Inspire Medical Systems, Inc. (INSP) stock analysis
Close on Nov 12, 2026Market cap $1.75BP/E 17.6Yield –
StockData Score
Prices as of Nov 11, 2026How the score works
Solid17 of 30 checks passed
Inspire Medical Systems passes 17 of the 30 checks behind our score; 9 could not be run for lack of data and count as not passed. Each dot in the shape is one check — hover it for the numbers.
- Valuation
- 5/6
- Growth
- 3/6
- Past performance
- 3/6
- Financial health
- 6/6
- Dividend
- 0/6
What stands out
Margin of safety over 20%
The price is 28.4% below fair value, more than the 20% cushion we look for.
Trading below fair value
The share price of $62.11 is below our fair value estimate of $86.70.
No debt
Inspire Medical Systems has no borrowings on its latest balance sheet.
Revenue growing 10%+ a year
Revenue grew 30.8% a year over the last three fiscal years.
What to watch
Return on equity under 15%
Return on equity was 13.5% over the last twelve months and averaged -1.3% over five years; we look for 15% on both.
Return on capital under 10%
Return on invested capital was 3.7%, below the 10% that usually covers the cost of capital.
Growing slower than the industry
Revenue grew -0.2% over the last twelve months; the Surgical, Medical, and Dental Instruments and Supplies median is 11.0%.
No dividend
Inspire Medical Systems has not paid a dividend in the last twelve months.
Valuation5/6
P/E below its 5-year median
Inspire Medical Systems's P/E of 18.1 is below its own 5-year median of 50.4.
P/E below the industry
Inspire Medical Systems's P/E of 18.1 is below the Surgical, Medical, and Dental Instruments and Supplies median of 27.7.
EV/EBITDA against its history
Needs positive EBITDA and price history.
P/B below the industry
Inspire Medical Systems's price-to-book of 2.17 is below the Surgical, Medical, and Dental Instruments and Supplies median of 3.22.
Trading below fair value
The share price of $62.11 is below our fair value estimate of $86.70.
Margin of safety over 20%
The price is 28.4% below fair value, more than the 20% cushion we look for.
Growth3/6
Revenue growing 10%+ a year
Revenue grew 30.8% a year over the last three fiscal years.
EPS growth over 3 years
Needs positive EPS three years ago and today.
Earnings acceleration
Needs positive net income now, a year ago and five years ago.
Growing slower than the industry
Revenue grew -0.2% over the last twelve months; the Surgical, Medical, and Dental Instruments and Supplies median is 11.0%.
Guidance raised
Inspire Medical Systems raised its Full Year 2026 revenue outlook on Aug 3, 2026.
Gross margin improving
Gross margin was 86.2% over the last twelve months, against 84.9% a year earlier.
Past performance3/6
Return on equity under 15%
Return on equity was 13.5% over the last twelve months and averaged -1.3% over five years; we look for 15% on both.
Return on capital under 10%
Return on invested capital was 3.7%, below the 10% that usually covers the cost of capital.
Return on equity above the industry
Inspire Medical Systems's return on equity of 13.5% is above the Surgical, Medical, and Dental Instruments and Supplies median of -31.3%.
Earnings over 5 years
Needs positive net income five years ago and in the latest year.
Net margin above its 5-year average
Net margin was 11.4% over the last twelve months, against a 5-year average of -2.0%.
Net margin above the industry
Inspire Medical Systems's net margin of 11.4% is above the Surgical, Medical, and Dental Instruments and Supplies median of -14.1%.
Financial health6/6
No debt
Inspire Medical Systems has no borrowings on its latest balance sheet.
Debt not rising
With no debt today, leverage cannot have risen.
Debt covered by cash flow
There is no debt to cover.
Interest well covered
No meaningful interest expense to cover.
Short-term assets cover short-term debts
Current assets are 6.45 times current liabilities.
Low bankruptcy risk
The Altman Z-score is 9.92; above 3 is the safe zone and below 1.8 the distress zone.
Dividend0/6
No dividend
Inspire Medical Systems has not paid a dividend in the last twelve months.
Yield against Treasuries
No dividend.
Yield against the market
No dividend.
Dividend stability
No dividend.
Earnings cover
No dividend.
Cash-flow cover
No dividend.
Fair value
How we estimate itOur estimate per share
$86.70
The share price is 28% below this estimate.
| Method | Multiple used | Own 5Y median | Industry median | Value per share | Weight |
|---|---|---|---|---|---|
| P/E | 39.1× | 50.4× | 27.7× | $134.67 | 40% |
| EV/EBITDA | 16.7× | – | 16.7× | $31.16 | 35% |
| P/B | 6.2× | 9.2× | 3.2× | $177.52 | 10% |
| Earnings power | 10.3% cost of equity | – | – | $27.84 | 15% |
| Fair value | $86.70 | 100% | |||
Valuation over time
Using the earnings and balance sheet published at each date, not today's.
- P/E at month end
- Own 5-year median 50.4
- Surgical, Medical, and Dental Instruments and Supplies median 27.7
An estimate from reported numbers and market multiples, not a price target or investment advice. It can be far off for companies whose profits are about to change sharply.
Market risk
From the past year of daily prices.
Liquidity
Low risk
- Average value traded per day
- $55.75M
- Value traded per 1% price move
- $20.61M
Downside
High risk
- Typical loss in a bad month
- 34.1%
- Volatility (annualized)
- 70%
- Sharpe ratio, 1 year
- -0.46
- Beta to the S&P 500 (5Y)
- 1.08
Typical bad-month loss, week by week
Margins
Share of revenue, fiscal years 2016 to 2025
Gross margin
Operating margin
Net margin
Growth rates
Compound annual growth to fiscal 2025
| Per year | 1 year | 3 years | 5 years | 10 years | Five-year pace |
|---|---|---|---|---|---|
| Revenue | +13.6% | +30.8% | +51.2% | – | |
| Gross profit | +14.6% | +31.6% | +51.4% | – | |
| Operating income | +41.2% | – | – | – | |
| Net income | +171.8% | – | – | – | |
| EPS, diluted | +179.4% | – | – | – | |
| Free cash flow | -13.9% | +216.6% | – | – |
Returns and balance sheet
10 fiscal years. Hover a measure to see how it is calculated.
| Measure | FY2016 | FY2020 | FY2025 | Trend |
|---|---|---|---|---|
| Return on equity | – | -31.0% | 19.8% | |
| Return on assets | – | -24.7% | 17.0% | |
| Current ratio | – | 13.02 | 6.08 | |
| Debt to equity | – | 0.11 | – | |
| Net debt to EBITDA | – | 2.99× | – | |
| Interest coverage | -13.2× | -26.6× | 371.9× | |
| Inventory turnover | – | 2.5× | 1.2× | |
| Capex to revenue | 1.9% | 2.1% | 4.2% | |
| Diluted shares | 1M | 26M | 30M |
Where the cash went
Fiscal 2021 to 2025, five years combined
Inspire Medical Systems generated $303.56M from operations and spent $290.03M on capital expenditure, dividends and share buybacks. 40% of that went back into the business.
DuPont analysis
Return on equity split into margin, efficiency and leverage
| Fiscal year | Net margin | Asset turnover | Equity multiplier | Return on equity |
|---|---|---|---|---|
| FY2025 | 15.9% | 1.06× | 1.17× | 19.8% |
| FY2024 | 6.7% | 1.08× | 1.18× | 8.5% |
| FY2023 | -3.4% | 1.01× | 1.16× | -4.0% |
| FY2022 | -11.0% | 0.95× | 1.19× | -12.4% |
| FY2021 | -18.0% | 0.81× | 1.26× | -18.3% |
| FY2020 | -49.6% | 0.50× | 1.25× | -31.0% |
| FY2019 | -40.5% | 0.43× | 1.26× | -21.9% |
| FY2018 | -43.1% | 0.45× | 1.36× | -26.4% |
Piotroski F-Score
Nine tests of profitability, balance sheet and efficiency, fiscal 2025 against fiscal 2024
- ProfitableNet income above zero$145.42M
- Cash generatingOperating cash flow above zero$116.98M
- Return on assets improvedROA up on the prior year7.9% → 18.0%
- Earnings backed by cashOperating cash flow above net income$116.98M vs $145.42M
- Less leverageLong-term debt to assets fell– → –
- Better liquidityCurrent ratio rose7.13 → 6.08
- No dilutionShare count did not rise31M → 30M
- Gross margin improvedGross margin up on the prior year84.68% → 85.39%
- More efficientAsset turnover rose1.19 → 1.13
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