DexCom has traded 20% growth for a steady low-double-digit pace, and the next step up depends on Medicare agreeing to cover people with diabetes who do not use insulin. Until that decision lands, profit is coming from switching its own customers onto a sensor that lasts 15 days.How much of DXCM's revenue now comes from outside the US?
Growth has settled into low double digits and stopped slowing.
Organic growth ran at 20% a year ago and has held at 12% for three straight quarters. Only about a third of the people who already have coverage use it, so the next gains come from persuading covered patients, not from new wins.What did DXCM's growth rate look like before the 2025 coverage wins?
The profit story is now DexCom's own customers, not new ones.
Gross margin has recovered from last year's scrap and freight problems to about 64%, where management guides the year. The 15-day sensor lasts longer at the same monthly price, so each customer needs fewer sensors for the same revenue.How does DXCM's gross margin compare with its closest device peers?
The next growth lever is a Medicare decision that has not been made.
About 25 million Americans have diabetes without using insulin, and roughly half are old enough for Medicare. Management expects a decision by year end with coverage starting mid-2027, and its 2026 guidance assumes no new coverage.
Bullish
Payers keep widening coverage faster than the guidance assumes. Guidance counts only the coverage that exists today, so each new plan adds patients DexCom can bill right away.
Half the US customer base moves to the 15-day sensor this year. The same monthly sales then need fewer sensors to make, so profit grows faster than revenue.
The Connect trial results keep winning payers outside the US. International patient numbers dwarf the US, so one payer there can add more users than a year of US selling.
Bearish
Medicare pushes its decision past the end of this year. Twelve million patients stay out of reach, so the company keeps growing at the pace it is growing today.
Ireland starts manufacturing before it produces much. Running the plant costs money in the fourth quarter before it produces, so this year's margin gain arrives next year.
Customers switch to the new sensor more slowly than planned. Past upgrades took a couple of years to roll through, so the profit gain from the switch keeps getting pushed out.
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