Tandem Diabetes Care (TNDM) Q1 2026 earnings summary

Executive summary

• Achieved record Q1 2026 pump shipments and sales, with over 29,000 pumps shipped globally and $247.2 million in sales, up 5% year-over-year, and 35% of revenue from international markets.

• Gross margin improved to 55%, an increase of 480 basis points from the prior year, driven by higher ASPs and favorable product mix.

• Net loss narrowed to $20.4 million from $130.6 million in Q1 2025, reflecting improved gross margin and lower operating expenses.

• Advanced key initiatives: modernized commercial operations, expanded direct international presence (UK, Switzerland, Austria), launched new technologies, and introduced Android compatibility.

• Launched pay-as-you-go reimbursement model in the US pharmacy channel, with expanded formulary coverage and direct international operations.

Financial highlights

• Q1 2026 worldwide sales grew 5% year-over-year to $247.2 million; US sales up 7% to $160.8 million; international sales up 3% to $86.4 million.

• Gross profit reached $136.8 million, with gross margin at 55% versus 51% a year ago.

• Adjusted EBITDA margin was 1% in Q1 2026, a significant improvement from -34% in Q1 2025.

• Free cash flow was positive at $4.8 million in Q1 2026, compared to negative $21.2 million in Q1 2025.

• Cash, cash equivalents, and short-term investments totaled $570.3 million at quarter-end.

Outlook and guidance

• Reaffirmed 2026 worldwide sales guidance of $1.065–$1.085 billion, with US sales of $730–$745 million and international sales of $335–$340 million.

• Gross margin guidance for 2026 is 56–57%, with adjusted EBITDA of 5–6%.

• Q2 worldwide sales expected at ~$255 million; US sales ~$175 million; international sales ~$80 million.

• PayGo and direct transition models expected to create sales headwinds of $70–$80 million in the US and $15 million internationally in 2026.

• Longer-term goals include 65%+ gross margin and 25%+ operating margin, with 80% of US pump shipments through pharmacy in 2–3 years.