All right, good morning. Why don't we get started? My name is Jeff Johnson. I'm the senior medical technology analyst at Baird. Our next presentation this morning is from Dexcom, a leader in the $8 billion global continuous glucose monitoring market. With us today from Dexcom, we're happy to have VP of Investor Relations, Sean Christensen, and, Sean, I know the rest of the team is on an executive offsite or something this week, so thanks for making the trip and, you know, doing us a solid here and still coming. So thanks for that. I'll turn it over to you if you have a few minutes of any prepared remarks you'd like to make, and then we'll move right into Q&A. Or-
Yeah-
Yeah.
I'll just start off really quick, and Jeff, thanks for hosting us today. We're thrilled to be here. It's an incredibly exciting year for Dexcom and obviously for the industry. So we, you know, are in the midst of the launch of our G7 in the U.S. It's been going great in 2023, building on the momentum we had at the end of 2022 with our international launch, as well as international momentum with our Dexcom ONE system as well. We're also in the midst of the largest coverage expansion that we've had in our company's history for CGM in the U.S., and so, a lot of excitement, a lot of momentum, and some great things that we can talk about today. Happy to be with you guys, and we'll turn it over to Q&A then for the rest.
Yep, great. So, some great things we can talk about after we get through the first topic.
Sure.
Which, I'm sure as you can... You know what's coming, but,
Yeah
... just on GLP-1. So, you know, I thought Insulet did a good job yesterday. We had a conversation up here, with them that I think the conversation did a good job of kind of dispelling some of the myths around Type 1 and GLP-1 use.
Sure.
I just want to cross-check with you, kind of your view, from the New England Journal article that came out last week, the small study of 10 patients, and that... You know, do you see any real implications of GLP-1 use in Type 1 diabetes? Again, it seems like it's a genetic and maybe an environmental component to the disease. It's beta cells dying, GLP-1s aren't going to reverse that. So just your thoughts on kind of the Type 1 implications of GLP-1.
Yeah, I think there's, you know, interesting, interesting science, interesting, very small study and, and things that we can evaluate over time. You know, I think when you look at this honeymoon period of still retaining some beta cell functionality and overall, you know, Type 1 momentum and the possibility to delay. Even if you look at and read the article itself, though, you know, for us as a CGM, you know, system, CGM still features very prominently in that study and in terms of kind of managing carb intake and calorie counts, tracking time and range, and then, you know, even if you're talking about a delay of onset, potentially in Type 1 diabetes, you're tracking to make sure that glucose is aligned in that time.
So, I think nothing would waver in terms of what you've heard, certainly on the Insulet side, though, in terms of we're not hearing much from KOLs in terms of that being, you know-
Type 1
... a preventative or a cure or anything in that regard, but certainly interesting to monitor.
Yeah. And to your point on Type 1, and again, if you don't need to put insulin into the body, then maybe there's an implication or not for insulin pump companies. But, as you said, in the study, even, I think eight out of the 10 patients were CGM, if I remember right, or was it all 10?
I think it was all 10.
All ten.
Yeah.
Okay. But it was a big number, and obviously, you guys had your slide that you put out last week that showed an increased use of CGM after GLP initiation.
Yeah.
which maybe is self-selecting some patients who are going on and caring a little bit more about their disease. So there could be a little self-selection bias in there, would be my view. But that issue aside, I think there's no doubt in Type 1, maybe the science isn't there to say GLPs are going to really make any change in the curve of Type 1 onset or disease. But in Type 2, you know, again, we'll get into the complementary nature in a second-
Sure
... maybe of CGMs and GLP use. But what's your view or the KOLs you talk to, the smarter people than me out there that you talk to about the size of the Type 2 market, of those who are actually using intensive insulin, who may be even using just basal insulin, do GLP-1s impact the size of the TAM? Not use of CGM, and that-
Sure
... we'll come back to that, but the size of the TAM.
Yeah, great question, important question. I think for us, you know, what we know right now is that as we look at the progression and the use of GLP-1 drugs over the past several years, so far we haven't seen a change in the addressable markets in the insulin population. Certainly something that we monitor and will continue to monitor over time. We also know that the incidence of diabetes and obesity, as we think about this global health epidemic, is continuing to move younger and younger. And so even if you're able to delay that onset, you still have this large funnel of people with metabolic health crises that we're trying to address.
So for us at Dexcom, we're really talking in support of earlier stage interventions, and that goes across the industry, and as we think about how do we drive better metabolic health with a variety of solutions. So as Jeff mentioned, we had this slide last week really talking about how doctors are using CGM in conjunction with GLP-1s, and we think that CGM has an incredible role to play as an earlier stage intervention, whether that's as a standalone system, where you see these benefits of really understanding and lifestyle management at those earlier stages, or certainly used to support the outcomes, the great outcomes that people can generate with GLP-1s, whether that's from the perspective of a customer or the perspective of the clinician that's working to manage the titration of that drug and the management of that patient.
Yeah, and I think what's interesting is, you know, one of the questions I continue to get, one, is who's going to pay for-
Sure
... pay for GLPs? And obviously, that's a big public health question. But more importantly is, you know, can you pay for CGM and GLP-1 use? You know, Erik Verhoef at Seagrove has-
Yeah.
has some really good survey data that would suggest 45% of payers think that they would at least be willing to consider coverage in standalone GLP-1 use over the next couple of years for, for a CGM. What are you hearing from payers, or what are you thinking about the coverage, the potential coverage? Because it's nice to say GLP-1 users can get benefit, but if they're having to pay for it out of pocket, it's also gonna be less uptake, we know, than when it's reimbursed.
Yeah, and it, it's, it's an important dynamic to think about the payer as a customer in the diabetes ecosystem as well, and so there's a lot of discussions taking place. And I think it reinforces something that we've been focused on for several years, which is, as we drive and focus on studies that demonstrate health outcomes for CGM systems, you know, at the same time, we need to show that those generate economic outcomes for the system as well. And so across the Type 2 landscape, we've been able to have a few studies that really highlight the cost-saving potential of being compliant with a CGM system. The numbers across multiple studies have been in the $5,000 per person per year of cost savings.
So when you think of Erik's research at Seagrove and the perspective of those early-stage payers, I think they're thinking of studies like that and the relatively smaller cost to a payer of a CGM system to generate that outcome. And then if you can talk about durability of health outcomes, the fact that, you know, if you're looking specifically at the GLP-1 class and thinking, you know, not everyone can stay on the drug. But in that same research, I believe you had nearly 80% of doctors in the Seagrove study saying that they think you can support a durability of outcome and retain weight loss with a CGM for those who can't stay on the drug itself.
There's a lot of compelling early-stage data that we're gonna work to continue to supplement, but you know, we definitely think of the payers as a customer and recognize the importance of continuing to demonstrate the economic viability of the CGM within that ecosystem of care for these customers.
Yeah, and one other interesting, I think, question I keep getting from investors, and it, it's a logical question. I'm just not sure it's a—that it will be true in the end, is, you know, as we've moved beyond the DiaMonD study from 2017 and Type 1 penetration, we all knew Type 1, you're gonna wear a CGM all the time. But as we moved into IIT2 and then into basal, there's always the question of compliance-
Yeah.
Are you gonna wear it 2x a year, 4x a year, every day? I'm getting that question on GLP-1s.
Yeah.
Well, okay, if I'm on a GLP-1, do I really need to use a CGM every day, or when I just kinda kick myself in the butt a couple of times a year, get back on the curve of, of behaving for a while, and then I go off to se... Historically, we've seen when people start wearing these CGMs, they like that daily feedback.
Yeah.
It becomes a lifestyle tool. So is there any reason in your mind to think GLP-1 utilization over a period of a year, on CGM is gonna be any different than it looks in basals or intensive Type 2s?
Yeah, I'm smiling as Jeff's asking this question because I think I've been at Dexcom for five years, and as we've, you know, long thought of how CGM fits into these users, I think many times we've always thought of these intermittent wear cases. Almost every time, as we've seen it play out and we've seen coverage expand, we've been surprised at the upside of how many people want to wear these systems full time. We see the value and actually demonstrate it clinically in the MOBILE trial, when we re-randomize the trial. Those who had the CGM taken away lost half of the outcome, and so there really is an accountability component beyond just the learning that the system provides.
We had a poster at ADA this year that had more than 7,000 of our users who are or customers who are not on insulin therapy, and the average wear time for those those people was greater than 80% of the time they're wearing the CGM. And so I think there's a lot of great emerging data, but people are really benefiting from that feedback and, you know, having worn many sensors myself, I can absolutely affirm that it really does change the way you behave. It changes your thinking, it provides motivation when you see a spike, and you want to bring that down to go for a walk and things of that nature that really reinforce great behavior.
Yeah, fair enough. Good. At your Analyst Day in June, you talked about a non-insulin-using CGM.
Now, when we first all heard this, and I think you're planning on launching that version of that sensor next year, you know, we think of IIT2 and Type 1 on the extreme scale over here. We've got to have Hypo Protect, we've got to have other kind of share data. You want... You know, you really want to protect the patient-
Yeah.
from hypo crises. When I think of a non-insulin sensor, I think, okay, you can take a lot of those bells and whistles away. Maybe the accuracy has to be close, maybe it doesn't have to be exactly, whatever. But it's definitely a lower-end potential sensor.
Sure.
GLP-1 use of a sensor, where does it fit in that spectrum? Is the non-insulin sensor that you were talking about in June, would it be good enough to use in a GLP-1 patient, or is that kind of somewhere in between?
Yeah, so it's a great question. So this non-insulin product that we've talked about and plan to introduce in 2024 will be built off the same hardware as our G7 system. So, there's no compromise in accuracy. We're using the same sensing technique, and we think accuracy is critically important regardless of your metabolic health state. When we think, though, then about GLP-1s and really Type 2 diabetes, it's a spectrum of metabolic health, and you see various stages of the disease, and we see GLP-1s used at all stages. So we have many people who are on a GLP-1 who are intensively managed. We have many people on a GLP-1 who are on basal insulin therapy, and then many who are non-insulin users. So I think, Jeff highlighted...
You highlighted the key really differentiator on who would qualify for our G-series system and who would go to this non-insulin product being those who are susceptible to hypoglycemia risk. So that would be anybody who's on insulin therapy, anybody in that, and additional people who are not on insulin therapy, but do have a risk of hypoglycemia or a hypoglycemic event in their past. Anybody with that risk goes to the G-series. Anybody without it in the non-insulin community, whether they're on a GLP-1, oral medications, they would be aligned to this non-insulin product. And then the way you framed it is correct, that is a different use case. There, you know, those are people looking to benefit more from engagement, from understanding the impact of both their medications, but their lifestyle on glucose management.
If we can reinforce the positive elements of the decision-making by having that sensor on, that's what we'll be looking to achieve with a different software experience than the G Series.
Okay.
-currently.
Yeah. All right. Well, let's move on to maybe a couple of other topics. I want to start on basal only. It kind of was a basal question, but just your press release yesterday, coverage in France.
Sure.
On T1 and IIT2 for Dexcom ONE, and basal, I think, right? It was-
Uh-
No, no, no.
Intensive.
You didn't get basal, and that was gonna be my question of-
Sure.
You know, we saw Abbott get basal, I think, in June, if I remember, right? Basal coverage in France.
Yes.
That opens up, I think there's a few million basals in France, if I remember right. A couple million, if not a few million, 500,000 of the T1 and the IIT2's. Is there a reason Dexcom ONE didn't get into the basal-only category?
Just a separate submission.
Okay.
So the data to support the expansion of coverage to the basal insulin community has been submitted, and would be in the next review cycle. So, nothing, you know, in terms of additional data needing to be generated, just a different matter of timing with those submissions. And we're excited about Dexcom ONE with the expansion of access. So maybe for the audience, for those who might not be familiar with Dexcom ONE, we really have a tiered product strategy in the European markets. Because many of these countries have really segmented their intensive insulin population by those at really high risk, so many people who are on pumps or susceptible to hypoglycemia, and then the broader population who maybe don't have hypoglycemia unawareness, and are using multiple daily injections.
So Dexcom ONE's a system more geared toward that second tier of patients, and one that we can slot into existing coverage and reimbursement like exists in France, in a way that's purely additive to our growth prospects, because we've only been competing currently with our G Series in that high-risk population. So really a nice extension, good momentum that we have across the business internationally on both platforms, and an extension of that strategy playing out now, in a key region for us.
Does getting Dexcom ONE to the G7 wearable, First off, is the timeline still next year for that?
Yes.
Uh-
First quarter.
Yeah, first quarter. Okay. And how much does that improve your competitive positioning in Europe? I mean, Libre 3 isn't covered in all markets.
Sure.
But I think if Libre 3, at a similar cost to a current D1 in a G6 wearable, probably I'd lean, personally, maybe a little bit towards the smaller sensor in Libre 3. So just how much does that, getting to the G7 wearable, really change the competitive dynamics in international markets?
Yeah, it's a great question. Most of the markets in which we're competing with Dexcom ONE against one of the products-
Against Libre 2
... of our competitors, it would be against their second gen or first generation product.
Yeah, that's fair.
And so not necessarily a form factor advantage. So I think the question there is really more about our sensor relative to our existing G6 platform. And G6 is a fantastic product, a real-time CGM, you know, been on the market now for five years, and the results are fantastic. I think incrementally, if you were a customer and you were faced with the choice of coming on a CGM system, the one potential pushback you might have on the G6 system is really form factor. Well, maybe two, form factor and simplicity, just because there's a two, you know, the transmitter is durable. So with G7 or the Dexcom ONE on the G7 form factor, you really take away maybe those incremental things that somebody could push back on. It's a better form factor, it's fully disposable.
You add the premium features and the performance of G7 onto the Dexcom ONE software system. And so I think it just makes us incrementally more competitive for that user who's faced with the choice of adopting a CGM.
Yeah. Okay. Yeah, and I said we were going down basal, but I've kind of segued here over into more G7. So let me just one other question there.
Sure.
Where are you on the adhesive issue with G7? And I think Bluetooth, you've pushed out an improved algo or improved reconnect on the Bluetooth side for G7. Where are we on adhesive for G7? I think that's if there's anything you see on chat boards and all that-
Yeah
... it's a little bit about sometimes the G7 falling off with the adhesive.
Yeah, it's a great question. So with G7, and actually just for the group, with our sensor platforms, we're constantly iterating. We're constantly looking to make improvements, to strengthen survivability, to make the experience of our customers, whether it be on the, the you know, the software or the experience of the sensor itself, even greater. So with G7, you know, the response has been fantastic. But to Jeff's point, you find people every once in a while who maybe the adhesive isn't strong enough and, and things of that nature, very active people, summer months, things of that, that nature. So we do have a adhesive, a new adhesive that has been FDA cleared, that we'll be rolling out, in the system and in the inventory that's going out.
We also, with the G7 hardware or the G7 software platform, have created something that's much more iterative. So our chief technology officer actually pushes his team to iterate our software now almost once a month on average, whereas previously on G6, I believe we had one software update in 2022. Since we've launched the product in the U.S., we've had five, and that includes features like Jeff mentioned with Fast Reconnect, where if you were to go out of Bluetooth range, and you walk back toward your phone, very quickly comes back into range and reconnects your software system and backfills your data.
So some really nice improvements for the user experience, and then just the ability to push out global software updates at a much faster cadence, much more scalable and sustainable in terms of what we can do to add to the software features.
All right. Fair enough. So let me get to my basal questions, I guess. So, you had record new patient starts in the U.S. Medicare channel, last quarter. I think that would suggest basal's off to a pretty darn good start. Are you seeing any difference in willingness on the part of basal-only patients in Medicare versus, I think you said, 60% coverage on the commercial payer side? Don't know if that's a little higher as we speak today, but, any difference in willingness to adopt CGM in the Medicare population versus the commercial channel?
... and not at the customer level or clinician.
Yeah.
We've frankly seen excitement across the board. I think you summarized it very well in terms of the Medicare comment on our Q2 call, of Q2 being a record Medicare patient quarter for us, highly correlated to that expansion of coverage.
Yeah.
Signaling a strong uptake in the basal community. That expansion to the commercial side of coverage actually came in much faster than we expected, and that allows us to be a little broader in our marketing efforts as well, knowing that we can, you know, really pull in a broader group of people who have access to the product at this point. So the response has been great. Typically, among Medicare users on our G-Series system, actually, before this expansion, they tend to be some of our most loyal customers and some of our highest NPS scores across our base. So, we haven't seen a huge kind of resistance among an older generation or population to adopting the technology itself. And we've seen that continue as we've expanded now into basal coverage.
Yeah. And, as part of our GLP work a couple of weeks ago, when we published a note, we kind of recast all our models, tried to segment them out even more. And one thing we settled on was about 10% current U.S. penetration of basal-only-
Yeah
... CGM use in the U.S. We biased most of that towards Abbott just because they've had their cash pay program for so long, and you didn't have coverage until April of this year.
Sure.
Are those two numbers or kind of the two thoughts there, 10% current penetration of basal-only use CGM in the U.S., and Abbott having probably the lion's share of that, fair at this point?
Yeah, I think those are fair assumptions, Jeff, and we, we've published the same estimate on the market penetration of 10%. And I think this is actually one of the things that makes us most excited, because when we look at the history of Dexcom and how we've performed, our strength historically has been when we have equal coverage, and we're on a competitive footing with out-of-pocket costs, and actually better coverage than our competitor at this point, we compete very well, and we get more than our fair share. And so, of that 10%, you're right, we, we haven't had a robust cash pay offering to customers over the years, but now we are in a situation where we have broad coverage and are in a great spot to really go out and win our fair share.
I think you're seeing that dynamic really play out in the marketplace right now with some of the competitive share dynamics-
Yeah
... in this really important expansion of coverage right now. So, incredibly excited. The field team's doing a really good job of capitalizing on this expansion and continuing to, you know, present Dexcom as the leading CGM in the space for those patients.
Would you be disappointed at a 50/50 share split in basal only over the next 12 or 18 months, between you and Abbott?
It's a great question. You know, I think... I don't want to speak on behalf of the team there in terms of what qualifies as excitement or disappointment. I think what we know right now is the team is doing a great job, as I said, fulfilling that, winning their share. And I think most importantly, when you think of what drives share for these users, most of them are treated in the primary care setting and where we haven't historically been as well indexed, although we're seeing incredible momentum there. We have more than half of our scripts now written among primary care prescribers. We've talked about since launching G7, we've had more than 8,000 new prescribers in primary care who, you know, before were unwilling to write Dexcom scripts.
So there seems to be a dynamic where both with this extension of coverage and the product itself being much simpler, that message is resonating, and our field team is really pushing that to capture those type of competitive share dynamics that we envision.
All right.
Huge markets, though. Honestly, both companies could probably do very well as we execute here, but we're obviously biased toward ours.
Yep, yeah, fair enough. All right, so when I think about your U.S. growth, and I want to go over O.U.S in a second, but on, on the U.S. side, I don't have this in my notes. Was it 19% growth last quarter?
21%.
21%.
Yeah.
Okay, so even better. I get in this battle with investors all the time. I mean, my view, and, you know, you tell me if I'm wrong here, but you've got a big base of Type 1. Type 1, I think, is 70% penetrated. You guys say it's lower, but you have a reason to say that, and I get that. But my view is the U.S. number, if we didn't have basal backfilling right now-
Sure
... I don't think you could keep up 20% U.S. growth. And so I look at it as, it's not like I take 20% growth and then add a basal contribution. I look at it as, hey, basal is going to be helping you support 20%-25% growth in the U.S. Now, I know your LRP suggests, you know, kind of mid-ish teens U.S. growth over the next, or 13-15, is that what the LRP calls for? Something like that, over the next 5 years or something. I'm getting my numbers confused. But bottom line is, do we think of basal being additive to kind of a baseline upper teens growth, or, hey, it's a darn good thing we have basal that's going to help us sustain this, you know, well above med tech growth-
Yeah
... but sustain it, not push it even higher?
Yeah, so I think there's potential that both there's somewhere-
Yeah, in the short run, this is longer.
We meet in the middle. Yeah. So I think, as you think about growth potential, obviously, given the size of our base in the U.S., given the size of, you know, our market here and how we've executed over the years, you have to drive a lot of new patient growth just simply given the law of large numbers. And we continue to see excellent growth in our Type 1 population.
Yeah.
We continue to see really strong growth among Type 2 intensives. But simply based on size, you have to drive a lot of incremental volume growth to both retain and then potentially accelerate. Now, the good news here is we just did have the largest expansion of coverage in our history, both with these 3 million basal patients, plus these 3-4 million people with Type 2 who are not on insulin, but susceptible to hypoglycemia. So if we're able to execute there and drive, continue to drive awareness, continue to drive our success, both in channels and with these primary care physicians, I think you have then the scenario you laid out. Certainly, you can retain your growth in what we feel is a premium growth rate, given the size of our business, and potentially accelerate if...
Depending on how we execute. So I think that's where we're at now, but I think there's a way that both of these are correct in some ways.
Yeah. No, fair enough. And just since we're down to about 5-6 minutes, just outside the U.S., I think one of the more exciting things is that, you know, you guys changed your reimbursement or your cost structure there, your pricing structure to some of the nationalized healthcare systems a couple of years ago now. Your biggest competitor has 3.5+, probably 3.8-3.9 million users outside the U.S. right now. You guys are sitting on around 600,000-700,000, I think, and now you've got a product that is in most markets, equally reimbursed-
Correct.
with a product that whether Libre 3 and G7 are pretty darn similar nowadays or not, you've still got that legacy of, "This is the premium product.
Yeah.
I think there's a lot of patients over there who never could get Dexcom and always wished they could, but they had to settle.
Yeah.
Abbott would hate me saying it that way, but, you know, they did. But now there's this legacy view of, "Hey, I can now get access to what legacy-wise tells me is the superior product at similar reimbursement" and all that.
Yeah.
How fast can you close that gap, and does it come from just a bigger share of new patient starts? Does it come from competitive share conversions?
Yeah.
Just how to think about that international growth profile.
So I think we're as well-positioned internationally as our company ever has been. You know, we had 40% organic growth in the second quarter, a really nice acceleration internationally, and strength across the board. We've seen, from a competitive share dynamic, we've seen nine consecutive quarters of market-leading growth in the international markets. And I think this highlights some of the dynamics, Jeff, that you just laid out. It's putting ourselves in a position from a product standpoint to maximize access, and therefore maximize growth. That's the Dexcom ONE G-series portfolio strategy. We've also. I think this is underappreciated. We've talked for several years, as we've committed to driving significant OpEx leverage down the P&L.
We've said that the source of those leverage are primarily gonna be G&A and R&D, but we need to reinvest in our commercial infrastructure in several regions to set ourselves up for success internationally. And so I, I wouldn't want to disconnect the market growth that you're seeing from Dexcom with those investments. We've gone direct in several countries. We've invested in our commercial sales force, and I think you're seeing the fruit of those results take off now in the marketplace to validate those investments. So it's been what I think is kind of the ongoing evidence of a successful few years of really a strategy coming together and setting us up well to continue that growth.
Whether it's share taking, and this depends very much on which country you're in and what the penetration rates are, things of that nature, there's still a pretty large greenfield opportunity, though, in many of these markets, given the sizes of these populations.
All right. Real quickly, just shifting over to AID system. So it sounds like Tandem should have Control-IQ integration with Libre 3 by later this year. Pod wouldn't commit to any kind of timelines with G7 or Libre 3 yesterday, even though I did try to push him on that. But you know, that's probably, let's call it, first half next year. I don't know, maybe swagging that a little bit, but somewhere in there. You know, for all intents and purposes, you guys are 100% market share with Control-IQ and Omnipod 5 right now.
Sure.
The only system integrated G6. Where does that market share go? Does it stay pretty high? Does it stay... Do you battle 50/50 on incremental uptake of AIDs from here? How does that go?
Yeah, so I'll speak to kind of why we have confidence in this population, and it's built, you know, I think, in a reputation that we've established over five years of driving AID systems via a Dexcom sensor. I think we're positioned well competitively because as more competition, integration, optionality comes to the market, we can come to clinicians and say that we have run all of the clinical trials for these systems. They've all been tested and proven with Dexcom sensors specifically. We can speak to the fact that we have more than 1.2 million patient years experience of Dexcom sensors driving AID systems at this point, whether that's Control-IQ or Omnipod 5 or several other integrated systems that we have internationally as well.
So I think we have a great safety profile, and we have great health outcomes that not only drive incredible loyalty of our existing base specific to their Dexcom sensors, regardless of the pump platform that they choose, but it gives us a great reputation with the clinicians as well. So I think, you know, loyalty is very strong in those patients, and then, I mean, I'm not gonna sit here and say we'll have 100% market share. That would take a second degree of hubris that-
Yeah
I don't think we, we have. But I think as we think of those incremental users, whether they're new to pump therapy or somebody potentially coming off of a competitive pump system that didn't have an option for a Dexcom sensor, I, I think we're very confident in our chances to continue to win those incremental customers to our sensing platform as the premium sensor.
All right. Fair enough. Well, we're down to one minute, so let me just ask one last question. You know, pregnancy, I think we could see some, you know, if we get an OGTT replacement or something like that. There's some TAM there, but the bigger TAM in my mind is hospital-based. I know we've been talking about it for a few years, and I know you've got so much growth to manage the next couple of years in other areas. But just talk to me about, real quickly, timeline on the hospital opportunities?
Sure
... and, you know, is it used in only diabetics or even the timeline to maybe being used as other analytes in the hospital setting? So, yeah.
Yeah. So Dexcom sensors continue to be used in many hospital systems, building on the temporary enforcement discretion that the FDA established during COVID. We've learned a ton from this experience. There's been, I believe, more than 30 peer-reviewed journal articles during this time of how CGM performs in the hospital systems. It really is a better alternative, both from a workflow perspective, health outcomes, and frankly, customer outcomes of not having to be stuck your finger every often one hour, while you're hospitalized. Right now, the focus from our team is really on the clinical and regulatory pathway, working with the FDA to leverage the breakthrough designation that they gave, in recognition of the promise of the category, to say: What are the ground rules for performance in a hospital setting?
The way that they've been used during COVID is that our indication and our discretion is for use in anybody who's hospitalized. You do not have to have diabetes, although we know that diabetes patients represent a large amount of people who are admitted to hospital systems. So there's much more to come there. We're generating great data, but we're focused, before committing to timelines, really on working with the FDA to establish kind of this initiation of what does CGM look like and those criteria, and then making sure the product is well suited for that environment.
All right. Well, that's great. That's, I think our time is up. So as a reminder, please join me in thanking Sean for a great overview here of Dexcom. And as a reminder, next presentation is set to begin at 10:15 A.M. Eastern Time, include ICON, Immunocore, Castle Biosciences, and Chimerix. Thanks.