Inspire Medical Systems, Inc. (NYSE: INSP) sells implantable hypoglossal-nerve stimulation systems for obstructive sleep apnea, principally for patients who cannot adequately use positive airway pressure therapy. Hospitals and ambulatory surgery centers purchase its devices. Inspire reports one operating segment and depends heavily on U.S. sales of the Inspire product family.
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A snapshot of what Inspire Medical Systems, Inc. owns and owes at a point in time.
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3 reports in this collection
| Report period | Filed with SEC | Form | Source |
|---|---|---|---|
| Dec 31, 20230001609550-24-000016 | Feb 9, 2024 | 10-K | Open 10-Ksec.gov |
| Dec 31, 20240001609550-25-000011 | Feb 10, 2025 | 10-K | Open 10-Ksec.gov |
| Dec 31, 20250001609550-26-000016 | Feb 13, 2026 | 10-K | Open 10-Ksec.gov |
Dates describe the filing metadata. Figures and reporting periods should be checked against the original statement. SEC links open in a new tab.
Inspire combines high device gross margins with substantial spending on sales, advertising and clinical support. Operating profitability improved in 2024 and 2025, but the much larger 2025 net-income increase principally reflected a noncash deferred-tax benefit. After the February 13, 2026 annual filing, coding and reimbursement disruption became a more immediate constraint: second-quarter revenue declined despite international growth and a favorable Inspire V product mix. First-half operating cash flow recovered, although inventory continued accumulating and stock compensation remained substantial. August guidance still anticipated revenue below 2025. Project Horizon targeted resources for growth reinvestment rather than guaranteed additional profit. The central uncertainty is whether clearer reimbursement pathways, improved patient access and commercial execution can restore growth while preserving profitability; the supplied disclosures do not establish that recovery.
Sources: 10-K · 2024-12-31 · 10-K · 2025-12-31 · 10-Q · 2026-06-30 · EX-99.1 · 2026-08-03
Inspire monitors breathing and stimulates the hypoglossal nerve to help keep the airway open during sleep. Adoption requires clinical eligibility, anatomical screening, insurance approval, an available implanting physician, and subsequent activation and follow-up. Initial patient contact to implantation can take six months. Revenue is recognized when control of the device transfers to the purchasing provider, not necessarily when surgery occurs. A long-lived implant is therefore not an annual subscription, and cumulative treated patients are not annual procedure volumes.
Inspire V entered U.S. commercialization in May 2025. It integrates respiratory sensing into the neurostimulator, eliminating a separate sensing lead; management attributes its higher gross margin to lower manufacturing cost. However, advertising, direct sales and clinical support consume much of that margin. International revenue represented only 4.4% of 2025 sales, leaving substantial dependence on one product family and U.S. reimbursement conditions.
Sources: 10-K · 2025-12-31 · 10-K · 2024-12-31 · EX-99.2 · 2026-08-03
Annual revenue advanced from $624.799 million in 2023 to $802.804 million in 2024 and $911.981 million in 2025. The 2024 transition to $36.083 million of operating income reflected gross-profit growth exceeding expense growth. Operating income reached $50.954 million in 2025, helped by Inspire V mix. Yet SG&A grew faster than revenue, while lower R&D partly reflected greater allocations to inventory and cost of goods sold—not simply reduced development activity.
The $145.422 million of 2025 GAAP net income is not a recurring operating-earnings benchmark. An approximately $88.8 million non-recurring valuation-allowance release drove the headline increase; pretax income was $65.697 million. Lower investment income and a $4.046 million strategic-investment impairment offset some operating improvement. Repurchases also reduced the diluted EPS denominator. The tax benefit created no equivalent operating cash receipt.
Sources: 10-K · 2023-12-31 · 10-K · 2024-12-31 · 10-K · 2025-12-31
After the latest annual filing, first-quarter revenue reached $204.583 million, but second-quarter revenue fell to $200.581 million from $217.086 million. Management primarily attributed the domestic decline to coding and reimbursement challenges, with WISeR authorization delays also affecting the first half. International growth provided only a partial offset. Higher Inspire V mix lifted second-quarter gross margin to 85.5%, but lower revenue still reduced gross-profit dollars.
Second-quarter GAAP operating loss narrowed to $0.514 million, partly because the comparison included accelerated stock compensation. Adjusted operating income nevertheless fell to $3.183 million from $9.575 million. First-half pretax income improved, but stock-compensation tax shortfalls and other tax effects produced a $10.980 million net loss. Narrower operating losses, weaker adjusted earnings and a larger first-half net loss therefore describe different aspects of the same results.
Sources: 10-Q · 2026-03-31 · 10-Q · 2026-06-30 · EX-99.1 · 2026-08-03
Operating cash flow declined from $130.246 million in 2024 to $116.976 million in 2025 as inventory and receivables absorbed cash. It included a $130.259 million noncash stock-compensation add-back. Cash capex was $38.499 million, while repurchases used $175.019 million. Combined cash and available-for-sale securities fell to approximately $404.6 million; only $104.813 million was cash and equivalents.
First-half 2026 operating cash flow recovered to $36.077 million, helped by receivable collections and a smaller inventory cash outflow. Inventory nevertheless increased to $170.451 million. At June 30, cash and equivalents were $127.761 million, separately from $287.403 million of investments. Cash capex used $18.886 million. No existing borrowing facility is established. No shares were repurchased during the first half; the remaining $100 million authorization is discretionary, not cash or a committed expenditure.
Sources: 10-K · 2025-12-31 · 10-Q · 2026-06-30
August 3 guidance projected $835–875 million of 2026 revenue and a 4%–6% adjusted operating margin, but GAAP EPS ranged from a $0.42 loss to $0.17 income. Project Horizon forecast $20–25 million of charges and approximately $30 million of annualized capacity for growth reinvestment—not assured retained savings. Coding uncertainty, physician capacity, GLP-1-related treatment deferral, single-source suppliers and unresolved legal proceedings remain material dependencies. Neither completed restructuring nor a durable reimbursement solution is established.
Sources: 10-Q · 2026-06-30 · EX-99.1 · 2026-08-03 · 10-K · 2025-12-31
USD 911.981 m
FY2025 · GAAP · consolidated · Attribution: consolidated · Reported currency
| Fiscal year | Value | YoY |
|---|---|---|
| 2025 | USD 911.981 m | 13.6% |
| 2024 | USD 802.804 m | 28.5% |
| 2023 | USD 624.799 m | — |
Consolidated product revenue recognized when control transfers to the customer.
Sources: 10-K · 2025-12-31
USD 53.509 m
FY2024 · GAAP · consolidated · Attribution: consolidated · Reported currency
| Fiscal year | Value | YoY |
|---|---|---|
| 2024 | USD 53.509 m | Turned profitable |
| 2023 | USD -21.153 m | — |
Consolidated net income or loss after income taxes.
Sources: 10-K · 2025-12-31
USD 145.422 m
FY2025 · GAAP · consolidated · Attribution: consolidated · Reported currency
| Fiscal year | Value | YoY |
|---|---|---|
| 2025 | USD 145.422 m | — |
Consolidated net income or loss after income taxes; includes the 2025 non-recurring deferred tax benefit.
Sources: 10-K · 2025-12-31
USD 116.976 m
FY2025 · GAAP · consolidated · Attribution: consolidated · Reported currency
| Fiscal year | Value | YoY |
|---|---|---|
| 2025 | USD 116.976 m | -10.2% |
| 2024 | USD 130.246 m | 428.3% |
| 2023 | USD 24.653 m | — |
Consolidated operating cash flow after working-capital movements and noncash adjustments.
Sources: 10-K · 2025-12-31
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