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 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 direct commercial operations in the UK, Switzerland, and Austria, and launched a pay-as-you-go pharmacy reimbursement model in the US.

• Expanded product ecosystem with Android compatibility, FDA clearance for Control-IQ+ in pregnancy, and prepared for international launches and integrations.

Financial highlights

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

• 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; US $730–$745 million; international $335–$340 million.

• Gross margin guidance for 2026 is 56–57%; adjusted EBITDA 5–6%; Q2 margins expected to remain consistent with Q1.

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

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

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