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Insmed (INSM)
NASDAQ:INSM
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Insmed
(NASDAQ:INSM)
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Rating:55Neutral
Price Target:
$165.00
▲(10.00% Upside)
Action:ReiteratedDate:02/20/26
The score is held back primarily by weak financial performance (large losses and rising cash burn despite strong revenue growth and improved leverage). Offsetting this, the latest earnings call provided strong 2026 growth guidance and a credible cash runway narrative, while technical signals are mixed and valuation support is limited due to ongoing losses and no dividend.
Positive Factors
Brinsupri launch scale & 2026 guidance
A strong initial commercial trajectory and explicit $1B+ 2026 revenue guide show Brinsupri moving from launch to large-scale commercialization. Durable payer access and rapid patient uptake underpin a multi-quarter revenue growth runway that can fund operations and validate the commercial model.
High product margins & ARIKAYCE growth
Sustained high gross margins and geographic ARIKAYCE growth indicate strong product-level economics and diversified regional demand. If margins remain elevated, incremental revenue from expanded indications or ENCORE success can flow to operating leverage and help improve long-term profitability.
Stronger balance sheet and cash runway
A materially strengthened liquidity position and sharply lower leverage provide strategic flexibility to fund launches, Phase III programs, and selective M&A without immediate dilution. Management's stated path to cash-flow positivity further reduces dependency on near-term capital markets.
Negative Factors
Rising cash burn
Substantial and increasing cash outflows mean the company remains reliant on prior financings or future positive free cash flow to sustain growth. Persistent negative cash flow raises execution risk if commercial momentum slows or one-time cash items recur, pressuring runway beyond planned milestones.
Large and widening operating losses
Deep, widening operating losses show that current revenue scale has not yet absorbed elevated R&D and SG&A investments. Continued negative profitability undermines return metrics and makes durability of earnings contingent on sustained high growth and successful margin leverage over multiple quarters.
Early adoption depth & payer friction
Broad prescriber reach with shallow per-physician penetration and ongoing documentation requirements creates rollout risk: slower refill rates, variable prescribing depth, and collection delays can blunt revenue realization and cash receipts, making topline sustainability sensitive to conversion efforts.
Insmed (INSM) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$34.19B
Dividend YieldN/A
Average Volume (3M)2.29M
Price to Earnings (P/E)―
Beta (1Y)0.76
Revenue Growth30.34%
EPS Growth-11.26%
CountryUS
Employees1,271
SectorHealthcare
Sector Strength45
IndustryBiotechnology
Share Statistics
EPS (TTM)-1.54
Shares Outstanding215,551,900
10 Day Avg. Volume2,329,622
30 Day Avg. Volume2,293,072
Financial Highlights & Ratios
PEG Ratio-1.93
Price to Book (P/B)50.31
Price to Sales (P/S)61.31
P/FCF Ratio-38.43
Enterprise Value/Market Cap0.93
Enterprise Value/Revenue52.69
Enterprise Value/Gross Profit66.35
Enterprise Value/Ebitda-27.16
Forecast
1Y Price Target
$217.29Price Target Upside44.86% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering19
EPS Forecast (FY)-2.7
Revenue Forecast (FY)$1.62B
Insmed Business Overview & Revenue Model
Company DescriptionInsmed Incorporated, a biopharmaceutical company, develops and commercializes therapies for patients with serious and rare diseases. The company offers ARIKAYCE for the treatment of Mycobacterium avium complex lung disease as part of a combination antibacterial drug regimen for adult patients. It is also developing Brensocatib, an oral reversible inhibitor of dipeptidyl peptidase 1 for the treatment of patients with bronchiectasis and other neutrophil-mediated diseases; and Treprostinil Palmitil Inhalation Powder, an inhaled formulation of a treprostinil prodrug treprostinil palmitil for the treatment of pulmonary arterial hypertension and other rare pulmonary disorders. Insmed Incorporated was founded in 1988 and is headquartered in Bridgewater, New Jersey.
How the Company Makes MoneyInsmed generates revenue primarily through the sales of its flagship product, ARIKAYCE. The company has established a pricing strategy that reflects the specialized nature of its therapies and the significant unmet medical needs they address. Additionally, Insmed engages in partnerships and collaborations with other pharmaceutical companies and research institutions to enhance its drug development pipeline, which can lead to milestone payments and royalties. The company also benefits from grants and funding aimed at supporting research and development in rare diseases, further contributing to its financial stability.
Insmed Earnings Call Summary
Earnings Call Date:Feb 19, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:Apr 30, 2026
Earnings Call Sentiment Positive
The call communicated a strongly positive commercial momentum driven by Brinsupri's launch (first full-quarter net revenue of $144.6M and guidance of at least $1B in 2026), solid ARIKAYCE growth (Japan +40% YoY) and a strong balance sheet (~$1.4B cash). Clinical progress (TPIP orphan designation and planned Phase III) and pipeline expansion via acquisitions were additional positives. Near-term challenges noted include early-stage depth of prescribing, some payer documentation requirements and increased operating spend (including ~$70M of one-time Q4 cash items). Management believes these lowlights are manageable and reiterated a path to cash flow positivity while retaining flexibility for selective business development. On balance, the highlights materially outweigh the lowlights.Q4-2025 Updates
Positive Updates
Brinsupri Launch and 2026 Revenue Guidance
Brinsupri received approval and delivered $144,600,000 in net revenue in its first full quarter. About 11,550 new patients started Brinsupri in 2025 (reported as <5% penetration of the initial target patient cohort). Management provided 2026 revenue guidance of at least $1,000,000,000 for Brinsupri and expects total company revenue in 2026 to be more than double 2025 levels. Gross-to-net for Brinsupri is guided to mid-20s to low-30s percent in 2026, with 2025 GTN already in that range.
ARIKAYCE Commercial Momentum and Potential Label Expansion
ARIKAYCE showed robust global growth: Japan delivered ~40% growth versus 2024 and accounted for >25% of ARIKAYCE global revenues; Europe grew faster (from a smaller base). The Phase III ENCORE readout is expected in March/April 2026 and, if successful, could expand ARIKAYCE's addressable market from ~30,000 patients to >200,000 patients.
Strong Cash Position and Path to Cash Flow Positivity
Insmed ended 2025 with approximately $1,400,000,000 in cash, cash equivalents, and marketable securities. Management expects to achieve cash flow positivity based on existing plans without needing to raise additional capital (while retaining flexibility to source capital for business development or pipeline expansion).
TPIP Progress and Orphan Drug Designation
TPIP (treprostinil palmitil) was significantly de-risked by 2025 clinical data and the FDA granted orphan drug designation for PAH, citing plausible clinical superiority. A Phase III registrational trial design has been presented and the company expects to initiate the PAH Phase III in H1 2026; FDA indicated one well-designed Phase III could support filing.
Favorable Market Access and High Payer Approval Rates
Management reported that over 90% of targeted patient lives have access to Brinsupri (GETRA/SUPRI) reimbursed via documented payer policy or medical exception. They noted very high payer approval rates so far, even among plans requiring documentation (CT scan and proof of ≥2 exacerbations), and indicated many payers are adopting attestation-based prior authorization with modest rebates.
Pipeline and Business Development Expansion
Insmed completed the acquisition of INS1148 (one-time cash impact noted) and reported entering two new gene therapies into the clinic (DMD and ALS). Management reiterated intent to pursue additional first-or-best-in-class assets (including further DPP1 candidates) and noted selective BD as a strategic priority.
Improved Product Margin Profile
Cost of product revenues for 2025 was $44,200,000, or 16.8% of revenues, a lower percentage relative to historical performance attributed to Brinsupri contributions, indicating a favorable impact on gross margin.
Negative Updates
Program Discontinuation
The company discontinued the CRS without nasal polyps program last quarter, representing a clinical pipeline setback in the inflammation area.
Early Depth of Prescribing and Adoption Risk
Although broad prescriber reach is established, adoption depth is still early: of ~4,000 physicians who wrote prescriptions through 2025, nearly half have prescribed Brinsupri to just a single patient. Early-stage limited per-physician depth (and inherent month-to-month variability) represents a near-term adoption risk as refill/word-of-mouth effects mature.
Payer Documentation and Administrative Friction
Some payers continue to require documentation (CT scan and proof of ≥2 exacerbations) rather than attestation, introducing potential administrative friction. Management flagged plan changes and reauthorizations as points of potential disruption, and noted that only a portion of recognized Brinsupri revenue had been collected in cash as of Dec 31, 2025, which affects near-term cash receipts.
Increased Operating Spend and One-Time Cash Uses
R&D and SG&A increased in Q4 2025 to support the Brinsupri launch and pipeline; Q4 cash burn included approximately $70,000,000 of one-time items (INS1148 acquisition and a milestone payment to AstraZeneca). ARIKAYCE gross-to-net is expected to increase slightly to the low-to-mid 20s in 2026 due to IRA-related manufacturer phase-ins and provisions.
Ex-U.S. Launch Timing Uncertainty
Ex-U.S. contribution for Brinsupri in 2026 is expected to be very small given original timelines. The company is awaiting clarity on MFN and other policy details before actively advancing full launches in Europe and Japan, which introduces uncertainty/timing risk for international revenue contribution.
Company Guidance
Management provided clear 2026 guidance focused on Brinsupri and overall company growth: Brinsupri revenue is guided at at least $1,000,000,000 in 2026 (Brinsupri generated $144.6M net in its first full quarter and added ~11,550 new patients in 2025), and company‑wide 2026 revenue is expected to more than double 2025 levels; they reiterated a >$5,000,000,000 peak‑sales framework tied to a U.S. diagnosed TAM of ~500,000 non‑CF bronchiectasis patients (with ~250,000 patients having ≥2 exacerbations as the core opportunity) and noted 32 million COPD/asthma patients as potential upside. Payer/access and product economics specifics: >90% of targeted patient lives have reimbursement access, Brinsupri gross‑to‑net is guided to the mid‑20s to low‑30s percent in 2026 (2025 GTN was in that range), and ARIKAYCE GTN is expected in the low‑to‑mid‑20s; ARIKAYCE grew 40% in Japan in 2025 (Japan >25% of ARIKAYCE global revenues) and the upcoming ENCORE readout (expected Mar/Apr) could expand ARIKAYCE’s addressable market from ~30,000 to >200,000 patients. Financial position and cash flow: year‑end cash, cash equivalents and marketable securities were ≈$1.4B, Q4 included ~$70M of one‑time cash items, cost of product revenues in 2025 was $44.2M (16.8% of revenues), and management expects a path to cash‑flow positivity in 2026 without needing to raise capital (while remaining open to opportunistic BD financing).Insmed Financial Statement Overview
Summary
Strong revenue growth and high gross margins are outweighed by very large and widening operating losses and accelerating cash burn. Balance sheet leverage improved sharply with much lower debt and stronger equity, but negative profitability and heavy free-cash-flow outflows keep the financial profile high-risk.Income Statement
Revenue growth is strong, accelerating materially in 2025 (annual revenue up ~36% to ~$606M), and gross margins remain attractive (~76–80%), reflecting solid product-level economics. However, operating losses remain very large and are widening (2025 EBIT and net loss both around -$1.25B), keeping net margins deeply negative and indicating the cost structure is still far ahead of the current revenue base.32
Negative
Balance Sheet
Leverage improved dramatically in 2025 as total debt fell to ~$46M from >$1.3B in 2024, bringing debt levels down to a conservative ~0.06x equity. Equity also strengthened to ~$739M (from ~$285M in 2024 and negative in 2023), improving balance-sheet stability. The key weakness remains persistently negative returns on equity driven by ongoing net losses, which continue to pressure longer-term capital durability if losses persist.58
Neutral
Cash Flow
Cash burn is substantial and rising: 2025 operating cash flow was about -$935M and free cash flow about -$968M (worse than 2024), indicating increasing funding needs. While free cash flow is roughly in line with net losses (cash outflow broadly tracking earnings losses), the company is not close to self-funding operations yet, leaving results highly dependent on external capital and/or a step-change in profitability.25
Negative
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 606.42M | 363.71M | 305.21M | 245.36M | 188.46M |
| Gross Profit | 481.55M | 277.96M | 239.63M | 190.23M | 144.31M |
| EBITDA | -1.17B | -818.79M | -660.18M | -447.37M | -383.65M |
| Net Income | -1.28B | -913.77M | -749.57M | -481.53M | -434.65M |
Balance Sheet | |||||
| Total Assets | 2.26B | 2.03B | 1.33B | 1.66B | 1.24B |
| Cash, Cash Equivalents and Short-Term Investments | 1.43B | 1.43B | 780.45M | 1.15B | 716.78M |
| Total Debt | 768.16M | 1.31B | 1.20B | 1.18B | 612.27M |
| Total Liabilities | 1.53B | 1.74B | 1.66B | 1.57B | 833.04M |
| Stockholders Equity | 738.98M | 285.38M | -331.92M | 87.95M | 410.47M |
Cash Flow | |||||
| Free Cash Flow | -967.58M | -705.80M | -549.53M | -410.32M | -370.59M |
| Operating Cash Flow | -935.01M | -683.88M | -536.25M | -400.44M | -363.30M |
| Investing Cash Flow | -64.58M | -583.17M | -223.60M | -34.58M | -64.28M |
| Financing Cash Flow | 954.07M | 1.34B | 168.44M | 793.27M | 612.55M |
Insmed Technical Analysis
Negative
150.00
Price Trends
164.28
Negative
174.23
Negative
141.75
Positive
Market Momentum
-2.70
Negative
42.07
Neutral
35.17
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For INSM, the sentiment is Negative. The current price of 150 is below the 20-day moving average (MA) of 153.22, below the 50-day MA of 164.28, and above the 200-day MA of 141.75, indicating a neutral trend. The MACD of -2.70 indicates Negative momentum. The RSI at 42.07 is Neutral, neither overbought nor oversold. The STOCH value of 35.17 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for INSM.
Insmed Risk Analysis
Insmed disclosed 53 risk factors in its most recent earnings report. Insmed reported the most risks in the "Tech & Innovation" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Insmed Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
83 Outperform | $20.11B | 15.61 | 29.87% | ― | 18.09% | 3563.21% | |
75 Outperform | $26.19B | 25.49 | 11.48% | 2.23% | 3.72% | -31.46% | |
74 Outperform | $12.03B | 34.48 | 5.94% | ― | 12.31% | 60.21% | |
66 Neutral | $18.05B | 18.78 | 17.65% | ― | 24.98% | 127.06% | |
55 Neutral | $34.19B | -23.21 | -249.28% | ― | 30.34% | -11.26% | |
53 Neutral | $26.66B | -41.77 | -2.94% | ― | 7.04% | -25.24% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
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Insmed Corporate Events
Business Operations and StrategyExecutive/Board ChangesFinancial Disclosures
Insmed director McGirr to step down after 2026 meeting
Positive
Feb 19, 2026
On February 17, 2026, director David W.J. McGirr informed Insmed’s board that he will not stand for re-election at the 2026 annual meeting, though he will remain on the board and continue chairing the audit committee until then, and the company said his departure is not related to any disagreement. For 2025, Insmed reported total revenues of $606.4 million, including $433.8 million from ARIKAYCE, which grew 19% year over year and exceeded guidance, and $172.7 million from BRINSUPRI, while ending the year with about $1.4 billion in cash and equivalents.
Management highlighted strong early uptake of BRINSUPRI following its November 2025 approval in Europe for non-cystic fibrosis bronchiectasis and projected at least $1 billion in BRINSUPRI revenue in 2026, alongside reiterating 2026 ARIKAYCE guidance of $450 million to $470 million. The company also advanced a broad pipeline, securing U.S. orphan drug designation for TPIP’s active ingredient treprostinil palmitil in pulmonary arterial hypertension, progressing multiple Phase 3 respiratory studies and gene therapy programs in Duchenne muscular dystrophy and ALS, and preparing new trials and regulatory filings that could expand its presence across respiratory, immunology, and rare disease markets.
The most recent analyst rating on (INSM) stock is a Buy with a $211.00 price target. To see the full list of analyst forecasts on Insmed stock, see the INSM Stock Forecast page.
Business Operations and StrategyFinancial Disclosures
Insmed Announces Strong 2025 Results and Pipeline Progress
Positive
Jan 9, 2026
On January 9, 2026, Insmed reported strong preliminary unaudited 2025 financial results and pipeline progress ahead of its January 12, 2026 presentation at the J.P. Morgan Healthcare Conference, highlighted by a landmark first full year for BRINSUPRI and continued growth of ARIKAYCE. BRINSUPRI generated approximately $144.6 million in unaudited revenue in its first full quarter and $172.7 million for full-year 2025 in the U.S., with roughly 4,000 prescribers and about 9,000 new patients initiating therapy in the fourth quarter, while ARIKAYCE delivered about $433.8 million globally in 2025, exceeding guidance and driving total company revenues to approximately $606.4 million, a 67% year-on-year increase. The company outlined an aggressive 2026 roadmap, including an anticipated EU launch of BRINSUPRI following its November 2025 European Commission approval for non-cystic fibrosis bronchiectasis and planned launches in the U.K. and Japan, expected 2026 global ARIKAYCE revenues of $450 million to $470 million, and key clinical milestones: topline Phase 3 ENCORE data in MAC lung disease in March–April 2026, Phase 2b CEDAR data for brensocatib in hidradenitis suppurativa in the second quarter of 2026, initiation and expansion of multiple Phase 3 TPIP trials across PH-ILD, PAH, PPF, and IPF, and the acquisition of Phase 2–ready monoclonal antibody INS1148, collectively signaling a rapid expansion of its respiratory and inflammatory disease franchise and a potentially stronger competitive position for shareholders and patients alike.
The most recent analyst rating on (INSM) stock is a Hold with a $157.00 price target. To see the full list of analyst forecasts on Insmed stock, see the INSM Stock Forecast page.
Business Operations and StrategyProduct-Related Announcements
Insmed Halts CRSsNP Program After Phase 2b Failure
Negative
Dec 17, 2025
On December 17, 2025, Insmed announced the Phase 2b BiRCh study of brensocatib for chronic rhinosinusitis without nasal polyps (CRSsNP) did not meet primary or secondary efficacy endpoints, prompting the discontinuation of the CRSsNP program. The study, conducted at 104 global sites with 288 participants, showed no significant improvement in outcomes compared to the placebo, but brensocatib was well tolerated without new safety concerns. Additionally, Insmed acquired INS1148, a Phase 2-ready investigational monoclonal antibody targeting respiratory, immunological, and inflammatory diseases, marking a strategic move that could enhance its pipeline for high unmet medical needs.
The most recent analyst rating on (INSM) stock is a Buy with a $256.00 price target. To see the full list of analyst forecasts on Insmed stock, see the INSM Stock Forecast page.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.