# Inspire Medical Systems, Inc. (INSP)

> Source: Nexqual · https://nexqual.com/INSP · data as of 2026-10-23 20:00 UTC · cite as "Nexqual, Inspire Medical Systems, Inc. (INSP), nexqual.com/INSP" · informational, not investment advice.

**Price:** USD 71.11 (-2.13% on the day) · last close of Oct 23, 2026; US market closed, not a live price. Prev close 72.66 · day 68.46–72.75 · 52w 38.91–147.03 · market cap $2.06B · NYQ

## Key facts
- Last four reported quarters (through Jun 30, 2026): revenue $899M, net income $135M (15.0% margin), free cash flow $117M (SEC filings).
- Valuation: P/E 15.2x (avg 62.3x at the last 2 fiscal year-ends).
- Insider open-market sales, last ~7 months: 4 Form 4 filings, $233K; 3 not under a Rule 10b5-1 plan ($202K); 0 by opportunistic insiders, 2 by routine insiders (three-year test, Cohen, Malloy & Pomorski 2012).
- Analysts: Hold (mean 3.06 on a 1–5 scale) (18 analysts), mean target USD 68 (range 40–97).
- Total return with dividends: 1Y -8.3% vs S&P 500 +13.4%; 5Y -73.6% vs S&P 500 +76.9%.
- Next earnings: 2026-11-02, EPS estimate USD 0.09, revenue estimate $204M.

## Financials (SEC 10-K; TTM = last four 10-Q/10-K quarters)
| USD | FY2021 | FY2022 | FY2023 | FY2024 | FY2025 | TTM |
|---|---|---|---|---|---|---|
| Revenue | $233M | $408M | $625M | $803M | $912M | $899M |
| Gross profit | $200M | $342M | $528M | $680M | $779M | — |
| Operating income | -$39.9M | -$47.6M | -$40.3M | $36.1M | $51.0M | $54.1M |
| Net income | -$42.0M | -$44.9M | -$21.2M | $53.5M | $145M | $135M |
| EPS (diluted) | -$1.54 | -$1.60 | -$0.72 | $1.75 | $4.89 | — |
| Free cash flow | -$24.8M | $2.5M | $1.0M | $91.1M | $78.5M | $117M |
| Gross margin | 85.7% | 83.8% | 84.5% | 84.7% | 85.4% | — |
| Operating margin | -17.1% | -11.7% | -6.4% | 4.5% | 5.6% | 6.0% |
| Net margin | -18.0% | -11.0% | -3.4% | 6.7% | 15.9% | 15.0% |
| Revenue growth | +102.3% | +74.7% | +53.2% | +28.5% | +13.6% | — |
| Cash + short-term investments | $214M | $451M | $460M | $446M | $308M | — |
| Total debt | $24.5M | $0K | — | — | — | — |
Fiscal years end Dec. EPS is split-adjusted.

## Valuation (price ÷ last four quarters, through Jun 30, 2026)
P/E 15.2x · P/S 2.3x · P/FCF 17.6x · P/B 2.5x · FCF yield 5.70% · Earnings yield 6.57% · Buyback yield (TTM) 4.86%
P/E at fiscal year-ends: Dec 2025 18.9x, Dec 2024 105.8x.

## Insider sales (SEC Form 4, open-market, last ~7 months)
1 of 4 under a Rule 10b5-1 trading plan (scheduled in advance). Unplanned sales were timed by the insider.
| Trade date | Insider | Role | Shares | Value | % of holdings sold | 10b5-1 plan | Insider type |
|---|---|---|---|---|---|---|---|
| 2026-08-07 | Kelly Jason P | See Remarks | 963 | $57K | 4.8% | No | Too little history (no open-market trades in 2023–2025) |
| 2026-05-15 | Rondoni John | See Remarks | 2,641 | $114K | 8.9% | No | Routine (sold in Feb each year 2023–2025; this trade is outside those months) |
| 2026-05-14 | Rondoni John | See Remarks | 700 | $30K | 2.3% | No | Routine (sold in Feb each year 2023–2025; this trade is outside those months) |
| 2026-05-08 | McCormick Shawn | Director | 696 | $32K | 2.2% | Yes | Too little history (no open-market trades in 2023) |
% of holdings sold = shares sold ÷ (shares sold + all holdings the insider reported on that Form 4, direct and through trusts).
Insider type follows Cohen, Malloy & Pomorski (Journal of Finance, 2012). An insider who traded the stock in the same calendar month in each of the past three years is a routine trader; one who traded in each of those years without such a pattern is an opportunistic trader. In their study, trades by opportunistic insiders predicted future returns and trades by routine insiders did not. Counts open-market purchases and sales only (SEC Form 4 codes P and S) by that insider in that company. Not investment advice.

## Analysts
Consensus Hold (mean 3.06 on a 1–5 scale), 18 analysts; mean target USD 68 (low 40, high 97).
Rating changes, last 120 days:
| Date | Firm | Action | Rating | Price target |
|---|---|---|---|---|
| 2026-10-14 | Truist Securities | Target raised | Hold | $62 → $78 |
| 2026-10-07 | Barclays | Initiated | Underweight | $65 |
| 2026-10-02 | Freedom Capital Markets | Maintained | Buy | $97 |
| 2026-10-01 | RBC Capital | Target raised | Sector Perform | $60 → $75 |
| 2026-09-21 | Freedom Capital Markets | Target raised | Buy | $71 → $97 |
| 2026-09-11 | Stifel | Target raised | Buy | $75 → $80 |
| 2026-08-04 | JP Morgan | Target raised | Neutral | $54 → $60 |
| 2026-08-04 | Mizuho | Target raised | Outperform | $55 → $65 |
| 2026-08-04 | Oppenheimer | Upgrade | Perform → Outperform | $85 |
| 2026-08-04 | Truist Securities | Target raised | Hold | $54 → $62 |
| 2026-08-04 | Evercore ISI Group | Target raised | In-Line | $40 → $54 |
| 2026-08-04 | Piper Sandler | Target raised | Neutral | $55 → $60 |

## Total return (dividends reinvested)
|  | 1Y (from 2025-10-24) | 5Y (from 2021-10-25) |
|---|---|---|
| Total return | -8.3% | -73.6% |
| S&P 500 (SPY) | +13.4% | +76.9% |
| Per year | -8.3% | -23.4% |
| Volatility (annualized) | 70.0% | 62.3% |
| Max drawdown | -72.2% (Dec 2025→May 2026) | -87.7% (Jul 2023→May 2026) |

## Peers (Medical Devices)
ALMR (Alamar Biosciences, Inc.) USD 30.69 +3.26% · ESTA (Establishment Labs Holdings Inc) USD 63.8 +0.44% · AXGN (AxoGen, Inc.) USD 38.06 +3.76% · UFPT (UFP Technologies, Inc.) USD 295.78 -0.52% · BFLY (Butterfly Network, Inc.) USD 6.76 -0.73% · TMDX (TransMedics Group, Inc.) USD 70.74 -1.83%

## More
Full page: https://nexqual.com/INSP · Free keyless MCP server with the same data and citations: https://mcp.nexqual.com/mcp · Guide for agents: https://nexqual.com/agents · https://nexqual.com/llms.txt

## Supply chain and relationships (SEC annual reports)

Named in INSP's own 10-K filed 2026-02-13 (https://www.sec.gov/Archives/edgar/data/1609550/000160955026000016/insp-20251231.htm):

| Relationship | Company | Sentence in the filing |
|---|---|---|
| Partner | Medtronic plc (MDT) | "License Agreement with Medtronic" |

## Revenue by region (quarter ended 2026-06-30)

| Line | Revenue | Share | YoY |
|---|---|---|---|
| United States | $187.3M | 93.4% | -9.6% |
| International | $13.3M | 6.6% | +33.6% |
| Total revenue | $200.6M | 100% | — |

## Company outlook (8-K filed 2026-08-03)

- "Guidance, and Strategic Growth Plan • Generated second quarter revenue of $200.6 million • Second quarter diluted EPS of $0.01; adjusted diluted EPS of $0.14 • Second quarter operating cash flow of $23.2 million • Announced strategic growth plan designed to unlock and redeploy $30 million for growth initiatives MINNEAPOLIS, MN - August 3, 2026 - Inspire Medical Systems, Inc."

## Analyst estimates and revisions

| Period | EPS est. | 90d ago | Change | Revenue est. | Analysts |
|---|---|---|---|---|---|
| Current quarter (ends 2026-09-30) | $0.09 | $0.14 | -35.5% | $204.3M | 14 |
| Next quarter (ends 2026-12-31) | $0.91 | $0.90 | +1.8% | $244.4M | 14 |
| Current fiscal year (ends 2026-12-31) | $1.25 | $0.90 | +39.5% | $853.9M | 14 |
| Next fiscal year (ends 2027-12-31) | $1.54 | $1.26 | +21.7% | $887.2M | 15 |

## Options: expected move (Cboe, 15-min delayed)

Expected move by 2026-11-20 (includes earnings 2026-11-02): ±17.9%; last 8 reports averaged ±14%.

| Expiration | Days | ATM IV | Expected move |
|---|---|---|---|
| 2026-11-20 | 27 | 81.9% | ±17.9% |
| 2026-12-18 | 55 | 71.2% | ±21.9% |
| 2027-01-15 | 83 | 66.9% | ±25.1% |
| 2027-02-19 | 118 | 68.8% | ±30.7% |
| 2027-03-19 | 146 | 67.2% | ±33.2% |
| 2027-05-21 | 209 | 65.9% | ±38.8% |