Research Reports

Prepared Highlights

2025 worldwide sales exceeded $1 billion for the first time (CEO), a 12% increase year-over-year; U.S. sales $707 million (+10%), international $308 million (+15%) (CFO)
Q4 2025 record worldwide sales of $290 million (+15% YoY), with U.S. sales $210 million (+14%) and international $80 million (+17%) (CFO)
Q4 U.S. pump shipments of more than 27,000 (highest quarterly ever); renewals accounted for over half of shipments, and ~2/3 of new customers were MDI conversions (CFO)
Full-year 2025 gross margin expanded 3 percentage points to 54%; Q4 gross margin reached a record 58% (CFO)
Q4 adjusted EBITDA was 11% of sales, a 10 percentage point improvement over prior year; Q4 operating margin positive at 3% of sales (first time since 2021) (CFO)
Free cash flow generated in both Q3 and Q4 2025; exited the year with nearly $300 million in total cash and investments (CFO)
Pharmacy channel sales in Q4 2025: $16 million, or 7% of total U.S. sales, nearly doubling from Q3; only a low single-digit percent of installed base ordered supplies through pharmacy in Q4 (CFO)
U.S. installed base at end of 2025 was approximately 325,000 (CFO)
Full-year 2025 international distributor destocking/inventory buyback impact was ~$7 million (slightly lower than prior estimate of $10 million due to partial delay into Q1 2026) (CFO)
2026 worldwide sales guidance: $1.065 billion to $1.085 billion (CFO)
2026 U.S. sales guidance: $730 million to $745 million, incorporating $70 million to $80 million in pricing headwinds from PayGo pharmacy transition; pump shipments expected to grow 10%–11% YoY (CFO)
2026 international sales guidance: $335 million to $340 million; includes ~$15 million impact from distributor destocking/buybacks, offset by ASP premiums of at least 30% in direct markets (CFO)
Q1 2026 worldwide sales guidance: $236 million to $240 million, including ~$10 million in headwinds split between U.S. and international (CFO)
2026 full-year gross margin guidance: 56%–57%, scaling from ~54% in Q1 to 60% in Q4; adjusted EBITDA guidance: 5%–6% of sales (negative 2% to negative 1% in Q1, positive from Q2) (CFO)
Long-term targets: gross margin of at least 65%, operating margin of 25% (CFO)
Key product launches planned for Q2 2026: international Mobi scaled launch, U.S. Mobi integration with FreeStyle Libre 3 Plus, Dexcom 15-day sensor globally; 510(k) for pregnancy indication for Control-IQ+ submitted (CEO)
Mobi Tubeless (patch pump with extended wear) 510(k) filing planned for Q2 2026, launch in H2 2026 (CEO)
Pivotal trial for fully closed-loop algorithm expected to begin later in 2026, targeting FDA filing in 2027 (CEO)

Mgmt quotes:

"2025 was a defining year for Tandem, where we surpassed the milestone of $1 billion in sales while delivering on our mission to provide new innovations, improved outcomes and a revolutionary experience to nearly 0.5 million customers worldwide." (CEO)
"Our first year of experience with pharmacy access proved these assumptions to be true. Therefore, in 2026, we are accelerating our efforts to increase pharmacy coverage for both t:slim X2 and Mobi platforms and plan to drive utilization of the pharmacy benefit for all our customers." (CEO)
"In transition from a model where revenue is typically recognized upfront, 2026 sales growth may be more moderated. We have the added benefit that can come from shifting our sizable existing installed base into pharmacy to lessen the near-term impact to sales." (CFO)
"We have great conviction that the combination of our differentiated portfolio of products and business model changes provide us the ability to achieve our long-term objectives of accelerated sales growth with a gross margin of at least 65% and an operating margin of 25%." (CFO)
"We are well positioned to deliver best-in-class technology to our customers in a more streamlined and cost-effective way while advancing our global business model and creating meaningful long-term value for our shareholders." (CEO)

Prepared Metrics

Metric	Value	Speaker/Context
FY2025 worldwide sales	>$1 billion	CFO
FY2025 U.S. sales	$707 million	CFO
FY2025 international sales	$308 million	CFO
Q4 sales (record)	$290 million	CFO
Q4 U.S. sales	$210 million	CFO
Q4 international sales	$80 million	CFO
Q4 U.S. pump shipments (record)	>27,000	CFO
Q4 gross margin (record)	58%	CFO
FY2025 gross margin	54%	CFO
Q4 adjusted EBITDA margin	11% of sales	CFO
Q4 operating margin	3% of sales	CFO
Q4 pharmacy channel sales	$16 million (7% of U.S. sales)	CFO
U.S. installed base (end FY2025)	~325,000	CFO
FY2026 worldwide sales guidance	$1.065B–$1.085B	CFO
FY2026 U.S. sales guidance	$730M–$745M	CFO
FY2026 international sales guidance	$335M–$340M	CFO
Q1 2026 worldwide sales guidance	$236M–$240M	CFO
FY2026 U.S. pump shipment growth guidance	10%–11% YoY	CFO
FY2026 gross margin guidance	56%–57% (scaling from ~54% Q1 to 60% Q4)	CFO
FY2026 adjusted EBITDA margin guidance	5%–6% of sales	CFO
FY2026 PayGo pricing headwinds (U.S.)	$70M–$80M	CFO
FY2026 pharmacy sales as % of U.S. sales	~15%	CFO
Long-term gross margin target	at least 65%	CFO
Long-term operating margin target	25%	CFO

Q&A Batch (1-5 of 19)

Q1 — Matthew Miksic

Topic: 2026年发货增长指引与PayGo定价影响
Key points:
- 总体发货量增长率约10%–11%，其中美国低双位数、海外中双位数（海外有1500万美元定价逆风）
- 新发货量预计恢复增长，是衡量业绩的最佳指标
- PayGo模式下患者终身收入翻倍以上，但收入受定价逆风影响，毛利率和调整后EBITDA仍稳健
Mgmt stance: bullish，因发货增长反映真实业务表现，且患者价值大幅提升

Q2 — Mathew Blackman

Topic: 药房渠道覆盖现状与2026年展望
Key points:
- 已与前三PBM签约，覆盖约80%受保人群；但处方集覆盖仅约1/3，合同将于Q1末生效
- 预计2026年全年平均20%泵通过药房发货（$0首付模式），开始量很低，逐季爬坡
- Q4末仅<5%客户通过药房订购耗材，全年平均约10%客户通过药房订购
Mgmt stance: neutral，刚起步，预期低基数后逐步放量

Q3 — Larry Biegelsen

Topic: 推出PayGo时机、长期药房目标及流失率
Key points:
- Q4药房业务经验验证可行性，当前是正确时机
- 2–3年内目标70%销售通过药房渠道（从当前DME模式反转）
- 即使无锁定期，用户粘性高：DME渠道用户平均使用超4年保修期，部分继续使用旧泵
Mgmt stance: bullish，相信用户试用后不会流失

Q4 — Christopher Pasquale

Topic: 国际直接销售转型进度与时间线
Key points:
- 2025年完成3个新国家的分销转型（建销售团队、基础设施），现已上线
- 2026–2027年按同样计划推进更多国家，分阶段避免风险
- 长期为混合模式（直接+现有分销商），2027年将完成大部分转型
Mgmt stance: bullish，进度顺利，2025年经验可作为可复用的操作手册

Q5 — Danielle Antalffy

Topic: 利润杠杆：定价、产品成本和运营效率
Key points:
- 定价是最大杠杆：药房渠道ASP显著更高，未来2–3年持续贡献收入与利润增长
- 产品成本降低：Mobi泵制造成本比t:slim低10%–15%；耗材（cartridge）成本比t:slim低20%以上
- R&D设计原则要求新产品利润率优于现有产品；运营端通过效率降低招聘需求
Mgmt stance: bullish，有明确的成本优化路径和定价优势

Q&A Batch (6-10 of 19)

Q6 — Matthew O'Brien

Topic: 2026 new pump shipment acceleration drivers
Key points:
- 2026 acceleration is one of the best numbers in several years; no Tubeless benefit assumed in 2026 revenue plan.
- Drivers: Mobi with multiple sensor integration, Android/iOS, Tubeless implementation; expansion into OUS markets; FreeStyle Libre 3 OUS expansion.
- Sales force productivity improvements via a new system coming online next month; pharmacy channel expected to impact business in 2026.
Mgmt stance: Bullish — high confidence in Mobi approval in 2025; combination of new technology, sales organization improvements, and pharmacy will drive growth.

Q7 — Michael Kratky

Topic: Tubeless Mobi 510(k) submission timeline
Key points:
- Planning to submit 510(k) in Q2 2026.
- Highly confident in approval in H2 2026 due to responsive FDA support.
Mgmt stance: Bullish — strong FDA engagement supports high confidence in H2 approval.

Q8 — Matthew Taylor

Topic: Pharmacy shift impact on P&L and sales growth in 2027–2028
Key points:
- For every PayGo customer, supply reimbursement is >4x what DME provides today.
- Over 300,000 t:slim Mobi customers in existing installed base; shifting them from DME to pharmacy creates immediate tailwind.
- Near-term headwind in 2026 (moderates revenue growth), but margin expansion still demonstrated; tailwinds build in coming years.
Mgmt stance: Bullish — pharmacy shift power shown in first year with margin expansion; future years will be even better.

Q9 — Shagun Singh Chadha

Topic: 2026 revenue headwind cadence and margin progression
Key points:
- $70M–$80M revenue headwind; bulk hits in last two quarters of 2026.
- Q1 headwind: low single-digit % of shipment volumes; averages to 20% for the year.
- Margins: start near 54% in Q1, scale linearly to ~60% in Q4.
- Q1 specific: ~$10M headwinds worldwide, split between international direct transition and PayGo transition.
Mgmt stance: Neutral — provides clear quarterly cadence; headwinds front-loaded, margins improve through year.

Q10 — Jonathan Block

Topic: International revenue growth decomposition and moving parts
Key points:
- Majority of international shipments still from new customers; renewal contributions just beginning.
- Direct markets provide ~30% price premium long term; 2026 blended price increase mid-single to high-single digit, building across year.
- International headwind sized at ~$15M; ~$5M in Q1, majority in Q4.
- Underlying growth strong; going direct puts Tandem closer to customers for better selling.
Mgmt stance: Bullish — confident and excited about international opportunity; direct transition funds headwinds and improves market position.

Q&A Batch (11-15 of 19)

Q11 — Travis Steed

Topic: 加速2027年及以后销售增长的驱动因素
Key points:
- 最关键的驱动因素是pay-as-you-go模式的持续实施，收入影响显著
- 现有325,000名客户可通过药房渠道转换为持续收入
- 今年将推出首款延长佩戴贴片，同类产品中算法更优，预计表现良好
- 2027–2028年有望推出全闭环系统，丰富产品管线
Mgmt stance: bullish，因为多个增长引擎（pay-as-you-go、药房转换、新品）叠加带来强劲信心

Q12 — Jeffrey Johnson

Topic: 药房渠道每月定价指引
Key points:
- 今年刚启动药房渠道，合同混合包含优选/非优选准入，影响返点和共付金额
- 建议建模用约 $350/月/客户 作为起点，后续根据实际监测调整
- 客户无论之前是否已购买泵，药房渠道定价一致（相当于重置）
- 该价格比当前DME渠道定价有明显优势
Mgmt stance: neutral，提供保守起始数字，强调需跟踪趋势再更新

Q13 — Elaine Cui

Topic: 2型糖尿病市场进展及C肽测试指南影响
Key points:
- 2型市场使美国及海外可及市场翻倍
- 2025年Q4全面商用后，新患者启动数从Q3到Q4显著提升
- 2026年将重点投资2型营销和PCP/海外研究
- C肽测试：参议院要求CMS于2026年8月审查NCD，若取消将大幅改善Medicare准入
Mgmt stance: bullish，已有1个季度积极数据，药房+Mobi+FreeStyle Libre 3等多重顺风，政策潜在利好

Q14 — Felipe Lamar

Topic: 更新泵出货量潜在下降及药房渠道的抵消作用
Key points:
- 2026年更新泵出货量预计仍保持 双位数增长
- 未来4年新机会数量可能下降，但药房渠道大幅降低对更新周期的依赖
- 国际市场的更新机会正在增长，成为更重要的贡献者
Mgmt stance: bullish，药房渠道和海外更新可平滑更新周期波动，维持业务增长

Q15 — Philip Coover

Topic: 毛利率轨迹及药房转型的短期压力
Key points:
- 2025年毛利率已同比提升 3个百分点
- 2026年尽管销售增速放缓，毛利率仍可扩大 2–3个百分点
- 预计2026年底退出时毛利率约为 60%
- 药房渠道短期带来一定压力，但为未来更快扩张创造空间
Mgmt stance: bullish，管理团队有信心将毛利率提升至竞争水平，并持续改善

Q&A Batch (16-19 of 19)

Q16 — Joanne Wuensch

Topic: 2026 revenue and gross margin progression
Key points:
- U.S. shipments: 80% through DME; seasonal pump shipment curve expected (lowest Q1, highest Q4).
- Gross margin trajectory: starts at ~54% in Q1, scales up to ~60% by Q4, with measurable step-ups each quarter.
- Headwinds from $0 pump price offset by supply pricing benefit (pharmacy channel) and OUS direct business scaling up.
Mgmt stance: Neutral — historical seasonal patterns persist, but pharmacy growth may eventually smooth curves.

Q17 — William Plovanic

Topic: PayGo breakeven timeline and 2026 free cash flow
Key points:
- PayGo breakeven: one PayGo customer plus two existing customers pays back within a handful of months.
- 2025 exit free cash flow positive; 2026 expected free cash flow neutral on an annual basis.
- Q1 cash dip typical (annual incentives); by end of 2026, ramping back to positive into 2027.
Mgmt stance: Bullish — PayGo eliminates DME barriers (large out-of-pocket, physician friction), driving new patient uptake.

Q18 — Shaymus Contorno

Topic: Moving patients from DME to pharmacy and bad debt risk
Key points:
- No unusual accounting treatment or bad debt considerations; revenue streams normal as supplies purchased over time.
- Patient transition: highlight lower out-of-pocket (vs. DME deductibles), maintain customer service, require new physician prescription.
- Friction is manageable but not overnight; confidence in ability to shift customers as access broadens.
Mgmt stance: Bullish — financial benefits and service continuity drive confidence, despite prescription step.

Q19 — John Sheridan (for Michael Kratky)

Topic: U.S. renewal growth drivers in 2026
Key points:
- 2025 renewal shipments grew well above 10%; 2026 renewal opportunities flat vs. 2025.
- Growth fueled by tail of customers from 2025 (especially Q4 warranties) and some from 2024; capture rate >70% after 18-month warranty expiry.
- Pharmacy transition reduces reliance on pump renewals; customers can stay on supplies indefinitely.
Mgmt stance: Bullish — double-digit renewal shipment growth achievable via prior-year base; pharmacy shift is a long-term positive.