DexCom Investor Day 2026 | New Stelo Sensors Unveiled To Expand Reach Beyond Diabetes Markets

Today, I'm able to throw 104 miles an hour. But only a couple years ago, I didn't even have the energy to take them out. I'm Mason Miller. I'm a pitcher for the San Diego Padres. I'd say my first memories come around 7, 7 or 8 with baseball. Growing up and playing a sport is always your dream to play at the highest level. In high school, I was a little bit of a late bloomer. I was always a skinny kid. I was going to college and trying to put on weight and that was what I'd heard my whole life was just, you know, eat a little more, work out more. It wasn't from a lack of trying, I promise.

And during my sophomore year, that's when I started showing some signs of diabetes. I was just tired all the time. I was sleeping in class. There's like an unquenchable thirst. I knew something wasn't right, but I didn't know what exactly it was. I planned on doing an internship, but as so many jobs are, you take a drug test beforehand. My blood glucose levels, they were over 700. So, they immediately called us and said, 'You need to go to the hospital now.' That was the shock. And I just remember driving in and just not really knowing what life would look like in the slightest. I didn't know would I be able to play baseball? What other limitations would I have?

I got my first Dexcom and it quickly made my life so much easier. You know, I've learned so much about how different things affect me. Like I know what's going on because whenever I need to, I can check my phone or I can check my receiver during games to know where I'm at. I just felt uplifted by the fact that I was finally starting to see like what I'd been searching for. So, I really was able to take my A1C to another level. I was consistently around 5.7 to 6. I felt great and that was what was so important to me.

My Dexcom has always been a constant for me since the day that I got on it. I get to go to work and pitch in a high-stress environment every day and that's one less thing that I have to worry about. It goes a long way for me and my network of people making sure and caring about me and wanting to know that I'm okay. And my now wife, Jordan, she always supported me from day one and it was like it was no big deal. She's had the follow app on her phone for so many years. It's a constant reminder of how awesome she is.

So excited to be partnering with Dexcom and be able to expand the reach of, you know, my impact, my ability to reach kids and bring them up to the ballpark, give them a chance to see firsthand that type 1 has no boundaries and won't hold you back. Living with type 1 is a part of who we are, but it doesn't define us. Dexcom G7 has given me a ton of freedom and a ton of reassurance. My name is Mason Miller and I'm a Dexcom Warrior.

Good afternoon everyone. I want to join Jake in thanking you for being here, making the effort to take the time to hear us articulate our vision for the company, and to give you reasons to believe why we can execute on that vision. A little over a year ago, I was approached by Spencer Stuart about this opportunity at Dexcom as Chief Commercial Officer, and I had two impressions at the time, two thoughts. The first was how ambitious a vision your organization had to be able to be in a position to add millions of patients' lives to the technology, and also to grow the revenue by billions of dollars within a fairly short period of time.

The second thought I had as I reviewed the job description was that what they were looking for in the Chief Commercial Officer aligned with my 15 years of experience at Masimo where I helped roll out as the Chief Commercial Officer there the extension of the brand across the globe, and also leveraging some of my experience when I was at Pfizer Consumer Healthcare running a lot of their OTC businesses where I had an opportunity to live about 10 years abroad. So, as I thought about that in preparation for this meeting, I thought how interesting it is. I've had the last year to dig in with my teams, make some changes, spend time in the field, get to know the individuals that report to me, and get to a chance to get to know the organization and build this LRP from the ground up and not from the top down. Because my mandate was from Jake, from Kevin, was to build it based on what we felt we could do, not build it based on an expectation of growth at a specific target. And that's exactly what we've done. And what I'd like to articulate is my confidence in what we're presenting to you today, why I believe we will achieve it, what are the facts behind it, what's the momentum that we have, and I'll give you specific reasons to believe why we are ready for this opportunity.

So, it's not just that we're relying on CMS to expand coverage, although that is built into the plan. There is so much more that we're ready for as we prepared for this moment. We've done it both in the United States and we prepared internationally. And I'll explain in some detail what I'm referring to. Firstly, we have the products that we need. Jake described what those are and what they are going to be in the future. We expanded our sales force a couple of years ago. It wasn't just the expansion, it was the focus on where patients will be going to be cared for as they deal with their burden of diabetes. And then we worked aggressively to expand our coverage in pharmacy and other areas in the United States as well.

At the same time, internationally, we looked at this and said, 'There are access opportunities both in the short, medium, and long term that we can leverage to really drive growth internationally and at the same time be judicious in expanding our presence and footprint around the globe.' I'll speak to some of those things as well. But let me speak first about the US. You're familiar with this data. We know on the far right side of this chart there are 15 million covered lives in the US. We also know that there are an astounding 9 million people that are not on CGM. And it's our opportunity at Dexcom, our obligation, to figure out how to align the needs of each of these different groups within diabetes, and ensure that our products and the experience they have with us match those needs. And they are different needs across each of these categories.

Jake referenced this a minute ago. We expect that this coverage is going to double by 2027. Some of you may have seen our previous statements. We expect the CMS coverage to add 12 million lives. So, then you say, 'Okay, that's 15 + 12 = 27. Where's the other three?' We expect that that will be following Medicaid formularies that will be coming online throughout the year as well, following on the footsteps, so to speak, of CMS. And I guess the point is there's just such extensive opportunity. But the thing that we have to do at Dexcom, again, is ensure that our messaging, the way we're speaking and delivering the experience to our customers aligns to their needs. Otherwise, when all of these people come in, how do you keep them? That's the question we're asking ourselves every day. How do we help them?

We do it by personalizing the experience. You know, as you look at the left side of the slide, the people who are dealing with this burden of type 1 are dealing with insulin dosing decisions. They're dealing with avoiding hypoglycemic events, minimizing them as much as possible. On the other extreme, for those who are at the type 2 NITs, they're wondering, 'How did I get here? And what do I need to do to change this to avoid it from progressing into something where I'm having to use insulin.' They're wondering what part they played in that, maybe feeling guilty and overwhelmed by the burden of that. And we're there and our intent is to be there as an accountable companion to help them work through what they need to do with data, but with specific insights that we're going to give them and I'll explain to you what I mean in a few minutes.

Here's some of the things that these type 2 NIT patients are looking for. They want to resist, many of them, resist food cravings. They want to be consistent in the way they use exercise to help them manage their glucose levels. They want to stick to a healthy diet, many of them. But they need to understand from us how exactly is Dexcom's data going to help them do all of those things? Like understand what the food that they're consuming is doing to them and what the exercise that some of them want to do is how it's going to benefit them. So, they have a lot of knowledge with our technology. What they need is a companion accountable to helping them get through it. And that means we've got to be very specific and nuanced in the way that we speak to them and that's what we're working on.

We've had the fortuitous opportunity to welcome Stello into this portfolio about a year and a half ago and we have learned a ton. Some of you might think, okay, well, I thought Stello was health and wellness. I thought Stello was pre-diabetes. It is, but we found that a lot of type 2 NIT patients who don't even realize they have coverage have come into the franchise through Stello. And we have gleaned a huge amount of information about how to speak to them, how to inform them and how to help them. And I, as one for example, I used Stello prior to joining the company. I found it extraordinarily helpful to a point. And so, this next video that we're going to show you is going to give you a sense of how we're thinking about this.

To show you, is going to explain to you what we've learned, what changes we're going to make to the app to enhance the information that we provide with the objective of being a companion, as I said, an accountability companion to our patients and those who use us. And then, you'll see in the video how it's not just our intent to keep it within Stelo, it's to migrate it into the G7 products to bring those technologies the same benefit and insights in those patients the needed information they need to make changes and avoid potentially sliding further up the acuity scale. So, here's the video.

So, I hope that you can see from that video the things that we're going to be doing to enhance the Stelo experience through this enhanced app. But, it's not stopping there. It's going to migrate its way and help us with type 2 NID patients to inform them as to what we can do to help them in a way that will really, really make a difference. Just briefly, I've been wearing this new version of Stelo for several months. I logged my meals. I get a meal score. So, it tells me like I ate a banana a couple of weeks ago. I had no idea that a banana would spike me to 190 and keep me at 190 for 2 hours. I didn't know that. And then, I found that exercising at a certain time in a certain way, layering foods in a certain way was all helping me. And then the app would tell me, 'Hey, I noticed that you did this, and I noticed that you ate at this time. I noticed you ate a little longer, a little later, and you might want...' And it gives me these insights. And I'm telling you, it is changing the way I am approaching this. So, I've been worried about sliding into type two, and now I've got like an injection of hope around this app that's helping me to understand what I can do differently. It's changing my behaviors. And that's what we're going to do here with the G series as well, with the aid of Stelo. We've already got a retention advantage versus our competitor, but I'm convinced that this sort of personalization is going to give people a reason to stay because they're going to see the reason for why they should use it. And they're going to see the impact on their lives. So, we're going to see, we believe, this retention gap widen, our retention strengthen, and we've got work to do there, and we're doing it now. Because otherwise, you sit here and you say, 'You've got this tsunami of new patients coming your way. You want to help them. It's a burden. So, you want to do everything you can to inform them, help them, and make it easier for them.' Now, we know that there are better clinical outcomes if people use the technology. This chart, there are two lines on this chart. And this is looking at A1C over 12 months. The first line, the top line, shows you an A1C reduction from using CGM less than 90 days in a year, which is great. I mean, I'm glad that people are using it. They're using it though less than 90 days, and they're seeing an impact from that. But the bottom line is are those individuals who are type two who are using the technology more than 270 days a year, look at what happens with their A1C reduction. It is profoundly improved. And what does that mean? I think you're all familiar with the concept of time in range. That difference means that an individual with type 2 will be in range 3 more hours per day, 21 more hours per week, right? And over time, that makes a difference in clinical outcomes. The other thing I love, that was a study that was published in JAMA last year. That same study showed the combination of CGM with SGLT2s and also with GLP-1s, those top two graphs. And you can see, of course, the lighter green line shows improvement using those drugs, which is wonderful and great. But what's fascinating is long-term use of CGM in combination with those two medications does even more for patients. It has an even more profound impact. Now, how do we tell people about this news? How do we let them know? Well, the way that we do it is to make sure that we ourselves are focused on where to go. You all know that endocrinologists are primarily dealing and helping type 1 patients. And you know that primary care physicians are primarily going to be working with the type 2 patients. So, we need to make sure that we are focused in that same way in providing insights to those different groups who have very different needs. I mean, there's a lot of information on this slide, but if you look down the left column, it talks about the endocrinologist and the primary care's information about knowledge, brand knowledge, and then goes down through a bunch of criteria, including their confidence in CGM. And it won't surprise you that endocrinologists have a high level of confidence in CGM. Primary care physicians, who are dealing with patients for a whole lot of reasons as we know, have limited confidence in the brand. So, or in the technology. So, we have to make sure that we're focused calling on bringing them information that also lightens their burden. That make it easier for them to get people on the technology. So, people are not going back to them dealing with them on how to onboard, etc. We're helping them with that. We're giving them the information that enables the PCPs to see more people and not sort of continually inform people who have tried to get on the technology. This, again, is one of the reasons why, prior to my arrival, there was a decision made to expand the sales force in the United States by 40%. It wasn't just the sheer size of it that we were trying to realize. It was making sure that we were calling on primary care physicians, anticipating this wave of patients that would be coming through and seeing these PCPs. We know it's working because we're seeing share gains. We're seeing share gains on the left side of this chart in these primary care offices. You see in the middle of that, in 2023, a roughly 30% share. 2025 has grown close to 40%. We're just getting started. You go over to the right side of this chart, you'll see the basal share has gone in a similar way between '23 and '25. The more we personalize and speak in a nuanced way to these patients, the more we inform the doctors, we lighten everyone's load, the more the share will grow, and it's happening now. So, in summary on the US before I transition for a few minutes over to international. We understand these customer needs. We're focusing our products on those needs. We've expanded the sales force. We're ready for the tsunami of new patients that are going to be coming, and we're confident that through the work we're doing, we're going to be able to lessen the burden for these patients and give them a reason to try and use the technology for extended periods of time in order to optimize their outcomes. Now, international. We're going to... As I mentioned to you earlier, I lived in Brazil, I lived in Singapore, I lived in Toronto, I lived in the UK. I love international. I've done a lot of work there, but we need to be careful in the way we spend and focus as we go forward, and we're going to do that. This gray area of the world is where Dexcom was not in 2015. In 2015, $50 million in revenue, roughly 30,000 patients, only three countries with over $5 million in revenue, and zero direct sales. All of this revenue was coming through distributors. Then you fast forward 10 years to 2025, and you'll see what we've done in that 10-year period of time. And you know that, as Jake alluded to earlier, there are half a billion people today outside of the United States who have diabetes, and it's going to grow to something significantly more. So, you can see the progress we've made in this time, but I think if you fast forward 5 years, you're going to see in the end of our LRP, you're going to see a multiplier effect on where we go with this. So, you'll see multi-billions of dollars in international, which we should do, and we can do, and we will do. One of the reasons we're having success in this area is because we have a portfolio strategy which recognizes the fact that one market in international is not all the markets that are international. They have very different approaches to reimbursement. They're in different phases of reimbursement. There are some that have broad reimbursement. That's where we have our G series products. There are places where there are tiered reimbursement, of course, and that's where we introduce our Dexcom One Plus product, which is really being used for people who are not pumping insulin. And then finally, when there's limited reimbursement, we'll use a plethora of products. And there's one that we're going to be introducing very soon. We've already pre-launched it in Germany. We're calling it Flex. This product is going to be focused on people with type 2 diabetes, basal and IIT. It's going to be specifically geared toward them. The app is going to speak to them in a way that makes sense to them. And we're going to then, after launching this in Germany in the short term, officially launching it, we will expand it internationally in many other locations. We're also going to be expanding Stelo starting this year in Korea, Australia, New Zealand, and then soon thereafter in the UK. Now, our international growth strategy, as I mentioned at the beginning, is really based on two things. First, it's recognizing that access is coming. And we know where it's coming, and we have a sense for when it's coming, and we're focusing on where to do that. And then as I mentioned, I'll briefly talk to some geographic expansion. A lot of flags and a lot of information on this chart. On the far right at the bottom, if you just tally that column, really, I think the first takeaway is in these 10 big international markets, there is roughly the same size of opportunity as there is in the US. So, this is why we're going to focus and continue to go deep in these top 10. The second thing that you'll notice in the upper left on the left side is that the type 1 penetration is slightly at or above the US, which is great. But then when you look at type two, you notice as you go down the slide in the center, there's a lot of opportunity for expansion in the type two space. So, what we're doing is simple. We're working with clinical bodies, leading clinicians in these different markets to put together what's needed, the clinical evidence needed to present to the governments to ensure that they understand what benefit could be had from their constituents using CGM for a prolonged period of time. And here's the way we sort of map this out, these 10 markets in these different categories. So, on the far left, you'll see what we think is near-term one to two years, medium we're defining two to three, and long-term four plus. And then those three columns, type two IIT, type two basal, and type two NIT. What I love about this is we're not forcing or making this something up. We're taking it and looking at what's happening, what we're seeing on the ground, the research that we're creating, and what it's going to take in order to penetrate these markets. We think this is a pragmatic approach which extends itself out and across our long-range plan. The other thing we'll do, we'll do this carefully as well. We did this a lot at Masimo and we had great success. Dexcom's had great success here going from distributors to direct markets, basically transitioning. When we did it in Germany where we bought that distributor several years ago, the revenue quadrupled within two years. We're doing the same thing in Japan now. We just transitioned a sales force from a third-party group to our own. We've hired those people, we're going. And we've done it as you see at the bottom and other places. And we have a road map of other places where we'll be doing this moving forward. Jake mentioned our scale. We're going to leverage that through the onboarding of our plant in Ireland. We're going to use that full capacity to help us expand. Jeremy's going to come up in a moment and talk about 15-day and how that incredible product is going to allow us to leverage opportunities around the world if and where we need to be more competitive in tenders, etc. And finally, we're going to leverage all those products at the bottom where we need to across the portfolio and across these different markets. It's working now. It's going to work moving forward. In the last couple of minutes, here's some three of the biggest markets where we plan to enter in the next 2 years. Hopefully sooner. India, Brazil, Mexico. You can see the total number of diagnosed patients with diabetes in those locations. It's a huge number. That's not necessarily what attracted us, although that is a reason. There are a lot of people, 15 million among those three countries, who are intensive insulin therapy users. And that we believe creates a major opportunity for us to go after them in the short term. So, in summary, my impression a year ago about the ambition and vision of Dexcom to grow its patient base profoundly, to grow its revenue dramatically, I think is backed up in the evidence that I presented today as we built this LRP from the ground up. We're ready in the United States through our expanded sales force, which is settled in and focused. Where we have expanded pharmacy coverage and where we have the right products that are now really beginning, I think, to build on this legacy, build on this idea of nuanced ways in speaking to the type 2 diabetics to keep them and retain them and help them along their journey. And second and finally, we have a great international plan. We have great people in the field. We have a really measured approach and we're going to execute it with excellence. So, with that, I'll turn the time to my esteemed colleague, our CFO, Mr. Jeremy Sylvain. Thank you very much.

Hey, thanks everybody and thanks for joining us here in Tempe. I think we're really excited to host you and host you at our facility later today. And I know you guys took a lot of time out getting out here to see us, so really thank you again. I really do appreciate it. You know, what we want to talk about here is we started with Jake talking about really our product portfolio, the clinical evidence we're generating over time, and the really exciting opportunities ahead of us. Then John came up and talked a lot about the commercial opportunities and you can see there's a long way to go. So, we're going to turn into now talk about really the financial and the investment case. And I think that Dexcom has an incredibly compelling investment case. We have a durable double-digit growth runway. That's certainly one. We believe and we know we have a really leading cash flow generation profile. The gross margin, operating margin, and cash flow generation over the coming 5 years and look forward to sharing with you a little bit of the how. And we believe there's a significant value creation opportunity available for us today. It's enabled by what you can see at the bottom here. There's an incredibly large TAM that's available to us today. We have an incredible product portfolio design, we have a massive unmet need, and we have investments targeted in driving that growth. And we look forward to talking a little bit about how those impact us over the course of the 5-year period. We've demonstrated the capability, and I think we'll demonstrate it a little bit more to walk through some of the leverage initiatives we have. And lastly, we're going to talk about our capital allocation strategy. It's been disciplined over time, and we're very excited about it. So, let me just first start with our sustained double-digit revenue growth. We have a 10% plus every year each year in our LRP through 2030. I want to be very clear, this is not a CAGR, this is not an average. It's 10% plus each year every year. And it's driven through multiple years of significant growth catalysts, and we're going to walk through them on the right through product launches and expansion. And as we dig into it, I hope you're going to see we are going to unlock lives, coverage of lives, significantly over the next few years. But we're going to exit our LRP in a better position than when we even started. We'll talk about that in a second. I also want to let you know that this isn't a rosy sky outlook. This is a very grounded outlook. This includes competitive bidding assumptions starting in 2028. This includes competitor product launches over the course of time. This includes classic price mix work that we'll go through over time. And we still feel highly confident 10% plus every year. And as you look at the growth catalysts, I'm going to walk you through those for some of the whys. Some of these have already been covered, but we're going to talk about launching three products outside the US this year. Dexcom Flex, it's going to start in Germany, but make no mistake, it's going to go beyond Germany over time. With the great feedback we've seen on Dexcom G7 15-day, we're going to launch that outside the US this year. And we're launching, as John just said, four countries in Stelo. And that's going to continue to happen outside the US. We're going to continue to expand those. The following year is when we launch G8. Jake alluded to it at the end of '27, early '28. G8, an incredible step change in accuracy, a sensor that adapts to you. It's an incredible opportunity. And Dexcom One Plus is going to launch in 15-day as we move into 2027. And we've seen incredible uptake across both our 15-day, and we expect to see incredible uptake with our G8 platform. We're going to launch G8 outside the US and on Stelo in 2028, and then outside the US on Dexcom One Plus. And that's just in what we've announced today. So, those catalysts, as we put those in front of coverage expansion, are going to be incredible opportunities. But now let's talk about the coverage expansion expected. And we'll get into it a little bit more on the next slide, but it's a very exciting opportunity here. Medicare, obviously we expect an announcement anytime now. We obviously for our LRP purposes, we put it in the middle of 2027, but we expect an announcement anytime here. And we will be ready. We'll be ready when that time comes. We'll be ready to serve the unmet need, and we'll be ready to serve it with product enhancements over time. I think you guys saw some of the app improvements we're launching with Stelo here recently. That will come over to the G series. We expect that to be a differentiator longer term. You can see below it and on John's slide, he laid it out. We expect expansion of coverage. This is just in the top 10 markets across type two IIT, basal, and type two NIT over these years. So, there's an incredible opportunity that sits right in front of us today. And just to show you how big that opportunity is, let's talk about it. Let's talk about how many lives we're going to expand that to. This year we have a little over 23 million lives covered around the world. We expect to exit around 52 million, more than double the covered lives by the end of this LRP. And maybe what's most interesting, the percentage of people that are on CGM as a percentage of covered lives will go down from where it sits today. This is the opportunity ahead of us. And we're making these assumptions under a measured basis. We're not assuming hockey stick effects or anything along those lines. What this is is a measured basis, a very reasonable grounded assumption. With this type of expansion in front of us, this incredible opportunity. As we exit 2030, the expectation, just to give you some context as to where the penetration sits, is in type 1 around the world getting close to 70-80% and intensive in the US similarly, but basal into the mid-40s and type 2 in a 10 to 15% range. And everywhere outside the world even lower than that. It just goes to show you even as we add all of these users over the next 4-5 years, you're going to expect to see even more opportunity as we exit the LRP. Now, that's just in the US and the top 10 markets. There's also the opportunity for geographic expansion. John alluded to it, there's 500 million people outside the US that have type 2. And as you get into the countries outside of the top 10, many of these finger sticks are still the standard of care. And we've shown time and time again as we move into these markets and we're able to replace finger sticks, coverage comes. With Dexcom One Plus, we went into seven countries, none of which had coverage. Six of which established coverage within the next 18 months. This is the kind of opportunity we have outside the US and we're going to go into some of these major markets. Over half the people with diabetes in the world sit in APAC. This is an opportunity, a massive opportunity in front of us. And then Stelo in the US and international. You know, Stelo is an opportunity to get out in front of really diabetes, pre-diabetes, health and wellness. As the world continues to look to be healthier where possible and technology advances, this is an opportunity to go deeper in the US. You know, one of the things we have a great opportunity here and we'll talk about it here in a second is what to do with it. John alluded to it earlier. Stelo will tell you what your glucose is. Now it's going to tell you what to do. And that's really important when it comes to therapy and lifestyle change. That's also going to come into our G series product as well, but this is really important as we move Stelo deeper into the US where there's more penetration, more opportunities for attention, utilization and certainly as we move outside the US where there's a desire for this particular product. So we're really excited about the opportunity here. And maybe lastly, let's talk a little bit about the catalysts, right? This is a recap of what's going on, but the catalysts across the organization are incredible. Obviously, we expect CMS coverage. We've talked about it for some time. It's not an if, it's a when and we've given you the when and we're really excited to share with you the results from our CONNECT trial in a few weeks. But there's an opportunity here. We've assumed that CMS penetration goes at half the rate of basal even after full coverage. There's an opportunity there potentially even to do any more. International access. Where we've moved direct into markets and I'm going to move the two in the middle together, where we've gone deeper into markets and gone direct in markets, we've accelerated our opportunities there. And we have the right product portfolio to do it. We talked a little bit earlier about the portfolio. That portfolio was designed for tenders. It was also designed for coverage. It's really for both and that's why we've ultimately built it. The Stelo expansion opportunity is incredible. We talked about diabetes being 550 million people across the globe. It's 589 now. That number is even bigger for pre-diabetes. The opportunity is incredible there and what is most interesting and we haven't put any of this into our LRP, but it's a real big opportunity for us is retention and utilization. As we integrate more and more of this AI experience, so the what to do with it, how do I improve it, what can I do with this product, how do I use it more? We're really excited to that product experience combined with an elevated level of service provided by elevated levels of coverage to potentially increase our retention over time. And again, that would be an upside opportunity across the board. So, I hope you guys are excited as we are about the revenue opportunity ahead of us. And certainly that's just one part of the case. But there's another part of the case which was, well, what about the profitability over time? We expect gross margin to grow into the high 60s by the end of our LRP. And like I said, this is a base case on how we think about it. 15-day will be our platform across the board. That is our base, that is our expectation, and we will move on to 15-day over time. We also know that that's going to take some time to convert. We've included this conversion schedule so that you guys can have a look at it. Please know that the graph to the right that nothing happens in an exact straight line. It's for depiction so that you guys can understand that transition over time. But these are all the products that are moving over to 15-day, which provides an incredible opportunity around gross margin expansion. But we're not stopping there. G8, our expectation is it costs at least 10% less than it costs to make G7. And that includes all the upgrading of silicon, all the upgrading of capability technology. We are going to improve the product and our expectation is it costs less. We're going to continue to improve our focus on optimizing freight and scrap. You know, some of the challenges we faced in the past, the opportunities ahead of us are incredible. And we're getting through those time and time again. You can see it in our improvements. This year we expect to do even better over time. And this is a positive. You guys will just make sure you consider it, the warranty rate. Well, the warranty rate may go up a little bit, that's okay. It's a 15-day product. This is an excellent thing for us. We've also included the assumptions around price, channel, product mix. Again, we want to make sure we understand as we go outside the US, there may be some cash pay markets we have to go after. There may be some markets where it's lower down the acuity curve. We've also included that in this number. And we are including assumption that there's cloud cost supporting Gen AI features. A long time ago we talked about shifting to a software company. You're starting to see us make that move. And I hope you see that through our product, our app, our experience. The hardware and the technology continues to get better, but so does our app, the experience, and what we really want to do, which is provide solutions to people at the end of the day. So, this is a very exciting time across gross margin, but it doesn't just stop there. We also expect our non-GAAP operating margin to get to 29 to 30% by the end of the LRP. That is getting to world-class margins. At that point we'd be at the top end of medtech. And we're really, really excited about it. The way it works out is about 150 basis points a year, mostly anchored in gross margin expansion. But the expectation is we continue to make investments in our organization, investments in generating AI, generating clinical evidence, generating expansion for capability, capacity, going into new countries. And we'll lay out what some of those targets look like to do so and still get leverage across OpEx. And so, it's an exciting time from that perspective. And just to put it into some context, this is our operating expenses as a percentage of revenue in 2025 and where we're going to go. You can see that we're going to continue to invest in R&D. And I know Jake is going to come up here after me and talk about some incredible things we're working on longer term in R&D, which I think is going to be really exciting. We're going into all of these countries and we are not going to starve the organization. We can create these world-class margins while not starving the organization, really fueling the growth engine longer term. And then lastly, G&A. Look, there's G&A work that's going to be done. We're going to have a team that invests in AI. We're going to have a team that invests in clinical evidence. We're going to have a team that supports infrastructure builds. Why? Because we have so much more to get after, but we're still going to get leverage across G&A. In doing so, we expect to get that level. Now, as we invest thoughtfully in these long-term levers, there's one other thing that I think is important to lay out, which we didn't lay out earlier, but I think it's also important in the back of your mind, which is through this process, we also have generated a ton of cash flow. We have one of the best cash flow models in all of MedTech. We expect our adjusted EBITDA margin to grow to 36% to 37%. Again, as we get into those mid to high 30s, that's a very significant cash flow generation opportunity. And what we've done is as we've created profitability over time, we've done so in a way that ultimately generates free cash flow conversion. And you can see we've had an incredibly high free cash flow conversion rate over the years. And there's even more opportunities in this because one thing we haven't discussed yet, but I think it's an incredible line is what you see at the bottom of this line. As we've gotten smarter and smarter over the years, we've thought about our machinery and how it supports our growth algorithm. And I think many of you know, we've leaned into technology more and more. You're going to see it this afternoon. The lines you see this afternoon are the same lines you're going to see that are going to produce G8. That is a massive opportunity. And if you think about the CAPEX we invest every year, it's an opportunity to leverage off that over time. So, very significant opportunity here across cash flow. Now, you may ask, 'How are we going to do this?' We talked a little bit about 15-day. We talked a little bit about obviously the revenue. So, how are you going to get the leverage? We started this 3 years ago, something called cost to execute. It's built into the fabric of our organization. And the way we think about cost is not just about how do we cut cost, it's about how do we spend our time and our opportunity cost to improve the life of the patient. That's at the end of the day. If it's not improving the life of the patient, the customer, the user, why are we doing it? How are we doing it? So, we might have put all of our costs into these areas. And through that process, we've created leverage. We're trying to eliminate the things that aren't necessary and invest in those things that are necessary. That framework has helped us out well. That framework was there last year as we got 300 basis points of operating expense improvement last year alone. But we're going to leverage our global infrastructure. These are investments that we've already made. I think it's really important as you think about the next 5 years, these are the kind of things you're going to need to leverage and those investments are already in place now. So, think about it. Manufacturing at scale. We've launched obviously in US, you guys are going to see our plan there. Malaysia, a million square foot facility up and running today and Ireland launching later this year. We invested in R&D centers of excellence. We turned San Diego last year into our innovation center where teams can come together, innovate quicker, in person, more efficiently. We've also started in India where we can leverage the talent base that's available in India to get ever more efficient around software development and hardware development. We've launched a new support model. And these support models are really important. We've built it on a platform that allows for things like agentification. We've built it on a platform that allows for self-service, that allows for us to have what's called My Dexcom common account. So, when you call, we know who you are. We know your history. We're able to be more efficient. We're able to elevate the customer experience, but lower the cost of ultimately supporting it. And many of you may already know this, but over 35% of our non-manufacturing organization already sits in GBS locations. That was zero in 2018. And that fixed leverage, that know-how that's built in these global shared service centers as we continue to get bigger and bigger as we continue to expand in it globally, we're going to have the capability to leverage these centers to continue to get better. But it doesn't stop there because technology is advancing and it's advancing pretty quickly. We have what's also called Dexcom AI. AI is going to be a springboard for efficiency really across the enterprise. We talk about it in our product and it's going to be an important part of our product. There's no question. And we spend a lot of time talking publicly about the impact on our product, but the reality is internally we spend a lot of time thinking about AI. In 2025 alone, 750,000 hours saved by leveraging AI. And we don't talk about it as much, but when you see 300 basis points of improvement, you know it's there. And those are the kind of things we're doing. Now, I'm not going to get into all the use cases here today. The reason is when you guys go over to our facility, our chief information officer is going to be there and we have an AI expo. So, you're going to see what we're actually up to, which I think will be very helpful and very valuable. These are actual experiences that are taking place in companies today. These aren't PowerPoints. These are actual things that are taking place that are making us more efficient time and time again. So, we're going to take you through that, but I think the big takeaway here is we know this technology is going to be important for the long term and you can expect us to continue to invest in it time and time again. So, I talked about revenue. We talked about being profitable. I think both are incredible pieces of the story as you think about our key stakeholders, our customers, our employees. But let's also talk about our shareholders. We have a disciplined approach to capital allocation. You know, one of the things we're very happy to have is we spend a lot of time really having a fortified balance sheet. That's important to take advantage of opportunities over time. And I hope that that continues. You guys see that. I think that's a continued opportunity for us. So, when opportunities come up, we have the ability to deploy. What are we going to deploy it on? Well, certainly we want to fund organic growth. We've been able to do that. Over the years, we've turned cash flow profitability to where we've been able to do that and have excess. We want to be able to support tuck-in M&A. You know, we talked about where we can go and be effective longer term internationally. Every time we've acquired distribution, it's always led to an acceleration opportunity. So, there's opportunities to continue to do that and look at distribution opportunities or where there's augmented technology that can help us enhance our technology a little bit quicker. So, it's looking at targeted M&A. And we also want to make sure we're able to return value to shareholders through share purchases when we see there's a disconnect. And boy, we see a big one today. So, we see an opportunity to return value. We've already authorized a $1 billion repurchase authorization. It will be fully executed in 2026. And going forward, we expect to apply at least 50% of our annual free cash flow to repurchases. We see an opportunity. We're going to take advantage of it. We're going to be aggressive in getting out where we see a disconnect in our share price today. So, with all that being said, the revenue opportunity, long-term double-digit growth, we've walked through the catalyst there. Top-tier operating margin and cash flow generation, you've seen our history there, the demonstration we're able to do that. We're putting in the pieces in place to continue that. And we are committed to returning value to shareholders starting now. We think this is an incredible value creation opportunity. So, with that said, let me thank you guys for being here. Let me turn it back over to Jake to bring us home. Thank you very much.

All right. Well, thank you again everyone for coming. We will take about a half hour now for Q&A. So, we have Matt and Joe available out here with the analysts on this side. And as usual, you'd think by our fourth investor day I would have learned that the stage lights always blind me. So, Matt and Joe, if I might need a little help, I think I can see most of you. So, yeah, why don't we go ahead and kick this off? So, who's got them? Who's got the mic? I got one. I got it. Okay. Oh, yeah, David.

All right. Sure, thank you. David Roman from Goldman Sachs. Maybe I'll just sort of start with one strategy question and then maybe tie it to the financials here. Jake, you concluded there with really talking about very future vision for the company. Maybe you could talk a little bit about kind of how you're kind of pushing the bounds here of interstitial tissue monitoring and how that applies across multi-parameters including the hospital setting. And then maybe just I'll relate that question here to Jeremy. As you kind of go through the LRP and talk about the 10% growth, is there any further perspective you can help us to think about your assumptions around volume versus price and mix over that time horizon?

Yeah, and to your question in terms of, you know, the price volume mix. The way to think about it is we've typically thought about 2 to 3% price kind of similar to you see today. Not every year created the same, right? We have assumptions around when coverage comes, when it kicks in. We have obviously assumptions around competitive bidding, but we do assume that mix comes down over the life. And so, we're not going to talk about volume because it's 10% plus is our assumption. But, I think as you at least pulled out the models and you can see what our coverage expansion expectations are. 2 to 3% price, not every year is same with mix coming down as we for the most part transition to a significant amount of our product to the pharmacy in the US. Coverage in CMS fee for service is going to be heavily in the DME given its part B coverage. And so you start to see that mix clearly coming down going forward.

Go to our next question. Why don't we go to Jeff?

Thank you and guys thanks for the presentation. Jeff Johnson from Baird. Jake, can I maybe two questions but let me just try to pin you down on the other analytes there. Just could you help us on the timeline? I know you talked about late 2017 early 2018 for G8 and then you I think you said just shortly thereafter the other analytes number one. Number two, I don't want to put words in your mouth but I think in the past you've made comments somewhere along the lines of, you know, if we need to get to ketones we can get to ketones fairly quickly. No mention of ketones today. It seems like your biggest competitor is still making progress towards ketones maybe sounded a little better this quarter than last I thought on getting the ketones sometime this year or next. Just where is your pathway on ketones specifically?

Fair enough. And then, I don't know if this question's for you or for John, but outside the US, you're going to have a lot going on, it sounds like, internationally the next 2 or 3 years. You know, four products, three new large markets you're talking about, T2 reimbursement, expansion. One, what could go wrong there with all those balls in the air? And two, I think help me understand just how you're going to position maybe Stelo versus Flex versus D1 Plus. Is there any markets where you're going to have all four in the same market? I guess I still am a little fuzzy Flex versus D1 Plus. Just help me out there. Thank you.

Yeah, maybe it's your last question on the focus and that's one of the reasons why when you see the investment in sales and marketing and the targeted investments, one of the things we've done, and this has been a key priority of Jake's, is to carve out dollars to make sure we're supporting that international expansion. And so if you see leverage in the organization and from all the work that we've done, really the opportunity then is to invest back in both verticals. And so I think what could have gone wrong is if you don't support investment the right way, but I think that's what we've particularly done in terms of how we set up the organization.

We're going to go to the next person below, Larry.

Thanks a lot. Larry Biegelsen, Wells Fargo. One for Jeremy, one for Jake. I'll just ask them both up front. So Jeremy, any color on, you know, the sales and margin assumptions in terms of cadence? And then for Jake on the type 2 non-insulin opportunity, why do you think it's taking longer for the CMS proposal and, you know, is mid-2027 for the finalization a conservative assumption? And related to that on the study that you're going to show at ADA, how important you think it is to see a benefit in the patients on GLP-1s and oral meds? Thank you.

Yeah, I can start with the cadence. So we haven't necessarily gone year by year. We'll do that as we kind of get into guidance by year. You know, clearly I think an easy way to think about gross margin at least in the near term is we talked about exiting this year in the US kind of approaching 50% of our population moved over. But I think what's really helpful is as you then think about next year and your starting point is much much higher as you roll forward that base. That's an opportunity on gross margin. When you combine that with some of the 15-day G7 work that we'll be doing, you can probably tell that there's some real interesting shorter-term gross margin opportunities given some of that 15-day base moving over. So, maybe that gives you at least some context to what we don't have a cadence to provide with you today as part of our annual guidance.

How about Joanne?

Thank you. Joanne Lynch from Citigroup. I think it's sort of the same question in terms of operating margin expansion and gross margin expansion is how to think about revenue over the next couple of years. You were pretty specific in saying it's not a keger for 10% plus, but at least 10% each year. You've got a lot of products and a lot of things going on. Which years might be stronger than others? And then I guess my next question is, maybe I missed it, but what is it about Flex Set you think works in the OUS environment that maybe makes sense to bring it to the US? Thank you.

Yeah, I'll start with at least the conversation about the guide and John, you want to talk about Flex maybe? So, you know, I think while we're not giving guidance by year, we've tried to give you what was a lot of the catalyst by year, so you guys could take a look at it and say, 'Hey, when is the coverage expansion taking place? When are your product launches going to take place?' We've been very clear. We wanted to basically underwrite a base case for everybody. And that 10% plus I think is a nice way to do that. We want to be, you know, conservative in terms of how we're thinking about providing a number and give you guys at least the building blocks to start to think about it. So, that's the starting point at least the 10% plus. You know, from there as we get into our annual guidance, we'll start to give more clarity as to what that looks like. But the hope is in looking at the LRP by providing all of those levers, it allows you at least to give some thought as to where those years you think might be interesting potentials for upside. But for now, 10% plus per year is what we're giving by year and then we'll get more clarity as we move on.

Question about Flex again, focused on type 2 NIT patients and potential and basal patients as well. The question about the US vis-a-vis Flex is yet to be determined whether that is a different product and or a software sort of app that's geared toward people who have those needs. That's the way I'd answer that question. We've not yet made that decision and or prepared to sort of speak to it more than that.

Let's see. We go to Chris.

Thanks. Chris Mascarenas. Two questions. One, you know, G8 comes to market, G7 won't be that long in the tooth, particularly the 15-day version. Are you anticipating any difference in the adoption curve here? Do you mean to try and push this for a rapid conversion across the customer base? Or does it become maybe a premium product initially for patients that really value that extra accuracy? And then Jeremy, could you just go into a little detail on competitive bidding? The latest thoughts there on how you expect that to change the market, the impact that you are baking in. Thanks.

Yeah. And to your question on competitive bidding, so our assumption there is 2028 is, you know, kind of letter of the laws is when that would play in. You know, we've taken a look at what obviously the OIG report would have indicated which didn't really appear that there was a lot of opportunity there. And we know that really CMS is heavily focused on fraud and potential risk around that. And so, you know, a lot of the concern we think is around fraudulent billing of CGMs that are actually never shipped and or sold. And that's where a lot of the concern is. In terms of our assumptions around it, look, we put in assumptions for some nominal price impacts associated with it. The reality is we think it's appropriately priced. And we think it's appropriately transferred. So, we don't want to get ahead of ourselves there, but obviously we build a range of those assumptions into there to make sure that we were covered in the event that it did take place. But I think the most important part starting in 2028, that's what the LRP assumes. And if things change, we'll certainly come back to you with an update as those assumptions play out.

I want to go to Matt O'Brien.

Thanks so much. Matt O'Brien, Piper Sandler. Thanks so much for putting this on. Was curious about, I think Jake, you mentioned, you know, OUS eventually being the same size as US. So, the interplay just between US and OUS growth over the LRP, how does that look? I'm assuming OUS is much faster. And then to Jeremy, you know, the gross margin expansions are around 140 bips per year. How does that interplay OUS get influenced or how does it influence gross margin over the LRP? Thanks.

Yeah, so I think you know the answer is I wouldn't underplay either of them, right? There's a massive opportunity in the US, but there's also a massive opportunity outside the US. So, they're both books of businesses we think they have a real opportunity for growth. Um, to your other question, what was the other question? Gross margin. Yeah, so I think you know the gross margin certainly as you move outside the US and we grow certainly volumes in that perspective with those moving to a 15-day as well. You might find that the higher reimbursed markets ultimately yield higher margins, but as a portfolio, the entire portfolio moves. So, even as international grows, you're getting the benefit of shifting your G7 10-day US customer OUS customers onto the 15-day platform as well, which is a significant piece of it. You're getting your Dexcom One Plus customers outside the US also moving onto a 15-day platform. So, the best way to think about the cadence is to look at our product launch and we kind of gave you product launches by year. That'll help you kind of feel cadence between OUS US, but really across the board all of those regions are going to move to a 15-day.

Joe, why don't we go to your side? We have a mic right there.

Hey, thank you. Great event, great info. A hardware question. Jake, I heard you had mentioned 15 days rolling out great. You made an update to adhesive that's being received well. I thought the adhesion code had been cracked. What are you working on there? Is the overpatch forever in Dexcom's future? Is G8 overpatchless? Thanks.

Now, I want to go to your side, Jason, in the back.

Thanks for hosting the event. Maybe just a couple questions. First, basal has been kind of the laggard here in terms of adoption. Jake, you spoke early on about smart basal. Is this the tool that opens up that opportunity and maybe just jam me on that. I think you said mid-40% basal penetration exiting the LRP. What does the US penetration look like in that?

Yeah, and to your question on basal, the number we said that was a US focused number, so it's really into that mid-40s. You know, from where this year it's kind of crossing into that we said 20 to 25 as we exited last year. So it's getting into that figure. Outside the US, very very small relative to that. And so that's coverage unlocks today. It really is only in Japan and France. And as you get to 2030, again, we expect unlocks of coverage to take place pretty significantly over that period, but the number would be significantly less of that just given the approval timeline. So, it's a real opportunity. I think we're going to exit with a lot of opportunity for basal to penetrate those markets outside the US.

Okay, maybe just a quick question. The role and focus of the new board members, what do you expect them to add that you didn't have?

One of the things is we've been pretty focused on refreshment of our board. We've actually, with the addition of these two new board members, in the last 3 years, we've brought in six new directors. So, we already have four that we've added in the last 2 and a half years across AI, healthcare. Rick Osterloh from Google has really significant experience in scale operations of consumer tech as well as AI integration with his experience at Google. So, I really think that we're building a board for the future for where we're headed. And these medtech operations directors are going to help us with that.

Joe, how about we go to Rich?

Hi, Rich New, RBC Capital Markets. Thanks for hosting this day. So, maybe just the first going back to the way to just think of the components US OUS, I know it's probably oversimplification because you have different launches and initiatives going on each year in each region, set of regions. But, should we be thinking of the OUS growth rate over the life of the long-range plan outpacing the US, and if that's the case, how do we think about, you know, do we need type 2 NIT as you move up the penetration curve in 2027 beyond to kind of sustain a double-digit US growth rate, or should we keep that kind of in that high single-digit, low double-digit? Just help us toggle those components, specifically US or OUS.

Yeah. So, I think you know, we haven't necessarily gone down each OUS US in the LRP. The expectation is certainly the unlocks across both of them, and you can see obviously the expectation of the CMS coverage here next year is the biggest unlock out there. And so, that's the reason why we're not talking down either, because ultimately 12 million, 15 million once the Medicaid lines come along would be the biggest expansion in the US we've ever seen. And it's a massive opportunity unlock there. At the same time, you've seen all the OUS countries we think that are coming in. So, to talk down either or to say that both don't have significant opportunities over the LRP, we haven't necessarily split those out. What I would say is our long-term algorithm, we've always said our long-term algorithm coverage is what we've always aimed to do. And so, I think that's why we've worked so hard to create the clinical evidence that ultimately drives coverage. And so, what I would say is longer term, our expectation is coverage comes, and that's part of our growth algorithm. It's showing that CGM improves lives, showing it takes cost out of the system. I think the best way to think about it is any sort of LRP we give, we do assume coverage is coming, and we're working hard to get that coverage. Rather than specific particular coverage unlocks, I would just expect us to continue to do the work around clinical coverage, because that does unlock lives.

And then just on the NIT penetration forecast exiting the plan, could you just remind me of what the type 2 percentage was you said that's embedded in the LRP? And what are you assuming for the wear, you know, for the adherence or compliance?

So, the assumption there is we exit at that 10 to 15% penetration across that population, US. OUS obviously very much smaller given the unlock comes later into the LRP. And the wear utilization is similar to what we have posted up on our website, 75 to 80% utilization. Again, as you go deeper and deeper into that population, you could potentially see that change. But, what we found is when coverage is there, and it kind of comes back to coverage, when coverage is there, you see people wear it. And you see people wear it at a high clip. So, that's the assumption there.

Now, how do we get to Josh?

Thanks, Josh Jen from TD Cowen. Appreciate you guys hosting. Getting south to Phoenix. Just Jeremy mentioned about coverage, and just wondering with the work being done in the pre-diabetes population, is the expectation that ultimately you can deliver the clinical efficacy and cost-effectiveness in that cohort, in that large cohort, and where should we be thinking that that's where Stelo will live and breathe within this LRP?

You want to start? You start. Yeah, so I think, you know, look, certainly we expect to be able to demonstrate outcomes in pre-diabetes. We've seen it. We see people wearing Stelo all the time that have pre-diabetes. And the outcome is very different than what you would typically measure today under diabetes, right? Diabetes typically, as you measure it, you're thinking about things like A1C, right? Well, in pre-diabetes, your A1C hasn't risen to that level quite yet to where you'd expect to see it. But, things like time in range, health care reductions, and preventative care, you can measure those types of things over time. So, Jake alluded to a day when everybody is wearing a sensor as just part of your annual physical or as part of what you would do to prevent diabetes. We do expect over time for that to be a use case that ultimately plays out because we know we can demonstrate the benefits of doing so. Whether that's coverage, whether it's employers covering it as part of health and wellness plans, whether it's through programmatic approaches, those are the things I think we're still working through and how we demonstrate that clinical evidence. But, make no mistake, we're building a product to help folks prevent ever getting to diabetes and that obviously focuses on that pre-diabetes space and then of course in the health and wellness space.

Thanks. You put a lot of analyte menu expansion action on the table here today. Sort of asked this question but I think you said it earlier in the year. I think you made some public comments and I think in some of our discussions with the team, you alluded to potential to go beyond kind of this enzymatic testing process in the interstitial fluid and looking at other mechanisms of testing to expand the menu further and I think on my mind I was thinking BNP, creatinine, some other biomarkers, but maybe you can just talk about where you are in that development process, clear maybe not in this LRP, but love to hear any updates there. Thanks.

We're close to time. So why don't we sneak in one last question if we can keep it to a single part question. Why don't we close with Shagun?

Thank you so much. Shagun Singh from RBC. You know, I think the big focus here is capitalizing on the large TAM and from that standpoint you also indicated that, you know, access is growing faster than penetration. Just from a commercial standpoint, you know, where is the biggest focus in order to unlock that or drive penetration higher so that you could have confidence in a base case that's greater than 10%?

John, you have, I think that was great. I think the matching experience and needs is number one. And then the second is taking the learnings from Stelo and this new app that we're going to be launching in the short term and leveraging it like crazy across the portfolio.

This will, I think this concludes our portion of the event here as we prepare for the manufacturing tour. Maybe for the management, if you want any closing words.