Good morning, and welcome to our third quarter 2026 earnings call. Joining me today are Ashley McEvoy, President and Chief Executive Officer, and Flavia Pease, 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.

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?

Good morning, everyone, and thanks for joining us to discuss our third quarter results. Our teams delivered a strong quarter with US 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 two 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 US 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 use across our markets, despite ADA guidelines recommending AID as the standard of care. 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 US 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 $1 billion 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 US sales force 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 US sales team. Optimization is ongoing, and we continue to educate our team 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 two 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 sales force 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 US 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 and 5,000 clinicians.

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 US.

The updated algorithm adds a new 100 milligrams per deciliter target and fewer automated delivery restriction alarms, 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 US integration with FreeStyle Libre 3 Plus, and as of today, we have extended integration to 10 new markets.

The iOS platform for Libre 3 Plus is underway, with US limited market release expected in quarter four, providing access for 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 on to 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 US, we continued 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 US, 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 US, 84% in the UK, 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 patient choice of AID, and these are the reasons people with diabetes choose Omnipod.

It's not just our customers. Prescribers view Omnipod as the most differentiated AID on the market.

Omnipod continues to lead among US 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. 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. 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. To close, our quarter three 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've 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 multi-billion-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.

Thank you, Ashley, and good morning, everyone. The Insulet team delivered another strong quarter with total revenue of $842 million, an increase of 19.2% on a reported basis and 19.6% on a constant currency basis.

Total company performance was supported by customer base growth of more than 20%, low single-digit growth in new customer starts, and stable pricing. We also saw a modest improvement in retention during the quarter, while utilization remained stable.

Our strong top-line performance, combined with continued operating leverage, drove significant profitability gains, with adjusted gross margin expanding 200 basis points, adjusted operating margin expanding 490 basis points, and adjusted EPS increasing 60%. In the US, Omnipod revenue grew 14.7% during the quarter, driven by continued demand across both Type 1 and Type 2, with our customer base growing in the high teens and new customer starts flat compared to prior year.

US pricing was down slightly in the quarter, but remains flat year-to-date, and we continue to expect positive pricing for the full year. International Omnipod revenue grew 31.7% on a reported basis and 33% on a constant currency basis, driven primarily by volume and continued favorable price mix realization.

Results in the quarter reflected a 250 basis points benefit from reserve adjustments, including approximately $3 million in France related primarily to a clawback accrual, and approximately $2 million in Canada related to reserve releases and updated program assumptions. Third quarter adjusted gross margin was 74.2%, up 200 basis points year-over-year.

Our continued gross margin expansion reflects the productivity gains we are realizing across our global operations. The scale of our manufacturing model remains a significant competitive advantage.

Turning to operating expenses. Within R&D, we continue to invest in our pipeline in support of the upcoming launch of Omnipod 6 in 2027 and advancing our fully closed loop for Type 2 diabetes, as well as progressing on our next-generation technologies and clinical programs.

Within SG&A, year-over-year growth was driven primarily by our previously discussed US sales force expansion, as well as continued investments in market development and customer support, including initiatives to strengthen the Type 2 customer experience and support adoption and retention. Importantly, we continue to balance these investments with disciplined expense management.

Third quarter adjusted operating margin was 22%, up 490 basis points year-over-year, reflecting strong revenue growth and gross margin expansion, as well as benefit from lower annual employee bonus accruals. These results demonstrate the operating leverage in our model and our ability to drive meaningful earnings growth, while investing in innovation, commercial capabilities, and continued category growth.

Third quarter net interest expense was $12.1 million, and our adjusted tax rate was 20.2%. Adjusted EPS in the quarter was $1.99, up 60% from $1.24 in the prior year, significantly outpacing revenue growth.

Turning to cash and liquidity. During the quarter, we upsized our corporate revolver to $750 million and refinanced our Term Loan B, reducing the rate by 25 basis points.

We ended the quarter with $584 million in cash and investments and the full $750 million available under our revolver. Year-to-date, we have generated $212 million of free cash flow, reflecting investments in working capital, inventory, and manufacturing capacity to support growth.

As Ashley mentioned, the Insulet board of directors has approved a $1 billion increase in our share repurchase program. The company plans to allocate $400 million toward repurchases in fourth quarter, which we expect to fund with excess cash.

The strength of the company's cash generation gives us the flexibility to return capital to shareholders, while maintaining our growth investments. Turning to our updated full year outlook, we have narrowed our revenue guidance to the high end of our prior range, and now expect full year constant currency revenue growth of 21% to 22% for total company and 21.5% to 22.5% for total Omnipod.

Foreign exchange is expected to positively contribute approximately 100 basis points to Omnipod and total company growth. Our outlook reflects our third quarter performance and expectations for the balance of the year.

While we saw encouraging indicators from the actions we took to strengthen onboarding and customer support in Q3, we're not assuming any additional benefit to our financial results for the remainder of the year. We are seeing early contributions from Omnipod Discover and our broader data and engagement capabilities, which we believe will have a meaningful impact in 2027 and beyond.

For the US, we now expect Omnipod revenue growth of 17.5% to 18.5% for the full year, which reflects year-over-year NCS growth, positive pricing, and fourth quarter attrition and utilization remaining similar to Q3 levels. For international Omnipod, we now expect 2026 revenue growth of 32% to 33% on a constant currency basis, reflecting strong performance year-to-date, continued momentum across our markets, as well as a price mix benefit which contributed high single digits to growth.

Foreign exchange is expected to positively contribute approximately 300 basis points to international growth. Based on our full year guidance, we would expect fourth quarter total company revenue growth of 13.5% to 17% and total Omnipod revenue growth of 13% to 16.5%.

On a reported basis, foreign exchange is not expected to have a meaningful impact on either measure. In the US, we expect Omnipod revenue growth of 10% to 13.5%, and internationally, we expect Omnipod revenue growth of 21% to 24%.

On a reported basis, foreign exchange is expected to be a headwind of approximately 50 basis points to international growth. Now turning to operating margin.

Given our outperformance in the third quarter, we now expect to drive approximately 150 basis points of adjusted operating margin expansion in 2026, driven by continued gross margin improvement and disciplined operating leverage. Below operating income, we expect net interest and other expense to total $40 million to $45 million, and a non-GAAP tax rate of 20% to 20.5%.

We continue to expect approximately 70 million shares outstanding and adjusted EPS growth of more than 30% for the full year. We expect free cash flow to be approximately $275 million in 2026, primarily reflecting higher capital expenditures and the impact of the MDC's and working capital uses.

These impacts are expected to be partially offset by strong earnings growth and margin expansion. Turning to 2027.

We're still working through our annual planning process, and will provide formal guidance on our fourth quarter call in February, but I want to share our latest thinking. We now expect 2027 total company growth to be modestly below the mid-teens framework we had provided on our Q2 call, as we plan to take a more conservative approach to our outlook and also factor in a tougher comparison and less price mix benefit internationally.

Our view of the US is broadly consistent with what we shared last quarter. We expect to guide toward the lower end of our prior framework, reflecting a more measured assumption for market growth and the impact of new competition, along with stable retention, pricing, and utilization, and limited contribution from our new product launches and our expanded sales force.

Internationally, our updated view reflects the tremendous year we're having, which creates a more difficult comparison for 2027, as well as reduced benefit from price mix, as more than 80% of our international customers will have converted to Omnipod 5. We'll also anniversary several large country launches.

We continue to see healthy underlying demand internationally, supported by robust growth in customer base. With that said, we expect international growth in 2027 to moderate meaningfully from 2026.

We remain committed to delivering top-tier revenue growth and expanding profitability, and we look forward to sharing our formal 2027 guidance in February. To close, we delivered another quarter of strong growth and significant margin expansion, while advancing our strategic priorities.

We remain focused on strengthening our commercial capabilities, accelerating innovation, and expanding the category to drive durable, profitable growth. We're focused on executing against the significant global opportunity ahead, and we look forward to updating you on our continued progress on our next call.

With that, operator, please open the call for questions.

Thanks. Good morning.

Thank you for taking the question. I wanted to start by double-clicking on some of your commentary on 2027, and specifically wanted to ask you, you mentioned it's 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.

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.

Sure, Matt. Thanks for the question.

Look forward to seeing you in London in a couple of weeks. I would say a couple of things.

Let me just kind of give a broad context to '26, which will be our baseline going in to '27. We anticipate closing out our 11th consecutive year of 20% revenue growth, which is pretty strong.

Again, coming off of a strong quarter three. 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.

We're taking that into consideration as we look at 2027. Coming off of that kind of base, we do expect our growth rate to moderate.

That's expected. Really comes for three 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 into the market.

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.

Maybe just as a follow-up, it looks like you didn't include some of the upside. 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.

No, thanks, Matt. I think Flavia said in her opening remark a little bit of what some of the going-in assumptions that our latest thinking took into consideration.

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 over 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 this 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, retention did improve, but we are building a more modest build over a period of time.

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. 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.

Great. Thanks so much.

Hey, thanks for the question. I guess I wanted to clarify.

You said US towards the lower end of the range in '27. Is that high single digits, or is it double digits for the US in '27?

Just want to make sure that's clear given the exit rate of 10 10% to 13.5%. There was a change in the guide philosophy back in November 2025 as well to be less conservative, 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.

Travis, thanks for the question. I'll start with your last question, and then 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, 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.

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 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.

Then just really clear-eyed about what's coming our way. As market leader, we know what to expect of what the market is.

We're just having a more conservative approach from our outlook as we approach 2027.

Thanks, Ashley. Travis, as we've said in our prepared remarks, we plan to guide towards the lower end of the framework that we provided in Q2, and we'll provide formal guidance in February with precise ranges.

What was the lower end of the framework in Q2? Was that high single digits or double digits?

Yeah. The prior range was 9%

to 14%. Thank you.

I'll stick to the one question.

Good morning, and thanks for taking the questions. Maybe just to follow up on the questions so far.

As we think about 2027, I realize you're not providing the full guide today, but I do think it's important given the trajectory of US 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. In the new more conservative outlook you're providing today, how are you thinking about it, and how is that different from the last quarter?

Then I have a quick follow-up. Thanks.

No, Robbie, 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.

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 from a revenue basis I'd say high teens, from 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 that, 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 US, we look at Type 2 US, and then we look at OUS Type 1.

All of the penetration rates for the category are well below CGM, 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 KPIs, what you're going to take to the bank.

We've shown some, I said, very modest improvement in the Type 2 US in quarter three. We expect that to build over time.

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.

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, Robbie?

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.

Hey, Robbie, it's Flavia. 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.

Good morning, everyone. I know most of the focus is on the US Omnipod business for good reason.

Outside the US, Flavia, you talked about a meaningful slowdown in growth next year, but you talked about maybe the global growth being just slightly below the previously communicated mid-teens. 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 in any other color there? Then I have one other follow-up.

Thank you.

Jeff, I'll start with the first part of your question, and then Flavia can join in. Our team, international OUS team, is absolutely on fire.

Year-to-date, they're posting revenue growth of north of 35%. They're on track to surpass $1 billion this year.

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 is a reflection of the value of your innovation, and they've mastered that.

We're on track to exit 2026 with 80% conversion. 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. With that as a backdrop, absolutely, growth will moderate next year.

Again, it will still be very competitive, top-tier growth OUS. 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.

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. On to that, maybe you want to

Sure.

first question about global.

I'm just going to reiterate that we're going to issue formal guidance in February of next year. Let me recap what we said in the call today, which is for the total company, we would expect the growth next year, or 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 US, we expect to guide at the low end of the framework we had provided in the second quarter.

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, I'll let you guys interpret what those mean.

Fair enough. Just for a follow-up, again, kind of a clarifying question, but is the T1 attrition rate still kind of sitting in the US close to that 10% range?

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 US as of last quarter.

I know our math was getting us around 25% to 30%. Is that 25% to 30% T2 attrition rate a fair number?

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.

Jeff, let me kind of first just take everybody back to kind of what drives our business model. The most important KPI is how many customers we have, and our customer base grew 20% in the quarter.

In the United States, it grew high teens. That is a really healthy measure.

Again, we saw globally stable pricing. 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 the Type 2 population.

Our Type 1 population is very consistent to the measure that you shared. We did see green shoots.

We saw improvement, modest improvement in that T2 retention trends. We also, again, saw when we think about going forward, 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.

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

Good morning. Thanks for taking the question.

Just on the Type 2 retention and the changes you're making, Ashley, how's the sampling program changing? 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 a change to your new start growth. Just related, you said losing a few share points in new customer starts in 2027.

I think that's a assumption in the outlook. Is that conservative enough with three new competitors?

Thank you.

Larry, thanks for the question. I'll start with a bit of some of our Type 2 actions.

One, we implemented a comprehensive approach to really improve how we're serving our Type 2 community in quarter three. Again, I'm very pleased with the speed and the intentionality that our team has addressed this.

Number one, you mentioned the samples. Yes, we have much tighter governance, and the field is now implementing our revised governance policy, which is really around adjudicating healthcare and making sure we have a 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. 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 care 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 of engagements. We've also then expanded our field force sales compensation program from, in addition to incenting them on NCS, but also incenting them on quality of staying into the franchise, particularly the first month.

Again, that's a newer program. We're going to see benefits of that in quarters to come.

Then importantly, as I shared in my opening remarks, we've launched Omnipod Discover, which is our new data platform, Larry. 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 on this patient engagement platform.

Again, I believe that that will build over time. I think we have the right strategies.

I think our strategies have momentum. I think that these are going to build over time, we are just as masterful at serving this customer base as we have been for the past 25 years of the Type 1 community.

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, growing, leading customer base, the largest customer base in the industry that has been growing in 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 in customer base.

We will continue to bring people into the category. We will be the NCS share leader.

Yes, of course, we're going to lose a couple share points with some of the competitive entrants coming in. 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.

As a category leader, we bring the majority of the volume from the MDI category into the AID. If you have any other kind of specific questions, Larry, happy to get you on the follow-up call on some of the numbers you were asking about.

That's perfect. Thank you so much.

Hi, good morning. This is Anna 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 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.

Thanks.

Anna, thank you for the question. I really don't have a lot to add that I just shared on Larry's question.

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 in these programs that are going to pay dividends for quarters and years to come.

Hey, good morning. Just one for me.

Ashley, in your prepared remark, 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, the 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.

Thank you, Mike, for the question. I would say a couple of things.

We always believe in broad access. It's one of our core philosophies.

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. 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. 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 unrivaled amount of volume going through this channel, we will be very disciplined. We believe in the clinical and economic value proposition of the AID category, do payers.

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.

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. The fourth quarter revenue guide for the US is 10% to 13%, 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.

Thank you, Jayson. Again, I'm really pleased with the strength of our US business.

We're three-quarters way through the year, and year-to-date, they're posting revenue growth of 20 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.

Again, the US has been delivering high-teens customer base growth, again with year-to-date stable pricing. 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.

That's what we will be entering 2027 with.

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 O6 should we really be focusing on? Thank you.

Joanne, thank you for the question. 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.

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.

That is why that's really what's enabled Omnipod to capture the market leadership. 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.

Again, it's going to be connected with the latest sensors. We're going to have phone control available OUS.

We will be launching this in the United States, as well as outside the United States simultaneously. This is a first in the company.

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.

Listen, thanks, everyone, for joining. 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.

We've got full conviction that we're going to continue to win more than our fair share of converts, 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.

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 of Team Pod and their maniacal focus on patients.

Thanks so much.