DexCom, Inc. (DXCM) Earnings Call Transcript & Summary

Welcome to the 2023 Dexcom Investor Day. As a reminder, this presentation contains forward-looking statements. Please note our safe harbor statement included here as well as our filings with the Securities and Exchange Commission. Please welcome to the stage, Kevin Sayer.

Good afternoon, everybody. Yes, I pick my own music. I'm old. This is what I grew up with. Welcome to San Diego, everybody, on behalf of Dexcom. We are thrilled to host you here and to have you here in San Diego at ADA. It's been 5 years since I got up on stage in front of you as an investor group. We had a virtual meeting in the middle, so it's even more fun for me now. We have more exciting things happening at this show than we've had at any show in the past, and you'll hear great things today. You'll see great things over there that we don't even have to tell you. Our agenda for today, I'll start off. I'll be followed by the longest tenured member of our team, Jake Leach, our Chief Operating Officer; then our newest member of our team, our Chief Commercial Officer, Teri Lawver. She's almost 6 months into the job and then thrown into the fire numerous times since she started; and then the one you know best, Jereme. And then I'll come back up and wrap things up. There's a lot of detail we're going to cover over the next couple of hours. But if we had to summarize the 3 key takeaways, this is what they would be. First, Dexcom access to our CGM -- market access to our CGM is expanding faster than ever. Most of you are aware of the recent coverage decisions by CMS to cover CGM for people on insulin with type 2 diabetes on basal insulin only. That just went into effect, and that is what we believe the single largest expansion in coverage in the CGM category ever. We're going to provide you with some incremental updates that you'll -- ever since this Medicare policy has changed, their coverage has expanded to a far greater degree. We're also excited to preview a new product for you today for the first time for years. Now I've been telling you that the Dexcom story is going to include different experiences to meet the tailor need of individual customer segments. And today, you'll see an example of this vision brought to reality. Teri is going to talk a little bit about that initial product, and we are very excited to be progressing towards this launch. And finally, our current 2025 LRP is only about halfway there. But we're in a position to be updating those numbers to the upside on a positive basis because of the growth we've seen in the last 2 years, our continued market expansion and our continued share gains all over the world. Take these things, our message is very clear: Our journey is only beginning. One of the best things about this job has been literally creating an industry. When we started at Dexcom, if we could have got to a phone, we would have been thrilled. But as you look at the first that have come to CGM technology that are brought to you by Dexcom here, we have created experiences that have made us the go-to first line of defense for the type 1 and for the intensive insulin-using community over the years. Every single major technological advancement in this space has been driven by Dexcom. We take that very seriously. We're not going to rest on our laurels. We're going to continue to advance CGM and bring solutions that are meaningful to patients across health. You see a few of the features that have demonstrated our leadership here on this new product. Our customers drive innovation at Dexcom, which is why you will see many of our customers and many of our product users all throughout this presentation. But it's not only our customers and the end users. It's their infrastructure and their ecosystem. It's their parents if they're children. It's people my age watching their parents if they have glucose problems and seeing that data. It's for physicians. We need to bring solutions into place that are meaningful. Anybody on our team will tell you, one of my favorite things to say, and they're kind of tired of it, when we come in with a new idea is I ask one very simple question: What problem are we solving? And if they can't answer it, we move on. This customer-centric focus has led to this platform that we have today. Our CGM platform is the most connected platform in the ecosystem. We've been connected to automated insulin delivery for helping people with type 1 and now type 2 manage their automated insulin delivery systems for a long time. Whatever your insulin choice is, we bring you a connected solution that could help. We are connected to caregivers through our SHARE system. Over and over again, we hear wonderful stories of people who see data from their loved ones within our SHARE system. And that ecosystem of data was incredibly valuable to health care professionals during the pandemic and remains valuable today as they offer great advice to their patients in the very short periods of time that they're able to see them. This connected platform has been very crucial as we've driven this industry, and we expect to continue to broaden our connectivity with more partnerships, more relationships than ever. We believe we can have a huge impact on global health. To give you a sense of what we believe and what we see going forward, let me show you a short video. [Presentation]

As we listen to our customer base, we understand their needs vary. For those on insulin, who are our core customers in a market we will always design and serve and be committed to, we've got to minimize the burden of diabetes, help with carb counting, help with insulin dosing and help alleviate the fear of hypoglycemia. But as we move to type 2 diabetes and possibly prediabetes, these are people looking for metabolic health solutions. And we hear less about the disease than we hear more about fear of the disease advancing. These people need tools to educate them and help them manage their conditions. Our CGM products, our hardware and our software solutions, were going to be custom -- they'll be custom and they'll be designed to meet those needs and address those problems. One of our core values at Dexcom is think big. We have 4. As we look at our mission statement on our wall, it said -- last year it said: To empower people to take control of diabetes. As you saw from that video and as we look at our opportunity, thinking big is more than that. So we changed the mission statement down to one word at the end: To enable -- empower people to take control of health. This is our new mission. Again, we'll never not be committed to the diabetes community, but we believe there is so much more we have to offer and so much more that we can do. We see a wonderful opportunity to expand what we do into broader metabolic health. So how do we do that? How do we broaden what we do? And how do we address bigger populations and do more? First of all, we have to have customized product experiences. When we build great CGM hardware, we'll have hardware experiences and customized software experiences to address those markets. Second, we have to establish glucose as a broader health measure, and we've got to show that more than time in range and lower A1cs and the diabetes-related metrics, we have to develop metrics and outcomes to other comorbidities, such as obesity, such as cardio health and things like that, to define glucose as a measure of the whole person. And finally, we need to show that our systems are cost effective and drive reduced costs throughout the system. Let's talk about a few of these. Tailored software experiences are coming, I said, again, 5 years ago at that meeting. And actually, I said it to Terry Gregg in my first month of work 12 years ago that I envision the day when Dexcom is going to be a software company, or more of a software company. That day is coming. Our Dexcom ONE product is our first foray into that world. That's a different software experience than we had before. As we look at each of the groups that we want to serve, we need to better develop software experiences for these people. Our insulin patients, again, AID connectivity, alerts, alarms, things that help them with what they do. For your expecting mothers in gestational diabetes, they manage glucose to a much tighter range, what is the proper experience for that group. For people with type 2 not on insulin, for health and wellness, the solution is really driving the right behaviors and educating them on what's going on. For example, what happens on a day when I don't take my meds? What happens on a day when I exercise? Things of that nature. And finally, for the hospital and inpatient care, our accuracy and our connectivity will position us very well in that marketplace over time. As we tailor our software needs, we need to highlight the importance of glucose all throughout the body, but it does more than just measure blood sugar and deal with diabetes. There are several studies over at the show that are going to demonstrate that. One of the things that I'll highlight here is we went through some clinical data of a lot of our type 2 intensive insulin-using patients who are on CGM and saw that there was significant weight loss within this user group. It's on basal insulin, I'm sorry, not intensive, but the basal insulin users, significant weight loss demonstrated over a long period of time. CGM helps tremendously, and we need to demonstrate outcomes of that nature. On the cost front, 1/4 of the dollars spent in United States on health care are spent on diabetes. These trends have to change. The only way to change those trends is to give people information that can make their health better and make them do better. Let's show you some examples of how Dexcom is doing just that. If we look at the 2017 cost data, 94%, 94% of dollars in diabetes care are spent in 3 areas: inpatient care, outpatient visits and prescription medications. If we want to be a part of the solution, we got to address these costs. We did look at a large subsection of our G6 users in type 2 on intensive insulin -- got my studies mixed up a little bit there before. We saw a 50% reduction in inpatient visits after they went on Dexcom CGM. When we provide data to people to make better health care decisions, they get healthier. And so doctor visits go down, and we've seen this happen over and over and over again. That's why the payer community is willing to pay for CGM because they know over time, we believe, that this reduces costs within the system. We have a long runway in the U.S. People ask us, how much more can you grow in the U.S. There are 7 million people on insulin in the U.S., and you can see, it is not overly penetrated yet. 28 million non-insulin-using people with type 2 diabetes. The recent CMS decision expanded coverage beyond just basal insulin use to people with type 2 diabetes who experience severe hypoglycemic events. We'll talk more about that in a minute later, but that expands our addressable market tremendously. We'll drive reimbursement in these other segments like we have in the ones on the top to eventually get CGM access to this entire population. Internationally, we continue to have great success. We've expanded our international markets really through 4 things here that are listed on this slide. We've increased reimbursement by providing tremendous outcome data that have convinced these reimbursement agencies to cover us. We've greatly expanded our direct sales presence: in some countries, just building it on our own; in other countries, acquiring distributors who have that infrastructure in place for us. We've entered new geographies, and we formed some very good strategic relationships that will help us build infrastructure and go to more markets. We've also introduced a product portfolio -- or tiered product approach in international markets. We learned that there are markets where we were not able to play or able to compete based upon our product configuration and our pricing models. We have our Dexcom ONE product and our Dexcom G Series product. And again, Teri will talk more about that later and how we factor this tiered product system into our international answer. Finally, I'll talk about patient stories. My wife's job is to wear Dexcom swag everywhere we go, so somebody in the airport will give me a hug. And it happens. But I made a new friend recently. We had a graduation party for a family that are good friends of ours, and I met the 80-year-old -- 81-year-old grandmother of my son's old college roommate and heard her story. She was diagnosed with type 1 30 years ago while she had 5 children. It literally crushed her. Her body has fallen apart. She had trouble hiking and dancing and doing all the things she love to do. And by the way, she has sent me videos of the commercial she wants to star in. She's promised she wouldn't be that expensive. But I talked to her about what she's done to take care of herself, and she described this incredible scientific journey, how she's adjusted her basal rates to be higher because her boluses are lower. And her life is better than it's ever been in diabetes care, 81 years old, Medicare patient. Basal insulins are going to have -- insulin users are going to have the same opportunity. I guess I'll have as much fun hugging the 81-year-old as I do the kids. With that, I'm now going to turn it over to Jake Leach, our Chief Operating Officer. Jake?

Ladies and gentlemen, please welcome Jake Leach.

All right. Thank you, Kevin, and good afternoon, everyone. It's an absolute pleasure to be here with you today. As Kevin mentioned, I've been part of the Dexcom team for nearly 20 years now. And one of the things that I hope you walk away from today with is a clear sense of why I and many people at Dexcom have chosen to spend the majority of our careers at this incredible company. At Dexcom, we have a very unique technology that can serve many customers around the globe and drive better health. It's a remarkable opportunity, and it's something that I get excited about every day. Now that opportunity also represents a huge responsibility. We need to develop products that really meet customer needs, that help them create better outcomes. As well as, as those customers experience these products, we need to be able to build them at scale. They need to meet the quality standards. All the things that our customers expect from us, we must deliver on that. So my goal today is to give you a glimpse of how we've created the best performing CGM on the market and how we're going to continue to drive new innovation at scale to solve a global health problem. So as we think about advancing our best-in-class technologies, we think about 4 simple things. Products need to be very simple to use, and they must have a very engaging user experience. Kevin mentioned that we listen to our customers. We put them at the forefront of everything we design. That's never going to change. The second thing we look at is building on the legacy of Dexcom's premium performance. We don't believe in a world where sensor accuracy is good enough. We believe that premium performance in accuracy is a competitive advantage no matter which population you're serving, whether it's insulin users, type 2 non-insulin users or even a broader health and wellness market. Third, we need to show that these products develop outcomes that really do matter, health outcomes as well as economic outcomes. Today, I'm going to give you a glimpse of quite a bit of data that shows how we think about these outcomes and how we're driving to expand them. And fourth, the products have to be scalable. That means we need to be able to build hundreds of millions of sensors a year at top quality levels. But we also have to be able to iterate on our software platforms quickly and deploy those across our growing user base around the globe. At Dexcom, we're well positioned to do this. So listening to customers, user needs vary. You can see the whole spectrum here across diabetes. Type 1 users, they're -- we're trying to help them manage the burden of diabetes, dosing insulin, fear of hypoglycemia, helping mitigate that. Type 2 users, it's more about metabolic health, helping them -- giving them knowledge and tools that can help them live healthier so that their disease doesn't progress. Our CGM systems need to address these different user needs, and we're going to do it with differentiated software. So we've combined a tremendous amount of user feedback into our latest generation system, the G7. We feel that the G7 has established a new standard in this industry. Highlighted by its premium accuracy, G7 is the most accurate CGM available. It's also an incredibly simple CGM to use, quick onboarding steps, all-in-one disposable, the fastest warm-up time of any CGM. It also is a very engaging platform. Our mobile app was redesigned to combine everything a user needs into one simple app. It -- also built into the platform is the leading connectivity that gives our users tremendous choice in their insulin delivery as well as their different data displays that they choose. So as we look to move forward on this platform, what we're doing is taking this core hardware platform and continuing to enhance it with features that drive outcomes for users and ultimately, drives better health. So as you can see, we've demonstrated the ability of our unique features of the Dexcom CGM systems to drive real clinical outcomes. Let's look at a few examples. Our predictive hypoglycemia alert, the urgent low soon alert. What does that alert do? It gives users 20 minutes heads-up on when they have an impending low glucose coming. They know before they go low. So what do they do at that extra time? It gives them an ability to treat that low before it happens. With that, users that use that feature, we've seen a significant reduction in hypoglycemia, but we've also seen a reduction in the rebound hyperglycemia. That's because they're not already low and overtreating that low then driving their blood sugar up. They're able to take a more measured approach. Similarly, the delayed onset hyperglycemia alarm. It's a brand-new alarm that we've introduced. And what that alarm does is it allows you to set a threshold and a time period because insulin takes time to act on high glucose. So they take insulin. This alarm can be configured to only notify them if the insulin that they took wasn't enough. So again, a more measured approach, more intelligent alarms, significantly increases time in range and also decreases rebound hypoglycemia. Again, they're not overtreating, so they're actually getting a better outcome. These outcomes extend to the caregivers as we built tools for them to remotely monitor their loved ones. Those who use the Follow app, we see that for the user, the CGM, more time in range, better quality of life. Our Dexcom Clarity software for both physicians and users is consistently ranked as one of the leading softwares in the industry. Users that engage with that software have significantly higher retention as well as better time in range and just overall satisfaction. So when you take all of these outcomes that are designed and built around custom features that Dexcom offers, you could easily draw a very clear conclusion that not all CGMs are created equal. And so let's take a look -- let's demonstrate this. Let's look at a group of patients. This is a recent pilot study that was done in a health care center in Northern U.K. And what we did was we enrolled patients that were on intermittently scanned CGM, have type 2 diabetes, on intensive insulin. And what did we see in this study? Well, what we did was they were on intermittently scanned for 1 to 3 months, and then we transitioned them to Dexcom CGM. And after the transition to the Dexcom CGM, we saw this group's hospitalizations go to 0, significant reduction in utilization of the health care system basically just by transitioning to Dexcom CGM. We also saw reduction in their primary care visits and specialty visits. So the technology and features of the Dexcom CGM dramatically reduced their utilization of the health care system, gave them a better outcome and ultimately, saves the system a significant amount of money per user per year after the cost of the CGM. Simply put, these greater safety metrics were driven by the use of CGM. Our leading safety profile that you just saw extends into automated insulin delivery. This is data from a very recent publication in diabetes therapy that highlighted all of the clinical studies that were used for either an approval of an automated insulin delivery system or showing the outcomes that, that system could produce. And what you see here is for the vast majority of AID systems on the market, all of those studies were driven by Dexcom CGM. We've dedicated nearly 15 years to this space, and we're incredibly proud of our ability to work with our partners to provide the best performing sensor as well as one of the best performing AID algorithms with our TypeZero technology in Control-IQ. This produces some of the most loyal and satisfied customers in our entire customer base, those on the AID systems. By leading this category, Dexcom has already powered more than 1.1 million patient years of AID, and that number increases every day. This is simply a safety profile that can't be matched. And as we continue to think about hypoglycemia, there is no more documented need in diabetes than hypoglycemia. So to give you a sense of the magnitude of the issue, this is the COACH study that we ran, which we believe is the largest controlled, observational CGM outcome study ever run. And what it was, was it was a large group of subjects, over 500, that were initially started with finger sticks. And they were tracked for a period of time when they're on finger sticks, and then they were all transitioned to CGM. During that period where they were not using CGM and they were on finger sticks, we saw 21x greater incidence of severe hypoglycemia than DKA. Both DKA and hypoglycemia are serious issues, but hypoglycemia is by far much more prevalent. What did we see after they transitioned to the CGMs? Well, we saw significant reductions in hypoglycemia, and the DKA events went to 0, which makes sense because they were using CGM to manage their diabetes. They were not experiencing extended periods of high glucose. So they weren't at risk of developing DKA. We've built our reputation on our ability to accurately sense glucose, particularly in the low region, to help minimize the fear that our customers and caregivers alike have. In fact, we're so confident in the ability of Dexcom CGM to address the core challenges of hypoglycemia that we ran a very unique study. It was called the HypoDE study. And what this was, was we enrolled patients who are at high risk of hypoglycemia. Most clinical studies in the CGM area exclude people who have hypoglycemia unawareness. But in this study, we took an absolute opposite approach. We only enrolled people who were either hypoglycemic unaware, so they can't sense that their glucose is low; or they had just had a very significant hypo event. Once these patients started using CGM, we saw a 72% reduction in their hypoglycemic events, major impact to their outcome. We also saw a reduction in their overnight lows, which is when they can be most susceptible to hypoglycemia, and we also saw less stress related to the management of their diabetes. We've clearly been at the forefront of addressing this core issue of diabetes management, and we are proud to extend this to a broader section of patients. If you recall, we advocated quite heavily to CMS for coverage of Level 2 and Level 3 hypoglycemia. And we were thrilled to see that CMS included -- they agreed with us and included those Level 2 and Level 3 hypoglycemia people who experience that in the coverage decision when they expanded it to basal insulin users as well. And so you may ask, why did we push so hard for that? Why was that so important to us? And many of you have asked us to size that opportunity since the decision occurred. And so I think -- as you're going to see on the next slide, you're going to see why we think this is so important. Problematic hypoglycemia is a major concern in type 2 diabetes even for those that are not on insulin. Our medical health and science economics team actually just a couple of hours ago presented a study where this data is based on. What they did was they looked at a very large population of Medicare Advantage patients, over 2 million patients, and these are patients that had type 2 diabetes that are not on insulin. And what we found in their medical record was that more than 15% of that population not on insulin had specific hypoglycemic events in their medical claims records. So with that rate of occurrence in a population of non-insulin users, that would suggest that there's somewhere between 3 million and 4 million additional people in the U.S. that can benefit from Dexcom CGM technology. Kevin mentioned at the onset of the presentation today that we're experiencing the largest expansion of coverage in history, and I hope that this helps you understand why we are saying that. We also believe that Dexcom, because of our strength in mitigating hypoglycemia, is uniquely positioned to win in this area. And in the same way that we've led the industry in outcomes data around time in range and A1c, we need to begin to think about how to expand the outcomes around CGM. We need to show that type 2 diabetes, when managing glucose, you can create better outcomes. The average type 2 patient is dealing with 3 or 4 other comorbidities, and weight loss is right at the top of that list. It's also weight gain in managing weight. It's actually one of the fears as to why people don't transition to insulin. Even though they could significantly benefit from basal insulin therapy, they don't transition because there's a fear of weight gain. So this is some brand-new data that's being presented here at ADA. Kevin made a reference to it. It's 300 insulin users -- basal insulin users from our customer base that went on to CGM, and we followed them for 8 months. And we saw clinically significant A1c reductions. That's expected, right? That's what we showed in our MOBILE study that A1cs came down for basal insulin users once they started using CGM. But we also saw clinically significant weight loss in this population, nearly a 5% average weight loss over that 8-month period for that population of users. It's incredibly powerful to be able to tell someone they can go on to insulin and effectively manage their diabetes, get a better outcome, hit their targets, without the fear of gaining weight. In fact, they can actually reduce weight. We've been a leader in outcomes around CGM since the inception of CGM, and we look forward to the next steps in our journey as the leader in this space. So when you look at all of those outcomes that we can drive and you combine that with the size of the opportunity in front of us, our ability to scale becomes incredibly important and the only way that we can take advantage of this opportunity. From the onset when we designed G7, we knew -- we hoped that we would be at this place, at this point in time where we could help people around the world, millions more individuals, live better health. And G7 was designed for scale from the start. With our automated sensor lines, we are in the midst of an unbelievable opportunity here. And it's not limited to the G7 platform. It's also with G7 and Dexcom ONE, we redesigned our software platforms so that we could deploy those software enhancements rapidly across the user base, giving them more features that they can utilize to drive better outcomes. So we've been building on our global manufacturing footprint, really thinking about it regionally and how to serve a global market. We just recently announced that we'll be building a new plant in Ireland to mainly serve our growing European business. I'm also very excited to announce today that our Malaysia plant is now producing commercial G7 sensors. In fact, a number of us are actually wearing G7 sensors that were produced in Malaysia as part of the initial qualification builds. It's a huge milestone for us. It represents years of investment in a facility that is a key step towards achieving our long-term cost targets. And here, you can get a sense of our scale journey. We began producing sensors locally here in San Diego. It's where our first sensors were produced. We introduced our Mesa facility in 2017. And you can see, the scale journey is in the number of sensors, the sensor capacity per year. And as we go from 2017 out to 2025 with the contribution of our Malaysia facility, we're going to increase our capacity by nearly 20x, and this is before any contribution from our Ireland facility. We often remind our investors that this is one of the -- our biggest advantages is our ability to scale rapidly and launch products at scale right after they're approved. And with our significant capacity expansion and the launch of our first international manufacturing facility, we're in a great position to give you 2 key updates related to our scale. I'm excited to announce that we remain on track for a long-term cost target, standard sensor cost of $10 per sensor. So that's $1 per day for a 10-day sensor. So combining this with the 15-day sensors, it gives us the flexibility to continue to expand our market and grow into new areas. Today, we're also in a very strong position with our ability to produce G7 hardware. We feel very confident about where we're at. Those lines are up and running. And as we are there, we are happy to announce that we'll be switching the Dexcom ONE product over to the G7 platform at the beginning of next year. There's 2 things for us. It lets us take advantage of the scale of the G7 hardware and manufacturing lines. But it also gives our Dexcom ONE user base, that continues to grow, the great benefits of the G7 platform from simplicity and ease of use. So as we drive forward on those important updates, we're also in a position to iterate now much faster on our software than we've been in the past. You've seen us as we've launched G7, we rapidly rolled it out across many different geographies, different languages. Our new software platform allowed us to do that. We've also had a steady cadence of enhancements to the G7 app since the U.S. launch. We implemented the ability to validate user accounts with text versus email, a significant reduction in the time it takes to set up accounts and onboard a new patient. We've also reintroduced the silence all alert with the new release that we did to the U.S. So those -- so U.S. customers could benefit from more discretion on their alert settings. And then we had another release that came out that is allowing users -- it allows the app to connect back to Bluetooth when the user walks away from their phones, when you have a Bluetooth connection loss. When they come back in, it connects up much faster. And with the investments we've made in this platform and our team over the last couple of years, we're just getting started with the speed at which and the amount of features that we can roll out that give our users meaningful features. And speaking of users, I'd like to share a story of one of our Dexcom warriors who is doing incredible things on his own while wearing CGM. Everyone, please meet [ Pietro Marcello ]. [Presentation]

Being a pioneer in this space is not just about Dexcom. It extends to our users who, through the use of CGM, are trailblazing new areas and ensuring that people with diabetes are represented in all facets of life. We can't wait to hear more stories like [ Pietro's ] as we press forward and bring CGM to millions of more people around the world. And to give you a better sense of how we're going to do that, I'd like to introduce you to the newest member of Dexcom's executive leadership team, our Chief Commercial Officer, Teri Lawver.

Ladies and gentlemen, please welcome Teri Lawver.

Good afternoon. I'm thrilled to be here today as the newest member of Dexcom's leadership team. And for many of you who I haven't met yet, I look forward to connecting throughout our events today. Over the last few months as I've traveled, meeting our teams, our customers and our investors alike, the first question I usually get is, "Teri, what attracted you to Dexcom?" Well, the answer to that is pretty straightforward and reflects several of the themes you're hearing throughout today. First, the sheer magnitude of opportunity for impact is unparalleled. The market -- total addressable market we can meet with Dexcom's products might be the single largest opportunity in all of health care. Then we combine that with our distinctive technology and customer-centered approach. And as impressive as Dexcom's growth has been in recent years, I believe we're just getting started. We see multiple growth curves on the horizon with both our current products and future products, some of which we'll preview today. And then I've seen firsthand with my family and friends the life-changing benefit that Dexcom technology can bring, and I couldn't be more excited to help bring those benefits to millions more people around the world. So today, I want to talk a little bit about our commercial strategy, our opportunity and how we're executing against those. Our commercial runway is truly unparalleled, and our commercial strategy is grounded in 3 tenets. First, we start with a distinctive understanding of customer needs and translate those needs into differentiated products that meet -- that deliver customer outcomes beyond what anyone else can do. You saw some of this from Jake and Kevin's presentations, and we're going to continue to raise the bar here, understanding and having insights to customer needs even before the customers can articulate those needs themselves. Two, as our markets evolve, we have to evolve how we translate our differentiated outcomes into differentiated medical education, differentiated promotional messaging and differentiated market access. You've seen some of this with our recent G7 launch in the U.S. and more to come. And three, as we're expanding into new markets, we have to do more than just expand into those new markets. Whether we're talking about geographic markets or market segments, we will continue to shape and lead those markets as we expand them. Now everything we do starts with the customer. And when we say customer, we define our customers holistically, starting, of course, with the end users and their families and caregivers, but also including our health care professionals, our channel and distributor partners and of course, payers and health systems around the world. And I'll address each of these, but let me start with the end users and their caregivers. We listen and learn every day from their experiences. And through our Dexcom Warrior program, we empower their voices as Dexcom ambassadors with the diabetes community. We started with 35 Dexcom Warriors back in 2015. And today, I'm proud to say we have more than 20,000 people who have raised their hands and raised their voices to advocate for Dexcom and those we serve. These include people from all walks of life and with all types of diabetes. People like Nick Jonas, who you've seen in many of our ads; and people like Mark Andrews, Pro Bowl tied in with the Baltimore Ravens, who will be joining us later today, and I understand you might -- some of you might have an opportunity to throw some passes with him. These warriors not only provide us with unparalleled insight into our products, their experiences and their needs. They also inspire us every day. So how does this translate into business impact? Well, let me start by describing how this is playing out in the U.S. market. We're passionate about our customers, and our customers are, in turn, passionate about Dexcom. We have achieved industry-leading customer loyalty and retention rates. When we look at the retention rates for Dexcom customers versus a comparable set of customers for our competitors, we see Dexcom's retention rate is more than 20% higher than our nearest competitor 12 months after starting on CGM. This is a powerful picture for prescribers, distributors and payers who are looking to drive the greatest value from each CGM start. And payers increasingly understand that Dexcom not only delivers clear clinical outcomes but that these clinical outcomes translate into value for the health system. At ADA this weekend, I encourage you to look for a late-breaking poster presented by our health outcomes team. This poster compared claims data for people with intensively-treated type 2 diabetes and demonstrates that based on the differentiated outcomes, Dexcom CGM delivers $1,700 per year of incremental value versus the nearest competitor's intermittent scan system. Now as a result of having such differentiated outcomes, we also have the most covered CGM system and the lowest out-of-pocket cost in the United States. Here, you see the pharmacy channel cost for Dexcom CGM versus our nearest competitor. Dexcom's most common out-of-pocket co-pay at the pharmacy is zero. And for the majority of claims, Dexcom out-of-pocket co-pay is less than $20. Now compare that to our nearest competitor for which the most common out-of-pocket co-pay is between $80 and $90, and the majority -- in the majority of claims, the co-pay is $70 or more. Now that's for the commercial coverage in the pharmacy channel. And as we know, for the Medicare channel, Medicare coverage is consistent across all competitors. So overall, Dexcom's out-of-pocket cost, lower co-pay along with the value creation for the health care system is a significant competitive advantage. And we have an opportunity to communicate this more clearly and consistently, and we'll be doing so starting this weekend at ADA. In addition to successfully advocating with payers and extending coverage, we've also strengthened our partnerships with the channel to prescribe more choice for our customers and -- for both health care professionals and end users. In the U.S., our products are available through both the pharmacy and DME channels. Now the majority of our volume runs through the pharmacy channel where clinicians appreciate the prescribing simplicity. And of course, for their end users, they're very familiar with the retail infrastructure. But we also work to maintain strong relationships with our DME distributor partners who provide great service to our customers. Many of these DME providers have a strong track record of serving the diabetes community, and they can offer an efficient path for distributing diabetes supplies that works really well for many of our customers. Now let me address the prescribing health care professionals. In 2021, we nearly doubled our U.S. field sales force, enabling us to call on significantly more primary care prescribers. And as you see here, now more than half of our prescriptions come from primary care, and we've expanded our presence in primary care while maintaining our coverage and leadership position in the endocrinology offices. As a sign of our continued field sales productivity and effectiveness, our rate of new patients per sales territory year-to-date in 2023 is nearly 30% greater than same time last year. So while Dexcom has made significant progress in shaping and leading the U.S. market, the runway ahead maybe even more significant. Among the 4.2 million people treated with intensive insulin therapy, which has been the source of our historical growth, and as you see the second and third rows here, CGM remains less than 50% penetrated. Growth in this segment continues to show steady momentum toward that 80% penetration level that we expect. Then if we look at the next 2 rows, 6 million to 7 million people on basal insulin and with problematic hypoglycemia risk, where Medicare coverage just opened up 2 months ago and current CGM penetration is still under 7%, this growth runway is set to continue for a long time. In sum, we have reimbursement today for more than 6 million people in the U.S. who are not yet on CGM. To put that in perspective, there's coverage in place today that could allow us to more than quadruple our U.S. customer base, and that's before we begin to talk about the population of those not on insulin and without hypoglycemia risk. Now I just went through some of those segments. Let me dive a little bit deeper into a couple of those. Let me start with our core intensive insulin population where we expect to maintain our leadership position. Now many of you will ask about the impact of competition in the AID-connected CGM space. As Jake described, AID is in our DNA. We understand the level of confidence prescribers and users need to have in the accuracy, safety and reliability of an AID-connected CGM. And with over 34 publications and 1.1 million years of user experience, Dexcom has, over the last 15 years, established an unparalleled accuracy, safety and reliability profile with distinctive features like our predictive low alerts. And customers agree. In the survey where AID customers were asked their primary reason for choosing their AID system, among our 2 current primary pump partners, these customers cited Dexcom integration as the #1 reason for choosing their pump. Now we do expect new entries into the CGM-connected pump space will grow this segment, and we intend and expect to continue leading in this segment. We're also well-positioned to extend our leadership into the type 2 basal insulin segment. Now most of you are aware of our MOBILE trial, first shared 2 years ago at ADA. It was this trial, along with support of its outcomes from the diabetes community, that led to the recent CMS coverage expansion. And we need to be very clear. The outcomes you see here on the slide from the MOBILE study were generated only with Dexcom CGM. And at the end of that study, 94% of participants wanted to continue using their Dexcom. One reason we're so confident in G7 is this product is not only distinctive at meeting the needs of the intensive insulin segment, it is also distinctive in addressing the needs of the type 2 basal population with features like customizable alerts, faster start-up and overall ease of use. On average, older adults can set up a G7 in under 13 minutes. Now having started my father on a Dexcom when he was 79 years old, I can tell you how meaningful that is. And 98% of G7 users on Medicare say they find G7 easy to use. Our teams are out there right now working to educate customers across channels of these distinctive benefits. And Dexcom's basal opportunity continues to be validated with the payers. It often can take 18 to 24 months for commercial coverage to catch up after a CMS coverage expansion. I'm pleased to report, however, that for Dexcom, we've already established 60% commercial coverage for type 2 basal users, including the 3 largest pharmacy benefit managers in the United States. This, of course, expands and amplifies the impact of all of our commercial efforts. Now let's talk about the non-insulin population with high risk of severe hypoglycemia. Most of the recent news about the CMS coverage expansion has focused on the basal opportunity. But as Jake described, this population is also significant. As data suggests, there are 3 million to 4 million people in the U.S. in this population, and Dexcom here again has the right product to lead in this population. Only Dexcom delivers both the most accurate sensor and urgent low soon, our feature that can predict the risk of severe hypoglycemia up to 20 minutes before it occurs and prevent it. There is no CGM better equipped to prevent severe hypoglycemia. Now this is a segment we have not traditionally focused on through our medical sales and marketing efforts. And so as we move into the back half of '23 and into '24, we will be elevating our commercial focus and leading the expansion with this significant population. Taken together, you can see why we're excited about our continued strong growth and leadership in the U.S. market. Dexcom delivers a leading customer experience with industry-leading loyalty and customer retention. And with G7, we have the industry's most accurate sensor that is incredibly simple to use, that is also the most covered and has the lowest out-of-pocket costs. We have the right commercial infrastructure for leading with the endocrinologists and expanding our leadership in primary care with the type 2 basal and severe hypoglycemia markets where coverage has just opened up in the last couple of months. And when we take these covered populations together, intensive insulin therapy, basal and those with severe -- risk of severe hypoglycemia, the CGM market in the U.S. is only 20% penetrated. So we have significant runway ahead in the U.S. Now let's turn our attention to the international opportunity where we are earlier in our growth journey but equally excited about our trajectory and our path forward. Our team is doing an excellent job executing on the strategy that was laid out at our last Investor Day. We're expanding access significantly. We've created a targeted approach that addresses the different market access environments around the world. And we're leveraging our product portfolio to both expand into and take share in new markets. Dexcom's product portfolio together with our differentiated clinical outcomes position us really well to compete across the different market access environments and landscapes we see around the world. In markets with broad and strong reimbursement like Germany, our G Series is our exclusive offering. Then if we look at the other end of the spectrum, there are markets that have traditionally had very limited reimbursement. In these markets, Dexcom ONE delivered through our e-commerce platform will be the primary offering. And it's been extremely encouraging as we've launched Dexcom ONE on this e-commerce platform in many of these markets to see government reimbursement actually follow quickly after our product introduction. And then there in the middle, there are several markets, in particular, in the EU where there is a tiered reimbursement system with one set of features and reimbursement required for a higher-risk population, typically that's an AID-connected population, and a different reimbursement scheme often for MDI or lower-risk populations. And here, we leverage the portfolio that Kevin described with both our G Series and Dexcom ONE being able to compete then across those segments in these tiered markets. With this approach, we have expanded our covered access for more than 3.5 million people outside the U.S. in just the last 2 years. In parallel, we continue expanding our global footprint. In 2020, we described our strategy to actively convert markets to direct operations. And we've delivered on that strategy, going direct in 8 new countries since our last Investor Day. And going forward, we expect to continue expanding our direct presence. Now simultaneously, we're expanding our presence through strategic partnerships in geographies where that approach makes more strategic sense. One recent example is our partnership with Roche, where we're leveraging their commercial presence in Italy to introduce Dexcom ONE to the MDI population there. And today, we're excited to share that through our Roche partnership, we're entering Latin America with Dexcom ONE now available in Argentina. Now while still early, we are already seeing this international strategy paying off with consistent strong double-digit growth rates in our international markets and continued share gains, and we're confident this momentum will continue. We anticipate our international revenue will grow to 30% of our total revenue by 2025, and that's against the backdrop of strong double-digit U.S. growth as well. So we feel really good about how we're positioned for continued worldwide growth with our current portfolio, but we know even that's not enough. And we expect you all to be asking the big question, what's next? So to answer that question, let me go back to an earlier slide where we shared the target addressable market and CGM penetration across different market segments. And you'll recall from that slide, at the bottom, was a bar that demonstrated that there are over 25 million people in the U.S. with type 2 diabetes who are not on insulin and not at risk of severe hypoglycemia. We see a significant unmet need for continuous glucose sensing in this broader market. And we're taking a multifaceted approach to addressing these needs, leveraging digital health partnerships, pursuing reimbursement and building a software package that is customized to this population. But before I say more, let's hear from a leading clinician, Dr. Thomas Grace, about the need and opportunity for CGM in this broader population.

Hello. My name is Dr. Thomas Grace. I'm a family medicine doctor practicing in a clinic in Findlay, Ohio. I'm here today to explain to you why I feel that CGM is so important in the lives of my patients with diabetes. I, myself, have type 1 diabetes diagnosed at the age of 3. I jokingly say that I live it, eat it, breathe it, sleep it, teach it and preach it. And in my clinic, I've been heavily using CGM for the last 6 years. I started the diabetes clinic because there was a need in my local community. And I saw right away right around this time that Dexcom G6 came out that this was a tool that we should be using in our patients, not just our patients that had insurance coverage, but everybody. Continuous glucose monitoring allows my patients to make changes that they wouldn't otherwise be privy to see. When they use this tool, they're able to watch their glucose readings intimately, but more importantly, my patients with type 2 are able to make behavior changes that help them in the long run. I feel it's more important than any medication that I can give patients, and that's why more than 90% of the patients in my clinic are using this technology. I am passionate about CGM because I've seen how much it can help my patients with diabetes, both Type 1 and Type 2. I'm so passionate about it that I'm on vacation recording this video. So the project that we started in Findlay, Ohio was initially rolled out with the Dexcom G6. Now that we've been using the Dexcom G7 with all its new features and ease of use, I think that this is going to get the ball rolling even faster. Patients have been coming back to the clinic after using the Dexcom G7 enamored with all the changes that have been made. And really, it's the ease of use and the more access to data. Clarity is now built in right into the receiver or into the app. And patients are able to find their data much easier now. And they're looking back in making those changes that they could have missed before. I'm excited about Dexcom G7 and how it's going to change the space of diabetes, especially in my patients with type 2. A few years ago at the big academic conferences that I used to present at, I would joke with people and say, hey, I'm glad you guys are at this talk. CGM is coming in here early. I'm now excited to say, CGM is here. You're behind the times as a practitioner if you're not using this technology. Not only using this, you should be using this first. We should rewrite the way we think about using CGM in diabetes. It should be the first and most important thing to give to patients. We can think of all the different medications and the untoward side effects that they have. The side effect of CGM is better glucose readings and a healthier lifestyle.

We always enjoy hearing from Dr. Grace. Now in addition to the data that you'll see from him at ADA is an abstract demonstrating that Dexcom CGM leads to meaningful improvements in glycemic control in a real-world study of more than 7,200 patients with type 2 diabetes who are not on insulin. And we hear from these customers and their health care providers every day that their needs are distinct from those who are on insulin therapy. These customers want personal insights to optimize their nutrition and exercise routines, and they want those insights without the burden of unnecessary alarms and alerts throughout the day. This population is highly motivated. They deeply fear progressing to injectable therapies and to insulin. And while this population is generally treated by a primary -- in the primary care office, they are more likely to make their own decision about a CGM or a glucose sensing product. Fundamentally, this population wants to feel empowered to take control of their health. And so today, we are announcing our plans to introduce a product designed specifically for people who are not on insulin and not at risk for severe hypoglycemia. Our first-generation non-insulin product will leverage our G7 hardware platform but will launch with customer software specifically designed for the needs of this population. This will be a 15-day system, leveraging recent advancements from our team that strengthen our system survivability. And this product will launch with a cash pay option to enable early and broad access as we build the case with payers for broader coverage. We are on track to introduce this first-generation non-insulin product in 2024. So stay tuned for more details. In closing, it all comes back to this. It's our customers. Last month, I was with my family hiking in Yosemite National Park, and I was trying unsuccessfully to keep up with my children as we were hiking up to Yosemite point. I was wearing my Dexcom hat. And a young woman came up to me, she saw Dexcom. She said, "Dexcom," and she ran over. She showed me the sensor on her arm and proceeded to share with me just the incredible life-changing impact that Dexcom has had for her and for her family. And this has happened multiple times even in just my few months here at Dexcom. When this happens, these aren't just friendly people coming up to make polite conversation, these people are our heroes. They are our inspiration. They are the reason why our teams around the world work with such dedication every day to deliver on our commitments both today and into the future. And this is a future I couldn't be more excited to help shape. Thank you for your attention this afternoon. And now it's my pleasure to turn the stage over to Jereme.

Ladies and gentlemen, please welcome Jereme Sylvain.

Hello, everybody. I see a lot of familiar faces. Certainly happy to have you here today. Thanks for spending a little bit of time this afternoon with us. I hope you've really enjoyed the presentations by Kevin really breaking down where we're going over time; Jake, laying out the R&D road map, the scalability; and certainly Teri's presentation around the commercial opportunities ahead of us. It leaves us incredibly excited about the opportunity to serve. There's so much opportunity out there for us to address this unmet need, and we're very excited to be the ones that are best positioned to serve it. Let me first start by circling back to a slide that Kevin shared. This slide has a little bit different meaning now we've been able to share a little bit of our road map. Just reminding you, starting in the top left section there, intensive insulin, this is where we've really been historically. And I hope we've demonstrated why we believe we'll continue to lead in this space now and going forward in a space that's less than 50% penetrated. On top of that, we think our advancements in technology specifically address that customer ease really help address that type 2 basal opportunity. As you might have walked in here, you might have assumed CMS coverage as the primary reimbursement, but now knowing that we have 60% coverage across this population in commercial Medicare Advantage as well as in CMS. It's an incredible opportunity to help meet that need. And we talked about problematic hypoglycemia with CMS coverage, 3 million to 4 million people and a real opportunity to help address that. And then of course, you heard Teri talk about the opportunity with our new nonintensive product really addressed at addressing the remaining 25 million people and beyond. And what we haven't talked about, and we're still making great progress is around gestational and hospital. And just as a reminder, we absolutely are working there, where we are working on clinical evidence around gestational, but we are taking our sales force in addressing some of the OB/GYN population and meeting the need of gestational diabetes and preventing it where possible as well as working on clinical guidelines, clinical outcomes as well as workflow on hospital. So an incredible position going forward. But I'm here to talk about operational efficiency. We haven't talked about that yet. And I want to share a little bit with you about where we're going. We have a really incredible track record of efficient growth. Most of us will talk here about the revenue CAGR over the past 5 years. 32% revenue CAGR, certainly impressive and a great organic growth opportunity. But over that same period, we've improved our operating margin by over 2,200 basis points. And just to put that in the context of a 2023 expectation, that would be about a $750 million increase to operating margin this year alone based on all the work we've put in over the past years. Maybe even as impressive, as we've built out our facilities, Jake took you through what we've been doing in Malaysia, 1 million square feet, able to build hundreds and hundreds of millions of sensors, significant investment in the business and yet our free cash flow has grown at twice the rate of revenue over that period. It just demonstrates the cash flow, the great organic growth story, but the cash flow we're able to drive as a business. And so how do we get there? What ultimately drives it? Our organization is really focused on the culture of embracing those challenges. I can't explain enough just how often we get in meetings and good isn't good enough. We always challenge ourselves to push further, and that's embedded in everything we do. It's not just in product development or in commercial landscape. It's everything we do all the way down to processing invoices. We're really focused on those changes. And you can see some of the things we've done about maximizing efficiency, channel optimization. For many of you that have been here over the years, we talked about, as we moved more into the pharmacy or moved out direct through the DME space, we were going to leverage that and ultimate profitability, and you've seen that in operating and margin expansion. And you'll see it continue to happen over the years. Our GBS, and we'll talk a little bit more about this. We've leveraged the technology and the capabilities and how we locate folks across the world, also how we focus on automation. Despite all the moves we've made over time, we've done an incredible job of maintaining gross margins. And it's core in our culture to think about how we design our product. And certainly, Teri talked about direct international operations. You can see where we're leveraging our footprint to go direct. It's built into our DNA. And I'm going to explain a little bit how and why we do that. But first, I want to tell you where we're going. We owe you an LRP update. So why don't we go ahead and get into the revenue range we're updating here? We're updating our revenue range by $600 million. So from $4 billion to $4.5 billion from our original LRP that we had shared with you in 2020 to -- for 2025 to $4.6 billion to $5.1 billion. And just to give you some context for that number, it's really driven by the strength in our core businesses in the U.S. in our international growth. We also expect to have 30%, as Teri alluded to, of revenue from our international markets. I hope this also gives you confidence after hearing the opportunities in basal as well as our nonintensive product and beyond. We are absolutely confident and well on track to reach our $700 million goal on contributions from new markets. Very -- and I hope that what you see is through the work we've done, you have the confidence in as well. And please remember, these are base cases. We look to come in front of you and provide a base case and always look to overperform. But I want you to know that we feel very confident in this going forward. I also want to update you on our gross margin. Jake came up and talked about all the things we're doing about scale. And with all the expansion and all the growth in Dexcom ONE and beyond, we've maintained our gross margin of 65%. Now that includes expanding access and manufacturing on G7 lines. It includes us on track to our $10 sensor standard cost. We're focusing on greater G7 volumes and that throughput we've talked about over time and leveraging fixed costs. By moving our Dexcom ONE system to G7, we expect to accelerate our capability to getting to full scale. And we talked about sensor duration getting to 15 days, announcing our first one with our noninsulin product in 2024 as well as making sure that you guys have the confidence and that the technologies are there. I also want to talk a little bit about then the updated LRP for our operating and EBITDA margin targets. So we're increasing our operating margin targets from 20% to 21% and our EBITDA targets from 30% to 31%. To put that in context, in 2025, that implies over $1 billion per year in operating margin and over $1.5 billion a year in EBITDA. It's incredible progress over time. And I think you can see the operating leverage we've been driving into the business, the capability of thinking of technologies to scale over time as well as how we thought about cash flow generation and discipline is really playing out. So now let's talk a little bit then about how we're viewing operational efficiency. We view operational efficiency as a growth driver. It's core to our business. It's not just on how we come up with new products, but it's really about how we drive our business for long-term revenue opportunities. You can see on this slide, we really focus on innovating everywhere. That's absolutely part of everything we do. But we know that operational efficiency and cost allows us to be flexible in our go-to-market solutions. It allows us to be flexible in working with folks for new markets that we're going to address over time. We also know as we move into new markets across the world, by addressing the cost of our product, the cost of delivering therapy, we can maximize growth and customer impact. We think about this from all angles, all angles. And at the end of the day, our goal is to help as many customers as possible by giving them access to our therapy. And we'll talk a little bit more about that, but we are first and foremost focused there. And before we get into it, I want to make sure you guys know, this is not about cost cutting. This is really about embracing investment, innovation over time and really driving it into the places that make difference. And so what are we doing? Well, we've got an initiative going on called cost-to-execute in our organization. We started this a few quarters ago. And it really goes from the board to the management team to every employee in the organization, every employee, every process, every effort is all part of this cost-to-execute performance, whether it's in manufacturing, developing new product, acquiring new customers, serving folks, supporting folks. Each of these work streams will continue to take place over years over a long-term target to help drive our strategy, to help drive profitability back to the organization, to help drive cost out of our product and ultimately to help drive our ability to meet more customer need. And you'll see us focus on this over time. And I'm going to dig into a few of these in a second. But remember, this is a backdrop culturally of where we're going. And so to think about that, let's talk a little bit about one of these cost to manufacture. Some of these you'll know about. For some of these, we may have made mugs that say this. So every day, we think about it as we drink from them, that'll be 15-day wear. These are the important things to us that drive us over time. And so as you think about 15-day wear, it is absolutely important. Our manufacturing and our R&D teams are highly focused on this. But we're also focused on other things like fully automated lines. As an organization, we created a new line called the [ FAST ] line for our G7 production. That wasn't fast enough. So we made a faster line, and we called it [ FASTER ]. Not the most creative name, but the team, that's not what we're there for, we're there for efficiency and driving capabilities. Jake talked about our manufacturing footprint. We're optimizing our manufacturing footprint over time. We're launching, obviously, in Malaysia. We're all [ Malaysian ] G7 sensors right now, but we also have Ireland as well, and we'll continue to mix and match as needed to help serve the globe on a more efficient perspective. We're traveling the world, finding new suppliers, making sure we find the right suppliers, the right efficiency, and we consistently balance in-sourcing with outsourcing. A great example is our G6 transmitter. We were able to make that for about half the cost we originally did by identifying where we source, how we source and how we make it. When you give our team time with these products, they do incredible things. We're also another deep dive in one of these is called cost to support. Sean Christensen, many of you know him, leads this charge back in 2018, the end of 2018, the start of 2019. On one hand, you could count the amount of people we had in our GBS location. And at that time, we were in Manila. Today, we have over 15% of our workforce in these GBS locations, and that will exceed 20% by the end of the year. This is cultural. It's driven in everything we do and how we focus and where we invest our time and effort. We've put in RPA and AI into our business to date. We've saved hundreds of thousands of man hours every year with the technologies already there with future technologies to come to help make us more efficient. As time moves on and we've changed the way we work, we continue to reevaluate facilities in IT. And our HR team, led by Sadie, our Chief Human Resources Officer, continues to look about how we develop our org design over time, knowing that how we develop our people, where those people go and how we structure our organization is a major way to ultimately drive capability. But that's not the only area we're focused, we're also focused on areas around capital deployment and value creation opportunities. We're certainly positioning the business to maximize it. Our capital deployment priorities, we are investing where the ROI is there. And when it's not there, there's plenty of room there. But our run rate CapEx is around $200 million to $300 million. So you'll find when we get back to normal CapEx investment, that free cash flow continues to drive even further. We use that cash flow to look for opportunistic M&A, share buybacks, addressing dilution associated with our debt and also funding future organic growth. We have a Board member that says it's never a problem having cash and cash flow on your balance sheet when you have a growth opportunity like this. We agree. We'll also continue to look for the most optimal cash structure -- optimal capital structures. That will continue to be part of what we do. And our tax structure will ever get more efficient over time. You can see with our global footprint, there's opportunities to rethink about where we structure, where we locate certain things in our IP structure that drive that. And so as you think about that value deployment, I think -- one thing that I think you can take away from this is we have set this organization up for an incredibly compelling plan for value creation. When you look at Teri and going through the organic growth opportunities, they really are unparalleled. There's a massive unmet need out there that we can absolutely address. But the one thing I think we've done that really sets us apart is during this period, we've driven maximum operating leverage despite still investing in the business. And that's just through the culture and the focus of our reinvestment. And meanwhile, we're also generating significant free cash flow, either to return to investors or to reinvest in the business and doing all the things necessary around capital structure and tax to help drive it. I hope you guys see this incredible value creation opportunity. Certainly, we believe in it, we believe in the opportunity here. And I hope today, we're able to demonstrate that to you. And maybe for my why story. We talk a lot about why in this organization, what drives us here. For those of you that know me, I've had people in my life who have had their lives saved by Dexcom technology, not helped, but actually saved. So this is very personal to me, but there's a bigger issue here. We keep talking about hundreds of millions of people. There's 0.5 billion people with diabetes in the world today. And a small, small fraction of those with the joy of having access to a CGM to help extend their lives, help those their loved ones, ultimately make it a better life as they move through. That's my why. It's about high time we're able to get the technology to everyone who needs it to help live the life that they were supposed to lead to live a life well lived. And so with that, thank you very much for your time here today. Really great to have everybody in the room. We look forward to ADA joining with all of you. I hope you've had a great time. Let me turn it back to Kevin to close down.

Ladies and gentlemen, please welcome back Kevin Sayer.

All right. Let's go back to the 3 takeaways. As we summarize, first of all, market access is growing faster than any time in our history. And you heard about some of those market access wins and those things we're doing to drive expansion of our addressable markets. We've introduced a new product concept to you that I can't wait to get out. In fact, I can't wait to use the prototype because you guys know I love the experimental stuff, and I'm really excited to experience this software app when we're ready to do it. And we've given you an upgraded LRP with $700 million in additional revenue over that period that ends in 2025 with increased operating margins. What a great story. But many of you came here asking, well, what's next? What are you guys going to do next? What's coming next, love to talk about what's next. But I think when you start with the present, we needed to finish G7 before we can move on to what's next. This lift has been incredible. Everything we do now is different from an operational perspective than it was before. We had to get G7 out to start that runway we have planned for the future. There are some very tangible G7 things that you can count on over the next several months. Our first extended wear product with the non-insulin using product that Teri described earlier will be launched in 2024. We also have a next-generation extended wear product for which we will start clinical studies before the end of this year. And we have incredibly big plans for this product and very aggressive goals. We expect the MRD for this product to start with a 7 with the possibility of moving it down to 6. We expect reliability to be 90% in all areas as far as customer experience. We may even see a life that will last beyond 15 days with this product. And we've invested in the infrastructure to make this happen as you talk -- as we've talked about, Jake's scale and Jereme has talked about our capital investment over the past several years. With these G7 launches, another one that's going to happen in the short term, we will go direct to Apple Watch before the end of the year. So G7 innovation is very tangible and those are some things you can measure us on. We're not going to stop going into these other markets. We need to broaden our type 2 acceptance, have targeted experiences for gestational diabetes and pregnancy and the needs of expecting mothers. We truly believe glucose management in the hospital setting will be a reality for us in the not-too-distant future. And quite candidly, CGM should become a broadly used diagnostic and treatment for prediabetes as well. All those things are coming. Now for the product and vision section, and I'll qualify it. I'm not giving you launch dates. I'm not giving you time frames. I'm not going to talk about timing, but we are working on some incredible things going forward that you should all be aware of. We have multiple hardware configurations planned over the next several years that we'll start with what we've learned and done with G7 that we can scale from what we've done. Smaller footprint, more reusable materials, more powerful electronics and more convenient low-cost receiver systems are not too far down the horizon for us. We have a next-gen algorithm with our TypeZero team that you're going to hear about over at the conference. And algorithm requires almost no patient intervention whatsoever. It's exactly what the market wants. It's delivering safety, it's delivering outcomes, and it is enabling people to live the lives they want to live with intensive insulin therapy. We are developing sensors that measure other things. Other analytes will be very important in the overall health package that we're looking to develop over time as we've changed our mission statement. We can see single or individual sensors to measure other things and combination sensor is coming. All things that go back to my fundamental question, what problem are you solving? It doesn't do us any good to measure something that isn't going to help somebody with their help, but we have some very good other analyte programs that we're working on. And finally, software experiences are only beginning. We've restructured our software and our G7 platform to whereby we can iterate much faster than we had before. And we plan on creating a number of software experiences over the next several years to delight potential users of our system and deliver the outcomes and the cost effectiveness that we've talked about. As you can tell, our future is incredibly bright. We have an opportunity not only to be one of the premier growth stories in the investment community, but quite frankly, have a global impact on health while lowering the cost. There couldn't be a better place to be working the DexCom today. Thank you for listening to us, and now we'll start our Q&A.

At this point, we welcome our presenters back to the stage as we transition into a time of Q&A from the sales-side analysts and attendants.

All right. Thanks, everyone. For those of you I have met, I'm Sean Christensen, Vice President of Finance and Investor Relations. We're going to transition now into a time of Q&A for our sell-side covering analysts, all of whom are focused over here. So Matt and Hannah have microphones over here. I'm going to ask the analysts upfront. A lot of us, obviously, we love the idea of maybe one question for each analyst. I know there's a lot to cover. So we love to stick with that rule. I know you guys are used to that with us. So why don't we start off. Rob, do you want to kick us off?

Robbie Marcus, JPMorgan. I appreciate the great Investor Day, really helpful lots of commentary. Maybe my one question. The type 2 nonintensive product, 15-day wear, maybe speak to, first, how we think about this technology as being different than what's out there today, what it adds, the price point we should be thinking about. And then with the 15-day wear, what's preventing it from putting it in the G7 product as well?

I'll start a bit, and then I'll pass it on to Jake and Teri, who I know are going to have comments. We're not going to talk about the price point today. And this will be built on a G7 platform. And over time, as I said earlier, we will move G7 and all other products to 15 days. But we truly believe this is a different experience for people. As I've talked to health care professionals, payers and people across the world, the one thing that drives health care outcomes is engagement. And we truly believe we can create an experience that people will engage in and start a platform with this product for noninsulin users as the designation for the product and how we're launching it that will engage them. But Jake, if you want to talk about the technical features, and Teri, some of the others, you guys go ahead.

Sure. Yes. Thanks, Kevin. So when you think about the feature set, as we said, it's really designed for the needs of that user. So again, you're not thinking about glucose alerts and alarms. You're thinking about helping that user connect the dots in how diet, physical activity and their medication impacts their glucose readings. And so there's no better tool to teach someone about their glucose dynamics than CGM. It really helps them understand how different behaviors impact glucose, and ultimately allows them to see the insights on how to live healthier and better manage their diabetes. From a technology perspective, we've been working on multiple different technologies that help expand the sensor life and the survivability. Some of those are being implemented into that new product to extend the life to 15 days. As Kevin mentioned, we have another product that has additional technology that further enhances the reliability. One of the things we know is that the customer retention that we see and the customer satisfaction that we see from our customer base and the reason why it's higher than others is because of the reliability of our systems. And so we want to make sure that any new technology absolutely meets those expectations or beats them.

I might just add, while we're not, I think, for confidentiality reasons, going to go into details about the feature set of this new product, I shared earlier that the noninsulin and nonsevere hypo-risk patient has a very distinctive set of needs. And what I didn't share is we know from our customer insights that current products on the market do not fully meet the needs of this population. And so we're designing a feature set that, to Kevin's point, will create a customer experience that is exactly what this population is looking for.

Great. Hannah, why don't we go to Joanne right next to you.

Joanne Weunsch from Citibank. So much to ask. I mean this has been just -- weight loss, that's where I'm going to go with this. The GLP-1s, the impact on sensors and pumps, I can't answer that question enough for investors, but I'd love to hear your response to that. And there was an interesting statistic of 5% weight loss. What do you do with this? And how do you incorporate that into the wave that's coming behind you or ahead of you?

Teri, do you want to start?

Sure, sure. The GLP-1s are a big advancement in health care. And we see Dexcom CGM as complementary to the utilization of GLP-1s and SGLT2s and the whole array of new drugs as they advance in this population. One of the things CGM delivers is behavior modification that helps address people's diabetes and overall health outcomes for the long term. So we see the opportunity here is really complementary.

You want to go ahead?

Yes. I think the only thing I'd add is, you asked about the weight loss. And so what was really unique about that 5% stat is that's in basal insulin users. And so it wasn't a weight loss study. It was basically -- we were just tracking how users were using the current product. And it's basically because they were able to better manage their diabetes and not gain weight that's often a fear for insulin use. And so with so many -- with so few people with type 2 diabetes hitting their targets, therapies like GLP-1s combined with CGM, we see as a great way to help people live healthier and hit their glycemic targets.

Now let me go to Jeff.

Thank you, Matt. Jeff Johnson from Baird. Kevin, you shared the statistic and I know you've kind of shared it in different forms in the past about the majority of claims paying less than $20 for Dexcom CGM versus a higher number for your competitor and most claims being at 0 versus a higher number for your competitor. That is consistently when we talk to PCPs especially a selling point for why those PCPs seem to prescribe to your competitor. They feel like that price point is lower out of pocket to the patient for your competitors' product. So you've got the statistics, you've got the data, I don't argue with that data. But how do you go out and change that mindset? And how important is it to change that mindset to the PCP themselves to maybe add to your competitive position in the PC channel?

I'll take that. It's absolutely critical that we change that perspective. I was recently out in the field and actually brought some physicians in-house, and we heard the same thing, and that really is not the truth. We have worked very hard to develop access and low-cost access for individuals and for their -- particularly for out-of-pocket costs. So we have an educational effort that we need to be better at, and that's why we doubled the size of the field sales force, and we're continuing to look at things we can do to make people aware of that. I think another thing that we have to work on, Jeff, and then working on robustly is not only the price point, but the access and the work required by the PCP themselves to prescribe our product. We've got to eliminate or greatly reduce, for example, pre-authorizations because there's a perception of expense if it's expense for the doctor's time and the time they use. And that's what I've heard in the field, and that's what we've heard from physicians as well that getting coverage is not enough, getting coverage that is easy for everybody is much more important. And I think some of these factors also bleed over into cost perceptions because if you can go to the drugstore and you don't have to fill out a preauth and do anything, that appears less expensive than when there is a preauthorization that has to happen. So we have a multifaceted approach for doing that. We continue with our educational efforts. Quite candidly, our field sales team have great tools to demonstrate that to physicians. But if you're a physician and you're spending 5 minutes with Dexcom rep, the last thing we want to do is take out an iPad and have to walk you through all those costs. But we have those tools and we present them. We just have to keep pushing and have better experiences for patients over time, and we will.

And we take a question from Matt Blackman, aisle, row 2.

Matt Blackman from Stifel. Question for Jereme on the guidance. On the gross margin, in particular, could you just maybe give us a little bit more color on the puts and takes there? I guess, a little bit surprised that it didn't have a little bit more upward pressure with Malaysia now online, obviously, 15-day. I heard you say, obviously, using opportunities to increase access with Dexcom ONE. But is there anything else in there that we should be thinking about? And I know you don't want to give beyond 2025 guidance, but is that how we should be thinking about sort of the baseline gross margin? Or is there a significant opportunity or opportunity for that to walk higher over time?

Yes. Let's stick with 2025, but let me give you some of the puts and takes, which I think will be helpful. So in that guidance figure, we're assuming we're not necessarily at full capacity by that point. And so as we exit 2025 at full capacity, that $10 sensor, but there's ramp that would take place over the course of that time. So some of that plays into it. We are assuming some contribution from Dexcom ONE, which as you know, is a lower gross margin profile, but still significant operating margin contribution. And when we talk about partners, I think Teri talked a little bit about Italy and Argentina, leveraging partners to go into some of these markets, we have almost no operating cost, but that is full -- the gross margin is fully flow through. So some of that margin ultimately accrues to our partner. All of that's contemplated in the 65% along with maybe not everybody on 15-day, not every product on 15-day for every population by that time. We're working through what do you do with peds versus adults. And so we've took all of that into contemplation to give you a base case. And you can probably imagine our goal then, of course, is to exceed that base case. But we want you to make those investment decisions based on what we know, a base case. Those are some of the puts and takes. And obviously, the team is fully at work to try to do better.

Now why don't we go to Larry.

Larry Biegelsen, Wells Fargo. On the new product, the noninsulin product, 2 questions on that. One is, it's a large market, 25 million people. What's the -- do you have the clinical data you think you need to drive adoption? Or do you need to develop more clinical data? And I'm trying to understand the 15-day comment why you would go with 15 days on that product first as opposed to your core insulin-intensive G7, where there's a higher immediate need.

Teri, why don't you start?

Yes. Sure. So when we think about this market opportunity for the type the broad -- sorry, nonbasal nonhypo risk type 2, we expect to launch with really compelling data for this population. I referenced some data that we'll see even this week at ADA. And we'll continue to generate data not just for impact in this population, but for differentiated impact in this population. I think just as we've done for each of the populations that we've entered over time and generated the data both for obviously, the regulatory approvals, but also a broad dossier of data for coverage over time. Maybe I'll let Jake talk about the technical decision about 15-day.

Yes. So we take everything into account on survivability and how our customers, where expectations are. And the way that we think about G7 is we want to further enhance the number of sensors that make it the full wear period. And so that's why we're thinking about these additional technologies that we want to integrate into G7 for our IoT customers and insulin users. And so we feel that, that's the right balance is to wait for those newer technologies before we integrate into the IoT space.

Hannah, why don't we go to Chris. He's right in front.

Chris Pasquale, Nephron. There's been some noise about noninvasive glucose sensing over the last several months. Curious your thoughts on the potential of that technology is something that Dexcom is actively working on? And do you think it could be a reality in 5 years, 10 years? Pick your time point.

I've seen those technologies for a very long time. I started in diabetes in 1994. And I've seen a lot of those technologies come and go over the years. We evaluate all those, Chris. We don't sit still and think that we're absolutely invincible and this is the only way to solve the problem. But we haven't seen anything that delivers the accuracy performance that we do. I think one of the problems with this category is the definition of noninvasive. Because if it's this big and it's kind of sitting on your arm, that's a lot more invasive than something a little bigger than a nickel that you can wear for 15 days and not even notice that it's there. And this ease of use and the simplicity of our current platform really takes the term noninvasive. It almost makes it go away as far as I'm concerned. We look at those things. We've not seen any scientific data or any performance frame that would indicate to us that, that is a threat. But it may come someday. And if it does, we will evaluate them. We'll be ready. We have a venture arm. We invest in some very cool technologies. If there's something that we saw that were spectacular, we'd probably take a look and invest. But today, we have not seen that.

Now why don't we go to Matt O'Brien.

Matt O'Brien, Piper Sandler. I'm going to ask my why question to Jereme, and you may not like this, so apologies upfront. But the OUS numbers looks good as far as growth there. It's going to be in the low to mid-20s for a while. But the U.S. number might be a little bit lower than some people have been expecting. You've got less pricing pressure, all these new patients you're going to be accessing. Why isn't it better than that? What have you contemplated in this updated LRP? Is there AID pressure? Or what else is contemplated?

Yes, sure. Look, I think, again, we try to deliver a base case. So as you think about that U.S. market, we'll just tell you, we assume that in that intensive market, it's 65% adoption. We expect it to get to 80% over time. And so one way to think about it is as that adoption in that market grows quicker and faster, you could imply that, that would grow quicker and faster. And certainly, as we talk about the nonintensive market, i.e., basal and nonintensive, we're certainly just being prudent about those markets, certainly, the nonintensive contribution. Make no mistake, our goal is to push adoption to 80%. We wanted to deliver the base case of 65% adoption intensive insulin. Of course, we'll be looking to push further than that. But it's a fair question, and hopefully, that gives you some context to how we thought about it as a base case.

Hannah, why don't we go to Jayson Bedford?

I didn't hear much and I may have missed it, but I didn't hear much on the basal opportunity in Europe. Your competitors seem to have a win in France on this opportunity. Can you just comment on basal in Europe and your ability to compete there?

Well -- and you guys correct me if I'm wrong. The opportunity in France is France opened basal insulin coverage for CGM for everyone. We have not submitted a tender for that yet. But when we submitted tender, we certainly expect to be able to play there, certainly with our Dexcom ONE platform, that's why we launched it. We believe, over the course of time, the geographies will open coverage to basal insulin users and follow the guidelines that CMS has established for helping these people stay healthy. And France has a perfect opportunity. They've expanded coverage. This has happened in other countries as well over the past -- literally over the past year. That's why we have the portfolio approach. That's why we've scaled. That's why we're moving Dexcom ONE to a G7 platform for these international markets going forward so we can participate in that market expansion. And we will.

Right. Matt, why don't we go to Marie?

Marie Thibault from BTIG. You sized that market of type 2 patients, noninsulin but hypo risk for us. And of course, they're getting coverage now through Medicare. I want to understand how easy it is to find those patients. Are the doctors seeing this in their medical records? And then as a second part there, are you going to be able to get commercial coverage the same way with that 60% win you had in basal? Are they going to cover this patient population as well?

Go ahead, Teri.

Yes. In terms of the identification, if you look at the CMS ruling, the requirement for identification of these patients is fairly straightforward. So we don't expect that to be a burdensome element in the adoption for this population. In terms of commercial coverage, certainly, this is an area that we are working on now that we have the coverage with CMS. The data is very strong, and we'll know as we start working with the commercial payers, what additional data may need to be generated, but we do expect over time to have commercial coverage follow.

Great. Hannah, why don't we go front row? Is that Margaret? I can't see that far.

Margaret Kaczor, William Blair. I'm going to slide one in just as a follow-up on the 2025 guidance. It didn't sound like you increased the noninsulin or basal opportunities, I guess, relative to that 2025 guidance. So are you assuming much, if any, products, I guess, that you had referenced in 2024 there? And why or why not? And then given that there's, frankly, already a significant number of noninsulin users today, can you speak to that patient characteristic profile that's using and how that might change by '25?

Sure. Yes. Let me start with the assumptions around the LRP, and then Teri, if you want to kind of augment with where the market is going. So just some context for that basal assumption because I think it's good to get all these assumptions and then obviously, we'll look to do better. So this assumes about a 25% to 30% adoption in the basal population. So Matt asked the question about the intensive insulin, that's about 65%. This is about 25% to 30%. Today, we talked about already being at 10%. And so that's assumed in that adoption. That's a majority of that $700 million. We're highly confident in those numbers. And again, highly confident these are base case numbers that we ultimately come up with. As we think about the nonintensive products, certainly, as we launch it in 2024 and likely the back half of '24, the contribution is going to be significantly in 2025. And so it's a little bit less of a contribution because as you know, we're a bit of a recurring revenue model business and so it takes a little bit of time for those to build. There's a little bit of contribution there from gestational and hospital as well. Again, we'll give more clarity on those as time moves on. So that's why the number was the same. Highly confident in that number, but the number is certainly the same. And again, I reiterate it all the time. These are our base cases, and we certainly are incentivized to certainly go further than that. Anything else you want...

I might just add or in some ways echo that for the new products we talked about, this is a product with a set of features in a category and target population that is new -- that really -- there hasn't been a product launch for them yet. And so while we expect significant opportunity over time, I think we're also being prudent as we're going to learn much more about what we can do to accelerate the uptake of that population once we've launched the product. And to Jereme's point, that time frame is really the growth starts more in 2025.

Now why don't we go to Travis.

Travis Steed, Bank of America. Thanks for putting the Investor Day together. I know it's a lot of work on your part. So Jereme, maybe you could talk a little about kind of what you're seeing in the basal uptake with scripts over the last few months as that population has come online. And we're kind of surprised to see the 60% commercial population, too. And then Kevin, if you get down to health, I know we talked about the new insulin product, you mentioned a lot of other things. If you could kind of break down kind of what you're willing to disclose on the new product standpoint today is a little confusion on. Is that G8 you're talking about or those will be incremental updates to G7? Just love to get a full picture of the new product front.

Yes. So why don't Teri and I kind of frick and frack on the basal uplift. Why don't you go ahead and start in terms of anecdotally, what you see and then I can kind of give you some context.

So it is early. We're still just a little over 2 months out of that CMS expansion coverage going into place. And of course, a lot of that government volume goes through the DME channel. So there is a bit of a time lag on when we see the data coming through. But anecdotally, what we are seeing and hearing is really strong uptake, and we would expect that Dexcom will get our fair share of that growth in the basal population.

Yes. And then just, again, it's more anecdotal, but in terms of excitement, excitement is building. I mean, you heard it in Dr. Grace, we have that panel of primary care physicians in our office. And the commentary has always been, I want to put everybody with type 2 diabetes on a sensor. The challenge, in many cases, is economic. And so as this coverage comes in, we know there's absolutely interest in it. It's just -- as Teri mentioned, it's going to take a little bit of time. Anecdotally, a lot of interest.

All right. I'll go back to the portfolio for a minute. I disclosed some very absolutes with respect to modifications you'll see from us over the next 12 to 18 months with respect to G7, the 15-day product that's a configuration for our noninsulin using product. We also have a next-generation extended wear product that we will start clinical studies on before the end of this year. I don't know if we're going to call it G7+ or G8 or G85. I don't know how Teri will market it and position it yet. But that is happening. And we'll have the direct-to-watch connection. Those are things that are very real. We then have a lot of projects that really are our future technologies and things we're going to do to continue to innovate. Again, as you look at that series of firsts that we've accomplished over time, what are those next first that we want to do. We've got more powerful electronic configurations that we're considering. We've got different footprints, different materials for the body wearable that we're looking at incorporating more reusable materials in what we do because as -- again, as we focus on ESG, like everybody else. I mean, in all fairness, I've had people mail me all of their G6 insertion devices to my home for a year and write me a nasty note, "How dare you use all this plastic. And by the way, your product has saved my life multiple times." So I forget the first part of the letter and I focus on the second one. Those are more of the future product portfolio and things that are going to contribute more than likely to this LRP that we're talking about today through the end of 2025. But the pipeline is robust, and there's many things. And the other thing I wanted to make sure you all understood because I feel a little handcuffed as has the rest of our organization. We had to get to the G7 platform before we can do these other things. We couldn't do it on the G6 platform. The G6 platform is fantastic. It is a great product, but it is a transition from where we were to where we need to go. And we need to get G7 done. And so now with the Malaysia manufacturing site, Arizona and San Diego running smoothly and plans to have one in Europe, we can build these multiple portfolios. One size is not going to fit all for the markets we intend to address. We intend to have not only software offerings as you look out longer than a couple of years, but multiple hardware configurations that will bring people exactly what they need and measure the things they need to measure.

Hannah, let's go to the back. Is that, Danielle?

Yes, Danielle Antalffy with UBS. I actually have a question on the numbers you put up there for penetration in type 1 and insulin intensive type 2. I was quite frankly surprised that type 1 is still only 55% penetrated. And I was wondering if you could -- especially with type 2 at 40%, 45%. So could you talk a little bit about what maybe is going on there? And why we haven't seen that sort of accelerate a little bit more as you've expanded into the new patient populations and ramped marketing and things like that?

I think your question, Danielle, really -- and thank you for the question, really points to the opportunity for continued innovation for our product portfolio. Our products are tremendous and they save lives every day. There are still additional needs and different features that some customers are looking for. And so I think your question points to the need for continued innovation. I think we also think, as I mentioned, that with additional entries into the AID connected space, this will actually grow and probably further accelerate the penetration in the type 1, certainly in the AID connected part of the type 1 and type 2 intensive space, and we think we have an opportunity to continue leading there as well.

We have time for a few more questions. Matt, how do we go to Steve?

Steve Lichtman from Oppenheimer. Just another question on the new market contribution in 2025. Jereme, is it fair to say that the hypo at-risk population is upside to that number since I guess, last time you provided, we didn't know about that inclusion in CMS? And what are you assuming from utilization for the basal only? What are you seeing out there so far? I know it's early days, and what are you assuming for that utilization in that group?

Sure. Yes, I can take that. So in terms of the contribution from hypo, I'll say, severe hypoglycemia or problematic hypoglycemia, it's a relatively small contribution assumed in the LRP. Why? We've got to drive awareness. And so look, Teri mentioned it, that's the challenge ahead of us. Driving awareness that you do qualify for reimbursement and letting these primary care physicians know. Clearly, we're going to drive towards that and try to outperform that, but it is a relatively small contribution. In terms of then your question on basal wear and how that wear, based on the mobile study and based on what we've seen, it's predominantly full-time wear. And while you may see some periods there where say there's a weekend, someone might take off. For the most part, it's full time wear. Mobile would have confirmed that. And so that would be our expectation, at least as the majority of folks are full-time wear. So a similar -- relatively similar utilization from our existing base.

Hannah, let's go to Kyle.

Kyle Rose, Canaccord. So Kevin, I wanted to ask about -- you made a comment about an advanced algo. I mean you've had TypeZero in house since -- for the last 5 years, inControl has been on the market for a few years now. And there's another company that just recently got approval for a more friendly user interface with a pump. So, I guess, just how should we think about the timing and the differentiated features as well as the potential commercial partners? And then kind of dovetailing off that, has your view or -- of the attractiveness of the pump market changed, given we've seen the emergence of the pharmacy channel as well as the other type 2 market in pumps more recently?

Jake, do you want to talk about the features and I'll talk about the overall market? Why don't you talk about that?

Sure. Yes, thanks for the question. So as we think about our TypeZero team, right, they did develop the Control-IQ algorithm, but it doesn't stop there. They've continued to advance the technology, did a presentation on ATTD earlier this year around. It was our first unveiling of that new algorithm. And it's really designed to get after some user needs that currently aren't addressed. It's designed to be a fully closed-loop system. So users are not required to do meal boluses as they are with the current technologies. The idea is it's hands-free, automated insulin delivery. And we expect that, that's going to bring new customers into that AID fold because of the simplicity that, that type of technology shows. What we did in the clinical study and some of the initial feasibility studies was we enrolled very unengaged type 1s in that study. So these are people who had very low time in range. We're talking 15%, 20%. And this product in that feasibility study made a really significant impact in their time and range glucose control because it was giving them the insulin that they had previously not been taking, and also helped to keep them safe from hypoglycemia at the exact same time, not having to worry about meal boluses. They didn't miss their boluses because the system was doing it automatically. So it's early days for that product. There's still multiple feasibility studies. We're going to need to run with it, but we do intend to commercialize it when it's ready.

And with respect to commercialization, we have several options from a licensing perspective. We've talked with our current pump partners, we've talked with others. I do believe, based on what I've heard from the clinicians who experienced this algorithm and this technology, this does open up the door for more pump penetration. And it does open the door for it to get more users there. We'll pick that commercial strategy as we continue to develop more data. We're excited for the opportunity to continue to expand the category and get people better lives. I think it -- what these guys have done is very much a breakthrough. When you listen to the doctor who runs the trial, I had dinner with him not long ago, it's pretty exciting. And so we do need to figure out a way to get this technology to market. What a great problem to have great technologies you need to get to market. I think we're good with that. We'll figure it out.

Why don't we take our last question from Matt Taylor. Hannah, right by you.

It's Matt Taylor from Jefferies. So I just want to ask another follow-up question on the nonintensive product and the opportunity there. You talked about starting out with the cash pay, but also doing some evidence development in the future to try a more formal coverage. So I was hoping you could maybe describe for us what you think you can do in terms of penetration with just cash pay? And anything that you could give us in terms of breadcrumbs on the pathway to more formal coverage?

Why don't I just start real quick and then I'll let Teri and Jereme take it. We think with cash pay, we can generate quite a lot of interest with this. Again we haven't talked about pricing, but if -- as we go through and do this, there are people who are claiming to wear sensors, and we want to address that market. There is a tremendous amount of clinical evidence that we have assimilated from all the studies we've been involved in on our own and with our partners. As we put that together, we think it will be compelling. But if you go through the history of this category, let's look at what's driven reimbursement. The DIaMonD study that we ran many years ago, where we showed people on MDI with sensors, could do incredibly well if they wore a CGM. The mobile study drove the expansion of this category into Medicare for basal insulin users. We'll work on thoughts and things that we need to do to drive that. We have not, again, designed a landmark study to show that. I think there's a lot of evidence that as we accumulate it, we can get to reimbursement. And if we get enough live real-time users as we go, I think that can be very compelling as well. I don't know, Teri, Jereme, do you guys have anything else?

Just to complement your point, Kevin, about the meaningful penetration that we can drive with cash pay for this product. We know that this population is highly motivated. But it's also a population that we know from our data and our insights in the primary care community that the primary care community is not typically speaking with this population about the need and opportunity for CGM outside of a small subset. I would say, early adopter primary care, who Dr. Grace represents, but that's not the general perception of primary care with respect to CGM use in people who are not on insulin. So I think as we expand with our footprint in primary care and we expand the education and awareness of this opportunity, there is meaningful growth we can generate with a cash pay option.

So if you're curious about wearing a CGM, you can probably then surmise how many people out there are also curious about it and want to use that. I think most folks in here, you -- most folks, you asked, they're curious and they want to know. And if we can create a product that's tailored to that curiosity that helps them ultimately drive outcomes, there's a lot of people that have interest.

We'll go ahead and wrap there. I know there's a couple of analysts I wasn't able to get to, so apologies for that. We'll make sure, certainly, we can address further questions on certainly the upcoming earnings call and others, but thank you, everyone, for attending today.

Thank you very much.

Thank you.

Thank you.

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