Insmed (INSM) reported Q4 2025 revenue of $263.8M (up 153% YoY), powered by the blockbuster BRINSUPRI launch ($144.6M in its first full quarter). EPS came in at -$1.54, missing estimates of -$1.07. Full-year revenue surged to $606.4M. Despite the EPS miss, shares rose ~6.5% on the company’s bullish 2026 guidance of $1B+ for BRINSUPRI alone. Cash on hand remains strong at ~$1.4B.
About Insmed
Insmed Incorporated (Nasdaq: INSM) is a people-first global biopharmaceutical company headquartered in Bridgewater, New Jersey, founded in 1988. The company focuses on developing and commercializing first- and best-in-class therapies for patients with serious and rare diseases, with core therapeutic areas in respiratory, inflammation & immunology, and neurology.
Insmed’s commercial portfolio includes two key products: ARIKAYCE (amikacin liposome inhalation suspension), approved for refractory MAC lung disease in the U.S., Europe, and Japan, and BRINSUPRI (brensocatib), which received FDA approval in August 2025 for the treatment of bronchiectasis. The company has approximately 1,660 employees as of year-end 2025, up ~31% year-over-year.
| Metric | Value |
| Ticker | INSM (Nasdaq) |
| Market Cap | ~$34.9B |
| P/E Ratio (TTM) | -26.05 |
| EPS (TTM) | -$6.42 |
| Dividend Yield | 0.00% |
| 52-Week Range | $60.40 – $212.75 |
| Employees | ~1,660 |
| Beta (1Y) | 0.55 |
Top Financial Highlights
- Total Q4 2025 Revenue reached $263.8 million, reflecting a 153% year over year increase compared to $104.4 million in Q4 2024.
- Full-Year 2025 Revenue totaled $606.4 million, representing a 67% increase from $363.7 million recorded in 2024.
- BRINSUPRI generated $144.6 million in Q4, marking its first full quarter of sales, with full-year 2025 revenue of $172.7 million.
- ARIKAYCE reported $119.2 million in Q4 revenue, contributing to a full-year total of $433.8 million, reflecting 19% annual growth and exceeding prior 2025 guidance.
- Q4 Gross Margin stood at approximately 83.2%, with cost of product revenues at $44.2 million, or 16.8% of total revenue, supported by BRINSUPRI’s lower manufacturing cost structure.
- Q4 Net Loss was $328.5 million, or -$1.54 per share, compared to a net loss of $235.5 million, or -$1.32 per share, in Q4 2024.
- Full-Year Net Loss reached $1,276.8 million, or –$6.42 per share, compared to $913.8 million, or -$5.57 per share, in 2024.
- Q4 SG&A Expenses increased to $212.5 million, up from $142.5 million in the same quarter of the prior year.
- Q4 R&D Expenses rose to $254.9 million, compared to $179.7 million in Q4 2024.
- Q4 Total Operating Expenses amounted to $583.6 million, versus $334.9 million in Q4 2024.
- Full-Year Total Operating Expenses reached $1,853.2 million, compared to $1,242.0 million in 2024.
- Cash, Cash Equivalents, and Marketable Securities totaled approximately $1.4 billion as of December 31, 2025.
- BRINSUPRI is projected to generate at least $1.0 billion in revenue in 2026.
- ARIKAYCE revenue is expected to range between $450 million and $470 million in 2026.
- Total 2026 Revenue Guidance is implied at approximately $1.45 billion to $1.47 billion, representing more than double the total revenue reported in 2025.
Beat or Miss?
Insmed’s Q4 2025 results showed a mixed picture: revenue was essentially in line with consensus, while EPS missed significantly due to elevated operating expenses tied to the BRINSUPRI launch and pipeline investments.
| Metric | Reported | Consensus Estimate | Difference |
| Q4 EPS | ($1.54) | -$1.07 (Zacks) / -$1.17 (Investing.com) | Missed by $0.37 to $0.47 |
| Q4 Revenue | $263.8M | $263.9M (Benzinga) / $208.2M (Investing.com) | In line to +26.7% beat depending on source |
| BRINSUPRI Q4 Revenue | $144.6M | N/A (first full quarter) | Exceeded internal expectations |
| ARIKAYCE Q4 Revenue | $119.2M | ~$104.4M (YoY comp) | +14.2% YoY |
| Full-Year Revenue | $606.4M | N/A | Up 67% YoY |
What Leadership Is Saying?
William Lewis stated that 2025 was a strong year, driven by disciplined execution and clinical progress. He emphasized the company’s leadership position in bronchiectasis and non tuberculous mycobacterial lung disease, supported by first to market therapies. Revenue guidance for BRINSUPRI is set at at least $1 billion in 2026, a milestone achieved by only a small number of drug launches in early quarters.
Sara Bonstein expressed confidence that the company can achieve positive cash flow under its current development and commercial strategy, without raising additional capital. She reported that fourth quarter 2025 cost of product revenues was $44.2 million, or 16.8% of revenues, reflecting improved gross margin performance supported by BRINSUPRI.
Historical Performance
Insmed: Q4 2025 vs. Q4 2024 (YoY)
| Category | Q4 2025 | Q4 2024 | Change (%) |
| Total Revenue | $263.8M | $104.4M | +152.7% |
| Net Loss | -$328.5M | -$235.5M | -39.5% (wider loss) |
| EPS | ($1.54) | ($1.32) | -16.7% (wider loss) |
| Cost of Product Revenue | $44.2M | $26.2M | +68.7% |
| SG&A Expenses | $212.5M | $142.5M | +49.1% |
| R&D Expenses | $254.9M | $179.7M | +41.8% |
| Total Operating Expenses | $583.6M | $334.9M | +74.2% |
| Operating Loss | -$319.7M | -$230.4M | -38.8% (wider loss) |
Insmed: Full-Year 2025 vs. Full-Year 2024
| Category | FY 2025 | FY 2024 | Change (%) |
| Total Revenue | $606.4M | $363.7M | +66.7% |
| Net Loss | -$1,276.8M | -$913.8M | -39.7% (wider loss) |
| EPS | ($6.42) | ($5.57) | -15.3% (wider loss) |
| Total Operating Expenses | $1,853.2M | $1,242.0M | +49.2% |
| Cost of Product Revenue | $122.9M | $85.7M | +43.4% |
Competitor Comparison
| Metric | Insmed (INSM) Q4 2025 | Vertex (VRTX) Q4 2025 | Sarepta (SRPT) Q4 2025* | United Therapeutics (UTHR) Q4 2024** |
| Revenue | $263.8M | $3.19B | $369.6M (prelim.) | $735.9M |
| FY Revenue | $606.4M | $12.0B | $1.86B (prelim.) | $2.88B |
| EPS | -$1.54 | $5.03 (non-GAAP) | TBD (est. -$0.87) | $6.19 |
| Net Income/Loss | -$328.5M | $1.3B (non-GAAP) | N/A | $301.3M |
Revenue Growth Comparison (YoY)
| Company | Most Recent Q4 Revenue | Prior Year Q4 Revenue | YoY Change |
| Insmed (INSM) | $263.8M | $104.4M | +152.7% |
| Vertex (VRTX) | $3.19B | ~$2.91B | +9.5% |
| Sarepta (SRPT) | $369.6M (prelim.) | $658.4M*** | -43.9% |
| United Therapeutics (UTHR) | $735.9M (Q4 2024) | N/A | +23.6% (FY basis) |
*** Sarepta’s Q4 2024 revenue of $658.4M included a large one-time ELEVIDYS contribution; the Q4 2025 figure reflects normalization.
How the Market Reacted?
Despite the significant EPS miss (-$1.54 vs. estimates of -$1.07 to -$1.17), Insmed shares responded positively to the earnings report, largely driven by the company’s bullish 2026 guidance. The stock showed a pre-market increase of ~1.56% immediately following the report on February 19, 2026. By February 20, 2026, shares traded as high as $163.14 intraday, settling around $161.00 – a gain of approximately 6.5% from the prior close of $151.11, on significantly elevated volume of 4.91M shares versus the 2.4M daily average.
The market clearly prioritized the forward-looking $1B+ BRINSUPRI revenue guidance and the “more than double” total revenue outlook for 2026 over the near-term earnings shortfall. Several analysts maintained or reiterated Buy ratings, with Stifel adjusting its price target to $205 from $212 while keeping a Buy rating, and the average analyst price target stands at $219.19, implying ~36% upside from current levels.
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