International revenue accounted for 28% of total revenue in 2023, highlighting the company's success in expanding its global footprint. The company continues to pursue growth opportunities outside the United States, particularly in Asia and Europe.

Dexcom is focused on research and development efforts and strategic third-party collaboration activities on the enhancement of current CGM products, the development of next-generation products and the development of novel technologies and services.

Dexcom continues to enter into collaborative arrangements with third parties to expand into new markets, including with insulin device manufacturers to integrate Dexcom CGM technology into the third parties' insulin delivery systems.

Dexcom has focused significant effort on continual improvement programs in manufacturing operations intended to improve quality, yields and throughput. The company has made progress in manufacturing to enable it to supply adequate amounts of product to support commercialization efforts.

Dexcom is deeply committed to the safety, health and wellness of its employees. The Dexcom Environmental, Health, Safety & Sustainability team develops global safety practices and procedures, trains employees, and monitors compliance.

Dexcom's journey to create a more diverse, equitable and inclusive workplace continues. As Dexcom continues to grow and scale, the company believes its DEI initiatives have been critical not only for company culture but also for the growing diversity of patients its products will benefit across the globe.

Dexcom acknowledges the risk of decreasing prices for its products due to pricing pressure from managed care organizations and other third-party payors. Cost-containment efforts by these payors could lead to reduced product pricing and/or sales, causing a reduction in revenue.

Dexcom relies on third-party suppliers for certain components and materials used in manufacturing. Disruptions in supply, suboptimal quality, non-compliance, and/or price fluctuations from these suppliers could harm the business.

Cybersecurity risks and cyber incidents could result in the compromise of confidential data or critical data systems and give rise to potential harm to customers, remediation and other expenses, expose Dexcom to liability under HIPAA, consumer protection laws, or other common law theories, subject it to litigation and federal and state governmental inquiries, damage its reputation, and otherwise be disruptive to its business and operations.

The market for glucose monitoring devices is intensely competitive, subject to rapid change and significantly affected by new product introductions and other market activities of industry participants. Dexcom competes directly with major players like Abbott, Medtronic, and Roche.

Dexcom is aware of companies outside the traditional medical device sector that are attempting to develop competitive products and services, including for the general health and wellness, or population health space. Some of the companies developing or marketing competing devices are large and well-known publicly traded companies.

Dexcom is also aware of the increasing use of GLP-1 products for the treatment of obesity and Type 2 diabetes. While Dexcom believes that GLP-1s are a companion product and used in conjunction with CGM systems, these treatments could potentially compete with Dexcom's CGM systems and reduce sales of our products.

Dexcom has focused significant effort on continual improvement programs in its manufacturing operations intended to improve quality, yields and throughput. The company has made progress in manufacturing to enable it to supply adequate amounts of product to support commercialization efforts.

The scaling of manufacturing capacity is subject to numerous risks and uncertainties, and may lead to variability in product quality or reliability, increased construction timelines, as well as resources required to design, install and maintain manufacturing equipment, among others, all of which can lead to unexpected delays in manufacturing output.

Cost of sales and gross profit increased primarily due to an increase in sales volume. The decrease in gross profit margin in 2023 compared to 2022 was primarily driven by the increase of the amortization of an intangible asset and price, product, and channel mix changes.

Dexcom is focused on research and development efforts and strategic third-party collaboration activities on the enhancement of current CGM products, the development of next-generation products and the development of novel technologies and services.

Dexcom plans to develop future generations of technologies that are focused on improved performance and convenience and that will enable intelligent insulin administration. Over the longer term, the company plans to continue to develop and improve networked platforms with open architecture, connectivity and transmitters capable of communicating with other devices.

Dexcom continues to believe that focused investments in research and development are critical to its future growth and competitive position in the marketplace, and to the development of new and updated products and services that are central to its core business strategy.

On October 24, 2023, the Board of Directors authorized and approved a share repurchase program of up to $500.0 million of outstanding common stock. The company entered into an accelerated share repurchase agreement with Bank of America, N.A. to repurchase shares.

Long-term liquidity requirements primarily consist of interest and principal payments related to senior convertible notes, capital expenditures for the development of manufacturing facilities and office spaces, and long-term material cash requirements.

The company expects to meet its long-term liquidity requirements from its main sources of liquidity as described above to support future operations, capital expenditures, acquisitions, and other liquidity requirements associated with its operations beyond the next 12 months.

Dexcom believes that taking into account the interests of its various stakeholders enables it to operate in a sustainable manner, supports the success of its business and drives long-term value. This is done by holding true to core values: Listen, Think Big, Be Dependable, and Serve with Integrity.

Dexcom's journey to create a more diverse, equitable and inclusive workplace continues. As Dexcom continues to grow and scale, the company believes its DEI initiatives have been critical not only for company culture but also for the growing diversity of patients its products will benefit across the globe.

Our research and development and clinical processes involve the handling of potentially harmful biological materials as well as hazardous materials. We are subject to federal, state and local laws and regulations governing the use, handling, storage and disposal of hazardous and biological materials.

Private third-party payors and other managed care organizations, such as pharmacy benefit managers, continue to take action to manage utilization and control costs. Consolidation among managed care organizations has increased the negotiating power of managed care organizations and other private third-party payors.

Our operations and performance depend on worldwide economic and political conditions. These conditions have been adversely impacted by continued global economic uncertainty, political instability and military hostilities in multiple geographies, concerns over continued sovereign debt, potential recessions, a potential U.S. federal government shutdown, monetary and financial uncertainties in Europe and other foreign countries, and global health pandemics.

In response to perceived increases in health care costs in recent years, there have been and continue to be proposals by the federal government, state governments, regulators, and third-party payors to control these costs and, more generally, to reform the U.S. health care system.