Dexcom Inc (DXCM)

2025 Guidance and Long-Range Plan
Q: Do you still expect to hit your 2025 guidance of $4.6 billion revenues and margin targets?
A: Yes, we are on track to hit our long-term guidance of $4.6 billion in revenues with the same margin targets we gave. - Based on what we're seeing today—record new patients this quarter, stability in the DME channel, increased productivity in the sales force, and international acceleration—we feel good about where we're going. - We haven't even really talked about Stelo, which is going to be a real interesting opportunity for us going forward. -

U.S. Sales and New Patient Growth
Q: Did the record new patient starts include Stelo, and how does patient growth compare to revenue growth?
A: The record new patient adds exclude Stelo; this is for our G-Series insulin products. - Our U.S. patient base is growing in the mid-20% range, but revenue growth is affected by factors like rebates and channel shifts. - We expect the gap between patient growth and revenue growth to close over time as these factors stabilize. -

CGM Market Growth
Q: Is the CGM market growth slowing, given it appeared to slow to about 10% in Q3?
A: We believe the market can grow faster than that going forward. - Our numbers were lower based on execution issues we needed to improve, but we're still very bullish on the category. - Basal coverage is still early on, and there are many people on intensive insulin who still don't use CGM. -

15-Day G7 Sensor Approval and Impact
Q: What's the status of the 15-day G7 sensor approval and expected financial impact in 2025?
A: We've submitted it and, while we won't speculate on approval timing, we would love a fast approval. - The financial impact will depend on launch timing and how long it takes to roll through the customer base. - There's an interesting lever here, and we're really excited about it. -

DME Channel Stabilization
Q: How are you stabilizing your position in the DME channel, and can you regain previous standing?
A: We've met with leadership, listened to them, and heard what they had to say. - We've encouraged our team to be more channel agnostic and send patients to DME when appropriate. - While this will take time to build back up, we believe we've taken very good steps to shift in the other direction. -

Competition in Type 1 Pump Segment
Q: How will you defend your position in the type 1 pump-integrated segment with more competition next year?
A: Every study in these AID systems has been done with the Dexcom sensor, and the results with our partners have been incredibly good. - We work closely with them to enhance the experiences of their customers, and the accuracy of Dexcom is tried and true and proven to these patients. -

Stelo Launch and Impact
Q: What are your plans for accelerating the Stelo launch in 2025, and how has it performed so far?
A: We have scheduled enhancements to the Stelo app and will expand distribution channels. - We've had positive feedback, and with over 70,000 users, it's a huge success for us. - We'll continue to enhance the experience and create a more delightful experience for users. -

2025 U.S. Recovery and Rebate Impact
Q: How do you see U.S. recovery in 2025, and will rebate eligibility impact your results?
A: It assumes a stable market moving into 2025, with stable trends in the DME channel. - Stelo has been considered in our modeling, and we feel good about the $4.6 billion number. - We have 100% rebates assumed, so you won't necessarily have that headwind. -

International Growth Drivers
Q: What do you see as the biggest drivers internationally in 2025?
A: We've opened up a tremendous amount of access across the world over the past several months. - For example, we just launched Dexcom in France in October, accessing 600,000 more individuals, and in Japan, there's access to 1 million individuals. - Access will be a big driver in the markets that we serve. -

Rebate Impact on Growth
Q: What is the rebate impact on growth in Q3, and what's being assumed in the Q4 guide?
A: The rebate impact was about 6 points of headwind in Q3. - It's less than that in Q4; it won't be 6 points. - We have ASPs pretty consistent moving from Q3 to Q4 because we do have them at 100% rebate rate. -

Stelo as a Gateway Product
Q: Have you seen any Stelo users transfer to the G7 product, and what are your expectations?
A: We haven't necessarily seen a lot, but we've heard some anecdotal stories. - What we have seen is our reps going into primary care offices with the Stelo message, which leads to positive conversations and G7 prescriptions. -

U.S. Commercial Strategy and Leadership Transition
Q: Given the leadership transition in the U.S., can you talk about your confidence in the commercial strategy getting into 2025?
A: We'll miss Teri, but we have a lot of good leaders in this organization. - I'm not concerned about the leadership of my U.S. team; they are very good and very strong. - We will work hard not to disappoint. -

New Patient Start Dynamics
Q: Can you give any qualitative commentary between type 1 and type 2 in your record new starts?
A: The record new patient starts exclude Stelo. - We're continuing to see robust adoption in all categories, with intensive insulin continuing to lead the way across type 1 and type 2. - Basal continues to be relatively strong, and we're seeing more uptake as we dive deeper with these physicians. -

15-Day Sensor Survival and Cost
Q: Will the 15-day sensor have incremental COGS, and will survival to full wear time be similar?
A: The standard cost doesn't change at all. - We expect the durability of the 15-day to be solid, and survivability is going to be very well received by the community. -

Competitor CGM Shortages Impact
Q: Did you benefit from competitor CGM shortages towards the end of the quarter in the U.S.?
A: We heard about some disruptions, but we didn't see anything necessarily change. - What we saw was our sales force getting out there and getting more interest in Dexcom. -

Risk of Channel Mix Shift Due to Competition
Q: Is there risk of persistent channel mix shift from DME to pharmacy with competitors accessing the pharmacy channel?
A: We've seen a major shift of our volumes to the pharmacy channel, particularly on the commercial side. - As others seek reimbursement and distribution in the pharmacy channel, we're well-positioned to serve that. - Medicare fee-for-service is reimbursed via Part B, so it won't necessarily shift to pharmacy anytime soon. -

Early Insights on Stelo Retention and Reliability
Q: Any early insights around Stelo reordering retention rate and product reliability?
A: At least 50% of individuals signed up on the subscription model, and reordering has just begun. - We're happy with the ordering rates right now. - We've learned that a consumer market has different expectations, and we're working to create a proper experience. -

DME Channel Strategies
Q: What specific strategies are you employing to improve relationships with DMEs?
A: We've met with leadership, heard their concerns, and are focusing on volume rather than price. - We've encouraged our team to be channel agnostic and consider DME when appropriate. - We're offering DMEs Stelo as an opportunity to market and sell to their large patient bases. -

Attrition Rates
Q: Have you seen any notable change in attrition?
A: We haven't seen many changes in attrition by category. - Intensive insulin users have traditionally stayed in a band, basal users are close, and non-insulin users tend to be in a band of its own; these continue to remain very similar categorically. -

Financial Impact of Stelo in 2025
Q: How are you considering Stelo's financial impact for 2025?
A: We've considered multiple ranges and opportunities. - We felt good about the $4.6 billion number, which includes all of that. - We'll give more clarity as we start to roll out commercial plans. -