Insmed, Inc. (INSM) Earnings & Analysis

Latest quarter

Insmed reported Q2 FY2026 revenue of $425.5 million, above the $389.7 million consensus. Adjusted earnings per share, as counted by the consensus, were −$0.52, compared with an expected loss of −$0.69.

Revenue rose from $107.4 million a year earlier. CFO Sara Bonstein said BRINSUPRI generated $309.2 million in the quarter, driven primarily by demand from new and existing patients. ARIKAYCE contributed $116.3 million, up 8% from the second quarter of 2025.

Insmed’s gross margin rose to 84.2% from 73.9% a year earlier. Bonstein said BRINSUPRI contributed to the improvement in the company’s gross margin profile. The operating margin was −0.36%, compared with −291.3% a year earlier, while diluted EPS was −$0.06, compared with −$1.70. Free cash flow was −$95.1 million, compared with −$209.1 million in the prior-year quarter.

Adjusted EPS is the figure the consensus estimates, not the GAAP EPS above.

What management said on the call

CEO Will Lewis said BRINSUPRI added approximately 7,000 new patients in the second quarter, ahead of the company’s expectation of approximately 6,300. He attributed demand to more prescribers and deeper prescribing by existing writers. About 30% of prescribers had written for at least five patients, up from around 20% at the end of March, he said.

Asked about demand, Lewis said the patients who had been ready and waiting for treatment were gone and described the quarter’s new starts as organic. He said the company’s peak-sales assumptions included a DPP-1 competitor entering the market and federal price negotiation taking effect in 2035.

CFO Sara Bonstein said BRINSUPRI’s second-quarter revenue also benefited from better-than-expected gross-to-net dynamics, the discounts and other adjustments between a medicine’s list price and the revenue Insmed receives. In response to a question about payer access and future gross-to-net levels, she cited an approval rate of about 90% and said most patients received approval in less than a week. Bonstein said gross-to-net naturally rises somewhat each year, but did not provide forward-looking guidance beyond the current year.

Lewis said European budget constraints complicated a traditional commercial approach to BRINSUPRI. He also said the process to determine an acceptable price in Japan was still underway.

On investment, Bonstein said Insmed planned to spend more in the second half on TPIP studies, BRINSUPRI advertising and commercial infrastructure in Japan. Lewis said patients who remained on TPIP in an open-label extension maintained or improved across efficacy measures at 12 months, and that Insmed identified no new safety signals despite longer use and higher doses. He said the phase three studies in pulmonary hypertension associated with interstitial lung disease and in pulmonary arterial hypertension were enrolling.

Guidance

Insmed reaffirmed FY2026 BRINSUPRI revenue guidance of $1.25 billion to $1.40 billion in October. On the Q2 call, Lewis had raised that range from a previous forecast of greater than 1 billion. Bonstein also updated BRINSUPRI’s 2026 gross-to-net guidance to mid- to high-20s from mid-20s to low-30s.