Inspire Medical Systems Q1 Revenue Rises 1.6% to $204.6M, Guides $825–875M
In Q1, Inspire Medical Systems delivered $204.6M revenue, up 1.6% year-over-year, and posted a GAAP loss of $11.3M (39¢ per share) with adjusted EPS of $0.10, beating forecasts. The company generated $12.8M in operating cash flow, held $399.7M in cash and guided 2026 revenue at $825M–$875M.
1. First Quarter Financial Results
In Q1 2026, Inspire reported revenue of $204.6 million, a 1.6% increase year-over-year, driven by market penetration of its Inspire V system. GAAP net loss narrowed to $11.3 million (39¢ per diluted share), while adjusted EPS reached $0.10, surpassing analyst estimates.
2. Operating Performance and Margins
Gross margin expanded 180 basis points to 86.5%, reflecting a higher sales mix of the higher-margin Inspire V. Operating loss improved to $1.1 million, adjusted operating income was $0.3 million, and operating cash flow rose to $12.8 million.
3. Cash Position and Balance Sheet
As of March 31, cash, cash equivalents and investments totaled $399.7 million, down $4.9 million sequentially. Improved working capital management drove net cash from operations up by $19.5 million year-over-year.
4. 2026 Guidance and Reimbursement Challenges
The company forecasts full-year 2026 revenue of $825–$875 million (a 4%–10% decline) and adjusted EPS of $0.75–$1.25, citing Medicare coding and reimbursement uncertainty for approximately 10,000 Inspire V cases. Management expects these issues to persist through 2026 but believes revenue growth will resume in 2027.