Inogen, Inc. Q4 FY2025 earnings call

Key Priorities - Driving top line growth: Focus on U.S. education of patients and providers on Inogen products, positive traction with newer products like Voxi 5, Simeox, and Aurora CPAP masks; international growth with $32.5 million in Q4 revenue, 15% year-over-year growth. - Advancing profitability: Through operational excellence and cost management, achieved positive adjusted EBITDA in 2025, narrowed adjusted net loss, strengthened balance sheet with $120.9 million in cash, etc. - Expanding innovation pipeline: Simeox had limited market release in U.S., initiated trial for reimbursement, near completion of trial in China; Voxi 5 launched as new stationary oxygen concentrator; Aurora CPAP masks entered sleep therapy market; launched Inogen patient portal for digital health.

In the fourth quarter of 2025, total revenue was approximately $82 million, with full-year revenue nearly $349 million, reflecting 4% year-over-year growth. Unit volumes grew over 20% year-over-year in both the fourth quarter and full year. U.S. sales in Q4 were $36.1 million, down 5.1% from the prior year. International business had $32.5 million in Q4 revenue, up 14.8% year-over-year. Rental revenue was $13.1 million, down 4.5% from the prior period. Gross margin in Q4 2025 was 43.1%, decreasing 220 basis points from the same period in the prior year. Full-year 2025 gross margin was 44.2%, a decline of 190 basis points from 2024. Adjusted EBITDA was positive $2.7 million for the full year 2025, the first year of adjusted EBITDA profitability since 2021.

Full year 2026 revenue guidance is approximately 6% year-over-year growth at midpoint of $366 million to $373 million. First quarter 2026 expected reported revenue in line with first quarter 2025, reflecting POC unit growth offset by channel mix change and declining rental revenue. Expect to continue to grow POC business in a different way. Committed to driving positive adjusted EBITDA in 2026, building on 2025 momentum. Long-term financial goals include achieving high single-digit revenue growth and 10% or better adjusted EBITDA over next 3-5 years, launching at least 1 new product per year.

Q: You attributed the fourth quarter miss to multiple large customer orders shifting into the first half of this year. Can you help us understand the magnitude of these orders? And of what shifted, how much has already been shipped in the first quarter versus is expected in the second?

A: Haven't gotten into specific dollar amounts, but orders spread out over first half. Some received to date, some to sprinkle in as first half goes on. POC demand up, HMEs more likely to provide POC to patients, changing channel mix.

Q: On the move to the new U.S. sales reporting category, with the mix driven by B2B orders pushed into the first half and through this year, how did the DTC channel perform in the fourth quarter? And how should we think about the blended growth here going forward?

A: Direct-to-consumer was down 15% in Q4, continuing to improve. New reporting structure to simplify and focus on product growth drivers. Not all products sold in all channels.

Q: How should we think about the ramp of revenue from the Aurora mask launch through '26? And what's the go-to-market strategy here? And can you walk us through what gives you confidence that you can carve out share in this market?

A: Not guiding to quarter-over-quarter on masks, expect more back-end loaded. Primarily through B2B channel, built sales organization. Conducted patient satisfaction study with exceptional results, early customer feedback positive. $2.2 billion market in U.S., repeatable business.

Q: On the EBITDA guidance, the expectations for 2026. I'm just curious on a quarterly basis, is Inogen targeting or expecting to be EBITDA positive in every quarter in 2026?

A: Keeping in mind Q2 and Q3 are strongest quarters, expect relatively consistent to previous years, not too far off. Have additional investments planned in 2026, but shouldn't be too far off from historical years.