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INSPInspire Medical Systems, Inc.
$50.08$1.4B
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Inspire Medical Systems, Inc. (INSP) Financial Ratios

Latest Ratios: P/E Ratio 10.2x · EV/EBITDA 21.1x · ROE 19.8%. (2016–2025 historical series)

Income StatementBalance SheetCash FlowRatios
AnnualQuarterly

INSP Valuation Multiples

Price-based multiples — how expensive the stock is relative to earnings, sales, book value, and cash flow

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Market Cap$1.4B$2.7B$5.7B$6.0B$7.1B$6.3B$4.9B$1.8B$616M——
Enterprise Value$1.4B$2.7B$5.5B$5.8B$6.6B$6.1B$4.7B$1.8B$544M——
P/E Ratio →10.2418.86105.93————————
P/S Ratio1.583.017.059.5417.3426.8742.5021.5312.18——
P/B Ratio1.913.518.2110.4114.2627.3821.3512.633.76——
P/FCF18.3934.9762.145821.232859.16——————
P/OCF12.3423.4643.47241.79611.18——————

P/E links to full P/E history page with 30-year chart

INSP EV Ratios

Enterprise-value multiples — capital-structure-neutral measures of total business value

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
EV / Revenue—2.936.919.2816.2926.1041.1221.5610.75——
EV / EBITDA21.1141.16130.03————————
EV / EBIT26.8952.4494.80————————
EV / FCF—34.0560.845664.302687.23——————

INSP Profitability

Margins and return-on-capital ratios measuring operating efficiency

Margins

Full margin charts and quarterly trend are on the Earnings History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Gross Margin85.4%85.4%84.7%84.5%83.8%85.7%84.7%83.4%80.1%78.9%76.2%
Operating Margin5.6%5.6%4.5%-6.4%-11.7%-17.1%-48.7%-42.5%-40.3%-56.0%-105.0%
Net Profit Margin15.9%15.9%6.7%-3.4%-11.0%-18.0%-49.6%-40.5%-43.1%-61.3%-112.8%

Return on Capital

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
ROE19.8%19.8%8.5%-4.0%-12.4%-18.3%-31.0%-21.9%-26.4%-1180.0%—
ROA17.0%17.0%7.2%-3.4%-10.4%-14.6%-24.7%-17.4%-19.4%-91.7%-141.3%
ROIC6.0%6.0%5.5%-12.5%-59.7%-50.4%-39.7%-22.4%-30.4%-210.8%—
ROCE6.7%6.7%5.5%-7.3%-12.6%-15.5%-26.5%-19.8%-19.7%-134.6%-296.1%

INSP Leverage & Debt

Solvency and debt-coverage ratios — lower is generally safer

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Debt / Equity0.040.040.050.040.030.150.130.180.1511.09—
Debt / EBITDA0.500.500.75————————
Net Debt / Equity—-0.09-0.17-0.28-0.86-0.79-0.700.02-0.445.06—
Net Debt / EBITDA-1.12-1.12-2.78————————
Debt / FCF—-0.93-1.30-156.92-171.93——————
Interest Coverage371.93371.932657.95—-25.40-18.72-25.97-14.67-5.61-8.99-13.22

Net cash position: cash ($105M) exceeds total debt ($32M)

INSP Liquidity & Efficiency

Short-term solvency ratios and asset-utilisation metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Current Ratio6.086.087.137.608.666.5013.0210.1217.863.371.68
Quick Ratio4.564.566.227.178.476.0812.619.7817.632.861.22
Cash Ratio3.213.215.035.897.385.1911.318.8716.872.260.92
Asset Turnover—1.010.990.920.720.790.410.450.251.141.25
Inventory Turnover0.920.921.542.855.561.932.082.343.771.641.16
Days Sales Outstanding—47.9042.3152.5154.7953.4579.2958.4148.1049.2946.46

INSP Shareholder Yields

Earnings, FCF, buyback, and dividend yields — total returns to shareholders

Dividends

Full dividend history and growth charts are on the Dividend History page

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Dividend Yield———————————
Payout Ratio———————————

Total Shareholder Return Metrics

MetricTTMFY 2025FY 2024FY 2023FY 2022FY 2021FY 2020FY 2019FY 2018FY 2017FY 2016
Earnings Yield9.8%5.3%0.9%————————
FCF Yield5.4%2.9%1.6%0.0%0.0%——————
Buyback Yield12.1%6.4%1.3%0.0%0.0%0.0%0.0%0.0%0.0%——
Total Shareholder Yield12.1%6.4%1.3%0.0%0.0%0.0%0.0%0.0%0.0%——
Shares Outstanding—$30M$31M$29M$28M$27M$26M$24M$15M$13M$12M

Key Metrics

Growth RegimeDecelerating
ProfitabilityStrained
Balance SheetHealthy
Cash FlowMixed
Top Statement Risk

Elective procedure demand sensitivity

Verified Source

Metrics are mathematically derived from official filings.

SEC 10-K (2026Q1)

Premium Valuation Facing Growth Headwinds

According to current market data, INSP trades at a forward P/E of 51.04, a multiple that appears increasingly difficult to justify as year-over-year revenue growth has decelerated to 1.6% in 2026Q1, signaling a potential disconnect between historical growth expectations and the current reality of market saturation.

The current valuation suggests investors are pricing in a return to high-growth trajectories that may not materialize given the competitive landscape and the elective nature of the procedure. The compression in forward multiples relative to historical peaks warrants caution, as the market may be overestimating the company's ability to maintain its premium status without accelerating top-line expansion.

Capital Efficiency Remains Highly Volatile

Based on reported financial statements, INSP's ROIC has fluctuated significantly, dropping to -0.1% in 2026Q1 from a peak of 5.2% in 2025Q4, which indicates that the company is currently struggling to generate consistent, value-accretive returns on its invested capital as it scales its commercial infrastructure.

The erratic nature of these returns reflects the heavy reliance on aggressive SG&A spending to drive patient adoption, which often outweighs the incremental gross profit generated. Investors should monitor whether the transition to the Inspire V platform can improve capital efficiency by reducing the complexity of the surgical workflow and lowering the cost of customer acquisition.

Working Capital Cycles Signal Inefficiency

As reported in recent filings, the company's cash conversion cycle has expanded to 429 days in 2026Q1, a significant increase from 130 days in 2024Q4, suggesting that inventory management and collection processes are becoming increasingly inefficient as the firm attempts to navigate a more complex U.S. commercial footprint.

The sharp rise in days inventory outstanding (DIO) to 507 days warrants further investigation, as it may indicate a buildup of older generation hardware that could necessitate future write-downs. This trend suggests that the company's operational leverage is currently being hampered by bloated working capital requirements that tie up cash and reduce overall liquidity.

Robust Liquidity Buffers Operational Risks

According to the most recent balance sheet, INSP maintains a current ratio of 6.34 as of 2026Q1, providing a substantial liquidity cushion that appears more than sufficient to cover short-term obligations and fund the company's ongoing direct-to-consumer marketing efforts despite the recent deceleration in top-line growth.

While the company's liquidity position is strong, the reliance on equity-based financing to maintain this buffer is evident in the minimal debt-to-equity ratio of 0.04. This conservative capital structure provides flexibility, but investors should be wary of the potential for future dilution if the company continues to prioritize aggressive marketing spend over achieving sustainable, self-funded profitability.

Misapplication of P/S Valuation Multiples

The market frequently misapplies the Price-to-Sales (P/S) ratio to INSP, which obscures the significant impact of stock-based compensation and high SG&A costs on the company's true earning power, leading to an incomplete assessment of the firm's actual cash-generating potential in a competitive medical device market.

Because the company is in a transition phase toward profitability, P/S ratios fail to account for the quality of revenue and the sustainability of the margins. Analysts should instead focus on free cash flow margins and adjusted operating income, which provide a clearer picture of whether the company can eventually convert its high gross margins into long-term shareholder value.

Download Financial Ratios Data

Includes 30+ ratios · 10 years · Updated daily

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INSP — Frequently Asked Questions

Quick answers to the most common questions about buying INSP stock.

What is Inspire Medical Systems, Inc.'s P/E ratio?

Inspire Medical Systems, Inc.'s current P/E ratio is 10.2x. The historical average is 62.4x.

What is Inspire Medical Systems, Inc.'s EV/EBITDA?

Inspire Medical Systems, Inc.'s current EV/EBITDA is 21.1x. This enterprise value multiple compares the company's total value (equity + debt - cash) to its EBITDA. The historical average is 41.2x.

What is Inspire Medical Systems, Inc.'s ROE?

Inspire Medical Systems, Inc.'s return on equity (ROE) is 19.8%. The historical average is -10.7%.

Is INSP stock overvalued?

Based on historical data, Inspire Medical Systems, Inc. is trading at a P/E of 10.2x. Compare with industry peers and growth rates for a complete picture.

What are Inspire Medical Systems, Inc.'s profit margins?

Inspire Medical Systems, Inc. has 85.4% gross margin and 5.6% operating margin.

How much debt does Inspire Medical Systems, Inc. have?

Inspire Medical Systems, Inc.'s Debt/EBITDA ratio is 0.5x, indicating low leverage. A ratio below 2x is generally considered financially healthy.