Tim Herbert: No problem. We don’t think it has any impact. We’ve been talking about supine AHI with our physicians since 2007 when we launched Inspire. In fact, when I worked on this project inside Medtronic back in the late ’90s and 2000, we’re focused on supine AHI. So this is not a new phenomenon. Gravity affects sleep apnea. And when you lay supine, it — gravity pulls the tongue back harder than if you lay on your side. When we program our devices, we program worst case. In other words, in a supine position. So we know with certain levels of energy required to treat supine AHI, that’s what programs — that’s what patients are programmed at. And then when they roll on to their site, you might argue that they are being overstimulated.
And that’s true because what we care about is making sure that we have equal treatment in both supine and non-supine, we had specific items in that in our STAR trial. So this is not a concern. We’ve been focused — laser sharp focused on supine AHI since the day we started the company.
Operator: And I show our next question comes from the line of Larry Biegelsen from Wells Fargo.
Larry Biegelsen: Well, one question from me, and maybe it will be a very short answer. Rick, it’s good to see the profitability progress. Any broad strokes on profitability goals beyond this year, and how should we be thinking about the tax rate?
Rick Buchholz: So for 2025, we’re not providing overall guidance here for 2025, but we’re going to be profitable for 2024 and we’re not expecting it to go backwards. So we expect to be profitable for 2025 and thereafter. And as far as effective tax rate, we’ll give more color on that. We have a lot of NOLs that we will get to recognize on that. And so for purposes of the model, we’ll provide more clarity on effective tax rates in the future call.
Operator: I show our next question comes from the line of Brett Fishbin from KeyBanc Capital Markets.
Unidentified Analyst: This is actually Liz on for Brett. Just one from me. Could you guys provide some updates on your broader DTC strategy and how it’s been progressing?
Tim Herbert: We’ve — as you go back a couple of quarters ago, we talked about refinement of our program and how we’re really focusing our DTC more targeted to our demographic and that’s been very successful. We continue to grow DTC. But as Rick mentioned, we stayed pretty consistent with where we were in 2023 and we’re seeing revenue grow beyond that as for capturing leverage from our DTC program. We continue with both national TV buys as well as with social media, but now we’re also getting into targeted digital placements that’s shown to be quite effective. So the DTC program has evolved since our commercial approval 10 years ago in 2014 and will continue to evolve as we learn more and find better ways to reach out to our specific patient population.
Operator: And I show next question comes from the line of Michael Polark from Wolfe Research.
Michael Polark: Apologies if I missed this, but sales force — sales territory adds or creations in the quarter was 11. I think the guide for each quarter of the year was 12 to 14. I see you’ve reaffirmed the guide for the year. But I’m just curious, in 1Q ’11 versus 12 to 14 kind of is that just timing, anything to flag there? And I asked just because it seems like a slight deviation and trend, that was a metric you had been guiding for a long time. And you typically were adding above the quarterly guide and this is a touch below. So any color on this one would be helpful.
Tim Herbert: Good observation, Michael. I think it’s the timing. I thin, we focus our new territory adds based on where we are adding new centers and where the need is. And so we don’t specifically target a number of new territories per quarter. And so there’s always, as you know, a little bit of fluctuation in there from quarter-to-quarter, but not a lot of change there. We reinforced our guide going forward and maybe just a little bit of timing on who was ready in the first quarter to be able to add a new territory, and we will continue that focus going forward. Did I jump early? Did you have a follow-up to Michael?
Michael Polark: That was good. Thank you, Tim.
Operator: And I show our last question in the queue comes from Suraj Kalia from Oppenheimer & Co.
Suraj Kalia: So Tim, a couple of questions. I’ll pose them right away, and hopefully, you get the gist of it. First and foremost, Tim, in terms of supine, non-supine, right, there was a recent paper highlighting quite low responder rates and AHI reduction with Inspire supine versus non-supine. So I guess if you could help reconcile your comment about the current titration based on a supine position. So help us understand why is the paper off if it is? That is one question. And the second question quickly, and if I could. I understand the consensus commentary about complementarity of GLPs to OSA and hyposenerve and CPAP. I get all that. Tim, what I’d love to understand more is aren’t we looking at just one side of the coin severely obese coming into, let’s say, the obese category.
But by the same token, the volume effect of overweight and obese patients that’s 10 times that of severe, right? Shouldn’t we be looking at the other side of the coin also? I’d love to get your perspective on that.
Tim Herbert: I’m going to go back and look at that paper. I think some of it was subjective evidence that was talked about and not the core evidence. But yes, our focus is always around supine AHI. In fact, in our clinical studies, we literally screened all patients who did not have supine AHI and — or were only supine. So we evaluated that in the STAR trial. We’ve been evaluating that all the way through. It’s very clear that supine with gravity is more challenging to treat. But we believe that that’s been a key focus for Inspire since the beginning of the company, and we’ll continue to focus on that going forward. Secondly, on the GLP-1s being complementary, it’s about the mechanism of action. I know we’ve talked about this quite a bit.
