Kim Blickenstaff
Analyst · Deutsche Bank. Your line is open
Thanks Susan, and welcome everyone to today's call. Also joining me today is Leigh Vosseller, our Chief Financial Officer. For anyone who has not have had the opportunity to meet Leigh, she assumed our CFO position at the first of the year and is already off to a strong start bringing in passion for Leigh's teams and delivering results. And looking back in 2017, it was a unique year, I am very proud of our ending results and the fourth quarter particularly. We demonstrated our more successful quarter to date with the greatest number of pump shipments and the highest sales in the history of our business, as well as continued gross margin in progress. We also successfully exited with several initiatives such as the launch of the t:slim X2 with Dexcom G5 integration in the third quarter. The launch of our custom t:lock infusion sets also in Q3. The transition of manufacturing to our new facility. And the advancement of our pumps with automated insulin delivery algorithms in the clinical trials. These addition to making meaningful operational progress and process improvements to improve our leverage allowed us to close the year very strong. Our positive momentum from the fourth quarter has continued in the first quarter of 2018. Last month, we successfully completed a $69 million financing which was beyond our original expectations and we anticipate will support our goal on reaching cash flow breakeven in the second half of 2019. Demand for the t:slim X2 remains strong and we anticipate demonstrating robust growth this quarter compared to the first quarter of 2017. We also reported outstanding results from a pivotal trial for t:slim X2 with Basal-IQ, which features a predictive low glucose suspend algorithm and recently submitted a PMA application for the FDA's review, which keeps us on track for a target to commercial launch the product this summer. We are also making meaningful progress in setting the foundation for sales outside of the United States beginning the second half of 2018. These achievements were make possible things for the resilience, perseverance of hard work of our employees especially over the past year. Thanks everyone including our distributors, suppliers, clinical partners for your continued dedication and efforts that contribute to building our business and improving the lives of people with diabetes. And taking a deeper look at Q4, the high demand for the t:slim X2 which driven by our successful launch of integration with Dexcom G5 Mobile CGM. The X2 is the smallest durable pump in the market and offers big features like color touch screen and Bluetooth radio. When we launched G5 integration in September, we set a new standards in the industry by simultaneously offering the feature of the both current and new t:slim X2 customers. We're able to do so through our revolutionary tool, the Tandem device updater which provides customers the ability to remotely update their pump software using a personal computer. Offering customers this capability underscores our goal to simplify the lives of people with diabetes by using software updates rather than hardware replacements to provide rapid access to new innovations. In a recently report from BQ&A [ph] a leading market research group dedicated the diabetes the ability to remotely upgrade pump software with among the top three reasons survey participants sides for choosing our pump along with good design, the style and the CGM integration. As the only pump company offering this feature, we believe it is a meaningful differentiating factor that tests apart today and for the foreseeable future. As we look to our new customers in the fourth quarter came from, it was great to see that more than half continued to report being new to pump therapy. It's a particular note as suggestion Tandem is continuing to expand the insulin pump market and bring the benefits of pump therapy to more people with diabetes. Of the customers who report converting from another manufacturer, we are glad to continue to see a high number of former Medtronic customers shows the fees for next year and we saw market increase from the former Animas customers following Johnson & Johnson announcement that they have decided to exit Animas from the insulin pump market. Historically, our shipments to former Animas, our customers who are in the low-teens, in December, we estimated grew more than 20%. As a reminder, Animas shows Medtronic to aid their customers and their transition to another pump. However, our inbound calls and subsequent orders substantially increasing the days following their announcement and they remain high. Early evidence suggest that the t:slim X2 will continue to be highly attractive to Animas users particularly because many Animas customers already use Dexcom CGM and we now offer the only Dexcom integrated insulin pump because Animas customers have a history of selecting an alternative pump to Medtronic. That being said, it's difficult to quantify the long term impact of Animas' decision on our business. Current prospective Animas customers had different options based on where they are within their pumps warranty period. Medtronic is in control the country list which puts us at a disadvantage. However, we believe that t:slim X2 is better aligned with the preferences of Animas users and we will be working hard to communicate the features and benefits of the t:slim X2 and to demonstrate our number one rated customer service the people using an Animas pump as they look to make their new pump purchasing decisions over the upcoming quarters. Overall, we're encouraged by the early interest from Animas' customers and we view this as a potential tailwind through most of 2019. As we look to what is going to help to continue to expand the insulin pump market and attract a high number current pumpers, our efforts to develop new and exciting innovation fall in the three main initiatives. First, automated insulin delivery or AID, which are algorithms for t:slim X2 platform. Two, our next generation hardware platform. And three, connected help. In 2017, the bulk of our R&D resources were focused on advancing our near term automated insulin delivery efforts which are Basal-IQ which we previously referred to is predictive low glucose suspender or PLGS and Control IQ, which is a hybrid closed loop algorithm using TypeZero's technology. Starting with Basal-IQ, this system utilizes Dexcom G5 center values to suspend insulin when low glucose is predicted and automatically resumes insulin delivery when glucose levels begin to rise. Our market research has shown that reducing the risk of hypoglycemia is the number one feature people with diabetes want in an algorithm, particularly at night due to the severity of the complications when left untreated. In January, we wrapped up the clinical trial of this product and support of our PMA, which we recently submitted to the FDA. The results were outstanding and showed that the system achieved the primary outcome of reducing time spent in hypoglycemia by 31% compared to sensor augmented pump therapy alone. These results are especially impressive given mystery participants started out very well controlled with meeting of A1C of 7.3%. Importantly this reduction of time spent in hypoglycemia was accomplished without any increasing the rate of hyperglycemia. We were thrilled to see these clinical results and equally important to us was the feedback and study participants, the system is easy to use and they had a high level of confidence using it without a significant training burden to get started. This support the usability data we presented at the Diabetes Technology Meeting in the fourth quarter, which demonstrated a 99% success rate among study participants who performed a series of critical past using the Basal-IQ system after initial computer based training. We believe the ease of use of our system will give us a competitive advantage compared to the other systems that are currently available and we are preparing to launch the t:slim X2 with Basal-IQ this summer subject to FDA approval. In the fourth quarter, we announced that all new features approved with the t:slim X2 by the FDA in 2018 including our Basal-IQ software will be made available to users for no cost. The tool is necessary for diabetes management can be expensive and this decision support our vision to new technology to reduce barriers that may delay access to ways available feature. Tandem has always been a leader on the consumer technology front, but I believe the launch of Basal-IQ will allow us to compete more effectively on the clinical and therapeutic front. Following the completion of the Basal-IQ trial, I received multiple letters from study participants as well as parents whose elementary school children participated telling their personal story about the system improved the quality of their lives. These letters provide continued motivation throughout our organization to bring this product to market as quickly as possible. We are also making great progress on our second generation automated insulin delivery system the t:slim X2 with Control IQ. Also designed as a software uptake for t:slim X2 users, this system utilizes Dexcom's G6 sensor values and automated insulin delivery technology that we got from the TypeZero. The system increases or decreases Basal insulin to minimize hypoglycemia and hyperglycemia and improve the user's time spent within a targeted glycemic range. The hybrid close look products has all been designed for competing products by providing automated correction analysis which we believe will bring additional benefits to our customers. And our market research people reported a strong preference for t:slim X2 with Control IQ as compared to the competitive system. Our participation in the International Diabetes Closed Loop Trial continues to progress. The trial was started in late 2016, is expected to include up to 360 adults with type 1 diabetes across all of its studies. Early phases of the stay use the Tandem insulin pump and Dexcom G5 sensor as a part of a blood glucose control system that combined these devices with a smartphone running TypeZero's in Control Closed Loop algorithms. The latest series of studies including the first pilot study was completed earlier this year used the fully integrated system. The pivotal trial is plan to commence in the second quarter. Accordingly we believe we are on an attractive file by rolling PMA submission to the FDA in the second half of this year and our goal is to launch t:slim X2 with Control IQ in the first half of 2019 following FDA review and approval. Our R&D efforts over the past year have prioritized bringing our automated insulin delivery products to market. However, we also continue make progress on our next generation hardware platform which we call t:sport. When we first launched the t:slim back in 2012, we were already planning and thinking about what our next generation hardware platform would offer. t:sport is a result of that effort and significant market research, prototyping and a second generation pumping hardware development and testing is already complete. t:sport is about half a size of t:slim and is being designed for people who seek even greater discretion and flexibility with the use of their insulin pump. We anticipate that t:sport will feature a low cost 200 unit cartridge and on pump is a rechargeable battery or a Control IQ algorithm and a Bluetooth radio. It's being designed for years with leading U100 insulin and this year, we plan to conduct research on the use of insulin concentrate as a potential alternative to t:flex for people with greater insulin needs. We're also evaluating offering a 300 unit cartridge alternative as Well. We anticipated clinical trial for t:sport in 2019 and our goal is to launch this product in 2020 or 2021 timeframe. Our third major R&D initiative which we refer to is Connected Health, really touches all of our current and future insulin pumps. Our Connected Health comprised of our t:connect data management application that is currently available by uploading data via USB to display pumping blood glucose and CGM information and has been the number one rated consumer's software since 2013. t:connect ACP which is a version of the data management application for healthcare providers will streamline use for multiple patients and office efficiency. The t:connect mobile application will utilize the capability a t:slim X2's Bluetooth radio to wirelessly upload pump data to t:connect for the first time and receive notification of pump alert forms, integrated other health related information from third party sources and support future pump control capabilities for t:sport. We intend to launch the first generation of our mobile application in the second half of 2018 with a subset of these features. Turning to a different type of growth initiative, we are actively preparing to commence sales outside the United States in the second half of 2018. We recently announced the filing of our medical device application in Canada and anticipate receiving CE mark in late Q1 or early Q2 this year. We expect to operate direct sales and clinical operation in Canada but primarily leverage our other domestic customer support resources. For other geographies, we plan to utilize distributors with mostly existing infrastructure and resources. As you can see 2018 will be another bust year for us. At the heart of our company is a passion to improve the lives of people with diabetes. Our product offerings and development efforts are in support of this mission as our sales and customers service initiatives. In the process, we are committed to building a sustainable business with improving margins and moving toward cash flow breakeven. In combination, these are challenged top priorities for 2018 and over the upcoming quarters, I look forward to sharing our future achievements. I will now turn the call over to Leigh to further discuss our results for the quarter and our financial guidance.