Tandem Diabetes Care, Inc.

What they do

Tandem designs, develops and commercializes insulin pumps and related diabetes technology, including the t:slim X2 and Tandem Mobi platforms, both featuring Control-IQ+ advanced hybrid closed-loop technology. The company serves nearly 500,000 people living with diabetes in more than 25 countries, selling durable pump hardware plus single-use supplies such as insulin reservoirs and cannulas. It sells primarily through durable medical equipment channels and is scaling a pay-as-you-go reimbursement model through the U.S. pharmacy channel.

Revenue drivers

• U.S. pump sales — The largest revenue line; U.S. sales were $179.3 million in Q2 2026, about 70% of the $254.6 million quarterly total, on more than 22,000 U.S. pump shipments.
• International pump sales — International sales were $75.3 million in Q2 2026, about 30% of the total, on approximately 11,000 pump shipments, with the Tandem Mobi international commercial rollout beginning.
• Single-use supplies and consumables — Durable pumps connect to single-use supplies (insulin reservoir and cannula) expected to be replaced every three to seven days, generating recurring revenue per installed user.
• Pharmacy channel reimbursement — A scaled pay-as-you-go reimbursement model accounted for 10% of U.S. sales in Q2 2026, an emerging route to U.S. customers alongside traditional DME channels.

Recent performance

Second quarter 2026 worldwide sales rose 6% to $254.6 million from $240.7 million, with U.S. sales up 5% to $179.3 million and international sales up 7% to $75.3 million. Gross margin was 57%, up 460 basis points year over year, and gross profit was $144.8 million versus $125.9 million. GAAP and non-GAAP operating loss was $13.8 million, or negative 5% of sales, compared with a GAAP operating loss of $51.8 million a year earlier, which included a $20.0 million litigation settlement charge. GAAP and non-GAAP net loss was $21.2 million, and adjusted EBITDA was positive $6.4 million, or 3% of sales. Full-year 2025 revenue was $1.01 billion with a net loss of $204.7 million and operating cash flow of negative $9.7 million.

Strategy

Tandem's stated strategy is to offer flexibility and choice in intelligent insulin delivery through an accessible portfolio of pumps, applications and insights. In 2025 it began expanding its addressable market from type 1 diabetes to include people with type 2 diabetes who require intensive insulin therapy. Recent product milestones include a 510(k) submission for Tandem Mobi tubeless capability, FDA clearance and CE Mark for Control-IQ+ use in type 1 pregnancy, CE Mark for type 2 adults, and sensor compatibility expansions with the Dexcom G7 15-day and Abbott FreeStyle Libre 3 Plus. The company is also scaling pay-as-you-go reimbursement in the U.S. and beginning the international commercial rollout of Tandem Mobi.

Risks

• History of significant losses — As of December 31, 2025, Tandem had an accumulated deficit of $1.3 billion and had net losses from operations in 2025, 2024 and 2023 despite positive gross margin.
• Balance sheet leverage and limited cash — At June 30, 2026, total liabilities were $1.02 billion against $130.4 million of shareholder equity, with $602.6 million of long-term debt and $62.8 million in cash and equivalents.
• Reimbursement channel transition — The company is scaling pay-as-you-go reimbursement through the U.S. pharmacy channel, which represented 10% of U.S. sales in Q2 2026 and carries pricing and transition assumptions disclosed in its 2026 guidance presentation.
• Underpenetrated and competitive pump market — U.S. insulin pump use is approximately 40% of people with type 1 diabetes and 5% with type 2, and international adoption averages about 20%, leaving growth dependent on converting MDI users in a competitive environment.

Outlook

For the year ending December 31, 2026, Tandem reaffirmed guidance of approximately $1.065 billion to $1.085 billion in sales, with U.S. sales of $730 million to $745 million and international sales of $335 million to $340 million. Gross margin is guided to approximately 56% to 57% of sales and adjusted EBITDA margin to approximately 5% to 6%. Non-cash charges in cost of goods sold and operating expenses are now estimated at approximately $85 million, reduced from $100 million, including about $65 million of stock-based compensation and about $20 million of depreciation and amortization.