Inspire Medical Systems, Inc.
- Open
- 45.21
- Day high
- 47.10
- Day low
- 45.21
- Prev close
- 44.61
- Volume
- 659K
- Mkt cap
- $1.3B
- P/E (TTM)
- 10.1
- EPS (TTM)
- $4.53
- P/B
- 1.7
- P/S
- 1.4
- Yield
- —
- Per share
- —
- ▼Insiders net selling -$176K over the last 3 months (0 open-market buys, 3 sales)
- 🏛Institutions mixed (13F)
Inspire Medical Systems, Inc. (INSP) is a Healthcare company listed on NYSE. The stock is down 66% over the past year. Over the trailing 3 months, insiders filed 0 open-market buys and 3 sales (SEC Form 4).
Inspire Medical Systems, Inc. (INSP) financials & analyst ratings
Fundamentals (TTM)
Analyst consensus · 10 analysts
Source: exchange market data + company filings. Figures are trailing-twelve-month or as most recently reported. For informational purposes only — not investment advice.
INSP earnings date, history & EPS estimates
| Report date | EPS est | EPS actual | Surprise | Revenue | Rev. surprise |
|---|---|---|---|---|---|
| May 4, 2026 | $-0.28 | $0.10 | +136.3% | $205M | +2.3% |
| Feb 11, 2026 | $0.69 | $1.65 | +139.1% | $269M | +25.6% |
| Feb 6, 2024 | $-0.09 | $0.49 | +644.4% | $193M | +4.2% |
| Aug 1, 2023 | $-0.51 | $-0.41 | +19.6% | $151M | +10.8% |
| May 2, 2023 | $-0.70 | $-0.53 | +24.3% | $128M | +7.2% |
| Feb 7, 2023 | $-0.57 | $0.10 | +117.5% | $138M | +5.2% |
| Nov 1, 2022 | $-0.75 | $-0.60 | +20.0% | $109M | +15.8% |
| Aug 2, 2022 | $-0.59 | $-0.53 | +10.2% | $91M | +16.5% |
| May 3, 2022 | $-0.78 | $-0.61 | +21.8% | $69M | +8.1% |
| Feb 8, 2022 | $-0.47 | $-0.09 | +80.9% | $78M | +5.1% |
| Nov 2, 2021 | $-0.61 | $-0.38 | +37.7% | $62M | +10.7% |
| May 4, 2021 | $-0.65 | $-0.60 | +7.7% | $40M | +10.8% |
INSP insider trading activity (SEC Form 4)
| Date | Insider | Type | Shares | Price |
|---|---|---|---|---|
| May 19, 2026 | Rondoni Johnofficer: See Remarks | Sell | 2,641 | $43.28 |
| May 15, 2026 | Rondoni Johnofficer: See Remarks | Sell | 700 | $43.01 |
| May 11, 2026 | mcCormick Shawndirector | Sell | 696 | $45.31 |
| May 4, 2026 | Tansey Casey Mdirector | Grant | 3,562 | — |
| May 4, 2026 | Curet Myriamdirector | Grant | 3,562 | — |
| May 4, 2026 | Mead Dana G Jr.director | Grant | 3,562 | — |
| May 4, 2026 | Burks Cynthiadirector | Grant | 3,562 | — |
| May 4, 2026 | Melenikiotou Georgiadirector | Tax | 50 | $56.70 |
| May 4, 2026 | Ellis Gary Leedirector | Grant | 3,562 | — |
| May 4, 2026 | mcCormick Shawndirector | Grant | 3,562 | — |
| May 4, 2026 | Melenikiotou Georgiadirector | Grant | 3,562 | — |
| May 4, 2026 | Broader Shelley Gdirector | Grant | 3,562 | — |
| Apr 16, 2026 | Tansey Casey Mdirector | Grant | 308 | $52.07 |
| Apr 16, 2026 | Ellis Gary Leedirector | Grant | 518 | $52.07 |
| Apr 16, 2026 | Melenikiotou Georgiadirector | Grant | 307 | $52.07 |
Source: INSP SEC Form 4 filings, latest May 19, 2026. For informational purposes only — not investment advice.
See the full INSP insider & 13F page →Inspire Medical Systems, Inc. company profile
Overview
Inspire Medical Systems, Inc. (NYSE:INSP) is a medical technology company founded in 2007 and headquartered in Golden Valley, Minnesota. The company went public in May 2018 and has established itself as a pioneer in neurostimulation therapy for obstructive sleep apnea (OSA). Since its founding, Inspire has grown from a development-stage company to a profitable enterprise that has treated over 100,000 patients worldwide. The company achieved its first full year of profitability in 2024, marking a significant milestone in its commercial journey.
Business
Inspire Medical Systems operates in the medical device industry, specifically focusing on neurostimulation technology for treating obstructive sleep apnea (OSA). OSA is a serious sleep disorder where breathing repeatedly stops and starts during sleep due to throat muscles relaxing and blocking the airway. Traditional treatments include continuous positive airway pressure (CPAP) machines, which many patients find uncomfortable and difficult to tolerate long-term. The company's flagship product is the Inspire system, an implantable neurostimulation device that represents a breakthrough alternative to CPAP therapy. The system works by delivering mild electrical stimulation to the hypoglossal nerve, which controls tongue movement. During sleep, the device monitors the patient's breathing patterns and delivers precisely timed stimulation to keep the airway open by moving the tongue forward, preventing airway collapse. The Inspire system consists of three main components: a small generator implanted under the skin in the upper chest, a breathing sensor lead placed between the ribs to monitor respiratory effort, and a stimulation lead that delivers therapy to the hypoglossal nerve under the tongue. Patients control the device with a handheld remote, turning it on before sleep and off upon waking. The company recently received FDA approval for Inspire V, its next-generation neurostimulator that eliminates the need for a separate breathing sensor lead by incorporating respiratory sensing capabilities directly into the neurostimulator. This advancement simplifies the surgical procedure and reduces implantation time from 60-90 minutes to 45-60 minutes. Inspire generates virtually all of its revenue from a single business segment - the sale of its neurostimulation systems, with the U.S. market representing approximately 96% of total revenue and international markets contributing the remaining 4%.
Revenue model
Inspire Medical Systems operates on a medical device sales model, generating revenue primarily through the sale of its Inspire neurostimulation systems to hospitals and surgical centers. The company sells complete systems at an average selling price of approximately $25,000 per unit in the U.S. market. Revenue is recognized upon shipment of devices to healthcare facilities, which then implant the systems in qualified patients. The company's customers are healthcare institutions - hospitals, ambulatory surgical centers, and specialty clinics - where ear, nose, and throat (ENT) surgeons and other qualified physicians perform the implantation procedures. Patients typically receive coverage for the procedure through private insurance, Medicare, or other government programs, with reimbursement rates generally supporting the system's pricing. Several factors influence Inspire's profit margins and growth trajectory. Positive margin drivers include the company's high gross margins of approximately 85%, driven by the specialized nature of the technology and limited direct competition. The company benefits from economies of scale as production volumes increase, and its focus on premium pricing reflects the device's clinical efficacy and patient outcomes. Expanding international markets and new product launches like Inspire V provide additional revenue opportunities. Margin pressures come from significant investments in research and development, extensive medical education programs needed to train surgeons, and substantial sales and marketing expenses to drive market adoption. The company faces ongoing costs related to clinical studies, regulatory compliance, and reimbursement advocacy. Competition from traditional CPAP therapy and potential future neurostimulation competitors could pressure pricing. Additionally, healthcare cost containment efforts and potential changes in reimbursement policies represent ongoing risks to the business model. The company's path to profitability depends on achieving sufficient scale to leverage its fixed cost base while continuing to invest in market expansion and product development.
Competitive moat
Inspire Medical Systems possesses a moderate but meaningful competitive moat built on several key advantages. The company's primary moat stems from its first-mover advantage in implantable neurostimulation for sleep apnea, having been the pioneer in bringing this technology to market. This early entry has allowed Inspire to build substantial clinical evidence, with over 100,000 patients treated and extensive peer-reviewed research demonstrating safety and efficacy. The company benefits from regulatory barriers that create significant hurdles for potential competitors. The FDA approval process for implantable medical devices is lengthy, expensive, and requires extensive clinical trials. Inspire's established regulatory pathway and ongoing relationship with the FDA provide advantages for future product iterations like Inspire V. Network effects strengthen Inspire's position as more physicians become trained and experienced with the technology. The company has invested heavily in medical education, training over 1,300 surgeons across more than 1,300 active centers. This physician expertise creates switching costs and preference for the Inspire system. Additionally, as patient outcomes data accumulates, it becomes increasingly difficult for competitors to challenge the established clinical evidence. However, the moat faces several potential threats. The fundamental patents protecting the core neurostimulation approach will eventually expire, potentially opening the door for generic or competing devices. Large medical device companies with substantial resources could develop alternative neurostimulation technologies or acquire competing startups. The emergence of new treatment modalities, such as pharmaceutical interventions or non-invasive technologies, could disrupt the entire treatment paradigm. The company's moat is also somewhat narrow, as it depends heavily on a single product category. While Inspire V represents an evolution of the technology, the company remains vulnerable to technological disruption or changes in treatment standards. The moat strength is moderate - sufficient to maintain competitive advantages in the near to medium term, but requiring continued innovation and market development to sustain long-term leadership.
Risks & safety
Inspire Medical Systems demonstrates a strong financial safety profile with minimal solvency risk and healthy cash generation, though trading at premium valuations. • Liquidity and Debt: Excellent liquidity position with $150 million in cash and short-term investments as of Q4 2024, minimal debt (debt-to-equity ratio of 0.05), and strong current ratio of 7.1 indicating robust ability to meet short-term obligations • Cash Flow: Positive free cash flow generation of $91 million for full year 2024, with operating cash flow of $130 million, indicating the business model is generating sustainable cash returns • Profitability: Achieved first full year of profitability in 2024 with net income of $53.5 million, demonstrating the company has successfully scaled beyond its investment phase • Valuation Metrics: Trading at premium multiples with P/E ratio of approximately 39x based on 2024 earnings, EV/EBITDA of 24x, and price-to-book ratio of 8x, suggesting high growth expectations are embedded in current valuation • Other Considerations: Revenue growth of 28% in 2024 supports premium valuation, though company faces regulatory scrutiny with DOJ civil investigative demand regarding marketing practices, which introduces some uncertainty but appears manageable given company's cooperation stance
Recent development
Over the past few years, Inspire Medical Systems has executed several strategic initiatives to strengthen its market position and drive growth. The company's most significant product development has been the FDA approval and launch of Inspire V, a next-generation neurostimulator that eliminates the separate breathing sensor lead by incorporating respiratory sensing directly into the device. This advancement simplifies surgical procedures and reduces implantation time, potentially increasing surgical capacity and physician adoption. The company has significantly expanded its medical education and training programs, growing from training primarily ENT surgeons to include advanced practice providers, with over 250 trained to date. This expansion addresses physician capacity constraints and broadens the pool of healthcare providers capable of managing Inspire patients. The company has also developed digital tools including SleepSync, a new programming system that enhances patient management capabilities. Market access improvements have been substantial, with the company securing country-wide reimbursement in France and obtaining European Union Medical Device Regulation approval, facilitating international expansion. In the U.S., the company has worked to update commercial payer policies and expand prior authorization support to improve patient access. The company has pursued indication expansions through FDA approvals, including extending treatment to pediatric patients with Down syndrome, increasing the treatable AHI (Apnea Hypopnea Index) limit from 65 to 100 events per hour, and raising the BMI warning threshold from 32 to 40. These expansions broaden the addressable patient population significantly. Operational scaling has been a key focus, with the company growing its active center network to over 1,300 locations and expanding sales territories to 323 in the U.S. The company has also invested in direct-to-consumer marketing and digital scheduling tools to improve patient engagement and conversion rates. The achievement of profitability in 2024 represents a major milestone, demonstrating successful scaling of the business model.
INSP company profile · for informational purposes only — not investment advice.
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