Insmed Incorporated Q4 FY2025 earnings call

• 2025 was exceptional with Brinsupri launch and ARIKAYCE's performance. • Clinically, entered new gene therapies into clinic and acquired INS 1148. • Intend to accelerate Brinsupri's US launch and grow ARIKAYCE. • TPIP received orphan drug designation and phase three trial design for PAH. • Discussed gross to net for Brinsupri and ARIKAYCE in 2026. • Cash position as of end 2025 was ~$1,400,000,000. • R&D and SG&A expenses increased due to launch and pipeline funding.

Brinsupri had net revenue of $144,600,000 in its first full quarter. ARIKAYCE had strong growth in Europe and Japan. TPIP was derisked by strong clinical data in 2025. Brinsupri revenue contribution is expected to be significant, with potential for growth. ARIKAYCE's revenue contribution is also important with growth in key regions.

• Revenue guidance for Brinsupri in 2026 is at least $1,000,000,000. • Anticipate total company revenue in 2026 to be more than double that of 2025. • Confident of achieving cash flow positivity without additional capital, but may source capital for business development. • Gross to net for Brinsupri in 2026 expected to be mid twenties to low thirties. • GTN for ARIKAYCE in 2026 expected to range from low to mid twenties.

Q: Question about developing other DPP one inhibitors within respiratory disease and how they differ from Brinsupri.

A: Intend to bring other DPP ones forward, e.g., ten thirty three for rheumatoid arthritis and irritable bowel disease in second half of 2026, and others for respiratory like COPD and asthma. Martina commented on distinct phenotypes of patients.

Q: Question about guidance for Brinsupri, specific elements of patient behavior.

A: Have detailed dashboard, seeing at or above targets, market access metrics good, low discontinuation rates, reauthorizations going through.

Q: Question about scripts trends, BD activity.

A: Script trends strong out of gate, confident in Brinsupri's billion dollar revenue, interested in BD assets like INS 1148.

Q: Question about clarity on $1,000,000,000 plus level guidance, documentation factor.

A: Market access picture good, some plans require documentation but field access managers support, uptake smooth.

Q: Question about approval rates, conversion speed.

A: Approval rates at or exceeding benchmark, conversion speed good.

Q: Question about ex U.S. contribution to Brinsupri guidance, launch strategy.

A: Ex U.S. contribution very small, strategy to launch in Europe and Japan, waiting for clarity on MFN policies.

Q: Question about additional capital for business development, achieving cash flow positivity.

A: Clear path to cash flow positivity, BD separate, can source capital if needed.

Q: Question about depth of prescribing, education.

A: Physicians try with one or two patients, positive feedback expected to drive depth, speakers bureau and other programs in place.

Q: Question about unknowns becoming known, revenue guidance.

A: Unknowns trending positive, will provide additional clarity on revenue guidance.

Q: Question about pulmonologists navigating payer requirements.

A: CT scan needed for definitive diagnosis of bronchiectasis, easy distinction to make.

Q: Question about COPD and bronchiectasis overlap, eosinophil levels.

A: Depends on patient's clinical status, physicians consider other possibilities if patients continue to exacerbate.

Q: Question about payers requiring documentation, covered lives.

A: Benchmarks met, market access picture not changing dramatically.

Q: Question about patient reauthorizations.

A: Feel good about reauthorization experience, no major issues.

Q: Question about tapping into COPD and asthma patient population.

A: All on label, through CT scan and pulmonologist diagnosis.

Q: Question about TPIP IPF study design, survival benefit.

A: Study design not finalized, will discuss with FDA.

Q: Question about Brinsupri guidance, ARIKAYCE data.

A: $1,000,000,000 guidance based on two pulmonary exacerbation patients, ARIKAYCE data around corner, feel good about ENCORE data.

Q: Question about Brinsupri persistence.

A: Refills going well, patients feeling better, preservation of lung function a driver.