Insmed (INSM) Q4 2025 earnings summary

Executive summary

• 2025 was transformative, with the U.S. launch of BRINSUPRI generating $144.6 million in Q4 and $172.7 million for the year, and ARIKAYCE delivering $433.8 million (+19% YoY), including 40% growth in Japan and 41% international growth.

• FDA approval and European Commission approval for BRINSUPRI were achieved, with the product positioned for significant market expansion.

• The clinical pipeline advanced with new gene therapies for DMD and ALS, positive TPIP data, and the acquisition of INS1148.

• The company is positioned for sustained leadership in bronchiectasis and NTM, with plans to accelerate BRINSUPRI's U.S. launch and continue ARIKAYCE growth.

• 2026 priorities include accelerating BRINSUPRI, expanding ARIKAYCE, investing in first- or best-in-class therapies, and pipeline expansion via business development.

Financial highlights

• Full-year 2025 revenues were $606.4 million, with BRINSUPRI at $172.7 million and ARIKAYCE at $433.8 million.

• Q4 2025 BRINSUPRI U.S. net revenues reached $144.6 million, surpassing comparable respiratory launches.

• 2026 revenue guidance: at least $1 billion for BRINSUPRI, $450–$470 million for ARIKAYCE, and total company revenues of at least $1.45 billion (+139% YoY).

• Cost of product revenues in Q4 2025 was $44.2 million (16.8% of revenues), reflecting improved gross margin due to BRINSUPRI.

• Cash, cash equivalents, and marketable securities at year-end 2025 totaled ~$1.4 billion.

Outlook and guidance

• Confident in achieving cash flow positivity in 2026 without raising additional capital, though may seek capital for business development.

• Gross-to-net for BRINSUPRI in 2025 and 2026 is expected to remain in the mid-20s to low 30s percent range.

• 2026 ARIKAYCE gross-to-net expected in the low-20% to mid-20% range.

• Spending will increase alongside revenue as launches and clinical programs are resourced.

• Continued investment in commercialization, regulatory submissions, and clinical development across the pipeline.