Analyst Ratings February 20, 2026

Mizuho lifts Tandem Diabetes target to $22 after stronger-than-expected pump shipments

Analyst keeps Neutral rating while revenue beat and shipment gains highlight mixed profit and channel-shift dynamics

By Maya Rios TNDM
Mizuho lifts Tandem Diabetes target to $22 after stronger-than-expected pump shipments
TNDM

Mizuho increased its price target on Tandem Diabetes Care to $22 from $21 but retained a Neutral rating after the company reported a revenue beat driven by record global insulin pump shipments. Management set fiscal 2026 guidance showing low-single-digit sales growth and modest EBITDA margin improvement, with notable headwinds tied to a shift of pump sales into the pharmacy channel and distributor inventory adjustments outside the U.S.

Key Points

  • Mizuho raised its price target to $22 from $21 and kept a Neutral rating, while the stock trades at $18.52 and has risen 73% over six months despite a 16% YTD drop - markets and healthcare sector impacted.
  • Tandem reported a $13 million revenue beat driven by record global pump shipments and delivered an adjusted EBITDA margin 250 basis points above expectations - medtech and device margins affected.
  • Fiscal 2026 guidance shows 5% to 7% sales growth and 5% to 6% EBITDA margin guidance; U.S. sales of $730M to $745M and outside-U.S. sales of $335M to $340M reflect channel shifts and inventory headwinds - pharmacy channel, distributors, and pharmacy/retail sectors impacted.

Mizuho raised its price objective for Tandem Diabetes Care (TNDM) to $22 from $21 while keeping a Neutral rating. The stock, which is trading at $18.52, has climbed 73% over the past six months despite a 16% decline year to date. Independent analysis places a Fair Value for the company at $21.32, suggesting the shares may be undervalued at current levels.

The company reported a revenue beat of $13 million, driven primarily by record global pump shipments. Adjusted EBITDA margin also exceeded expectations, coming in 250 basis points above forecasts. For fiscal 2026 management guided to total sales growth of 5% to 7% year over year, below Street estimates of about 8.5%. EBITDA margin guidance was set at 5% to 6%, versus the Street estimate of 5.2%.

U.S. revenue guidance is $730 million to $745 million. Management attributes the U.S. outlook to pump shipments growing 10% to 11% year over year and higher consumables sales moved through the pharmacy channel. These positives are offset by a $70 million to $80 million headwind resulting from a shift in sales mix - roughly 20% of pumps sold are expected to migrate from durable medical equipment (DME) to pharmacy under a pay-as-you-go model.

Outside the U.S., leadership is projecting $335 million to $340 million in sales. That guidance reflects a continued transition to a direct sales model, increasing the share of direct sales from approximately 5% to 15% of international revenue by year-end. The company expects direct sales to carry a roughly 30% higher average selling price, but forecasted results include a $15 million headwind tied to distributor de-stocking and inventory buybacks.

On product adoption, Tandem said renewals remain stable and forecasted that conversions of patients from multiple daily injections to pump therapy should resume growth over 2026. Mizuho noted competitive pressures remain a consideration for future adoption trends. The company reported a 53% gross profit margin, which the firm described as healthy despite ongoing profitability challenges.

Alongside Mizuho’s update, two other large analyst firms adjusted their stances on Tandem. BofA Securities upgraded its rating to Neutral from Underperform, citing the company’s strategic shift toward the pharmacy channel and a pay-as-you-go model that the firm expects will support improved profitability over the next two years. Baird moved its rating to Outperform from Neutral, citing the expected mid-2026 launch of the Mobi-T insulin pump as a material catalyst. Both BofA and Baird have increased their price targets to $30.

The company’s guidance and recent analyst actions paint a picture of mixed near-term dynamics: stronger shipment volumes and margin beats on the one hand, and channel-related headwinds and inventory adjustments on the other. Management’s guidance implies modest revenue growth and incremental EBITDA margin improvement in fiscal 2026, but the extent of recovery in new pump conversions and the competitive landscape will influence outcomes.


Summary: Mizuho raised its price target to $22 and maintained a Neutral rating after Tandem reported a $13 million revenue beat driven by record pump shipments and an adjusted EBITDA margin 250 basis points above expectations. Fiscal 2026 guidance calls for 5% to 7% revenue growth and 5% to 6% EBITDA margins, with notable channel and inventory headwinds in both U.S. and international markets.

Risks

  • Channel-shift headwind: Approximately 20% of pumps sold are expected to move from durable medical equipment to pharmacy under a pay-as-you-go model, creating a $70M to $80M headwind that could pressure near-term revenue recognition - impacts medical device and pharmacy sectors.
  • Inventory and distributor disruption: Outside the U.S., a $15M headwind from distributor de-stocking and inventory buybacks may constrain international sales growth and distort near-term demand signals - affects international distribution and supply-chain dynamics in medical devices.
  • Competitive pressure on conversions: Mizuho highlighted ongoing competitive concerns that could slow the return to growth in conversions from multiple daily injections to pump therapy during 2026 - impacts adoption rates and medtech market share dynamics.

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