Revenue growth decelerated sharply to -7.6% year-over-year in 2026Q2, while gross margin remained robust at 85.5%, but SG&A expenses consumed 73.4% of revenue, leading to a $514K operating loss.
Inspire Medical Systems, Inc. (INSP) annual income statement — 10-year revenue, gross profit & net income history
| Metric | TTM | Dec'25 | Dec'24 | Dec'23 | Dec'22 | Dec'21 | Dec'20 | Dec'19 | Dec'18 | Dec'17 | Dec'16 |
|---|
| Sales/Revenue | 898.74M | 911.98M | 802.8M | 624.8M | 407.86M | 233.39M | 115.38M | 82.05M | 50.59M | 28.57M | 16.43M |
| Revenue Growth % | 4.35% | 13.6% | 28.49% | 53.19% | 74.75% | 102.28% | 40.62% | 62.18% | 77.1% | 73.9% | - |
| Cost of Goods Sold | 124.64M | 133.22M | 122.99M | 96.58M | 66.11M | 33.28M | 17.62M | 13.64M | 10.06M | 6.02M | 3.9M |
| COGS % of Revenue | - | 14.61% | 15.32% | 15.46% | 16.21% | 14.26% | 15.27% | 16.63% | 19.88% | 21.07% | 23.77% |
| Gross Profit | 774.11M | 778.76M | 679.82M | 528.22M | 341.74M | 200.12M | 97.76M | 68.41M | 40.54M | 22.55M | 12.52M |
| Gross Margin % | 86.13% | 85.39% | 84.68% | 84.54% | 83.79% | 85.74% | 84.73% | 83.37% | 80.12% | 78.93% | 76.23% |
| Gross Profit Growth % | - | 14.55% | 28.7% | 54.57% | 70.77% | 104.7% | 42.91% | 68.75% | 79.77% | 80.08% | - |
| Operating Expenses | 719.98M | 727.8M | 643.74M | 568.49M | 389.33M | 239.97M | 153.97M | 103.3M | 60.91M | 38.55M | 29.77M |
| OpEx % of Revenue | - | 79.8% | 80.19% | 90.99% | 95.46% | 102.82% | 133.44% | 125.9% | 120.4% | 134.95% | 181.26% |
| Selling, General & Admin | 620.3M | 624.64M | 529.61M | 451.96M | 320.69M | 202.62M | 127.87M | 90.47M | 53.53M | 32.36M | 22.68M |
| SG&A % of Revenue | - | 68.49% | 65.97% | 72.34% | 78.63% | 86.81% | 110.83% | 110.26% | 105.8% | 113.27% | 138.09% |
| Research & Development | 99.68M | 103.17M | 114.13M | 116.54M | 68.64M | 37.35M | 26.09M | 12.84M | 7.39M | 6.19M | 7.09M |
| R&D % of Revenue | - | 11.31% | 14.22% | 18.65% | 16.83% | 16% | 22.61% | 15.65% | 14.6% | 21.68% | 43.17% |
| Other Operating Expenses | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | -16K | 42K | -29K |
| Operating Income | 54.12M | 50.95M | 36.08M | -40.27M | -47.59M | -39.85M | -56.21M | -34.9M | -20.38M | -16M | -17.25M |
| Operating Margin % | 6.02% | 5.59% | 4.49% | -6.45% | -11.67% | -17.07% | -48.72% | -42.53% | -40.28% | -56.02% | -105.03% |
| Operating Income Growth % | - | 41.21% | 189.6% | 15.38% | -19.43% | 29.1% | -61.07% | -71.25% | -27.34% | 7.25% | - |
| EBITDA | 71.33M | 64.91M | 42.63M | -37.42M | -45.73M | -38.63M | -55.37M | -34.4M | -19.98M | -15.72M | -17.15M |
| EBITDA Margin % | 7.94% | 7.12% | 5.31% | -5.99% | -11.21% | -16.55% | -47.99% | -41.93% | -39.5% | -55.02% | -104.4% |
| EBITDA Growth % | 36.68% | 52.26% | 213.92% | 18.17% | -18.38% | 30.23% | -60.94% | -72.14% | -27.15% | 8.35% | - |
| D&A (Non-Cash Add-back) | 17.21M | 13.96M | 6.55M | 2.85M | 1.86M | 1.22M | 840K | 495K | 393K | 285K | 103K |
| EBIT | 65.89M | 65.83M | 58.48M | -19.91M | -42.59M | -39.84M | -54.97M | -31.08M | -18.52M | -15.76M | -17.23M |
| Net Interest Income | 15.33M | 17.4M | 23.23M | 20.56M | 3.37M | -2M | -1.02M | 1.68M | -1.43M | -1.55M | -1.25M |
| Interest Income | 15.46M | 17.54M | 23.25M | 20.56M | 5.05M | 125K | 1.09M | 3.8M | 1.87M | 203K | 57K |
| Interest Expense | 133K | 137K | 22K | 0 | 1.68M | 2.13M | 2.12M | 2.12M | 3.3M | 1.75M | 1.3M |
| Other Income/Expense | 15.26M | 14.74M | 22.37M | 20.36M | 3.32M | -2.12M | -880K | 1.69M | -1.45M | -1.51M | -1.27M |
| Pretax Income | 69.38M | 65.7M | 58.45M | -19.91M | -44.27M | -41.97M | -57.09M | -33.2M | -21.83M | -17.51M | -18.53M |
| Pretax Margin % | 7.72% | 7.2% | 7.28% | -3.19% | -10.85% | -17.98% | -49.48% | -40.47% | -43.14% | -61.3% | -112.79% |
| Income Tax | -65.66M | -79.72M | 4.94M | 1.25M | 613K | 72K | 115K | 40K | 0 | 0 | 0 |
| Effective Tax Rate % | -94.64% | -121.35% | 8.46% | -6.26% | -1.38% | -0.17% | -0.2% | -0.12% | 0% | 0% | 0% |
| Net Income | 135.04M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M | -57.2M | -33.24M | -21.83M | -17.51M | -18.53M |
| Net Margin % | 15.03% | 15.95% | 6.67% | -3.39% | -11% | -18.01% | -49.58% | -40.52% | -43.14% | -61.3% | -112.79% |
| Net Income Growth % | 154.22% | 171.77% | 352.96% | 52.87% | -6.75% | 26.5% | -72.08% | -52.3% | -24.65% | 5.49% | - |
| Net Income (Continuing) | 135.04M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M | -57.2M | -33.24M | -21.83M | -17.51M | -18.53M |
| Discontinued Operations | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| Minority Interest | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 0 |
| EPS (Diluted) | 4.67 | 4.89 | 1.75 | -0.72 | -1.60 | -1.54 | -2.19 | -1.40 | -1.50 | -1.30 | -1.49 |
| EPS Growth % | 167.3% | 179.43% | 343.06% | 55% | -3.9% | 29.68% | -56.43% | 6.67% | -15.38% | 12.75% | - |
| EPS (Basic) | - | 4.95 | 1.80 | -0.72 | -1.60 | -1.54 | -2.19 | -1.40 | -1.50 | -1.30 | -1.49 |
| Diluted Shares Outstanding | 28.94M | 29.76M | 30.54M | 29.3M | 28.07M | 27.26M | 26.07M | 23.8M | 14.58M | 13.49M | 12.46M |
| Basic Shares Outstanding | 28.84M | 29.37M | 29.76M | 29.3M | 28.07M | 27.26M | 26.07M | 23.8M | 14.58M | 13.49M | 12.46M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - | - | - | - |
Quick answers to the most common questions about buying INSP stock.
For fiscal year 2025, Inspire Medical Systems, Inc. (INSP) reported total revenue of $912.0M. This represents a 5451.7% increase compared to $16.4M in 2016.
Inspire Medical Systems, Inc. (INSP) is profitable, generating $145.4M in net income for the fiscal year ending 2025 with a net profit margin of 15.9%.
Inspire Medical Systems, Inc. (INSP) reported an operating income of $51.0M, resulting in an operating profit margin of 5.6%. This margin reflects the operational efficiency of the business before interest and taxes.
Inspire Medical Systems, Inc. (INSP) generated $778.8M in gross profit for the year, representing a gross profit margin of 85.4%. This demonstrates the company's core pricing power and production efficiency.
Key Metrics
Top Statement Risk
Reimbursement and competition risks
Metrics are mathematically derived from official filings.
Growth Deceleration Amidst Market Expansion
Revenue growth slowed to -7.6% year-over-year in 2026Q2, a stark contrast to the 28-32% growth seen in 2024 quarters, suggesting a potential inflection in demand dynamics. According to the latest income statement data, this deceleration warrants close monitoring.
The sharp decline in revenue growth from 29.6% in 2024Q2 to -7.6% in 2026Q2 indicates a significant slowdown, possibly due to market saturation or competitive pressures. While the company raised full-year guidance, the sequential revenue drop from $204.6M in 2026Q1 to $200.6M in 2026Q2 suggests that the growth narrative may be losing momentum. Investors should assess whether this is a temporary blip or a structural shift in adoption rates.
Gross Margin Resilience Amidst Cost Pressures
Gross margin remained robust at 85.5% in 2026Q2, despite a slight decline from 86.6% in 2025Q4, indicating pricing power and cost control. As per the financial statements, this stability suggests the company can maintain profitability even as revenue growth slows.
The gross margin has hovered around 84-86% over the past ten quarters, reflecting the proprietary nature of the device and limited manufacturing cost inflation. However, the slight dip in 2026Q2 could signal early impacts from product mix shifts or input costs. The high gross margin provides a buffer against operating expense increases, but the sustainability of this margin will depend on the successful launch of Inspire V and potential competitive pricing pressures.
Operating Leverage Elusive as SG&A Scales
Operating income swung to a loss of $514K in 2026Q2, despite revenue of $200.6M, as SG&A expenses consumed 73.4% of revenue, indicating limited operating leverage. Based on reported figures, the company's heavy investment in sales and marketing continues to suppress profitability.
SG&A expenses have remained elevated, ranging from $125.6M to $162.0M over the past year, with no significant decline relative to revenue. This suggests that the company is still in a heavy investment phase to drive adoption, but the lack of operating leverage is concerning given the decelerating revenue growth. The positive operating income in 2025Q4 and 2025Q3 appears to be seasonal, driven by Q4 strength, rather than a sustainable trend. Investors should monitor whether management can rein in SG&A as a percentage of revenue to achieve consistent profitability.
Earnings Quality Masked by One-Time Items
Net income of $314K in 2026Q2 was artificially boosted by a $136.1M net income in 2025Q4, which included a $4.66 EPS, likely due to a one-time tax benefit. As reported in the income statement, this volatility obscures the underlying earnings power.
The net margin swung from 50.6% in 2025Q4 to 0.2% in 2026Q2, indicating that the Q4 figure was not sustainable. The large EPS of $4.66 in 2025Q4 likely reflects a one-time tax asset or other non-operating gains, which inflates the apparent profitability. Excluding such items, the company's core operations are barely breaking even, as evidenced by the negative operating income in several quarters. Stock-based compensation remains high at $31.2M in 2026Q2, further diluting earnings quality. Analysts should adjust for these items to assess the true cash-generating potential.
SG&A Dominates Cost Structure
SG&A expenses of $147.3M in 2026Q2 represent the largest cost line, exceeding R&D by nearly six times, highlighting the company's focus on commercial expansion. According to the latest financial data, this spending is essential for driving adoption but pressures profitability.
The cost structure is heavily weighted toward SG&A, which is typical for a medical device company in a growth phase, but the magnitude is notable. R&D spending has remained relatively stable around $24-30M per quarter, indicating a consistent investment in product development. However, the SG&A intensity suggests that the company is prioritizing market share capture over near-term profitability. Management's commentary about 'increased discipline and focus' may indicate a future shift toward cost control, but the current data shows no significant improvement in SG&A efficiency.
Growth Sustainability Under Scrutiny
The sharp deceleration in revenue growth to -7.6% in 2026Q2, coupled with rising competition from Nyxoah and GLP-1 therapies, raises questions about the durability of Inspire's growth. Based on the income statement trends, the company may face headwinds in maintaining its historical growth rates.
Short-sellers could argue that the company's growth is decelerating faster than expected, and the raised guidance may be overly optimistic. The increasing competition from Nyxoah's U.S. entry could pressure pricing and market share, while GLP-1 drugs may reduce the addressable patient pool. Additionally, the company's heavy reliance on direct-to-consumer marketing may become less efficient as the market matures. The negative operating income in recent quarters suggests that the business model may not be scalable without significant cost reductions. Investors should closely monitor the company's ability to sustain growth while improving profitability.