Tandem Diabetes is changing how customers in the U.S. get its t:slim X2 and Mobi insulin pumps. Instead of the standard 4-year commitment under durable medical equipment (DME), the company is launching a pay-as-you-go pharmacy model. With new “PayGo” contracts, users can start a pump with little or no upfront cost and pay over time through supplies billed at the pharmacy. Tandem says this should lower out-of-pocket costs and improve access as coverage shifts to pharmacy benefits.

The move also changes Tandem’s revenue model. Instead of a large one-time hardware sale, revenue will come from ongoing pharmacy-dispensed supplies like infusion sets and cartridges. The company expects higher lifetime revenue per customer, with a short-term 70 to 80 million dollar shift in 2026 as revenue moves from upfront to spread out over time. Tandem views that as the trade-off for better access and stronger long-term growth.

Tandem now joins a growing list of companies moving into pharmacy-based pump access, including Insulet’s Omnipod and Sequel Med Tech’s twiist insulin pumps. Beta Bionics is working to expand pharmacy coverage for its iLet Bionic Pancreas as well.

We’ve covered these transitions on our podcast, including a conversation with a Beta Bionics’ director of payer strategy on why pump companies are moving into pharmacy access and in a separate episode, Diana Isaacs, PharmD, BCACP, BC-ADM, CDCES, highlighted the risks that come with easier pump switching, from coverage challenges to gaps in training and follow-up support.

What are your thoughts on pumps going through pharmacy benefits? Leave your thoughts in the comments below.

Disclaimer: Diabetech content is not medical advice—it’s for educational purposes only. Always consult with a physician before making changes to your healthcare.