Inspire Medical Systems (INSP) 2 May 232023 Q1 Earnings call transcript

Good afternoon. My name is Del [ph] and I'll be your conference operator today. At this time, I'd like to welcome everyone to the Inspire Medical Systems First Quarter 2023 Conference Call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there'll be a question-and-answer session. instructions] [Operator

the President your Inspire. of hand Yagci, speaker, call Vice the Investor conference now first to Ezgi I'll Relations at

may conference. begin You the

in Del, call. you, and you for Thank thank participating all today's

Herbert, President Financial on the the press copy Chief today, three Joining me ended Earlier website. are and Executive XX, Rick Officer. results Officer, financial released available of March release our Chief we months is Buchholz, and for A Tim XXXX.

are of operations, statements meaning estimates various you Federal make limitation, investments undue forward-looking and effects actual statements differ. All full based these COVID-XX continued upon this financial statements, should Securities material financial of outlook business, On involve results management materially statements. forward-looking place pandemic, and the Laws. that year call, will operational our those within assumptions. relating or financial condition, and the access and including could These without Accordingly, XXXX and not the market improvements uncertainties our risks to in our to cause on events results current reliance in

speaks Please new and Inspire to law information which events filed future information, or these obligation the see today, of Exchange as forward-looking update contains May earlier otherwise. Securities live the because time-sensitive broadcast description SEC a afternoon by except or conference XXXX. disclaims uncertainties. whether revise or any of projections statements, XX, This was any this required call for the intention financial only risks with as our including and our of with Commission, filings Form-XXQ, and or

to pleasure my it over that, is turn Tim? to the Herbert. With Tim call

quarter for and our for joining of business Ezgi, update the call you, everyone XXXX. thanks Thank first

has commitment best first we reiterate foremost patient experience to and always, As ensure possible with that each therapy. to patient Inspire the our outcomes and

fifth want our our full been. to updated tremendous XXXX. To update results outlook will we call, and introduced the it surpassed Inspire employees, first an Inspire patients a syndrome. start, year improvements IPO has our important what in story. XX,XXX highlighted of many XXX very on today's milestone therapy, approval During the marks IPO, for our patients, for incision with received therapy to we dedicated a the quarter anniversary the pediatric highlight years grown company surgical approach, Down provide over for reimbursement, a by has most treated and code discuss two CPT and five Today with received recently, Since the

years to nine Down the therapy first we celebrate and indication, to all celebrated Jesse and pediatric by FDA To we syndrome with Exchange Stock pediatric had patient Inspire rang the Rivera, Jesse syndrome at joined were our approval New the opening momentous occasion as receive bell Thursday, this of last Down we along the privilege ring York with the the ago, bell.

pandemic. review million, represents the growth XX% In the let's of COVID we results. XX% quarter This first quarter, that, our our With growth to compared rate post representing revenue an first XXXX. rate quarterly increase highest the of generated $XXX.X

by growth be of to is continues and centers centers. new higher existing by complimented the Our driven at utilization activation

quarter, to to Given XXXX. expect to expect implanting XX to to XXX quarter now to range the the US, we we revenue in be the are adding strong of in centers continue XX% year total $XXX of increase compared in our we XX% momentum full activate centers per of with XXXX, seeing million the we million ending business, our In continue the $XXX first a capacity XX quarter. to centers to the a remainder new XX increase for by

sales we bringing our quarter, total to team, Regarding created US XX in XXX. first sales territories new the the

quarter. per add of XX continue sales remainder we the to expect to to XXXX, For territories sales XX

growth quarter, the initiated the visitors the million, adoption. introduction of number our patients for XXXX, which website the January The In spike therapy website in of quarter, is X.X the has source the surpassed to is very in but surpassing one-time national the website current first in in we campaign, significant. million strong entering X.X in media In the XXXX. a visitors in which of our resulted volume position us a first first

services database XX,XXX visits, From to Inspire Of these to receiving have over we through outreach. has therapy. patients whereby conversion implemented steadfastly the improved therapy journey patients our and experience, and help nurturing of program, patient including reengage we are their our in a significant had several physician contacts patient team to contacts enhance note, patient our leveraging proactive

digital one physician appointments Secondly, adding a scheduling is our which in phone we tool with to participating compared centers, strides we improvement technology collaboration care sleep and and continues pilot is Further, our experiencing in including program make date. the email improving XX% centers. to through time, Ognomy, our support to promise showing to are traditional currently wave scheduling continue pilot scheduling of next advisor of to and focus and process the studies, great are on

to focus towards in approximately patient pathway the to six signs time capacity specifically patient the our be surgeon continues improvement and finally, contact increasing be by from of And see months. and which implant, reducing we continues

over strong XX% during unfavorable positives reimbursement finalized the in in the several headwinds rates. expand Germany, business efforts our Netherlands, international the including international growing have and first year, exchange first performance We Belgium from the continues prior in were There increased despite countrywide there. the quarter, ongoing our on, Switzerland. quarter our Moving and in to business commercial

XXXX. France the announced reimbursement Asia, we country. in from In that in recently of a of countrywide growth have hired strong the fourth sequential the quarter anticipation in we formal of Furthermore, manager listing country

Japan, be We pleased and direct flow. cases sales good patient transitioned our see and launched growing strong momentum completed continue to Singapore and in in to progress we the organization, with In two in Hong Kong. outcomes patient with first a Inspire.jp

device pressure sensing the to continue to the incorporate Inspire The and on qualification work will of Inspire generation the we fifth sensor using inside R&D, to accelerometer an eliminate our measure lead the neurostimulator Turning Five respiration. neurostimulator.

tools, integration testing and end well is to our team the of this and submitting specifically application the as quarter. operational the the planned, digital The to Inspired continue production with by FDA is as continuing committed sync. as qualification sleep We

review FDA time cycles, to this normal to respond into Given including approval FDA questions, XXXX. early move could

SleepSync, continues adoption patients Our SleepSync Bluetooth-enabled strong number users we the have with currently number to in system. the the remote along of in of system experienced make launch and of since connected progress of the growth significant in patient the

ADHERE patient of registry, expanded and patients the is be the enrolled is The of patients Another release the our sync. will ADHERE registry X.X XXX registry. the current X,XXX forward, into moving SleepSync integrated ADHERE example will patient into next incorporate of within of be which sleep second utility version will the cap

Subsequent programming. digital incorporate monitoring programs will a and remote sleep patient device

silicone-based continue good leads. of production the and the stimulation to make Regarding with ramp progress we operations, sensing

improved levels We programmer. are components, neurostimulator, one strong the position of in are stock. for the quarter our physician safety growing all and the an other inventory and Inventory remote inventory of to levels the goal including patient Inspire

aspects confident new DTC driving beyond, continue long-term adding centers. in and adoption stakeholder the centers, XXXX significant are excited center outcomes initiatives, and enhanced will continue We we future these capacity expansion by In and ongoing patient focused we momentum drive these seeing of education is our in prospects We the efforts, have are to and business. appropriate experiencing at while and in physician utilization training of we investment productivity to increase The to all extremely our support improved on opening of financial are call the therapy. our about our that our strategy summary, performance. campaign place from our and value. remain which our remain In we existing

I'd that, for Rick our the to turn of like to With review his financials. over call

utilization an managers. was which outside million the US on in year-over-year increase Thank sold while in of $XXX.X XX% driver first a good a quarter increase Total everyone. from increased $XX.X revenue US an basis, year-over-year. you, the centers. a was XXXX. the was of Tim, XX% from reported year growth the and and XX% The US $XX.X is at million, primary drivers $X.X existing to revenue the million, quarter prior growth for period. of the increase quarter implanting the first new generated first Other units the Revenue $XXX.X in afternoon, million direct-to-consumer higher marketing, XX% grew the higher territory in of centers, expanded outside addition US include number the million,

the increase in of price the compared $XX,XXX selling X% The reflects that price period. quarter in May average uplift prior to US The XXXX. year was first began $XX,XXX in our

was to sales driven a We ASP XXXX, during outside unfavorable expect ASP the rates the in first exchange the which of Asia. The for to at current distributor the the US lower $XX,XXX was steady quarter ASP compared remain $XX,XXX in US quarter and by level.

prior drive in the due quarter Total that in the first the million, margin Gross the partially expenses increase of increase began compared costs year XX.X% were to to $XX.X of organization, was period, for as to quarter investments of compared first first is operating growth of $XXX.X primarily by business. our costs. in an of the quarter to XXXX. make component The general XX.X% was efforts development to expenses offset increase marketing parts, sales programs, certain price million the higher of May to XX% areas increase This plan of our reflective our increase in and product key in planned expansion continued long-term and operating due XXXX. corporate in direct-to-consumer ongoing continued

the $XX,XXX higher cash prior income by This to $X.X a totalled ago. and Interest year compared dividend million period. rates to on year compared in was quarter our the higher increased driven income balances interest first in

the The in quarter loss million shares first first the weighted The to of was in net loss net first for first $XX.X was average $X.XX XX.X number prior compared to the compared quarter the million of per year per $X.XX outstanding share loss of quarter a XXXX. for loss period. Net was million. the for $XX.X the net share quarter

million. be second the weighted average expect XX.X outstanding shares We to quarter approximately

$XXX improvement, $XXX end. new us and opening cash of training growth centers. position quarter The investments increased strategy our procedure allows continued and during strong operating at Given implanting our executing remain centers year while cash our million first focused to the at to leverage on existing from volumes million increasing

updated on to Moving XXXX guidance.

in XX% $XXX we million. the revenue million $XXX XXXX updated to momentum of XX% be year to strong we million an guidance range of $XXX in now initial This full our to represents guidance full business, revenue. the increase compared to million, to are revenue growth from expect our Given $XXX seeing year

to continue We in full range year XX% to gross XX%. the expect be margin to of

in confidence centers in quarter our XXXX. sales per outlook As establish the In Tim to XXXX. XX momentum to territories provide our us business to XX with new performance quarter per and new conclusion, we our and activate expect XX noted, strong for of remainder XX

are open With may Dule our for you prepared that, concluded. questions. remarks [ph], now the line

of I our go [Operator Please JPMorgan. from from question the instructions] And line Robbie first show ahead. Marcus comes

the questions great. for and Oh, congrats great Thanks on taking quarter. another

Thanks Robbie. you a if want We'll you up follow too it. give

growth No, center question. that I'm going I've asked just and ask about I'll all you of -- one to before.

to launch awareness, product function at more and little the ahead organization can to just Thanks looking really thinking type to step lot. patient incremental So just that procedure and and centers, drive even Inspire thoughts groundwork the comes wanted a do of utilization bit than when now of forward the here lay what get an X of your a better launch. and a better out on make

a that's a great of this. different Well, go can I areas question. lot with

improving key help sleep them tools program. Advisor with to is patients the several continue think handle be having the of they to working funnel their that the we're alongside SleepSync and enter we're Care be our to patient I on program the implementing part able as sync will And and journey. as that

cases studies, electronic for tools as referrals when surgeon day. Inspire even we in more the to to some to able gain them add capacity that's tools to some we going sleep see mentioned to timing We've efficiencies help of a improved provide X, time to move such in, improvements additional get in given but be the scheduling, electronic OR

induced sensor in we specifically, the the and that improvements Then drive can with we're we I'm surgeon's really further, I'm reimbursement, do study the by inside able time talk and about moving we'll, later progress drug reliability require the data further be we'll Predictor incorporating ways that outcomes than them and improve improvements the to we'll different even expect to see finding making sure forward, sleep endoscopy. sorry, thereby to a like to the by on

just So launch all composite the continue the to in as allowing utilization going together of therapy. be we timeframe in of X, those are us same Inspire the the at to coming increased

Great. again. Appreciate Thanks lot. a Congrats it.

show line from UBS. I question go next ahead. And the our Please Danielle of comes from instructions] [ph] [Operator

for really year. Thanks guys. start afternoon great of good taking Hey, quarter so the another Congrats on and the strong much question.

Just sort study they've a been but eased now constraints question of and MedTech earnings, your weeks from two me going on through, we've pathway the that feels staffing the quite different guys' into thinking sleep or is bit, very there. a whole the like, requirements about with so

if And that than there wasn't issue? could how So or any much. still even Thanks evolving. pressure expected it you're seeing just have we, better than if curious was the and an still so if quarter that's better been

Thanks Danielle.

advance, well, for that so with in quite staffing we're of good sleep the growth patients in studies think we're pretty is patients and corridor, to that them which number and able help the able in to XX% the And of I that issues and we've able We're with we're work able we been process. the line have that the sight really to extraordinary. is achieve around therefore to the tremendous. schedule

surgeon So for manage do we we of line with that that sure, the we're think made sight I with greater continue E&T really patients, of room surgeon procedures. have be more I that the if in tends advanced kind because factor operating present able had is quarter to we factor and could the capacity; surge some limiting think our if of could have our time. think do of -- centers we more planning is to if limiting the to even our but had time I issues And our to staffing improve

So who when focus very with the but staffing, we themselves I advanced through kind our think are the work procedure, can look at staff surgeon we of we is on that. plan, but more doing support necessary, the obviously

from And the I Larry comes of our Wells from line show Fargo. [Operator go instructions] next Please question Biegelsen ahead.

high question on think on quarter. get Rick, just about in to taking the a nickel then upfront. how questions. the saw Good rest and cadence I'll ask for and I'd love data at reaction level, preliminary congratulations Sir, afternoon. echo we on question my the and follow taking preparing the competition just both usual how the question, the eventually Thanks for Tim, I'll your another you're to Robbie's for Thanks revenue of strong just the for year Tim, on about to just market.

Yeah. Hey Rick. Larry, this is

and our proud first We're by from and excited opportunity. the of achieved really we're the team the of the beginning excited yeah, So guidance initial results in quarter, the we year. about increase guidance did our

We we're well utilization so the and haven't that take going year. increasing existing focus centers see strategy add the in we to increase and gonna be changed as as it's if on to our where centers additional if, throughout continue rateable guidance, you guidance really at entire

a a of that, release purpose from year there doesn't releasing any far when that release they the by unorthodox anybody that the and the of make final knows from of And a is was are a because and FDA very Good. X but able it's It that's data what be other those have out. isn't tech what Phase early think med those, available, data. that released. numbers to it's As early they and data, in that matter to Larry? the maybe so available study was been put hard it's sure says data judgements doing pretty it's not until all to now assess lot and limited who's very as Okay. I pivotal

on all that's we're to going comment that. So really

technology been is is competition, the physician future. viable to able large in help think that for know having that and the benefits developing do open that the it's as that have meantime and happen. to market this we're competition good can show The to experience. we we're As to in the patients But we've tremendous. to our market going What will far horizon and competition improve extremely has therapies patient I Larry, patients and on in

edge, Inspire improve with patient the the to take then if or of able best of X of the therapy neurostimulator outcomes time reduce be and world example SleepSync in today, a improving reliability outcomes sensor, by eliminating care to not leading is best, that a be to the one tying system. going into that's perfect the patients, our

I they anyways. trials think pass we're several expect competition any be position to if until going in the years time even for see very strong to probably their we'd

our show from comes America And next of Travis Thank question Please the line Securities. from you. I Steed Bank ahead. go of

about on how Maybe And just question quickly weight that the taking I'd Congrats higher again OpEx how have the then are and a revenue up year. within thoughts competitive you Larry's think the kind loss for quarter. less question OpEx in to a on you this that, about other the maybe about you're you in. think and have of when revenue competition margins guide the for guide, thinking thanks the little follow Hey, go is overall you. Thank question, if profitability drugs just than and -- up would good environment? would

Fantastic.

wall. like touch me drugs coming the the drugs on therapy our moves is then as base and tongue-based out, which a it genie obstructions, treatment is because hypoglossal on and will challenge weight have that lateral that Let nerve We doesn't system and No weight Rick base forward. we for is touch the loss OpEx. really it tongue loss glasses, the we stimulate treat walls a can stimulation address movement lateral

we drugs, collapse. wall that weight think inspire. a to have and but and it weight if can new of to reduce we will XX% complimentary Those lateral collapse, tongue-based address even XX%, so doesn't loss BMI related that's with collapses really loss higher patients injectable positive lose -- wall that the Lateral some really

of two concert the patients higher can work to need into forward us that able we have the look when to get day we be treat can and Inspire. that group high their BMI populations the the So down bring really more in them together with to from BMI treat to to relief

discussion it's really for of complimentary Hand and Rick development -- think I we're by off very OpEx. So the and those a drugs. here to it's encouraged quite of

Travis. Hey, Yeah.

has quarters, As we the growth the several trended growth. revenue the OpEx we've last outpaced

the guidance we significantly, guidance revised little less XXXX, Not with revenue. of full less but new of on our be for the XX% that for revised the so maybe for our OpEx growth year XX% And to just revenue than to updated than bit expect updated guidance. a

and far profitability, we're but have our And understand the as run on to we're people going fourth our business of our a improvement then because leverage. as our changing quarter profitability tone that some We first guiding not our as that to did in across we approach the operating do show and XXXX. some profitability time to seasonality. at plan our we year, We're is the lose not that it's through know of discipline quarter we want continue investments progress and playbook. our this of on spending leverage I to profitability. in important, we in But to demonstrated

Thank you. next Stifel. Block John show the comes from of go from ahead. our question line And I Please

on up small levels Tim. I below comments, the I'll could benefit afternoon. there a Good clean a guess, sure seemed ask inventory like just Thanks. both I guys. from rebuilding an actually from end front, inventory be it normal or user wasn't based XQ was really Great levels. bit, perspective still inventory demand also was mine

there be any would helpful. clarity So

above our particularly number centers the well estimate. solid, then And were of

and of to are So done importantly, on hear than then ASC. maybe that a quicker the of types just ramp board, percent them I didn't being centers coming what's about previously talk

you. you from take Thank that if So I'll handy, you that got guys.

it. of There's much. quarter. Yeah, there's from about. Got no a very question that bit little carryover Thanks first the

sorry, was As little a and on we we every about were sure we scheduled, were bit close that, into our gross of talked fourth but that able certainly that still relatively were implant And carryover growth account, in XX% we we but quarter, taking carryover, make there's XX% from call quarter small. but to exists. that supported is the that even to achieve to with the I'm -- that that allocation even

we running line and improved that and is position and have up inventory Our ramping.

all today we're so orders grow with now continue right forward. inventory and to And we're able to positive support that gonna

that we which phenomenal. As percent XX, this the point ASCs -- get XX%. increase The to we did is experienced, far now as centers number of is at XX% an

quarter, of ASCs which than will So grow we as a because little well. will is which faster to the continue continue an bit to uptick hospital the prior good setting, slightly grow from

be we meantime, But just to where, why able that's think I of open the opening continue XX leaving we new scale and where just the the that spend some new number up on we'll to our for and opening So it centers quarter time to we're the have over centers was. guidance that able quarter.

question show I from Piper And ahead. our the comes go you. Thank Maeder Please from Sandler. Adam next line of

Rick. start for then the the label. Hi of from the opportunities, upper Tim. to the specifically limit to raising label start around taking language Thank you the the BMI AHI nice Wanted expansion couple of the change current and questions congrats a also Hi year. and on the to on

timing up? had any thoughts I on Thanks. latest a Just follow then and

We the how these XXX. the and the answered we've past, PMA been Absolutely. in been XXX days, they're FDA. the but day supplements at working asked We've questions passed question. about with FDA process, go We've talking

and in is very have we received that we towards see responded future. questions, It's and approval the coming We the promise questions. FDA with near back approval review to the moving those think in

those patients other really member patients of think to study. the goes submission to limitation have them Inspire. for the AHI, benefit right days of don't that fit in AHI high just and for The fit is natural includes this early be alternative submission I clinical the the to a able the into so back AHI right high that's both now and any BMI. really The

AHI. really there's So to upper no have limit on reason

reimbursement support commercial can able both or this approval to but We be of think take really that patients and garner to get to population. quickly Medicare approved streamline also process, payers coverage get experience be that really their patients quicker. able I patient the to going care quite be insurance through and those in we'll those to appeal from able is

something what's BMI, as the very need take collapse treat to while that presents to far because that's a BMI, As of with get stimulation. to opportunity, tongue-based we'll of won't the about we remember difficult nerve that lateral is the careful will the because care be hypoglossal but and good they with collapse, high also it it concept wall Patients introduces improvement we the improvements desire. satisfaction get that a total higher

be so we're collapse that want patients And to going lateral address they're to higher BMI wall before going those to eligible.

we early take said, own stimulate to about to that collapse, care advance have our and to going to wall of right on being That now. talk work our system pretty but lateral do

quick Okay. step R&D question that. healthy l That's great had quarter, to color, over Tim. the a And in and which the a on P&L, just up. spend Thanks for Rick switching saw maybe

I work the of from? So the being of base new and drove how and so kind forward? we for about kind Is what to going spent first, guess this so dollars r of the Thanks are those Thanks questions. much cadence spending and taking do for. d think much increase? Where

the of and function revenue qualification just is about and a increase has Adam. has increased of up it just historically to It XX% of is was really been timing R&D. revenue. of XX% Inspire That Hey of sequentially that in of X. that in Part full entering that year-over-year XX% Yeah.

future be we mid-teens continue we range And make will R&D R&D investments in exit in and that as so so continue we expect the to XXXX. to to

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

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

and quarter about million is in EBITDA and $XXX,XXX the look $XX stock-based first was to That loss compensation was there that's quarter so XXXX accurate. in for a million driver of When the the EBITDA you fair first at still comment. big loss $X.X and is quarter compared the accurate

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

two out Sure. Well, doing I think there's studies. people there clinical

think I old already add-on code, existing of they they [ph] is which code. remember Lenova is with have using we the experience data an and probably more more it for forefront got fits our that because were and at the

implanted with going go be to forward. able that lead stimulation neurostimulator they leverage their they're that, have code So to a and as they already

not to what with so As little be. Nick, comment, that's that and they're a figure far say you going but got as to up go CMS than do that's always their jury's Inspire to challenging it's to code, to going they more out out and that's but for

number get to go. that to data is years coverage, publish you coverage, Now publish in us which have our data. we we to XXXX. had believe to get companies extensive that to you was need In and one if order I large their have with Aetna to for approval. after Remember deal one being of had said, to that challenge. back coverage, both four years five remember and first FDA was was back clinical studies the And

getting you allows does bring home, you the FDA business approval reimbursement that if your not So phase development. to of enter

to way long So go.

comes I Nephron Chris Thank ahead. Research. you. Pasquale from go next our question the show of from line Please And

what Hi. the you're doing to patients. Tim, experience Can what solve? reaching out a One, problem talked Thanks and bit services you improve more questions. you about new to Two trying proactively to and there talk guys. you're patient about really

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absolutely. Oh,

script that that of So scheduling, means with come through the with lot just highlighted have challenges patients because doctor we patients significant the of that Care centers. our we're work the pilot the from program XX% That improvement we can't getting phone there's or process. the actually a and hung have We are number appointments the email. that either getting a in up a in electronic in seeing Advisor

them And that back more them and so care to the them doing program can game we're and a and healthcare organized a get process get such emailing take back provider them as them. through the connected things to in reengage help of

effective going to continue to be getting that patients tools the we of just we've and of all our consumer work through our and because in giving of one kind be really much Inspire that that's conversion the has a been, patients. show been that over people process system that significant years to we're direct many interest are couple better able but out proactively other first the challenges have more know working just in to help now as example, number chance to to years the as better we and a So reaching them to

is focused really factors programs. and that are on electronic the really different patient just leading scheduling whole communication two those and team improving So

Thanks. sense. what And makes a curious, That there? behind noticeable that's decision whether in direct the I'm you to implant just on to have was go a, and impact activity expect going Japan

on same the that you maintain that XX a be we and in bag sell, think Europe, have their product focus to products, No, able States patients. successful it's positions really have of to provide will in products great and implanted to They're it's very and United to absolutely. so able be they the those that's to the people. commitment have. utilization. a in for distributor love drive direct their representation partner to But level Yeah, need difficult about on base, XX commitment customer the every you we because the if great, to And focus company

we And was and just a we a heading that's have worked for to we we to right that agreed thing being was and direction done. there our saw appropriately there and hire couple what years, partner for do with that force direct the us the

country a have manager. We

US it's We inspire we reps new the who for the together. Minneapolis of sales of And all University, as have through rep in week them last and how train part were new to great well. the as sales first part and force go every be quarter come

We just authorized a today. new trainer

talking about response We we when bit also we're you're and opened up website a performance think have promise a little team. great marketing forward. showing start to Japan of so We I the going and going see

from I line And question Capital our Mishan of go ahead. KeyBanc comes Please Matthew you. from Thank show Markets. next the

Can great range building fairly trends keeping difficult from a one, the I utilization think you about trends I'm like without finding couple the model, bit modest into it talk within coming quarters I'm of on congrats your and little to of the next as kind two? utilization into out the several of my stay quarters. off quarter. Afternoon next guidance

last utilization to, that to X.X. I have think as a quarter little We see year, think January, of showed step I X.X QX up you and so quarter. in X.X about bit it's up in the Absolutely always we, first pullback a had the we in at primarily from consistent of we through seasonality fourth

and consistent utilization pretty we see past with going first what into the quarter going is here, so stay years job focused grow the from and continue to And our forward. to

to will continue keep opening again, see that to do centers, in the to procedures come and just utilization, you're by We growing going through a year. utilization of from majority growth our increased believe the plan additional revenue complimented but

compensation well to continue so Some to, really on managers changed utilization and team we that forward. modification's that territory going we existing structure as that centers far have with talked the received and to been the we haven't is monitor by about mentioned the we'll we focus keep at previously higher

the the quarter. I'm expecting answer pull you're me. pretty adding to the XQ. for per XQ XX to clarification that The still new incremental one just of sure and then centers know you're And didn't number you're, XX Excellent. XX from I XX that. to to Is do in and XX XQ,

and do takes opening six and centers centers. committee to put Well, time from add it go agreements. But anywhere the will is contracts months, to have to they at to go if we we a to upon open go XX commit they three our have know with XX center new guide take we value always if depending or said, what through can pricing

to is why the quarter patients will control ready of their we they're and line centers but steady. from be to trained, we is to the be. number what a they've as that's why we're cadence a and little but the able ready sight above identified and So in that to case is of guide know to tend and bit, open first that bit just so when means everybody centers holding quarter that's past, kind We to do you of we're little the means see a they're going never of have that kind the guide end basis where we point

ahead. from question of go [Operator instructions] Petrone the Security. comes our And Please show line I next Mizuho from Anthony

it implant lead then to where about incisions? up procedure sensing that strong can would two pressure with where follow and be think Gen have with on where we remind rid the the thanks. follow implant time of and Yeah, And just think us And go platform? and questions getting time you I couple you procedure can when do that come a stands up. congratulations three procedure X, with maybe time to the back Thanks on I'll XQ was a here. Tim, incision total with

when to two down approximately time hours So procedure went from Inspire to when X, we the went were we doing, XX minutes average. on

general, two XX the were at we within So in minutes. incision,

lot a procedure that high top centers they experience, of the today. time have Now XX about at run routinely they have utilization, minute a

of range with minutes say minutes. and you XX is procedure between two the today XX time incision So can

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last quick and helpful very DOJ. a and Phillips, tuned Phillips opaqueness around also a week ResMed and still SEC with there's into just and was update last we maybe and that FDA just lot of It week on reported process

So, just what of you're around hearing any kind updates Phillips the recall? on Thanks.

have physicians prospect They're apnea could that no changed think, paradigm milder I has new we an viewpoint, many that take they patients? for can for just out it's dedicated look and there treating From it'll of And which resolve. opening a this done frustration and how sleep gone is years and our there's CPAP. saying, cases. Yeah, by our right, what what a possibly drug, just hopefully other longer methods And do of the on treat now, care up are two someday ongoing everybody. it's sleep at

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it's Rick. Hey Suraj,

up if procedures it high basis. overall year quarter a a -- year on a down It If we up your but to on give quartiles point, level, the look from first don't but little the our at progressed is as from have ago, mentioned, on quarterly nicely utilization is a So, ago quartiles of all the we up in QX you completed. of from Tim seasonality, a four a ago. because those that on are are utilization number details, from year

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Very good.

Okay.

address BMI. Let's high

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I Thank from comes last ahead. Polark our go of Please question from you. Research. And Michael show Wolfe the line

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pacing FDA during by do respiration. And our for times accelerometer have inventory detection, to this responsive of rate an clinical the to been And the existing of with the by synchronous accelerometer, clinical a and Sure, that improve did, phase cleaner providing we can second to a synchronicity study is for show using stimulation respiratory system, been years who couple thanks Inspire patients them do to measure is reviewed phase signal. we're has already evidence a provides with and a is is to improved algorithm that's going went in X have Mike. external We which take use what able respiratory that we the respiration. the which inspiratory used capture

demonstrate that already provided we've to and patients existing to So FDA. the able with that been information

removing going to reliability, a many sensor. with going show to pressure launched to able benefit. revisions by we're our of sensor, be procedure easier when know well the we be So we patient And surgeon a we're it's the have improvement to because in the to of the evidence have that result just both secondly been pressure for date then and that as going as a

itself the able show that and device already be So to pretty dated confident have in

about question the stage is event, any your the who like at one research for this look If I I physicians Hopeful, the thought promote movements for that [indiscernible] part targets I you're it stuff, appreciate curious airways specifically just your a can follow-up to on But simulation seemed that perspective your was my different that. more in that knows? thinking line on of the patients competitor's and different intriguing the there presented ask road? stuff in on different treat you and in to line, early targets most potentially interesting

Absolutely. great question. Absolutely.

about We chronic question the about have we collapse acute channels mentioned does have our that to Inspire capability stimulation. X the we in study of to with that talking already lateral really program a more and and going. the around patients. of concept the dual into have several is wall going We've discussed have device what this moving be we own the our technical done ongoing after study near We're research Suraj's just term and

described modifications the to take those for lateral BMI to able as and We that a a But lead. want we adding stimulation of patients. and we high a of care mechanical care second able solution port take be stimulate will to area we've take what wall need patients to collapse care second therefore find identified really of to be good by

active very to going a more great that hear near with future, but about So lot We're yeah, you're in questions. the that.

for conference. the for session remarks. I'd now Q&A Tim the like turn to closing concludes any it to back This

joining and call today. very for you thank all much the Thanks

As commitment work and continued is team and success. achieve motivation consistent to successful grateful Inspire the of hard their patient The to and element to enthusiasm, our unmatched remain patients team's employees to always, the outcomes. for dedicated I'm growing most important Inspire

expanding our focused teams remain for I all Europe wish US, our thank efforts as to well the as continued as of further the we employees in their Asia. and healthcare on business

safe months we call, appreciate to and healthy. in stay Inspire, and and look you continued supportive updates all interest For the the forward providing Please of further on with you ahead. you

today's concludes This conference call.

disconnect. now may You