Inspire Medical Systems, Inc. (NYSE:INSP) Q1 2023 Earnings Call Transcript

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Adam Maeder: Okay. That’s great color, Tim. Thanks for that. And maybe switching over to Rick and the P&L, l just had a quick question on R&D spend in the quarter, which saw a healthy step up. So I guess first, what drove the increase? Where are those dollars being spent and how do we think about kind of cadence and of r and d spending going forward? Is this kind of the new base to work from? Thanks so much for. Thanks so much for taking the questions.

Rick Buchholz: Yeah. Hey Adam. Part of that increase is up in R&D. It was about 20% of revenue. That historically has been in that 15% to 20% of revenue and it has increased just year-over-year and sequentially just is really a function of the timing of entering that full qualification of Inspire 5. And so we will continue to make R&D investments in the future and so we expect R&D to continue to be in that mid-teens range as we exit 2023.

Operator: Thank you. And I show our next question comes from the line of Rich Newitter from Truist Securities. Please go ahead.

Rich Newitter: Hi, thanks for taking the questions. Two quick ones from me and congrats on the quarter. One, just the first Rick, following up on the profitability line of questioning here, I think in the — I think last quarter you said that you do think that adjusted EBITDA on a year-over-year basis will be higher than it was in 2022, based on your comments around OpEx growth being below the top line growth rate. It sounds like all of that should still be intact. I just want to make sure that, we’re thinking about that correctly and that would imply positive adjusted EBITDA excluding stock based comp still. Is that fair?

Rick Buchholz: That is fair and that’s accurate. When you look at EBITDA was about $900,000 loss for the first quarter compared to a $6.1 million EBITDA loss in the first quarter of 2022 and the big driver there is stock-based compensation was $18 million in the quarter and so still accurate comment.

Rich Newitter: Okay, very good. And then just thinking about competition. I know there is none in the US currently, but assuming your competitor gets there, I think they suggested they could use either your code or there would be potential modifier situations with other codes that that would get them kind of a, I don’t want to use the word fast track reimbursement, but bypassing what you have to go through from a coding standpoint. I’d love to just hear what your view is in light to some of those comments and any perspective you might have there. Thanks.

Tim Herbert: Sure. Well, I think there’s two people out there doing clinical studies. I think Lenova is probably at the forefront of it because they got more data and more experience and they already have an existing code, which is remember the old fits for that we were using with our add-on code. So they already have a code with their implanted neurostimulator and stimulation lead that, that they’re going to be able to leverage as they go forward. As far as Nick, so that’s that jury’s out and they got to go figure out what they’re going to do with their code, but that’s up to CMS and not for Inspire to comment, but that’s always a little more challenging than you say it’s going to be. Now that being said, both companies have to deal with coverage, which is their number one challenge.

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