Inspire Medical at KeyBanc Forum: Strategic Launch Plans

On Tuesday, 18 March 2025, Inspire Medical Systems (NYSE: INSP) presented at the KeyBanc Annual Healthcare Forum 2025, outlining its strategic initiatives for the year. The company revealed plans for the Inspire five launch, shared financial guidance, and addressed ongoing challenges, including competition and regulatory scrutiny.

Key Takeaways

• Inspire Medical plans to launch Inspire five in 2025, with a focus on managing inventory and production capacity.
• The company maintains its 2025 revenue guidance of $940 million to $955 million.
• Inspire Medical achieved its first year of profitability in 2024.
• Changes to the prior authorization process are improving patient access.
• The company is cooperating with a DOJ review regarding compliance and false claims.

Financial Results

• Revenue Guidance: Inspire Medical reiterated its revenue projection for 2025, estimating between $940 million and $955 million.
• Profitability: 2024 marked the first year of profitability for the company.
• Reporting Metrics: Future updates will focus on revenue, earnings per share (EPS), and metrics such as the number of territory managers and field clinical representatives.
• Seasonality: The first quarter is typically the slowest due to deductible resets and surgeon vacations, with stronger performance expected in the fourth quarter.
• Reimbursement: Ambulatory Surgical Center (ASC) reimbursement is set to increase by $1,000 with a new code.

Operational Updates

• Inspire five Launch: A full market launch is planned for 2025, with inventory levels currently limiting expansion. The company will open more centers as inventory builds, with a focus on a back-end weighted rollout.
• INSPIRE5 Success: All 44 implants in Singapore were completed successfully.
• Prior Authorization: Enhancements, including the SteepSync system, are automating the authorization process, improving patient access.
• Manufacturing: Inspire Medical is qualifying additional production lines with new partners.

Future Outlook

• Inspire five and six: Inspire five introduces a platform technology by removing the pressure sensing lead, with Inspire six expected to feature auto activation.
• Competition: The company anticipates competition but views it as an opportunity to grow technology adoption.
• Patient Management: Digital tools, including a strong app, are expected to enhance patient management and communication with practitioners.
• Marketing Strategy: Inspire Medical will update its website and launch targeted email campaigns to highlight Inspire five benefits.

Q&A Highlights

• Air Pocket Concerns: CEO Tim Herbert minimized concerns about inventory levels, noting continued use of Inspire four until Inspire five is available.
• GLP-1 Impact: The potential effects of GLP-1 medications on Inspire therapy are still uncertain.
• CID and False Claims: The company is cooperating with a Department of Justice review and remains confident in its compliance and ethical standards.

For further details, readers are encouraged to refer to the full conference call transcript.

Full transcript - KeyBanc Annual Healthcare Forum 2025:

Brett Fishman, MedTech analyst, KBCM: I’d like to welcome everyone back to the KBCM Healthcare Forum. My name is Brett Fishman, MedTech analyst, and I’m pleased to be joined this afternoon by Inspire Medical, who is represented today by Tim Herbert, the CEO Rick Buchholz, CFO and Esky Jaja, vice president of investor relations. I’ll start us off with q and a. Just for anyone who’s attending their first meeting today, there is a question and answer box below the screen, and you can feel free to submit questions to me, which I can then relate to management if you have them.

So just to get things started here, you know, getting a little bit further into 2025, compared to your fourth quarter earnings call and was just curious if you guys could kick things off with maybe a high level update on how you’re viewing the underlying environment around procedural activity as well as trends around physician contact and website traffic?

Tim Herbert, CEO, Inspire Medical: Absolutely. Well, first off, thank you for hosting us and having us join your event. And we want to thank everybody, all the other investors that we’ve met with through the day. So very organized event. And thank you very much for hosting us on Fireside Chat here.

Great leading question. I think the, it’s always exciting starting the new year, especially with a lot of the key elements that we have going into this year. And, we’re very excited about Inspire five. We’ve been talking quite a bit about that. I know we’ll talk a little bit more about that on this call.

But the year started well with the team and and we know that we come off a strong q fours. We had our earnings call right there and and we work with our seasonality. We have so many, so much activity late in the fourth quarter, especially in December between the holidays. And we really kind of fatigue the physicians and our staff. And so when we come into January, it’s people need to have a little bit of a refresh.

We do our national sales meeting in January, then people hit stride. So while January always starts a little bit slow, we really hit stride as we get through February and March and proceed into the rest of the year. So very exciting as we continue to make great progress with INSPIRE5 and just taking care of patients with the amount of web activity and the demand that we see for INSPIRE therapy.

Brett Fishman, MedTech analyst, KBCM: All right, great. And just turning back to the fourth quarter call, a couple of weeks ago, you came out and reiterated the guidance that you provided at a conference earlier this year, specific to the revenue guidance $940,000,000 to $955,000,000 dollars Just wondering if you could unpack that a little bit and just talk through some of the bigger like puts and takes behind that range. I guess my question would be, is the range mostly tied to when Inspire five fully launches or are there some other factors that you think are bigger swing factors for this year?

Tim Herbert, CEO, Inspire Medical: Well, I think coming back, I do think Inspire five is an exciting time for us. And we think that, we don’t market it today. It’s not on our website. And so centers continue to take care of their patients with INSPIRE four today. We don’t see any kind of air pocket per se with that as we move through.

When we get into the second quarter, yeah, we’ll talk a little bit about the inventory with Inspire IV. But most centers don’t have that much inventory to burn down and the top centers that do have a more significant amount of inventory, they do so many implants on a monthly basis up to over 20 implants in a month. So they can work through their inventory, relatively quickly. We looked at the overall guide, so I think INSPIRE five is pretty exciting. Our ability with our DTC to be able to reach patients and bring them to our website.

And we’re gonna spend a lot of time this year helping and working on our tools to help them make that first appointment. And that conversion has always been a little bit of a challenge in the past. But one example is we’ve talked about is the digital scheduling has really shown to be an effective way to help the patients communicate and get that first appointment set up with their centers. So they don’t have to go back and forth with email or go back and forth with trading voice mails with the center to get that first appointment made. So we’re making good progress with that earlier in the year.

And you will hear us talk more in the year about developing our digital technology as well. We do look at some factors. GOP ones, it’s hard to see how that’s gonna really come into play in 2025. And we talked to our physicians and are they going to be prescribing GLP-1s to help patients lose weight, to help them with their sleep apnea? And that’s a question that still remains out there.

And I think that’s gonna get pushed back to the weight management centers as well as to the family practice doctors to help kinda weigh, help people lose weight, therefore, qualify for INSPIRE. We’ll talk a little bit about competition. I think we did put that there may be some trialing at academic centers. But again, not looking too significant to add that, but certainly wanted to recognize that with the success that we’ve had, we will see competition in the future. We know that.

But I’m not sure it’s going to have much of an impact in 2025.

Brett Fishman, MedTech analyst, KBCM: All right. No, it makes a lot of sense. We’ll keep our eye on some of those topics as the year progresses. Just maybe turning back, I think you commented a little bit on you make a very big push in fourth quarter every year and usually comes in quite strong and then 1Q is always the softest quarter just thinking about how procedures are done. Maybe if you could just expand a little bit or elaborate on how you’re viewing seasonality in 2025 compared to the past several years and just like specifically given the midyear timing of the potential Inspire five launch?

Rick Buchholz, CFO, Inspire Medical: Yeah. Good question, Brett. So we have typical seasonality since we’ve gotten approval, you know, ten years ago now that we’re really excited about that we we have seasonality. You know, a vast majority of our business is, commercial payers versus Medicare. And so we we see a a real busy q four with the high deductible plans, then they reset.

And as as Tim alluded to, our seasonality is is really in the first quarter, specifically in the in January. Because we really fatigue the system with with procedures in the fourth quarter. People take vacations in January, meaning our surgeons. And if a lot of those centers have have one implanting surgeon, we can we can feel the impacts of seasonality. We have our national sales meeting.

So we have the sales organization out of the field for for a week, and and then we get going. And then we kinda resume back into February and March. So we have seasonality. We also have, the year strengthens throughout the year, given that stronger Q4. And with the Inspire five launch, we have assumed that in our guidance, but we’ve not assumed a dramatic or significant change in utilization with Inspire five.

But with that being said, with the moving parts of the launch, it could be a little bit more heavily back end weighted in the second half of the year.

Brett Fishman, MedTech analyst, KBCM: Yes. For sure. Appreciate that color, Rick. The one other interesting topic this year just with guidance and how folks are thinking about their modeling assumptions, you’re making some changes to the reporting metrics, which you’ve been telegraphing for over a year now. But just kind of following up on that topic, wanted to ask, like, why you decided to make those changes?

And then, like, specifically, what metrics investors should expect, like, will be provided on a go forward basis each quarter?

Tim Herbert, CEO, Inspire Medical: Well, I think we started at the top and the key metrics that are what we’re going to guide to what’s really most important is obviously revenue

Brett Fishman, MedTech analyst, KBCM: on

Tim Herbert, CEO, Inspire Medical: the top line. But last year was our first year of being profitable, very proud of that. So that’s a new guide for us is giving earnings per share to let people understand while we’re investing for growth going into the future, we’re certainly doing that as a profitable company and that’s very exciting. Secondly, I think people get a little bit too focused on the individual centers. And we know that the top two quartiles are the centers that do the majority of the volume and that’s where we see the utilization growth.

And so we wanted to kind of get away from that level of detail and focus more on a macro level on. We’re still going to come back and make sure we provide people with the number of territory managers that we have. But we’re adding more to that too to kind of enhance that. We’re also providing the number of field clinical representatives that we have. Now remember, a field clinical rep is an individual that they do the case coverage.

They’re in the Operating Room. They do the training on how to do the patient programming and do patient follow-up to the centers. And so they can help the procedures within the center. And therefore, the territory managers can help their own macro items such as patient flow, right, or being able to, find additional capacity at within the centers or find additional surgeons at a center that thereby can add capacity. Right?

So we really want the territory managers to be cultivating their territories and really the field clinical rest to really be focused on, patient flow and efficiencies within the center. That takes the the, bonus of just the specific number of centers and utilization. We’re still going to be focusing on same store sales and growing the utilization at the top two quartiles of our centers that have the ability to grow. This is community based healthcare that the hospitals in our community still really love the academic centers. They’re still going to be a very important part of our business, still going to continue to fight to grow our business, do the early clinical research, and help us navigate our next generation activity.

But the community health is really where we see the highest volume centers that can take care of patients in their own neighborhoods, in their own communities. So that’s why it’s so important that we just provide the number of territory managers, the number of field clinical reps. And in general, we want to maintain basically the same ratio of territory managers to centers. So as a rough estimate, people can still be comfortable. We’re not really changing our business, but just providing different information.

Brett Fishman, MedTech analyst, KBCM: Yeah. No, it makes sense. I guess maybe just a little bit of a follow-up. Is it partially that you’re viewing like revenue per territory as more relevant? I know there was like one consideration that you have implanters who are opening second centers, which takes away from their time and weighs on like a same store metric.

Is that part of the thinking or anything else?

Tim Herbert, CEO, Inspire Medical: Well, I think we know that 25% of our centers are secondary sites of service. Those are like the quartile four centers. And yes, that is a dilutive element or calculate as part of the calculation. But it’s really not focusing on those centers because it’s good that those doctors have secondary sites of service. So if their primary hospital is full that they do have an overflow to be able to take care of the patient.

So that’s a necessary, element. We like those centers. Right? Some of the academic centers, while they’re so important, they’re not gonna be doing the high volume because they have a lot of other responsibilities, in their jobs that they’re limited on the number of, procedures that they’re going to do on a monthly basis. So that’s why we want to kind of move away from centers and really just focus on the territory managers.

Brett Fishman, MedTech analyst, KBCM: Sure. And one other question I had just on this year and some of the procedure trends. Like a pretty big topic, I think it was around 1Q and 2Q of last year, were some of the issues with prior authorization and like the process around that. And you guys have gone in and made some changes in how you’re going about doing that. And I was just curious if you could discuss like how those changes have worked and like if you’re seeing improvements to patient overall patient access and efficiency to, you know, get get the therapy that they need.

Tim Herbert, CEO, Inspire Medical: Yeah. Well, let’s take everybody back a year or two. And what the intent was is we were doing a pilot to see if centers could do their own prior authorizations that INSPIRE was at the level of care that it could be standardized within the prior authorization teams of existing practices. In several sites, we were successful with that and they continue to do their own prior authorizations today because they have the teams to be able to do that. But what we found in general is centers just are not ready to take that on with the payers yet.

We need to continue to provide support to their centers and the preparation of packages. So when they submit them to the insurance companies, they have a higher chance of a consistent message that can drive approvals. So we pulled that back in and work with the centers to make sure that the prior authorization process is done consistently and proper to maximize those returns. And I think that that really has showed itself well in the third and fourth quarters and all the way through 2024. And we’re going to continue to improve this process and we’ll be looking to do technology enhancements even part of the SteepSync system to really help automate that process and make it easier for centers to get approvals with the healthcare providers.

And a consistent message to the healthcare providers also is so important that they recognize it’s part of their able to see the indication around the specific patients, the coding that will be used in this procedure and then to be able to provide an approval in a short just two to five day period. So I think that we’ve come a long way with that. And it’s really about streamlining the process that as you say help patients receive therapy.

Brett Fishman, MedTech analyst, KBCM: All right. Let’s shift gears a little bit and talk about Inspire five, which is the big upcoming product launch that everyone is really excited for. I’m just curious if we could start and maybe give an update where you currently stand with the limited market release and how many centers have how many centers currently have the device and what’s been the latest feedback over the past three or four weeks?

Tim Herbert, CEO, Inspire Medical: Sure. I think the excitement is we started on Singapore and they’ve completed the, grant that I think they completed their 44 implants and all of them were successfully completed. Those patients are being titrated and we’ve had several sleep studies already with those patients. Very exciting. I think the idea is that some of the data from those patients will actually be presented in June at the AASM meeting, American Academy of Sleep Medicine to really show the benefits of INSPIRE5.

So that’s really exciting. We also did the first implants in The United States back in 2024. And since then have opened up several more additional limited market large centers, as we continue to build up inventory and we’ll continue to open up more in waves as we continue to proceed forward and be able to capture additional data going forward. But the feedback from the physician so far has universally been very strong feedback. Number one, in not placing the pressure sensing lead.

That’s the whole point of developing the Inspire five system was really to get rid of that pressure sensing lead and incorporate that using an accelerometer. So we can sense from inside the can and we don’t need that external sensor, which again was placed in the chest wall, which is just not where ENT, ear, nose and throat surgeons operate on a daily basis. So really great feedback from that standpoint.

Brett Fishman, MedTech analyst, KBCM: Great to hear. And just a quick follow-up, I’ll give this one a shot. You’ve talked about a full market launch at some point in 2025. I know at one point you thought it would be earlier in the year now to sometime in the year. Are you able to provide any more color or specificity around when you possibly move into a full market launch?

Tim Herbert, CEO, Inspire Medical: Well, our manufacturing facility, the first one that’s qualified is delivering product. We’re building our inventory. And so that’s really exciting for everybody, especially the patients as you say. But we are going to continue to go on waves and continue to open up centers in the limited market release. And when we get to the point that we have sufficient inventory to be able to support the broad launch, we will proceed to do so.

But again, we may commit to be fully converted by the end of the year.

Brett Fishman, MedTech analyst, KBCM: Were there any, like, surprising challenges that took place with this early manufacturing ramp that is currently underway? Just thinking about like a little bit of the change in language for a full market launch. And if so, are those kind of in the past? And like how have you been able to address like any issues that might have come up?

Tim Herbert, CEO, Inspire Medical: It’s a brand new production line with new state of the art technology to provide not only a high yield, but a high material throughput. And so it’s not unexpected challenges. It’s the normal course of debugging a production line and to a point where we can start to turn up the throughput. And now we’re in stage two, which is really adding stations to really take the throughput to the next level. So, like what we see from a qualified production line that is in control and can be consistently monitored and managed and deliver consistent product flow, but then really bring the value add in to be able to increase, the overall throughput.

And in the same time, start working with our second and third partners to be able to get third production lines, qualified and up and running. And the second part of the Inspire five program was we were going to have redundancy in our manufacturing to be able to have security or comfort in our product supply. And again, that’s what the limiting factor. We’re just being a little bit careful to make sure that we have this efficient inventory before we do the full launch, but things are progressing quite nicely right now.

Brett Fishman, MedTech analyst, KBCM: Yes. No, it makes a lot of sense. And I’m guessing those manufacturing partners are also just as eager to kind of kick it up and get more production flowing. So

Tim Herbert, CEO, Inspire Medical: Everybody is excited about getting five moving. No question about it.

Brett Fishman, MedTech analyst, KBCM: I had one question come in from the audience. If you guys care to comment on how many U. S. Cases have you performed so far in this LMR?

Tim Herbert, CEO, Inspire Medical: Yes, we’re going to be a little careful about that. And also with the number of centers just in respect of all of our participating centers in The United States. So we continue to bring waves in and work with our advisors and some of the centers of excellence to garner and gain more information, but not getting really specific on the numbers.

Brett Fishman, MedTech analyst, KBCM: All right. Fair enough. I’m guessing that you’ve been asked this question today in some of the meetings, but maybe just trying another way from what we’ve already heard people ask. I think there’s just this sense of concern around, like, an air pocket or potential couple softer weeks ahead of this full market release. I’m just curious maybe if there’s any, like, strategies that you can employ to try and limit the extent of that if if it does happen.

Tim Herbert, CEO, Inspire Medical: Sure. For the most part, I think you talked a little bit about inventory, burn down of existing inventory, and also patients waiting for the new technology. It was kind of the two elements of the question that we’ve been hearing quite a bit about. Let’s take them one at a time. Inventory for the most part, most centers only have two or three units.

And so for them to burn down the inventory, it’s really not a significant burden. Even those centers that have the highest utilization, they tend to keep a par level or a certain number of units on the shelf, even if it’s eight or 10. These are the CortelONE centers that are doing anywhere from 10 to 20 implants on a monthly basis. So even for them, it doesn’t take a lot of time to be able to work through their existing inventory to be able to move on to five. So we’ll monitor that closely as we start moving into the full launch, but I think it’s quite manageable.

And the second side to that is we have experience. We’ve done that before. We’ve gone from the Inspire two Neurostimulator to the Inspire four stimulator and worked in the inventory. Went from the old remote to the Bluetooth remote. Went from polyurethane leads to silicone based leads.

So we’ve done this in our, short history and and we know how to kind of work through these inventory issues as as we launch the new products. The second side really comes down to patients waiting for therapy. And we talk about it at like your conference here and investor conferences, but it’s not on our website. We don’t market Inspire five yet. It’s not broadly communicated out in the field.

And as people are listening in and they read their investor comments, they listen to our transcript, they’re investigating Inspire, so they really do their homework and learn. And if people want to wait for five, that’s fine. And I know there are people out there that are excited about five when it becomes available on their community and then they don’t want to wait for that. We think that’s fine. But I think there’s enough of a backlog too that the physicians don’t want to give up their OR slots.

They’re going to continue to practice, medicine. They’re going to continue to see patients as we move forward. And they’re going to continue to implant forward right up until the time INSPIRE5 becomes available. So again, we’re going to monitor the transition period, but we think that physicians are going to continue to provide Inspire four, which is a wonderful product. It’s been around for many years and really is a safe and efficacious therapy.

But again, I’m sure they’re excited to go to five as well.

Brett Fishman, MedTech analyst, KBCM: For sure. And you kind of hinted at it. You’re not currently like advertising this product or going out of your way to tell potential patients about it. Just thinking ahead a little bit, are you thinking about changes to the marketing strategy? Not necessarily dollars spent, but just in terms of kind of like communicating what these incremental features and benefits are maybe to patients who like had heard of Inspire but had certain concerns or like any overall change in messaging to the public that you’re thinking about?

Tim Herbert, CEO, Inspire Medical: Sure. When we, do the full launch and we’re gonna have a a web page update, Right? And and we’ll, at that point, talk about the benefits of INSPIRE five. During outpatient outreach, you may hear a little bit more about, INSPIRE five. Over the years, we’ve had a significant number of patients come to our website and provide them or provide us their contact information to keep them informed of advancements in our technology.

So we’ll do an email campaign to make sure that those patients know that the new technology is now available in their community as well. So sure, there will be many avenues where we’ll be able to communicate, the message of Inspire five. And this is inclusive. We have a lot of activities working right now regarding communication with cardiovascular, physicians, with general practice, family practice doctors to let them know about Inspire and where to refer their patients, even the sleep physician community. So there will be some work out there to make sure we get the message out there on five.

Brett Fishman, MedTech analyst, KBCM: I think the most obvious feature that stands out to everyone is change from the second lead to the accelerometer, which has extremely obvious benefits for the implanter. Just thinking about from like a patient perspective, do you think that there’s other features that maybe don’t get as much discussion from the investment community that are like maybe more incremental or like patient experience oriented that like you’d share or like just like other benefits to the patient outside of kind of simpler procedure and maybe some of the remote software updates?

Tim Herbert, CEO, Inspire Medical: Well, initially with Inspire five, we as a side, we just recently published our new quality report. It’s available on our website. And it gives updates on the very few revisions or, removals that patients would experience with Inspire. But of the small number of revisions, the majority of those today are result of the pressure sensing lead. So, it’s a reduction of risk for the patient of needing a revision procedure.

So, that’s really just the first step. The second is the future. Because five is not only just removing the pressure sensing lead, which is so important, but it also is a platform technology. It’s a microprocessor based system that allows for upgradability. One example is we’re already working on Inspire six, which is gonna have auto activation.

So when the patient falls asleep, the device will turn itself on at night. When they wake up, it’ll set itself up. Future adaptations will even get into automaticity of the device or auto programming. If you think about, a CPAP or an AutoPAP device that auto programs the pressure, we also are building the thought of automaticity in the Inspire system as well. And if you have an Inspire five, lot of those upgrades can just be downloaded into your device as a future upgrade, right?

That’s really exciting, being able to move forward with it. I think the other key to it is the whole digital program really lends itself to, improvements in patient management for the state physicians, but also for the patients. So they have a very strong app on their cell phone to be able to monitor their own procedure and how it’s helping out with their sleep and be able to communicate more directly with their practitioner. So, really advancing technology. And Inspire five is just kind of the start of that platform.

Brett Fishman, MedTech analyst, KBCM: I think it’s super exciting. You’re getting the implant and you know that from that point going forward, it’s only gonna get better with new features. It’s almost like getting a new phone and being able to do software updates and, you know, one year you have a new feature. I think, sleep detection stands out as something really exciting for the patient and

Tim Herbert, CEO, Inspire Medical: We’ve got to add for sure. I’ll just say and there’s more. I just want to add on to that too. Think about the patients who received Inspire eleven years ago and their batteries are coming around for replacements and it’s reverse compatible. And so, when they come in with an Inspire two device that they get upgraded to an Inspire five and can have those benefits going forward and how exciting that is for those.

And this is we got approved in 2014. This is really the start of the replacement, gravitated replacement cycle is just starting right now and how exciting it would be if we can offer INSPIRE V to these patients who have been with INSPIRE for all these years.

Brett Fishman, MedTech analyst, KBCM: Yes, absolutely. Just one other question on Inspire five and it’s come up on the earnings call and a couple other calls is just the change in reimbursement coating. I was hoping you could just recap for people who might not be like as familiar with the changes, specifically what’s changing. And then my question is just assuming that the doctors are going to be making a comparable amount per minute of procedure time, like is there less of a selfish incentive for them to push through more procedures if they’re not necessarily making more money per minute spent?

Tim Herbert, CEO, Inspire Medical: Oh, I don’t think doctors think that way. I think that, well, let’s back up. Let’s talk through this. From 2014 to twenty twenty two ish, we always use 64568 as our base code, but we had that pressure sensitivity. So we needed the add on code.

It was a Plus40466T. Right? Ironically, back then it paid $400 then what we did is we move forward and we went to 64,582, which is the new code for Inspire that we’ve been using for a while. And in that process, doctors, the professional fee went down $200 because 64,582 was based on a rec survey on the amount of work it took and the number of RVUs it took to be able to implant the Inspire four system. Now that the pressure sensor lead isn’t there, it reverts right back to the original code 64568.

And we don’t need the add on code. And so it’s a reduction in the amount of work that the surgeons need to do. But therefore, there should be less RVUs and the reimbursement for those procedure is appropriate. And when you look at the amount of reimbursement on a permanent basis, that competes with any other ENT procedure that they do. So what we need to do is focus on the efficiencies in the physician’s practice to do more cases in a day, which generates additional revenue for the practice to help them pay the overhead, the salaries and everything else in their practice going forward.

But what’s important is if they do additional procedures in a day, they’re really driving revenue for the site of service. And if the surgeon happens to be owner of an ambulatory surgical center, the reimbursement of the new code 64568 is 1,000 higher. And so now it provides an avenue to be able to increase the number of procedures at ASC. So I think all in all, surgeons aren’t gonna be too worried about the individual professional fee. The pressure sensing need going away is the true benefit of five and that allows them to do more cases in a day because it reduces the operating room time for each procedure.

Brett Fishman, MedTech analyst, KBCM: All right. Got it. And we have just maybe two or three minutes left. I’m going to try and squeeze in a couple of questions here. Just one on competition, from our point of view, it’s been relatively quiet.

I think we’ve gotten some directional news from one of the competitors. But maybe just open ended for you guys, Have you seen any big developments out in the field? And then just like how are you thinking about the risk of competition as it relates to the 2025 plan?

Tim Herbert, CEO, Inspire Medical: Answers to the question, no, we have not seen any impact. I think it’s very early. We need to see if the FDA approval comes through and when that comes through. But that’s just the start of the project. Then you have to start worrying about reimbursement.

And it’s not just identifying a code and if that is the proper code, but then you need to have peer review publications to work with the payers to get coverage. So, yeah, we’re very aware of the technology. We’re aware of the, of the company itself. And I think the key that we always stress is, we want we don’t have competition with the success that we’ve had. There’s no question about it.

But we want that competition to be additive to grow the adoption of the technology on the market. And for that, we expect the patient outcomes, the safety and efficacy to be at least on par with Inspire. And so, we set the bar high and that’s the expectation in the field that they that effectiveness will be that high. So we know we’ll have competition. We know that the some of the academic centers will do a trialing this year, but we’ll continue to monitor with everybody.

But our job is to keep our technology advancing from five to six and our digital tools and continue to grow our sandstorm sales.

Brett Fishman, MedTech analyst, KBCM: I’m going to try and squeak in two really quick ones to finish this off here. One from the audience, I think you guys addressed this at least during earnings, but do you feel generally comfortable with how The Street is modeling the cadence of revenue this year based on the guidance?

Tim Herbert, CEO, Inspire Medical: We talked about that at our last earnings call. We provide annual guidance, but in the context there that we said the quarterly guidance wasn’t unreasonable.

Brett Fishman, MedTech analyst, KBCM: Alright. And then last one, you had to look a little bit of news come out around the CID and false claims. Are there any updates you’re able to share on that? And if not, are there any, like, key milestones that you have visibility to as we work toward a resolution there?

Tim Herbert, CEO, Inspire Medical: Very early on. And I think that, we have retained our council. It’s being managed out of the jurisdiction here in Minneapolis. Our council is also in Minneapolis with direct experience working with the DOJ. So they’re in communication right now to refine what information the DOJ is asking for in the very early stages of a review.

So not a lot to add to that. We do know from others who have done some analysis on these that they take quite a period of time to be able to resolve and with varying levels of results. What I will say is we have full confidence in our policies and procedures. We operate our business on a very, compliant and ethical manner. And we are not making changes right now in how we operate.

So we’re going to continue to provide patients with the best possible therapy to get the best possible, possible outcomes. And we’ll continue to do that in a very compliant and legal and ethical way. And we will be fully transparent and cooperative with the DOJ as they do their review.

Brett Fishman, MedTech analyst, KBCM: Alright. Tim, Rick, Etzke, thank you so much for taking the time to join us today. Thank you to everyone in the audience for tuning in and have a great rest of the day.

Tim Herbert, CEO, Inspire Medical: Great, Brad. Thank you so much. Great to be here. Thank you.

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