Q3 2025 Senseonics Holdings Inc Earnings Call

Speaker #4: Please stand by . We're about to begin . Good day , everyone , and welcome to today's Senseonics third Quarter 2020 Earnings Conference Call .

Speaker #4: At this time , all participants are in a listen only mode . Later , you will have the opportunity to ask questions during the question and answer session .

Speaker #4: And please note , today's call will be recorded . I'll be standing by should you require any assistance . And it is now my pleasure to turn the conference over to Mr. Jeremy Feffer from Lifesci Advisors .

Speaker #4: Mr. Pfeffer , please go ahead , sir .

Speaker #5: Thank you . This is Jeremy Feffer from Lifesci Advisors . Before we begin today , let me remind you that the company's remarks include forward looking statements .

Speaker #5: These statements reflect management's expectations about future events , operating plans , regulatory matters , product enhancements , company performance , and other matters , and speak only as of the date hereof .

Speaker #5: These forward looking statements involve a number of risks and uncertainties . A list of the factors that could cause actual results to be materially different from those expressed or implied by any of these forward looking statements , is detailed under Risk Factors and elsewhere in our Annual Report on Form 10-K for the year ended December 31st , 2024 , and our 10-q and our other reports filed with the SEC .

Speaker #5: These documents are available on the Investor Relations section of our website at . We undertake no obligation to update publicly or revise these forward looking statements for any reason except as required by law .

Speaker #5: Joining me today from Senseonics are Tim Goodnow , President and Chief Executive Officer . And Rick Sullivan , chief Financial officer . I'll now turn the call over to Tim .

Speaker #6: Thanks , Jeremy . And appreciate everyone's time . Joining us today . As mentioned in our earnings release earlier today , the third quarter was truly exceptional for Senseonics .

Speaker #6: We're pleased to see the growth in interest and adoption of Eversense . 365 , supported by Senseonics , DTC campaign and sales efforts .

Speaker #6: Our third quarter revenue grew by 90% from Q3 last year . During the quarter , we also executed a memorandum of understanding with Cynthia .

Speaker #6: Diabetes care to re-assume control of Eversense commercialization . We're excited about the upcoming change and seeing it as enabling us to control the strategy and investments into building Eversense through this change , commercialization efforts will continue to be led by Brian Hansen , who has been appointed as Chief Commercial Officer of Senseonics .

Speaker #6: I'll provide some additional details on the progress we've made with the Ascensia CGM division in a few minutes . But first , I'll share some additional accomplishments from the third quarter .

Speaker #6: This time last year , we committed to doubling the number of patients on Eversense in 2025 , and we are on track to achieve that goal .

Speaker #6: The 90% year over year revenue growth in the third quarter was driven by 160% in new patient shipments for the quarter over the prior year period .

Speaker #6: These growth numbers are a testament to the effectiveness of our direct to consumer marketing , which we continue to invest in driving demand with patients asking their physicians to prescribe the world's only 365 day continuous glucose monitor .

Speaker #6: During the quarter , we made meaningful DTC investments to augment ascensia spend , leading to an increase in patient leads through our digital campaigns of 300% year over year and 85% sequentially .

Speaker #6: Approximately 60% of our new patients in Q3 originated from our DTC advertising , and 40% from HCP referrals . A historically larger portion .

Speaker #6: Now coming from DTC due to the scaling of our direct to consumer strategy and investments . We will continue to invest in direct to consumer marketing , primarily through social media .

Speaker #6: Our increased spending has directly contributed to our increased number of leads prescribed referrals and prescriptions written in the third quarter . We continued to break records for the most new patient starts with September being our highest number of new patient starts in a month , and Q3 being our highest quarter in the company's history .

Speaker #6: New insertions increased nearly 150% year over year , and more than 50% sequentially . As a result , our installed base grew over 150% year over year and nearly 40% sequentially , reflecting accelerating adoption of Eversense 365 among both patients and providers .

Speaker #6: As expected , reorder volumes were minimal for the quarter following the one time transition to the 365 day sensor . This means that essentially all of those patients inserted with Eversense in the quarter were new users .

Speaker #6: In Q4 , with the first 365 adopters coming up for Reinsertion . Reorders will make a more meaningful contribution to sales . Our ACP channel continues to expand and deepen engagement , as well .

Speaker #6: The number providers actively prescribing Eversense grew more than 55% year over year , reflecting broadening awareness and confidence in the 365 day system .

Speaker #6: Importantly , we added 75 new trained Inserters in the quarter , 140% more than the same time last year . The capacity of our Inserter network continues to expand , ensuring continued access and scalability as demand accelerates .

Speaker #6: Many of these new patients that we added are now supported by our Eon Care Direct insertion business , which provides greater access to Eversense through our network of providers .

Speaker #6: Eon care delivered a standout quarter , advancing its role as a key strategic driver of insertion capacity , access and standardized patient experience .

Speaker #6: While still early in its development , Eon now represents approximately one quarter of all insertions nationwide , and we continue to expand Ian's capacity by adding significantly more inserters in the network in Q3 .

Speaker #6: Eon is a central enabler of nationwide access and adoption . Patients love the convenience and affordability , and prescribers appreciate having a trusted , certified eversense inserter .

Speaker #6: They can refer patients to . We will continue to expand Ian's capacity in Q4 and beyond as it becomes an increasingly important enabler of Eversense growth in new product development .

Speaker #6: Our CE Mark application for Eversense 365 in Europe was submitted in February , and while in the final stages of review , we continue to expect to receive the approval before the end of 2025 .

Speaker #6: Approval in Europe is anticipated to support additional growth beginning with our planned launch in the first half of 2026 . Now , utilizing our own Senseonics European sales force after the transition away from the Ascensia BGM team prior to the European launch of 365 , we expect to work with Ascensia through transition service agreements .

Speaker #6: While we set up our own infrastructure to support a smooth transfer of some employees, the hiring of a new CGM, dedicated sales reps, and transferring current customer contracts and tender agreements is in contrast with the U.S. commercial integration, which we expect to be in place by January 1st. The European transition will be taking place in the first half of 2026, with support from ADC.

Speaker #6: We are currently finalizing these arrangements with Ascensia and planning this transition in a collaborative process . We've made good progress since the announcement in early September .

Speaker #6: Nearly all of the employees from ADCs US , CGM business have elected to join the Senseonics team for the planned transition . On January 1st , including Brian Hansen leadership team .

Speaker #6: The European CGM employees are expected to transition over later in the first quarter . The sales operations team has been extremely busy getting our CRM system up and running , and many of our distribution agreements between the distributors and Senseonics are already in place .

Speaker #6: Or in the process of being transitioned . We appreciate the cooperation between the Senseonics and ADC teams who are working hard to ensure that we get this right for the patients and the providers .

Speaker #6: I'm pleased with the execution that has taken place over the past 60 days to bring Ascensia CGM business into Senseonics. Our partner Sequel is working towards expanding its launch of the Twist insulin delivery system to include compatibility with Eversense 365, representing another top line growth driver for us in 2026.

Speaker #6: As the first pump integration . We are excited for the opportunity to be part of the closed loop system with sequels , twist pump making , insulin delivery decisions based on the data received from Eversense .

Speaker #6: We expect this closed loop system to allow patients to forget about glucose monitoring for an entire year . As there , ever since 360 .

Speaker #6: Five communicates directly with the twist for real time adjustments in insulin delivery . Beyond sequel , we hope to make additional announcements on insulin pump integrations in the coming quarters .

Speaker #6: In addition to the integration work , our R&D team remains focused on delivering our seminal pipeline of products Gemini and Freedom . With the IDE for Gemini on track to be submitted in the fourth quarter and the US approval still planned for late 2026 , we expect to file the IDE for freedom in the second half of next year with a commercial launch of our truly invisible transmitter , three .

Speaker #6: 65 day CGM targeted by early 2028 . I also would like to highlight the margin improvements that Rick will speak to . We are currently seeing meaningful improvements from the 365 product , and expect to see even more as a result of the commercial integration .

Speaker #6: Based on what we've seen in the first three quarters of 2025 , we are on track to hit out of the year with gross profit margins .

Speaker #6: Now north of 40% compared to 25% at the end of 2024 . Based on the benefits and performance of Eversense 365 . And we expect our transition with ADC to further positively impact our margins .

Speaker #6: As noted , when the deal was announced , we currently project that our gross margin would grow to roughly 50% in 2026 and reach approximately 70% at scale for the unified business .

Speaker #6: Hopefully , this update on our growth drivers and our strong performance during the first year of Eversense 365 launch gives you a good sense of where we are headed to continue to drive shareholder value and meet the needs of our patients and providers .

Speaker #6: We remain committed to expanding access to our unique system and continuing to advance our technology to simplify glucose testing for people with diabetes .

Speaker #6: I'll now turn the call over to Rick to walk through the Q3 financials , highlighting revenue growth , margin improvement , cost reduction , and steady progress on execution .

Speaker #7: Thank you , Tim , and thanks to everyone for joining us . This afternoon . First of all , this has been an extremely busy quarter for Senseonics .

Speaker #7: And I'm grateful for all the team has achieved this quarter . Since announcing our plans to Reassume CGM commercial operations from Ascensia Diabetes Care , we've made enhancements to the CRM system , expanded our ERP system , planned the transition of most of the necessary contracts with us distributors , and have offers accepted from almost all of the US employees .

Speaker #7: Joining Senseonics from Ascensia . We continue to invest in DTC advertising , and as we've said previously , we plan to continue this spend for the foreseeable future .

Speaker #7: This investment has been extremely helpful in driving awareness and adoption , as evidenced by our strong top line revenue growth . As you may have seen with support from our shareholders , we executed a reverse stock split .

Speaker #7: This was an important step for the company as we had the opportunity to speak with many investors that were interested in the story , but were unable to invest in a sub $1 stock .

Speaker #7: The reverse split enables access to new large investors and significantly simplifies our cap table . Following the split , we currently have approximately 41 million shares of common stock outstanding .

Speaker #7: Now transitioning to the quarterly results in the third quarter of 2025 , net revenue grew 90% to 8.1 million , compared to 4.3 million in the prior year period .

Speaker #7: On the strength of top line Eversense 365 US revenue , US revenue for the third quarter was 6.4 million and revenue outside the US was 1.7 million .

Speaker #7: Also , as a quick reminder regarding revenue recognition through our collaboration agreement with Ascensia , we recognize a portion of the Eversense revenue under our revenue sharing agreement with the expected transition from Ascensia distribution .

Speaker #7: We anticipate that we would recognize 100% of revenues due to elimination of the revenue share without the collaboration reported revenue in Q3 would be nearly 20% higher based on the current channel mix , and we expect a similar channel mix going forward .

Speaker #7: We also sell product through an office consignment program , which continues to grow . Now making up over half of our global revenue in Q3 .

Speaker #7: In this channel , we recognize revenue at the time of procedure and at the same time , record a commission expense to sales and marketing expenses based on the current revenue sharing percentage for commercial support , which we also anticipate being eliminated on January 1st in Q3 2025 , gross profit was 3.5 million and increase of 7.5 million from the prior year period .

Speaker #7: This increase in gross profit was primarily driven by the one time charges incurred in the prior year . As a result of the transition from Eversense E3 to Eversense 365 , as well as more favorable margins on the 365 day product sales , research and development expenses in Q3 2025 were 7.8 million , a decrease of 2.7 million compared to the prior year period .

Speaker #7: The decrease was primarily due to the completion of the Eversense 365 system, clinical trials and development efforts, as well as the reduction in headcount.

Speaker #7: Third quarter 2025 selling , general and administrative expenses were 15.3 million , an increase of 7 million compared to 8.3 million in the prior year period , primarily driven by higher selling and marketing personnel costs .

Speaker #7: Promotional expenses , mainly due to the DTC investments Sales Commission expenses to Ascensia . As we increased consignment sales and other general and administrative costs .

Speaker #7: Net loss was $19.5 million , or a 43 cent loss per share , in the third quarter of 2025 , compared to a net loss of 24 million , or a $0.77 loss per share in the third quarter of 2020 .

Speaker #7: For net loss decreased by 4.5 million , primarily due to improved gross margins of Eversense 365 . Sales in the United States and the overall reduction in research and development costs .

Speaker #7: We now expect full year 2025 global net revenue to be approximately 35 million . As we progress the launch of Eversense 365 in the US , this financial outlook takes into consideration several factors , including the timeline for regulatory approval and the planned commercial launch of Eversense 365 outside the United States .

Speaker #7: Plans with respect to spending on the US , DTC marketing campaigns to generate leads . Continued progress in our launch activities , reinsertion and pricing dynamics .

Speaker #7: With the shift from a 6 to 12 month product , the status of other sales and marketing initiatives . And importantly , this excludes any one time accounting adjustments related to the technical review of the final Ascensia agreement , including the transition of inventory back to Senseonics .

Speaker #7: During the business Integration . The full year 2025 financial outlook assumes approximately doubling the global patient base in 2025 compared to 2024 . We achieved our target of approximately one third of planned annual revenue in the first half of the year , with the remaining two thirds of revenue expected in the second half .

Speaker #7: Because of the steady increase in patients and the seasonality of program discounts and patient deductibles, we expect the majority of revenue in the fourth quarter due to the continued momentum in new patient starts and, importantly, reorders from our first U.S. 365 patients as we pass the first anniversary of our Eversense 365 launch.

Speaker #7: Excluding accounting adjustments in one time benefits that have a positive impact to gross profit margins , we continue to see Favourability due to our sales channel mix and the execution of our manufacturing and supply chain teams .

Speaker #7: We are continuing to monitor the impact of tariffs and currently expect that we'll be able to mitigate much of the negative impacts , taking into consideration our margin performance to date , the anticipated continued favorability and excluding favorable accounting adjustments , we now expect full year gross profit margins to be between 35 and 40% .

Speaker #7: As Tim mentioned , we are excited about our margin expansion next year . As a result of bringing the commercialization of Eversense back to Senseonics , and expect gross profit margins north of 50% next year , growing to approximately 70% or more with scale .

Speaker #7: It is still too early to provide guidance for 2026 at this time , as we execute the transition of the commercial team and work closely with them on our financial plans , considering balanced investments in DTC sales force expansion , other commercial programs , inventory balances across the various channels , and inventory , transitioning back to Senseonics depending on the final agreement with Ascensia , we intend to provide initial 2026 guidance in early January .

Speaker #7: We continue to expect cash utilization in 2025 to be approximately 60 million , largely as a result of tight cash management , while meaningfully contributing to the DTC spend .

Speaker #7: Our September 30th cash restricted cash and cash equivalents balance was 111.3 million , and debt and accrued interest was 35.3 million , with that , I'll turn it back to Tim .

Speaker #6: Thanks , Rick . These are exciting times for ever since . And the accelerating growth of our revolutionary 365 day product , we are seeing significant new patient additions and top line growth due to expanding awareness and adoption of Eversense 365 in the US , DTC investments are paying dividends as more people become aware of the compelling benefits of our product .

Speaker #6: Our margins are improving . The sales force is gaining traction . Rep productivity is improving , and we are now entering a cycle where renewals will contribute to the sales .

Speaker #6: As the initial 365 patients restart the clock on 365 days of carefree , continuous glucose monitoring . The Gemini and Freedom programs are advancing , and our European approval is on track , as is our compatibility with sequels .

Speaker #6: Twist , insulin pump . We are making good progress in executing the transition to resume control of Eversense commercialization and look forward to our full independent direction in a couple of months .

Speaker #6: Overall , this was a record setting quarter , highlighted by all time highs in new patient shipments , insertions , and installed base .

Speaker #6: Our hybrid DTC and provider model , amplified by Ian Care's growing network , continues to accelerate awareness , access , confidence and growth in ever since 365 and positioning us for sustained growth .

Speaker #6: Heading into 2026 . Thank you all for joining us today and for your continued interest . With that , I'll now turn the call over to the operator to answer any questions that you may have .

Speaker #6: Operator , let's go ahead and open up the call for questions .

Speaker #4: Certainly . Thank you , Mr. Goodenough . Ladies and gentlemen , at this time , if you do have any questions or comments , please press star one on your telephone at this time , you can always remove yourself from the queue by pressing star two .

Speaker #4: And again , that's star one for questions . We'll go first . This afternoon to Matt Miksic of Barclays . Matt , please go ahead .

Speaker #8: Hey , thanks so much for taking the questions and congrats on all the great the great progress . I wanted to follow up on on some of the some of the some of the growth opportunities that you've shown in DTC .

Speaker #8: And I have one one other quick follow up . So just on the new patient implants which which made up the majority here in Q3 , can you talk a little bit about what you're learning , if at all , about the you know , where these folks are coming from ?

Speaker #8: Terms of new , in terms of , you know , tired of of externally worn sensors , you know , just just color .

Speaker #8: Color would be super interesting and helpful to understand . You know , where the demand is coming from . And then , as I mentioned , I have one quick follow up .

Speaker #6: Sure , Matt , appreciate the time as well . So overall , geographically , it's a very nice distribution as you know , we are certainly focused on obviously the highest prescribing .

Speaker #6: You know , best reimbursement , highest insulin utilization . So you know , no one locale , I would say is driving it .

Speaker #6: But we are definitely seeing and we gave a hint to it is we are seeing a significant growth in the number of switchers .

Speaker #6: So as you may recall , we typically saw about 75% were folks that were coming from existing CGM . And now it has increased DTC .

Speaker #6: We're seeing that right around at 90%. So we clearly are reaching out to the folks that are currently on CGM. I would say of those switchers, it's probably 60% to 65% coming from Dexcom and 35% to 40% coming from Libre.

Speaker #6: So , so good distribution . There . Typical demographics . We're still seeing a nice utilization and interest in the in the Medicare space with probably , you know , two thirds of it still coming from from commercial pay .

Speaker #6: So hope that helps .

Speaker #8: Yeah . No . Absolutely . And then just want to follow up the integration with with with twist . You know maybe if you could talk a little bit about how that ramps I know I know , you know twist and sequel are now kind of ramping up their launch .

Speaker #8: You know , maybe give us a sense of when you think and expect that that'll start to make a note , a measurable contribution that we can start talking about .

Speaker #8: And recognizing the numbers. Thanks again.

Speaker #6: Yeah , Matt , we are we're excited about that opportunity in 2026 . You know they are still executing on some of their early launch activities .

Speaker #6: So our expectation at this point is that our first patients will go on early in the in the first quarter . And that we would ramp from there .

Speaker #6: We've got a number of our large sites that are very interested , but there does need to be enough capacity on the on the pump site to support all of that .

Speaker #6: So my expectation is that for the first couple of quarters , it may be gated by the pump availability , but expecting that later in the year that that'll be an expansion .

Speaker #6: And certainly, we are excited about the work that we're doing with Sequel. We are working with them quite closely. You know, we've got a number of joint accounts that we're already calling on.

Speaker #6: So expect that to be a bigger part later in the second half of the year .

Speaker #8: That's great . Well , congrats again and thanks so much for the color .

Speaker #4: Thank you. We'll go next to Josh Jennings with TD Cowen.

Speaker #9: Hi . Good afternoon . Congratulations on the continued progress with the Eversense 365 launch . I was one of the objectives you've called out Tim has been just enhancing access to ever since 365 .

Speaker #9: And you detailed the Ian care build out . I was hoping to get a better understanding of just how you envision the Inserter network evolving from here .

Speaker #9: Outside of Ian and just how providers are, especially with the Medicare reimbursement that's in place, and some private payers following with bundled payment reimbursement coverage being attractive, potential financial incentive for providers to be implanters. Where do we stand today, and how do you see that evolving as we move forward?

Speaker #6: Yeah , so , Josh , as we've spoken , the Ian is an important part because it really helps fulfill the need for our expansion , really in a lot of the a lot of the primary care focus when we go out and offer the

Speaker #6: course , that's driven by the clinician's perspective . You know , many have an interest in doing it themselves , and they'll they'll institutionalize it .

Speaker #6: We're seeing that in some cases in primary care, where we're getting some of our new Medicare patients from, they don't yet have the installed base to go to where seniors are.

Speaker #6: That's where the Ian care works extremely well . So we'll have a nurse in the area that they can refer to . Somebody that has a nice connection with the , you know , with the with the patients and with the clinical staff .

Speaker #6: And we can work hand in hand to get that all coordinated to , to really help with a white glove type handoff and treatment .

Speaker #6: There are some folks that have recognized the attractiveness from the CPT code and some of our largest prescribers and utilizers come from those as well .

Speaker #6: So they're they're more than willing and more than happy to to institutionalize that , that insertion process and that , that certainly continues to grow for us as well .

Speaker #6: We've got a number of very large accounts that are concentrated on it , because they see the the benefit of eversense for the patients , but also being able to to control that whole insertion process and be appropriately remunerated for it from the CPT codes is attractive for them as well .

Speaker #9: Great . And I just was hoping to to get potential update on just the private payers moving over to the bundled payment reimbursement .

Speaker #9: I know you guys have had some progress in the first half of the year , and how that's trending and how you expect that to trend into 2026 , and then lastly , just with with the growth in in prescribers and the provider community , maybe just give us a sense of , of the mix between Endos and PCP , if that's kind of 50 over 50 or more heavily weighted towards Endos or PCP .

Speaker #9: Thanks for taking the questions .

Speaker #6: Sure, we are still more heavily weighted towards the endos, with the PCP certainly growing in primary care, especially with that Medicare expansion.

Speaker #6: I don't have the exact numbers , but I can certainly get that . And get back to you . Josh on it again , sorry .

Speaker #6: The first part of the question .

Speaker #9: , I was just hoping for an update on just private payers of following CMS's lead and how they expect that to evolve from here , and whether you could have the majority of private payers sometime in 2026 , and maybe too aggressive , but I'd love to hear your thoughts .

Speaker #6: Yeah, I do expect to continue to transition. I would say the first half of the year we had a couple of large payers, and we transitioned United.

Speaker #6: Of course , being the largest . That was one of them that went to the bundled payment . You know , I would expect that to to continue to go as well .

Speaker #6: We are still working on the Kaiser partnership , and I would anticipate it'll go in that direction as well , which would be in 2026 , but otherwise I do expect because of the one time use per year , it is more consistent with the with that buy in bill approach .

Speaker #6: And obviously we'll continue to support that . There are a fair number of folks that continue to to of course , offer it through that DME channel , and we support those with our with our distributors .

Speaker #6: And we'll we'll work as , as best works for those payers , whether it's in that that consignment buying bill or , or the , the traditional DME commercial right now , as you heard us say , it's about half and half .

Speaker #6: But we do expect that that consignment channel to grow faster in 2026 .

Speaker #9: Great . Thanks again .

Speaker #4: Thank you . We'll go next . Now to Anthony Petrone with the Mizuho Group .

Speaker #10: Hi . Good afternoon everyone . Thanks for taking the question . Congrats on on the quarter here . Maybe on the Essentia transition .

Speaker #10: You know , as we head into that Gen one 2026 go live , a lot of the reps from Essentia jumping over . But of course there'll also be a DTC push here from from Senseonics .

Speaker #10: So maybe , you know , what does that push look like ? When is it start ? What will be the commitment at the line ?

Speaker #10: You know , how does that layer in through 2026 . And then I'll have a follow up on new patient starts .

Speaker #6: Yeah . So we've definitely seen progress . Anthony , as you've heard with DTC , you know clearly awareness is an area that we can invest in and continue to grow .

Speaker #6: And it's exciting to bring those new patients to the to the product . You know I would anticipate that the level of DTC that we've invested in , in 2025 will materially be consistent in in 2026 , we'll of course , gate it to the the buying patterns .

Speaker #6: As you'll recall , the fourth quarter is really the largest , especially for , you know , a more expensive piece of medical equipment with new deductibles and so forth .

Speaker #6: In Q1 it tends to tends to soften a little bit . So I do expect that to be a , you know , a material part of the combined investment that we're going to make as the new Senseonics after after January 1st .

Speaker #6: And we do expect that it will continue to to show good , positive trends for us .

Speaker #10: That's helpful . And then DTC new patient starts rather record in three Q record in September , maybe if you could provide a little bit of color on October trends , which would be helpful on new patient starts .

Speaker #10: And when you look at the space in totality , there was just some noise out there . About , you know , had a distributor sort of , you know , D stock kind of event .

Speaker #10: And then , you know , Dexcom had some issues with , with supply specifically . So it seems like some share shifted around .

Speaker #10: It looks like the company gained some of that share , but maybe the competitive , you know , dynamic , how do you you know any any long lasting patterns that you're noticing .

Speaker #10: Anything that's out of the ordinary in type two basal only . So just some of the context on new patient starts in October and how it's shaking out competitively .

Speaker #10: Thanks .

Speaker #6: Yeah . Yeah I would say as , as you're aware , you know , the , the guidance that we've given calls for a very material Q4 and certainly , you know , October is appears to be no disappointment in , in heading us down that path , which is obviously the basis of us of us giving that very guidance , you know , from a supply perspective , there's certainly no issues on the on the other side , we continue to to supply , you know , from a competitive perspective , as I said , I don't know really where it comes from .

Speaker #6: I think the majority of it honestly is to reach right as we get awareness up higher and higher with that DTC investment , we're waking , you know , the first people that typically respond are those that are currently on a product .

Speaker #6: They may be looking for some element , whether it's duration , the accuracy that we have or just that long term , you know , put the sensor in and enjoy it for the next 365 days is really attracting people over to it .

Speaker #6: So no , no supply issues . Certainly no destocking , as Rick has told you , we you know , a sense is kept about 60 days worth of supply in the channel .

Speaker #6: You know , we're going to work to tighten that up in 2026 . But there's been no no impact in 2025 . Basal only continues to be very interesting for us .

Speaker #6: You know , a good portion of our Medicare patients are , you know , our basal only . And those that we convinced to try the product have been very excited with it and very happy with the performance .

Speaker #6: It does take a little bit longer to do the sale on the basal only patients , just because they're coming from more of a naive , naive position on CGM where of course , anybody that might be on a pump or or even MDI just further up that technology learning curve .

Speaker #10: Thanks again . I'll back in .

Speaker #4: Thank you . We'll go next . Now to John Block with Stifel .

Speaker #11: Thanks and good afternoon , guys . Rick , maybe just high level or conceptually for 26 . And I know you don't want to give specifics , but again , just conceptually , do we sort of like take our previous top line thoughts and gross it up by approximately 20% ?

Speaker #11: Or are there some , you know , call it international markets that you might not pursue or more of a scaled back approach ?

Speaker #11: You know , now that you'll be able to go at it from a direct perspective .

Speaker #7: Yeah . Hey , John , thanks for the question . So , you know , as I think about it and I alluded to briefly in my prepared remarks , there's there's likely going to be some inventory dynamics .

Speaker #7: I've mentioned before with Essentia holding somewhere between 60 and 90 days between them . And the other sales channels . And we're going to reduce that .

Speaker #7: We're going to be closer to 30 days . So that means there's 1 or 2 months of of inventory in the channel that we won't recognize revenue on for next year .

Speaker #7: So we're not going to see the full 20%. So it's not as simple as that. But we will see the margin improvement that I've talked about for everything that we do sell.

Speaker #7: So, we will see those margins up at 50%.

Speaker #11: Okay . In the international market , dynamic or TBD .

Speaker #7: So , you know , I think we talked about it briefly . Excited to launch the 365 day product us with our own sales force .

Speaker #7: And so , you know , we made that conscious decision to wait until we had our entities established and had hired our own reps to to really launch the products .

Speaker #7: The way we want to . And so that'll be in the first half of the year . And , and , you know , until then , it's going to be steady state in Europe .

Speaker #7: And then we'll expect to see the similar growth as we did in the US outside the US .

Speaker #11: Okay . Fair enough . Thanks for that color . And then Tim , just to shift gears , I thought I heard you correctly .

Speaker #11: Maybe you alluded to freedom in early 2028, and I thought previously, in my mind, it was late 2027. I know we're talking a ways out, but I was just curious if I've got that correct.

Speaker #11: And then was there anything specific on why that would be a new sort of early 28 versus previous target of back half of 27 ?

Speaker #11: Thank you .

Speaker #6: John . No , no change in the development schedule at all . I was referring to really the the commercial contribution would really be in 28 .

Speaker #6: Right ? As , as the anticipated approval is just that continues to be that in the in the fourth quarter of 27 . But it really has the ability to contribute in the in the 28 fiscal year .

Speaker #11: Fair enough . Thank you .

Speaker #4: Thank you . We'll go next . Now to Ben Haner of Lake Street Capital Markets .

Speaker #12: Good afternoon , gentlemen . Thanks for taking the questions . Just wondering on the DTC marketing spend , you know , as you kind of look at the data there and , you know , slice and dice it by demographics , geographies , what have you , you know , do you see that ?

Speaker #12: X dollars in equals y patients . Do you see any sort of saturation or inflections as you spend more over time ? Or how does that kind of track and , you know , various subsegments of the the folks you're targeting in geographies , you're targeting ?

Speaker #6: Yeah . Thanks , Ben . Yes , there's a number of observations , but clearly as you increase the DTC , there absolutely is .

Speaker #6: You know , a direct increase on the number of patients come to ever since , which is which is good news . It is , however , obviously a conversion process .

Speaker #6: You need to go through . There is quite a bit of education . And obviously we've we've been continuing to optimize the algorithms of who we reach .

Speaker #6: Obviously , the reimbursement for folks that are on insulin is one of the key things that we look for . We did run some pilot work .

Speaker #6: We were doing some linear television , and in that recognize that we got a much , much broader audience . Many of those folks were actually not on insulin , or they were looking for , you know , starter material in the sense of something that they could that they could try for free , perhaps Medicaid patients where there isn't where there isn't good reimbursement yet .

Speaker #6: So we certainly recognize, as you go very broad in the advertisements, you do get less and less in the center of the bullseye.

Speaker #6: So therefore you're , you know , the effectiveness of the investment can drop off in that , in that . So we've tried to stay pretty pointed , pretty geo targeted , as you know , that we can do with the with the investment these days .

Speaker #6: But we also of course tie that to where we make sure that we have good depth of insertion capability gives us an opportunity as well .

Speaker #6: We're approaching 50 million nurses and we're excited . And one of the reasons that we're going to double that to 100 next year is just because of that breadth that we can get with it , and then further expand the the DTC investment from that .

Speaker #12: Okay . Great . Thanks for the color there . And then lastly , for me , I appreciate that you don't plan on giving guidance until January for 2026 , but I think high level you've talked about , you know , kind of roughly doubling patients this year , doubling patients next year .

Speaker #12: And the following year . Has there been any change to your thinking on kind of that high level of patient doubling ?

Speaker #6: No , we're still driving , John , to do exactly that . Ben , I'm sorry . And making the investments that we talked about with , with the DTC , I do want to echo Rick's comments .

Speaker #6: We do have this one time dynamic as we switch from Ascensia and Senseonics , right where they had product in the channel . You know , they kept about 30 days .

Speaker #6: They put up to 60 days when the distributors we're certainly going to try to pull that back . But , you know , in the normal practice , they of course do have that in the channel .

Speaker #6: So that will have a one time impact on 2026 . It's not going to impact patient starts , but since the product is in the channel , they'll need to be some consideration for that .

Speaker #6: For the first 60 days or so of the year , as we as we go through that transition .

Speaker #12: Makes sense . Got it . Well , thanks for taking the questions , gentlemen .

Speaker #4: Thank you . We'll go next . Now to Jason Bedford of Raymond James .

Speaker #13: Good afternoon . Just just a couple quick ones , I guess , on the 35 million in revenue guidance , I think the old guidance was 34 to 38 .

Speaker #13: Just any any details on what changed ?

Speaker #6: No , we're we're right in that range , Jason . I think as we get more fine tuned and manage this , this inventory transition between Essentia and us , it just gives us a little bit better , better visibility .

Speaker #6: As I said , we're still absolutely on track for doubling the patients . So , you know , the revenue behind it is just dictated by timing or , you know , some of these transition accounting dynamics .

Speaker #13: Okay . On the G&A , spend a little bit of lift . There . Is there any way to frame the size of the DTC spend .

Speaker #13: And I assume this continues in the fourth quarter ?

Speaker #6: Yeah . Rick , you want to go through that .

Speaker #7: Yeah . I mean , much of the lift was the DTC spend that we made in the third quarter , and it'll be it'll be similar in the fourth quarter .

Speaker #7: You know , I think we we raised our cash utilization range to the top at 60 . And so , you know , it's somewhere up to $10 million in DTC for the for the year that we're going to be spending to it to bring up the awareness .

Speaker #13: Okay . And then just lastly on on twist , what's left to be done here . Is it all in Sql's hands right now .

Speaker #6: There's joint marketing activities that need to be done . There's some scaling activities that twist is going through at this point . So we're we're essentially ready to go .

Speaker #6: And I know they're getting pretty close as well . So we're down to the , you know , 5 or 10 yard line .

Speaker #13: Okay . Thanks .

Speaker #4: Thank you . We go next now to Sean Lee with H.C. Wainwright .

Speaker #14: Hey guys . Good afternoon and thanks for taking my questions . I just have a couple of ones on the European side of the business .

Speaker #14: I may have missed it , but did you provide an update on the CE mark or the . Ever since 365 . And I also understand that the transition on Europe is expected to take longer .

Speaker #14: Are you also transitioning the Essentia employees over or building a new team from the ground up on that side ? And what else should we ?

Speaker #14: What other color can you provide on the transition process ? There ?

Speaker #6: Sure , sure .

Speaker #7: Thanks .

Speaker #6: CD marketing . Rick . And then I'll let you pick up on the on those transition and and our thoughts on launching 365 on CE .

Speaker #6: Mark . Sean , we continue to be on track . Obviously we'd like to have it sooner rather than later . We did submit it in February , so it has been under review for some time period .

Speaker #6: There are no issues . We are down to the very final stages , so that's why we , you know , we continue to believe that we'll have the approval on it here this quarter .

Speaker #6: Unfortunately , the CE marking will use BSI , they're not actually a little bit less predictable than the FDA is . And I think we're just , you know , we're just in there .

Speaker #6: They're normal process of of final review . So no issues , nothing new . You know we're certainly happy to to get it over to the folks in Europe .

Speaker #6: But with the transition, we are thinking a little bit differently about when to bring it out. And Rick, I'll let you speak to that.

Speaker #7: Yeah . That's right . So we are transitioning the the European business over the first half of the year . And we're in the process of setting up our entities .

Speaker #7: We'll transition the the current CGM dedicated employees and then hire our own sales force . And so there was some 365 contribution that we had previously thought for revenue in 2025 .

Speaker #7: But making the decision to launch the product with our own sales force that we direct and control was certainly the way to go .

Speaker #7: So we'll launch that product in the first half of the year with our own sales force outside the US .

Speaker #14: Great . Thanks for the additional color on that .

Speaker #4: Thank you . And ladies and gentlemen , it appears we have no further questions this afternoon . So that will bring us to the conclusion of today's conference call .

Speaker #4: We'd like to thank you all so much for joining us this afternoon for our conference , and wish you all a great remainder of your day .