Revenue Growth Despite Headwinds
Revenue increased 1.6% year-over-year to $204.6 million in Q1 2026, driven by increased market penetration despite coding/reimbursement and WISER-related disruptions.
Improved Profitability Metrics and Margins
Adjusted EBITDA margin improved by 100 basis points to 17.5%; adjusted operating income and operating cash flow improved versus the prior year.
Operating Cash Flow and Strong Balance Sheet
Operating cash flow was $12.8 million for the quarter, an improvement of $20 million year-over-year. Cash and investments totaled $400 million with no debt.
Clinical and Scientific Momentum
Multiple clinical milestones: ADHERE 5,000-patient trial complete; PREDICTOR manuscript accepted for publication; full Inspire V Singapore trial results to be presented; independent VCU study published showing significantly lower odds of major cardiovascular events for Inspire patients. Company has treated >135,000 patients since inception.
Field Organization Optimization
Ended quarter with 284 U.S. territories and 288 U.S. field clinical reps, hired 13 field clinical reps in the quarter and reached goal of a one-to-one territory manager to field clinical rep ratio, plus targeted territory consolidation.
Product Flexibility and Inventory
Maintained inventory of Inspire IV to support centers concerned about Inspire V reimbursement; Q1 implant mix remained predominantly Inspire V but IV is available as a bridge.