Inspire Medical Systems, Inc.

Price story Before the numbers, the tape. A stock price moves through four repeating seasons: a flat base (stage 1), an advance (2), a top (3), a decline (4). Where the price sits in that cycle frames everything below.

Inspire Medical Systems, Inc. trades at $64.1, between stages. That is −6.5% against its own 200-day average. It sits at 25% of a 52-week range of $40 to $137. On relative strength it has been ahead of the S&P 500 on a trailing-13-week view for 1 straight week.

Today the stock is between stages. At $64.1 it trades −6.5% versus its 200-day average and sits at 25% of its 52-week range ($40–$137).

Against the market, two honest reads. Cumulative: over the last 1.1 years the stock moved −51% while the S&P 500 moved +24% — behind the index over the full window. Recent form: on a trailing-13-week view the stock has been ahead for 1 straight week — the ribbon below is that same metric, week by week.

What would end the trend, mechanically: two Friday closes in a row below the 200-day line. That is the exit rule — no debates.

Valuation P/E is the price of $1 of annual profit: how many dollars the market pays for each dollar the company earns in a year.

Inspire Medical Systems, Inc. trades at 13.9× P/E, mid-range by its own standards (46th percentile). Its long-run median P/E is 15.9×, measured across 1.1 years of weekly readings. This places the multiple against the stock’s own record, and says nothing about what the business is worth.

Today's P/E of 13.9× is mid-range by its own standards (46th percentile), against a long-run median of 15.9× measured over 1.1 years of weekly readings. This is a comparison against the stock's own history — not a claim about what it is worth.

One caveat before moving on: margins are the best this company has ever printed — cheap against its own history on record margins is not the same thing as cheap. If profitability mean-reverts, today's multiple is higher than it looks.

Why the multiple sits where it does: over the past year annual EPS moved +179.4% against a −49.1% price move — earnings outran the price, pushing the multiple DOWN its own range.

Put together: the multiple is unremarkable against its own past, so the story rests on the earnings line underneath it, not the multiple.

Stage: No read Every business sits somewhere on a fundamental arc, and this page names the spot before anything else. The last twelve quarters of revenue, profit and EPS growth — plus the return the business earns on its capital — are read as curves: Deteriorating (the curves are falling), Turning around (a trough has just formed and the last few quarters lift off it), Improving (the climb off the trough is sustained), Consistent (steadily positive with healthy returns), Topping out (still high but decelerating from the peak). When the curves genuinely disagree the read is Mixed; too little history is No read. CAGR (compound annual growth rate) is the smooth yearly pace that turns the starting value into the latest one — the fairest way to compare growth across different time spans. Read the columns together: if the 1-year number towers over the 10-year, recent growth is running hotter than the long-run trend. A dash means that window is not held, or the base year was a loss (where a growth rate is not meaningful).

Inspire Medical Systems, Inc. reads as no read on its fundamental arc. Under eight usable quarters on the growth trio — not enough history for an honest trajectory read. The read is built from 12 quarters across 2 curves, on partial evidence.

Why it matters: with too little history, an honest page says so instead of guessing a trajectory.

One or more growth curves carry a base-effect spike — a large year-on-year move off a near-zero or loss-making comparable quarter. Those spikes are capped before the classifier reads the trajectory, and shown pinned on the chart, so a single distorted quarter does not drive the stage call.

Fewer than eight usable quarters on the growth curves — this page will not guess a trajectory from a stub of history.

4-Factor Sector Score

40.0/100 — rank 23 of 30 in Medical Devices · 75% evidence confidence

Inspire Medical Systems, Inc. scores 40.0 out of 100 against the 30 companies it is compared with in Medical Devices, ranking 23. Balanced evidence: keep at normal research priority and require another comparable period before raising conviction.

The four contributions add to the total exactly: 17.3 + 6.1 + 12.3 + 4.3 = 40. This is the SAME number shown on the sector comparison — it is computed once, for the whole peer set, and read here.

What would change it: The read weakens if profit growth turns negative or margin improvement reverses while sector-relative strength deteriorates.

Revenue Revenue is the top line: everything the company billed its customers in the period.

Inspire Medical Systems, Inc. reported $0.2 B of revenue in the Mar 26 quarter, +0.0% year on year. Over 4 years it has compounded at 41.0% a year. The last full year, FY25, came in at $0.9 B. The last four reported quarters add to $0.9 B.

FY25 revenue came in at $0.9 B (+13.7% on the year), capping 4 years at 41.0% compound. The latest quarter (Mar 26) printed $0.2 B, +0.0% year on year.

Pace check: the last four quarters averaged +8.1% growth against the decade's 41.0% — the current year is running slower than its own long-run rate.

Acceleration check: trailing-twelve-month revenue grew +8.3% over the last 4 quarters against +18.3%/yr over the last 8 — rolling over.

Operating margin Operating margin is what is left of every $100 of sales after running the business, before interest and tax. It is the cleanest read on pricing power and cost control.

Inspire Medical Systems, Inc.'s operating margin is 0.0% in the Mar 26 quarter, +0.0 percentage points against the same quarter a year ago. That is the widest this company has ever printed on a full-year basis. Across 5 fiscal years the operating margin has ranged −17.4% to 5.5%. The current quarter sits inside that band.

The latest quarter's operating margin is 0.0%, +0.0 pp against the same quarter a year ago. Across 5 fiscal years the operating margin has ranged −17.4%–5.5%, and FY25's 5.5% is the top of that band — a record year.

Why the margin moved: operating margin went +0.0 pp year on year while gross margin went +5.0 pp — the gain came mostly from the gross line: input costs and pricing.

Worth repeating from the valuation section: cheap against its own history on record margins is not the same thing as cheap — a record margin flatters every ratio built on top of it.

Net profit Net profit is what survives every cost, interest and tax — the number EPS, dividends and book value all grow from.

Inspire Medical Systems, Inc. posted a net loss of $0.01 B in the Mar 26 quarter. Full-year FY25 profit was $0.1 B. That loss is 5.0% of the quarter's revenue. The same quarter a year earlier earned $0.0 B. 4 of the last 12 reported quarters were loss-making.

Mar 26 profit was $−0.0 B, null year on year. On the full year, FY25 printed $0.1 B (+200.0%).

Pace comparison, last four quarters: profit +33.3% vs revenue +8.1%. Profit is growing faster than sales — fixed costs are being spread over a bigger base, and each extra dollar of revenue drops more to the bottom line.

Cash flow — the router The P&L says what was earned; the cash-flow statement says what actually arrived. Operating cash flow (CFO) against profit is the cleanest lie detector in the accounts.

Over the last 2 fiscal years 125% of Inspire Medical Systems, Inc.'s reported profit arrived as operating cash — the cash follows the profit. In FY25 that was $0.1 B of operating cash against $0.1 B of profit. After $0.0 B of capital spending, $0.1 B was left as free cash.

FY25: operating cash of $0.1 B against reported profit of $0.1 B, leaving free cash of $0.1 B after $0.0 B of capital spending. Across the last 2 fiscal years the conversion rate is 125% of profit.

Cash-flow readings here are annual — that is the resolution our series carries, so this section moves once a year.

Why: conversion is measured cleanly, but the working-capital day-counts behind it sit below what we hold — the move is shown without inventing its driver.

Router verdict: the visible cash user is investment — the next section checks what the spending is buying.

Where the cash goes Working capital is the cash tied up between paying suppliers and getting paid: debtor days (customers owe), inventory days (stock waits), and the cash conversion cycle (the whole loop, in days of sales).

Inspire Medical Systems, Inc. does not report the debtor, inventory and payable day-counts a cash cycle is built from, so this section reads the investment side instead. Capital spending ran $0.0 B over the last 3 years. Averaged over those years that is 0.0% of FY25 revenue a year.

Working-capital day-counts are not in our numbers for this stock, so this section reads the investment side — where the cash is being put to work.

On the investment side: capital spending of $0.0 B over the last 3 fiscal years.

The synthesis: the cash is going into capacity, not disappearing into the cycle — the question becomes whether the new capacity earns.

Return on equity Return on equity (ROE) is the profit the business earns on its shareholders’ money. With the full capital-employed split not in our numbers, ROE is the cleanest long ladder we can draw here.

Inspire Medical Systems, Inc. earns a ROE of 19% in FY25. That is up from a trough of −17% in FY21. Return on invested capital clears the cost of that capital by +2.3 percentage points, so growth here adds value rather than only size. The wiring behind it is 16.5% net margin on 1.00× asset turns.

FY25 ROE is 19%, recovered from a FY21 trough of −17% — the full ladder below shows the fall and the climb, undoctored.

Why the return is what it is — the wiring (FY25): 16.5% net margin × 1.00× asset turns × 1.17× balance-sheet leverage ≈ 19.3% on equity. Margin is doing the heavy lifting; leverage is modest — this is an earned return, not a borrowed one.

The capstone test — ROIC − WACC: 10.1% − 7.8% = a +2.3 pp spread. The 7.8% is an estimate of this company's own cost of capital — read the sign and the size of the spread, not the decimals. Positive but thin — value creation with little room for error.

Dividend

Inspire Medical Systems, Inc. pays no dividend. Across the last 12 reported quarters it has declared no dividend per share, so there is no payout history to chart and no yield to quote. Companies at this stage typically reinvest earnings rather than distribute them, which makes the cash-flow and reinvestment sections the place that cash shows up.

Inspire Medical Systems, Inc. does not currently pay a dividend. Across the last 12 reported quarters the company has declared no dividend per share, so there is no payout history to chart and no yield to quote. Companies at this stage typically reinvest earnings instead of distributing them.

Debt Debt-to-equity says how much of the business is funded by borrowings. Low is the safe corner; the trend matters as much as the level.

Inspire Medical Systems, Inc. carries total debt of $0.0 B against shareholder equity of $0.8 B as of Mar 26, a debt-to-equity of 0.04 — effectively unlevered. On the annual view that ratio went from 0.13 in FY21 to 0.04 in FY25. The returns elsewhere on this page are therefore earned rather than borrowed.

Mar 26: total debt of $0.0 B against shareholder equity of $0.8 B — a debt-to-equity of 0.04. On the annual view, debt-to-equity went from 0.13 (FY21) to 0.04 (FY25). The returns on this page are earned, not borrowed.

Ownership There is no quarter-by-quarter holder register to read here, so we read the crowd through short interest — the slice of tradable shares currently sold short, positioned for a fall.

17.1% of Inspire Medical Systems, Inc.'s tradable float is currently sold short — a large bloc is positioned against it. At typical trading volumes those positions would take about 3.8 days to buy back. There is no quarter-by-quarter holder register to read for this filer, so the crowd is read through short interest instead.

The latest reading: 17.1% of the float is sold short, and at typical trading volumes it would take about 3.8 days to buy those positions back. A large bloc is positioned against it. This is a single point-in-time reading — we do not yet hold its history, so we show no trend chart.

Why it sits there: who is doing the shorting, and why, does not travel with the number — the level is shown without inventing its story.

Safety line The Z-score estimates how far a company sits from balance-sheet distress — above roughly 3 is safe, below roughly 1.8 is the danger zone. It was built for manufacturers, so it is not applied to banks and lenders.

Inspire Medical Systems, Inc.: the Z-score reads 16.83. A Z-score above roughly 3 reads as safe and below roughly 1.8 as the distress zone, so this sits well clear of distress. It is a distance-to-distress estimate from the balance sheet, not a forecast of failure.

Why it matters: a Z-score of 16.83 sits well clear of the distress zone — the balance sheet is not the risk here.

The safety line in one sentence: the Z-score reads 16.83.

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