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TD Cowen 46th Annual Health Care Conference

Mar 4, 2026

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Welcome to our session with Tandem Diabetes. My name is Matt Blackman. Very pleased to have with us, senior leadership from Tandem, John Sheridan, CEO, to my left, and Susan Morrison to my far left, Chief Administrative Officer, Executive Vice President, wearer of many hats at Tandem.

John Sheridan
President and CEO, Tandem Diabetes Care

She runs the company.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah. Essentially. Right?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Facts.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Thank you for making the trip out. Really appreciate it. I thought maybe to start we'll sort of take a step back. We'll do sort of a big picture reflection on 2025. There's a lot that went on. I think a lot of it was also behind the scenes for investors, a lot that we didn't see and may not appreciate. Maybe John, if you just take a moment or some moments just to detail some of the most significant drivers and challenges, and we'll call it, you know, in Tandem's transformation. Again, I think a lot has happened that maybe we don't appreciate, and how you see all the efforts, initiatives sort of shaping or reshaping the company's strategic direction looking ahead.

John Sheridan
President and CEO, Tandem Diabetes Care

Well, thanks, Matt. It's good to be here. I think if you look back, in the 2020 timeframe, Control-IQ had come to market, and it was incredibly successful. I think that if you look at the base competition at that point of time, it was outcomes. People wanted a simple device that had great results, and that's what Control-IQ provided. I think as time has gone on, additional competitive devices have come to market, I think the basis of competition has changed. Now its outcomes are still important, but market access is an important element, and so is form factor. I think that, understanding that, we really had to go back and look at the way we run the business.

I think in the 2024 timeframe, we basically devised a strategy that said we're going to do three things. We're going to focus on monetization of the sales force, we're going to focus on new innovative products, and we're going to focus on market access through the pharmacy channel. I think in 2025, you know, we started to see the results of those. In the early part of 2025, you know, we grew the sales force. We provided them new sales models. We've just now implemented a brand new CRM system which substantially improves their productivity. We've also brought on new leadership in the sales team, people who have grown companies from $1 billion to $4 billion and have a strong focus on data and analytics. I'd say previously we were focused on relationships, which is very important.

You've got to do that. When you look at the competitive space we're in today, having data that helps you understand where you should go and what you should say is very important. Those are all things that began to take place through 2025. In addition to that, we decided to go direct in the OUS countries. It's a kind of a two-phase strategy. In 2025, what we did is we implemented all of the IT infrastructure, and this is one of those things that it's a massive amount of work that the team had to do to put in place all of the IT necessary to run a business independently in Europe. We've done that. We've hired the sales force, and in January, went direct in three new countries.

We plan to do the exact same thing this year for three countries. That'll start in 2027. That was very exciting. While we were doing that, we also grew the business, OUS. It was a flawless execution of this system implementation and growing the team. In addition to that, you know, if you look at the innovative aspects of the company, in 2025, we introduced Control-IQ+, which I think is as easy, if not easier to use than anything that's on the market today. We also introduced the FreeStyle Libre 3 on t:slim, and we introduced Android for Mobi. If you look at Mobi is still in its development. We're adding new features all of the time.

Android was a very important feature to add, since when you look at the U.S. market, about 60% of the people use iOS or excuse me, use iPhones.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Eyelets.

John Sheridan
President and CEO, Tandem Diabetes Care

Wow. iPhones.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Data analytics has got a long time to go.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, sorry about that. They use iPhones. Then the other 40 use, and this is for diabetes specifically, use Android. It's a big add to the market that we've got. Then we also started to go into the pharmacy channel, and we learned a great deal in the year. We started off just with Mobi pump and supplies. I think as we got into the third quarter, we realized that we could actually get t:slim supplies into the pharmacy channel. Then in the fourth quarter, you know, just watching what was going on, interacting with the payer organizations, we learned that we can actually do a PAYGO model.

We were planning it, I would say, in the end of the year, we have just begun executing PAYGO. The beauty of PAYGO is that if you look at the four year life of the product, we essentially double the reimbursement for that timeframe. That's a substantial jump in the growth of the company as well as revenue and profitability. We're moving aggressively in that way right now. I think when you look at 2026, you know, we have the same things. We're continuing to emphasize productivity of the sales team. We've got a lot of very exciting new products coming to market this year, including tubeless Mobi, which we think is going to be a game changer for us. We're going to continue to push the PAYGO.

PAYGO is, you know, obviously this is a transitional year for us because we're going to start to give away pumps. The offset of that is the t:slim or the current supplies. We have 325,000 people in the US today that all purchase supplies every month or every quarter. We're going to be working to convert them to the pharmacy channel at the same time. That provides, you know, a huge benefit for us. It offsets the, you know, the cost or the headwind that comes from giving away pumps this year.

Over time, that worked its way out, and I think in a couple of years, you know, we'll be an entirely different company. It's been an exciting year in 2025, and I think we look forward and very excited about our potential to grow the business and also significantly improve profitability as we move forward.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

I'm just going to sort of jump right into it and sort of pay-go, why now? I think you sort of answered it in parts in that opening commentary, why is this the right time now? Obviously, from a competitive standpoint, it's been a disadvantage. Also, again, I'm answering for you, which I should stop doing. Also it feels like the organization's at the right time and at the right sort of place for this to work. Whether it's the momentum in the underlying business such that, you know, the impact is notable, probably not as significant perhaps if the business wasn't performing as well. Why don't I let you answer the question?

John Sheridan
President and CEO, Tandem Diabetes Care

I mean, I would just say that we've learned a lot in 2025 about the pharmacy channel. I think as we've learned, we've taken advantage of the things that we've learned. I think in the latter half of 2024-2025, we began to recognize that PAYGO is absolutely an opportunity for us, why not?

I mean, I think that it does substantially improve the business model. It's, again, it gets us to a point where we expect to see significant growth and profitability and in revenue. More importantly, though, I think that one of the biggest issues, like, when it comes to patients is the cost of the pump, and this substantially changes that dynamic. It also improves the ease of access for a physician. Today in DME, there's a lot of paperwork that's required. It's complicated, it takes time, and you just take all that friction off the table and all they have to do today. I think that from the patient and the physician's point of view, this is an ideal thing to do. It's really why not now?

Why not I think as soon as we understood we could do it, then we started.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. Can you frame how the model is different than some of your peers, whether it's Insulet and Beta? I know the pricing numbers that you put out maybe are a little bit lower than what some of your peers. Just in general, how it's the same and, if at all, different from some of the models we're familiar with some of your competitors.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Sure. I'd say the models are very similar. When you look at the pricing difference, it's not because we're competing on pricing. If you look at the WACs, they're all actually pretty similar to one another. What we've given people as direction for the year is to think about it in terms of about $350 a month per patient when you go through a PAYGO structure. That compares to about $83 a month when you're through DME. The 350 assumes that Tandem is taking there's a rebate that we're paying, for example. It also assumes that potential co-pay assistance. There's also a few other elements that you can layer on from a pricing perspective. We're trying to get more clarity on what that net to Tandem amount is going to be.

350 is the right place to start, and then we'll provide greater updates as we gain more experience in the channel.

John Sheridan
President and CEO, Tandem Diabetes Care

I'd say there's, I mean, first of all, with Insulet, obviously, they've been there for a while. They've done that. They pretty much pioneered the market. There's no question about that. When you look at the other competitors that are out there today, we have the benefit of a large install base. That gives us the advantage of actually converting, you know, the install base to pharmacy as quickly as possible. Like I said, it offsets the headwind that as you start to convert pumps into PAYGO. Our smaller competitors don't have that advantage.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Just remind us again sort of the price lift expectations for supplies and pumps, how we should think about that. You mentioned the $350 per month. I guess the other question that I was curious about is SteadiSet, when that comes out, does that get lopped into this as well? I think you were going to get a premium price in the DME channel. Do you still get a premium price? Just any help on that.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Sure.

John Sheridan
President and CEO, Tandem Diabetes Care

I think with SteadiSet, even if we don't get a premium price, you know, they're going to purchase less over a period. It's every seven days.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yep.

John Sheridan
President and CEO, Tandem Diabetes Care

You might purchase three to four for a month versus 10.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah.

John Sheridan
President and CEO, Tandem Diabetes Care

You know, that immediately gives you the benefit. We'll have to see. It's a bit early. We haven't got it, you know.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

You haven't launched it yet.

John Sheridan
President and CEO, Tandem Diabetes Care

into the system at point.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah. Yeah.

John Sheridan
President and CEO, Tandem Diabetes Care

I think as we do, I think there's no reason why we wouldn't be looking for premium pricing because it is a substantially better product that's on the market today.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. it was $350 per month for the pump, and that would include the supplies as well?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

That's for the supplies portion of it.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Think about it as the pump is $0, and then the supplies are $350 a month.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. I guess the other piece too, and I don't know that it came up on the call, and it ultimately probably proves moot, but does this model now insulate you from Competitive Bidding risk, whatever that may have been, however minimal it may have been?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Yep. It prepares us to actually be able to support more of a pay-as-you-go model. I'd say it's kind of separate because there's going to be a portion of our business, at least the government plans, we're considering those to continue going through DME. I think it does help prepare the organization if it does shift in that direction.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. I wanna frame the rest of the conversation around the inbound that I've been getting, the questions, the pushback, since you reported the fourth quarter. I think maybe the first place to start is just the mechanics of how this is going to work, and if we could sort of break it up. Like, I think it's pretty straightforward for a new patient coming on a pump. Maybe describe sort of how the process is and how heavy a lift it is to get your install base to start going through the pharmacy for supplies.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Sure. John said it well, that it's a patient focus. How do we get the lowest out-of-pocket cost for the patient so that they're best leveraging their benefits? For a new customer, when they call in, we check both their DME as well as their pharmacy benefit, and that helps us shape which direction they're going to go in. We'll have about 1/3 of U.S. lives under coverage for pharmacy in 2026. That's going to scale across the year, but it's also somewhat limiting because we can't market broad-based to people. We don't wanna upset 2/3 of people in the U.S. because we don't have coverage quite yet. It's a very targeted marketing effort, understanding what physicians are in areas where there is more plan coverage. I'm working with the individual to understand what their plan benefits are as we work through this transition.

It is more customized and targeted this year. We do the same thing for our existing installed base. Typically, people are purchasing new supplies every 30 to 90 days, and so when we have that interaction, it's an opportunity to test their benefit and better understand and explain how they can get the lowest out of pocket.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

John Sheridan
President and CEO, Tandem Diabetes Care

The other thing, it's new pumps and renewals.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yes.

John Sheridan
President and CEO, Tandem Diabetes Care

You know, that's just they have to consider that as well. As Susan said, people are purchasing supplies on a monthly or quarterly basis, and that gives us the opportunity to have the conversation and check their insurance coverage.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Right. A new patient, obviously they're going to get a prescription, and it's going to go through the pharmacy channel. The existing installed base patient is going to have to get a new prescription as well, right?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

A new prescription, so-

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

That's the mechanics that are a little bit different.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

That's true. Also just explaining to someone, if you're used to paying a copay, and you've used our product for years, and then all of a sudden you come in and you say, "Wait, you no longer have to pay anything," sometimes there can be a little bit of hesitation. "What's the catch?

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Help me explain what this is." There is an educational curve that goes along with it. You're right, it's making sure they've got the coverage and then working with the prescriber to get that new prescription. Sometimes if they just wrote one a few months ago, they're, "Wait, why do you need a new prescription?

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Right.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

All of those pieces need to align, which is why we're assuming that this happens over a curve throughout the year.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

I think I've got the slide picture in my head, but when you look at sort of the expectations for pumps through the pharmacy versus, supplies through the pharmacy, pumps through the pharmacy is a little bit higher. I think 20% expectation-.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

20% for the year.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

and 10% for supplies, right?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Exactly.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Beause it is a little bit of a heavier lift. It is a little bit out of your control.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

That's correct.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay, that makes sense. I guess maybe we'll get to the sort of the real, I think, hot topic, which is the biggest pushback I get, and I'm sure you hear it as well, is that you're guiding to 10%-11% pumps shipped growth. I just want to start with first, that's pumps shipped, so that's new patients and renewals, correct?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Correct.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

I think that's an important distinction. I don't think you have, but I think you have said more than half of the pumps shipped this year will be renewals. I mean, is it as simple as saying, you know, a little bit more than half of that growth comes from renewals, and a little bit less than half of that 10%-11% comes from new patients? Is that a fair way to frame it?

John Sheridan
President and CEO, Tandem Diabetes Care

That's fair.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Yes.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

John Sheridan
President and CEO, Tandem Diabetes Care

The other thing we've said that's very important is that we expect to see a return to growth in MDI conversions.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

John Sheridan
President and CEO, Tandem Diabetes Care

That's a very important, because we have seen a softening over the last couple of years.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay, new patients with therapy.

John Sheridan
President and CEO, Tandem Diabetes Care

As new patient starts, we'll see growth there.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. I'll get to that in one second. I wanted to also sort of put the, let's call it a mid-single digit new patient growth rate. Those are my words, not yours. That's off of a 2025, I think, decline of, call it, low mid-single digits. Is that the right base? Again, I'm just trying to frame, you know, the, you know, how high a bar, in fact, is implied in this guide. Is that the right way to think about it?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Sure. It was a decline in 2025, a slight decline. When you look at the sequential growth, third quarter to fourth quarter, and some of the drivers behind our adoption in fourth quarter, that's what gives us confidence in the numbers that we put forth for 2026.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Did you grow new patients in the fourth quarter?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

We haven't provided any detail, but we'd say that overall, when we're looking at where our growth is coming from.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

You exited at a higher rate than you did at entry.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

Exactly. It's that trajectory. When you look at things across the year, it painted an interesting picture, and we saw the early growth drivers from, as John mentioned, FreeStyle Libre 3 integration with t:slim. We were in the very early stages, only early access for Mobi Android, but yet we saw contribution. Our Type 2, the expansion of that effort from a marketing perspective. When we looked at each of these elements, we could see where there was a path and a positive trajectory, all of those elements gave us confidence. In addition to pharmacy drives volume, not just a pricing advantage. Cost is one of the biggest barriers for pump adoption today, so by having the pharmacy benefit, it also contributes to volume growth.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

How does that impact renewals? I mean, there's a, you know, it's not day one after four years that people renew. There's a tail to that. Do you think having the pharmacy option, the ability to get back on that pump without having to plop down a $1,000 maybe, contracts that window that we're seeing in terms of renewals, maybe accelerates your close rate, we'll call it? Is that embedded in the guidance, or if it's not, is that a reasonable expectation?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

We still assume about 80% of our pumps are going to go through DME today.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

That is a reflection of this takes time and what our covered lives look like for across the year. I think it's also a big opportunity for us because we can see where people are. It takes a little bit of time to go through this from a renewal perspective, and it puts less reliance on the renewal cycle. As we have more and more people moving to a PAYGO model, we don't need to chase them down to say, "Oh, you need to make sure you need to get that upfront renewal." They may choose to hold on to a pump for six years. For Tandem, you have that ongoing supply revenue. It really puts less reliance on that upfront purchase and really shifts the business model.

John Sheridan
President and CEO, Tandem Diabetes Care

That's a really important point.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Right. They're still paying, so if they don't renew, you're still getting the same value for that patient.

John Sheridan
President and CEO, Tandem Diabetes Care

That's right. It's also there's no seasonality.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah.

John Sheridan
President and CEO, Tandem Diabetes Care

Because it's all now based on the supplies, and people need supplies every month, every quarter.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah, makes sense. Have you talked specifically at what sort of the ramp has been in terms of Type 2 mix? I know historically in any given quarter, before the label, and, you know, the algorithm enhancements had been sort of 10-ish%. Where are we now on that metric?

John Sheridan
President and CEO, Tandem Diabetes Care

We haven't talked specifically. I will say that, you know, if you, if you think about what happened in 2025, we got the approval in, I don't know, sometime in late spring. We started off with a couple of pilots first. In the fourth quarter we went full, you know, full on with the entire sales force. I can say we saw a good deal of growth in Type 2 in the fourth quarter. We haven't said specifically. Now we've got the entire year. I think as we get more, there's more time under our belt selling, I think we'll talk more specifically about it in the future. Right now we haven't said anything. Although, you know, we're very pleased with the adoption that we're getting.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

It's going in the right direction. This one, again, this is the harder part that we can't see.

you have alluded to it, but just all the changes to the sales force, the expansion, but also the, you know, enhanced tools they hav

What have you seen in terms of productivity as sort of the year has unfolded? Again, as I think about embedded in that 10%-11% guide has to be some- You've got a larger, now more productive sales force. Is that the right way to think about it?

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, for sure. We expect, I mean, I honestly, I think that the sales force is something that's p eople talk about the products and they talk about the market access. I think that the sales force is just not, they're not getting the credit for what's going to happen this year. Because again, you know, there's a lot of administrative work that they've had to do in the past because of the systems that we've used. That's going to now go away, and there's a great deal of automation. So that itself is going to drive productivity, and that's happening right now. You know, so I think that plus, you know, I just believe that when we sell a pump or, and you give it away essentially, that that's also a positive.

We just have to get through the reimbursement issues and the pharmacy contracts. I think there's a lot of things out there that are happening that are going to continue to make them productive this year, and I'm counting on seeing it.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Again, I think I asked this on the call, but the pharmacy contracting, how heavy a lift is that? I know there's sort of, there's contracting and then there's, you know, you have to get on the formulary. There's sort of multiple steps here. Again, it's sort of a measure over the next several years, but how challenging is that process?

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

We have about 80% of lives under coverage from a PBM perspective, and then, as we've mentioned, about a third under formulary.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

Susan Morrison
EVP and Chief Administrative Officer, Tandem Diabetes Care

There's work. We've built those relationships, and so a lot of, I'd say the foundational effort started in through 2025, even though we had been talking to them for quite some time in years prior to that. We just needed to have the right product. Once Mobi launched, we were able to have the right conversations with them. There was a lot more receptivity to our entering the channel. We needed to do it in a stage-wise approach. First, building the processes as well as the relationship with the Mobi pump. Once there was more openness, adding on those t:slim supplies.

When we had the discussions with them about how the model should be represented in 2026, there was a great level of enthusiasm, in part because we have high volume, but also because they could see where we allowed them to have access to information that allowed them visibility to greater population health analysis, total cost of care, things like that they assign great value to that we're able to provide to them. Because of that, we're doing this off cycle. It's hard to say exactly where this could go during the year because there's a lot of openness to the discussions. Historically, there was a very strict calendar cycle where we're seeing them having more flexibility to go off cycle in our conversations. Our team is driving that forward.

It is very much about working those relationships and making sure that there's understanding of the value that we're able to provide them.

John Sheridan
President and CEO, Tandem Diabetes Care

We have a specific team that's focused on these downstream contracts, and they have experience, and they have relationships. You know, it is a process that does take time, but I think we've got the right resources in place with the right experience.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

You've already laid some tracks that give you.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

some confidence.

John Sheridan
President and CEO, Tandem Diabetes Care

That's right.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Let's transition and talk about Mobi Tubeless. It might be helpful. We just had a panel, I think, as I was mentioning to you, the panelists were interested in Mobi Tubeless, obviously, very big fans of the algorithm. There's still some questions of what is it, frankly, and how big is it going to be. Maybe if you could just take a second to remind folks in the room, and I don't know if you want to, but you can if you'd like to sort of compare and contrast it with other patch pumps on the market, just in terms of size and wearability. Anything you can give us on that would be helpful.

John Sheridan
President and CEO, Tandem Diabetes Care

Well, first of all, it's the exact same pump as being sold today. It's really we're changing the supplies. There's a new cartridge, and instead of an infusion set, there's an infusion plate. The infusion plate that we're using for the Mobi Tubeless has the seven-day SteadiSet infusion set technology on it. We've done clinical studies with this cannula, and the results have been very positive. You can basically tie it in a knot and it still delivers insulin. By the virtue of the way it's designed, it's painless. The people that have been through the clinical studies really liked it. This is a big step forward.

Again, we're going to have the first extended wear patch pump on the market, which is a big deal. I'd also say that from a size point of view, it's just, it's a little bit bigger. It comes with so many other benefits. I don't think that it's just the fact that it's a patch and it's small. I think that by itself is appealing. I, you know, as I said, when we, you know.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

What would the other benefits be if you-

John Sheridan
President and CEO, Tandem Diabetes Care

You can take it.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah

John Sheridan
President and CEO, Tandem Diabetes Care

first of all. You don't lose your insulin. The patch stays on your body for seven days, and you can change the cartridge. It's a very simple process to do all of that. I said the SteadiSet technology itself today is a very positive. I can tell you that today, if you look at our competitive conversions, number one competitive conversion today is from the other patch maker, and that's because we have a better algorithm. The advantages that they've had in the past have been form factor and market access, and we're changing that today. With that, it gets back to outcomes again, and we know we've got a better algorithm with better outcomes. We expect this product to be a game changer.

Again, it gives people the flexibility to go back and forth between tubed and tubeless if they, if they feel like it. I can just say that's interesting because one of the things that we have been learning is that people who have actually converted from the other patch to our deviceGet the control they wanna see. They're very pleased with the performance. The other thing that they recognize is it's not that big a deal to wear a tube. you know, that's, you know, I think that's the other piece of it. I think that it gives people incredible versatility. It's extended where you can take it off, and it has our algorithm in it. We think this is a winning product, and I think it's going to change the competitive dynamic in the market.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Again, it's a second quarter filing, second half commercialization?

John Sheridan
President and CEO, Tandem Diabetes Care

That's right, yeah.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

out of the gate it'll be available with which sensors?

John Sheridan
President and CEO, Tandem Diabetes Care

All of them. It'll be the same sensors we've got on everything else.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

iOS and Android or iOS?

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, it'll be iOS. It's the same pump. The pump today.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay

John Sheridan
President and CEO, Tandem Diabetes Care

... is integrated with both, you know, the sensors, and it's also integrated with, both iOS and Android.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay. I wanna talk a little bit about the algorithm pipeline. I sort of said this on the last panel. I admitted my ignorance. We're getting to the point, sort of algorithm evolution, where it's getting really challenging, I think, to sort of differentiate between what's what, and particularly as we're now moving to sort of this closed loop, you know, backdrop of algorithms. Where are you with the closed loop algorithm? How important is that? Is there any sort of dramatic change? I guess at the end of the day, it's really about patient burden, right? What does that do versus what we see today with Control-IQ to decrease the amount of interaction burden on the patient.

John Sheridan
President and CEO, Tandem Diabetes Care

Right

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

... to manage their disease?

John Sheridan
President and CEO, Tandem Diabetes Care

Well, we have worked with UVA for the last 10 years. The Control-IQ algorithm came out of UVA. We have a great partnership with them. The reason we chose Control-IQ back in 2015 was because UVA had the most clinical data on it, and the clinical data was very strong. What that does, what that means is the FDA has seen this product many, many times, so when they actually see the study that we submitted, you know, they were aware of it and it's not like something new that they've got to think about. We got the approval. We've been working with UVA since then. We also have our own internal algorithm development team that has also been working on this for the last 10 years. Today we have a fully closed loop algorithm.

We're integrating it onto the pump right now. We intend to begin clinical studies this year for a pivotal study. We've done multiple feasibility studies already. We intend to start our pivotal study this year for the fully closed loop system, which is the data that you need to submit to the FDA to get it approved.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

How is the patient experience different? I mean, I guess at the end of the day, I'm sure it does a whole bunch of things, but if I'm on Control-IQ, I know it's not point zero, today, and then I'm on the fully closed loop, what do I not have to do? Or how is my life different?

John Sheridan
President and CEO, Tandem Diabetes Care

The system is fully closed loop, so you can basically put it on, and you don't have to interact with the pump, and you will get results as good as you get from a t:slim today or Omnipod today.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

John Sheridan
President and CEO, Tandem Diabetes Care

You get very good results without any interactions. One of the things that we've noticed as other products are out there that don't allow you to interact with it, I think the physicians and the patients find that very frustrating. This system here, you can run it in fully closed loop as if you want, but if you prefer to make some adjustments, if the physician feels like there's a better, you know, a setting optimization that will provide better performance, you can do that. I mean, that, I think that's the beauty of it.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

There's a switch. There's a toggle.

John Sheridan
President and CEO, Tandem Diabetes Care

You can go back and forth. Again, you can make adjustments if you'd like to, but at the same time, if you wanna run it in closed loop, you can. I think that gives people the optimum experience. We think this is a game changer. As I said, we're going to start the pivotal study this year.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

It sort of answers my next question, which is how do you adapt the algorithm for primary care physicians? This seems to be how you would.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, I think the benefit of this is it's so easy to use and it's so easy to get on, you know, that it's going to be. I mean, right now I think that there's some fear of complexity when PCPs are starting to engage to use pumps. I think this basically eliminates that challenge. Also I think from the patient's point of view as well, it's much easier to use. Training will be simplified. A lot of things like that that come along with it that have caused friction. I think that as you look at the patient population in Type 1, and as you start to move into Type 2, devices like this are essential.

I think that's really what's going to drive continued growth in the Type 1 end and into the Type 2 space.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

2026 is the RCT, and then I forgot what you said in terms of commercial timelines.

John Sheridan
President and CEO, Tandem Diabetes Care

It typically takes a year to do the study. It's, it'll be a large study, and then it'll probably take another six months to get it through the FDA.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

like 2028.

John Sheridan
President and CEO, Tandem Diabetes Care

About 18, 20 months. Yeah, maybe early 2027, 2028.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Back half of 2027.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, something like that.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Late 2027, early 2028.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah, that's right. Yeah.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Okay.

John Sheridan
President and CEO, Tandem Diabetes Care

Did I say that? That's what I meant.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

It's all right. That's why I'm here. All right, 45 seconds. I may or may not be the investor that's asking these questions. I don't own the stocks, just for full disclosure. I think the question that really sort of on our minds is, all right, let's say you're successful. You know, you check all the boxes on this pharmacy transition, whether it's two years or three years. You know, what is the new Tandem from a growth profile standpoint? You've sort of talked to, again, the gross margins and the operating margins, but from a top-line standpoint, you've historically talked about this being a double-digit grower. Does it become a mid-teens grower? Is it an upper teens grower?

I know you're not going to answer, but just give me some direction in terms of how we should think about the growth and profitability profile if you're able to execute on this PAYGO model.

John Sheridan
President and CEO, Tandem Diabetes Care

Well, I think it's PAYGO plus innovation.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Innovation. Sure.

John Sheridan
President and CEO, Tandem Diabetes Care

I think that we believe that we've got the most exciting pipeline in diabetes. We have a steady flow of very exciting new products that we're bringing to market, and that'll continue to happen. We've got a smaller version of Tubeless Mobi coming to market at some point in the future. We're not going stop working on algorithms, and so I think that that's a very important consideration. I think that when you look at the biggest hurdle that people have when it comes to getting on a pump today, it is cost. By basically providing a pump for free, the best pump on the market with the most exciting features and capabilities, I mean, that's going to drive growth, and it's going to be a significant change from what we've had, you know, been through for the last 10 years or so.

I think we absolutely expect to see double-digit growth, as we've said, and also we've got objectives out there for profitability and for gross margin. We said we'll get to 65% gross margin without pharmacy. We had confidence we can get there with pharmacy. You know, it's just a matter of time. We also said 25% operating margin. I think when you double essentially the revenue, a four year revenue for the product, you give us the chance to get there much faster. I think that we had used 1 million people in the past. We've taken that off now, and I think that as we get through 2026, we'll have a much better understanding of how fast it's v take us to get there.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah. I did notice on the slide that when you reiterated those margins, profitability objectives, there was a plus next to the 2025 now. I don't think there was a plus before. Anyway, that's, I'm going to end it there.

John Sheridan
President and CEO, Tandem Diabetes Care

I'm going to be happy with 2025, I'm going to say that.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Yeah. All right. Well, thank you so much.

John Sheridan
President and CEO, Tandem Diabetes Care

Thank you, Matt.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Really appreciate it.

John Sheridan
President and CEO, Tandem Diabetes Care

Yeah. Thanks, everybody.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Good seeing you guys.

John Sheridan
President and CEO, Tandem Diabetes Care

Thanks for having us.

Matt Blackman
Managing Director and Senior Equity Research Analyst, TD Cowen

Thank you, everybody, for joining us. Thank you.

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