gross Margin (%)	55.7%	57.2%	50.9%	53.8%
Total Operating Expenses ($USD Millions)	$16.654	$24.726	$27.613	$32.375
Loss from Operations ($USD Millions)	$(9.453)	$(13.037)	$(18.642)	$(19.872)
Net Loss ($USD Millions)	$(12.449)	$(18.108)	$(28.656)	$(16.869)
Diluted EPS ($USD)	$(2.07)	$(2.72)	$(0.93)	$(0.39)
Adjusted EBITDA ($USD Millions)	$(7.805)	$(11.254)	$(15.535)	$(14.526)

Actual vs Consensus (Q1 2025)

Metric	Actual	Consensus	Surprise	Vs Consensus
Revenue ($USD Millions)	$17.639	$16.149*	+$1.490	Beat
Diluted EPS ($USD)	$(0.93)	$(0.506)*	-$0.424	Miss
Adjusted EBITDA ($USD Millions)	$(15.535)	$(17.918)*	+$2.383	Beat

Values with asterisks retrieved from S&P Global. EPS estimates: 5; revenue estimates: 7.*

Segment/channel breakdown

Segment	Q1 2024 ($USD Millions)	Q1 2025 ($USD Millions)
DME – iLet	$10.373	$9.628
DME – Single-use products	$1.732	$4.199
Total DME	$12.105	$13.827
PBP – iLet	$0.291	$0.506
PBP – Single-use products	$0.537	$3.306
Total PBP	$0.828	$3.812
Total Net Sales	$12.933	$17.639

Channel trend (quarterly totals)

Channel	Q4 2024 ($USD Millions)	Q1 2025 ($USD Millions)	Q2 2025 ($USD Millions)
Total DME	$18.063	$13.827	$18.644
Total PBP	$2.377	$3.812	$4.594
Total Net Sales	$20.440	$17.639	$23.238

Operating KPIs

KPI	Q4 2024	Q1 2025	Q2 2025
New patient starts	4,084	3,853	4,934
% from MDI	70%	71%	71%
Installed customer base	15,298	19,151	24,085
Pharmacy mix descriptor (% of new starts)	Low-teens	Low 20s	High 20s

Guidance Changes

Metric	Period	Previous Guidance	Current Guidance	Change
Total revenue	FY 2025	$80–$85M	$82–$87M	Raised
% of new patient starts reimbursed via PBP	FY 2025	>20%	22%–25%	Raised
Gross margin	FY 2025	At least 50%	50%–53%	Raised

Management noted the raised pharmacy mix implies a ~$1M headwind to FY25 revenue with up to ~$8M net tailwind over 2025–2028 assuming no attrition, and expects GM to increase modestly through the year on scale, lower BOM, and installed base-driven high-margin supply sales .

Earnings Call Themes & Trends

Topic	Previous Mentions (Q-2)	Previous Mentions (Q-1: Q4 2024)	Current Period (Q1 2025)	Trend
Pharmacy reimbursement strategy	N/A	Explained pay‑as‑you‑go economics; Prime Therapeutics formulary starting Feb 1; preference for pharmacy long term	Faster-than-expected plan adoption; low-20s% mix; FY mix raised; send all eligible scripts to pharmacy	Accelerating adoption
Ease-of-use/algorithm differentiation	N/A	Detailed “weight-based start, learns and adapts”; democratizing outcomes; fully closed-loop analysis shared	Reiterated algorithm advantage and real-world outcomes; sales force armed with clinic-level evidence	Strengthening narrative
Product performance/CGM integrations	N/A	Libre 3 Plus integration; Color iLet; Bionic Circle launch	Q1 supported by these launches and traction	Positive pull-through
Sales force expansion	N/A	Planned expansion to 63 territories exiting Q1	Added 20 territories in Q1 to 63; ramp to contribute from Q2	Expanding capacity
Tariffs/macro	N/A	Nairobi protocol exempts custom components; minimal tariff impact	Minimal tariff impact; contemplated in GM guidance	Neutral
R&D execution (patch pump)	N/A	Commercialization by end of 2027 reaffirmed	Demo planned at ADA; “Mint” patch pump brand announced later in Q2	On plan
Bihormonal/glucagon program	N/A	PK/PD bridging study path outlined	Bridging trial enrollment in Canada; work with Xeris; later Q2 dosing completed; results expected H2 2025	Advancing

Management Commentary

“We delivered $17.6 million in net sales… 3,853 new patients… Low 20s percent reimbursed through pharmacy… notably, we’ve already achieved our previous guidance of greater than 20% of new patient starts through pharmacy.” — CEO Sean Saint .
“Our gross margin… was 50.9%, down… primarily attributable to the substantial year-over-year increase we delivered in the percentage of new patient starts going through the pharmacy channel.” — CEO .
“We are increasing guidance across the board… net sales $82M to $87M… 22% to 25% of our new patient starts reimbursed through the pharmacy… gross margin 50% to 53%.” — CFO Stephen Feider .
“We send every patient that we can through the pharmacy… if they are covered, we send them there; if not, we send them to DME.” — CFO .
“The iLet… autonomously determine[s] initial insulin dosing based on weight alone, and then… adapts to the user and continuously adjusts those doses over time.” — CEO .

Q&A Highlights

Pharmacy adoption drivers and visibility: faster plan activation under Prime; sustained pharmacy mix expected through year; explicit routing of covered scripts to pharmacy .
New patient starts cadence: only ~4% sequential decline from seasonally strong Q4; minimal contribution from 20 new territories in Q1, with ramp from Q2 onward .
Revenue/GM cadence and pharmacy economics: mid-year pharmacy mix growth slows; GM expected to rise slightly through 2025 via scale and installed base despite pharmacy headwind .
Type 2 off-label usage: ~20–25% of Q1 new starts estimated type 2; focus on primary care applicability and pharmacy access; no label timeline disclosed .
Competitive landscape: management remains confident in iLet’s differentiated algorithm and fully closed-loop capability; monitoring competitor launches without seeing near-term risk .

Estimates Context

Q1 2025 actuals vs consensus (S&P Global): revenue $17.64M vs $16.15M* (beat); EPS -$0.93 vs -$0.506* (miss); adjusted EBITDA -$15.54M vs -$17.92M* (beat). EPS estimates: 5; revenue estimates: 7.*
Implication: Revenue strength (pharmacy-enabled access and product launches) offset by higher opex and warrant liability mark-to-market impacting GAAP EPS; models may need higher recurring supply revenue, higher pharmacy mix, and slightly higher opex run-rate, with GM trajectory modestly improving through FY per guidance .

Values with asterisks retrieved from S&P Global.

Key Takeaways for Investors

Q1 2025 was a top-line beat with margin compression from pharmacy mix; management raised FY revenue, pharmacy mix, and GM guidance, signaling confidence in demand and unit economics .
Pharmacy channel adoption is the core growth engine: near-term headwind to reported revenue/GM flips to tailwind ~month 11 of patient life; company controls channel routing of scripts .
Recurring, high-margin supply revenue should build as the installed base expands (19,151 in Q1 → 24,085 in Q2), supporting GM through 2025 despite mix shift .
Sales capacity expanded to 63 territories; expect contribution beginning Q2 and into 2H, aligning with management’s back-half heavier cadence and GM uptick .
Product differentiation (algorithm that learns and adapts; CGM-agnostic integrations) and reduced patient out-of-pocket via pharmacy underpin share gains versus traditional pump models .
Pipeline progress (Mint patch pump demo; bihormonal PK/PD bridging trial) adds medium-term optionality; investor event and H2’25 glucagon data could be narrative catalysts .
Near-term modeling: raise pharmacy mix assumptions and recurring supply ARPU, reflect higher opex from public company scale, modest GM improvement by 2H25; monitor warrant liability effects on GAAP EPS .

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