Tandem Diabetes Care (TNDM) Q1 2026 earnings summary

Executive summary

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

• Gross margin improved to 55%, an increase of 480 basis points from the prior year, driven by higher average selling prices 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.

• Expanded product ecosystem with Android compatibility, launched a pay-as-you-go reimbursement model in the US pharmacy channel, and advanced direct commercial operations in the UK, Switzerland, and Austria.

• Demonstrated positive free cash flow and strengthened the balance sheet with a 0.00% convertible debt offering.

Financial highlights

• Q1 2026 worldwide sales grew 5% to $247.2 million; US sales reached $160.8 million (up 7%), and international sales were $86.4 million (up 3%).

• Gross profit was $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 $4.8 million, up from negative $21.2 million year-over-year.

• 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%; adjusted EBITDA margin expected at 5–6%.

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

• PayGo pharmacy model expected to create a $70M–$80M sales headwind in 2026; international direct transition to impact sales by $15M.

• Cash position and projected cash flows deemed sufficient to fund operations for at least the next twelve months.