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Dexcom Aims to Expand CGM Benefits to All Diabetic Patients and Beyond · Vanguards of Healthcare by Bloomberg Intelligence

• 0:19
  Speaker 1: Welcome to another episode of the Vanguards of Healthcare series.
• 0:22
  Speaker 1: My name is Matt Hendrickson, the medical technology analyst at
• 0:25
  Speaker 1: Bloomberg Intelligence, which is the in house equity research platform
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  Speaker 1: of Bloomberg LP. Where pleased to have with us today
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  Speaker 1: Jake Leech, CEO of Dexcom, a medical device company pioneering
• 0:35
  Speaker 1: continuous glucose monitors or cgms for short, to help patients
• 0:39
  Speaker 1: keep track of their glucose levels. You can dive deeper
• 0:42
  Speaker 1: into the company and as financials by typing in DXCM
• 0:45
  Speaker 1: equity go on your Bloomberg terminal. Jake, thanks for joining
• 0:48
  Speaker 1: us today.
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  Speaker 2: It's a pleasure to be here. Matt.
• 0:51
  Speaker 1: Jake, I mean you are now? Are you in one month?
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  Speaker 1: And it's your new CEO role of this.
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  Speaker 2: I am, yeah, yeah, I started January first.
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  Speaker 1: Okay, there we go, and so a little over month,
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  Speaker 1: and but you've been with Dexcom for over twenty years now,
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  Speaker 1: and I would just love to kind of hear your
• 1:05
  Speaker 1: story because of how much Dexcom has changed in those
• 1:08
  Speaker 1: twenty twenty two years, your evolution in your career path
• 1:13
  Speaker 1: from your first days at Dexcom until now your current
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  Speaker 1: CEO role.
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  Speaker 2: Yeah, it's an amazing thing to have been a part
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  Speaker 2: of and to be a part of is the development
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  Speaker 2: of this continuous glucose sensing technology, starting way back in
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  Speaker 2: nineteen ninety nine when the company was founded. I joined
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  Speaker 2: in two thousand and four, and the idea was to
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  Speaker 2: try and figure out how do you build this continuous
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  Speaker 2: biosensor that can accurately measure glucose and the whole goal
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  Speaker 2: was to make managing diabetes easier, and so I joined
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  Speaker 2: as an engineer. I had some particular talent in antenna
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  Speaker 2: design and electrical engineering, and so I joined and I
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  Speaker 2: was one of the only electrical engineers at the company.
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  Speaker 2: It was about thirty people there when I joined. The
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  Speaker 2: vast majority of the folks that the company were all
• 1:58
  Speaker 2: focused on developing the technology. We had no marketing, no sales,
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  Speaker 2: we didn't even have a product yet. And over the
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  Speaker 2: years we continue to make the technology better and really
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  Speaker 2: innovate on making the product more reliable, more accurate, and
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  Speaker 2: easier to use for customers. And that's been a journey.
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  Speaker 2: We're now in our seventh generation of technology in the market.
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  Speaker 2: We're working on our eighth generation, and so it's really
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  Speaker 2: been an incredible opportunity to have such an impact on
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  Speaker 2: the lives of people that live with diabetes.
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  Speaker 1: That's great and sol you know, you talked about your
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  Speaker 1: seventh generation of the dex common device. Why don't we
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  Speaker 1: just kind of take a quick step back and you know,
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  Speaker 1: what is the c GM technology, what is it designed
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  Speaker 1: to help patients monitor? And you know, how has that
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  Speaker 1: seventh generation evolved over the previous six.
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  Speaker 2: Yeah, Matt, it's a great question. As you think about
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  Speaker 2: the technology, it's in contact with the glucose molecule under
• 2:53
  Speaker 2: the skin, so we call it subcutaneous. It's in that
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  Speaker 2: zone right under your skin, and it's actually measuring the
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  Speaker 2: concentration of glucose in the body. And why that's so
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  Speaker 2: important is for someone who's trying to manage diabetes, it's
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  Speaker 2: all about managing glucose and trying to keep it in
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  Speaker 2: a normal range. Those of us that don't have diabetes
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  Speaker 2: or pancreas works as normal. We produce insulin, and that
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  Speaker 2: insulin is a hormone that helps us regulate our glucose.
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  Speaker 2: People with diabetes, either type one or type two for
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  Speaker 2: different reasons, but their bodies either don't make insulin or
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  Speaker 2: don't process it. As efficiently, and so they're always in
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  Speaker 2: an effort to manage their glucose. They need to know
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  Speaker 2: what their glucose is. And historically, before continuous glucose monitors existed,
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  Speaker 2: it was all about fingersticks. You poke your fingers, squeeze
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  Speaker 2: their blood onto a test strip, measure it, and you've
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  Speaker 2: got a single reading. There was issues with accuracy on
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  Speaker 2: that your hands are to be super clean, but it
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  Speaker 2: also didn't give you a perspective of how glucose is changing.
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  Speaker 2: And one of the things that's really interesting when someone
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  Speaker 2: wears a CGM for the first time is they don't
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  Speaker 2: actually realize until they wear that CGM how much their
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  Speaker 2: glucose actually changes throughout the day and how much different
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  Speaker 2: foods and it can have an impact. You know, we
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  Speaker 2: often we eat, our glucose goes up a little bit,
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  Speaker 2: you know, pancreas takes over. But with some of the diabetes,
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  Speaker 2: the difference between different food choices can be very dramatic
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  Speaker 2: in their glucose. And so the CGM is really a
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  Speaker 2: tool that teaches them in real time about what's going on.
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  Speaker 2: I mean, one of the beauties of CGM is because
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  Speaker 2: it's real time, it's in the moment. It's an amazing
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  Speaker 2: tool for learning about different foods, activity levels, even how
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  Speaker 2: sleep impacts. And so we have seen a progression of
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  Speaker 2: CGM move throughout into people who don't have diabetes starting
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  Speaker 2: to look at or people pre diabetes starting to use
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  Speaker 2: it because of the benefits and the learning it gives
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  Speaker 2: you about how your body individually reacts to food and exercise,
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  Speaker 2: sleeping things. But getting back to the technology, it was
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  Speaker 2: originally we originally founded to build an implant sensor. We're
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  Speaker 2: trying to build this long term implant that would measure
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  Speaker 2: glucose again in that subcutaneous region. And then right aboy
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  Speaker 2: the time I joined the company, we switched and went
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  Speaker 2: to this the current kind of our chitecture, which is
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  Speaker 2: a disposable sensor. We wear it for a couple of weeks,
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  Speaker 2: you peeled off, you put it on. The first ones
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  Speaker 2: actually only lasted three days, and so part of the
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  Speaker 2: journey of the technology was evolving it so that it
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  Speaker 2: lasted longer. The other big step. There's been many, many innovations,
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  Speaker 2: but one of the biggest ones that we were working
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  Speaker 2: on for many years was this idea that you don't
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  Speaker 2: have to calibrate it all of the previous technologies. Before
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  Speaker 2: our G six R sixth generation technology, you had to
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  Speaker 2: prick your finger still with a fingerstick and enter the
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  Speaker 2: value and calibrate your CDM. And so we wanted to
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  Speaker 2: get to this idea of a factory calibrated where you
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  Speaker 2: just put it on and it gives you glucost readings,
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  Speaker 2: no calibrations required. That was a big part of our
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  Speaker 2: G six technology. G seven has taken it even farther,
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  Speaker 2: which is the current product platform in the market, where
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  Speaker 2: it's improved the accuracy even further. And there's still plenty
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  Speaker 2: of opportunity for us to continue innovating, both on the
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  Speaker 2: wearable technology that's on the body sensing glucose, but also
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  Speaker 2: the mobile app and all the software.
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  Speaker 1: Yeah, and you know, it's one of those things where
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  Speaker 1: every company you always always trying to keep evolving because
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  Speaker 1: if you have to keep evolving to keep up with
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  Speaker 1: the pace. So how does that then with your first year,
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  Speaker 1: as you know CEO entering twenty twenty six, what are
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  Speaker 1: your key priorities kind of to keep that momentum going.
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  Speaker 2: Yeah, if you look at the CGM market and the
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  Speaker 2: benefit that CGM can provide, we're in the very early
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  Speaker 2: innings of the game here in terms of getting this
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  Speaker 2: technology that people can benefit. When as I step into
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  Speaker 2: the role of CEO, obviously having been in the company
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  Speaker 2: for a long time, I have this better understanding of
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  Speaker 2: the innovation the technology that's got us to this point,
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  Speaker 2: and so one of the things we're really focused on
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  Speaker 2: is really continuing to bring new innovations to the product
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  Speaker 2: that truly benefit users, solving real problems for real, real people.
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  Speaker 2: We have many examples of how we've done that in
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  Speaker 2: the past, and I'm really looking forward to bringing even
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  Speaker 2: further new features, new functionality, everything from the product to
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  Speaker 2: the service model. Our goal is to be the premier
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  Speaker 2: glucose sense solution for all users. So that includes the
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  Speaker 2: people that wear the CGM, It includes the prescribers, the
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  Speaker 2: physicians who are helping people with their diabetes management, includes
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  Speaker 2: our partners. We have quite a few partners across different
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  Speaker 2: aspects of our business, whether it's automated insulin delivery where
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  Speaker 2: our sensors are powering closed loop insulin pump systems for patients,
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  Speaker 2: or our digital health partners that are taking in the
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  Speaker 2: glucose data from our systems and then amplifying the value
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  Speaker 2: of it in some way giving users further benefits from
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  Speaker 2: their systems, and so really it's about being the premier
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  Speaker 2: glucose solution. The other thing is really elevating the customer experience,
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  Speaker 2: and we've historically set the bar for service. We've recently
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  Speaker 2: been awarded by Forbes is the top ten of customer service.
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  Speaker 2: But I want to raise that bar. I want that
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  Speaker 2: bar to continue to improve because as we impact the
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  Speaker 2: lives of so many more people, we need to continue
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  Speaker 2: to make this technology really seamlessly fit into their lives,
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  Speaker 2: and there's plenty of opportunity for us to do that.
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  Speaker 1: Interesting, so let's just take a step back with the
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  Speaker 1: products themselves. You talked about the seventh generation sensor that
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  Speaker 1: you have, but it kind of, in my opinion, it's
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  Speaker 1: almost a seven and a half generation because it's extended
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  Speaker 1: the where time from a ten day to a fifteen
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  Speaker 1: day ware. And you were just talking the first generation
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  Speaker 1: was three days, So you're guys, you're doing a great
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  Speaker 1: job of being able to expand that to fifteen days.
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  Speaker 1: How do you convert those patients that are on the
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  Speaker 1: ten day ware into a fifteen day war And then
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  Speaker 1: just on top of that too, is there patients on
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  Speaker 1: the sidelines who are waiting for that fifteen day war
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  Speaker 1: that are saying, Okay, now that that's there, I can
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  Speaker 1: jump in and be able to use the product.
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  Speaker 2: Now, Well, you're right, Matt. We just launched the fifteen
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  Speaker 2: day G seven, so it is the next generation of
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  Speaker 2: the G seven platform, going up to fifteen and a
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  Speaker 2: half days. We actually have this really cool grace period
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  Speaker 2: we call it on the end of the fifteen days.
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  Speaker 2: It gives you extra twelve hours for patients to determine
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  Speaker 2: when it's convenient for them to change your sensor. And
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  Speaker 2: that was really feedback that we got from users from
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  Speaker 2: G six, so we added it with our G seven product,
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  Speaker 2: and so to convert them from ten day, it's actually
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  Speaker 2: quite simple. They need a new prescription for the fifteen
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  Speaker 2: day products, so when they go see their physician, they
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  Speaker 2: get a new prescription fifteen day and then we fill it. Generally,
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  Speaker 2: most patients get our products from a pharmacy, so they
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  Speaker 2: can go in and get their prescription filled and we
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  Speaker 2: have the lowest out of pocket cost when it comes
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  Speaker 2: to cgms out there, we work very very hard to
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  Speaker 2: ensure coverage across all of the different payers, and then
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  Speaker 2: also minimizing that out of pocket for users because what
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  Speaker 2: we know is that is people use the technology, they
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  Speaker 2: get the benefit, and we don't want the cost to
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  Speaker 2: be a bird in there. And so as we've developed
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  Speaker 2: that technology, the fifteen day product is really convenient for
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  Speaker 2: users because they don't have to change their sensor as often.
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  Speaker 2: Where the original G seven was a ten day so
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  Speaker 2: you had a changer sensor three times a month, is
• 9:57
  Speaker 2: now it's just about two. So it is really convenience
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  Speaker 2: for the user. It's also a better we're not shipping
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  Speaker 2: as many sensors. It helps us with capacity. We can
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  Speaker 2: only have to produce less units to serve the same
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  Speaker 2: number of people, but we are obviously adding tons of
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  Speaker 2: capacity because this is a very rapidly growing market.
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  Speaker 1: Well that's the thing, and you know, you guys talked
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  Speaker 1: in your pre announcement that you know you have three
• 10:19
  Speaker 1: and a half million users. Even if you are cutting
• 10:22
  Speaker 1: down the number of you know, sensors per month from
• 10:25
  Speaker 1: three to two, that's still a lot of sensors for
• 10:28
  Speaker 1: a lot of patients per year. But that manufacturing component
• 10:31
  Speaker 1: and that capacity, how much of a difference is the
• 10:35
  Speaker 1: manufacturing process for the fifteen day versus the ten day.
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  Speaker 1: Where is is that part of the transition as well,
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  Speaker 1: or is it something where the ten days now approved
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  Speaker 1: for fifteen day and it's the same manufacturing process.
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  Speaker 2: It's you know, in general, it's the same manufacturing lines.
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  Speaker 2: But what we've done is we've taken everything we've learned
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  Speaker 2: on the ten day platform and applied it to the
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  Speaker 2: fifteen day platform. And so it is a unique build
• 10:58
  Speaker 2: for us. It has unique software on It has an
• 11:00
  Speaker 2: algorithm in the fifteen day product which is the technology
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  Speaker 2: that takes a sensor reading and turns it into a
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  Speaker 2: glucose value for a user. So that is updated technology.
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  Speaker 2: And then we're also we actually updated the patch, which
• 11:13
  Speaker 2: is the the ad tiesive part. We updated that on
• 11:15
  Speaker 2: the ten day in anticipation of the fifteen day. Oh interest,
• 11:18
  Speaker 2: So our product platforms benefit across the board from the
• 11:21
  Speaker 2: different innovations we bring, and so we've refined some processes
• 11:25
  Speaker 2: around making sensors. That has helped us get to that
• 11:28
  Speaker 2: fifteen day where.
• 11:29
  Speaker 1: Yeah, and then it's not just the G seven to
• 11:31
  Speaker 1: fifteen day where that you're launching you're also launching the
• 11:34
  Speaker 1: Stello device. How is the Stello device different from these
• 11:38
  Speaker 1: G seven sensor and based off of technology or what
• 11:42
  Speaker 1: customers it's targeting.
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  Speaker 2: Yeah, Stello is a really exciting product for us that
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  Speaker 2: we launched towards the end of twenty twenty four, so
• 11:49
  Speaker 2: it's only been in the market for just over a year.
• 11:51
  Speaker 2: It was the first over the counter CGM ever approved
• 11:54
  Speaker 2: by the FDA, and we launched that product actually with
• 11:58
  Speaker 2: a fifteen day ware and it was really the reason
• 12:01
  Speaker 2: why over the counter so important is because it opens
• 12:03
  Speaker 2: up access for so many people to be able to
• 12:06
  Speaker 2: experience CGM that weren't able to get it before. So
• 12:10
  Speaker 2: over the counter, it doesn't require prescription, and it's the
• 12:12
  Speaker 2: first time we've ever offered CGM for ninety dollars a month,
• 12:17
  Speaker 2: so it is the lowest price CGM we've ever been
• 12:19
  Speaker 2: able to offer, And so it gives people this ability
• 12:22
  Speaker 2: to just basically you can go on Amazon, you can
• 12:24
  Speaker 2: on stello dot com, order it and get it shipped
• 12:27
  Speaker 2: directly to your house, download the app for free, and
• 12:28
  Speaker 2: then get up and running. So that product has really
• 12:31
  Speaker 2: expanded the use of CGM and we see a lot
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  Speaker 2: of people who have type two diabetes but don't yet
• 12:39
  Speaker 2: have coverage for CGM. If they had coverage, they'd used
• 12:41
  Speaker 2: G seven, but they don't. So there many of our
• 12:45
  Speaker 2: patients on Stello are Type twos that are basically getting
• 12:48
  Speaker 2: the technology and fitting from it while we wait for
• 12:52
  Speaker 2: their reimbursement to come.
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  Speaker 1: Oh that's interesting because you talked about that out of pocketpay.
• 12:57
  Speaker 1: I'm like, oh, so reimbursement will come up for Stello
• 12:59
  Speaker 1: even but it sounds like if you would do the
• 13:03
  Speaker 1: reimbursement pathway, it would just be expanding the G seven
• 13:06
  Speaker 1: reimbursement pathway for those Type two non insulin patients. Or
• 13:10
  Speaker 1: is there still a path for reimbursement for those Stello devices.
• 13:14
  Speaker 2: There even the long run, there is an opportunity to
• 13:18
  Speaker 2: you know, have a CGM that's reimbursed just like Stello.
• 13:22
  Speaker 2: But what we see happening is as reimbursement continues to
• 13:25
  Speaker 2: expand G seven is in the United States here, that's
• 13:28
  Speaker 2: the platform that is covered, and we'll continue to innovate
• 13:31
  Speaker 2: on G seven actually bring some of the Stello features
• 13:34
  Speaker 2: that we've been able to innovate there over to the
• 13:36
  Speaker 2: G seven platform for the users that can benefit. As
• 13:40
  Speaker 2: we see a broader population of users and different segments
• 13:44
  Speaker 2: start to use G seven, we'll keep innovating G seven.
• 13:47
  Speaker 2: You know, the original cgms are really focused for type
• 13:49
  Speaker 2: one diabetes, and as we've expanded our portfolio over time,
• 13:53
  Speaker 2: we started designing for type one, type two on insulin,
• 13:55
  Speaker 2: and now we're starting to see a lot ofmark coverage
• 13:57
  Speaker 2: come for anybody with diabetes, so not only those that
• 14:00
  Speaker 2: treat their diabetes with insulin, but any other medication. And
• 14:04
  Speaker 2: so as we've see that expand we'll keep innovating on
• 14:06
  Speaker 2: the product to meet those needs. And I you know,
• 14:09
  Speaker 2: someday there's a possiblity where we could even see pre
• 14:12
  Speaker 2: diabetes covered. If you think about the one hundred million
• 14:15
  Speaker 2: people in the United States of pre diabetes on their
• 14:18
  Speaker 2: way to diabetes, and you really can make a huge
• 14:20
  Speaker 2: impact on that by providing them a CGM so they
• 14:23
  Speaker 2: can learn about how the different foods and activities affect
• 14:26
  Speaker 2: their levels their glucose levels, so that we can either
• 14:29
  Speaker 2: stop or really slow down that progression towards diabetes.
• 14:32
  Speaker 1: Yeah, and that's a really interesting thing about this spectrum
• 14:34
  Speaker 1: of patients because you got the insulin intensive and they
• 14:37
  Speaker 1: need to measure They need that measurement every five minutes
• 14:40
  Speaker 1: to make sure that whether or not they need to
• 14:42
  Speaker 1: incorporate more insulin, or they need to drink of orange juice.
• 14:45
  Speaker 1: And then the other end of the spectrum, which is
• 14:48
  Speaker 1: the pre diabetes, and they don't need it every day
• 14:51
  Speaker 1: because then it comes with my You know, I was
• 14:53
  Speaker 1: doing my math and you talked about Stello sales being
• 14:55
  Speaker 1: one hundred and thirty million in twenty twenty five. I
• 14:58
  Speaker 1: think my rough math was about thir five million twenty
• 15:00
  Speaker 1: twenty four. You do fifty dollars per cent, or you
• 15:04
  Speaker 1: do five hundred thousand dollars, five hundred thousand users. Since
• 15:07
  Speaker 1: the launch, my math got to six or seven sensors
• 15:10
  Speaker 1: per user, which is coming back to like one sensor
• 15:14
  Speaker 1: per quarter per patient. That's kind of my thought process
• 15:17
  Speaker 1: for those who are not using insulin, because you know,
• 15:20
  Speaker 1: you just need to make sure that you know your
• 15:22
  Speaker 1: trends are going long term trends are on track. You're
• 15:26
  Speaker 1: not progressing as you're saying you're not. Your progression is
• 15:28
  Speaker 1: not accelerated to a point where you need insulin. What
• 15:31
  Speaker 1: are your thoughts about that kind of one sensor per
• 15:34
  Speaker 1: quarter for those non insulin patients. Is that are you
• 15:37
  Speaker 1: in the am I in the right ballpark? Are you
• 15:38
  Speaker 1: thinking that this is an expansion strategy beyond one per quarter.
• 15:43
  Speaker 2: Well, I think we certainly see people that use sensors
• 15:46
  Speaker 2: once per quarter with particularly with STELLO. But the exciting
• 15:51
  Speaker 2: thing about STELLO is it's been a great opportunity to
• 15:52
  Speaker 2: kind of learn how people want to use CGM in
• 15:56
  Speaker 2: a non reimburse environment. What we do see though, is
• 15:59
  Speaker 2: those that have diedabetes, even not taking insulin, benefit greatly
• 16:03
  Speaker 2: from continuous use of the Sensor's not just one per quarter,
• 16:06
  Speaker 2: because it really there's the component of learning that's at first,
• 16:10
  Speaker 2: where you're really educating yourself on the different food choices
• 16:14
  Speaker 2: and lifestyle choices and habits that you have and how
• 16:17
  Speaker 2: it impacts glucose. You start making changes, the CGM shows
• 16:20
  Speaker 2: you how those things are changing. The other amazing thing
• 16:22
  Speaker 2: continuous glucose monitor does is it shows you the effectiveness
• 16:26
  Speaker 2: of whatever glucose lowering medication you might be on, whether
• 16:28
  Speaker 2: you're on a GLP one now we have the oral
• 16:31
  Speaker 2: GLP ones coming out or met Foreman SGLT twos. There's
• 16:36
  Speaker 2: so many different options for treatment of type two diabetes,
• 16:41
  Speaker 2: and so the CGM really shows you the effectiveness of
• 16:43
  Speaker 2: that medication. When you do take in and so adherence
• 16:47
  Speaker 2: is better. The other thing two is there's an accountability
• 16:49
  Speaker 2: component of wearing a CGM continuously, you know, for yourself
• 16:53
  Speaker 2: as well as anybody who happens to be following you
• 16:55
  Speaker 2: with our remote monitoring system. And so it is across
• 16:59
  Speaker 2: the board. We and all the studies we've ever run,
• 17:01
  Speaker 2: whether it was type one tap two, and now we're
• 17:03
  Speaker 2: in the midst of running a large type two study
• 17:05
  Speaker 2: for non insulin users, we see the patients get the
• 17:09
  Speaker 2: most benefit when they use the sensors continuously. That being said,
• 17:12
  Speaker 2: it's really about choice and so users can choose to
• 17:14
  Speaker 2: use them, you know, as frequently or less frequently as
• 17:17
  Speaker 2: they want. I do see an opportunity for there to
• 17:20
  Speaker 2: be check ins. I mean, we also see a lot
• 17:22
  Speaker 2: of STELLO users who don't have diabetes using it. Some
• 17:24
  Speaker 2: use it continuously, a lot of the others just kind
• 17:26
  Speaker 2: of try it out. So it is it is quite
• 17:28
  Speaker 2: a spectrum when it comes down to this non reimversed environment.
• 17:32
  Speaker 1: Yeah, well it's very interesting because actually I have a
• 17:34
  Speaker 1: stello and I've been meaning to try it, and I
• 17:37
  Speaker 1: was going to try it maybe you know, before this conversation.
• 17:40
  Speaker 1: But I also knew it was earning season. I also
• 17:43
  Speaker 1: know I eat more candy during earning season, especially late
• 17:45
  Speaker 1: at night, and I'm like, I don't want to see
• 17:48
  Speaker 1: that spike yet with the during earning season on my
• 17:50
  Speaker 1: stello yet, so I get that accountability platform. And so yeah,
• 17:55
  Speaker 1: we were talking about and like one of the things
• 17:56
  Speaker 1: that we're talking about with this too is the just
• 17:59
  Speaker 1: the reur and this is just you You're seeing how
• 18:01
  Speaker 1: these patients are interacting with the stello. They're purchasing patterns
• 18:04
  Speaker 1: without reimbursement. And it's interesting because you are preparing a
• 18:10
  Speaker 1: randomized trial, which if I did my math right, was
• 18:13
  Speaker 1: it might be presented this ADA in June. And I'm
• 18:18
  Speaker 1: just curious that the trial design because you know, it
• 18:21
  Speaker 1: also seems like, you know, you had this the Landmark
• 18:25
  Speaker 1: Diamond trial in twenty sixteen, you had the Landmark Mobile
• 18:28
  Speaker 1: RCT trial in twenty twenty one, which coincidentally just lines
• 18:33
  Speaker 1: up with all these snowstorms that we're getting in It's
• 18:36
  Speaker 1: you know, we talk about the you know, two feet
• 18:38
  Speaker 1: of snow outside. It's but the last time we had
• 18:41
  Speaker 1: a major snowstorm was twenty twenty one, and then twenty
• 18:44
  Speaker 1: sixteen was also that crazy one, So it just got
• 18:47
  Speaker 1: to be coincidence. But I'd love to hear your thoughts
• 18:49
  Speaker 1: about how this new randomized trial is going to, you know,
• 18:54
  Speaker 1: be that next catalyst or that next inflection point for
• 18:57
  Speaker 1: kind of the adoption of these CGM products.
• 19:00
  Speaker 2: Yeah, the connection to snowstorms is a new one I
• 19:02
  Speaker 2: had heard yet, but you never know. But the important
• 19:07
  Speaker 2: thing around generating access for CGM, one of the most
• 19:10
  Speaker 2: important things is building the evidence that shows the benefits
• 19:14
  Speaker 2: people get from using the technology. And so, as you mentioned,
• 19:16
  Speaker 2: x Com has been the leader in running all of
• 19:19
  Speaker 2: the large randomized control trials that have opened up access
• 19:22
  Speaker 2: for CGM from millions of people, starting with that Diamond
• 19:25
  Speaker 2: study mentioned, which was for patients of diabetes either type
• 19:28
  Speaker 2: one or type two that were taking multiple daily injections
• 19:31
  Speaker 2: of insulin and so multiple we call that intensive insulin therapy.
• 19:35
  Speaker 2: That study showed significant benefit for users that used the CGM,
• 19:39
  Speaker 2: and it was really a combination of CGM versus whatever
• 19:42
  Speaker 2: the standard care was at the time, which was really fingersticks,
• 19:45
  Speaker 2: and so that was how that study showed tremendous outcomes
• 19:48
  Speaker 2: for those that use the CGM. The Mobile study you
• 19:50
  Speaker 2: mentioned next was our study in basal insulin users, and
• 19:53
  Speaker 2: so that's the long acting one injection per day. Really
• 19:57
  Speaker 2: it's a type two therapy. So that study again showed
• 20:01
  Speaker 2: significant improvements using CGM over again fingersticks. What's really interesting
• 20:07
  Speaker 2: about the next study that we're running is it's a
• 20:10
  Speaker 2: randomized control trial in people diabetes that don't use insulin.
• 20:14
  Speaker 2: So that's the majority of people with type two diabetes
• 20:17
  Speaker 2: don't use insulin. These all sorts of other Their physicians
• 20:21
  Speaker 2: prescribe them other medications to lower the glucose. But the
• 20:25
  Speaker 2: interesting is that group is very infrequently measuring our glucose.
• 20:28
  Speaker 2: They don't actually see it very often, and they certainly
• 20:30
  Speaker 2: aren't seeing it continuously in the normal standards of care.
• 20:34
  Speaker 2: And so now with this study we're running, it's really
• 20:38
  Speaker 2: comparing CGM use, continuous CGM use with a standard of
• 20:43
  Speaker 2: care which is not measuring your glucose, and so that
• 20:46
  Speaker 2: has we're really excited about that study. It's wrapping up here.
• 20:50
  Speaker 2: We plan to read it out as you mentioned, the
• 20:52
  Speaker 2: first half of this year, and so it will be
• 20:56
  Speaker 2: we are expected it'll be an important cornerstone for opening
• 21:00
  Speaker 2: access for more people with diabetes around the globe, not
• 21:03
  Speaker 2: just here in the US. These studies that we run here,
• 21:06
  Speaker 2: we've run them in the US, but we use them
• 21:09
  Speaker 2: around the world to grant access as the evidence for
• 21:13
  Speaker 2: access for many different countries. And so this is anoxt
• 21:16
  Speaker 2: important milestone for US and for people with diabetes to
• 21:20
  Speaker 2: generate more access to CTMs so they can get the benefits.
• 21:23
  Speaker 1: Yeah, and so you know, because the patient base is different,
• 21:28
  Speaker 1: are the endpoints different in any way? I know with
• 21:31
  Speaker 1: the diamond and the mobile, you know, you looked at
• 21:33
  Speaker 1: the reduction in a one C you looked at increases
• 21:36
  Speaker 1: in the time and healthy glucose ranges. Are those kind
• 21:42
  Speaker 1: of the same metrics that you're looking at comparing between
• 21:45
  Speaker 1: the CGM and you know, the standard of care.
• 21:48
  Speaker 2: Yeah, it's it's the same metrics HBO and c glucose
• 21:52
  Speaker 2: variability dynamics. We also, though, in all those studies, we
• 21:55
  Speaker 2: also looked at, you know, psychological impact of diabetes and
• 21:59
  Speaker 2: do people feel more confident managing their diabetes when they
• 22:02
  Speaker 2: have a CGM. And the resounding answer to that is yes,
• 22:05
  Speaker 2: because they have the information they need to be able
• 22:08
  Speaker 2: to understand what's going on in better better manager diabetes
• 22:11
  Speaker 2: and get a better outcome. And that's really in the end,
• 22:13
  Speaker 2: this is what this is about getting technology to people
• 22:16
  Speaker 2: that can benefit from it, and so we're really excited
• 22:19
  Speaker 2: about reading this out here middle year.
• 22:21
  Speaker 1: Yeah, and then when you talk about the CGM, because
• 22:23
  Speaker 1: we were talking about the you know, expanding the reimbursement
• 22:26
  Speaker 1: coverage for G seven. Is the G seven the one
• 22:29
  Speaker 1: being used in this trial or is it Stello or
• 22:32
  Speaker 1: is it either?
• 22:33
  Speaker 2: So in that study, we are using G seven and
• 22:37
  Speaker 2: because that we feel that that's the right product for
• 22:40
  Speaker 2: that study. But in general, as we look at the
• 22:43
  Speaker 2: different platforms, the wearables are very similar, but when it
• 22:47
  Speaker 2: comes to the software experience, they are different. And so
• 22:50
  Speaker 2: I see over time the Stello product will continue to
• 22:53
  Speaker 2: migrate towards pre diabetes and health and wellness as G
• 22:57
  Speaker 2: seven takes over that the entire diabetes spec.
• 23:00
  Speaker 1: Yeah, we're talking a lot about the product development, but
• 23:03
  Speaker 1: there's also the commercial expansion. And because the US market
• 23:07
  Speaker 1: is you know, I feel more accustomed to the CGM
• 23:11
  Speaker 1: technology that's out there and penetration rate is higher, but
• 23:14
  Speaker 1: you still have the large international opportunity. So what is
• 23:18
  Speaker 1: the strategy in twenty twenty six to kind of keep
• 23:20
  Speaker 1: that expansion going in the OUs countries.
• 23:24
  Speaker 2: Yeah, one of my initiatives as a stepped into the
• 23:27
  Speaker 2: CEO role January first is to expand our international market share,
• 23:31
  Speaker 2: and we built Dexcom on this leadership in the United
• 23:35
  Speaker 2: States market. It is the United States has some of
• 23:37
  Speaker 2: the best coverage for people with diabetes for CGM around
• 23:41
  Speaker 2: the world, but we are seeing coverage open up in
• 23:43
  Speaker 2: a number of countries and really a strategy is continue
• 23:47
  Speaker 2: to generate the evidence and have the conversations needed and
• 23:51
  Speaker 2: the submissions needed to expand more access to CGM. The
• 23:55
  Speaker 2: interesting thing historically xcom our technology was more focused on
• 24:00
  Speaker 2: the higher end, more acute portion of the diabetes population.
• 24:03
  Speaker 2: So you think about people who use automated in some
• 24:05
  Speaker 2: delivery systems, you think of children with diabetes. We think
• 24:08
  Speaker 2: of adults that have hypoglycemia unawareness. They don't can't feel
• 24:12
  Speaker 2: their blood sugar, so they need something that these alertsil
• 24:15
  Speaker 2: arms and so that really for many years in the
• 24:17
  Speaker 2: international markets, that's really where we played, which is like
• 24:19
  Speaker 2: only about ten percent of the market. A number of
• 24:22
  Speaker 2: years ago, we launched a product called Dexcom one Plus
• 24:25
  Speaker 2: that is a part of the portfolio. So you have
• 24:27
  Speaker 2: g seven product to expand in the automated and delivery
• 24:31
  Speaker 2: areas and pediatrics, and then you have x comone plus
• 24:33
  Speaker 2: for a much larger population of people with type one
• 24:36
  Speaker 2: and type two, and so that product is really where
• 24:39
  Speaker 2: a lot of the growth internationally is coming from as
• 24:41
  Speaker 2: we see more coverage come for Type two patients. We
• 24:46
  Speaker 2: saw basil coverage here open up recently in France, and
• 24:49
  Speaker 2: so that's been one of our faster growing markets in
• 24:52
  Speaker 2: Europe because now people have access to this new product.
• 24:55
  Speaker 1: Yeah, and you know, with that market expansion, obviously, the
• 24:59
  Speaker 1: next natural question is the competitive landscape. My observation over
• 25:03
  Speaker 1: the last few years is that new companies are trying
• 25:06
  Speaker 1: to enter this market, most particularly Roche was, you know,
• 25:10
  Speaker 1: having headlines about having a CGM product out there, but
• 25:13
  Speaker 1: it silver remains a doopoly between you and Abbott. What
• 25:17
  Speaker 1: gives both of you the competitive advantage over these new
• 25:20
  Speaker 1: entrants who are trying to enter this kind of you know,
• 25:23
  Speaker 1: large market market opportunity.
• 25:25
  Speaker 2: Well, it's no surprise that there's a lot of interest
• 25:28
  Speaker 2: in the space of glucose sensing and folks trying to
• 25:31
  Speaker 2: do it. And so you know, we've seen that over
• 25:33
  Speaker 2: many years, many different types of technologies trying to enter
• 25:37
  Speaker 2: the space. I think when it comes to Dexcom, the
• 25:39
  Speaker 2: competitive advantage is really the multiple decades of knowledge, research,
• 25:46
  Speaker 2: intellectual property, trade secrets, and really experience building sensors at scale.
• 25:52
  Speaker 2: It's one thing to be able to build a glucosensor
• 25:54
  Speaker 2: that tracks glucose. There's many lab experiments and paper has
• 25:58
  Speaker 2: been published on people that have done that. But to
• 26:00
  Speaker 2: be able to do it at scale, do it reliably
• 26:02
  Speaker 2: and serve a global market that is this large, it
• 26:06
  Speaker 2: takes significant knowledge and also significant investment. We've invested billions
• 26:11
  Speaker 2: of dollars in our manufacturing plants around the world, and
• 26:14
  Speaker 2: our and our equipment and our manufacturing lines. And the
• 26:17
  Speaker 2: other thing is we're not stopping here. We're going to
• 26:19
  Speaker 2: continue to drive innovation across the entire product portfolio, which
• 26:24
  Speaker 2: also includes how we manufacture sensors. And over time we've
• 26:28
  Speaker 2: actually been able to bring the price of sensors and
• 26:32
  Speaker 2: the cost of sensors down based on that experience and
• 26:35
  Speaker 2: that scale and designing, you know, for lower cost sensors.
• 26:39
  Speaker 2: In the beginning, it was all about just making a
• 26:40
  Speaker 2: sensor work reliably. Now it's about that, improving that, but
• 26:44
  Speaker 2: also continuing to enhance our ability to manufacture more sensors
• 26:48
  Speaker 2: at a cost profile that makes it more accessible for
• 26:51
  Speaker 2: more patients around the world.
• 26:52
  Speaker 1: That's interesting because I always, you know, when I first
• 26:55
  Speaker 1: started covering x Com and you know the other CGM
• 26:58
  Speaker 1: companies out there, used to be that it was a
• 27:01
  Speaker 1: four dollars per day per customer type of revenue stream.
• 27:05
  Speaker 1: But it seems like it's creeping towards that three dollars
• 27:09
  Speaker 1: per day revenue stream. And it sounds like the answer
• 27:13
  Speaker 1: is that the increased efficiency that you're having in your manufacturing.
• 27:17
  Speaker 1: But what is the secret sauce that it allows you
• 27:20
  Speaker 1: to be able to manufacture it at scale that allows
• 27:24
  Speaker 1: you to lower that per day cost for the customer.
• 27:26
  Speaker 2: Yeah, it requires a number of things, and one of
• 27:30
  Speaker 2: them is just the sheer volume and scale that you
• 27:33
  Speaker 2: operate at and the efficiencies you can get by doing that.
• 27:37
  Speaker 2: It also a big part of those is how you
• 27:38
  Speaker 2: manufacture the sensors, the overhead required, how fast your lines
• 27:41
  Speaker 2: can produce sensors, how much square footage, how much factory
• 27:45
  Speaker 2: space basically it takes to be able to make sensors,
• 27:48
  Speaker 2: and all of that. Over are many different generations. Our
• 27:51
  Speaker 2: original sensors, there was a lot of very manual hand operation.
• 27:55
  Speaker 2: We actually had a clean room with an army of
• 27:57
  Speaker 2: operators building these almost like hand crafted sensors in the
• 28:02
  Speaker 2: very early days. We're now have these automated systems that
• 28:06
  Speaker 2: are producing tens of millions of sensors per year, and
• 28:10
  Speaker 2: we're going to continue to innovate on those because every
• 28:12
  Speaker 2: time you launch a new technology or you develop a
• 28:15
  Speaker 2: new technology, you learn from it. And that's what dex
• 28:18
  Speaker 2: comes all about, this continuous learning and continuous improvement. And
• 28:22
  Speaker 2: that's how we've been able to both improve the technology
• 28:25
  Speaker 2: but also reduce the cost.
• 28:27
  Speaker 1: Yeah, and you know the other thing too is you know,
• 28:29
  Speaker 1: you have your Mesa Arizona plant, you have your Malaysia plant,
• 28:33
  Speaker 1: and then you're eventually opening up your Ireland facility. But
• 28:37
  Speaker 1: you're expanding and I mean you're also expanding in the
• 28:40
  Speaker 1: Mesa and the Malaysia plant at the same time that
• 28:42
  Speaker 1: you're building out this Ireland plant. So how is that strategy?
• 28:46
  Speaker 1: Is this a kind of diversifying your supply chain across Europe,
• 28:51
  Speaker 1: Asia and the US? Are there other parts of the
• 28:55
  Speaker 1: strategy that are involved with kind of expanding in all
• 28:57
  Speaker 1: three regions?
• 28:58
  Speaker 2: Important part of the strategy is business continuity and making
• 29:02
  Speaker 2: sure we've got diversified supply chain. Mace Arizona, as you mentioned,
• 29:06
  Speaker 2: that was our first high volume facility here in the
• 29:09
  Speaker 2: United States that we built, and then we built our
• 29:11
  Speaker 2: Malaysia plant, and then we have our plant in Ireland
• 29:13
  Speaker 2: which is nearing completion. We'll be producing commercial sensors later
• 29:17
  Speaker 2: this year. But another big part of it is getting
• 29:21
  Speaker 2: the production closest to the markets that we're serving. So
• 29:24
  Speaker 2: the plant in ireland's really designed to service the European
• 29:28
  Speaker 2: Middle East markets, and then the Malaysia plant services the
• 29:32
  Speaker 2: Asia Pacific region, which is growing rapidly. Half of the
• 29:36
  Speaker 2: people in the world with diabetes live in the Asia
• 29:38
  Speaker 2: Pacific region and we're just getting started there and so
• 29:42
  Speaker 2: we have a tremendous opportunity to serve more patients in
• 29:45
  Speaker 2: that region. And so the Malaysia plant service is that
• 29:48
  Speaker 2: as well as some of Europe and some of the US.
• 29:50
  Speaker 2: It's kind of like the extra overflow goes there. But
• 29:54
  Speaker 2: it's really important for us to have these plants in
• 29:56
  Speaker 2: the different areas, in the different markets we serve.
• 29:59
  Speaker 1: Yeah, you know, we'll close out this episode with just
• 30:02
  Speaker 1: the product development, which is that second kind of tier
• 30:05
  Speaker 1: that you were talking about, and this is the G
• 30:07
  Speaker 1: eight that you've announced. It's early in the development, but
• 30:11
  Speaker 1: what can you tell us about the product and the
• 30:13
  Speaker 1: development process so far.
• 30:15
  Speaker 2: Yeah, consistent with our history is we come out with
• 30:18
  Speaker 2: these new generations of the hardware platform. The wearable component
• 30:22
  Speaker 2: of the continuous glucost monitor. G eight is going to be,
• 30:25
  Speaker 2: you know, following G seven, it's going to be the
• 30:27
  Speaker 2: next generation. And so we've been working on this for
• 30:30
  Speaker 2: a number of years and really the idea here was,
• 30:32
  Speaker 2: let's make the most accurate, most reliable, smallest It's going
• 30:38
  Speaker 2: to be our most innovative warble we've ever produced. There's
• 30:42
  Speaker 2: a number of technologies that are going into G eight
• 30:44
  Speaker 2: that've been into development for multiple decades and we finally
• 30:48
  Speaker 2: got to the point now where we're ready to introduce
• 30:49
  Speaker 2: them commercially. And so we're going to share more of
• 30:52
  Speaker 2: that this year as we kind of go out throughout
• 30:54
  Speaker 2: the year in terms of what exactly G eight is.
• 30:56
  Speaker 2: But what you can count on is it's going to
• 30:59
  Speaker 2: be the small lest sense are wearable. It's going to
• 31:01
  Speaker 2: be the most accurate and most reliable wearable, and it's
• 31:05
  Speaker 2: going to be the software experience around it. It's going
• 31:08
  Speaker 2: to be a whole new innovation around how cgms work
• 31:12
  Speaker 2: for a much broader use of patients. We talked a
• 31:15
  Speaker 2: little bit about G seven is starting to be used
• 31:17
  Speaker 2: by a very broad population of users. At G eight
• 31:19
  Speaker 2: is going to continue to broaden that.
• 31:22
  Speaker 1: Yeah, And you know, one of the things I've noticed
• 31:24
  Speaker 1: as well is, you know, between G five, G six,
• 31:27
  Speaker 1: G seven, you know, it's four year product cycle, give
• 31:30
  Speaker 1: or take. So we're December of twenty twenty two is
• 31:33
  Speaker 1: G seven comes out. But I'm curious about the product
• 31:38
  Speaker 1: cycle as these technologies get more and more sophisticated. I mean,
• 31:42
  Speaker 1: because with the G seven you already have gotten the
• 31:45
  Speaker 1: marred or the mean absolute relative difference. You've gotten that
• 31:49
  Speaker 1: down from the ten percent range to now eight percent
• 31:53
  Speaker 1: sub eight percent. Each incremental improvement seems like it's going
• 31:56
  Speaker 1: to require more and more technology or higher technologology, higher developments.
• 32:02
  Speaker 1: Is that something to consider as we kind of think
• 32:04
  Speaker 1: about these product cycles, is because of how much improvement
• 32:08
  Speaker 1: has already taken place between G five and G seven,
• 32:10
  Speaker 1: just that incremental improvement takes a little more time in
• 32:13
  Speaker 1: that product cycle.
• 32:15
  Speaker 2: It can, but not necessarily. And the great thing about
• 32:20
  Speaker 2: each generation is that it builds on the previous one,
• 32:22
  Speaker 2: So all of the technology and learnings that went into
• 32:24
  Speaker 2: the previous generation are applied and then all of course
• 32:27
  Speaker 2: all the new innovation. And so we have had a
• 32:31
  Speaker 2: pretty regular cadence of introduction of new platforms, and you know,
• 32:35
  Speaker 2: I think one of the newer considerations that has come
• 32:39
  Speaker 2: in as we particularly with G seven was the scale
• 32:42
  Speaker 2: and just the equipment and how you modify your lines
• 32:45
  Speaker 2: to be able to build the new technology. But we've
• 32:48
  Speaker 2: gotten pretty good at that, and so I'm very excited
• 32:50
  Speaker 2: about the new innovations we've made both on the GA
• 32:53
  Speaker 2: technology but also in how we manufacture it that'll lead
• 32:56
  Speaker 2: to being able to scale larger, broader populations. You know,
• 33:00
  Speaker 2: this this end market is so large and there's so
• 33:03
  Speaker 2: many people out there that could benefit. And right now
• 33:05
  Speaker 2: we estimate there's about ten million people using CGM, you know,
• 33:09
  Speaker 2: but there's you know, six hundred million people with TYPEE.
• 33:11
  Speaker 2: So there is a lot of opportunity, and so it's
• 33:14
  Speaker 2: on us to make sure we have a technology that
• 33:16
  Speaker 2: can both service that market but also at the ample
• 33:19
  Speaker 2: supply and quantities. And so that is a really big
• 33:22
  Speaker 2: part of the G eight and so we'll announce you know,
• 33:25
  Speaker 2: timelines here as we get closer to launch on it.
• 33:28
  Speaker 2: But we're feeling really good about the progress that made
• 33:30
  Speaker 2: so far.
• 33:30
  Speaker 1: Yeah, that's that's all great. And as we close out,
• 33:33
  Speaker 1: you know, I always like to say, what inning do
• 33:36
  Speaker 1: you think we are in utilizing this technology. You've been
• 33:39
  Speaker 1: here for you know, twenty years. You're starting now as
• 33:42
  Speaker 1: the CEO role. But you already mentioned we're in the
• 33:45
  Speaker 1: early innings. You talked about the ten million patients on
• 33:48
  Speaker 1: CGM versus the nearly six hundred million patients that could
• 33:52
  Speaker 1: potentially benefit from it, so that all those make sense
• 33:55
  Speaker 1: of early early innings, But how do you see that
• 33:57
  Speaker 1: plane out over the next few years as we go
• 33:59
  Speaker 1: from of maybe let's say top of the second to
• 34:02
  Speaker 1: the bottom of the second. And you know, one number
• 34:04
  Speaker 1: that caught my attention to in the pre announcement was
• 34:07
  Speaker 1: you were expecting to get one billion dollars of free
• 34:09
  Speaker 1: cash flow in twenty twenty six. So how do you
• 34:14
  Speaker 1: start using that dry powder to help get you from
• 34:17
  Speaker 1: the top of the second to the bottom of the second? Ding.
• 34:19
  Speaker 2: Yeah, it's a fantastic question, and we are extremely proud
• 34:22
  Speaker 2: of how our teams have operated in the free cash
• 34:25
  Speaker 2: flow we've been able to generate, and it's really about
• 34:28
  Speaker 2: looking at how can we speed up and accelerate our portfolio,
• 34:33
  Speaker 2: our capabilities as a company, and so we certainly are
• 34:36
  Speaker 2: always looking for opportunities to use that try powder as
• 34:40
  Speaker 2: you mentioned, to be able to accelerate ourselves. And it's
• 34:43
  Speaker 2: interesting when we talk about being in the early innings.
• 34:46
  Speaker 2: We are so early in terms of diabetes when we've
• 34:49
  Speaker 2: talked about those numbers of ten million using six ceremion,
• 34:52
  Speaker 2: but then the opportunity to ex expands well beyond that,
• 34:55
  Speaker 2: like the six hundred million people are more that have
• 34:57
  Speaker 2: pre diabetes in the world, and so that to me
• 35:01
  Speaker 2: sounds like extra innings. So I mean, it is an
• 35:04
  Speaker 2: amazing technology that has an incredible opportunity to make a
• 35:07
  Speaker 2: significant difference across all of health care. And it is
• 35:10
  Speaker 2: such a cost effective technology when it comes to the
• 35:14
  Speaker 2: outcomes that drives because you're basically the type two complications
• 35:17
  Speaker 2: that people are afraid of developing or that cost the
• 35:20
  Speaker 2: healthcare system a lot, those are either eliminated or highly delayed,
• 35:26
  Speaker 2: and so you really have this technology that can benefit
• 35:28
  Speaker 2: people today, and it's our job to figure out how
• 35:30
  Speaker 2: to get it to them.
• 35:31
  Speaker 1: Yeah, and I think that kind of goes back to
• 35:33
  Speaker 1: you know, I listened to your first presentation earlier this
• 35:37
  Speaker 1: month or now we're in January, back in January, and
• 35:40
  Speaker 1: you started it off with the impact of metabolic health,
• 35:43
  Speaker 1: and I think what you just said explains that is
• 35:46
  Speaker 1: moving on beyond just glucose, and there's more to it
• 35:49
  Speaker 1: than just glucose.
• 35:50
  Speaker 2: There is. There's so much more to it as we
• 35:52
  Speaker 2: think about metabolic health in general and the impact that
• 35:57
  Speaker 2: CGM can have on that and helping people live health
• 36:00
  Speaker 2: your longer lives, and so really excited about the opportunity
• 36:03
  Speaker 2: in front of us.
• 36:04
  Speaker 1: Yeah, and Jake, thank you so much for joining us today.
• 36:07
  Speaker 1: I appreciate you coming in. Yeah, it's a pleasure to
• 36:09
  Speaker 1: be here, Matt, and thank you to our producer Mariam
• 36:11
  Speaker 1: Try for all the behind the scenes work, and thank
• 36:14
  Speaker 1: you to our listeners for tuning in today. We hope
• 36:17
  Speaker 1: you join us for future episodes, and if you'd like
• 36:19
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• 36:21
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