Kevin Ronald Sayer - DexCom, Inc.
Management
Well, Germany has been very successful for us. While we've grown quite a bit in Germany, it's still only about 20% of our total international revenue. So, it's not as big as it can be. We have contracts in place with less than 20% of the payers. We're sitting in front of two of the largest ones with contracts that should be executed shortly that would get us up to 50% of contracted reimbursement with the payers we have been contracted with. We can process those claims and get paid, but it's very much one-off and requires a lot of documentation. So, Germany will provide us some significant growth opportunities going forward. With respect to our estimates for the year and our pump patients, there are a number of factors that we look at as we weigh this. Again, we have our Medicare situation. We have a robust pipeline of potential new patients to serve without promoting it. Once we got this, we're excited we think we can add a number of patients there. We think on the patient number front, that would offset some softness on the pump side, and possibly more than offset any softness on the pump side, where the Medicare model is a little bit different, is the revenue we derive from a new patient when we add them. And if I can give you an illustration, you all know if we go back in time or if you look at a new patient, the initial transmitters and a receiver and three sensors, the hardware is between $800 and $900 and three boxes of sensors just for the sake of being simple, let's say they're $300 apiece or $75. So, you've got somewhere between $1,500 and $2,000 to startup a new patient. On the Medicare side, as you've all read the CMS rulings, we're not going to get that big of an upfront payment. We will be getting – us or our distributors will be getting rental payments on the receiver over a 13-month period and the average payment per month on the disposable components would be somewhere between $205 and $300. So a new patient in that first quarter of use will bring us somewhere $750 to $900. So even if we grow the patient base significantly past the 270,000, if a number of them are Medicare patients, it won't have the immediate pop that we've experienced in our commercial business in the past. As we look out, as we look at the opportunities and the number of patients who continue to request CGM, the number of new non-Medicare patients in our pipeline, we're comfortable with our guidance for the year in spite of all the other diabetes news that is out there and we plan on achieving those goals. And second quarter, typically for us, has been up over first. We certainly expect that it will be much better than the first quarter and we'll see how it goes from there.