Revenue growth has significantly slowed from a 39.6% peak in 2023Q4 to just 1.6% in 2026Q1, even as the company maintains a stable gross margin profile of approximately 86.5%.
| Sales/Revenue | 915.25M | 911.98M | 802.8M | 624.8M | 407.86M | 233.39M | 115.38M | 82.05M | 50.59M | 28.57M | 16.43M |
| Revenue Growth % | 8.94% | 13.6% | 28.49% | 53.19% | 74.75% | 102.28% | 40.62% | 62.18% | 77.1% | 73.9% | - |
| Cost of Goods Sold | 130.19M | 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 | 785.06M | 778.76M | 679.82M | 528.22M | 341.74M | 200.12M | 97.76M | 68.41M | 40.54M | 22.55M | 12.52M |
| Gross Margin % | 85.78% | 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 | 733.74M | 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 | 632.55M | 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 | 101.19M | 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 | 51.32M | 50.95M | 36.08M | -40.27M | -47.59M | -39.85M | -56.21M | -34.9M | -20.38M | -16M | -17.25M |
| Operating Margin % | 5.61% | 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 | 62.23M | 64.91M | 42.63M | -37.42M | -45.73M | -38.63M | -55.37M | -34.4M | -19.98M | -15.72M | -17.15M |
| EBITDA Margin % | 6.8% | 7.12% | 5.31% | -5.99% | -11.21% | -16.55% | -47.99% | -41.93% | -39.5% | -55.02% | -104.4% |
| EBITDA Growth % | 6.25% | 52.26% | 213.92% | 18.17% | -18.38% | 30.23% | -60.94% | -72.14% | -27.15% | 8.35% | - |
| D&A (Non-Cash Add-back) | 10.91M | 13.96M | 6.55M | 2.85M | 1.86M | 1.22M | 840K | 495K | 393K | 285K | 103K |
| EBIT | 57.34M | 50.95M | 58.48M | -19.91M | -42.59M | -39.84M | -54.97M | -31.08M | -18.52M | -15.76M | -17.23M |
| Net Interest Income | 12.33M | 17.4M | 23.23M | 20.56M | 3.37M | -2M | -1.02M | 1.68M | -1.43M | -1.55M | -1.25M |
| Interest Income | 12.47M | 17.54M | 23.25M | 20.56M | 5.05M | 125K | 1.09M | 3.8M | 1.87M | 203K | 57K |
| Interest Expense | 137K | 137K | 22K | 0 | 1.68M | 2.13M | 2.12M | 2.12M | 3.3M | 1.75M | 1.3M |
| Other Income/Expense | 12.61M | 14.74M | 22.37M | 20.36M | 3.32M | -2.12M | -880K | 1.69M | -1.45M | -1.51M | -1.27M |
| Pretax Income | 63.94M | 65.7M | 58.45M | -19.91M | -44.27M | -41.97M | -57.09M | -33.2M | -21.83M | -17.51M | -18.53M |
| Pretax Margin % | 6.99% | 7.2% | 7.28% | -3.19% | -10.85% | -17.98% | -49.48% | -40.47% | -43.14% | -61.3% | -112.79% |
| Income Tax | -67.2M | -79.72M | 4.94M | 1.25M | 613K | 72K | 115K | 40K | 0 | 0 | 0 |
| Effective Tax Rate % | -105.11% | -121.35% | 8.46% | -6.26% | -1.38% | -0.17% | -0.2% | -0.12% | 0% | 0% | 0% |
| Net Income | 131.14M | 145.42M | 53.51M | -21.15M | -44.88M | -42.04M | -57.2M | -33.24M | -21.83M | -17.51M | -18.53M |
| Net Margin % | 14.33% | 15.95% | 6.67% | -3.39% | -11% | -18.01% | -49.58% | -40.52% | -43.14% | -61.3% | -112.79% |
| Net Income Growth % | 97.18% | 171.77% | 352.96% | 52.87% | -6.75% | 26.5% | -72.08% | -52.3% | -24.65% | 5.49% | - |
| Net Income (Continuing) | 131.14M | 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) | 4.57 | 4.89 | 1.75 | -0.72 | -1.60 | -1.54 | -2.19 | -1.40 | -1.50 | -1.30 | -1.49 |
| EPS Growth % | 107.04% | 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 | 28.7M | 29.76M | 30.54M | 29.3M | 28.07M | 27.26M | 26.07M | 23.8M | 14.58M | 13.49M | 12.46M |
| Basic Shares Outstanding | 28.7M | 29.37M | 29.76M | 29.3M | 28.07M | 27.26M | 26.07M | 23.8M | 14.58M | 13.49M | 12.46M |
| Dividend Payout Ratio | - | - | - | - | - | - | - | - | - | - | - |
Elective procedure demand sensitivity
According to recent quarterly filings, INSP's year-over-year revenue growth has decelerated significantly, falling to 1.6% in 2026Q1 from a peak of 39.6% in 2023Q4, suggesting that the company's rapid expansion phase is encountering market saturation or increased competitive friction within the core sleep apnea segment.
The sharp decline in top-line growth indicates that the initial adoption curve for the Inspire system may be maturing faster than anticipated. Investors should monitor whether this deceleration reflects a temporary lull in physician training or a more structural shift in patient acquisition efficiency.
As reported in financial statements, the company maintains a robust gross margin profile of approximately 85% to 86%, demonstrating significant pricing power and a high-value product proposition that remains largely insulated from the inflationary pressures impacting lower-margin medical device peers in the current operating environment.
The consistency of these margins suggests that the proprietary nature of the Inspire system allows for premium pricing despite the elective nature of the procedure. This structural advantage provides a necessary buffer as the company navigates the high variable costs associated with its intensive direct-to-consumer marketing strategy.
Based on reported figures, SG&A expenses continue to consume a substantial portion of gross profit, with 2026Q1 operating income turning negative at -$1.1M, highlighting the company's ongoing struggle to achieve sustainable operating leverage while maintaining its aggressive investment in patient navigation and specialized sales force expansion.
The inability to consistently scale operating income alongside revenue suggests that the current business model requires high, sustained spending to maintain market share. This reliance on heavy SG&A investment warrants further investigation into the long-term efficiency of the company's patient referral funnel.
Analysis of recent income statements reveals that stock-based compensation, which reached $30.7M in 2026Q1, significantly impacts the quality of reported net income, often masking the underlying cash-generating capability of the business and complicating the assessment of true operational profitability for long-term institutional investors.
The volatility in net income, exacerbated by these non-cash charges, suggests that GAAP earnings may not be the most reliable metric for evaluating performance. Investors should focus on adjusted operating metrics to better understand the core profitability of the firm's implantable device business.
Data from the most recent periods indicates that the company's reliance on a single-therapy platform creates a concentrated risk profile, where any disruption from emerging weight-loss therapies or new market entrants could disproportionately impact the firm's ability to sustain its historical growth and valuation premiums.
Short-term sentiment may be overly optimistic regarding the company's ability to defend its market position against lower-cost alternatives or pharmaceutical interventions. The current deceleration in revenue growth may be an early indicator that the addressable market is more constrained than the current valuation implies.
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.