Senseonics (SENS) Q3 2025: DTC Drives 160% New Patient Growth as Margins Expand Above 40%
Sensonics posted record highs in new patient adoption and insertions, fueled by direct-to-consumer (DTC) marketing and a strategic shift to in-house commercialization of Eversense 365. The company’s transition away from Ascensia Diabetes Care unlocks higher margins and strategic control, while robust patient and provider growth signals durable momentum heading into 2026. With reinsertion and reorder cycles set to contribute, Senseonics is positioned for sustained top-line and margin expansion as its DTC and EonCare models scale.
Summary
- DTC-Led Growth Surge: Direct-to-consumer campaigns now drive 60% of new patient starts, reshaping acquisition dynamics.
- Margin Expansion Accelerates: Gross margin climbs above 40%, with a roadmap to 50% in 2026 as Sensionics takes over commercialization.
- Operational Independence: Full transition from Ascensia unlocks strategic flexibility, with European launch and reinsertion cycles ahead.
Performance Analysis
Sensionics delivered a breakout quarter, with revenue up 90% year-over-year, driven by the U.S. launch of Eversense 365, a 365-day continuous glucose monitor (CGM), and aggressive DTC marketing. U.S. revenue accounted for roughly 79% of the total, with international sales steady ahead of the planned European relaunch. New patient shipments surged 160%, powered by a 300% year-over-year increase in digital campaign leads and a 150% jump in new insertions. The installed base grew over 150% YoY, underscoring rapid adoption and expanding market reach.
Gross profit margin improved to over 40%, up from 25% at the end of 2024, as Eversense 365’s economics and the shift to direct commercialization took hold. Operating expenses rose, reflecting higher DTC and salesforce investments, but the net loss narrowed by $4.5 million due to improved margins and lower R&D costs. The one-time inventory and channel transition with Ascensia will temporarily affect 2026 revenue recognition, but underlying patient growth and margin levers remain intact.
- DTC Channel Dominance: 60% of new patients originated from DTC, up from historical levels, reflecting the impact of targeted digital spend.
- Reorder Cycle Inflection: Q4 will see the first meaningful reorders as initial 365-day users reach renewal, boosting recurring revenue.
- Consignment Model Scaling: Office consignment now exceeds half of global revenue, aligning with bundled payment adoption and provider incentives.
With the upcoming full control of U.S. and European commercialization, Sensionics is set to recognize 100% of Eversense revenue, eliminating revenue share drag and positioning the business for margin and cash flow leverage as scale builds.
Executive Commentary
"Our third quarter revenue grew by 90% from Q3 last year. During the quarter, we also executed a memorandum of understanding with Ascensia Diabetes Care to reassume control of Eversense commercialization. We're excited about the upcoming change and seeing it as enabling us to control the strategy and investments into building Eversense."
Tim Goodnow, President and Chief Executive Officer
"With support from our shareholders, we executed a reverse stock split. This was an important step for the company as we had the opportunity to speak with many investors that were interested in the story but were unable to invest in a sub-$1 stock. The reverse split enables access to new large investors and significantly simplifies our cap table."
Rick Sullivan, Chief Financial Officer
Strategic Positioning
1. Direct-to-Consumer as the Primary Growth Engine
Sensionics’ DTC strategy, digital marketing directly to patients, has transformed its patient acquisition funnel. DTC campaigns contributed 60% of new patient starts, up from historical norms, and digital leads rose 300% YoY. The company will maintain this investment level in 2026, focusing on geo-targeting and conversion optimization to maximize ROI and minimize spend dilution outside core insulin-using demographics.
2. In-House Commercialization for Margin and Control
The transition from Ascensia Diabetes Care to direct Sensionics control ends revenue sharing and enables full recognition of product revenue, driving gross margin expansion. Nearly all U.S. CGM employees are joining Sensionics, ensuring continuity. The same approach will be taken in Europe, with a dedicated Salesforce launching the 365-day product in H1 2026, setting the stage for international growth on Sensionics’ terms.
3. EonCare and Inserter Network as Access Multipliers
EonCare, Sensionics’ direct insertion provider network, now accounts for one quarter of all insertions, addressing clinical access constraints and enabling rapid scaling. The number of trained inserters increased 140% YoY, and EonCare is expected to double its nurse network in 2026, supporting continued nationwide expansion and provider engagement.
4. Pipeline and Platform Integration
Product pipeline momentum continues with Gemini and Freedom, next-generation CGMs targeting late 2026 (Gemini) and early 2028 (Freedom) launches. The upcoming integration with Sequel’s Twist insulin pump, an automated insulin delivery system, is slated to begin patient ramp in early 2026, positioning Eversense as a core component of closed-loop diabetes management.
5. Provider and Payer Channel Evolution
Provider engagement is broadening beyond endocrinology into primary care, supported by Medicare and private payer adoption of bundled payment models. The consignment channel, where providers buy and bill for insertions, is poised to outpace traditional DME (durable medical equipment) channels in 2026, aligning incentives and supporting higher provider adoption.
Key Considerations
This quarter marks a structural inflection for Sensionics, with operational and strategic independence coming into focus as patient and provider adoption accelerate. Several factors will shape the company’s trajectory in 2026 and beyond:
Key Considerations:
- Reorder Tailwind: Q4 marks the start of the annual reinsertion cycle, converting new users into recurring revenue streams and improving revenue predictability.
- Margin Expansion Roadmap: Direct commercialization and manufacturing scale are projected to drive gross margins toward 50% in 2026 and 70% at scale, fundamentally improving profitability.
- Inventory and Channel Transition: The handoff from Ascensia will create a one-time inventory absorption effect in early 2026, temporarily dampening reported revenue but not underlying patient growth.
- Pipeline Execution: Timely regulatory approvals and successful launches of Gemini, Freedom, and Twist integration are critical to maintaining competitive differentiation and long-term growth.
- Payer Mix Shift: Ongoing transition of private payers to bundled payment models will impact channel economics and provider engagement, with consignment expected to outpace DME in 2026.
Risks
Key risks include execution risk around the Ascensia transition, as any delays or missteps could disrupt sales or margin realization. Regulatory approval timelines for new products and the CE Mark in Europe remain potential bottlenecks, while competitive responses from larger CGM players could pressure pricing or limit share gains. Macro headwinds such as reimbursement shifts or tariff impacts, though currently mitigated, warrant continued monitoring.
Forward Outlook
For Q4 2025, Sensionics expects:
- Majority of annual revenue to be recognized, driven by new patient starts and first 365-day reorders.
- Continued DTC investment at 2025 levels, sustaining lead generation and patient growth.
For full-year 2025, management guided to:
- Approximately $35 million in global net revenue, reflecting doubled patient base and launch execution.
- Gross profit margin between 35% and 40%, with upside as commercialization transitions complete.
Management emphasized that full 2026 guidance will be provided in January, citing inventory normalization and the timing of European launch as variables. Patient base doubling remains the high-level target, with margin expansion and new product launches as core growth levers.
Takeaways
Sensionics is executing a high-conviction transition to operational independence, with DTC-led patient acquisition, expanding provider access, and structural margin improvement as core drivers.
- Patient Growth Foundation: Record new patient starts and a rapidly expanding installed base set the stage for recurring revenue and scale leverage.
- Margin and Channel Transformation: The end of revenue sharing and shift to direct sales unlocks gross margin potential and strategic flexibility.
- 2026 Watchpoints: Monitor the pace of reinsertion cycles, provider consignment adoption, and the impact of pipeline launches and pump integrations on competitive positioning.
Conclusion
Sensionics’ Q3 marks a decisive pivot toward sustainable growth and profitability, with DTC marketing and channel control driving both top-line momentum and margin expansion. As the company finalizes its transition from Ascensia and prepares for new product launches, investors should focus on execution milestones, payer mix evolution, and the durability of patient conversion trends.
Industry Read-Through
Sensionics’ success with DTC marketing and consignment-based provider models signals a shift in CGM market dynamics, with patient preference and access models becoming central to share gains. The move toward annualized, long-wear CGMs and integration with closed-loop insulin pumps is accelerating, pressuring legacy device cycles and reimbursement structures. For the broader diabetes device sector, the importance of direct patient engagement, recurring revenue models, and operational control is rising, with implications for both established players and emerging entrants targeting durable, high-frequency use cases.