Insulet Q3 2026 Earnings Call Transcript

Insulet (NASDAQ:PODD) reported third-quarter financial results on Wednesday. The transcript from the company’s third-quarter earnings call has been provided below.

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Summary

Insulet Corporation reported strong third-quarter 2026 results with a 20% year-over-year revenue increase and guided towards the high end of their full-year outlook.

The company achieved significant growth in international markets with a 33% increase and reported increased global customer base growth of over 20%.

Insulet announced a $1 billion increase in share repurchase authorization, allocating $400 million for Q4, funded by cash on hand.

The company is preparing for the launch of Omnipod 6 in 2027 and expects a more dynamic competitive environment with new products entering the market.

Management remains confident in the company’s long-term growth prospects and highlighted advancements in their innovation pipeline, including Omnipod Discover and the fully closed loop system for type 2 diabetes.

Full Transcript

OPERATOR

Good morning and welcome to the Insulet Corporation third quarter 2026 earnings call. As a reminder, this conference is being recorded. I would now like to turn the conference over to your host, Claire Trachtman, Vice President, Investor Relations. Please go ahead.

Claire Trachtman (Vice President, Investor Relations)

Good morning and welcome to our third quarter 2026 earnings call. Joining me today are Ashley McEvoy, President and Chief Executive Officer, and Flavia Peace, Chief Financial Officer. On the call this morning we will be discussing Insulet’s third quarter results along with our financial outlook for the fourth quarter and full year 2026. With that, let me start our prepared remarks by reminding everyone that certain statements, including comments regarding our financial outlook, the anticipated impact of our strategic actions, the potential impact of various regulatory and operational matters, and the macroeconomic environment on our results of operations, contain forward-looking statements that involve risks and uncertainties and, of course, our actual results could differ materially from our current expectations.

Please refer to today’s press release and our SEC filings for more detail concerning factors that could cause actual results to differ materially. In addition, on today’s call, non-GAAP financial measures will be used to help investors understand Insulet’s ongoing business performance, including adjusted operating income, adjusted EPS, adjusted tax rate, and constant currency revenue, which is revenue growth excluding the effect of foreign exchange. A reconciliation of certain non-GAAP financial measures being discussed today to the comparable GAAP financial measures is included in the accompanying investor presentation and available in our earnings release issued this morning, both of which are available on our website.

Additionally, unless otherwise stated, all financial commentary regarding dollar and percentage changes will be on a year-over-year reported basis, with the exception of revenue growth rates which will be on a year-over-year constant currency basis. During the Q&A session this morning, Ashley, Flavia, and I will be available to address any questions. Now I’d like to turn the call over to Ashley. Ashley.

Ashley McEvoy (President & Chief Executive Officer)

Good morning everyone and thanks for joining us to discuss our third quarter results. Our teams delivered a strong quarter with U.S. performance in our guidance range and international performance that exceeded our plans. As we near the end of the year, we’ve narrowed our total company full year outlook to the top end of our prior range to reflect this strength. Throughout the quarter we continued advancing our strategic priorities, strengthening our commercial capabilities and execution, accelerating innovation and expanding the category by increasing access and building relationships with prescribers. Importantly, we made progress against the type 2 action plans we laid out on our quarter 2 call. We are pleased with our progress in the quarter and I want to take a step back and provide some broader perspective.

Insulet has a strong leadership position in one of the largest, fastest growing and most underpenetrated segments in MedTech. We are actively extending our leadership in automated insulin delivery and are confident that Omnipod will continue winning a leading share of MDI converts to AID, providing the foundation for sustained top-tier growth. We are clear-eyed and confident about Insulet’s near and long term prospects for growth and outsized value creation, factoring in new competitive products entering the market as well as our own product pipeline.

Let’s jump into the details starting with our performance. In the third quarter we achieved revenue of 842 million, up nearly 20% year over year with approximately 15% growth in the U.S. and 33% growth internationally. Our increased revenue was supported by over 20% growth in our global customer base compared to the prior year period. You may recall that we ended last year with more than 600,000 global customers and we continue to drive a 20% plus growth rate versus year-ago levels.

This installed base provides a substantial recurring revenue foundation as well as a growing source of real-world evidence and data. Globally, new customer starts grew low single digits versus the year-ago period and year to date, new customer starts have grown low double digits. The majority of people with diabetes who convert from MDI to AID choose Omnipod and over 85% of Omnipod new customer starts come from MDI, demonstrating our success growing the category.

There continues to be a large delta between CGM and AID across our markets despite ADA guidelines recommending AID as the standard of care and we see a significant opportunity to grow the AID market and reduce the burden of diabetes for millions of people worldwide. New customer starts in quarter three were again balanced across type 1 and type 2 globally, with type 2 diabetes patients accounting for over 40% of U.S. starts. We have not observed an impact from increased GLP-1 use on type 2 new customer starts and we continue to view GLP-1s as complementary to insulin.

We delivered record gross margin and expanded operating margin in the quarter, reflecting Insulet’s industry-leading manufacturing capabilities and ongoing productivity improvements. At the same time, we continue to invest in the company’s innovation pipeline and commercial capabilities. As I mentioned, we’ve narrowed our full year revenue guidance to the top end of our prior range, reflecting third quarter results and our expectations for continued momentum in the fourth quarter.

As we get closer to 2027, we are providing an updated perspective for next year. We expect the pace of innovation across the category to increase next year, including our launch of Omnipod 6 which will accelerate market growth over time. At the same time, we expect the competitive environment to become more dynamic as new products come on the market. We plan to take a more conservative approach to our 2027 outlook. While we remain highly confident in Insulet’s long-term growth opportunities, Flavia will walk through what this means in terms of our full year 2026 guidance range and our updated perspective for 2027.

Before I turn to our strategic priorities, I want to note the share repurchase we announced this morning. The Board approved a billion-dollar increase in our share repurchase authorization. The company expects to allocate 400 million toward repurchases in quarter four. Funded with cash on hand, these plans reflect our confidence in the strength of the Omnipod platform, our robust pipeline and the company’s long-term trajectory. Insulet has the balance sheet and cash flow to facilitate the repurchases while we continue investing in our future.

Now let me turn to the progress we continue to make against our strategic priorities: strengthening our commercial capabilities and execution, driving innovation, and expanding the category. First, commercial capabilities and execution. We are taking the right actions to build long-term relationships with people with type 1 and type 2 diabetes and the global healthcare providers who care for them. In quarter three, we completed our second U.S. salesforce expansion in two years, increasing our footprint by nearly 25%.

In this latest phase, our field representatives also completed a new four-month certification program preparing them to communicate the clinical and real-world value of Omnipod more effectively. In August, we rolled out the company’s first new CRM platform in more than a decade to our U.S. sales team. Optimization is ongoing and we continue to educate our teams on how to make the most of these new capabilities. We expect the new platform to facilitate better targeting, more effective message delivery, faster decision making and closer collaboration over time.

Specific to type 2 diabetes, we have now put in place the action plan we shared with you all on the quarter 2 call and we are pleased with our progress in improving the quality of starts, the onboarding experience and the first 90 days of the customer journey. We adjusted our salesforce compensation so it now adds a customer retention element and refined our approach for deploying samples. We also continued to strengthen our customer care team by adding clinical specialists focused on retention.

We have begun to see an improvement in our sampling program and onboarding and saw type 2 retention rates improve modestly in the third quarter. We expect to see the impact of these initiatives continue to build over time, consistent with our type 2 action plan. As well as our strategic priority to accelerate innovation that improves outcomes, we completed the full market release of Omnipod Discover in the U.S. in October. Every day our products make over 100 million automated dosing decisions and process over 850 million data messages, giving us one of the largest real-world diabetes data sets. This data enables Omnipod Discover, our proprietary engagement platform, to deliver personalized insights and decision support to strengthen engagement, outcomes and customer loyalty for people with diabetes and healthcare providers using Omnipod.

During the Omnipod Discover limited market release, we saw stronger retention, increased time in range and three-quarters of our users reported feeling more confident managing their diabetes. In October, we began onboarding people with diabetes regardless of healthcare professional enrollment and we have seen very strong engagement. As of this call, Discover has been adopted by more than 35,000 users. We are in the early innings of this platform but believe Omnipod Discover will be another differentiator for Insulet as people seek more connected and self-managed health solutions. Another recent advancement is our new algorithm enhancement, the most significant improvement to Omnipod 5 since its launch. Now in full retail across the U.S., the updated algorithm adds a new 100 mg per deciliter target and fewer automated delivery restriction alarms so users stay in automated mode longer.

Real-world evidence shows users achieve more time in range without a meaningful increase in lows, reinforcing Omnipod 5’s leadership in delivering strong outcomes with a simple, seamless experience. Robust algorithm innovation will continue to be an important focus with an emphasis on helping more people address their needs in a differentiated manner. Our expansive real-world diabetes data set gives us a unique opportunity to continue building upon our industry-leading position while improving outcomes for Omnipod users.

We’re excited about this flywheel of innovation and patient impact and what it means for people with diabetes and all our stakeholders. In quarter two, we expanded sensor choice through our U.S. integration with FreeStyle Libre 3 Plus and, as of today, we have extended integration to 10 new markets. The iOS platform for Libre 3 is underway with U.S. limited market release expected in quarter four, providing access to 450,000 MDI users. Our teams are executing against this opportunity. At the same time we are advancing our broader innovation roadmap including Omnipod 6 and Omnipod fully closed loop for type 2 diabetes.

Omnipod 6 adapts to how you bolus; with 40% fewer boluses, adults and adolescents with type 1 diabetes spent 76% of time in range on Omnipod 6. We have submitted the second and final 510(k) for Omnipod 6 and continue to expect launch in 2027. We believe we are better prepared for the Omnipod 6 launch than we have been for any launch in our history, from customer targeting and marketing to manufacturing and international expansion. Our fully closed loop system for people with type 2 diabetes is a transformational opportunity to move additional MDI users onto AID. It offers people with type 2 diabetes a user-friendly experience nearly identical to CGM with no user boluses or settings required and training completed at home in less than 40 minutes. Last month at EASD we highlighted the significance of this innovation with the Evolution 3 feasibility study which demonstrated adults with type 2 diabetes using both a GLP-1 and CGM saw additional time in range benefit and had no user-initiated boluses.

We completed enrollment in the Evolve pivotal study and continue to target a 510(k) submission in 2027 with a planned launch in 2028. Our market-leading innovation and R&D spend will drive significant future product differentiation. Now turning to our last strategic priority, expanding access and developing the category. In the U.S. we continue to extend our prescriber base this quarter with nearly 34,000 healthcare providers now prescribing Omnipod, up more than 20% year over year. Outside of the United States, we successfully launched in Spain which has 175,000 people with type 1 diabetes and 200,000 people with type 2 diabetes on MDI. In the U.S. we have finalized one of our three PBM contracts for 2027 and expect to complete the remaining two in the next few weeks.

Our goal is to maintain broad access to Omnipod and strengthen our leading position across the pharmacy channel. We have a broad-based supply chain network across Acton, Malaysia and, in the coming years, Costa Rica which provides us with the resiliency and capital efficiency to produce tens of millions of pods every year. Our execution against these strategic priorities positions us to extend Insulet’s leadership position in AID even with new products coming to market and continue to deliver top-tier revenue growth and value creation. Omnipod 5 captures the majority of new AID customers today and AID is one of the largest, fastest growing and most underpenetrated segments in MedTech. Over the past five years, Insulet has driven two-thirds of global market growth. Our SG&A is over half of category spend and our R&D is nearly half of category spend.

Across our markets there is still a significant delta between AID and CGM penetration, providing a meaningful opportunity for us to continue to grow the category. Based on our latest survey across six countries, Omnipod is the number one AID choice among providers and people with diabetes. Awareness of Omnipod among people on MDI is now 67% in the U.S., 84% in the U.K. and 74% in Canada, up significantly in each market versus last year and well ahead of other AID brands.

Across every market studied, lifestyle fit and confidence in managing diabetes ranked among the most important factors associated with patients’ choice of AID and these are the reasons people with diabetes choose Omnipod. And it’s not just our customers. Prescribers view Omnipod as the most differentiated AID on the market. Omnipod continues to lead among U.S. healthcare professionals on key measures: preference, prescribing intent, satisfaction, trust and brand affinity.

We continue to strengthen prescriber perception of Omnipod across markets through professional education, clinical evidence and innovation. At EASD we presented our largest data set of international real-world data to date showing consistent time in range improvements across more than 384,000 people with type 1 diabetes in 17 countries and we are not slowing down. Our innovation pipeline is the strongest in the company’s history and provides a clear pathway for us to remain the AID of choice among new and existing AID users.

In addition to our unique form factor and highly differentiated customer experience, we have manufacturing and operating scale and unrivaled financial capacity which provide durable competitive moats. We invested billions of dollars over decades to build our manufacturing capabilities and scale. Competitors will be producing a fraction of what we make in their initial years on the market. We will also benefit from our well-established market-leading position.

Insulet has the largest customer base, the highest brand awareness, one of the largest data sets of real-world diabetes evidence and we are the number one most requested and number one most prescribed brand for people with diabetes. For all of these reasons we are going to continue to get a disproportionate share of new starts, and studies show that once people with diabetes convert to an AID they are unlikely to switch brands. The path forward is clear. We will continue to expand the AID market and as the AID market grows, we grow too. To close, our quarter 3 results reflect the strength of Insulet’s model. We are enhancing the customer experience and onboarding journey, accelerating our innovation roadmap and expanding the category. We have outstanding leaders across our company to drive this work and the progress we’ve made in quarter three reinforces our confidence in the initiatives we implemented. 2026 is expected to be our 11th consecutive year of 20% plus revenue growth. We are now preparing for Insulet’s next chapter led by the launch of Omnipod 6 and other meaningful innovations which will again drive our company and category forward in 2027. Reflecting the timing of innovations and our much larger revenue base, we expect our growth profile will moderate. It’s a testament to the strength of our product and opportunity that we expect to still deliver top-tier growth on a multibillion-dollar revenue base and further expand profitability.

We are entering the next phase of market evolution with the scale, customer experience, commercial and manufacturing capabilities and innovation pipeline to remain differentiated. With that, I’ll turn the call over to Flavia to walk through the financials and guidance in more detail.

OPERATOR

Thank you. We will now begin the question-and-answer session. I would like to remind participants that this call is being recorded, and a digital replay will be available on the Insulet website. We ask that you please help us respect time by limiting to one question and one follow-up. If you would like to ask a question, please press star-one to raise your hand. To withdraw your question, please press star-one again. We ask that you pick up your handset when asking a question to allow for optimum sound quality, and if you are muted locally, please remember to unmute your device.

Please stand by while we compile the Q&A roster. Your first question comes from the line of Matt Taylor from Jefferies. Your line is open. Please go ahead.

Matt Taylor (Analyst)

Thanks. Good morning. Thank you for taking the question. So I wanted to start by double-clicking on some of your commentary on 2027, and specifically wanted to ask you: you mentioned some conservatism in the new assumptions, and you also made some changes to fundamental assumptions around market growth and competition, and obviously the tough comps internationally. So I just wanted to understand how much of the 2027 change we should attribute to conservatism versus some of those other fundamental factors, if you could provide some more context.

Ashley McEvoy (President & Chief Executive Officer)

Yeah, sure, Matt. Thanks for the question. Look forward to seeing you in London in a couple weeks. I would say, you know, a couple things. Let me just kind of give a broad context to ’26, which will be our baseline going into ’27. You know, we anticipate closing out our 11th consecutive year of 20% revenue growth, which is pretty strong, again coming off of a strong quarter three. You know, we have very strong trends in our global customer base, which is up about 20%, and some really healthy KPIs when we look at the front end and the back end of the funnel.

And so we’re taking that into consideration as we look at 2027. You know, coming off of that kind of base, we do expect our growth rate to moderate. That’s expected and really cut for three areas. One is the strength of our base as we’re going to exit ’26. We’re looking at our pacing of innovation and when Omnipod 6 will be coming to the market. You know, as market leader, we’re clear-eyed around the state of new competitive entrants coming, and so we are going to be really thoughtful as we guide for the outlook for next year.

Now I still have absolute confidence that we’re going to deliver top-tier revenue performance as well as expanded profitability going forward.

Matt Taylor (Analyst)

Maybe just as a follow-up, it looks like you didn’t include some of the upside that you said—limited contributions from new products, the sales force, and just assuming stable retention versus any improvement from type 2. I guess maybe you could speak to what could drive some upside and if you’ve really included much from your pipeline in the initial thoughts on ’27?

Ashley McEvoy (President & Chief Executive Officer)

Yeah, no thanks, Mike. I mean, I think Flavia said in opening remarks a little bit of what some of the going-in assumptions that our latest thinking took into consideration. So, you know, I’m really pleased with our sales force expansion that we conducted in quarter three. We increased that 25%. Again, that’s going to pay dividends in quarters and years to come. I’m really pleased with a new CRM platform that we’ve implemented in 10 years — the first in 10 years.

Again, we’re going to equip the field with all these new tools, again, that will build over time. Again, very pleased with how the field in quarter three, with speed and intentionality, got after the Type 2 action plans. While you heard in my opening remarks, we saw some early green shoots around those — you know, retention did improve — but we are building a more modest build over a period of time, and that’s what we mean by having a bit of a conservative outlook. We also understand when our innovation is going to hit. We also understand the impact that some of the new competitive entrants will have.

So taking that all into consideration, we’ve been really deliberate on our guide for ’27. Again, it’s not our official guide because we’ll be coming back in quarter four. It’s really our latest thinking. Thank you.

OPERATOR

Your next question comes from the line of Travis Stead from Bank of America. Your line is open. Please go ahead.

Travis Stead (Analyst)

Hey, thanks for the question. I guess I wanted to clarify, you said U.S. towards the lower end of the range in ’27. Is that high single digits or is it double digits for the U.S. in ’27? Just want to make sure that’s clear given the exit rate of 10 to 13 and a half. And there was a change in the guide philosophy back in, like, November 2025 as well to be less conservative. So just want to make sure I understand kind of the message on the guide philosophy now in terms of kind of the expectations of kind of beating and raising and how conservative this guidance is now versus prior guidance philosophies.

Ashley McEvoy (President & Chief Executive Officer)

Yeah, Travis, thanks for the question. I’ll start with your last question and Flavia can answer some of the specifics to your first one. Again, I just have to say I’m very pleased with the quarter performance. I’m very pleased with 2026 — you know, on track to have our 11th consecutive year of 20% plus growth. We have continued to grow this category. We’ve been driving two thirds of the category growth, bringing new patients from MDI into AID. And so we’re just being really intentional for our thinking for next year to say we have a much stronger base this year.

We understand the pacing of our innovation. We’re very ready and prepared for Omnipod 6 to bring this to, you know, thousands and thousands of people around the world. Very pleased with all the prep that we’ve been doing with that, I have to say. And then just really clear-eyed about what’s coming our way as market leader. We know what to expect of what the market is. So we’re just having a more conservative approach from our outlook as we approach 2027.

Flavia Pease (Chief Financial Officer)

Yeah, thanks, Ashley and Travis. As we said in our prepared remarks, we plan to guide towards the lower end of the framework that we provided in Q2, and we will provide formal guidance in February with precise ranges.

Travis Stead (Analyst)

What was the lower end of the framework? Thank you. Is that high single digits or double digits?

Flavia Pease (Chief Financial Officer)

Yeah, the prior range was 9 to 14%.

Travis Stead (Analyst)

Okay, thank you. I’ll stick to the one question.

OPERATOR

Your next question comes from the line of Robbie Marcus from JP Morgan. Your line is open. Please go ahead.

Robbie Marcus (Analyst)

Good morning and thanks for taking the questions. Maybe just to follow up on the questions so far, as we think about 2027 — and I realize you’re not providing the full guide today — but I do think it’s important given the trajectory of U.S. sales particularly. How are you thinking about the market evolving for insulin pumps next year? There’s a lot of moving pieces where you have new patient starts for the market overall, you have a lot of competitive products coming, and I think people are struggling with how much will be just straight market share loss of patch pumps versus how much will the category expand.

So in the new, more conservative outlook you’re providing today, you know, how are you thinking about it and how is that different from the last quarter? And then I have a quick follow-up. Thanks.

Ashley McEvoy (President & Chief Executive Officer)

Yeah, Robbie, thanks for — listen, I appreciate the color you’re trying to get clarity on for ’27. Maybe it’s helpful if I kind of start some of the building blocks. You know, number one is the market. And this year, early in the first half of the year, this is an AID market that has been performing. On a revenue basis, I’d say high teens. On a customer basis, I’d say mid-teens. We, as market leader, have been driving the majority of that expansion and have been delivering revenue and customer base growth higher than those.

We have been, I will tell you, driving all of the NCS growth for the category coming from MDI. As I mentioned in my opening remarks, the majority of volume for the AID category comes from MDI, and we’ve been sourcing higher than category average — near 90% coming from MDI. We look at kind of the fundamentals of the category, and we see a very large TAM that’s underpenetrated, that’s very broad-based. We look at Type 1 U.S., we look at Type 2 U.S., and then we look at OUS Type 1. All of the penetration rates for the category are well below CGM. So we believe we have meaningful headroom ahead for this category. Now when we think about 2027, we think the category is going to expand with new entrants. We think that we are going to be building off of a very strong customer base.

Entering 2027, we have the largest customer base in the industry. As I mentioned, it grew 20% in quarter three. That’s really the customer base KPI — it’s what you take to the bank. We’ve shown some — I said very modest — improvement in the Type 2 U.S. in quarter three. We expect that to build over time, and again for NCS we are going to be the leader in NCS. Of course we’re going to lose a couple share points as competitors come in to enter this space.

But again, I’m really confident that in this moderated growth profile for Insulet, it still will command top-tier growth with expanded profitability. I think you had a second question, Ravi.

Robbie Marcus (Analyst)

Yeah, thanks. Ashley, I think on the last quarter call you had mentioned 20% plus EPS growth for 2027. I didn’t hear that comment today. Is that still a valid comment? Thanks a lot.

Flavia Pease (Chief Financial Officer)

Hey Ravi, it’s Lavi. I’ll take that one. Obviously we’re not guiding yet for 2027, but we continue to have confidence in our previous remarks of growing EPS 25% over our horizon.

OPERATOR

Your next question comes from the line of Jeff Johnson from Baird. Your line is open. Please go ahead.

Jeff Johnson (Analyst at Baird)

Thank you. Good morning, everyone. Thought I’d ask — I know, you know, most of the focus is on the U.S. Omnipod business for good reason. But outside the U.S., Flavia, you talked about a meaningful slowdown in growth next year, but you talk about maybe the global growth being just slightly below the previously communicated mid-teens. So could you suss out for us maybe or just kind of clarify — slightly below mid-teens for global — would that still be in the double digits for global?

Would that be the low teens or low double digits? Just how would you maybe qualify that comment about slightly below mid-teens for global? Any other color there? And then I have one other follow-up. Thank you.

Ashley McEvoy (President & Chief Executive Officer)

Yeah, Jeff, I’ll start with the first part of your question then Flavia can join in. First of all, like, I mean, our team — international OUS team — is absolutely on fire. I mean they, you know, year-to-date they’re posting revenue growth of north of 35%. They’re on track to, you know, surpass $1 billion this year. And really I attribute it to three things that they’ve just been unbelievably focused on. One is market access. In countries like the UK we have the highest penetration rates of pediatrics on AID of anywhere in the world.

Two is innovation. They’ve done an amazing job of upgrading patients from DASH to Omnipod 5, commanding a premium price — it’s a reflection of the value of your innovation — and they’ve mastered that. We’re on track to exit 2026 with 80% conversion. And three, preparing and executing well with new geographic expansions. Omnipod 5 will now be in 20 markets around the world — six new launches this year. So with that as a backdrop, absolutely, growth will moderate next year. Again, it will still be very competitive, top-tier growth OUS. And that’s because we’re going to anniversary some of these big country launches and we’re going to not have the favorability of a one-time price mix realization. And we’re really going to be preparing our markets for the innovation coming their way of the new sensor integration, the new phone control, as well as Omnipod 6.

So on that, maybe you want to take your first question about global.

Flavia Pease (Chief Financial Officer)

I’m just going to reiterate that we’re going to issue formal guidance in February of next year. But let me recap what we said in the call today, which is for the total company, we would expect the growth next year — to guide next year — to be modestly below mid-teens, which was the framework we provided in the second quarter. That’s for total company. For the U.S., we expect to guide at the low end of the framework we had provided in the second quarter.

And then, to your point, Jeff, we expect the growth internationally to moderate meaningfully from where we are today. Not going to provide specifics until we guide in February, so I’ll let you guys interpret what those mean.

Jeff Johnson (Analyst at Baird)

Fair enough. And just for a follow-up, again, kind of a clarifying question, but is the T1 attrition rate still kind of sitting in — in the U.S. — close to that 10% range? And I know you said maybe a very slight improvement on T2 retention. We’ve all tried to back in on your comments last quarter what that T2 attrition rate might be looking like in the U.S. As of last quarter, I think we were all — I know our math was getting us around 25 to 30%.

Is that 25 to 30% T2 attrition rate a fair number? And could you quantify — did you improve that a couple points or anything in the quarter just to help us understand how much progress might have been made thus far? Thank you.

Ashley McEvoy (President & Chief Executive Officer)

Yeah. Jeff, let me kind of first just, like, take everybody back to kind of what drives our business model. And the most important KPI is how many customers we have. And our customer base grew 20% in the quarter, and in the United States it grew high teens. And that is a really healthy measure. And again, we saw globally stable pricing, and our consumption patterns — which is the amount of volume that our customers are using — were very close and mirrored the customer base number — again a very healthy measure.

As I shared in our quarter two call, we did see some erosion in that quarter on attrition in a Type 2 population. Our Type 1 population is very consistent to the measure that you shared. And we did see green shoots. We saw improvement — modest improvement — in our T2 retention trends. And we also, again, saw when we think about going forward and we look at kind of structurally no difference than what we’ve called on the TAM and the penetration rate for the Type 2 marketplace.

So I call these execution challenges that we’ve now addressed, and I believe that they will have — I have full confidence that they’re going to have — meaningful value as we build into next year.

OPERATOR

Your next question comes from the line of Larry Beagleson from Wells Fargo. Your line is open. Please go ahead.

Larry Biegelsen (Analyst)

Good morning. Thanks for taking the question. Just on the type 2 retention and the change you’re making, Ashley, how’s the sampling program changing and how might this impact new customer starts? Given that you include samples in new starts, I’m wondering if having a more stringent sampling process could result in, you know, change to your new start growth. And just related, you know, you said losing a few share points of new customer starts in 2027.

I think that’s the assumption in the outlook. Is that conservative enough with three new competitors. Thank you,

Ashley McEvoy (President & Chief Executive Officer)

Larry. Thanks for the question. I’ll start with a bit of some of our type 2 actions. One, we implemented a very comprehensive approach to really improve how we’re serving our type 2 community in quarter three and again I’m very pleased with the speed and the intentionality that our team has addressed this. Number one, you mentioned the sample and yes, we have much tighter governance and the field is now implementing our revised governance policy, which is really around adjudicating health care and making sure we script. In fact, I was in the field that had consistently been doing that on Friday and they were seeing attrition rates, low single digits. So we know that that’s going to be a winning playbook as we build over quarters.

The second is we’ve added to our customer team clinical retention specialists and they’re trained, they’re up and going. They are having, I think, early green shoots of interaction in terms of quality, quality of engagements. We’ve also then expanded our field force sales compensation program from in addition to incenting them on NCF but also incenting them on quality of staying into the franchise, particularly the first month. And again that’s a newer program.

We’re going to see benefits of that in quarters to come. And then importantly, as I shared in my opening remarks, we’ve launched Omnipod Discover, which is our new data platform, Larry, and again we now have in full market release 35,000 people with diabetes using Omnipod Discover and we now have over 5,000 clinicians. I will tell you I was in the field on Friday in a safety-net hospital with 1,500 patients on Medicaid. They’re seeing remarkable retention trends using this patient engagement platform. Again, I believe that that will build over time.

So I think we have the right strategies. I’m seeing, I think, our strategies have momentum. I think that these are going to build over time so we are just as masterful at serving this customer base as we have been for the past 25 years of the type 1 community. So when I think about next year, Larry, again, I’m going to start with what I was sharing with Robbie. We have a very strong, strong, growing, leading customer base, the largest customer base in the industry that has been growing at a phenomenal pace in 2026. When I think about next year, I still think we’re going to have the leadership share in the customer base. I still think we’ll expand our share and customer base. We will continue to bring people into the category.

We will be the NCS share leader. But yes, of course we’re going to lose a couple share points with some of the competitive entrants coming in. And again, we’re going to play upon the strength of our customer base and the retention efforts we’re doing and the continued improvement that we continue to do with a category leader. We bring the majority of the volume from the MDI category into the AID. And if you have any other kind of specific questions, we’re happy to get you on the follow-up call on some of the numbers you were asking about.

Larry Biegelsen (Analyst)

That’s perfect. Thank you so much.

OPERATOR

Your next question comes from the line of Matthew O’Brien from Piper Sandler. Your line is open. Please go ahead.

Ana (Analyst)

Hi, good morning. This is Ana on for Matt. Thanks for taking our question here. I just wanted to sort of focus in on those type 2 initiatives that you’ve got going on. Just any sort of color you can provide on the early indicators that the first 90-day experience is starting to improve durably. I know it’s, you know, still early days, but maybe if you could just, yeah, elaborate on some of the leading indicators that are most predictive of durable retention going forward.

Ashley McEvoy (President & Chief Executive Officer)

Ana. Thank you for the question. I really don’t have a lot to add that I just shared on Larry’s question. You know, again, our strategies are having momentum to improve type 2 retention. It’s going to build over time. We’ve made meaningful investments in our field and these programs that are going to pay dividends for quarters and years to come.

OPERATOR

Your next question comes from the line of Michael Pollard from Wolfe Research. Your line is open. Please go ahead.

Michael Pollard (Analyst)

Hey, good morning. Just one for me. Ashley, in your prepared remarks, you highlighted one PBM agreement updated for 2027, two more to finalize here in coming weeks. The next mention in your script was about manufacturing scale and scope. And I want you to tell me what you were telling me there, kind of highlighting scale alongside the PBM agreements where you, and then competition coming. Is there a message about pricing in there that I need to hear or am I not putting the two tidbits together?

And if I’m not putting them together correct, can you tell me what I should take away from that message? Thank you.

Ashley McEvoy (President & Chief Executive Officer)

Thank you, Mike, for the question. I mean, I would say a couple things. We always believe in broad access. It’s one of, like, our core philosophies. And we pioneered the pharmacy channel. We have a leadership share in the pharmacy channel. We produce a lot of volume through the pharmacy channel in the United States and we have outstanding coverage, over 98% coverage. We have very strong coverage in Medicaid and we have very strong coverage in Medicare.

We also have a meaningful amount of preferred coverage, which means it’s much more accessible for patients. They don’t have to have prior authorizations. And we’re going to keep on that strategy. It’s a winning strategy. It’s a winning strategy for the category. We’ve seen new competitors come in. They’ve been very disciplined on pricing. We have an unrivaled amount of volume going through this channel. So we will be very disciplined. We believe in the clinical and economic value proposition of the AID category. So do payers. And I’m pleased to see, as expected, we’re a third of the way through our negotiations. We expect to complete the others in the next several weeks and it will be intact with our strategy overall.

We think in the United States it’ll be stable pricing. Thank you.

OPERATOR

Your next question comes from the line of Jason Bedford from Raymond James. Your line is open. Please go ahead.

Jason Bedford (Analyst at Raymond James)

Good morning. And I’ll keep it to one as well. Wanted to ask about the interplay between user base and revenue growth. I think you mentioned that the US installed base grew high teens in 3Q, which is better than I was thinking. But the fourth quarter revenue guide for the US is 10 to 13%. So I’m just wondering why these two numbers wouldn’t be a bit closer. And maybe you can help us bridge some of these factors.

Ashley McEvoy (President & Chief Executive Officer)

Yeah. Thank you, Jason. Again, I’m really pleased with the strength of our US business. I mean, we’re three quarters of the way through the year and, year to date, they’re posting revenue growth of 20, you know, slightly north of 20%. Now clearly that’s going to moderate a bit in quarter four because we have a big comp coming into quarter four. So that’s really the simple answer. And again, the US has been delivering high-teens customer base growth again with year-to-date stable pricing and that installed base and the consumption, as I mentioned, the consumption which is the volume that that installed base is using, is very consistent to the growth rate of the customer base. And that’s what we will be entering 2027 with.

OPERATOR

Your final question comes from the line of Joanne Wuensch from Citibank. Your line is open. Please go ahead.

Joanne Wuensch (Analyst)

Good morning and thank you so much for taking the question. It sounds like we should really be thinking and focusing on the introduction of Omnipod 6 in 2027 as sort of a competitive response. Can you give us a little bit of an update on the timeline, the expectations and which features about Omnipod 6 should we really be focusing on? Thank you.

Ashley McEvoy (President & Chief Executive Officer)

Yeah, Joanne, thank you for the question. I think it’s helpful to, as market leader, we’ve done a lot of work the past year kind of understanding what the biggest unmet needs in the market are, how are we positioned versus what’s coming into the market and what matters most to people with diabetes as well as prescribers. And as I said in my remarks, the number one thing that people with diabetes are looking for as well as prescribers is lifestyle fit, quality of life.

This is a chronic progressive disease that people, they never get a break from it. And so that’s really what’s enabled Omnipod to capture the market leadership. And we’re going to play from our position of strength as we launch our sixth generation of Omnipod next year. What we’ve learned is it’s going to give improved clinical outcomes. The early data that we shared has people with type 1 diabetes at 76% time in range, with 40% less bolusing, which is a lot less manual intervention. And again, it’s going to be connected with the latest sensors, we’re going to have phone control available, and we will be launching this in the United States as well as outside the United States simultaneously.

This is a first in the company and we’ve had the benefit of time to really prepare to master how we sell our clinical evidence, how we sell our lifestyle fit and quality of life, how we really equip our field as well as our peer-to-peer education to really have a leadership share of voice, of making sure that prescribers and people with diabetes are aware of this meaningful innovation. Thanks for the question, Joanne.

OPERATOR

There are no further questions at this time and I will hand it back to Ashley McEvoy, President and CEO, for closing remarks.

Ashley McEvoy (President & Chief Executive Officer)

Listen, thanks everyone, for joining. You know, you heard our reminder of the strength of this market that we are the leader in. It’s one of the largest, fastest growing, most underpenetrated segments in medtech. We always know when it’s helpful to have the market on your side. And we’ve got full conviction that we’re going to continue to win more than our fair share of converts, you know, given our really unique user experience, our unbelievable manufacturing scale.

As I mentioned, we’ve invested billions over the years. We produce tens and tens of millions of pods a year. And then our other durable advantages. We’re on the precipice of a remarkable innovation agenda ahead of us, beginning with Omnipod 6. And then what we believe will be the industry’s first fully closed loop, which will be a transformation for type 2 and bring more people from the MDI category into this industry. And we’re just going to continue focusing on improving outcomes and reducing the burden of living with diabetes and serving more and more people. Couldn’t be more pleased with all my colleagues around the world at Team Pod and their maniacal focus on patients.

Thanks so much.

OPERATOR

This concludes today’s call. Thank you for attending. You may now disconnect.

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