Insulet Corporation (PODD) Earnings Call Transcript & Summary

Good morning, everyone, and welcome to Insulet's 2025 Investor Day. I'm Clare Trachtman, Vice President of Investor Relations. And on behalf of the entire team, I'd like to thank you all for joining us this morning, both in the room and online. We have an exciting program for you today. The leadership team will share our long-term strategy and innovation road map, along with our financial outlook for 2025 through 2028. Before we dive in, we do have a few housekeeping items. Let me start by reminding everyone that certain statements, including comments regarding our financial outlook, the anticipated impact of our strategic actions the potential impact of various regulatory and operational matters and the macroeconomic environment on our results of operations contain forward-looking statements that involve risks and uncertainties. As a result, our actual results could differ materially from our current expectations. Please refer to our SEC filings for more details concerning factors that could cause results to differ materially. We will be discussing a few of our latest products, which are investigational use and have not yet been cleared by the regulatory authorities. In addition, some products we will be discussing are not yet available in all regions. You can find the list of these products here. In addition, non-GAAP financial measures will be used to help investors understand Insulet's ongoing business performance, including adjusted operating margin, adjusted EPS and others. A reconciliation of certain non-GAAP financial measures to the comparable GAAP financial measures is included in the investor presentation. As we move on to the agenda, we're proud to present a compelling lineup of presentations from our executive leadership team, complemented by inspiring stories from our guest speakers and concluding with the Q&A. We'll take a short 15-minute break at approximately 10:20 and plan to wrap up the formal presentations by 12:30. For those of you joining us here in Acton, Grab and Go box lunches will be available following the presentations, and we have manufacturing tours available for those who signed up. With that, I'd like everyone to turn their attention to the screen for a short video before handing things over to our President and CEO, Ashley McEvoy. Thank you again for joining us today. We truly appreciate your interest in Insulet. [Presentation]

Well, good morning. Thanks for joining us today, and welcome to Insulet's 25th anniversary of our company and our 2025 Investor Day. And for us, this is like a first in a decade. So while investor days are focused on the future, I promise you we will get to that soon enough. I'd like to start by honoring the past, partly because it's our 25th anniversary and partly because I'm excited to share the special qualities that have shaped this company since its founding. Now it isn't lost on me as a new CEO talking history, but it's impossible to spend time with the Insulet team and all of our Podders worldwide without seeing how this journey has defined the company we are today and the company we will become. Let me share a remarkable story for the past 25 years. It's really a story of ambition and disruption and ingenuity. One of our founders had a bold vision to challenge the market leader. Back then, we were a tiny start-up with the feisty focus determined to really disrupt the incumbent. Does that sound familiar? Industries, this is how industries are born and how they evolve. Over the last 25 years, our company has achieved remarkable feats. Through ingenuity and the marriage of technology, we launched Omnipod in 2003 and we followed on by Omnipod 2 Eros, DASH and now for over 3 years in the United States, Omnipod 5. Each generation has marked a breakthrough in technology that has brought us ever closer to really making life with diabetes, dare I say, normal. Soon, we'll expand to many more places around the world. The power of this engineering marvel has made the market leader, which is the Omnipod right now, made us the market leader in the U.S. and has helped grow our community to over 600,000 Podders globally with revenue of $2.7 billion. I believe before you look to the future, you must honor the past. We've recently had one of our founders, John Brooks, right here on campus. He retold the story of Omnipod's origins. John's vision was quite simple. He wanted his child with type 1 diabetes to feel as normal as possible. Able to swim, shower, go on sleepovers and not be tethered by tubes or electronics. In John's heart in mind, he knew there has to be a better way. So what started with a sketch on a napkin has turned into a multibillion dollar market-leading Omnipod brand that you know today. Thanks to John's vision, tenacity and steely eyed resiliency, we are now carrying that baton forward. So one thing that fervently is true from the founding to where we are today is our North Star. We will find a better way. When I joined Insulet, everyone I met, whether it be in the plant or in labs or customer service or even in the field echoed this humble, open-minded belief that we can find a better way. We're going to bottle that spirit and carry it forward for the next 25 years. With this as our North Star, we refined our vision and our mission. Our vision is clearer than ever. We create a world where diabetes demands less every day, everywhere. Diabetes is still daunting. It's a major cause of mortality and morbidity in the world. And if we can help people with diabetes feel just as normal as possible, diminishing the disease into the background, we will have done our job. So I've been very fortunate because I've been involved in some companies that have incredible purpose and value. But really, what's unique here at Insulet is I can feel it, I can see it, it's personal and every Insulet employee I meet. So our mission, our mission embodies what we aspire to do on a daily basis. Whether that be our employees who've been here for 6 weeks, 6 months or 25 years. Our mission resonates where we've been and where we're committed to going. We are born of empathy and we are driven by ingenuity, and we are proven by science, and we transform the lives of people with diabetes. Simply put, a little bit profound and a very humble calling. For this, this is what guides us every day to be where we need to be paying attention to, to serve more Podders all around the world, and it will guide our future. Because you see at Insulet, what guides us is empathy led science-driven innovation. Omnipod 5 is the most recent product of our commitment to ingenuity, impact and intimacy. It's the world's first tubeless wearable automated insulin delivery system. It's a 70-piece engineering marvel that puts the therapy and the sensors and the algorithm and the connectivity, all into a disposable patch, the size of an AirPod case and lets you control it with your phone. It's simple enough that kids and seniors alike can handle it on their own. But above all, Omnipod 5 is a pod. It's the only pod-based automated insulin delivery in the U.S. Now the form factor is core to our origins, but now this is a smart connected device delivering medicine for Podders all around the world. Podders tell us all the time, it almost feels like I don't have diabetes anymore. Well, that's the goal. That's what Omnipod delivers, peace of mind, freedom from the constant worry that you are one oversight away from an emergency. Our clinical data confirms this RADIANT and SECURE-T2D, our most recent flagship studies show proven outcomes, reduced A1c increased time and range, lower insulin usage, less hypoglycemia and improved quality of life. But the real magic achieves these results without making a person feel like a patient. So after Omnipod, Romy's [indiscernible] was able to sleep through the night and Garrett got his time back and Anna was able to be a kid again. In order for Romy and Garrett and Anna to become Podders, we needed to ensure that we made access as easy as possible. At Insulet, we are fierce advocates for access and affordability. Innovation isn't just reserved for our technology. It's our ethos and it extends to every aspect of our business and one of the most innovative strategic decisions in our history, was to pioneer our pay-as-you-go pharmacy model. Where you see insulin pumps have historically been sold as a durable medical equipment, a channel, I'd say poorly suited for a pod. So starting in 2015, we set out to create a better way. It took many years of concerted advocacy. But today, all of our U.S. powders pick up their Omnipod 5 prescriptions in the same place as their insulin. And the more than 47,000 pharmacies around the country. This channel makes it easy to start and to stay on therapy. There are no upfront costs no multi-thousand dollar barriers. Most patients, in fact, pay around $1 a day. And for many, the cost is zero. We have coverage with more than 300 million lives in the United States and Omnipod was the first pump covered with Medicare Part D. We are taking this proven market development playbook and deploying it globally. To deliver Omnipod at scale across the world, we've had to rethink our supply chain from the ground up. For many years, pods were handmade and then they were later hand assembled. With our growth and the demands of a device put on every 3 days, we will produce more than 7x more pods this year than we did 10 years ago. The solution has been relentless automation of every aspect of our business. We've invested more than $1 billion to build one of the most advanced automated manufacturing systems in medtech, with proprietary solutions to produce a highly complex electromechanical device at medical standards and consumer electronic scale. For those of you here in person, you're going to be able to go check out our place in Acton. And you will see very similar to what you see in Acton, you'll see it in Malaysia. And we have created a scalable cost-efficient supply chain that delivers durable advantage rules both in quality, reliability and cost. Our approach to access makes AID readily available and our approach to manufacturing meets ensures that we can meet all of the consumer demand. But it's the power of our Podders and the power of our brand that fuels our engine. Today, Omnipod is the most requested and most prescribed brand of automated insulin delivery in the U.S., and it is #1 in new customer starts, both in the U.S. as well as the EU. The demand -- this kind of demand has grown the Podder population for more than 600,000 strong. But you know what distinguishes our brand is the trust that we've built and the loyalty that had is earned within the Podder community. And in turn, Podders, their passion and their engagement really infuse our brand and that helps us with relevance and authenticity and that drives deep personal connections which fuel our growth. Now let me show you how this has culminated in industry-leading performance results for our business. To put it simply, we are not just the market leader, we are the market driver. Over the last 5 years, insulin has driven 66% of the global market growth. We have grown 26% in our revenue CAGR more than 3x the growth of any rate of any company in the market. We are the leader in new customer starts and from less than a 30% share in 2020, we are now approaching 50% global revenue share, and we're confident we can continue to lead. This proven performance gives us the confidence and a renewed ambition for what the future will be. There is so much more we can do even in the markets in which we already play. In the U.S., our type 1 market, which is more than a $9 billion market, AID penetration is 40%, well lagging behind CGM penetration of 70%. In our OUS type 1 market, which is more than a $10 billion market, only 1 out of 4 people with diabetes is on AID therapy. Where CGM penetration is around 65%. And as you know, we are just getting started in the type 2 basal-bolus market in the United States, which is around a $12 billion market with less than 5% penetration. Later in the day, you'll meet Carolyn Sleeth, our Head of the U.S., our largest market, and a Podder herself and she will walk you through our strategy to drive penetration in the U.S. type 1 market as well as all of the learning we've gotten to drive the type 2 market in the U.S., building on our remarkable strength built over 25 years of serving people with type 1. And Eric Benjamin, I'm pleased to share our newly elevated Chief Operating Officer. He's going to share what our innovation road map is and how our strategy to grow, expand internationally and globalize insulin. Together, what you'll hear are our efforts to help more people with diabetes drive growth in the market to $9 billion by 2028. So in total, we see this as a $30 billion total addressable market with low AID penetration and a significant opportunity for us to grow. This market opportunity represents our ability to transform 8 million people with diabetes. Now what you may not have line of sight to, which we have line of sight to, are an additional 9 million colleagues and people with diabetes that we have the opportunity to serve around the world. And that would double our total addressable market from 8 million to 17 million people with diabetes. So let's first take a look at outside the United States. Similar to the U.S., where we built on our strong foundation of type 1 when we entered with type 2, we have line of sight to take type 2 to the OUS market. This would add another 4 million people with diabetes that we could serve. Now in the U.S., we will take our learnings and capabilities apply them to the type 2 basal-only community, which will allow us to serve another 3 million people with diabetes. And last, is Asia and the millions of people in Asia that have diabetes and are in need of care. There are more than 2 million people with type 1 diabetes. So in total, if you look at the 8 million people with diabetes and markets we already serve and you add another $9 million, and this doesn't include the people in Asia who have type 2 diabetes, we're still assessing that approach. You can see that this TAM gets larger. Now clearly, this is not in our immediate 3-year road map. We have this on our longer-term road map. But when we look to the future, what gives us confidence is this remarkable opportunity and where we play overall in the unique landscape and how we plan to build on our competitive moats. So I'd like to take a moment to share where I believe we sit in the global marketplace. And what is I like to say, what's our unique piece of real estate. I see us at the nexus of 3 distinct industries and at the top of the game in each of these industries, the ones that create the most enduring value. We -- you could say they represent what we look like on their best day. Many of you are probably the most familiar with medtech. Medtech is where engineering marvel meets technology, and it's about ingenuity. It's about smarter, less invasive devices and more personalized solutions. Health care, it's about impact. It's about getting after the biggest areas of unmet clinical need like diabetes and metabolic disorder, which are the leading causes of morbidity and mortality in the world. It's about being science-backed and evidence-driven, partnering with clinicians to advance the standard of care. Now the last is consumer. We're all consumers. I can go into your cupboards and see what everybody is shopping and buying. Some call it consumer staples, some call it consumer health. This is about intimacy. This is about the power of brand and a lifetime partnership. Powerful brands in this space understand the daily habits and practices and rituals and they understand how to deliver superior performance that people can count on. Because of this unique positioning, we hold in the marketplace, we need to ensure that we're masterful in all of these areas, in innovation and building evidence and working closely, with clinicians on how to advance the standard of care. So the latest science is reflected in clinical practice and cultivating brand love with superior connections with our Podders. And when we live into this, we will have built a beloved brand and business that will have enduring trust and when you have enduring trust, you have enduring value. And when you have enduring value, we will deliver above-market industry performance consistently. Now let me take you a little bit inside the company and share what I believe is Insulet's secret sauce. To realize these massive opportunities, we are doubling down on what has differentiated Insulet and what makes us unique. We're investing to extend our leadership and enhance our ability to find a better way and really make sure that this culminates in 6 critical elements, again, I call the Insulet difference. The first is around a purpose-driven team who's relentlessly determined to find a better way for people with diabetes. The second is innovation born of empathy with a strong legacy of disrupting transformative, disrupting the category and bringing transformative solutions. The third is a fierce commitment to eliminating barriers to care, deepening access in current markets and expanding globally. The fourth is superior science, health care professional partnerships, patient advocacy, using this advantage to shape guidelines and advance the standard of care for patients. Fifth, it's our beloved brand and commercial excellence. It's passionate Podders and health care professionals who've seen, heard and feel that they are absolutely intimate at every touch point on the latest science. Six, it's about our technical and manufacturing superiority. We design and deliver millions of engineering marvels with unmatched speed and quality. I'd like to share more on the first 3 of these Insulet differences. And later today, you will hear from Eric Benjamin, our Chief Operating Officer; Dr. Trang Ly, our Chief Medical Officer; and Manoj Raghunandanan, our Chief Growth Officer. So let's start with our people. We have a unified team with a very strong sense of purpose with deep industry experience and functional expertise, this team is well aligned to Insulet's unique position with experiences in medtech, in health care and in consumer and is fully equipped with the skills and the capabilities needed to deliver on our vision and our ambition. Beyond these leaders at every level and across every function, we are surrounded by our highly engaged employee community. Their experiences with diabetes care foster the empathy that fuels the search for a better way. While I am incredibly proud to represent the people at Insulet, I'm even more excited about what we are collectively going to create for the future. As I said earlier, this is where the innovation comes in, take a deep breath, get ready. We haven't talked about innovation in our pipeline in a while. So as I said earlier, each generation of our technology has marked a true breakthrough in making life with diabetes a little more normal and bringing Omnipod to even more people around the world. What's coming next delivers on that same high bar, but we're moving a little faster now. So starting in 2026, another big step forward for Omnipod 5. First, we're adding a lower target and extending Podder's time and automation operation intended to enhance time and range and usability. And then in the first half of 2026, Omnipod 5 will connect with all of the major CGMs, yes, we will be launching with Libre 3 Plus. And then we will be bringing a new data platform called Discover, you can see it next door that will really provide actionable insights to both health care professionals as well as our Podders. In 2027, I'm pleased to announce that we will be launching Omnipod 6. The next-generation hybrid closed loop for type 1 and type 2 with an improved adaptive algorithm that makes the pod even easier to use. We anticipate Omnipod 6 will significantly expand our market, both in type 1 as well as type 2. And then in 2028, we need like the drum roll, pa rum pum pum pum. Okay, we are pleased to launch a new revolutionary fully closed loop system for people with Type 2. Our fully closed loop marks a step change in simplicity, in ease of use, a fully automated system that is ready to use out of the box. This technology will greatly reach greatly expand our reach with both the endocrinology community and also importantly, the primary care physician community and unlock that much larger share of the $12 billion type 2 market that I shared earlier. Omnipod 6 and our fully closed loop offering, they reflect our vision of patient-centric innovation and an innovation that's designed to deliver a better way, better outcomes, better quality of life and better availability. Eric, who has been working on product for 10-plus years, is going to share with you our pipeline through 2028 and a little bit beyond. As I mentioned at Insulet, we have a fierce commitment to eliminating barriers to care not just in the United States but around the world. And as the leader in AID, it's our responsibility to grow the market to get those colleagues from MDI on to AID. We're doubling down to where we're strong in markets which have large patient populations of people with diabetes. They have attractive access and attractive reimbursement while efficiently allowing other markets to draft off of their successful growth. We will always take a disciplined approach to entering new markets. Across the board, we are committed to further investments in health economics, market access, public policy that will ensure that we're able to continue to fuel that category growth and allow more people with diabetes around the world to benefit from AID therapy and most importantly, the Omnipod brand. Now I've had a chance to walk you through our core strategies, our innovation, our investments and what makes us unique. Now I'd like to share with you how this will culminate of what our business will look like over the next 3 years. You've heard me talk about the opportunity to increase AID penetration and our $30 billion total addressable market. Over the next 3 years, we will drive AID penetration across all 3 markets in which we serve. This will help grow the market from $8 billion today from $6 billion today, rather, to $9 billion in 2028. And clearly, we intend to take more than our fair share. We plan to grow our Podder base from a community to over 1 million. And could you imagine 1 million Podders for whom we have created a world where diabetes demands less every day, everywhere. From a financial perspective, this will support an approximately 20% revenue CAGR over the next 3 years. And thanks to our scalable reoccurring revenue business model, we plan to deliver 100 basis points of annual operating margin expansion. Flavia Pease, our Chief Financial Officer, will take you through our financial algorithm in detail later in the day. So let me close by taking you back to the big picture. There is a large underpenetrated TAM with significant runway to unlock additional growth for the AID markets, which is one of the fastest-growing categories in all of medtech. Insulet benefits from a very strong competitive moats across scalable manufacturing, strong brand loyalty, scientific rigor, innovative market access strategies and an experienced leadership team that you're going to meet today with a winning culture and I would say, creating an enviable leadership position in the marketplace. Insulet has robust innovation with a multiyear platform. We have 3 new product launches slated for the next 3 years. These innovations will drive deeper penetration in our core markets and unlock that additional total addressable opportunity that I spoke about. We operate from a position of strength with a healthy balance sheet supported by strong, steady cash flow generation, it provides us with financial flexibility and resilience. And this enables us to fuel our innovation and to support our own growth. We are strongly positioned to succeed and to execute this strategic plan, driving sustained top-tier performance, top-tier revenue growth, enhanced profitability and robust cash flow generation. We are backed by science. We are pioneered by empathy and inspired by our Podder community, and we are united by one belief. We will find a better way. That belief has brought us here, and it will guide us forward. Now I am delighted to introduce a very special guest, a former colleague of mine a dedicated father, a division 1 all American athlete, a former C-suite executive with Starbucks, Sorry, Duncan, and a remarkable man who has lived with diabetes for over 28 years and has been a Podder for 17 of those years. I'm incredibly pleased and grateful to welcome Michael Conway.

Ashley, thank you for that wonderful introduction, and good morning. It's my pleasure to be here with you this morning to share my story of the impact that Insulet has had on my life. So the year was 1997, and everything was falling into place. I was 31 years old. I was a former athlete as Ashley said, I was a rising executive actually just a few weeks away from my first expat assignment in Brussels. I was married for 5 years, and we were looking forward to starting a family. I had so much to look forward to. However, something just wasn't right. And I didn't know what it was. Looking back now, I had all the symptoms. I was thirsty. I was losing weight. And when I went to the doctor, the diagnosis was swift and it was clear, you have type 1 diabetes. My world came to a screeching halt. What does this mean? I had so many questions. Could I go on this international assignment, in fact, beyond that, what would my life be like? I had no idea. I remember like it was yesterday, I got back in the car. My wife was waiting for me, and I shared the diagnosis and we sat there in the parking lot, and we cried because we didn't know what the future would hold, where do we go from here. Well, those first 10 years was all about figuring it out how to balance things, how to balance living my life while living with diabetes. While I'm glad to say I was able to get and go on that first international assignment, and I continue to grow and advance my career, which added more pressure and more complexity to my life in managing diabetes. But I also chose not to share broadly for fear the stigma would have in the workplace, and I just want it to be discrete. So what that meant was I had to sneak into the bathroom to dose myself insulin and to check my blood sugar. And worse yet, there were times when I'd be in a business meeting much like this, and I didn't want to get up and walk out and so I didn't and you know that's not good either. So I had to balance meetings, travel, my health, fitness and now kids. It was a constant tension. And I have to say, I was barely getting by. So when I return to the states after my second international assignment in Switzerland, my endocrinologist suggested once again, that I should consider a pump. And I was ready to tell her once again, no, that's not for me. But then she described something that was different, a new tubeless pump I felt like someone was finally starting to ask the question that I was asking myself, is there a better way? There has to be a better way. This was transformational because it wasn't a pump. It was a pod. It sounded perfect and actually sounded like it was made just for me. It was simple to use. There were no needles at freedom from tube so that I could maintain my active life and also be discrete. So I immediately signed up I transition to Omnipod, and 17 years later, I'm still a loyal user. Honestly, I can't imagine using anything else. This was transformation that I could feel in every part of my life. Diabetes start to feel a little bit smaller, and I could focus more on living my life. So since starting Omnipod, my life and career just kept moving forward. I rose to the executive level, both at Johnson & Johnson, where I met Ashley and also at Starbucks. I lived in or had responsibility for international markets, almost the entire time with the last few years running international for Starbucks. Over that same time, Insulet just kept innovating. Now I'm using Omnipod 5 with Dexcom, and I've got even more freedom, fewer devices to deal with, more integration. Now I've got just the phone, my Apple Watch, managing my diabetes was even more simple, and I could even be more discrete. And actually, I can spend more time looking at my colleagues, engaging with my family members and less time worrying about the devices and looking at the devices. So what once felt like a limitation became empowerment through technology. So here we are today. Amazingly, 28 years later since diagnosis I raised the son and a daughter who were both now young adults. I've maintained an active lifestyle. I've managed a global career. And most importantly, I'm proud to share that because of Omnipod and my own commitment to my health I have no complications typically expected with someone who had diabetes for nearly 3 decades. I attribute this to being blessed to live in an era of breakthrough technology and I have deep gratitude for the innovators who are driving change, which is why I'm here today. So I would imagine by hearing the story, you would assume that I would have shared this many times before. But the fact is today is the first time I've shared the story. I have never shared my story outside with my family members and close friends and certainly not in any environment as public as this. However, I could not think of a better moment and opportunity to share my story with you, the investors. So you can hear how grateful I am for the impact that Insulet has had on my life. I want to ensure that Insulet thrives because if they do, I do. Thank you very much. And now I'd like to introduce Eric Benjamin.

Michael, thank you for inspiring all of us at Insulet to find a better way. Good morning. I'm Eric Benjamin, Chief Operating Officer. I've had the privilege of being with Insulet for the last 10 years as we've repeatedly found a better way to make diabetes demand less. In 2015, when I joined, our product pipeline was empty, in part because we were still learning to manufacture third-generation Omnipod reliably and cost effectively. So we prioritized R&D investments in those areas. In contrast to the Insulet that I joined, today, we have world-class innovation capabilities fueled by significant R&D investment. So it's with great pleasure that today, I get to tell you more about the exciting future of Omnipod and how our empathy led science-backed innovation continues to make lives easier, unlock growth, and extend leadership in automated insulin delivery. As Ashley shared, 25 years ago, Insulet was a small team with a bold idea, to make insulin delivery tubeless and truly wearable. In 2003, we earned FDA clearance for the first generation Omnipod. In 2005, the second version launched commercially. Omnipod Eros launched in 2013, our third generation and the first that was ready for scale. In 2018, we secured Medicare Part D coverage a breakthrough that made Omnipod more accessible than ever and a big step in transitioning to a purpose-built pay-as-you-go business model. Later in 2018, came Omnipod DASH, a leap in consumer-like usability and connectivity. 4 years later in 2022, Omnipod 5 became the first and only tubeless, wearable, automated insulin delivery system cleared by the Food and Drug Administration. As you saw from Ashley, Omnipod 5 is the device that people with diabetes have been waiting for to adopt AID, phone controlled, easy to use, affordable and AID that fits into life and delivers great clinical outcomes. Omnipod 5 has accelerated category adoption, fueled market leadership, as people who would not otherwise have adopted technology, start on Omnipod from MDI. I recently heard about a physician who after 50 years of using MDI, finally tried Omnipod, telling us he never thought a pump was for him and didn't even realize a tubeless version was available. Breakthroughs didn't stop with Omnipod 5. Last year, Omnipod 5 expanded the type 2 diabetes, opening an entirely new market. In parallel, we continue to improve Omnipod's CGM integration, smartphone connectivity and geographic availability, to bring technology to more people on more devices in more countries around the world. We've gone from disruptor to industry leader now focused on accelerating impactful innovation for customers including leveraging AI to write hundreds of thousands of lines of software. 25 years of continuous innovation and a global R&D community of more than 1,000 engineers and scientists has produced a strong intellectual property portfolio as we develop novel solutions to our customers' toughest problems and continuously improve our unique technology like automated cannula insertion, we protect these valuable inventions. To date, Insulet has more than 700 patent applications pending and more than 900 active patents worldwide, covering a range of innovations, spanning design, data, connectivity and clinical functionality. This portfolio has allowed Insulet to defend its valuable technologies time and again and is an important moat around the Omnipod platform and the products that we're innovating today. At Insulet, we innovate differently. We aspire to make technology so compelling that people with diabetes know instinctively that they want it and later tell others, it changed my life. Last year, I was on vacation with my wife and 3 daughters. And my middle daughter, Madeline, made friends with another little girl in the pool. When the 2 girls got out, we learned they were both named Madeline. And the other Madeline wore Omnipod 5. My wife casually mentioned that I worked at Insulet, not saying what I did. And they spend the next 10 minutes enthusiastically telling us how Omnipod 5 had changed their lives. Parents slept through the night, Madeline confidently went to school. We ran over them twice more that weekend. And each time they were overflowing with gratitude that they felt compelled to share. To make products that have this kind of impact on people, we are relentlessly focused on innovating to enhance clinical outcomes broaden availability and improved quality of life. These deceptively simple objectives guide every product and innovation decision that we make and compel us to tackle the most challenging design problems to deliver simpler, better products. Omnipod 5 is the best example of how we do this. We compressed hundreds of thousands of lines of software for an AID system and CGM connectivity to fit on every disposable pod, thereby enabling a true wearable AID experience, just a pod and a sensor on the body. We put a SIM card in every controller, streamlining office visits for health care providers and creating a digital ecosystem that gives every customer access to the latest Omnipod 5 controller updates with just the push of a button. We simplified the user experience, planning ahead to be ready for people living with type 2 diabetes. And we made the algorithm adaptable and unconnected to manual inputs so that everyone, even those cared for outside of experienced specialty diabetes clinics could experience consistent life-changing clinical benefits from Omnipod 5. Together, these choices have given hundreds of thousands of Podders like Madeline, more freedom to swim, to dance and to go about their lives with more joy and less worry. As a result, Omnipod 5 is the #1 AID system in new customer starts in the U.S. and in Europe. We have a first-mover advantage bringing the technology to those who live with type 2 diabetes. And we've grown our prescriber base to more than 27,000 clinicians in a market that has about 8,000 specialists. And the future is even brighter, with significant advancements coming in each of the next 3 years. In 2026, Omnipod 5 gets better with AID improvements, Libre 3 Plus connectivity in our new data platform, Omnipod Discover. In 2027, we plan to launch Omnipod 6, a step change in tubeless, automated insulin delivery. And targeting launch in 2028 will deliver a fully closed-loop AID system for those living with type 2 diabetes, an AID system is so simple that we aspire for every prescriber of insulin to be able to offer the benefits of AID to their patients. Together, these products are designed to make insulin therapy more effective, more accessible and more human and bring the benefits of Omnipod to hundreds of thousands more people. Starting with 2026, another big step for Omnipod 5 with smarter automation, broader accessibility and deeper insights. We're adding a 100-milligram per deciliter target glucose and extending users' time and automated operation. These changes are designed to offer customers better glycemic control, fewer device interactions and greater confidence. Second, full CGM integration. In the first half of 2026, Omnipod 5 will connect with all major CGMs, including Abbot's FreeStyle Libre 3 Plus. Offering sensor choice helps make Omnipod 5 more accessible to customers and it streamlines conversations between health care providers and patients when deciding to start Omnipod. And third, we're introducing Omnipod Discover, a new data platform that gives customers and health care providers actionable insights. Discovery uses machine learning to identify trends, efficiently highlights ways for health care providers to optimize care and inform self-care for Omnipod 5 users. It also streamlines the process of starting on Omnipod to make that even easier. These enhancements make Omnipod 5 smarter, more available and make the entire diabetes management experience more connected, more human and more effective. Then we take a giant step forward with Omnipod 6, another ingenious improvement designed for better, more personalized clinical outcomes, ease of use and connectivity. all delivered on a foundation for faster innovation. Omnipod 6 features an algorithm that learns from each user's unique insulin requirements, designed to deliver better performance and outcomes, especially for those who bolus less. It will also offer improved connectivity to support greater reliability and wear flexibility for users as CGMs get smaller. We're also introducing a new app and controller experience designed to make setup, training and daily use simpler and more intuitive than ever. And finally, a new pod. One pod that works across all CGM systems and features, simplifying logistics for Insulet and prescriptions for health care providers and most importantly, is designed to allow us to push new innovation such as future CGM integrations directly to pods in the field. By eliminating manufacturing and channel stocking, we aspire to bring technology to customers as much as 6 to 9 months faster. And by further simplifying the process of prescribing Omnipod, we enable more prescribers to write AID. Development of Omnipod 6 is progressing quickly. We have fully enrolled STRIVE, the pivotal study for the algorithm and expect results and regulatory filing in 2026, paving the way for launch in 2027. Like Omnipod 5, Omnipod 6 will target indications for both type 1 and type 2 insulin-requiring diabetes. Omnipod 6 not only strengthens our competitive position, it further simplifies the Omnipod experience, thereby expanding the AID market and accelerating the adoption of advanced technology. Omnipod 6 is a huge step forward for people living with type 1 and type 2 diabetes, but there is still more we can do to make the technology better, simpler and more accessible. Today, prescribing, training and managing insulin therapy remains complex and time-consuming. Even endocrinologists can find the process challenging. And for the many primary care physicians who manage approximately 70% of basal bolus type 2, can prevent them from prescribing AID altogether. Fully closed loop is the solution to unlock dramatic category expansion in type 2, but not just any fully closed loop system can do it. Last year, I visited a busy primary care clinic in Nashville. An energetic PharmD was curious about Omnipod, and I was there for her second meeting with our team. In the first, she had seen the simple operation of the pod and was struck by the elegance of automatic cannula insertion and the wearable tubeless experience. And we were back that day to explain the process of prescribing and patient training so that she could get started offering Omnipod 5 in her clinic. She listened attentively, but then hesitated when she saw the pump order form that goes with a prescription and heard about patient training, unsure that her supervising primary care physician colleagues would sign off despite her readiness to provide ongoing care. Omnipod fully closed loop for type 2 solves these problems. It's designed to make AID accessible to virtually everyone. With an algorithm that adjusts intelligently in real time, there is no need for meal announcements, carb counting or manual input by users. Put it on, connect to CGM and live. By eliminating all inputs to start the device, prescribing and managing AID is dramatically simplified for prescribers. And finally, we aim to enable customers to pick up a prescription or even start with a sample kit in an office and enjoy the benefits of automated insulin from the comfort of their own home on their own schedule. This improves the experience and dramatically reduces the commercial investment that we have to make to drive growth in this large market. We're moving at pace to make fully closed loop for type 2 a reality. As you heard on our third quarter call, we've already completed enrollment for EVOLUTION 2, our safety and feasibility study, and we plan to start the pivotal study in 2026. We're targeting a regulatory submission in 2027 and launch in 2028. Our fully closed loop system for type 2 is designed to improve clinical outcomes and unlock access to AID for millions of people who have never considered AID as a treatment option. It will reduce the burden of managing type 2 diabetes and give patients and providers a therapy that's effective, empowering and fits in their lives and busy practices. While our initial focus will be the type 2 basal-bolus market, the simplicity of a system designed for primary care also enables us to target the type 2 basal market over time. True to our ethos, we are relentlessly finding a better way for people living with type 2 diabetes. But wait, there's more. Beyond 2028, we continue solving the toughest problems to push the boundaries of what's possible in diabetes management by investing in next-generation platforms. During the planned period, we'll be investing in fully closed loop for type 1, leveraging the learning from our type 2 fully closed loop program. We expect the road to fully closed loop will be iterative with significant improvements delivered over time. We're also excited to be working on a new pod hardware platform. Both of these are investment areas over the next 3 years that we'll launch beyond 2028. And finally, we are constantly listening to Podders and health care providers to deeply understand their daily frictions and have ongoing technology research targeted at the highest areas of unmet need, including higher insulin capacity, form factor improvements and longer wear. As always, we'll approach these challenges with empathy and ingenuity, always relentlessly seeking a better way. So let me leave you with a few things. Insulet's approach to innovation is rooted in empathy, guided by customer intimacy and powered by ingenuity. We solve the hardest technology problems to deliver the best, simplest products. Second, with the launch of Omnipod 5 enhancements, Omnipod 6 and fully closed loop for type 2 diabetes, we expect to extend our leadership with the aim of improving outcomes, breaking down barriers to adoption and unlocking new segments of our total addressable market. And finally, we are already investing in next-generation platforms that will launch beyond 2028, including a fully closed loop for type 1 and a new pod hardware platform. As Ashley reminded us this morning, Insulet was built on one simple belief. There has to be a better way. I'm partnering with our teams every day to make our ideas real, impactful, reliable and scalable so that everyone living with diabetes can benefit from Omnipod. I'm now pleased to welcome Dr. Trang Ly, who will explain how our science and outcomes are helping everyone indeed see that there has to be a better way. Thank you. [Presentation]

Good morning, everyone. 9 years ago, at our last Investor Day, I shared a vision for AID. It was ambitious, but still in its infancy. And today, 3 years after Omnipod 5 launch, its impact is tangible, and we're continuing to push the boundaries of innovation. Our Omnipod story is far from complete. As a pediatric endocrinologist, I've witnessed the transformative impact of our innovation in the lives of people with diabetes worldwide. And this morning, I'll present robust Omnipod 5 safety and efficacy data supporting our indications for both type 1 and type 2. And I'll also share how we're advancing the sites to unlock even greater possibilities. We're still early in the global AID adoption curve, and that represents a tremendous opportunity for growth and impact. So let's start first with type 1 diabetes. Omnipod 5 has transformed treatment through simplicity, innovation and durable performance. the RADIANT study proved that more children and adults could have reached glycemic goals versus MDI. Here, you could see that everyone started the trial with an A1c above 8%. And not only does this signify a suboptimally managed group of patients, it also describes the majority of the 1 million people in the U.S. who are not using AID. Patients were then randomized to either start Omnipod 5, shown here with the solid black line or stay on injections, shown here by the solid purple line. And at 3 months, patients on Omnipod 5 lowered their A1c to 7.2%, a level that was maintained through 6 months. Patients on MDI remained at 8% until 3 months when they switched to Omnipod 5 and also achieved a favorable reduction. And this improvement is significant. It reduces rates of diabetes complications and premature death. And it supports an AID first approach in type 1. It's a proof that can overcome the clinician's resistance to recommending technology to a broad population. We also have data supporting how Omnipod 5 has redefined what's possible for managing type 2 diabetes. In our SECURE-T2D study, we enrolled insulin-dependent patients on MDI or basal insulin and then started them on Omnipod 5 for 3 months. And importantly, we allowed continuation of their GLP-1. The results were overwhelmingly positive. The overall population reduced their A1c by 0.8%, which is remarkable. And even more so is the 2.1% reduction for patients whose baseline A1c was 9% or higher. And to underscore this significance a 2% reduction in A1c is equal to 3.5 years of extended life for a person with type 2 diabetes. And you may be wondering what about those on a GLP-1. Here, you can see that the results were similar where the patients were on a GLP-1 or not, which in practice means that people need both, both the GLP-1 and better insulin treatment. And it's not an either/or phenomenon. This A1c improvement, combined with improved timing range, reduction in insulin and minimal weight gain, are clearly positive results. These are not incremental improvements. They represent a seismic shift in diabetes care. Beyond our clinical trials, our real well performance demonstrates excellent results for a broad range of patients. These data represents people whose baseline A1c range from 7% greater than 14%, and all were able to achieve levels lower than 8%. And this is not only redefined expectations to how diabetes can be managed, it also accelerated our algorithm innovation by giving us valuable real-world insights. And it enabled us to develop robust in silico methods with digital twins to precisely predict how algorithm changes will affect outcomes and reduce the burden of human trials, another unique strategic advantage. At Insulet, we know what it takes to build the best algorithms for optimal performance. And with that, we're generating the evidence we need to unlock innovation and accelerate adoption. Right now, STRIVE, our pivotal study for Omnipod 6, is investigating the ability to enable patients to have even tighter glycemic control, and results will be shared at ADA next year. And the next major advancement for patients and for Insulet growth is a fully closed-loop system for people with type 2 diabetes, and we're pleased to report great progress on this front. We're in the middle of our feasibility studies, EVOLUTION 2 and simple use and new results will be shared at ATTD in March. We're about to start EVOLUTION 3 shortly and expect to commence our pivotal trial in 2026. These studies will validate safety and efficacy for our next growth phase, shape clinical guidelines and inform payer policies. And we can't wait for this innovation to reach patients. With all of this evidence, I'm pleased to report a strong impact on clinical guidelines, but it did take us a while to get there. In 2021, the guidelines for using AID in diabetes care were weak. But since then, the generation of evidence from Insulet and others have resulted in the strong language we see today. AID is now the preferred insulin delivery method in type 1 diabetes and the guidelines for type 2 are also stronger because of secure T2D. And we expect the language to be even further strengthened in 2026, clearly endorsing the safety and efficacy of AID for all people with diabetes. And as these guidelines evolve, Omnipod is ideally positioned for accelerated adoption as it remains the simplest product to start and onboard. But today, there remains a shortfall in AID adoption for type 1, leaving too many patients at risk. So these recent claims data that came from the end of 2023 show that only 1 in 5 children and 1 in 4 adults are meeting glycemic goals of 7%. AID use is also not where we want it to be. The black lines show only 47% of children and 22% of adults use both CGM and pumps. So despite the availability of proven therapies like ours with grade A evidence, AID is still far from reaching the majority of patients. Disappointing certainly, but it's an opportunity that drives us because every day without AID is another day patients spend accumulating risk of complications. And the story is even more alarming for people with type 2 diabetes. This is a large and underserved population and the outcomes are worsening. There's more than 30 million people with type 2 diabetes in the U.S. alone with 5.5 million on insulin. The latest U.S. National Health survey results show that people are being diagnosed younger with even more advanced disease. So despite there being more than $50 billion spent on diabetes medications, the outcomes for people with type 2 are not improving. What we also see in clinical practice is that A1c continues to rise as the disease progresses even if you're on a GLP-1. And these data from 23,000 real-world users of semaglutide showed that A1c trends increase over time despite maintenance of weight loss. And this presents a unique opportunity for Omnipod 5 to work in a complementary way with GLP-1 to positively impact glucose management. With clear evidence that Omnipod 5 delivers superior outcomes for type 1 and type 2 diabetes, our efforts are focused on closing the gap between incredible data and clinical practice. With a goal to overcome clinical inertia, one of the biggest barriers we see is the bias that persists amongst clinicians. Many still believe that AID is only for highly engaged individuals or that multiple daily injections is good enough. And share of mind is another barrier that presents an opportunity to drive an understanding that it's the simplicity and efficacy of Omnipod 5 that makes it suitable for everyone living with diabetes. I recently met an endocrinologist in suburban Chicago, and I asked her for her opinion on the use of pumps in type 2. And she told me that she would only consider it if patients were on multiple daily injections and they had renal failure. I nearly fell off my chair. It was just so shocking to me that she only saw AID as a late-stage therapy rather than a proven intervention that could prevent renal failure in the first place. And while I was able to broaden her awareness, it was a great reminder that we have to take HCPs on a journey using education, training and experiential learning to enable them to see the broad use and benefits of Omnipod. And then the third barrier is in experience. Overcoming inertia won't come from data alone. Clinicians need to see tangible and repeated positive outcomes. And this is certainly an area where we shine. We can accelerate behavior change by making it easier for clinicians to start patients on AID and experience those results firsthand. And you heard Eric speak about how our innovation pipeline will do just that, significantly expanding the universe of Omnipod prescribers. To close, Omnipod has an abundance of evidence supporting its use and the guidelines clearly endorse AID as first-line therapy for type 1 diabetes from diagnosis and should also be offered for type 2. And while real-world practice lags behind the data, that simply signals that there's also so much opportunity. We're continuing to invest in clinical evidence to validate our innovation as well as shape guidelines and change clinical practice. And I look forward to sharing our progress in the future. I'd now like to welcome Michelle Nemeth and Rusty Segan to the stage. 9 years ago to describe AID, I shared the analogy of driving with cruise control. It was a good analogy, but looking back, it doesn't quite capture the burden of disease. And it's beyond my wildest streams to see where we are with Omnipod 5 today, and I'm so proud to welcome Michelle and Rusty to share their story. [Presentation]

Good morning. Thank you, Trang, and really the entire Insulet family for having us. I'm Rusty. I'm a general surgeon. My bride, Michelle, she's a neonatologist. But today, we're here as Zoey and Phebe's mom and dad. The video you saw is who Zoey is now. It's her full of joy life, confident but to understand how transformational Omnipod 5 has been, you have to understand where we started.

In 2019, Zoey began losing weight, drinking constantly and becoming unusually tired and irritable. By late summer, she was bed wetting and confused. Then on September 18 came the call, I will never forget. Her blood glucose is over 600, you need to go to the ER now. As a physician, I knew exactly what that meant. Head started spinning, but as a mother, I thought my heart break immediately. The carefree life Zoey had lived was suddenly gone. type 1 diabetes will touch everything from a simple snack to play dates, friendships and her growing independents. A childhood sorry, that should have been spontaneous for now become a series of half tubes just to stay safe. And I feared for her future. What about her relationships, having children someday and most of all, her ability to live a joyful life with a full heart. The following 3 days in the hospital were painful and terrifying IVs, fingersticks, injections, endless instructions, calculations and lots of tears. But the truth is the hardest part began when we went home.

Life before Omnipod, that first year was brutal. Every meal was math and fear. Every night, we've set alarms to wake up multiple times just to make sure Zoey was safe. Michelle spent months sitting outside her school in her car outside of dance every play date, just to be ready to rush in for a shot or a rescue for sugar went low. As highly trained specialist physicians, we've both taken care of some of the sickest patients in the world. And yet with our own child, we felt helpless, overwhelmed and terrified. Zoey was only 6 she just wanted to be like other kids, but diabetes is relentless. It never sleeps, it never pauses, really never lets you forget.

As doctors, we understood the physiology as parents we experienced the total heartbreak, the hundreds of decisions a day, the tears, the frustration the loneliness that we felt when she realized her life suddenly had rules and limits, no one else her age had to even think about. And yet even in the middle of all that, Zoey showed the incredible resilience. She asked for CGM just 2 months after diagnosis. A year later, she said, "Mom and dad, I think I'm ready for the pump." We let her lead, and that led us to Insulet an Omnipod. She wanted a pump, she could dance with, swim with, play with without tubing or fear of getting caught on anything. DASH gave her, her first real breadth of freedom and at the age of 10 her very first sleep over. Then Omnipod 5 changed everything. It gave her independence, freedom and brought back the joyful spontaneity. It gave her confidence and it gave us, as parents peace.

As you saw in Zoey's video, Omnipod 5 gave her back the one thing every child deserves her childhood, it made diabetes for her and for us, it's smaller, a smaller part of life exactly as the Omnipod promise says. To everyone at Insulet, your work matters. The Omnipod 5 has proven to be reliable, a trustworthy partner and it's been life-changing. You've made our daughter feel safer, healthier and freer. You have proven as relentless as the disease you seek to cure. With that, we can't thank you enough. So we thought it best to let Zoey have the final words, and I'll share them with you. Zoey, can you please stand up so everyone can see you in the back. I just had my sixth diaversary. Diabetes will always be part of my life, but it is part of -- taught me to appreciate my life. I cherish every childhood memory of fitting in because you never know when things can change. Even though I've had diabetes for 6 years, I am healthy and happy. I have great friends. I'm in 12 dance classes and a family who loves me. Yes, I am a person with type 1 diabetes, but diabetes does not define me. Thank you very much.

All right. Good morning. My name is Manoj Raghunandanan. I'm the new Chief Growth Officer here at Insulet. And man, if I'm just being honest, I have to tell you, over just the couple of months that I've been here, it's stories like you just heard from the Segan family and from Michael Conway that have moved me from just being excited to join this organization to be inspired and motivated. For people like that, I'm all in, and I'm ready to go. I just wanted to tell you a little bit about where we're headed and what we're planning to do. As Ashley mentioned, we've moved from being a disruptor in the category to now being the AID leader. And so as we establish this leadership position, we've also established the growth organization. And really, the growth organization is responsible for architecting the growth between where we are today that 20% CAGR that you saw over the next 3 years and beyond. I've had the privilege of bringing health solutions to people around the world for a few years now. And I can tell you, I have never seen a combination of 3 things like this, differentiated technology, compelling clinical evidence and brand love. This combination is unique and it's an incredible foundation that's going to allow us to accelerate our growth. You saw the TAM charts. I noticed some people wanted to take pictures of those. They're good. But I want to let you know what is our framework here at Insulet to take advantage of that TAM in order to really have a true growth framework. So I'd like to share that with you. It starts very simply with the foundation of what Insulet is and what it's been, incredible innovation, phenomenal science backing that innovation that allows us to be best in class. That will always be our foundation, and that's what Eric and Trang showed with you earlier. Then on top of that, we have market development and market development is critically important here. You saw those low penetration numbers for AID. It's our responsibility as the leader in the category to grow that penetration. We have to grow that penetration and we will grow that penetration and we'll do it in a category redefining way. The next part of our framework is demand generation. When you think about demand generation, this is us finding ways to take more than our fair share. Demand generation is everything, including the incredible sales force that Carolyn leads to what we do on the marketing front to all of our efforts with our HCPs and our KOLs and our leaders so that we can really show our science and demonstrate how we can grow share within the market. Let me dive a little bit deeper into market development. And really, I want to just tell you a simple story. The reality is we have absolutely redefined the category as it pertains to market development in AID. You think about what we have done in the U.S., the pay-as-you-go model that you know, our sampling programs, our pharmacy access I know you know those things well. But what we've also done is taken this and globalized it. If you look in the U.K., we've been able to get the technology appraisal from NICE, which is the National Institute of Health and Care Excellence. They've said that for people with diabetes, no less than 50% of them should be on AID therapy. What does that do? It expands the AID market in the U.K. But here's the message, penetration is not where it needs to be, and there's so much more that we can do. If you think about the U.S., Trang just showed you the guidelines that are in place. We need to pull those into standard of care. They're not yet, so that makes it critical for us to intensify our efforts in clinician education and the use of real-world evidence. And when we look at new markets, as Ashley said, we'll be strategic and we'll be thoughtful about doing it, and we'll pick the right markets. for example, Saudi Arabia. The opportunity here is great. We know there's a large population. We know AID penetration is only at about 5%. And soon, we'll be launching Omnipod 5 as part of a national government tender, which will unlock scale. So that's the message. We have to create access and affordability. But the foundation of what we do in market development really comes down to our science. First, with guidelines. We have to establish those guidelines. You've heard what we did on type 1. The guideline on type 2 diabetes from the ADA only came out in 2025. It's always good to have guidelines but we need standard of care to match those guidelines. And that's what we'll be working in market development. And we also use things strategically like health economics in order for us to prove that case. Once you advance the guidelines, then we need to partner to change practice. This is about patient advocacy, it's about thoughtful physician engagement. It's about investing in education to really get the standard of care to change in markets around the world. The good news is we're seeing progress. We're seeing these previous barriers to type 1 come down, and we've demonstrated over time that we can grow the market. Let's remember, we're not just the market leader we are the market driver and we are the ones who will grow this AID market. Now once we've grown that market, it's critically important for us to think about how can we win that market. And when I think about how we can win the market, we have this incredible envelope this passport of credibility. It's our brand. When you have a great brand, it first is able to reach people in moments that matter. That's called relevance. Think about the stories you heard today. We're there in those moments that matter relevancy then it's resonance. It's about meeting people with a message that fits the moment that I'm in because we understand their insights better than anybody else. From that, we're able to create connection. When you create connection time after time, you eventually get followership. I know you're all working hard, you're analysts but you're also consumers, too. There are brands that you care about. There are brands that you are loyal to. There are brands in which you will not buy any other. I ask you how do you think the Segan family feels about this brand? What do you think they tell other people about this brand. This is what's critical. But what I want to show you is we have a brand that not only is powerful in its own right, it stands out in the category. Let's take a look at some of this data here. We do brand tracking studies on about a quarterly basis to understand from people in our category, how do they feel about our brand, how do they feel about other brands. We look at these customer surveys and we try to see where does Omnipod stand? Well, number one, we have the highest total consumer awareness among MDI users. And why is that important? Those MDI users are the ones outside of the AID market. If they know about our brand, they're more likely to think about our brand when it's time to make a switch. They're more likely to be with us. Then when we ask people who are using a pump, how do you feel about your product? We have the highest rating for brand trust and love. This is how they feel about us. And we also track a Net Promoter Score. That means we have the highest Net Promoter Score amongst competitive brands. This tells us that now people that are not only using the pod are doing what, they're recommending this pod. And advocacy translates directly into more new customer starts, reinforcing the strength of our demand generation engine. Even our youngest Podders can be advocates. I just want to tell you a brief story, there is a gentleman named Garrett, who works in radio. He had a young son, his young son had a friend over. And Garrett, as he usually did, because he was a type 1 diabetic, was taking 1 of his daily injections. He was putting in his daily injection, his son's friend came in the room and watched him and wondered what he was doing, and he looked at him a little bit like what are you doing? Before Garrett could even explain the young boy pulled up his shirt and he said, I have a pod, why don't you? Garrett said, "Well, listen, when a 5-year-old checks you like that, you have to kind of think about it." Garrett's now a loyal Podder, and he is one of our biggest advocates. That's what happens when you have a brand like ours. That's what happens when you have technology, science and innovation like Eric and Trang described. Now listen, I love one-to-one recommendations. They're meaningful and they're powerful. But what's even more important is what we're able to do on a broader scale. Here, you get to see a community that is thriving and growing and influencing with engagement metrics that honestly are on par with best-in-class consumer brands. This online activity multiplies that effect that I just described. Think for a moment, year-to-date, video content across Omnipod social channels, 80 million times it's been viewed. Think about how unique we are in the category. Folks are out there, and I know some of you come on and are using a little hashtag retweets that happens from time to time. Well, 2.4x more than any of our competitors. People are hashtagging Omnipod, Omnipod 5 and Podders. They are multiplying the effect that we have in the marketplace and more people know about our business. This level of engagement is not typical in medtech or health care. This is that consumer slice of our unique nexus that we own and it's the proof of emotional connection and cultural relevance of our brand. Now you've seen these metrics, and you might just wonder what is it doing for my business? How is it helping you grow? Let me show you a few more numbers. This one is quite compelling. For people that go into a prescriber office, and they ask for a brand, 70% of the time they're asking for Omnipod. 7 out of 10 people that walk into an office and ask for a brand are asking for this brand. That directly ties to new customer starts. We also do a lot of DTC efforts in order to drive leads. You'll see quarter-over-quarter in the most current quarter Q3, this is. We saw a 50% increase in our leads. Now we made some investments in order to make that happen, some strategic choices that we were able to do. But these leads, we monitor and we track them. We're actually using AI in order to make sure there are more quality leads, and we're driving down the cost per lead. But those leads get engagement and as they get engagement, we turn them into Podders, and we're always working in order to turn more leads and find more effective ways to turn them into their Podders. So DTC directly growing leads, but I think perhaps most compelling statistic that there is for what we do DTC and what we do with marketing and our brand to HCPs, but more importantly to DTC in this instance is our impact on nontargeted HCP offices. Those leads I mentioned, 65% of them are coming from nontargeted offices. But the next one is my favorite. About 20% of NCS come from nontargeted HCP offices. What does that mean? That means that somebody heard about our brand, saw our brand, engage with our brand, felt trust with our brand, knew our brand, went into an office that's not currently prescribing and asked for it. This has the impact of our sales force by going into offices that we're not in and now turning them into a prescribing office. So let's not be mistaken. We have the absolute power with this brand and with really measured and metric ways of DTC to grow our business. But I want more. I think there is more. We talked about our brand as a tool for brand growth. In my experience, there's an opportunity for us to do more, and that's to turn it from a tool for brand growth to be more about brand love. I'd like to introduce you to Grant. [Presentation]

That's Grant, receiving his first-ever Omnipod. It's not a PlayStation. It's not an Xbox. That young man is thinking about no more fingersticks, no more injections. That's brand love. For those of you who wonder what brand love does for Grant, imagine what that does for Grant's family, for his parents and for their advocacy. So I'd like to propose to you that we have an opportunity here to turn brand love into a further moat for this business. done well. We can do this. We're well on our way, and I'm convinced that we can do it moving forward. Now listen, like any kind of good love, we don't want that to be one way. Brand love has to be both ways. And it's important that we show up every single day for our powders. The way in which we do that is by measuring the customer experience. And I will tell you in the growth office part of our mission is we are obsessed with improving the customer experience. We measure their experience all the way from the time they consider to the time that they're thriving. But the unique benefit that we have here is our data. We have an extreme amount of data that allows us to really pay attention to what they're going through. We have 9 million engagements on our website globally, 250,000 unique HCP interactions. We have 1.7 customer care and product engagements. We have the data that we collect that's happening that's safely stored, responsibly used, we also have 96 million user days in our database. So as we collect this data in a responsible way, we're able to turn it into a way in which we can better manage their experience Eric talked about how we are relentlessly focused on improving it and making it easier. That's not just our new products. That's improving their experience daily as well. Let me show you a small example of how we do this. When there's a customer who's thriving, leading that full life with diabetes, we're able to use some of the data in a predictive analytics AI model. There's about 700 data points that we look at. They're on product, but we look at these data points because we think that they're good predictors. We use an AI model that shows when somebody might be at risk of going off therapy or might be at risk of going off their Omnipod. And you can see from January, we've been working this algorithm and working these analytics and getting better and better and better. What we're able to do is figure out where are they in that journey, what are their tension points, what's the right way that they want to be communicated with. How can we responsibly use the data we have to reach out to them? I'm really excited to share with you that the team in the month of October was able to make sure that 1,000 people did not come off therapy. That's a pretty meaningful number for us. And as we continue to get better at this, we'll continue to manage more people, keep them on their therapy, keep them healthy. But more importantly, as we think about what we can achieve, we get closer to that journey, and we can improve the experience every day. Everything I've talked to you about is part of a larger demand generation flywheel. This is the way that we think about it. It includes things like uncovering insights. This is where we use our capabilities in the growth office of insights and analytics and marketing health economics, market access, but we start everything with insights. We develop those resonant campaigns. We then activate an office and pull through, and Carolyn is going to tell you all about that in her amazing sales force. We manage the customer experience and then we learn and we refine and we learn and we refine and then we put it back into our insights. But what I also want you to know is that we do this in an incredibly responsible way. We metric and measure all aspects of our demand generation. Our CAC is our cost to acquire. We're always paying attention to our cost to acquire. We're optimizing this wherever we can. We're experimenting and learning so that we can get the cost of acquired to be as efficient as it possibly can be. Then we look at our cost to serve through the customer experience. We look for efficient ways that we can manage this cost to serve down. And if we're able to do that well, then we're able to do what, manage down attrition, if we manage down attrition, we have great lifetime value. This too is a circle that we are always managing so that we can be as efficient and effective and impactful as we need to be, not only on the business but on the P&L. And this entire story is wrapped around an incredible category-leading brand. So I'd like to leave you with this, really 3 messages. One is that we have industry-leading market development. That's critical in this category. We're the leader in this category. No one is going to grow if we don't grow the category. And so we need to grow that AID market, in order to take advantage of that TAM. We've proven that we can do it, and we're going to continue to do that. Then there's this idea of demand generation. We have the brand strength. We have precision marketing, -- we now have the ability to use our data responsibly to stay part of that journey. And so that will allow us to win share and maintain customer lifetime value. And finally, we will always focus on the customer experience, we're going to advance global capabilities here so we can create a repeatable and scalable growth engine. It will be more personalized over time and will absolutely increase our lifetime value over time. So what I want you to know is we're just getting started. There's so much more that we can do. As a growth office, we are confident in our ability to support our markets to deliver sustainable growth to bring long-term value for our shareholders, our customers and our community. Listen, the opportunities here, they are extraordinary. The landscape for growth is there, and Insulet is clearly ready to lead the transformation of diabetes care globally. So with that, I think you guys have earned a break. So I want to make sure we give that to you. It's going to be about 15 minutes. You can sit and send e-mails about all the incredible things you just heard about. That's fine. You can also go back into our experience center, if you want to follow up on that a bit, but you will hear some chimes when you need to return to your seat. But thank you for being with us, and thank you for your time. [Break]

Good morning, and welcome back from the break. I'm Carolyn Sleeth and I lead our U.S. business. I'm pleased to introduce a member of our Podder community Zac Harman, who will share how Omnipod has transformed his experience of living with type 2 diabetes. [Presentation]

Good morning. I want to talk to you about my journey with diabetes -- began in 1997 when I was diagnosed, like most people, as a musician, musicians are hardheaded. We don't listen. So I'm playing maybe over 150 shows a year. I'm playing in Europe, I'm playing in South America, I'm playing in Canada, I'm playing in Africa, I'm playing in India. I don't have time to plan food. I don't have time to plan, time to check and plus, I don't want to do it because you know what? I didn't feel bad. I felt okay. I'll go to the doctor. I'd have double-digit A1c but I didn't feel bad. They don't know what they're talking about. I'm fine. I'm playing music, I'm doing good, but it all came to an end in 2006 when my son was diagnosed with diabetes. That kind of changed things for me. So I just needed to make sure that I made enough money. I can keep him with the best medical care. I have a wonderful wife and she was on top of everything and I could continue to play music, and I can do everything I wanted to do because once again, I didn't feel bad, but then that changed. I played a Blues Festival in Sarasota, Florida, and there were about 10,000 people in the audience, and I was wailing. And the next moment I found myself on my back. Passed out because I didn't have time to eat and my blood sugar dropped. Well, the audience didn't know they thought, well, that's part of the show. But listen, it really was a wake-up call. So we move forward. I have my son is now in college. He's a second year pre-med unit. And he says to me, Dad, you ever thought about a pump. And I'm like, well, no, but I'll talk to my doctor about it. And that's when I found out about Omnipod. My doctor put me on Omnipod. I, for the first time, went to the doctor and my A1c was single digits. And then as I continued my A1c kept going down, the last time I went, I was 6.5 man. I got to tell you, this is such a game changer. And you really have to understand that for people like me who have a lifestyle that we cannot plan to live and do all the things that a person with our condition should have to do, having Omnipod is everything. Thank you so much.

Thank you, Zac. That was really powerful. Like Zac, I also have diabetes. I've had type 1 for more than 30 years. And 2.5 years ago, I had never heard of Omnipod. My endocrinologist, though I see her regularly, she never told me about pod therapy. I was on a tubed pump, and I struggled to keep my A1c under 7%. But then a corporate recruiter called me and told me about Insulet and this job, and I made the switch to wearing pods, and I felt the night and day difference. Diabetes started demanding less and life got easier. I now enjoy activities I had given up like swimming with my son. He's five. Last spring, he and I spent a full morning in the ocean in Hawaii playing, and I didn't have to worry about not getting the insulin I needed. It still surprises me that my endo wouldn't have mentioned other options besides my tubed pump. My story is a very real, very personal example of clinical inertia. And this experience gives me the conviction, the passion to help others living with diabetes, not yet at their best life. And I believe that Insulet is creating a better way for me and for others. We have an immense opportunity in the United States to drive the penetration of the type 1 market and create the type 2 market. In type 1, adoption of automated insulin delivery is still only around 40%. As Dr. Ly shared, the new clinical guidelines recommending AID for type 1 at diagnosis support broad technology adoption, but they are not enough on their own. So we are working to make AID standard of care in practice in type 1 and change how providers think about therapy. Moving from you're fine on MDI to there's a better way to manage your diabetes. In type 2, we're building on our strong type 1 foundation as we create a new market. We have regulatory approval and proven outcomes for AID for this population. But this is a market we are developing. There's a different clinical context and patient journey. And only about 5% of people with type 2 diabetes who take basal-bolus insulin use AID today. So our U.S. strategy is tailored to the two markets we serve, raising penetration in type 1 and creating the type 2 market with the playbook and platform already in place to do it. So where are we today? In the U.S., as the market leader, we are driving the growth of the AID category. We serve more than 385,000 customers in the U.S. And we are capturing over 65% of all new customer starts in the category. Our U.S. business represents over 70% of Insulet's total revenue with strong and expanding margins. When patients are going on automated insulin delivery, they are coming to Omnipod. We have established ourselves as the #1 most requested and prescribed AID system in the U.S. and the leader in new customer starts since 2023. As Ashley said, our products are available in more than 47,000 pharmacies. I pick up my Omnipod at my corner drugstore. Our reach extends far beyond endocrinologists. It demonstrates how simple effective technology and affordable pharmacy-based model expand access to care. Today, approximately 40% of people with -- with people with type 1 use AID. And over the next 3 years, we'll use 3 commercial levers to bring innovation to people with diabetes and help penetration reached more than 50% by 2028. First, we are leveraging demand generation for AID, which raises awareness, brings people into the category and drives market growth. and Omnipod share. Second, and I'll spend a little more time here on the next slide. We are strengthening our commercial excellence. And third, we are creating a seamless user experience making getting and staying on Omnipod as easy and affordable as possible. As I said, I want to spend a couple of minutes here on how we are driving commercial excellence with a high-performing team. Now not only do we call on the endocrinologists, approximately 8,000 providers, but we also reached another 10,000 prescribers in primary care. These are providers who see a lot of people living with diabetes. They're self-style, diabetologists, and they see both type 1 and type 2 in their practices. Endocrinology as a specialty is overwhelmed. There are simply too few medical doctors to care for all the people living with diabetes and metabolic disease in the United States. And many patients don't adhere to their treatment plans, leading to provider frustration and clinical inertia for both patients and providers. Primary care is even more time constrained. The ones we call on no diabetes, they prescribe rapid-acting insulin and continuous glucose monitoring, but visits are short. They're curious about technology, but they need it to be simple and fit in their workflows. This means there are 2 different sales. In type 1, it's about category adoption and selling the benefits of Omnipod compared to daily injections and tube competitors. In type 2 it's about helping providers believe in AID for this population. Our team has extraordinary passion and now we are marrying that passion with rigorous commercial execution. We have a prioritized list of sales targets, and we are driving reach and frequency to increase share of voice with high volume and high opportunity providers. We know frequency matters, especially for new riders that we're activating and those with significant volume. Our people are a key advantage. We attract sales professionals who are results-oriented and motivated to grow a business. Some of our top territory managers come from adjacent health care sectors like dental or vision, people who understand technology sales to a health care provider and know how to sell in the office and support pull-through with patients. And I will tell you in the office, the conversation has shifted. AID is no longer a choice. And HCP can't feel comfortable letting a person living with Type 1 continue to take multiple daily injections. Too many lows, too many highs. Omnipod 5, an affordable, predictable way to control blood sugar. It's in front of them. And we are leading those conversions and positioning Omnipod 5 as first-line therapy, which people can try with our affordable pay-as-you-go model. Our team is out talking about real-world evidence that shows that when patients go on Omnipod using the right settings, they get higher than 80% time in range. And when providers see how effective Omnipod is in their patients, they become believers and we get the conversions. Now let's talk about type 2. The opportunity is immense, and we are well positioned to shape the market. There are a lot of similarities in how type 1 and type 2 patients on multiple daily injections manage their diabetes. There are roughly 2.5 million people with type 2 diabetes in the U.S. taking multiple daily injections. And within that group, AID penetration is only around 5%. And that means 90% of patients who could benefit from AID, are still managing their diabetes manually. Omnipod was the first AID system cleared for Type 2 in the United States. And critically, Omnipod is covered through Medicare Part D. It's a powerful access advantage. Our leadership is proven in the numbers. We've more than doubled our new customer starts in type 2 over the past 12 months. And we have built the largest Type 2 prescriber base in the category. We've learned a lot in the year that we've been on the market with type 2. Despite similarities, type 2 has a different clinical context than type 1. Type 2 patients are more clinically complex, they're older with more core morbidities and there's often social stigma around their diagnosis. Their care is also far more fragmented. About 70% of basal bolus type 2 patients are managed primarily by primary care physicians, not endocrinologists. Many PCPs have limited time and less exposure to pump technology. So familiarity with AID remains low. That's something we will change. Our opportunity is to make AID intuitive for PCPs to prescribe and to integrate it seamlessly into how diabetes is managed. For many people living with type 2 diabetes and their health care providers, insulin has historically been treated as an end of the line therapy. Type 2 patients have often been living with diabetes for a while. When first diagnosed, they probably tried to manage it using diet and exercise. And physicians have likely spoken about insulin and taking shots almost as a threat. This is something you're going to have to do if you don't eat better. This is something you'll have to do if you don't get more exercise. Our focus is to shift that narrative and help both patients and physicians to see AID as an opportunity for better care and a better life. We have an enormous opportunity in the type 2 basal bolus population. And we are building the commercial engine to help more than double penetration by 2028. To win, we're accelerating growth through 3 commercial levers. First, we're driving demand and adoption and capitalizing on it with rigorous commercial execution. Second, we're delivering a best-in-class end-to-end user experience to build patient awareness, improve onboarding and enhance retention. And third, we're removing barriers and demonstrating Omnipod's clinical and economic value. First, demand generation. When patients succeed on Omnipod, health care providers experience its power and begin to advocate. They speak on our behalf to their peers about the improvement in clinical outcomes their patients see and that it works for patients who weren't considered good candidates for tubed pumps. Providers often tell us appreciatively that patients ask about Omnipod after seeing it on social media like what Manoj showed us earlier. Our DTC efforts foster patient interest in better managing their diabetes, saving physicians a difficult conversation and making it easier for them to prescribe. This demand generation helps activate new prescribers. Because of the simplicity of Omnipod, we can bring the technology to those who have not prescribed insulin pumps historically. And we are teaching our team how to win in these sales calls. We pursue this opportunity with flawless commercial execution, driving deeper into the T2 call point. We've strengthened our competitive and clinical selling skills, so our reps can confidently engage a broader set of prescribers. As I mentioned earlier, not only do we have 100% coverage of endocrinologists but our sales team also reaches an additional 10,000 providers caring for people with diabetes. And our overall reach through media and patient demand extends meaningfully beyond that, to primary care providers who write prescriptions for rapid-acting insulin. And we have invested to equip our teams with improved data access, enabling sharper targeting, we expanded our U.S. field team in 2025, and we are consistently expanding to support our growth ambitions, while optimizing revenue per rep and new customer starts per rep in a territory. We watch these metrics closely, so we know when it's time to scale further. And we're making it easier for new patients to start on therapy because Omnipod is fully disposable. We can place active Omnipod samples in physician offices, allowing a patient to start therapy the same day they have an appointment. Only Omnipod can do this. Let me tell you a quick story. One of our territory managers in South Boston told me about a physician that she'd been trying to connect with for a while, a doctor who had never prescribed Omnipod. When she brought Omnipod samples into his clinic last month, he asked to meet with her. Since then, he has put 3 new patients on Omnipod. One, a fairly elderly gentleman, another one, a patient without a smartphone, and another patient, he was actually just starting on basal insulin, but he felt Omnipod would be a good fit. This alone highlights the diversity of our reach and the range of people who can benefit from Omnipod. As a result, we have seen type 2 experiences snowball. As providers see strong outcomes and how simple Omnipod is to use, they start prescribing it more broadly. Even for people they may have previously assumed wouldn't be comfortable using the technology. And as we scale in type 2, our focus is on creating and delivering a seamless user experience another lever that pulls patients in and keeps them on therapy. That begins with awareness, reinforced through direct-to-consumer engagement. We are investing in capabilities to support patients as they learn about AID and advocate for themselves to try new technology. Once a patient chooses Omnipod, we've strengthened our onboarding and support systems to ensure a smooth start. And we've built up capabilities to accommodate virtual training for patients. As Manoj said, we've developed an AI tool that helps us identify when patients are at higher risk of attrition, enabling us to deliver proactive support at these critical milestones. And we're continuing to make the Omnipod experience even more effortless and responsible. We recently launched the U.S. Pod Takeback program, allowing Podders to recycle their used pods, extending our better way ethos to sustainability as well as diabetes care. Third, market access, one of the most powerful levers for growth in the United States. Our efforts here have been deliberate and sustained. Omnipod delivers compelling value for the health care system, which has been key in driving our broad coverage in the U.S. Over 300 million lives covered across more than 200 payer plans. Our coverage has largely reduced payer requirements for prior authorization. But of those that still exist, we've implemented tools to simplify this process for both prescribers and patients. This is driving strong prescriber engagement with approval rates of prior authorization now above 70%. We're broadening co-pay buydowns that make the first step simpler and more affordable, while our dedicated access teams support high-volume clinics through coverage and access challenges. For payers, we helped lower the economic burden of diabetes care by improving outcomes and reducing costly acute events. Did you know a single severe hypoglycemia can cost as much as $13,000, and a diabetic ketoacidosis event can cost as much as $36,000. The annual cost of Omnipod is a fraction of these numbers. For people living with diabetes, Omnipod meaningfully improves quality of life. When patients get on therapy, we see a dramatic reduction in diabetes distress and improvement in quality of life scores. That improvement makes Omnipod the preferred choice and keeps patients on therapy. And this retention is reflected in our continued growth in the pharmacy channel. It's proof that when patients succeed, payers see value. These initiatives are on top of our existing structural advantages that make it easier for people to start on Omnipod than any other AID. The combination of our disposable product and our pay-as-you-go model remains a major differentiator, giving people the freedom to try Omnipod with ease. To close, we have a large underpenetrated market in the U.S. in both type 1 and type 2 diabetes, and we are uniquely positioned to capture the opportunity. Our aspiration is clear, make AID the standard of care in practice across the full type 1 population and make Omnipod the standard of care for type 2. And our strategy is clear. We're driving growth through demand generation, commercial excellence, market access and development. And with that, I'm pleased to welcome Eric back up here to tell you about our international market strategy. Thank you. [Presentation]

I am back. You just heard from Carolyn, how our U.S. business is accelerating penetration in type 1 and creating the type 2 market. I'll now discuss how we're scaling that success globally to strengthen and expand our durable international growth engine. I first got to know our international markets in 2016. Our then distributor was beginning to launch Omnipod Classic into more countries in Europe. I was responsible for our external supply chain, distribution and logistics at the time. I sat in a small conference room down the road in our Billerica headquarters getting a new higher forecast for France each week, watching new customer starts accelerate. And just staying ahead of back order as we expedited more starter kits and pods to meet rising demand. France was the first market that showed us the true power of the pond. Omnipod took about 2/3 new customers start share against open-loop tube competitors. And we quickly became the market leader. It's been an instructive lead market for us ever since contributing insights that inform the design and development of Omnipod 5. These days, I spend time in global markets garnering insights that inform go-to-market strategy around the world. inspiring work by health care providers south of London resembles work of community care providers outside New Orleans. While diabetes care in Hamburg informs what we do in Washington, D.C. The needs of people with diabetes and their families are consistent around the world despite differing health care and reimbursement structures. And over the last 7 years, we've refined a proven playbook that marries local execution with the universal benefits of Omnipod to drive growth in global markets. As you've seen from our recent results, the AID opportunity outside the U.S. is significant. Demand for a better way to manage type 1 diabetes is already widespread and over the long term, development of the international type 2 opportunity will significantly expand our addressable market. Let's start with where we are today. AID adoption is expanding quickly in global markets, and Insulet is growing even faster. We have the privilege of serving more than 220,000 customers outside the U.S. Our international business spans 24 markets, 13 of which have Omnipod 5 and contributes approximately 30% of company revenue at attractive gross margins. Since the launch of Omnipod 5, we are the #1 AID system for new to pump users in Europe and are rapidly taking share in each market where we launch. In the short time since we really established our direct presence 7 years ago, Insulet has become one of the most recognized names in diabetes care across Europe, Canada and Australia. That progress reflects disciplined execution, building capable local teams, engaging with clinicians and payers and establishing access. Another key driver has been disrupting the capital sales model established by legacy tube systems. Most of our largest global markets benefit from the unique accessibility of our pay-as-you-go model, fully aligning customer benefits with payer costs. We've invested in local evidence across European markets to engage key opinion leaders and demonstrate the value of Omnipod 5 and our foundation of strong evidence and broad access is powering adoption. As Ashley shared, the international insulin delivery markets are large and AID is still underpenetrated at just 25% of people who live with type 1 diabetes. In the markets where we operate, there are approximately 4 million people living with type 1. But 80% of these are in Europe and about 20% are in Canada, Australia and the Middle East. Penetration is low despite engaged payers and clinicians, mature health care systems and significant unmet need. Our focus is, therefore, to lead market growth through market development and win share through demand generation in our largest markets. Beyond the plan period, we're beginning to develop the international type 2 market to bring the benefits of Omnipod to another 4 million people. Our success unlocking this opportunity in the U.S. and early conversations with key opinion leaders in major European markets, gives us confidence in our ability to unlock this opportunity over time. Finally, there's significant unmet need in Asia, where we see future opportunities to reach another 2 million people living with type 1 and more living with type 2 over time. We have a long runway to drive profitable international growth. Our growth internationally is powered by a repeatable playbook built on our core competitive advantages. Our technology, form factor, proven clinical outcomes and pay-as-you-go model enable profitable market entry. In our scalable, efficient global supply chain and service operations ensure that we can reliably serve markets around the world. Just like in the U.S., the Omnipod brand is quickly becoming a key driver in future competitive moat. When we enter a market with Omnipod 5, we quickly grow share of new customer starts. We achieved this through launching with strong market access that is both affordable and commensurate with the proven clinical value of Omnipod 5. We then invest to strengthen local commercial excellence, adding sales, clinical trainers, access managers and medical teams while increasing reach with marketing to generate demand. Market development follows with investments in evidence and advocacy to broaden guidelines and expand coverage as we partner with key opinion leaders to lead the change in clinical practice locally. Finally, we expand our lead through continuous innovation. This disciplined framework marries the global strength of Omnipod with local execution to deliver durable, profitable growth in every market. Europe is where we developed our playbook. We have direct presence in 4 of the 5 largest markets. Access is established and health systems are ready for technology. Investing in the EU 5 is therefore our focus and the largest driver of growth within the plan period driven by market-specific local execution. We launched Omnipod 5 in the U.K. in summer of 2023 and are the clear market leader, taking the majority of new customer starts and recently securing the #1 position for total market share. Manoj described the expanded NICE guidelines and NHS England funding to broaden eligibility of AID. We are investing commercially as our team pioneers more efficient group trainings and facilitates care optimization using Omnipod 5's unique cloud data to support NHS England and bringing AID to that expanded population. In France, we are rapidly taking share with Omnipod 5. Just a few weeks ago, we received reimbursement for Omnipod 5 with FreeStyle Libre 2, and we'll be launching this important unlock for the French market shortly. We also advocated to remove criteria requiring high A1c before accessing Omnipod 5 and streamline the transition from MDI to AID, accelerating market growth in our leadership. In Germany, we're again following our proven playbook, investing commercially to support our recent Omnipod 5 G7 launch and the upcoming launch of Omnipod 5 with Libre 3 in 2026. In 2026, we plan to enter Spain with Omnipod 5, launching with our unique pay-as-you-go model and a differentiated CGM of Choice offering. As 1 of the top 5 markets in Europe, Spain is an important future market and our entry reflects our priority of investing in the largest scalable opportunities. Europe is our core growth engine internationally. We know it well. And as a market leader, are making tailored investments to drive share growth and market expansion through commercial execution, demand generation and market development. Beyond Europe, we plan to invest in Canada, Australia and the Middle East with particular focus on Saudi Arabia given the size of the opportunity. We launched Omnipod 5 in Canada and Australia just this year, and adoption has been stronger than anticipated. We're seeing significant increase in new customer starts and revenue as we expand access to Omnipod 5 and continue launching sensor integrations. We entered the Middle East in 2022 with DASH. We now have direct presence in Saudi Arabia and the UAE, supported by regional distributor partners in other markets. We plan to launch Omnipod 5 in early 2026 and are already seeing signs of strong demand. I recently heard from Celia, a 12-year-old girl who moved to Saudi from the U.S. after using Omnipod 5 for 3 years. Omnipod 5 transformed her and her family's life and the thought of returning to injections made her as anxious as the move. Her mom Nora is adamant that everyone living with diabetes should have access to Omnipod 5 and in just a few months, everyone in Saudi will. AID penetration in Saudi is low, approximately 5% and despite strong funding and a government focus on improving care for people living with diabetes. We're preparing to invest for scale impact driving penetration and share. These markets are just beginning to contribute as we execute our playbook for growth. Disciplined investment in local commercial teams, demand generation and access expansion give us a clear path to scale another source of durable, diversified international growth as we improve the lives of nearly 1 million people with diabetes. We're also beginning work to unlock the international type 2 AID market, which we expect to contribute to growth beyond 2028. Today, there is effectively no access to AID for the approximately 4 million people with basal bolus type 2 in our international markets. Our initial target population will be the approximately 1.5 million people whose diabetes is higher risk, such as high A1c or early onset type 2. In 2026, we intend to file for a CE Mark to expand the label of Omnipod 5 for use in type 2. This will allow us to gather early clinical experience with key opinion leaders and establish real-world evidence in Europe. Next, we'll expand that work, investing in health economic and outcomes data required for broad access. Longer term, our goal is to secure coverage in target countries and broaden our commercial focus to include type 2. People living with type 2 diabetes around the world deserve AID therapy. Unlocking the market provides an opportunity for us to build a profitable international growth engine for the next decade and improve millions of lives. Beyond the regions we serve today, Asia is our next target region, offering large markets for growth beyond 2028. There are roughly 2 million people with type 1 diabetes in Asia and more living with type 2. This is a significant long-term opportunity for which we're laying the groundwork in type 1 diabetes now. With growing CGM use in an established access pathway, we see Japan as an attractive first market in Asia. We are also evaluating several other large markets and timing for entry. We currently expect Japan to be our first launch in the region as part of our next phase of global growth. To close, we are establishing global leadership in large underpenetrated AID markets as Omnipod 5 drives record adoption and share gains, proving our ability to scale profitability. Our proven playbook, launch with Access, invest commercially, broaden guidelines and coverage and deliver continuous innovation is delivering today and will sustain durable growth. We're building on our strength in Europe, accelerating commercial execution and focusing investment in the largest opportunities like EU 5 and Saudi Arabia. And we're preparing to unlock the global type 2 market and enter Asia, extending leadership and fueling profitable growth for years to come. With that, let me welcome Flavia to tie together what you've heard today and explain how it drives our financial growth algorithm. Thank you.

Well, thank you, Eric, and good morning, everyone. I'm sure you're feeling as inspired as I am after hearing my colleagues walk through the strategic building blocks that have established Insulet as a market leader and how our continued innovation and execution will drive our future growth. What I'll do now is connect that to the financial framework that sustains our purpose and creates value for shareholders. While I felt fortunate to support the Insulet team in my previous capacity as a Board member, when the opportunity presented itself for me to join the team, I jumped at it. This is a dream job for a CFO, a differentiated asset with a compelling mission and the opportunity to make a big impact in the lives of people with diabetes. Since joining, I've seen firsthand how this team lives the Insulet mission every day, which makes it all the more important that we build on our success and run a disciplined, scalable business model. Our financial algorithm reflects our focus on profitably scaling Insulet to continue to bring freedom to millions of people with diabetes and to capitalize on our immense market opportunity. With the launch of Omnipod 5, Insulet moved from a category disruptor to the clear leader in AID. Revenue has compounded at a 25% CAGR since 2021, reflecting strong new customer starts and durable retention, both here in the United States and internationally. During that same period, adjusted operating margins have expanded nearly 600 basis points and adjusted EPS has grown much faster than revenue. We became cash flow positive in 2023 and have accelerated free cash flow generation ever since. Now let me tell you, this leadership position was not earned overnight. It is the product of decades of focused investment. Insulet has deployed nearly $2 billion into R&D to develop progressively easier to use and more effective devices. We pioneered our Pharmacy business with a pay-as-you-go model, which is a simpler and more convenient way for people to start therapy, afford therapy and stay on therapy. And we have invested more than $1 billion into scaling and automating our manufacturing and supply chain infrastructure to more efficiently serve people with diabetes on a global scale. Over this time, we also cultivated a uniquely strong and engaged community with hundreds of thousands of Podders actively using our technology and being advocates for this treatment. That advocacy and engagement is a competitive moat, rooted in the positive experiences that the Podders live every day. Podders will always be our best spokespeople. Collectively, these competitive advantages give us the confidence in the durability of our growth, our sustained market leadership and the return on the investments we are making today. Our investments, our strategies and our execution, they all come together on our financial growth algorithm. As I mentioned earlier, this framework reflects our focus on driving profitable growth to create shareholder value. Through 2028, we forecast revenue will grow at a CAGR of approximately 20%, driven by the strategy to increase penetration in our core markets. We expect adjusted operating margin to expand by approximately 100 basis points per year as leverage and efficiency build throughout the P&L. And finally, we are forecasting adjusted EPS to grow faster than revenue at a CAGR of 25% plus with continued strong free cash flow generation. Let me take you through our winning formula in more detail. Our financial framework, it benefits from operating in a very large and under-penetrated market with the adoption of AID still in its early innings. In the United States, we continue to grow share in type 1 through strong demand generation, ongoing innovation and a user experience that help us retain Podders for years. We see our type 1 penetration growing from approximately 40% today to 50% to 55% by 2028 and our market share continuing to increase. In Type 2, we're investing in new products in education, evidence and access to unlock adoption in a population with significant unmet needs. At just about 5% penetration today in the United States, we expect our actions to more than double penetration by 2028, at which point we'll still be in the early stages of adoption. With the launch of our Fully Closed Loop System for Type 2, the long-term growth potential is substantial. And finally, in our third market, Type 1 international, we are deepening penetration where we already operate and entering new attractive markets with our repeatable playbook, as you heard from Eric. We expect penetration rates to increase from approximately 25% today to 30% to 35% by 2028, again, with significant market share gains. So across these 3 segments, we expect overall penetration to increase from 20% to 25% today to 30% to 35% over the next 3 years, further expanding the user base from about 600,000 Podders to over 1 million by 2028. But in addition to expanding AID penetration, innovation is also at the forefront of our growth strategy. During the next 3 years, we plan to invest over $1 billion in R&D, enabled by our teams here in Acton and in San Diego, who are developing the next-generation technologies to further advance treatment options. This ambitious investment will funnel more dollars towards products that improve outcomes, overcome barriers and create the next markets in diabetes. As you heard today, our TAM includes millions of people globally who could really benefit from AID, and we today only serve a small portion of that population. Our next-generation products, Omnipod 6 and our Fully Closed Loop for Type 2 will significantly expand both the number of people with diabetes we can serve and the number of physicians who are comfortable prescribing AID. Over the next 3 years and beyond, we expect our investments to drive meaningful innovation and continue to make AID accessible to a much larger segment of the diabetes population. We are also augmenting our capabilities in how we can drive revenue, scale demand and increase profitably. Manoj mentioned that our focus is on sustaining growth by investing thoughtfully in market development and demand generation. So starting in market development, we're investing in building our capabilities to improve access globally and to ensure that more prescribers understand how our technology can help their patients. We are confident that these efforts will help unlock an even greater portion of the TAM in the existing markets we are today and then also open up new markets. Our investments in demand generation are optimizing how we reach and convert new customers, reducing customer acquisition and service costs through more efficient targeting and on-boarding. Let me give you an example. We recently deployed AI support tools in our customer service operations, which enabled us to reduce our global cost per call by 35%, while maintaining very high customer satisfaction and Net Promoter Scores. These initiatives are focused on strengthening engagement and retention, which then translate into greater loyalty and higher lifetime value across our user base. In addition, we're also focusing on driving efficiency in our G&A functions through leveraging our newly created global business services. We are committed to driving increased profitability through operational excellence, which enables us to expand our adjusted operating margin by approximately 100 basis points annually through 2028. This is going to be driven by modest gross margin expansion, target commercial investments and optimize G&A. It will then translate in adjusted EPS CAGR of 25% plus, outpacing revenue as we drive SG&A leverage. As you saw in the video before I just came on stage, over the last 25 years, we made significant investments to scale and automate our manufacturing footprint, and we are not stopping. We see capital investments increasing substantially during the next 3 years to support our future growth. Our U.S. manufacturing hub here in Acton will remain the center of our advanced automation initiatives. We're continuing to make investments in adding capacity, skilled talent with plans to further develop our state-of-the-art manufacturing capabilities. I hope you will take advantage of the tour and be able to see it firsthand. Our Malaysia facility that just opened last year is a 400,000 square foot factory, which adds geographic diversification and significant capacity. We are in the early innings of scaling that site, and we expect to continue to invest in the coming years with the introduction of additional lines. And as we have done before, we will continue to invest ahead of demand to ensure that we have sufficient capacity to support our continued growth. With that, I'm pleased to share that we'll be adding a new facility in Costa Rica scheduled to come online in 2029. Alongside our site here in Acton as well as Malaysia, this is another key step in building a geographically balanced global manufacturing network. We have spent years perfecting our manufacturing processes and global supply chain network to enhance product quality and drive efficiency. We will continue to advance automation, ensuring that every pod we make meets our high standards of safety, performance and reliability. Together, these capital investments are strengthening supply chain resilience, supporting margin expansion and enhancing our quality, ensuring that we continue to provide uninterrupted supply chain to our growing customer base. Moving now to free cash flow, where we are operating from a position of strength with a healthy balance sheet, providing financial flexibility to fuel innovation and support our growth for years to come. Our strong free cash flow generation positions us to stay ahead of competition and capture incremental market share. In addition, we will evaluate selective inorganic opportunities with the potential to accelerate growth and enhance our current capabilities. To conclude, I'm confident you will agree that we've laid out a compelling investment thesis today. As Trang mentioned, millions of people are still managing Type 1 and Type 2 diabetes with multiple daily injections. So we have a huge opportunity ahead of us. Our markets are large, expanding and still very under-penetrated. Our growth is driven by our powerful innovation engine that is constantly creating new products and capabilities. Our technology, our supply chain, our market access model and our brand, they're all strong advantages built over decades of investments that are very, very hard to replicate. Together, they create a highly scalable global business model that converts top-tier growth into expanding profitability and strong sustainable cash flows that will fund the next phases of our journey. As you heard throughout the day, our Ethos drives everything we do. There has to be a better way. It means we never stop improving and innovating. Our technology, our operations, our financial performance, we will continue to raise the bar and look for new ways to help people like Zoe and Michael and Zach live easier and healthier lives. We're really proud of what we have achieved to date, but we are even more excited about the future. Thank you for being with us today and for your continued interest in Insulet. In a moment, we'll open up for Q&A. Please remain seated while we just set up the stage. Thank you.

So we're now going to kick off our Q&A session. Before we get started, let me cover some ground rules, Matt. [Operator Instructions]. With that, now we can begin the Q&A.

Matt O'Brien, Piper Sandler. I'll ask both of them upfront. I would love to start with the guidance on the top line. When I do the math on the penetration rates you're expecting domestically, I'm getting like 20% growth roughly in the U.S. over the next several years. So maybe just deconstruct the growth rate because it seems like maybe you're saying U.S. is a little lower than 20%, OUS is a little higher? But again, just based on the math, it seems like it would actually be better than that. And then the second question is, what are you assuming in terms of pricing competition? As we go over the next few years and just the confidence in your ability to kind of work these people as they're coming in.

Yes, Matt, thank you for the question. I'll start and then Flavia, you can add about guidance. What we've put forth is approximately 20% revenue CAGR for the next 3 years. And that really reflects, if you think that first chart that I put up there around the $30 billion TAM in the markets that we compete, really driving increased penetration in U.S. Type 1, what Carolyn talked about U.S. Type 2 and then OUS Type 1. We're not getting into the specific splits. We're not giving guidance on the U.S. or OUS. But we really feel like we're going to take the competitive moat that we've built is what gives us confidence on innovation, globalization, access and affordability. What Manoj talked about, about market development and demand generation winning more than our fair share of market share. And then really what Flavia enunciated, which is our world-class supply chain, which is our moat, and we're going to continue to invest about $1 billion in R&D. So those are really our guiding philosophies, but I'll turn it to Flavia, if you want to add anything on guidance.

Sure. And as I said in the third quarter call, we wouldn't be issuing guidance for 2026 today. We'll wait until our fourth quarter and 2025 full year call in February. But I did say that we would be providing color, which we did. And I think as you look into 2026, you can assume that we will be at or better than the multiyear targets that we provided today.

Robbie Marcus, JPMorgan. First for me, I wanted to ask on sort of the competitive moat and how you feel about that. You have a lot of competitors that are all talking about patch pumps. None of them are fully disposable. None of them have automated cannula insertion. I know you've spent a lot of time and money and effort to get your patch pump to market and functioning every time it goes on a patient for the most part. So maybe you could just speak to sort of some of the trials and tribulations you went through, how you view the competitive moat and how you're thinking about competition moving forward in the patch pump market?

Thank you, Robbie, and happy birthday. Thanks for joining your birthday with us. I'll have Eric talk. He's been here for 10 years, Tell us a little bit of our journey, and then I'll share some additional comments.

Robbie, thanks for the question. Maybe a two-part answer. So first, just thinking about competitively in the market. As the market leader, we set the bar for what people expect from a pod-based automated insulin delivery system. It's wearable, it's tubeless, it's waterproof. It's automatic cannula insertion. It's fully disposable. So if one falls off, they can put another pod on and not remembering to charge anything. It's easy to use. It fits in their life. It delivers great clinical outcomes, and it works every single time they put it on with very few exceptions. All of that, and it's available at 47,000 pharmacies around the U.S., broadly covered and affordable with a typical out-of-pocket cost of about $1 a day. So that's the bar that we set in the market for folks who are interested in trying to bring another technology to market. We are the market leader. That's the bar that we set. And in 2026, we're going to raise that bar by making Omnipod 5 even better. We're adding 100-milligram per deciliter target glucose to give folks an option for even tighter glycemic control. We're integrating with FreeStyle Libre 3 plus in order to make Omnipod 5 even more broadly accessible to folks have more CGM options to integrate. And the addition Omnipod discover, it gives folks better insights and even easier to start on Omnipod 5. So as a market leader, we set the bar. In 2026, we take that bar up. In 2027, we take it up a lot more with the launch of Omnipod 6. Omnipod 6 is a new pod, designed for faster innovation so we can update pods that are in customers' hands with our latest innovation. It's got designs for better connectivity. We know as sensors get smaller, folks still want to put wearable devices where they want on their body, and we have designed that into Omnipod 6. It's got designed to have an even easier experience as we keep pushing the boundaries of how simple we can make the technology. And most importantly, it's got a personalized Automated Insulin Delivery Algorithm that improves outcomes, especially for those who bolus less. So bar goes up in 2026 as we make Omnipod 5 better. It goes way up again in 2027 when we launch Omnipod 6. So that's kind of how we think about the competitive landscape and how we continue to extend leadership with the technology.

Just to add to that to. Do you want to hit your part two?

Before or after?

Are you comfort...

Okay. Part two, you also asked about sort of what does it take to get here. And I mentioned in my comments when I joined the company in 2015 as we were scaling essentially the mechanical platform that we still leverage today. And for several years, we had to divert all of our R&D dollars to improving the manufacturing technology to make that happen. And the reality is in order to make a device like Omnipod at scale. It takes iteration and it takes time and it takes investment. It starts with a design that can be manufactured and then you learn by making it that some of what you thought was going to work. It turns out a supplier can't make it that way because we're at the edge of tolerances for what people can do. And it turns out that when suppliers can make it, the automation doesn't work the way that you expect and you iterate through that process. And at the end of 10 years of that, those of you who are here in person will get to see the culmination, which is at the end of 10 years of a journey, we can produce about the same number of pods with 200 -- 7x more pods with about the same number of people as we did 10 years ago. And the pods are more reliable, cost effective, and they work when people put them on. So that's the kind of journey it takes in order to set the bar as a market leader of what people expect for a wearable AID experience.

Thank you, Eric. And I would just add lastly, Robbie. So we talk about our competitive moats, and we pioneered the pharmacy pay-as-you-go model 9 years ago. And as Trang shared up here, we have an unbelievably proven strong clinical and economic value proposition that gives us differentiated access, and we continue to maintain that going forward. And then that, coupled with what Manoj shared, which is really about the power of brand, people trust us and they rely on us given our repeatable quality and the expectation, and that has really served to be a moat as we go forward. And then as Flavia had mentioned, we've invested $1 billion in our supply chain. We're going to continue to invest ahead of the curve on advanced automation and scale. And we have the financial backing of a very attractive balance sheet that will enable us to continue to be the pacesetter in innovation going forward.

Maybe one quick follow-up. I wanted to ask, some investors were I think surprisingly a little upset there wasn't a new form factor today. But for me, it's always about the software. And I imagine you're aggressively spending on software. You talked about R&D and how you're thinking about it. But maybe just give us a little more on where you're spending the R&D? Is it on hardware? Is it on software? And how we should think about the future of innovation? I see the pipeline is predominantly software. Is that the way to think about future innovation in Diabetes Management with pumps?

Yes. We have Eric, why don't you start?

Yes. So in the next 3 years, we've got 3 innovations coming that are more software than hardware, but they actually -- they do include hardware changes. So in 2026, it is software as we make Omnipod 5 better, add the 100-milligram per deciliter target for tighter glycemic control, Libre 3 for broader availability and Discover. Omnipod 6 includes some new hardware. So in order to get the kinds of connectivity benefits that we are targeting, so people really have flexibility in where location there is new hardware in addition to software to continue improving the AID experience. And then we shared that we are already investing in new pod hardware. So for the 3 products that are coming over the next 3 years, that is more software weighted than hardware. But we are investing significantly in a future pod hardware platform. And our bar for that is very high because we know that -- what it takes in order to bring that to market successfully. And so the amount of innovation we need to bring with that, we're solving some of the toughest problems for our customers to make sure that they are delighted when we bring that to market.

Yes. I would just add to that, Robbie, I mean, in addition to kind of hardware and software, what's going to drive category penetration. And again, we've driven 66% over the past 5 years of the market growth, and we have full intention to continue to do that. It's not necessarily just a hardware, software. It really is taking our competitive moat around making Omnipod 5 more available to more people around the world, loading into the innovation, keeping the accessibility and the affordability, really igniting the brand development of taking the guidelines into clinical practice and really getting much more broader brand awareness that there is an available solve and then being able to meet demand in a cost-efficient way. Those elements are what are really going to enable the penetration of AID going forward.

Travis Steed, Bank of America. Thanks for hosting the Analyst Day. Maybe I'll ask both my questions upfront. One, 2026, you said was kind of at or better than the LRP, but you have the pipeline coming in the kind of in '26 and '27. So are you baking in the pipeline into the LRP? Or is that upside to the LRP? Or how are you kind of embedding that? And the second question is like we do the math on the patients. It looks like it's about a 20% CAGR as well. I would think more international would be lower revenue per patient. So how are you thinking about revenue per patient, both in the U.S. with some of the new technology and Hybrid Closed Loop and also internationally as well?

I'll take those. So first, we are confident on our ability to deliver guidance, as I said, at or above our targets in 2026 when we issue it. And the innovation that Eric shared today is part of the 20% approximately that we see over the next 3 years. So it's not additional upside to that. As you think about what will drive the 20% growth, the majority of that is going to be volume, both in the U.S. and internationally. Internationally, though, we will continue to benefit from a price mix benefit, which will continue as we continue to expand the adoption of Omnipod 5 into other geographies. So whereas in the U.S., it's primarily volume, OUS is mostly volume, but also has a little bit of a tailwind from price/mix realization that will continue in the 3-year horizon.

David Roman, Goldman Sachs. I wanted maybe just to dive in a little bit more on the strategy to unlock the PCP channel. These are physicians, I think, who spend an average of under 8 minutes per patient. This is a new therapy for them. There's a lot getting thrown at them now. Maybe talk through how you go after that population? And to what extent that comes from commercial strategies, whether it's DTC or otherwise? And then what in the product pipeline is key to going after this population?

No, thank you for the question, David. I'm going to turn it to Carolyn to start.

Yes. We talked a little bit about it earlier. Now we have this very strong presence with endocrinology, and we are looking at reach and frequency to make sure we're optimizing new customer starts per rep, revenue per rep and thinking how do we grow, how do we reach? And this is really complemented by what Manoj described because what's happening is patients are learning about it, HCP is learning about it, and there's demand that's generated. We then go in and are able to turn those brand-new prescribers into more regular prescribers. So that's really driving that continued push in reach and frequency. I don't know, Manoj, if you want to build on it from the brand.

I think all I would offer is like it's two parter, right? So you mentioned the DTC, and I think I had that chart that showed about the non-called upon offices, right? So that's a big part of what we think DTC can do for us uniquely. I think the other thing I would offer, it's an innovation that hopefully you learned about the other room, which is our Discover platform, right? Empathy-Led Innovation is not safe for our products, hardware, software alone. That's a data product whereby we've really thought about what is that experience like for that practitioner who only has a couple of minutes with a patient and they need to very quickly kind of understand what is going on with them and provide them a recommendation. That platform now all of a sudden provides really easy to read, bang, bang, I have it on a sheet. Now I'm able to engage with this patient. And by the way, my engagement with that patient is even better than it used to be, because it's informed by data that I got very quickly. So this is like innovation on multiple fronts that I think is going to allow us to really crack that code. And then obviously, everything that Eric talked about with Fully Closed Loop and what that will do for Type 2. I don't know if you want to build on that.

Yes. Maybe just a couple of quick build. I think the way we think about it is today, we're able to get into and have success activating the PCPs who see a lot of diabetes and they are willing to learn about the technology. Carolyn's team does an amazing job walking in and saying, look, you're already prescribing insulin. Omnipod 5 is just a better way for people to get insulin, let us help us Insulet help you, the PCP offer that to your patients. That's what we're doing today, and we're complementing that with DTC. In the future, in order to do that scalably and really get deep into PCP, which is where 70% of the people who live with insulin requiring Type 2 are. We need a product that's as simple for them as CGM. And that's what we are developing. When we say Fully Closed Loop, we mean a product that is so simple that a PCP can confidently send an e-script, a patient can go pick that up at their pharmacy, take it home and self-start on the product. And the PCP is going to have confidence that, that's going to work. The patient is going to be safe and they're going to get great outcomes and the patient is going to have that experience and be safe and get great outcomes. And that's the level of simplicity that we're targeting bringing to market in 2028 so that we can dramatically unlock the Type 2 opportunity even beyond the success we're having today.

Thank you. Did you want to add anything, Trang?

Yes. I just wanted to add that Omnipod 5 today, we're making improvements to enhance the experience for PCPs. Just this year, actually, we made the input of settings a lot easier. All we need from the PCP is a weight and a total daily insulin and then we figure out the rest and then they can get started on Omnipod. So we don't -- we're not waiting for 2028 for PCPs.

Larry Biegelsen, Wells Fargo. Two for you, Eric, on the pipeline, I'll ask come upfront. So competition, 3 companies developing 2-piece semi-disposable. Can you be really clear about why you think disposable -- fully disposable is better and confirm you're not developing an internal program of semi-disposable. And on the Fully Closed Loop, how de-risked is it? And how is it different from [eyelid]?

Let me take those in reverse. So I have the Fully Closed Loop first because we were just on that topic. So we have been in feasibility studies for the fully closed loop this year. We've talked about those. That's our evolution series of studies, and we'll turn to Trang here in a second and tell us a little bit more about them. But as Flavia said, we give guidance that we expect to deliver. And so we're in EVO 2. We intend to start a pivotal study in 2026 and aim to bring to market a transformative product for Type 2 fully closed-loop Omnipod that is designed to go deep into primary care in 2028.

I would say, Larry, our expertise is in algorithm development, and we have developed this in-house, and we've spent several years now perfecting that algorithm. So we have confidence in what we're going to deliver to patients in 2028.

I think on the multi-piece patch pump perspective, we do a ton of research with customers, and we're always listening to customer needs. And we've never heard somebody ask, "Hey, Eric, can you please make this thing have multiple parts with the charger" So that I can carry the charger around? Like it's just not one of the things customers ask for. And the unique simplicity of a product that you can put it on, it automatically inserts, you never see a sharp. You can wear it in the shower, you can wear it in the pool or at the beach with your son, and it's going to deliver great clinical outcomes. It's affordable at your local pharmacy, and it goes with you. I mean one of the things that can be hard to understand, and Carolyn may want to elaborate on this, but people have diabetes bags they take with them when they're traveling. And the amount that the fully disposable Omnipod shrinks that amount of stuff that follows around people with diabetes, it's hard to overstate how impactful those kinds of small details are. And a fully disposable product means you throw a couple of pods in your bag and you go. I heard about a [indiscernible] Denali last year with Omnipod. And you can do that because you're not charging it, you're not plugging it in, you're just living and it's different.

Can I add a little bit? I mean I think when you think about what is it like to change a pod, it's not as simple as brushing your teeth. It's maybe more like flossing your teeth. It's like, okay, it's going to take a minute or 2. And so I'm thinking in the number of seconds that it takes me to try to take every 3 days. I'm going to do this every 3 days. So if you're going to add a minute to that, I don't know. Like this is about measured in seconds, what am I going to do every few days. And so each step we remove from that process is extremely meaningful to a consumer.

Jeff Johnson from Baird. So I guess, Dr. [Lyon], I'm going to start with a question for you or Eric, and then I want to come back one for Flavia. But just on the 2028 or beyond 2028 on getting type 2 into Europe or getting that to be part of the growth objective. Secure T2D data is out there now. It's fantastic data. It's driving uptake in the U.S. on the type 2 side. Why would Europe be 3, 4 years behind? Especially now that we're seeing Europe so aggressively move on the type 1 side?

Do you want to start?

Start. I think the short answer is just there isn't a history of access in the same way as there is in the U.S. So as most folks probably know, we've had a history of access for type 2 here in the U.S. DASH was actually covered under Medicare Part D, and we've extended that with Omnipod 5. So there's both a history of access, and therefore, there's a bit more clinician experience. In markets outside the U.S., France is really the only market that has a little bit of access for type 2 and it's marginal. And in most markets, there just has not been access turned on. And what that has meant is that there's not the same sort of clinical experience. There's not the KOLs who are aware of the therapy. And we got to bring all that. And that's what market development is. It's sharing global best practices with local markets in order to create access and then pull that through in clinical practice. So we know the therapy works. And actually, we've been really gratified that in the last 6 months as we've been having conversations with local KOLs, they see it, and they're hearing about it at global conferences and so forth. So our enthusiasm for doing it is high.

I would just say we're just getting started. I mean it only just hit the 2025 guidelines for ADA and leading at ADA. So really international guidelines. We've got some work to do to improve the language to support AID use internationally. But it's clear that it works. We just need to generate the evidence.

It's good that you're hearing us talk a year into the marketplace in the U.S. that we already have the ambitions to take it to more patients outside the U.S., right? But I view that as a sign in our confidence of what this can do for people with diabetes and type 2.

Dr. Trang, I apologize if I said Tang. Just one question just on the U.S. again, kind of looking at the LRP. I heard you talk about price/mix benefits in Europe should continue. In the U.S., how do we think about price mix over the next few years when we talk about co-pay, buydowns as we go into that next tranche of patients as we think about maybe increasing tiering competition in the Pharmacy channel, at least a little bit. And I think there's one other issue I was thinking about on the -- maybe just those two, I guess, but price mix in the U.S. outlook.

I'll start and then obviously, Carolyn can add as well. I think as you think about price, it really is about the value that you're bringing to the payers. And with our track record of the innovation that we deliver and the value -- the clinical value and the outcomes that we generate for patients, that translates to value for payers and providers, right, in terms of reduction of acute events. And that is what has allowed us to have the formulary preferred positions that we experience today. Our plan is with the innovation that we're going to continue to bring, as you heard Eric say, to continue to raise that bar and enhance glycemic outcomes, time and range and make it compelling that the value proposition continues to resonate with payers. Carolyn, I don't know if you want to add a little bit more.

I add a little bit. I mean I think what's so inspiring for me as a user is that the way we think about innovation is this rooted in empathy. And so when we're innovating, it's solving actual problems, problems for prescribers, actual problems for patients. And so you're wearing a pod, fewer hypoglycemias, fewer -- less DKA, much better time and range, less diabetes to stress. We don't talk about this as much, but like I'm less stressed about my diabetes. We see quality of life scores go up. All of that value for patients translates into value for payers.

Yes. I would just add to that, Jeff, is that Carolyn mentioned our investment in samples, which is highly a differentiated experience versus what's available in the marketplace, number one. We can help with prior authorizations. We can help with co-pays in a very capital-efficient manner. And we're consistently looking at our cost to acquire, cost to serve, lifetime value to make sure that we're getting the right returns. So we have confidence that we can make that access really differentiated going forward.

And the strength of our financial position allows us to make those investments, whether it is capital investments in capacity or investments to continue to support our differentiated access. And that's why our #1 priority is to continue to invest in this durable, profitable growth engine that we have.

Joanne Wuensch from Citibank. For clarification, 2027 Omnipod 6, is that a global launch? Or is that just in the United States?

We haven't specified. We tend to prioritize markets in order of impact. So we're definitely going to make sure we get it to the U.S., and we'll bring it to our largest markets as quickly as we can thereafter.

And then my real question has to do with SG&A. One of the pushbacks we get sometimes from investors now is, do they need to spend more incrementally to obtain the next Omnipod Podder? And how do you think about the incremental dollar, the incremental outcome from that, particularly as you lean more into DTC campaigns and things like that?

Thank you, Joannne. Thank you for the question.

Yes. As I said, we expect to continue driving operational leverage and see SG&A as a percent of sales reducing over the 3-year horizon. And while the G&A portion will lead the way with continued investments in automation, process improvements and driving scalability, especially with our global business services, our commercial functions are not immune. And you heard Manoj talk about it today. While we are making investments, we have not just the capability, but the uniqueness of data to be able to know and turn on and off and impact our cost to acquire, cost to serve and really enhance our lifetime value in a very sophisticated and ROI positive way. You heard several examples throughout the day in our cost to acquire, we talked about onboarding patients in group training sessions in the U.K. in our cost to serve. You heard me talk about reducing our call by 35%. And you also heard Manoj talking about how we now have ability to interject in a customer journey and retain them even before they think about potentially stopping or dropping, which obviously increases our lifetime value. So when you put all of that together, Joanne, we feel really good about the investments that we make and the returns that we're getting from them. And all of that comes together with the ability for us to continue to drive margin expansion. Our goal is to expand at least 100 basis points per year over the next 3 years.

Yes. And the only build I would offer to that, Joanne, as Manoj shared in quarter 3, we've got 20% of our new customer starts from some of that [DT] activation is one, reciprocity of value, but we also got new prescribers, as Eric was mentioning. And there's a lifetime value in both of those. And we kind of -- I often get asked that question, and I say, you know what, how many companies are going to deliver top-tier performance of 20% revenue, 100 bps of operating margin expansion, EPS 25% with a very healthy balance sheet with a recurring revenue business model? And so I just wanted to echo that we're going to be really disciplined, but thoughtfully continuing to invest in this very strong durable moat.

I think just 30 seconds on DTC. I wouldn't want the takeaway to be that DTC means this massive investment that we have to make all over the place in order to do it, right? Long gone are the days of spraying and praying with media all over the place, right? It is a much more hyper-targeted database performance marketing approach that you take that allows you to develop these relationships and be really efficient with those dollars that you're spending, right? And as I mentioned before, we have data that we can use in a responsible way. The teams do a great job today, and there's even more we can do in terms of how you use digital channels to really efficiently impact what you need to do. So it's not a model of back in the day of radio, television and print where we're going to put hundreds of millions of dollars out there, but we're going to find the right moments to resonate and to connect. And the benefit of the balance sheet that we have and the financials that we have allow us to experiment sometimes. But ultimately, my aspiration is for us to be an incredibly efficient machine when it comes to DTC because the more personalized we can be, the better chance we have of making impact.

Danielle Antalffy with UBS. I'll say Hi ladies, but also Manoj, and Eric. Trang, just a quick question for you on some of the clinical data around utilization and -- or I guess, I should say, insulin utilization, especially in the type 2 patient population and sort of what the message you guys are building to take to PCPs around lower insulin utilization with better time and range? And then I do have one quick follow-up, probably for you, Eric, and that's on this concept of putting samples in the primary care physician's office. I mean this might be a very naive question, but why wouldn't every primary care just send a patient home with a pod if that's the case?

Great idea, Trang?

We're trying to do that. What I'll -- okay, your question was about insulin utilization. So in our clinical data for a secure -- but actually, a lot of our data shows roughly a 30% reduction in insulin when people move from multiple daily injections to Omnipod, and I think that's from a number of reasons. One of the reasons is that it's a better physiological insulin delivery. So people are getting it exactly when they need it. And I think that's a really compelling value proposition for doctors and patients as well that you're not just more convenient insulin delivery, but it meets your physiological needs. And I think it's not just less insulin, but actually, what we showed with SECURE T2D, which is quite differentiated from some of our competitors is that we saw minimal weight gain, and a big reduction in insulin, and we got high timing range as well. So I think that's a big differentiator. That's very compelling for doctors and patients to hear about. And I think the other thing, and I actually just heard it yesterday with a call from one of the doctors, multiple daily injections, he said, Trang, that's just like guaranteed failure. When you prescribe MDI, the issue is that patients don't take all of it. So you don't really know exactly how much the patient is getting. They come in with suboptimal outcomes, you keep ramping up the dose. And so it becomes a pretty inaccurate surrogate of exactly how much insulin they need. But with Pod therapy, you know they're getting exactly the amount of insulin that your pod is delivering. And so it's just much more effective therapy. And with our system, it kind of doesn't really matter too much exactly what you're entering into the system because it's an adaptive system. And if you need more insulin, we'll give you more insulin. And if you need a lot less because you're doctor [indiscernible] taking really high rates, we will give you less. And that's what our data shows.

Maybe just to close out that last question. Do you want to talk a little bit about how we're going to scale sampling?

I'm going to cut from there. So -- and we are really seeing sampling make a huge difference for patients, but also opening the door into offices where maybe it would have been harder to call. And so overall, I'd say it is making a real difference. But I want to tell a specific story. I heard about this story in Dallas the other week. So there's a clinic that the territory manager calls on in Dallas and three nurse practitioners, all who work there, all of whom have diabetes. And one wears Omnipod, but she's out on maternity leave. And the two others wear two pump. And she brought samples to that office. And so there's -- these two women who are wearing two pump, but training many patients who are asking for Omnipod. And at one point, one of the NPs turned to the team and was like, you know what, I think I'd like to get better at training on Omnipod. Could I use one of those samples? So then she started using Omnipod, fully switched. And the other NP kind of was like, maybe could I use another sample and the entire office has now switched to wearing Omnipod. So that's what we're actually seeing in the field of like it's so easy to just try it even if you were a little nervous or think maybe it's not right from a user, but even for an HCP who kind of has a candidate bias in their head, let's try it. If it doesn't work, fine, but let's just try it. And that's that multiplier effect that Manoj was talking. You start to get the office and the staff using it and then they become [fossil] and ambassadors.

Mike Polark from Wolfe Research. Fully closed loop for type 1, is the company still investing in that? What's the path -- why start with type 2? What challenges remain for this concept in T1? And then the other topic was I heard the word inorganic, and I would just be interested in a few categories to think about here, OUS distributors, software capabilities, vertically integrating supply chain, something else. What do you have in mind when you say inorganic?

Thank you, Mike. Do you want to talk a bit about type 2 first?

Yes, I'll start with fully closed loop. So we are investing in fully Closed Loop for type 1. And we see that being iterative, whereas the technology gets better, more and more people choose to interact with the system without bolusing. And we draw a distinction between that and fully closed loop. And that's why we say fully closed loop for type 1 will come after 2028. We will see more and more people use Omnipod 5, Omnipod 6 as a fully closed loop system choosing not to bolus as the personalization and the AID gets better and better. But we see that as iterative where systems have the option to bolus because in general, people who live with type 1 expect quite tight glycemic control and the risk of hypo is severe. And so balancing those two things, we see that being iterative. Technology gets better, bolus -- the option of bolus is there and over time, fewer and fewer people take it. That's sort of the arc of what we expect in type 1. I'll just contrast that. We talked about this a few minutes ago, but the opportunity we see in type 2 is profoundly different than that. It's -- we can leapfrog over that iteration. We can [leapfrog] over the need to have a bolus option. We can leapfrog over the need for there to be anything to put in the system so that we really do have a technology that is as simple for primary care providers as CGM. And so what we see is the opportunity to bring that to market in 2028 as we're iterating towards Fully Closed Loop for type 1 with that same very high bar of what that means for us, iterating our way there for type 1, but jumping straight there for type 2 in order to unlock dramatic category expansion.

Yes. And the last point, I think, Mike, is just about investments. It really just echoes the growth algorithm that we shared. We're going to invest. We are a partner of choice as we go pursue our innovation and algorithm development. We are -- as we invest more in our supply chain around the world, we have multiple suppliers that we are a partner of choice, so we're investing on that. And so we're just -- and we're always going to stay very vigilant around like where is the cutting edge science going? And do we need new partnerships so we can be part of the solution. Thank you.

Chris Basal with Nephron. I want to follow up real quick on just something you said there about type 2, Fully Closed Loop. Do you expect this to be the default option for type 2 patients? Or is it going to be a choice in that population as well?

I think as we've thought about how the markets evolve, we certainly expect to bring to market a portfolio ourselves. So we expect to have a Hybrid Closed Loop option, again, as we iterate our way towards fully closed loop for type 1 and this dramatically simpler Fully Closed-loop product for type 2. I think our expectation is that in offices that are used to AID technology, we'll bring that portfolio. But as we think about that dramatic unlock, how do we go deep into PCP, what is the technology that we will invest commercial effort in bringing to PCP? That will be the simple Fully Closed-loop product that's really designed for them.

Okay. Then I want to ask about Omnipod 6 and some of the enhancements you're making, the data that we're going to see next year. How do you expect the improvements to manifest in the clinical data? Should we be focused on time and range improvement? Are there other metrics that we should be keen in on as we look at how big a leap this is over 05?

Yes. Why don't I have Trang -- why don't you lead with that?

Yes, we're still wrapping up the study. And so we're going to have to wait until ADA next year to see those results. We're going to improve the overall experience. So I think one of the targets will certainly be time and range.

And Chris, maybe just to build. So Omnipod 6 brings together 4 new things, all in one sort of big step forward for pod-based automated insulin delivery. And so the more personalized algorithm designed for better glycemic control, that's what's going to show up in the data at ADA. What's not going to show up in the data at ADA are the other three big innovations that are coming in Omnipod 6. So we talked about some of these already, but just to recap, there's new hardware in that pod in order to deliver a big improvement in connectivity. And connectivity as sensors get smaller is really important to users so they can wear pods where they want to. We're not going to see that in the headline data at ADA. We're going to see great data, but those benefits aren't going to show up on the podium at ADA. Similarly, as we keep simplifying the experience and making it easier to get on, stay on and use, that's unlikely to show up in the data. And so you'll see some things in the data, and you'll see some things that won't be in the data. Obviously, the pod that can be updated in the field, that the won't be in the data, but it's a huge innovation in order to help us accelerate continued innovation on top of Omnipod 6 for customers over time.

Issie Kirby from Redburn. You teased a future hardware platform and potentially a little bit early, but I thought this would be a good platform to ask. What are your priorities when you're thinking about a future hardware platform? You mentioned capacity, form factor, wear time. Would love to think about sort of order of importance for you with those factors. And then do you see Omnipod really becoming a sort of multiproduct platform over time, potentially different sizes, different forms? And then final follow-up on that is what are the implications for your manufacturing as you think about future hardware, maybe tying this into Costa Rica in 2029? Just how flexible can you really be with what you have today as you think about innovating and iterating on Omnipod over time?

Thank you, Izzy. I'll start with kind of a couple of overarching themes, and then Eric, please jump in. It's a beautiful question of like what's next beyond 2028. So we heard that. I would first start with we have a lot of runway ahead of Omnipod 5 is first. And there's a lot of countries who don't have Omnipod 5, and we're really doubling down in the 9 markets, I think that we have Omnipod 5 to really double penetration there. Two, we're just new 1 year into type 2. And as you've heard, everything we're doing from the customer experience to how we're selling it, to how we're really taking away any kind of barrier to access and affordability, we're really going to go deep there. And then you heard all the innovation that's coming for type 1 and type 2, both next year and 2026, as well as Omnipod 6 in 2027 and then really a revolutionary Fully Closed Loop. So I would tell you that is the vast majority of our focus. But we also -- we look to the areas of unmet clinical need, and we look 10 years back, and Eric teased you with a little bit of that today because we very thoughtfully and in a disciplined fashion are going to be investing some dollars. So we wanted to be -- give you visibility to that. So I'm going to pause there and turn it to you.

Yes. Maybe just a couple of additions to that. The first is we are working on the problems that are the most important to customers so that it justifies investment in manufacturing, investment in having 2 SKUs. And that's the bar that we have to clear is to bring something to market that is so compelling that we expect a very positive return on the investment that we're making there. And as Ashley just said, we have line of sight to what we think that is. And it's by working on some of the things that we've heard over the years are really important to people with diabetes. And I shared some of those innovation targets. We're not going to give away for competitive reasons of the specifics of it, but they are the things that people care about, and that's what will go into the platform, and that's what will justify the manufacturing investment, the refinement and the manufacturing of having 2 SKUs for a while.

Just a couple of questions on margins. On the 100 basis points of op margin expansion annually, depending on where you shake out on gross margin, I think it implies kind of mid- to high teens OpEx growth. The model kind of lends itself to leverage. So I'm just wondering, at what point in the longer-term strategic plan do you allow for more margin expansion? And then maybe just on a similar vein, cost to acquire, is there much difference between someone with type 1 diabetes and type 2 and then U.S. and international?

Yes, I'll take the first part. I think the 100 basis points of margin expansion that we have in the horizon for the next 3 years are going to continue to put us and make us remain in a very differentiated position of being able to grow 20% and add margin by the end of the [LRP], we will be above 20% margin as well. So if you think about that Rule of 40 -- that we think about in technology, we're going to be there. I think as I said, in terms of our priorities for capital deployment, while we are very confident on the ability to continue to deliver margin expansion, we see a tremendous opportunity to continue to support that growth. We're guiding for the next 3 years, but we have had 10 years of growing above 20% in constant currency. So we see the opportunity to continue investing in our engine as the highest return ROI for capital deployment that we can have. Of course, we're going to be disciplined. And I think 100 basis points is nothing to be ashamed of. It's quite a nice margin that we're going to get by the end of the LRP. And my colleagues here have a lot of ideas across all of them. And I think it's a very compelling investment opportunity for us.

And we're not going to get kind of into the mix in type 1 or type 2 or OUS. I would tell you, in aggregate, the nice thing is we have a balanced portfolio. If you look at our sources of growth over the 3-year [LRFP] we're very balanced from U.S. type 1, U.S. type 2 and OUS. We enjoy very attractive margins, both in the U.S. as well as OUS, and we have very healthy retention rates in aggregate as a company.

I know you all have a lot of questions. We're going to take our final question from Josh over here. So there you go, Josh. We got to get you all on your tour. So I apologize. I know there's a lot of questions, but we'll all be available in the experience room after too.

Josh Jennings from TD Cowen. I was hoping to just ask a couple of multilayer question on the U.S. Medicare patient opportunity, maybe coming a more important channel with the type 2 indication opening up. But I think, one, just is Omnipod 5 over or underrepresented in the Medicare channel? Two, just from a revenue per patient -- annual revenue per patient per year, is there any delta between Medicare patients and private pay? And then third, I just heard the Part D access, I should have this under my belt already. But is there a wider access [indiscernible] just in terms of two pump competitors gaining pharmacy channel access for Medicare patients versus private pay? Sorry for 3 questions in one there, but... Yes.

Thank you, Josh. And maybe, Carolyn, I would just say maybe in aggregate, just share kind of the Medicare D experience versus some of the private pay.

Yes, yes. I mean as we shared, we're low penetration in that type 2 basal-bolus population, and we're looking to really help to drive that penetration over the long-range plan. And what we see is Medicare is a significant part of that opportunity and our ability to be covered our access through Medicare Part D is indeed a differentiator and 2 pumps are not covered in that Medicare Part D. And so absolutely, we're seeing lots of opportunity there, and we're continuing to drive volume. So definitely.

And I would just say like on average, Jeff, when we look at it, it's around $1 a day. And for many, particularly government-backed funding, it's for zero cost. So we're in a very healthy position from a coverage, from a payer point of view. And again, it's really due to everything [indiscernible] started is a very strong clinical benefit and a very strong economic benefit of keeping people in control and keeping them safe. Okay. On that note, I think we are going to wrap. I wanted to say thank you to everyone, and thank you for the questions. I did wanted to thank Clare and the entire Insulet team. As I mentioned earlier, this has been our first Investor Day in nearly a decade. So we hope it gives you a really strong grounded foundation from which we can keep our innovation in our conversation going forward. I really wanted to wrap with a couple of things. We have a very strong, compelling growth algorithm, and we plan to have an approximately 20% revenue CAGR, 100 bps operating margin expansion, 25% plus EPS, very strong free cash flow. That looks all really good on the financial point of view. But what matters really equally so to the team at Podder are all those millions of people that are now waiting for us to come on Pod. So I'm going to close with reminding everyone, we have a very large addressable TAM. Remember, the number, $30 billion, very low penetration. We have built over 25 years, a very strong, compelling competitive moat. We're going to continue to innovate to ensure we have that moat in a durable fashion. And then I'm going to just conclude with this, the people of Insulet, it's infectious. We're unbelievably purpose-driven. If you didn't experience that today, I did see some tears. I wanted to thank some of our Podders that came to join to share their life story. We have many Podders in the community in Insulet, which is remarkable. And so they kind of keep us on every day to make sure that Podders centricity is front and center. Thank you very much.