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    TNDM
    Earnings call· Jun 2026(Q2 FY26)

    TANDEM DIABETES CARE Q2 FY26 earnings call TNDM

    Aug 6, 2026 Source

    Executive summary

    Tandem Diabetes Care Q2 FY26 — Strong Execution and Strategic Momentum

    Tandem Diabetes Care delivered a strong second quarter, marked by robust execution against strategic priorities including the Pay-as-You-Go (PAYGO) pharmacy model transition and modernization of its commercial organization. The company achieved significant financial improvements, notably in gross margin and adjusted EBITDA, while advancing its technology pipeline with the FDA submission for Mobi Tubeless and progress on the AIDANET algorithm. Despite initial headwinds from infusion set supply constraints and the PAYGO transition, management remains confident in its full-year guidance, anticipating continued momentum from new product launches and increased pharmacy adoption.

    Highlights

    5
    • Worldwide pump shipments grew more than 10% year-over-year, reaching 33,000 units.

    • Gross margin improved by 5 percentage points year-over-year to 57%, the second highest in company history.

    • U.S. new pump starts from Multiple Daily Injection (MDI) grew mid-single digits year-over-year, now representing approximately 70% of new starts.

    • Pharmacy channel sales increased to 10% of total U.S. sales in its first full quarter, with 45% formulary coverage achieved.

    • Adjusted EBITDA margin increased to 3% of sales, marking the fourth consecutive quarter of positive results.

    Concerns

    3
    • Infusion set constraints from a key supplier created an approximate $8 million headwind on U.S. sales and a greater-than-anticipated impact on international sales in Q2.

    • Initial headwind from pharmacy pumps on revenue was approximately $8 million in Q2 due to upfront reimbursement changes.

    • International sales were impacted by approximately $3 million related to distributor inventory buybacks and de-stocking.

    Guidance & targets

    14
    CategoryTargetConfidence
    Full-year 2026 Worldwide Sales
    $1.065B - $1.085B
    high materiality
    High
    Full-year 2026 U.S. Sales
    $730M - $745M
    high materiality
    High
    Full-year 2026 International Sales
    $335M - $340M
    high materiality
    High
    Full-year 2026 Gross Margin
    56% - 57%
    high materiality
    High
    Full-year 2026 Adjusted EBITDA Margin
    5% - 6%
    high materiality
    High
    Q3 2026 Worldwide Sales
    approximately $265M
    medium materiality
    High
    Q3 2026 U.S. Sales
    $180M
    medium materiality
    High
    Q3 2026 International Sales
    $85M
    medium materiality
    High
    Q3 2026 Gross Margin
    approximately 56%
    medium materiality
    High
    Q3 2026 Adjusted EBITDA Margin
    approximately 2%
    medium materiality
    High
    Mobi Tubeless Scaled Launch
    H2 2026
    high materiality
    High
    AIDANET Pivotal Study
    later this year
    medium materiality
    High
    Q4 2026 Margins
    highest margins for the year
    medium materiality
    High
    Stock-based compensation expense
    approximately $65M
    low materiality
    High

    Segment performance

    2
    SegmentRevenueYoYQoQMargin
    U.S.
    U.S. sales saw measurable improvement in pharmacy adoption, partially offset by infusion set constraints. New pump starts showed impressive sequential growth, driven by Mobi and pharmacy access.
    Pump shipments: 22,000Pump shipments YoY growth: 7%New pump starts QoQ growth: >20%New customers from MDI: mid-single digits YoY growthMobi share of new pump starts: >50%Pharmacy pump shipments: ~10% of total U.S. shipmentsPharmacy sales: 10% of total U.S. salesInstall base: ~325,000 peopleInstall base using pharmacy for supplies: 6%
    $179M5%
    International
    International sales growth was primarily driven by distributor markets, with encouraging traction in direct European markets. Sales were impacted by distributor inventory buybacks/de-stocking and greater-than-anticipated infusion set constraints.
    Pump shipments: 11,000Pump shipments YoY growth: 19%Direct channel sales: ~13% of international revenue
    $75M7%

    Operational metrics

    18
    Worldwide pump shipments
    33,000>10% YoY growth
    Q2 FY26

    Reflects continued demand for Control IQ, new product innovations, and improved channel access.

    U.S. new pump starts
    nearly flatYoY
    Q2 FY26

    Improvement in new start trajectory, led by MDI transitions.

    New customers from MDI
    mid-single digitsYoY growth
    Q2 FY26

    Driven by increasing enthusiasm for Tandem Mobi and pharmacy availability.

    Mobi share of new pump starts
    >50%
    Q2 FY26

    Reflects increasing enthusiasm for Tandem Mobi.

    Renewals
    double-digit growth
    Q2 FY26

    Robust source of business, reflecting high customer satisfaction.

    Pharmacy pump shipments
    ~10%
    Q2 FY26

    First full quarter under PAYGO structure; creates a near-term revenue headwind compared to traditional DME sales.

    Pharmacy supply conversions
    6%
    Q2 FY26

    Existing customers who transitioned from DME benefits to pharmacy for supplies.

    Average monthly ASP for pharmacy supplies
    higher than $350vs original assumption
    Q2 FY26

    Early data is encouraging, but company wants more experience before updating baseline assumption.

    International direct channel sales
    ~13%more than double prior year levels
    Q2 FY26

    Reflects execution of transition strategy to direct operations.

    Distributor inventory buybacks/de-stocking impact
    $3M
    Q2 FY26

    Related to markets transitioning to direct operations and de-stocking ahead of future transitions.

    Gross margin
    57%5 percentage points YoY, 2 points QoQ
    Q2 FY26

    Second highest gross margin in company history.

    Operating expenses
    $159Mrelatively flat YoY
    Q2 FY26

    Continued investment in strategic growth initiatives, global commercial infrastructure, and product portfolio.

    Adjusted EBITDA margin
    3%
    Q2 FY26

    Fourth consecutive quarter of positive results, reflecting benefits of scale and gross margin expansion.

    Stock-based compensation expense
    $16Mdown from 11% of sales in prior year
    Q2 FY26

    Improvement reflects changes to equity granting practices, contributing to 8-point improvement in operating margin.

    Cash and investments balance
    $456Mvs $570M at Q1 FY26 end
    as of Q2 FY26 end

    Change reflects investments in new CRM system, Roche Settlement Agreement payment, and strategic investment in Secure.

    Infusion set constraints impact
    $8M
    Q2 FY26

    Partially offset by pharmacy adoption; greater than anticipated impact internationally.

    PAYGO formulary coverage
    ~45%
    Q2 FY26

    Already approaching the high end of the company's goals for the year.

    C-peptide decision
    expected to be positive
    August 2026

    Expected to eliminate the C-peptide decision requirement for Medicare population, which would be a tailwind for Type 2 adoption.

    Industry KPIs

    8
    MetricValueDetails
    Pricing realized pricehigher than $350USD
    New product launch rampscaled launch
    Procedure volume growth>10%%
    Installed base system placements33,000units
    Segment franchise organic growth6%%
    Sales force commercial capacity builddeployed
    Indicated addressable patient populationunder-penetrated market
    Pivotal trial clinical evidence milestonesIDE approval

    Product announcements

    6
    ProductTypeDetails
    Control IQ+expansion
    Tandem Mobiexpansion
    Freestyle Libre 3+ compatibility (T-Slim)update
    Dexcom G7 15-day sensor compatibility (Mobi and T-Slim)update
    AutoSoft Pluslaunch
    SteadySetlaunch

    Deals & partnerships

    3
    SecureStrategic investment in a private company

    Additional strategic investment in Secure, a private company Tandem has invested in since 2021. Secure provides simple mealtime insulin delivery through a wearable patch, offering a low-tech option for people with insulin-dependent diabetes not seeking an AID system. It complements Tandem's automation-focused strategy and provides insights into a new Type 2 segment.

    RocheSettlement Agreement payment

    Second annual payment made under the Roche Settlement Agreement, contributing to the change in cash and investments balance.

    CIGIAcquisition of technology resources

    Tandem has taken CIGI's technology resources from Switzerland and brought them to San Diego to incorporate into the next-generation Mobi. This technology will be part of a future product launch, not in the immediate term.

    Risks & headwinds

    4
    Infusion set supply constraintsQ2 FY26, expected to lessen in H2 FY26

    approximately $8M headwind on U.S. sales in Q2; greater than anticipated impact on international sales in Q2

    Mitigation: Launch of AutoSoft Plus to reduce demand for allocated SKUs; expected improvement in supplier availability through H2 2026; launch of SteadySet in H1 2027.

    Initial revenue headwind from PAYGO pharmacy modelnear-term

    approximately $8M in Q2

    Mitigation: Offset over time by higher pricing for recurring supplies from new PAYGO customers and existing customers transitioning from DME benefits; momentum building in pharmacy adoption.

    Distributor inventory buybacks and de-stockingQ2 FY26

    approximately $3M impact on international sales in Q2

    Mitigation: Part of the transition strategy to direct operations in international markets.

    Type 2 patient attritionstable over the past five years

    modestly higher than Type 1 rate

    Mitigation: Intentional strategy to be selective and focus on patients with the highest likelihood of success.

    What to watch in Q3 FY26

    5

    Mobi Tubeless FDA clearance and scaled launch

    H2 FY26
    Current510K submitted in Q2 FY26, under review
    TargetFDA clearance and scaled launch initiated

    Why it matters

    This is expected to be a significant inflection point for revenue and market share in the tubeless pump segment, crucial for future growth.

    Our goal remains to begin a scaled launch this year. after which time we'll begin training our field and HCP community on the novel tubeless MOBI feature.

    Q&A highlights

    7

    What areas of friction or surprises have been encountered during the PAYGO transition, and does management still have confidence in the full-year guidance for pharmacy adoption?

    Management is very pleased with the early PAYGO experience, reinforcing conviction in its opportunity. The friction points are normal learning curves associated with implementing a new end-to-end process, with no major surprises. The 10% of U.S. sales through pharmacy in the first full quarter is encouraging, and the company remains confident in its full-year targets.

    I would say there was nothing that was surprising. We feel like we're on track. We're still continuing to work on developing efficiencies.

    asked by Unknown Speaker · answered by John Sheridan

    3 min read7 chapters

    Detailed Narrative

    01

    Strategic Priorities and Operational Momentum

    Tandem is executing against three strategic priorities: reshaping its business model, modernizing its commercial organization, and delivering new technology. This focus led to worldwide pump shipments growing over 10% year-over-year and sequentially in Q2. The company is seeing improved new pump start trends in the U.S., particularly from MDI transitions, and accelerated international adoption in direct launch countries. Significant margin improvement was also a highlight, with gross margin reaching the second highest in company history.

    02

    Pay-as-You-Go (PAYGO) Pharmacy Transition

    The company launched its PAYGO reimbursement model in the pharmacy channel in March, aiming for better economics and broader access. Q2 was the first full quarter of implementation, focusing on updating processes for prescribing, customer support, and order processing. Tandem has achieved approximately 45% formulary coverage, nearing the high end of its annual goal. U.S. sales through the pharmacy channel reached 10% in Q2, reinforcing confidence in the strategy despite an initial $8 million revenue headwind from pumps.

    03

    Commercial Modernization and International Expansion

    Tandem has been modernizing its commercial organization for the past year, deploying a new CRM system to enhance salesforce efficiency and global channel strategy. This supports the U.S. pharmacy transition and direct commercial launches internationally. Direct launches began in the UK, Switzerland, and Austria earlier this year, with France planned for Q4. This strategy aims to better serve customers and healthcare providers while strengthening the financial profile.

    04

    New Technology and CGM Compatibility

    The company expanded its global portfolio with Control IQ+, now having the broadest indication of any AID system in the U.S., including pregnancy. It also received CE mark for pregnancy and Type 2 in Q2. Tandem Mobi is being introduced internationally in over 10 countries by year-end. CGM compatibility has broadened, with T-Slim now compatible with Abbott's Freestyle Libre 3+ in seven ex-U.S. countries, and Dexcom's G7 15-day sensor compatible with Mobi and T-Slim in the U.S., with international markets to follow.

    05

    Mobi Tubeless and Infusion Set Innovation

    Tandem reached a key R&D milestone with the 510K submission for Mobi Tubeless in Q2, designed to transform the existing MobiPump into a tubeless AID system with extended wear technology. A scaled launch is planned for H2 2026, pending FDA clearance. The company is also launching AutoSoft Plus, a new infusion set, in Canada and later the U.S. to help manage supplier shortages. SteadySet, a proprietary 7-day wear infusion set, is in manufacturing scale-up for a H1 2027 launch.

    06

    AIDANET Algorithm and Future Innovation

    Tandem is advancing the University of Virginia's AIDANET algorithm, aiming for a fully closed-loop system for Type 1 and Type 2 users without meal announcements or other user inputs. The system is designed to incorporate user context for personalized responses. The company received FDA IDE approval in Q2 and plans to begin a pivotal study later this year, marking a significant step towards its artificial pancreas vision.

    07

    Financial Performance and Outlook

    Q2 saw record worldwide sales of $255 million, up 6% YoY, and 33,000 pump shipments. U.S. sales were $179 million, up 5% YoY, with 22,000 pumps shipped. International sales totaled $75 million, up 7% YoY, with 11,000 pumps shipped. Gross margin was 57%, and adjusted EBITDA margin reached 3%. The company reaffirmed its full-year sales and margin guidance, expecting Q4 to achieve the highest margins due to increasing pharmacy supply orders and direct European presence.

    AI-generated summary of the company’s earnings call. Not investment advice.