| Factor | Score | Distribution | Value | Avg | Rank |
|---|---|---|---|---|---|
Valuation | 39 | 16.1x | 17.8x | Bottom tier | |
Growth | 76 | 4.3% | 7.1% | Top tier | |
Quality | 86 | 15.3% | 4.5% | Top tier | |
Safety | 96 | — | 2.6x | Top tier | |
Capital Return | 74 | — | 2.12% | Top tier | |
Momentum | 38 | -35.4% | 2.9% | Bottom tier | |
Sentiment | 62 | 9 | 3 | Around median |
Estimates — analyst targets and a simplified DCF, not investment advice.
Ten ratios that matter, each compared against its sector median and average — so you can see whether a number is rich or cheap relative to peers in the same sector.
Inspire Medical Systems develops treatment for obstructive sleep apnea through Inspire systems, which use hypoglossal nerve stimulation and are surgically implanted in eligible patients. Revenue generation is tied to implant procedure volume, adoption of the therapy by centers and surgeons, and securing prior authorizations and insurance coverage; Inspire V accounted for the large majority of implants during fiscal Q2 2026, while some centers continued using Inspire IV for Medicare cases. The company stated that it has treated more than 140 thousand patients since its founding.
In fiscal Q2 2026, revenue declined 7.6% to $200.6 million, with management attributing the decline primarily to coding and reimbursement disruption and lower prior authorizations in the previous quarter. Gross profit was $171.5 million, representing a gross margin of approximately 85.5%, benefiting from a higher Inspire V mix, while net income according to EDGAR data was approximately $314 thousand and diluted earnings per share were $0.01. On an adjusted basis, earnings per share were $0.14 and the earnings before interest, taxes, depreciation, and amortization margin was 19.4%, down 90 basis points.
The company ended fiscal Q2 2026 with no debt and approximately $415 million in cash and investments, and generated operating cash flow of $23.2 million during the quarter and $36.1 million during the first six months of fiscal 2026. The improvement in first-half cash flow exceeded that of the corresponding period by $40 million, driven by improved working capital. Internationally, management pointed to strong growth in continental Europe, including France after obtaining nationwide coverage, alongside contributions from Germany, Austria, Switzerland, the Netherlands, Belgium, the United Kingdom, Japan, and Singapore, without disclosing the revenue value of each market.
Automated analysis for informational purposes only — not investment advice.
The analyst consensus is neutral, with an average target of $60.3 and a wide range between $39 and $85; even the highest target is approximately 42% below the 52-week range high of $147.03, reflecting a sharp re-rating tied to the revenue decline and coding and reimbursement disruptions. In contrast, Oppenheimer’s upgrade to Outperform on August 4, 2026 supports the positive case following the adjusted earnings-per-share surprise, but the absence of an available price-to-earnings ratio and the wide target range justify continued caution until the trajectory of growth and margins becomes clear.
Figures in the text are as of 2026-09-01; the live price is shown at the top of the page.
Revenue declined 7.6% to $200.6 million, with management attributing this primarily to coding and reimbursement disruption and the decline in prior authorization requests that began in fiscal Q1 2026. The company estimated the quarterly impact of coding and reimbursement challenges and the WISeR program at approximately $40 million. The company began training the top 25% of centers by volume and said on August 3, 2026 that the trend in prior authorization requests had begun to improve.
The company expects revenue of between $835 million and $875 million in fiscal 2026, compared with $912 million in fiscal 2025. It expects an adjusted operating margin of between 4% and 6% and adjusted earnings per share of between $1.05 and $1.45. GAAP earnings per share range from a $0.42 loss to a $0.17 profit, with an expected effective tax rate of between 95% and 100%.
Project Horizon is a plan to redirect resources and consolidate production with the goal of providing $30 million in annual investment capacity. The company will direct this capacity toward increasing patient flow, supporting prior authorizations through SleepSync, improving the post-implant experience through Inspire Connect, and expanding the number of centers and surgeons. The company expects pre-tax restructuring expenses of $20 million–$25 million, with approximately 90% recorded in fiscal Q3 2026 and most actions completed by the end of fiscal 2026.
Inspire V accounted for the large majority of implants in fiscal Q2 2026, and its higher mix helped improve gross profit despite lower sales. Gross profit was $171.5 million on revenue of $200.6 million, representing a gross margin of approximately 85.5%. In June 2026, the company presented the full results of the Inspire V trial in Singapore, including accelerometer-based sensing technology and safety and efficacy data.
Procedure-specific C codes were introduced into the WISeR system for the six included states, and the company said that hospital and ambulatory surgery center reimbursement did not change in fiscal 2026. CMS proposed for fiscal 2027 increasing outpatient hospital reimbursement to $35,414 and ambulatory surgery center reimbursement to $31,722, but proposed reducing physician reimbursement for CPT code 64582 to approximately $699. The company is awaiting the final rates in November 2026, and its revised application for a new single-lead CPT code will be reviewed in September 2026 and could take effect on January 1, 2028 if approved and the pricing and reimbursement stages are completed.
The company ended fiscal Q2 2026 with no debt and approximately $415 million in cash and investments. Operating cash flow was $23.2 million in the quarter and $36.1 million during the first six months of fiscal 2026, an improvement of $40 million from the corresponding period. The company also plans capital expenditures of between $35 million and $40 million during fiscal 2026, alongside funding Project Horizon initiatives.
