Inspire Medical Systems Inc (INSP) 2025 Q2 法說會逐字稿

Good afternoon. My name is [Dilem], and I'll be your conference operator today. At this time, I would like to welcome everyone to the Inspire Medical System second quarter 2025 conference call. (Operator Instructions) I'll now hand the call over to your first speaker, Ezgi Yagci, the Vice President of investor relations at Inspire. You may begin the conference.

午安.我的名字是 [Dilem]，今天我將擔任您的會議接線生。現在，我歡迎大家參加 Inspire Medical System 2025 年第二季電話會議。（操作員指示）現在我將把電話交給第一位發言人，Inspire 投資者關係副總裁 Ezgi Yagci。您可以開始會議了。

Thank you, [Dilem] and thank you all for participating in today's call. Joining me are Tim Herbert , Chairman and Chief Executive Officer, and Rick Buchholz, Chief Financial Officer. Earlier today, we released financial results for the three months ended June 30, 2025. A copy of the press release is available on our website.

謝謝[Dilem]，也謝謝大家參加今天的電話會議。與我一起的還有董事長兼首席執行官蒂姆·赫伯特 (Tim Herbert) 和首席財務官里克·布赫霍爾茨 (Rick Buchholz)。今天早些時候，我們發布了截至 2025 年 6 月 30 日的三個月的財務業績。新聞稿的副本可在我們的網站上查閱。

On this call, management will make forward-looking statements within the meaning of the federal securities laws. All forward-looking statements, including without limitation, those relating to our operations, financial results, and financial condition, investments in our business, full year 2025 financial and operational outlook, and changes in market access are based upon our current estimates and various assumptions.

在本次電話會議上，管理階層將根據聯邦證券法做出前瞻性陳述。所有前瞻性陳述，包括但不限於與我們的營運、財務表現和財務狀況、對我們業務的投資、2025 年全年財務和營運前景以及市場准入變化有關的陳述，均基於我們當前的估計和各種假設。

These statements involve material risks and uncertainties that could cause actual results or events to materially differ. Accordingly, you should not place undue reliance on these statements. Please see our filings with the Securities and Exchange Commission, including our Form 10-Q which we filed with the SEC earlier this afternoon, for a description of these risks and uncertainties.

這些聲明涉及重大風險和不確定性，可能導致實際結果或事件產生重大差異。因此，您不應過度依賴這些聲明。請參閱我們向美國證券交易委員會提交的文件，包括我們今天下午早些時候向美國證券交易委員會提交的 10-Q 表，以了解這些風險和不確定性的描述。

Inspire disclaims any intention or obligation, except as required by law to update or revise any financial projections or forward-looking statements, whether because of new information, future events, or otherwise. This conference call contains time sensitive information and speaks only as of the live broadcast today, August 4, 2025. With that, it is my pleasure to turn the call over to Tim Herbert. Tim?

Inspire 不承擔任何意圖或義務，除非法律要求更新或修改任何財務預測或前瞻性聲明，無論是由於新資訊、未來事件或其他原因。本次電話會議包含時間敏感訊息，僅代表截至今天（2025 年 8 月 4 日）現場直播的內容。說完這些，我很高興將電話轉給提姆·赫伯特。提姆？

Thank you, Ezgi, and thanks everyone for joining our business update call for the second quarter of 2025. I'll start by highlighting some key takeaways of our second quarter results. I'll then discuss our updated 2025 guidance and provide additional context and rational rationale around the change. Then Rick will provide a financial review. We will then open the call for questions.

謝謝 Ezgi，也謝謝大家參加我們 2025 年第二季的業務更新電話會議。首先，我將重點介紹我們第二季業績的一些關鍵要點。然後，我將討論我們更新後的 2025 年指南，並提供有關此變更的更多背景資訊和合理理由。然後 Rick 將提供財務審查。然後我們將開始提問。

It has been an impressive start to the year 2025, and we have achieved many key milestones. That said, I want to provide some important context on the challenges we are facing in the commercial rollout of our Inspire V next generation system, which began in May.

2025 年是一個令人印象深刻的開始，我們已經實現了許多重要的里程碑。話雖如此，我想提供一些重要的背景信息，介紹我們在 5 月開始的 Inspire V 下一代系統商業推廣中面臨的挑戰。

As the quarter progressed, we encountered certain headwinds that slowed our efforts to transition customers to Inspire V. While we are disappointed with the elongated time frame we now expect for the rollout, we remain focused on advancing the transition of our customers to Inspire V.

隨著本季的進展，我們遇到了一些阻力，減緩了我們讓客戶過渡到 Inspire V 的努力。雖然我們對目前預計的推出時間延長感到失望，但我們仍然專注於推動客戶向 Inspire V 的過渡。

To this end, we are taking concrete actions that we believe will allow us to complete this transaction in the next few quarters. Strong market demand, positive patient and surgent feedback and favorable clinical results give us conviction in our platform and ability to make a difference in the lives of our patients with obstructive sleep apnea.

為此，我們正在採取具體行動，我們相信這將使我們能夠在未來幾季內完成這筆交易。強勁的市場需求、積極的患者和急救反饋以及良好的臨床結果使我們對我們的平台充滿信心，並有能力為阻塞性睡眠呼吸中止症患者的生活帶來改變。

I'd now like to provide some detail regarding the challenges faced during the quarter and the steps we're taking to actively address the factors at play. First, in the second quarter, many centers did not complete the training, contracting, and onboarding criteria required prior to the purchase and implant of Inspire V. Specifically, implementation of SleepSync has been the most challenging step to accomplish.

現在，我想詳細介紹本季面臨的挑戰以及我們為積極解決這些因素所採取的措施。首先，在第二季度，許多中心沒有完成購買和植入 Inspire V 之前所需的培訓、簽約和入職標準。具體來說，SleepSync 的實施是最具挑戰性的一步。

Although not technically difficult, the approval process from our customers' IT departments has taken longer than expected. Additionally, some centers have been delaying implementing SleepSync until the first patients are scheduled to receive the Inspire V device.

儘管從技術上來說並不困難，但我們客戶 IT 部門的審批過程比預期花費的時間要長。此外，一些中心一直在延遲實施 SleepSync，直到第一批患者預定接收 Inspire V 裝置。

To increase the rate of implementation of SleepSync by our customers, we began and continued to leverage our technical teams. To date, we have completed the implementation at over 50% of the US centers. With these technical resources fully engaged, we expect to complete the vast majority by the end of the third quarter.

為了提高客戶實施 SleepSync 的速度，我們開始並將繼續利用我們的技術團隊。到目前為止，我們已經在超過 50% 的美國中心完成了實施。隨著這些技術資源的充分投入，我們預計在第三季末完成絕大部分工作。

As an aside, most of the units sold in the second quarter were inspire IVs. Therefore, we did not experience much inventory destocking in the second quarter. The burn down of Inspire IV inventory will remain a headwind in the second half of 2025 as we continue the transition to Inspire V. The second challenge related to adoption of CPT code 64,568 for Inspire V for Medicare patients.

順便說一句，第二季銷售的大部分產品都是 Inspire IV。因此，第二季度我們並沒有經歷太多的庫存去庫存。隨著我們繼續向 Inspire V 過渡，Inspire IV 庫存的消耗仍將是 2025 年下半年的一大阻力。第二個挑戰與醫療保險患者採用 Inspire V 的 CPT 代碼 64,568 有關。

The approval of the code change was announced in April with a retroactive effective date of January 1, 2025. However, the software updates for claims, submissions, and processing did not take effect until July . Thus, although traditional Medicare and Medicare Advantage patients could receive inspired therapy, Implanting centers would not be able to bill for those procedures until July 1.

該代碼變更的批准於 4 月宣布，其追溯生效日期為 2025 年 1 月 1 日。然而，索賠、提交和處理的軟體更新直到 7 月才生效。因此，儘管傳統的醫療保險和醫療保險優勢計劃患者可以接受啟發療法，但植入中心直到 7 月 1 日才能夠為這些程序開出帳單。

Given this dynamic, many centers continued to treat Medicare patients with Inspire IV. With this software update now complete, we anticipate centers will ramp up their efforts to transition to Inspire V. Third, certain patients opted to wait for the Inspire V device, knowing its availability was imminent instead of being treated with Inspire IV.

鑑於這種動態，許多中心繼續使用 Inspire IV 治療醫療保險患者。隨著此軟體更新的完成，我們預計各中心將加大力度過渡到 Inspire V。第三，某些患者選擇等待 Inspire V 設備，因為他們知道該設備即將上市，而不是使用 Inspire IV 進行治療。

And as more centers transition to Inspire V into the third quarter, these patients should start receiving Inspire V therapy. Fourth, we intentionally held off on patient marketing and education spend and footprint expansion, namely new centers and territories in the first half of the year. This was a strategic decision given all the resources required for the Inspire V transition.

隨著第三季越來越多的中心轉向 Inspire V，這些患者應該開始接受 Inspire V 治療。第四，我們有意推遲了患者行銷和教育支出以及足跡擴張，即上半年的新中心和新地區的擴張。考慮到 Inspire V 轉型所需的所有資源，這是一個策略決策。

As we move into the second half of the year, we have ramped up both marketing and footprint expansion efforts to increase patient awareness and build capacity across the US. These investments have already started to be implemented, and we have already experienced an increase in website activity, calls into our advisor care program, and appointments to healthcare providers.

隨著進入下半年，我們加強了行銷和擴張力度，以提高患者意識並在美國各地建立醫療能力。這些投資已經開始實施，我們的網站活動、顧問護理計劃的呼叫以及醫療保健提供者的預約數量均有所增加。

We continue to leverage our ACP to connect patients interested in inspired therapy with qualified physicians, including through the expansion of digital scheduling. In addition, we are ramping our medical education and local community health talk efforts to promote the launch of Inspire V. These efforts should provide a tailwind into the second half of 2025 and beyond.

我們繼續利用我們的 ACP 將對啟發療法感興趣的患者與合格的醫生聯繫起來，包括透過擴展數位化排程。此外，我們正在加大醫學教育和當地社區健康宣傳力度，以推廣 Inspire V 的推出。這些努力應該會為 2025 年下半年及以後帶來助力。

Lastly, we believe some patients may be delaying inspired therapy to try GLP-1. We are unable to quantify this and continue to believe GLP-1 wants present a tailwind long term as we do hear of patients losing weight to qualify and receive inspired therapy.

最後，我們相信有些患者可能會推遲嘗試 GLP-1 療法。我們無法量化這一點，並且仍然相信 GLP-1 希望能夠長期帶來順風，因為我們確實聽說患者減肥以達到資格並接受啟發性治療。

As an example, when a prospective patient fails, the DICE procedure due to complete consent or collapse, our centers work with the patients to help address their high BMI, including prescribing a GLP-1. As a result of these headwinds, we are adjusting our full year revenue guidance to a range of $900 million to $910 million from our previous revenue guidance of $940 million to $955 million or a 4% reduction at the midpoint.

例如，當潛在患者因完全同意或崩潰而導致 DICE 程序失敗時，我們的中心將與患者合作，幫助解決他們的高 BMI，包括開出 GLP-1。由於這些不利因素，我們將全年營收預期從先前的 9.4 億美元至 9.55 億美元調整至 9 億美元至 9.1 億美元，中間值減少 4%。

The new revenue guidance reflects growth of 12% to 13% over 2024 revenue. We are also reducing our diluted net income per share to a range of $0.40 to $0.50 from our previous guidance of $2.20 to $2.30 per share to reflect this change in revenue guidance and to a lesser extent the planned increase in patient marketing costs for the second half of the year.

新的收入指引反映出2024年營收將成長12%至13%。我們還將每股攤薄淨收益從先前預測的每股 2.20 美元至 2.30 美元下調至 0.40 美元至 0.50 美元，以反映收入預測的變化，並在較小程度上反映下半年計劃增加的患者行銷成本。

I will now take a few minutes to highlight the success we have already seen with the Inspire V system and what to expect moving forward. The early results of our Singapore clinical study have been presented at the recent sleep meeting and demonstrated a 20% reduction in surgical times. This reduction will provide for increased capacity at centers.

現在，我將花幾分鐘時間重點介紹我們已經看到的 Inspire V 系統所取得的成功以及對未來的期望。我們在新加坡臨床研究的早期結果已在最近的睡眠會議上公佈，結果顯示手術時間減少了 20%。此次削減將提高中心的容量。

In fact, we have already noted that the US centers that have completed the transition to Inspire V, have experienced a more than 20% increase in patient implants in the first half of 2025 as compared to the same period in 2024. From an efficacy standpoint, the accelerometer study we highlighted at recent investor conferences suggested significantly improved sensing capability, including an 86% inspiratory overlap with the patient's breathing.

事實上，我們已經注意到，已完成向 Inspire V 過渡的美國中心在 2025 年上半年的患者植入量與 2024 年同期相比增加了 20% 以上。從功效的角度來看，我們在最近的投資者會議上強調的加速度計研究表明感知能力顯著提高，包括與患者呼吸的吸氣重疊率為 86%。

Synchronization with respiration is essential as the airway collapses during the inspiratory phase of respiration. The early review of AHI reductions appears very promising as well, and we plan to present this data at the upcoming ENT meetings in October.

與呼吸同步至關重要，因為氣道在呼吸的吸氣階段會塌陷。對 AHI 減少的早期審查也顯得非常有希望，我們計劃在 10 月即將召開的 ENT 會議上展示這些數據。

Regarding reimbursement. CMS recently released the 2026 proposed OPPS rules, which, if approved, would provide positive increases for Medicare reimbursement for the inspire system. As for Inspire V centers will be billing CPT code 64,568, which has been accepted for plans covering over 90% of our $300 million covered lives, including Medicare.

關於退款。CMS 最近發布了 2026 年擬議的 OPPS 規則，如果獲得批准，該規則將為激勵系統的醫療保險報銷帶來積極增長。至於 Inspire V 中心將使用 CPT 代碼 64,568 進行計費，該代碼已被接受用於覆蓋我們 3 億美元保險金額的 90% 以上的計劃，包括醫療保險。

The national average Medicare hospital reimbursement for CPT code 64,568 is proposed to increase to $32,000 up roughly $1300 or 4% from 2024, and the ASC reimbursement is proposed to increase to $28,000 up $1300 or 5% compared to 2024. Finally, the surge in reimbursement for CPT code 64,568 is projected to increase to $660, up 11% as compared to 2024.

建議將 CPT 代碼 64,568 的全國平均醫療保險醫院報銷金額增加到 32,000 美元，比 2024 年增加約 1,300 美元或 4%，並將 ASC 報銷金額增加到 28,000 美元，比 2024 年增加 1,300 美元或 5%。最後，CPT 代碼 64,568 的報銷金額預計將增至 660 美元，與 2024 年相比增長 11%。

Should the proposed rules be finalized as expected in early November; the new reimbursement would take effect January 1, 2026. With respect to clinical evidence, we are very excited to have submitted the predictor manuscript to a leading journal and expect it to be published later this year.

如果擬議規則按預期於 11 月初最終確定，新的報銷政策將於 2026 年 1 月 1 日生效。就臨床證據而言，我們非常高興能夠將預測手稿提交給一家領先的期刊，並預計它將於今年稍後發表。

As a reminder that clinical evidence proposes an algorithm which uses BMI and neck circumference to determine a patient's eligibility, thereby eliminating the need for a DICE procedure for the vast majority of patients.

提醒一下，臨床證據提出了一種使用 BMI 和頸圍來確定患者資格的演算法，從而消除了絕大多數患者進行 DICE 手術的需要。

We're all excited to announce that we became a corporate champion of the American Academy of Old Laryngology. The sponsorship positions inspires a leading voice in ENT innovation, aligning with top thought leaders and decision makers. It also strengthens our brand and trust within the ENT community, which is vital for expanding Inspire's influence and adoption.

我們非常高興地宣布，我們成為了美國老年喉科學會的企業冠軍。贊助職位激發了耳鼻喉科創新領域的領先聲音，與頂尖思想領袖和決策者保持一致。它還加強了我們在 ENT 社群內的品牌和信任，這對於擴大 Inspire 的影響力和採用率至關重要。

It also provides a platform for collaboration and research and policy, thereby advancing inspires market leadership and hyper glossal nerve stimulation. Before I turn the call over to Rick, I'd like to take a moment and discuss the personnel announcement we made today.

它也提供了一個合作、研究和政策的平台，從而促進了市場領導力和舌神經刺激的發展。在我將電話轉給里克之前，我想花點時間討論一下我們今天發布的人事公告。

No one has lived up to our commitment to delivering strong patient outcomes more than Randy Ban, our executive Vice President, Patient Access and Therapy Awareness. Randy recently announced his intention to retire at the end of January 2026.

沒有人比我們的患者訪問和治療意識執行副總裁 Randy Ban 更能履行我們為患者提供良好治療結果的承諾。蘭迪最近宣布他打算在 2026 年 1 月底退休。

As one of our earliest team members and a longtime commercial leader at Inspire, Randy has played a significant role in advancing access to inspire therapy and building a strong, mission-driven organization. He will remain fully engaged in his current role into early next year to support a smooth and thoughtful transition. We are grateful to Randy for his many contributions and wish him the best in his well-earned retirement.

作為我們最早的團隊成員之一和 Inspire 的長期商業領袖，Randy 在推動激勵療法的普及和建立強大的、以使命為導向的組織方面發揮了重要作用。他將全心投入明年年初的現有工作中，以確保順利、周到的過渡。我們感謝蘭迪的諸多貢獻，並祝福他在退休後一切順利。

At the beginning of this year, Carlton Weatherby assumed the lead of the US sales and marketing teams and will continue to build upon the robust history of growth in the adoption of inspired therapy, initiated by Randy many years ago.

今年年初，卡爾頓·韋瑟比 (Carlton Weatherby) 出任美國銷售和行銷團隊領導，並將繼續鞏固蘭迪多年前發起的啟發療法的強勁增長歷史。

In summary We remain focused on the patient to continue the growth and adoption of inspired therapy. We will execute our growth strategy of driving high quality patients low and increasing the capacity of our of our provider partners to effectively treat and manage more patients.

總之，我們將繼續關注患者，並繼續發展並採用啟發式療法。我們將執行我們的成長策略，降低高品質患者的數量，並提高我們的醫療服務合作夥伴有效治療和管理更多患者的能力。

Our key strategies include training advanced practice providers, certifying additional surgeons qualified to implants for therapy, and driving the adoption of SleepSync and our digital tools, all of which are embedded strategies and our commercial team's objective to increase provider capacity.

我們的關鍵策略包括培訓高級執業提供者、認證更多有資格進行植入治療的外科醫生以及推動採用 SleepSync 和我們的數位工具，所有這些都是嵌入式策略，也是我們商業團隊提高提供者能力的目標。

Looking ahead, we are confident about our future and that we have the appropriate strategy in place to drive long-term stakeholder value. We have our arms around the headwinds that I described, and actions are already underway to accelerate the adoption of Inspire V in the latter half of the year.

展望未來，我們對自己的未來充滿信心，並且我們已製定適當的策略來推動長期利害關係人的價值。我們已經克服了我所描述的不利因素，並已開始採取行動，以加速今年下半年 Inspire V 的採用。

Looking beyond 2025, we continue to take actions to position the company for strong profitable growth. With that, I'd like to turn the call over to Rick for his review of our financials.

展望2025年以後，我們將繼續採取行動，使公司實現強勁的獲利成長。說到這裡，我想把電話轉給里克，讓他審查一下我們的財務狀況。

Thank you, Tim, and good afternoon, everyone. Total revenue for the quarter was $217.1 million, an 11% increase from the $195.9 million generated in the second quarter of 2024. US revenue in the quarter was $207.2 million, an increase of 10% from the $187.8 million in the prior year period. Revenue outside the US was $9.9 million, which was a 23% increase year over year. Gross margin in the quarter was 84% compared to 84.8% in the prior year period.

謝謝你，提姆，大家下午好。本季總營收為 2.171 億美元，較 2024 年第二季的 1.959 億美元成長 11%。本季美國營收為 2.072 億美元，較去年同期的 1.878 億美元成長 10%。美國以外地區的收入為 990 萬美元，年增 23%。本季毛利率為 84%，去年同期為 84.8%。

The year over year decrease was primarily due to a $2.1 million charge for excess inspire for subcomponents, which reduced gross margin by 100 basis points in the quarter. Total operating expenses for the quarter were $185.7 million, an increase of 15% as compared to $160.9 million in the second quarter of 2024. This increase was primarily due to the expansion of our sales organization and increased general corporate costs, partially offset by a reduction in R&D year over year.

年比下降主要是由於子部件超額激勵費用 210 萬美元，導致本季毛利率降低 100 個基點。本季總營運費用為 1.857 億美元，較 2024 年第二季的 1.609 億美元成長 15%。這一成長主要歸因於我們銷售組織的擴張和一般公司成本的增加，但被研發費用的年減部分抵銷。

In addition, operating expenses included accelerated, non-cash stock-based compensation expense of $11.2 million for employees who are now retirement eligible in accordance with the implementation of changes to the treatment of equity awards upon an employee's death, disability, or retirement.

此外，營運費用還包括加速的非現金股票薪酬費用 1,120 萬美元，用於支付根據員工死亡、殘疾或退休時股權獎勵處理變化實施而符合退休資格的員工。

Operating expenses also included $1.7 million in legal fees related to a civil investigative demand from the Department of Justice and a patent infringement suit that we filed against a potential competitor. These items do not reflect costs associated with our ongoing operations. Please refer to our earnings press release for a reconciliation of these items.

營運費用還包括與司法部民事調查要求以及我們針對潛在競爭對手提起的專利侵權訴訟相關的 170 萬美元法律費用。這些項目並不反映與我們持續營運相關的成本。請參閱我們的收益新聞稿以了解這些項目的對帳情況。

Interest and dividend income total of $4.5 million in the quarter compared to $5.9 million in the prior year period. Operating loss for the quarter totaled $3.3 million compared to an operating income of $5.1 million in the prior year period. Net loss for the quarter was $3.6 million compared to a net income of $9.8 million in the prior year period.

本季利息和股息收入總計 450 萬美元，而去年同期為 590 萬美元。本季營業虧損總計 330 萬美元，而去年同期的營業收入為 510 萬美元。本季淨虧損為 360 萬美元，而去年同期淨收入為 980 萬美元。

This represented a loss per share of $0.12 for the quarter compared to a net income of $0.32 per share in the second quarter of 2024. Adjusted EBITDA for the quarter totaled $44.1 million, which is a 14% increase compared to $38.7 million in the prior year period. The adjusted EBITDA dub margin in the second quarter was 20% and consistent with the second quarter of 2024.

這意味著本季每股虧損 0.12 美元，而 2024 年第二季每股淨收入為 0.32 美元。本季調整後的 EBITDA 總計 4,410 萬美元，較去年同期的 3,870 萬美元成長 14%。第二季調整後的 EBITDA 利潤率為 20%，與 2024 年第二季持平。

Adjusted net income per share totaled $0.45 compared to $0.32 in the prior year period, or an increase of 40% year over year. The weighted average number of diluted shares outstanding for the quarter was $29.5 million. We entered the quarter with $411 million in cash and investments. Our strong cash position allows us to remain focused on executing our growth strategies.

調整後每股淨收益總計 0.45 美元，而去年同期為 0.32 美元，年增 40%。本季流通在外稀釋股份的加權平均數為 2,950 萬美元。我們本季的現金和投資總額為 4.11 億美元。我們強大的現金狀況使我們能夠繼續專注於執行我們的成長策略。

Moving on to 2025 guidance, as Tim mentioned, we now expect full year revenue to be in the range of $900 million to $910 million down from $940 million to $955 million representing an annual increase of 12% to 13% compared to full year 2024 revenue. We expect Q3 revenue to increase 1% to 3% sequentially from the second quarter as we continue the transition to Inspire V. We continue to expect full year gross margin to be in the range of 84% to 86%.

談到 2025 年的指引，正如蒂姆所提到的，我們現在預計全年收入將在 9 億至 9.1 億美元之間，低於 9.4 億至 9.55 億美元，與 2024 年全年收入相比，年增長率為 12% 至 13%。隨著我們繼續向 Inspire V 過渡，我們預計第三季營收將比第二季環比成長 1% 至 3%。我們繼續預計全年毛利率將在 84% 至 86% 之間。

We now expect diluted net income for the full year, 2025 will be $0.40 to $0.50 per share, a decrease from our previous range of $220 to $230 per share. The reduction is primarily due to the revised revenue guidance and to a lesser extent, the planned increase in patient marketing costs for the second half of the year. We ended the quarter with 348 US territories and 259 US field clinical representatives.

我們現在預計 2025 年全年稀釋淨收入將為每股 0.40 美元至 0.50 美元，低於我們之前的每股 220 美元至 230 美元的範圍。減少的主要原因是修改了收入指導，以及在較小程度上由於計劃增加下半年的患者行銷成本。本季結束時，我們在美國擁有 348 個領土，美國實地臨床代表有 259 人。

We continue to expect our reported tax rate in 2025 to be roughly 10%, primarily related to state and local taxes. We expect the full year diluted shares outstanding to be approximately $31 million. With that, our prepared remarks are concluded. Dilam, you may now open the line for questions.

我們繼續預期 2025 年的申報稅率約為 10%，主要與州稅和地方稅有關。我們預計全年稀釋流通股數約為 3,100 萬美元。我們的準備演講到此結束。迪拉姆，你現在可以開始提問了。

(Operator Instructions)

（操作員指示）

Adam Maeder, Piper Sandler & Co.

梅德（Adam Maeder），Piper Sandler & Co.

Hi, good afternoon. Thank you for taking the questions. A couple from me, I guess. The first one is on the revised guidance and. You guys outlined a handful of different headwinds that are facing the business here.

嗨，下午好。感謝您回答這些問題。我想，我也有幾個。第一個是關於修訂後的指南。你們概述了這裡的業務面臨的一些不同的不利因素。

Was just hoping to get a little bit more color there if you could kind of put some force rank order around those different items or quantification around those items so we can kinda understand those different components and kind of how you're thinking about the potential impact in the second half of the year and the night of follow up. Thanks.

我只是希望能夠獲得更多的細節，如果您可以對這些不同的項目進行一些強制排序或量化，那麼我們就可以了解這些不同的組成部分，以及您如何看待下半年和後續行動的潛在影響。謝謝。

Sounds great Adam. How are you doing? Good to good to hear from you. I think when we laid out the four key items that we highlighted. The first two are really the predominant factors that we had and the first one certainly being the number of centers that have completed their full training and adding SleepSync to their systems to be able to use the Inspire V programmer and the second is really the concern over billing Medicare, which is, everybody was aware of it being approved but not being able to build it until July 1 has really put some centers in a tough spot and so they chose to continue to implants for IV and those two factors really are the predominant drivers and we really got our arms around both of those.

聽起來很棒，亞當。你好嗎？很高興收到你的來信。我認為當我們列出我們強調的四個關鍵項目時。前兩個因素確實是我們面臨的主要因素，第一個因素肯定是已經完成全面培訓並在其係統中添加了 SleepSync 以便能夠使用 Inspire V 編程器的中心數量，第二個因素實際上是對醫療保險收費的擔憂，也就是說，每個人都知道它已獲批准，但直到 7 月 1日才能建造它，這確實讓一些中心陷入了困境，因此他們選擇繼續進行靜脈植入，這兩個因素確實是主要的驅動因素，我們確實已經掌握了這兩個因素。

Of course, the Medicare is now approved and centers are able to bill 645,684 Inspire V and we have a full team working to get all the other centers trained and up and running as we mentioned over 50% of the centers have already have access to sleep sick.

當然，醫療保險現在已經獲得批准，中心可以收取 645,684 美元的 Inspire V 費用，而且我們有一個完整的團隊致力於讓所有其他中心接受培訓並開始運行，正如我們提到的，超過 50% 的中心已經可以使用睡眠病了。

That's helpful color ,Tim. Thank you for all that and for the follow up you know, I'm going to test my luck on 2026 and the roll out obviously going slower than expected with Gen V here this year, but you gave some kind of helpful, color around kind of how you're thinking about the trajectory in the back half of the year.

這顏色很有幫助，蒂姆。感謝您所做的一切以及後續行動，您知道，我將在 2026 年試試運氣，今年 Gen V 的推出速度顯然比預期的要慢，但您給出了一些有用的信息，說明了您對下半年發展軌蹟的看法。

maybe to ask it a little bit more directly, would you expect a revenue in 2026 to accelerate over the 12% to 13% that you've guided to and. FY '25?

也許可以更直接地問一下，您是否預期 2026 年的營收成長率會超過您預測的 12% 至 13%。25 財年？

Absolutely well we're going to provide our next year's guidance of course, at a year-end call but we're making several investments, as I've already mentioned, to get the sites up and running with Inspire V.

當然，我們會在年底電話會議上提供明年的指導，但正如我已經提到的，我們正在進行幾項投資，以使網站能夠使用 Inspire V 運行。

We talked about the increased marketing with our direct to consumer spend expanding our footprint both with new centers with surgeons, bringing back some of the surgeons who were doing as many procedures because of the pressure sensing need with before and so yes we would expect our revenue growth to exceed the 12 to 13 we're talking about now.

我們談到了透過直接面向消費者的支出來增加行銷，擴大了我們的業務範圍，包括設立新的外科醫生中心，讓一些之前由於壓力感測需求而做過很多手術的外科醫生回來，所以是的，我們預計我們的收入增長將超過我們現在談論的 12 到 13。

Thanks very much.

非常感謝。

Travis Steed, Bank of America Corporation.

特拉維斯‧史蒂德 (Travis Steed)，美國銀行公司。

Hey, thanks for taking the question. I wanted to ask about the EPS guide change, and the numbers in the press release, the 220 to 230, went to 40 to $0.50. There was, I guess, a $0.57 one-time charge this quarter, but trying to get the bridge kind of back to the underlying EPS guide and on an adjusted basis if you could kind of help walk how the guide changed versus the 220 to 2:30 that you gave last quarter.

嘿，謝謝你回答這個問題。我想問一下每股盈餘指引的變化。新聞稿中的數字，從2.20美元到2.30美元，變成了4.0美元到0.50美元。我猜，本季有一筆0.57美元的一次性費用，但是為了使調整後的每股收益指引回到基礎每股收益指引，您能否在調整後的基礎上，解釋一下該指引與您上一季度給出的2.20美元到2.30美元相比有何變化？

Sure. Hey Travis, so, the most significant item there is just the gross margin that we're going to, the reduced gross margin that we would obtained had we had higher revenue. So really the biggest impact there is the reduction of the of the revenue guide from our previous midpoint of $948, $48 million down to $905 million. So that's the majority of that. But we are also increasing our DTC spend too. So to a lesser extent there's some impact there from continued investments.

當然。嘿，崔維斯，最重要的項目就是我們要獲得的毛利率，如果我們有更高的收入，我們就會獲得更低的毛利率。因此，真正最大的影響是收入指南從我們先前的中點 9.4848 億美元減少到 9.05 億美元。這就是大部分內容。但我們也在增加 DTC 支出。因此，在較小程度上，持續投資會產生一定的影響。

And the big driver there is that we expect to actually increase our DTC investments, significantly now, that we've got the launch underway. And so, part of that launch is we want to take advantage of the of the launch with Inspire V to ensure that we're building patient awareness and so that that growth we had DTC at 95 million in 2024 expect that to be over 20% growth, which implies about $115 million in 2025.

最大的驅動力是，我們預計實際上會大幅增加我們的 DTC 投資，因為我們已經開始了發布。因此，此次發布的一部分是，我們希望利用 Inspire V 的發布來確保我們正在建立患者意識，這樣我們預計 2024 年 DTC 的成長將達到 9,500 萬，成長率將超過 20%，這意味著 2025 年約為 1.15 億美元。

So the $0.40 to $0.50 EPS guide is excluding the $0.57 one-time charge this quarter just to be clear?

那麼，0.40 美元至 0.50 美元的每股盈餘指南不包括本季 0.57 美元的一次性費用，只是為了清楚起見？

No, that's included. It’s GAAP, EPS. It's inclusive of that.

不，這包括在內。這是 GAAP、EPS。其中包括這個。

Okay, so if I take the 220 versus 230, subtract the $0.57 and that's, that should be the underlying EPS guide, right?

好的，如果我用 220 比 230 減去 0.57 美元，那麼這應該是基本每股盈餘指南，對嗎？

Yes, because you have the original, the underlying guide is midpoint of $0.45 roughly, $1.20 for the reduction in revenue and then and then the roughly $0.60 for the one-time items yes.

是的，因為您有原件，所以基本指南是大約 0.45 美元的中點，收入減少 1.20 美元，然後一次性項目大約 0.60 美元。

Correct. Okay, just want to make sure that was clear since it's confusing for a lot of people and then the second question I had was just on the Q3 guide and any kind of view on June July trends that kind of helped inform that Q3 guide up 1% to 3% sequentially. Thank you.

正確的。好的，只是想確保這一點清楚，因為這對很多人來說很困惑，然後我的第二個問題是關於第三季度指南以及對 6 月 7 月趨勢的任何看法，這些看法有助於告知第三季度指南環比上漲 1% 至 3%。謝謝。

Hi Travis. No, I think the, as we come out, it's always a little bit lower at the beginning of a quarter, especially when you're talking about the beginning of July, but, we do, see the patient flow that we're working through in the second quarter and be able to get a handle on where we are from, patient flow and expected implants to be able to guide the 1% to 3% step up over the second quarter revenue. So that's, those are just the early views that we see from the patient flow.

你好，崔維斯。不，我認為，正如我們所看到的，一個季度初的收入總是會低一些，特別是在七月初的時候，但是，我們確實看到了第二季度的患者流量，並且能夠掌握我們的現狀、患者流量和預期植入物，從而能夠引導第二季度收入增長 1% 到 3%。所以，這些只是我們從病患流量中看到的早期觀點。

Okay, thanks a lot.

好的，非常感謝。

Danielle Antalffy, UBS Securities LLC.

丹尼爾‧安塔菲 (Danielle Antalffy)，瑞銀證券有限責任公司。

Hey, good afternoon guys thanks so much for taking the question. Just want to make sure I understand what's happening here on underlying volume trends appreciate all the color you provided, Tim, but I guess even if it's a matter of like slower transition to Inspire V, volumes seem to be lower than what well certainly than what you guys have been tracking over the last few years but then what a lot of people expected and so I guess some of that is patients choosing to wait but I guess I'm just curious like why you're still seeing such pressure on volumes.

嘿，大家下午好，非常感謝你們回答這個問題。只是想確保我理解這裡發生的基本數量趨勢，感謝你提供的所有細節，蒂姆，但我想即使是向 Inspire V 過渡較慢的問題，數量似乎也低於你們過去幾年追踪的數量，但也低於很多人的預期，所以我想其中一些是患者選擇等待，但我想我只是好奇為什麼你仍然看到數量如此大的壓力。

I know it's hard to quantify like the GLP-1 impact things like that but anything you can say there to just give us some more confidence that this is truly temporary and not something structural in the market would be would be great. I know that's an open-ended question and I'll just leave it at that.

我知道很難量化 GLP-1 的影響之類的事情，但只要你能說些什麼，讓我們更有信心，相信這只是暫時的，而不是市場結構性的問題，那就太好了。我知道這是一個開放式的問題，我就不多說了。

Thanks Danielle. I think well first off in the second quarter we did achieve expectations with our revenue and taking care of patients and so we did have a good patient flow there to achieve what we set expectations or set guide to be in the second quarter, but as we look forward, knowing the delay in getting all the centers up and running, that pushes, our cases forward and it also limited our ability to increase the footprint so we didn't add as many centers in the second quarters we're working on the transition.

謝謝丹妮爾。我認為首先在第二季度，我們的收入和患者護理確實達到了預期，因此我們確實有良好的患者流量，從而實現了我們設定的第二季度預期或指導，但展望未來，我們知道所有中心的啟動和運行都會延遲，這會推動我們的病例向前發展，也限制了我們擴大覆蓋範圍的能力，因此我們在第二季度沒有增加那麼多中心，我們正在努力實現。

We didn't add as many territory managers as we noted in the script. We did increase the number of field clinical reps because that builds the capability to move forward and again, as Adam asked earlier on, the two key factors are getting the sites up and running transition to five and really the ability to build Medicare centers really had a difficult time building Medicare knowing that they wouldn't get billing excepted until July 1.

我們沒有像腳本中提到的那樣增加那麼多區域經理。我們確實增加了現場臨床代表的數量，因為這增強了前進的能力，而且，正如亞當之前所問的，兩個關鍵因素是讓站點啟動並過渡到五個，以及真正建立醫療保險中心的能力，在建立醫療保險方面確實很困難，因為他們知道直到 7 月 1 日他們才會獲得賬單豁免。

The other two factors do play as well, of course, with the patients who are expecting or waiting for Inspire V, but until the centers are up and running they certainly can't get in the queue to be able to get scheduled for that, but we know those patients are there.

當然，另外兩個因素也對期待或等待 Inspire V 的患者有影響，但在中心投入運作之前，他們肯定無法排隊等待治療，但我們知道這些患者就在那裡。

And then finally, with the majority of the units being sold and the quarter being inspired for us, we still have a burn down of inventory that will carry forward moving forward. So yes, we have strong confidence in our ability to move forward and that's really highlighted by the great performance that we're seeing with Inspire V devices so far both in the US and again as you mentioned.

最後，由於大多數單位都已售出，並且本季對我們來說是鼓舞人心的，我們仍然會消耗庫存，並將繼續前進。所以是的，我們對我們前進的能力充滿信心，這一點從我們迄今為止在美國以及您提到的 Inspire V 設備所表現的出色表現中可以看出。

From the clinical study in Singapore and we're going to be proud to present some more of those results at the upcoming ENT meeting. So yeah, the team's got their head down, they're working hard. We think we've got our arms around the headwinds, limiting the Inspire V transition and have good confidence that we have the corrective actions in place to be able to overcome those.

來自新加坡的臨床研究，我們將自豪地在即將舉行的耳鼻喉科會議上展示更多結果。是的，團隊正在埋頭苦幹，努力工作。我們認為我們已經克服了限制 Inspire V 轉型的阻力，我們有信心採取糾正措施來克服這些阻力。

Okay. Thanks for the comprehensive answer.

好的。感謝您的全面回答。

Thanks Danielle.

謝謝丹妮爾。

Robbie Marcus, J.P. Morgan Chase & Co.

馬庫斯（Robbie Marcus），摩根大通公司

Oh great, thanks for taking the questions, second for me first one. Tim, I appreciate you're not commenting on 2026, but with the expectation be given this is a transient issue that you, you'd basically go back to your prior run rate in 2026, meaning you'd get back the $40 million to $45 million in revenue cut that you had here, in '25 next year if it's not demand related.

哦，太好了，感謝您回答這些問題，我先回答第二個問題。提姆，我很感激你沒有對 2026 年發表評論，但考慮到這是一個暫時的問題，你基本上會在 2026 年回到之前的運行率，這意味著你會在明年收回你在 25 年減少的 4000 萬到 4500 萬美元的收入，如果它與需求無關的話。

I think that, that's what we're going to be targeting for. I think that, we do think this is a short term issue, and with the shift it limits our ability to work through Q3 and Q4, but it does set us up for a very promising 2026 and beyond as we need to be focused to get all the sites transitioned over, but we already have the payers in place as we mentioned with the CPT coding we have Medicare now in place.

我認為這就是我們的目標。我認為，我們確實認為這是一個短期問題，而且隨著轉變，它限制了我們完成第三季度和第四季度工作的能力，但它確實為我們非常有希望的 2026 年及以後做好了準備，因為我們需要集中精力完成所有站點的轉換，但我們已經有了付款人，正如我們在 CPT 編碼中提到的那樣，我們現在已經實施了醫療保險。

And we have seen positive experience from centers that have already implemented Inspire V. So again, we're going to give the formal guidance when we move forward, but our intent is to bring the growth back absolutely.

我們已經從已經實施 Inspire V 的中心看到了積極的經驗。因此，我們將再次給出正式的指導，但我們的目的是絕對恢復成長。

Great, maybe just to follow up you you've had approval for a long while now you were in limited launch for many months. The launch isn't going according to plan. What would you say if you compare now versus on the first quarter call which was partway into the second quarter? What exactly didn't go to plan? What was the biggest delta versus expectations, and how do you plan to fix those shortcomings?

太好了，也許只是為了跟進一下，您已經獲得批准很長一段時間了，現在已經有限地發布了好幾個月。發射並未按計畫進行。如果將現在的情況與第二季中期第一季的電話會議進行比較，您會怎麼說？到底什麼事情沒有照計畫進行？與預期相比，最大的差距是什麼？您計劃如何彌補這些不足？

Through the rest of the year. I think it's this is the largest launch in the history of the company. There's no question about it. It's one of the largest launches in Medtech based on where we are today. So, there are challenges that go with it. At the beginning of the year, really we're focused more on making sure we have sufficient inventory to be able to even start the launch.

度過今年餘下的時間。我認為這是該公司歷史上規模最大的一次發布。毫無疑問。根據我們目前的狀況，這是醫療技術領域最大的發布之一。因此，它也面臨挑戰。在年初，我們確實更加重視確保我們有足夠的庫存，以便能夠開始發布。

And so we're really limiting the number of centers that could be exposed to Inspire V, still being able to pick up enough data to have confidence moving forward in the roll out as we got to May when we did the full launch and started to roll it out, we did have the opportunity with the extended time to be able to get all the reimbursement in place and we did have Medicare approved although when they do their documentation they do it twice a year and of course the we weren't part of the January release knowing we had to wait until the July release had one issue.

因此，我們實際上限制了可以接觸到 Inspire V 的中心數量，仍然能夠收集到足夠的數據，以便有信心在 5 月份全面推出並開始推廣時繼續推進，我們確實有機會利用延長的時間獲得所有報銷，並且我們確實獲得了 Medicare 的批准，儘管他們每年進行兩次文件編制，當然，我們沒有參與 1 月份的發布，因為我們知道必須等到一個 7 月份的問題。

So that's a timing factor, but then the SleepSync is really the big change too because that gives us the advantage to be able to capture the information when physicians do the device programming. So that's really a long term opportunity to build the robustness of the Inspire system and so it is a complex launch but I think now we have our arms around it.

這是一個時間因素，但 SleepSync 也確實是一個很大的變化，因為它使我們能夠在醫生進行設備編程時捕獲資訊。所以這確實是一個長期的機會來建立 Inspire 系統的穩健性，所以這是一個複雜的發布，但我認為現在我們已經掌握了它。

I think having inventory earlier would have allowed us to release this earlier albeit we still would have been constrained from a Medicare standpoint but yeah we do take it to heart and do look closely at a lot of the details and when we go into our programs moving forward on what can we do to enhance that going forward and have some better planning to address some of the challenges that we've seen.

我認為，如果能更早地擁有庫存，我們就能更早地發布這些信息，儘管從醫療保險的角度來看，我們仍然會受到限制，但我們確實會認真對待這個問題，並仔細研究很多細節，當我們繼續推進我們的計劃時，我們可以做些什麼來加強未來的發展，並製定更好的計劃來應對我們所看到的一些挑戰。

Appreciate it. Thanks Tim.

非常感謝。謝謝蒂姆。

Richard Newitter, Truist Securities Inc.

Richard Newitter，Truist Securities Inc.

Hi, thanks for taking the questions. Just a couple here and I'll list them all up front, I'm curious if you could just parse out a little bit more clearly for us. Is this entirely. Inspire V execution related and it and that's the transient item that gives you confidence here for moving into '26.

你好，謝謝你回答這個問題。這裡只有幾個，我會把它們都列在前面，我很好奇你是否可以為我們更清楚地分析一下。完全是這樣。Inspire V 執行相關，這是暫時的項目，讓您有信心進入 '26 年。

You did call out GLP1 impact a little bit more concretely than you have in the past. So I'm just trying to understand between that and maybe capacity utilization. What, what's potentially, nearer term transient and then what's related to those other items and anything you can give us some kind of underlying demand trends, since there is inventory in the channel, and then, sorry, two more, your accounts receivable stepped up.

您確實比過去更具體地指出了 GLP1 的影響。所以我只是想了解這和產能利用率之間的關係。什麼，什麼是潛在的，近期的瞬態，然後什麼與其他項目相關，以及任何你能給我們某種潛在需求趨勢的東西，因為渠道中有庫存，然後，抱歉，還有兩個，你的應收賬款增加了。

I just wanted to know kind of how that factors into some of these considerations and then lastly you talked about a 20% increase for Inspire V users that have adopted in the first half. I'm just curious what's driving that? Is that patients that just aren't able to get Inspire V that they found the few physicians who have them going there, or is it actually throughput increases and physicians doing more procedures on their planned Inspire days? Thank you.

我只是想知道這些因素是如何影響這些考慮因素的，最後您談到了上半年採用 Inspire V 的用戶數量增加了 20%。我只是好奇是什麼導致了這種情況？是因為病人無法使用 Inspire V，所以他們找到了少數幾位醫生讓他們去那裡，還是實際上吞吐量增加了，醫生在計劃的 Inspire 日內做了更多的手術？謝謝。

You bet, Rich. Got it. Okay, start with number one. It's for V, transition and is that really the overriding element that's limiting patient flow? Again, I think we had good patient flow in the second quarter, and we achieved the expectations that we set forward, but it was the continuation of the patient flow going into the third quarter.

當然，里奇。知道了。好的，從第一點開始。這是為了 V，過渡，這真的是限制病患流量的最重要因素嗎？再次，我認為我們在第二季度的患者流量很好，並且我們實現了我們設定的預期，但這種患者流量延續到了第三季度。

While the Inspire V is the leading issue there are underlying elements to it. Well, obviously the four items I talked about with the Inspire IV specifically sites being ready to go with V, the Medicare, some patients waiting for the Inspire V, and of course the burn down of inventory.

儘管 Inspire V 是主要問題，但也存在一些潛在因素。嗯，顯然，我談到的與 Inspire IV 有關的四個項目具體來說是準備與 V 一起使用的站點、醫療保險、一些等待 Inspire V 的患者，當然還有庫存的消耗。

We also held back, remember a little bit on our DTC and a little bit on our footprint expansion, so not purposely going out and adding a lot of reps, making sure that the team stays in place, focused with existing centers, get them transition to V, and then turn around and really start to expand that that specifically is what we started here in the third quarter, not just increased DTC but an increased focus on building the footprint in the United States.

我們也有所保留，記住在我們的 DTC 和足跡擴展上做了一些努力，所以不是故意出去增加很多代表，確保團隊留在原地，專注於現有的中心，讓他們過渡到 V，然後轉身真正開始擴展，這正是我們在第三季度開始做的事情，不僅增加了 DTC，而且更加註重在美國建立足跡。

And then we'll come back to, that's going to grow, capacity, no question about it. GLP-1 impact, we're going to keep watching that closely. We do think that as the indication has come out, we may see pockets of that, with some of our centers of patients wanted to trial a GLP-1 and we've talked about that with you before, but again, we do think that's a real tailwind into the future.

然後我們會回到這個問題，毫無疑問，容量將會成長。GLP-1 的影響，我們將繼續密切關注。我們確實認為，隨著跡象的出現，我們可能會看到一些這樣的情況，我們的一些患者中心希望試用 GLP-1，我們之前已經與您討論過這個問題，但再次強調，我們確實認為這是未來的真正順風。

It's really about helping patients lose weight, addressing the lateral wall collapse, so we don't think that's a significant impact, but we're watching that very closely. I'm going to skip by accounts receivable to give that to Rick and go down to the third question, which is the 20% improvement in patient flow with implants with our physicians.

這實際上是為了幫助患者減肥，解決側壁塌陷問題，所以我們認為這不會產生重大影響，但我們正在密切關注。我將跳過應收帳款部分，直接交給 Rick，直接進入第三個問題，即我們的醫生植入植入物後病患流量提高了 20%。

These are with our limited release sites. And this is patient implant, this is patient flow. Those are real numbers. We're tracking their implants during the first half of '25 versus the first half of '24, and these are new centers in '24. These are centers that had full year 24 as well. So it's a true apples to apples, and it's a reduction in the surgical complexity of V that allows them to improve their capacity.

這些都是我們有限發行的網站。這是患者植入物，這是患者流程。這些都是實數。我們正在追蹤 25 年上半年和 24 年上半年的植入情況，這些都是 24 年的新中心。這些中心也擁有全年 24 小時的營運時間。因此，這是真正的蘋果對蘋果，並且它降低了 V 的手術複雜性，從而允許他們提高其能力。

But more importantly, Rich, it's about them not having to put in the pressure sensing lead because as we remember, that sensing lead into the thoracic, not into the thoracic cavity to the intercostal muscles is part of the surgery that is just not the most comfortable part for ENTs.

但更重要的是，Rich，他們不必放入壓力感測導線，因為我們記得，將感測導線放入胸腔，而不是放入胸腔到肋間肌，這是手術的一部分，對耳鼻喉科醫生來說，這不是最舒服的部分。

And that really has been the number one primary positive feedback. So that being said, I'm going to back up to number two and ask Rick to come in on accounts receivable.

這確實是最重要的正面回饋。話雖如此，我還是要回到第二點，請 Rick 來處理應收帳款。

Yeah Rich, the accounts receivable increase is really a twofold item. The primary driver there is in May we actually completed a transition to a new customer billing service that helps automate and streamline our billing process which is an upgrade from our previous manual billing process and with that implementation of the new system we had a temporary delay in the delivery of customer invoices actually with the new portal and our and our new automated delivery process.

是的，Rich，應收帳款的增加其實是雙重的。主要驅動因素是，我們在五月實際上完成了向新客戶計費服務的過渡，這有助於自動化和簡化我們的計費流程，這是對我們以前手動計費流程的升級，並且隨著新系統的實施，我們在新門戶和新的自動交付流程中實際上暫時延遲了客戶發票的交付。

That temporary delay has been resolved and we expect to have this fully remediated in the third quarter. So it's really just the timing we'll get those collections here as we get into the third quarter and then to a much lesser extent too is the second quarter was a little back and loaded in the fact that we had a really strong June, and so that also contributed to the increase in accounts receivable balance at the end of the quarter.

該暫時延遲問題已解決，我們預計將在第三季完全解決。因此，這實際上只是我們進入第三季度時獲得這些收款的時機，然後在較小程度上，第二季度略有落後，而且由於 6 月份表現非常強勁，因此這也導致了本季度末應收賬款餘額的增加。

David Rescott, Robert W. Baird & Co.

大衛雷斯科特、羅伯特W貝爾德公司

Oh great, thanks for taking the questions, Ricky, you answered, the question earlier, but I wanted to just make crystal clear, the updated EPS guide for the year, the $0.40 to $0.50 that's now in in the guide relative to the prior to $2 plus guide.

哦，太好了，謝謝你回答這個問題，Ricky，你回答了之前的問題，但我只想清楚地說明，今年更新後的每股收益指南，相對於之前的 2 美元以上的指南，現在的指南中是 0.40 美元到 0.50 美元。

Is that $0.40 to $0.50 relative to the negative $0.2 of net income per share or relative to the $0.55 of adjusted net income per share you've delivered year-to-date so far, and, I guess based on that answer, are you expecting, incremental stock based comp for this retirement. Component in the back half of the year as well, and I'd follow up.

這是相對於每股淨收入負 0.2 美元還是相對於年初至今實現的每股調整後淨收入 0.55 美元而言的 0.40 美元至 0.50 美元？我想，根據這個答案，您是否預期這次退休將獲得增量股票補償？今年下半年也會有組件，我會跟進。

Yeah, it's your first question, it's relative to the $0.02 earnings per share to address your first question and then the implementation of the retirement policy was really a onetime charge, and we expect our stock based compensation to revert back to traditional levels as a percentage of our of our revenue going forward.

是的，這是您的第一個問題，它與每股 0.02 美元的收益有關，回答您的第一個問題，然後退休政策的實施實際上是一次性費用，我們預計我們的股票薪酬將恢復到傳統水平，占我們未來收入的百分比。

Okay, that's helpful, and then, Tim, you called out, maybe three or 445, components of this lowered, outlook for the year and, I'm curious on if you can bucket it in so much as to the progress that those have recovered either in June, in the back half of the quarter or already in in July and just based on kind of some of the trends that you're seeing in the back half where we kind of stand from a hey, are some of these headwinds bottoming out are they on the up at this point? Any color that would be helpful. Thank you.

好的，這很有幫助。然後，蒂姆，您提到了下調今年前景的三個或四百四十五個組成部分，我很好奇，您是否可以將其歸類到這些部分在 6 月份、本季度後半段或 7 月份已經恢復的進展中，並且僅基於您在下半段看到的一些趨勢，我們的立場是，嘿，這些不利因素中的一些是否已經觸底，現在是否正在上升？任何有幫助的顏色。謝謝。

Absolutely David. So the first two, the primary contributors as we mentioned. The first one being the centers being up and running. Remember we had to do the training, contracting, and implementation of SleepSync, and we mentioned Sleepsync is already adopted in 50% of the centers.

絕對是大衛。正如我們所提到的，前兩個是主要貢獻者。第一個是中心已經啟動並運行。記得我們必須進行 SleepSync 的培訓、簽約和實施，我們提到 50% 的中心已經採用了 Sleepsync。

Training is already complete because the training of surgeons is relatively straightforward, right? Don't implant the pressure sensing lead anymore and this, and it's a little bit more streamlined and contracting is even above that of implementation of SleepSync.

訓練已經完成了，因為外科醫生的訓練相對簡單，對嗎？不再需要植入壓力感測導線，而且它更加精簡，收縮甚至高於 SleepSync 的實作。

So we've really got our arms around those three elements of getting centers up and running so I think we're in a good position there with a strong focus from the team. Number two, of course, is Medicare and that is complete, right? We do have the new code 64,568 approved by Medicare. The documentation is complete, the software is updated, and Medicare is accepting billing for inspired procedures to that new code today.

因此，我們確實已經掌握了啟動和運作中心的這三個要素，所以我認為我們在這方面處於有利地位，並且得到了團隊的高度關注。第二，當然是醫療保險，它已經齊全了，對吧？我們確實有 Medicare 批准的新代碼 64,568。文件已完成，軟體已更新，Medicare 今天正在接受根據新代碼啟發的程序的帳單。

So that one is complete. The rest of them will keep coming as we keep expanding, and then beyond, that we are working diligently to increase the footprint again, add additional centers to train additional centers, and maybe those physicians who weren't as excited about implanting the pressure assessing lead that creates an opportunity for us and the team is really leaning in on that.

這樣就完成了。隨著我們不斷擴張，其餘的人會繼續來，而且，我們正在努力再次擴大規模，增加更多的中心來培訓更多的中心，也許那些對植入壓力評估線索不那麼興奮的醫生會為我們創造機會，而團隊真的很依賴這一點。

So again, we think we have our arms around that as well and look forward to continue to report back on that.

因此，我們認為我們已經掌握了這一點，並期待繼續報告這一點。

Michael Sarcone, Jefferies LLC.

Michael Sarcone，Jefferies LLC。

Good afternoon and thanks for taking the question I guess just first Tim to follow up on the Medicare billing and software update. You said that's been available since July 1. Could you give us, any sense of what kind of uptake maybe you've seen since July 1 now that these centers are able to build Medicare?

下午好，感謝您提出這個問題，我想先請提姆跟進一下醫療保險帳單和軟體更新的情況。您說這個功能從 7 月 1 日起就可以使用了。您能否告訴我們，自 7 月 1 日以來，這些中心已經能夠建立醫療保險，並且取得了什麼樣的進展？

Pretty limited early in the in this quarter so far and that we had to get the sites up and running before they're in a position to build it. So a lot of sites weren't even going through the full implementation process until they're able to really step in.

到目前為止，本季度初期的資金非常有限，我們必須先讓網站啟動並運行，然後他們才能開始建造。因此，許多站點甚至還沒有完成完整的實施過程，就真正開始介入。

And so now that Medicare is in place, we can say that's no longer a barrier. Now we get to lean in with a lot of those centers. Hence, that's really kind of the push into the third quarter here that's driving a lot of the guidance changes.

現在醫療保險已經到位，我們可以說這不再是一個障礙。現在我們可以依靠許多這樣的中心。因此，這實際上是推動第三季度發展的一種動力，推動了許多指導性變化。

Great. That's really helpful and then a follow-up on, the growth in the accounts that did transition to Inspire V, you said over 20% growth, 125 versus 124. You just talk about, the phenotype of those accounts and the characteristics, is there any reason why we shouldn't expect that analog to hold for kind of the average account for Inspire?

偉大的。這真的很有幫助，然後是後續問題，過渡到 Inspire V 的帳戶增長情況，您說增長超過 20%，125 個帳戶對 124 個帳戶。您剛才談到了這些帳戶的表現型和特徵，有什麼理由讓我們不期望這種類比適用於 Inspire 的平均帳戶嗎？

Your question. I think the key is when we look at the accounts that were in our limited market release, obviously these are accomplished centers, but when we can see that kind of growth in the accomplished centers, the high volume centers are already, yeah, we want to use that to translate in across the board into other centers to be able to show to show that kind of growth going forward.

您的問題。我認為關鍵在於，當我們查看有限市場發布的帳戶時，顯然這些都是成熟的中心，但是當我們看到成熟的中心出現這種增長時，高容量中心已經是，是的，我們希望利用這一點將其全面轉化為其他中心，以便能夠展示未來的這種增長。

And we can use that as an example with centers to show that capacity increases by the reduced OR time and ease in during the programming with these patients. So yes, we want to reflect that across other centers as well and we'll communicate that to the centers and to our team. Great thanks Tim. Thank you.

我們可以以此為例，說明透過減少手術室時間並在對這些患者進行編程的過程中簡化操作，可以提高容量。所以是的，我們也希望在其他中心反映這一點，並且我們會將這一點傳達給這些中心和我們的團隊。非常感謝蒂姆。謝謝。

Shagun Singh, RBC Capital Markets LLC.

Shagun Singh，RBC Capital Markets LLC。

Great. Thank you for taking the question. I wanted to get a better sense of the implied Q4 guide. It assumes a substantial step up from Q3 to Q4, about 20% growth, and just what is your confidence in that in that number, and that it won't be pushed into 2026 any assumptions you can quantify for that would be helpful.

偉大的。感謝您回答這個問題。我想更了解隱含的 Q4 指南。它假設從第三季到第四季會有大幅成長，大約 20% 的成長，您對這個數字有什麼信心？而且它不會推遲到 2026 年？任何可以量化的假設都會有所幫助。

And then just on Q3, I think somebody asked the question earlier, but can you give us a sense of volume growth that you've seen in July, specifically how many accounts have been converted and lastly just have you heard any pushback from customers around profitability? Thank you for taking the questions.

然後就第三季而言，我想有人早些時候問過這個問題，但您能否告訴我們您在 7 月份看到的交易量增長情況，具體來說有多少個帳戶被轉換了，最後您是否聽過客戶對盈利能力的反對意見？感謝您回答這些問題。

I'll go backwards. No, we haven't really seen any press any pressure from centers on profitability. I think that the new Medicare rates, the OPPS rules coming out, that really helps set off quite a bit, and I think the 64,568 gives a little bit better reimbursement for ASCs and again that steps up again, quite well going into 2026. So really not any too much pressure from that standpoint. Second question was -- what was the second question?

我會倒退。不，我們確實沒有看到任何媒體對獲利中心施加壓力。我認為新的醫療保險費率和出台的 OPPS 規則確實有很大幫助，而且我認為 64,568 為 ASC 提供了更好的報銷，並且這一數字在 2026 年會再次上升。所以從這個角度來看，確實不會有太大的壓力。第二個問題是──第二個問題是什麼？

So I was just wondering if you can comment on the Q4 guide? Any quantification you can provide, and then also on July specifically, anything you can share on volume growth?

所以我只是想知道您是否可以對 Q4 指南發表評論？您能提供任何量化數據嗎？另外，具體到 7 月份，可以分享一下銷售成長嗎？

Yeah, I, I'm not in a position to really comment too much on the early July as we're new into the quarter right now. We did talk with Michael on the last question in regards to really leaning in to really get the other centers kind of up and running and then when we look at the fourth quarter, remember that's our, the big quarter, that's the one where we have our seasonality because of the high deductible insurance plans.

是的，我還不能對 7 月初發表太多評論，因為我們現在才剛剛進入這個季度。我們確實與邁克爾就最後一個問題進行了討論，關於真正努力讓其他中心真正開始運轉，然後當我們看第四季度時，請記住這是我們最重要的季度，由於高免賠額保險計劃，這是我們具有季節性的季度。

And so if you kind of look historically we always get a pretty good step up from Q3 to Q4 and when we set our guide this time and we talked about the 1% to 3% step up from Q2 to Q3 and then the what we'd expect through Q3 to Q4 with that seasonality, that's how we set that overall guidance. Thank you.

因此，如果你回顧歷史，我們總是從第三季度到第四季度取得相當不錯的增長，當我們這次設定指導時，我們談到了從第二季度到第三季度的 1% 到 3% 的增長，然後我們預計第三季度到第四季度的季節性增長，這就是我們設定總體指導的方式。謝謝。

Anthony Petrone, Mizuo Americas.

安東尼·佩特羅內 (Anthony Petrone)，Mizuo Americas。

Thanks, I'm going to go into three quick ones, rattle them off on some of the headwinds here, and one is capacity, and then you talked about SleepSync and then GLP-1. So on the capacity side maybe just an idea of where general surgeons can be as a channel heading into '26 on SleepSync.

謝謝，我將快速解釋三個問題，快速解決其中的一些不利因素，一個是容量，然後您談到了 SleepSync 和 GLP-1。因此，從容量方面來看，這可能只是一個想法，即普通外科醫生可以作為 SleepSync 進入 26 年的一個管道。

Can it be fully up and running to all accounts by the end of the year? And if so, what does that do in terms of unlocking channel? And then a failed dice, going to GLP-1 like how often does that happen? And in the experience so far, have you gotten any of those patients back at this point? thanks.

它能在年底前全面啟動並運作於所有帳戶嗎？如果是的話，這對於解鎖頻道有什麼作用？然後骰子失敗了，轉到 GLP-1 這種情況發生的頻率是多少？從目前的經驗來看，現在有沒有病人回來呢？謝謝。

Absolutely good question. Thank you. From a capacity standpoint, the first step that we're doing is with existing centers and making sure that they understand the improved capacities with Inspire V. We just talked about the demonstrated 20% over 20% increase already in the sites in the limited market release, but we do think that the next step is going to be added ENTs, both those that were reluctant to do procedures based on the pressure sensing lead or those that were trained and really haven't really engaged and done a lot of procedures, and we believe the pressure sensing lead has a factor in that and that we can improve it.

絕對是好問題。謝謝。從容量角度來看，我們採取的第一步是針對現有中心，確保它們了解 Inspire V 帶來的容量提升。我們剛剛談到在有限的市場發布中，站點已經證明了 20% 以上的增長，但我們確實認為下一步將增加 ENT，包括那些不願意根據壓力感測導線進行程序的人，或者那些受過培訓但實際上並沒有真正參與和做過很多程序的人，我們相信壓力傳感導線在其中起到了一定作用，我們可以改進它。

Then we can move forward and talk about both oral surgeons who do Maxillomandibular Advancements and even general surgeons. Now that we don't have that pressure sensing need, it can lend to improved adoption by general surgeons. We do have a few that are already doing that and quite successful with that.

然後我們可以繼續討論進行上顎下顎骨進展的口腔外科醫生甚至普通外科醫生。現在我們不再需要壓力感測，這有助於普通外科醫生更好地採用它。我們確實有一些人已經在這樣做了，而且相當成功。

Going to your second question on SleepSync. SleepSync is a long-term view. It's our cloud-based patient management system, and it is what is going to provide improved patient outcomes because it's going to help sleep physicians with the monitoring and programming and care of their patients from a longitudinal standpoint and having that as part of the Inspire V system is another conduit to be able to have data into the Sleep sink overall.

回到您關於 SleepSync 的第二個問題。SleepSync 是一種長遠的觀點。這是我們基於雲端的患者管理系統，它將提供更好的患者治療結果，因為它將幫助睡眠醫生從縱向角度監測、編程和護理他們的患者，並將其作為 Inspire V 系統的一部分，是能夠將數據整體傳輸到睡眠接收器的另一個管道。

So it is a very important part of it. Yes, we plan to have the majority of the sites all up on SleepSync who every site who will be doing Inspire V will be up on SleepSync. There may be a few sites that we'll continue with IV, but I think that a great majority of sites will have SleepSync implemented. And that really provides a long term benefit both to the centers, especially to the patients because we can monitor their outcomes and of course for Inspire because it is a competitive edge as well.

所以這是其中非常重要的一環。是的，我們計劃讓大多數網站都運行 SleepSync，每個使用 Inspire V 的網站都會執行 SleepSync。可能會有少數站點我們將繼續使用 IV，但我認為絕大多數站點都會實施 SleepSync。這確實為中心帶來了長期利益，特別是對患者而言，因為我們可以監控他們的治療結果，當然對 Inspire 而言也是如此，因為這也是一種競爭優勢。

And then finally GLP-1's, the failed dice, as you know with the predictor study, we're saying that we now have an algorithm for patients who have a BMI less than 32. That we can use the BMI 32 and the next circumference to predict their qualifications for Inspire.

最後是 GLP-1，失敗的骰子，如您所知，透過預測研究，我們說我們現在有一個針對 BMI 小於 32 的患者的演算法。我們可以使用 BMI 32 和下一個週長來預測他們是否有資格獲得 Inspire。

And therefore eliminate a endoscopy for those patients with a higher BMI and when you start to get a BMI up at about 35, it could be as high as 50% of patients, would have a large enough neck circumference to have complete consent or collapse, and those patients need to lose weight so we can reduce the lateral wall collapse and be able to treat them with a tongue-based collapse or hypoglossal nerve stimulation.

因此，對於那些 BMI 較高的患者，無需進行內視鏡檢查。當 BMI 開始上升到 35 左右時，高達 50% 的患者，頸圍會足夠大，導致完全同意或塌陷，而這些患者需要減肥，這樣我們就可以減少側壁塌陷，並能夠透過舌側塌陷或舌下神經刺激來治療他們。

Chris Pasquale, Nephron Research LLC.

Chris Pasquale，Nephron Research LLC。

Thanks. I had a couple, but Tim, I want to start off just taking a different spin on Shagun's question. To your point, upload single digits and 3Q, then up 20% plus and 4Q. That's very similar to what we've seen in the past couple of years.

謝謝。我有幾個問題，但提姆，我想先從不同角度來回答沙岡的問題。正如您所說，上傳個位數和 3Q，然後上漲 20% 以上和 4Q。這與我們過去幾年看到的情況非常相似。

I guess my question is, should this year follow the typical seasonality? It seems like many of the headwinds you called out are going to be peaking here in 3Q. It's going to take you some time to realize the benefit from ramping back up the DTC spend. So why shouldn't we expect 3Q to be weaker than usual and then maybe even have a steeper ramp in the year end than we might typically see?

我想我的問題是，今年應該遵循典型的季節性嗎？看起來您所說的許多不利因素將在第三季達到頂峰。您需要花一些時間才能意識到增加 DTC 支出的好處。那麼，我們為什麼不應該預期第三季的經濟表現會比平常更弱，甚至可能在年底出現比我們通常看到的更急劇的成長呢？

Sure. I think what we said in Q3, it's going to be about 1% to 3%. Historically if you can look at it, it's usually a little bit higher than that maybe coming out of Q2, and so it's a little softer in our guide as we mentioned, but then we put the consistent step up going into Q4 so the key is going to be we just need to keep focus on.

當然。我認為我們在第三季說過，這個數字將在 1% 到 3% 左右。從歷史上看，如果你看一下，它通常會比第二季度時略高一點，所以正如我們所提到的，它在我們的指南中會稍微軟一些，但隨後我們在進入第四季度時採取了一致的舉措，所以關鍵是我們只需要繼續關注。

The corrective actions that we have in place and all the actions to be able to get the patient flow going and you're correct, the DTC does have more of a longer term impact both in Q4 and then of course, setting up for 2026.

我們已經採取了糾正措施，以及為了讓患者順利流動而採取的所有行動，您說得對，DTC 確實會在第四季度以及當然還有 2026 年的設置中產生更長期的影響。

Okay.

好的。

And then you said you haven't heard a lot of pushback on reimbursement yet. One of the things that we have heard from some high volume physicians is that the lower payment rate for Medicare patients under the new CPT code makes it less attractive for them to treat that population and they're thinking about de-emphasizing that cohort in their own practice.

然後您說您還沒有聽到很多關於報銷的反對意見。我們從一些高診量的醫生那裡聽到的一件事是，根據新的 CPT 法規，醫療保險患者的支付率較低，這使得他們不再願意治療該人群，他們正在考慮在自己的實踐中減少對這一群體的重視。

So how confident are you that everything we're seeing here is really just a matter of getting all the pieces in place so that it's easy to do the billing and not a broader issue around those patients getting served?

那麼，您是否確信我們在這裡看到的一切實際上只是將所有部分放到位的問題，以便於計費，而不是圍繞患者接受服務的更廣泛的問題？

That's a good point. And so we need to continue to communicate that the difference between the old code 64582, the new code 64568 did have a $200 Medicare gap and we also think that's reflective in the work that they do not have to put in the pressure sensing leads, so it is a reduction in time and the reimbursement per minute for the high level implanters, the experienced implanters will be a wash.

這是一個很好的觀點。因此，我們需要繼續溝通，舊代碼 64582 和新代碼 64568 之間確實存在 200 美元的醫療保險差距，我們也認為這反映在他們不必放入壓力感測導線的工作中，因此對於高級植入者來說，時間和每分鐘的報銷都會減少，而經驗豐富的植入者則不會。

Now the good news is with the OPPCS rules coming out, there's a $600 increase in 64,568. There is a slight decrease in 64,582 we're not too concerned about that needs a little bit more review, but it really has significantly reduced that gap.

現在的好消息是，隨著 OPPCS 規則的出台，64,568 美元的補貼將增加 600 美元。64,582 略有下降，我們並不太擔心，需要進一步審查，但它確實顯著縮小了這一差距。

Nonetheless, with the increase to $660 proposed with 64,568, and with the experience that they can get with the reduced OR time, it should increase their capacity and we believe and as we've shown with our initial sites, patient flow and implant volume has increased over 20% with the first limited market release site. So I think we'll be able to work with the surgeons, communicate that and get their commitment to take care of patients. Thanks.

儘管如此，隨著提議將費用增加到 64,568 美元，並且隨著他們在縮短手術時間方面所獲得的經驗，這應該會增加他們的容量，我們相信，正如我們在初始站點所顯示的那樣，隨著第一個有限的市場發布站點，患者流量和植入物數量增加了 20% 以上。因此我認為我們能夠與外科醫生合作，溝通這一點並獲得他們照顧患者的承諾。謝謝。

Larry Biegelsen, Wells Fargo & Co.

比格森（Larry Biegelsen），富國銀行

Hi, good afternoon. Thanks for taking the question. Hey Tim, I think some of us, maybe just me, might be struggling to understand how the delay in Inspire V negatively impacted Q2 because Inspire V doesn't really have a clinical benefit over Inspire 4.

嗨，下午好。感謝您回答這個問題。嘿，Tim，我想我們中的一些人，也許只是我，可能很難理解 Inspire V 的延遲如何對第二季度產生負面影響，因為 Inspire V 實際上並沒有比 Inspire 4 具有臨床優勢。

So I wanted to run the factors that impacted Q2 that I heard on this call by you to see if I'm missing anything. So Q2, it sounds like was negatively impacted by patients who are waiting for Inspire V1. Some burning down of Inspire IV inventory lower hires and center edges and some impact from GLP-1 trialing. Is that kind of the right way to think about why the US growth in Q2 was about 10%?

因此，我想分析我在這次電話會議上聽到的影響第二季度的因素，看看我是否遺漏了什麼。因此，第二季度聽起來受到了等待 Inspire V1 的患者的負面影響。Inspire IV 庫存的一些燒毀降低了僱員和中心邊緣的工資，並受到了 GLP-1 試驗的一些影響。這是思考為什麼美國第二季的經濟成長率達到 10% 左右的正確方法嗎？

Yes, but yes, and we communicated that on the Q1 call, what we expected of Q2 and that's what we delivered.

是的，但是是的，我們在第一季的電話會議上傳達了我們對第二季的期望，而我們也確實實現了這一目標。

Okay, and the GLP-1s, what makes you think the impact is temporary and short-lived, why couldn't it get worse from here? And do you have any visibility on liked test growth like the top of the funnel? Thanks.

好的，那麼 GLP-1，是什麼讓您認為其影響是暫時的、短暫的，為什麼情況不會變得更糟？您是否了解喜歡的測試增長情況，例如漏斗頂部？謝謝。

Thanks Larry. We do monitor the dice growth and when they get scheduled, but we do track from the top of the, funnel all the way through, and when we just had communicate with some of our sites, that's where we get the anecdotal, feedback that some patients may be trialing it.

謝謝拉里。我們確實會監控骰子的增長情況以及它們何時被安排好，但我們確實會從漏斗的頂部開始全程跟踪，當我們剛剛與我們的某些站點進行溝通時，我們就會得到一些軼事反饋，即一些患者可能正在試用它。

We do think with the focused effort on the high BMI patients with dice and the cognitive effort to get those patients to help them lose weight with BMI, they're being proactive around that to offset any challenge we may have with GLP-1s, but of course we'll, to your point, monitor that very closely to see how patients are doing with the GLP-1s.

我們確實認為，透過專注於治療高 BMI 患者，並採取認知措施來幫助這些患者透過 BMI 減肥，他們正在積極主動地應對 GLP-1 可能帶來的任何挑戰，但當然，正如您所說，我們會密切監測，了解患者對 GLP-1 的反應。

But again, the data to date really shows that it has the best impact with the high BMI patients and lower BMI patients don't really have the lateral wall claps. They're the tongue-based claps that is treated with inspired therapy, and those are the patients that we are targeting.

但再次強調，迄今為止的數據確實表明，它對高 BMI 患者的影響最大，而低 BMI 患者實際上並沒有出現側壁痙攣。它們是用啟發療法治療的舌部拍打，而這些正是我們的目標患者。

Alright thanks Tim.

好的，謝謝蒂姆。

Jonathan Block, Stifel Financial Corp.

喬納森·布洛克（Jonathan Block），Stifel Financial Corp.

Thanks, guys, good afternoon. Maybe just to break it apart, are you going to sell Inspire for in 2026 in the US and you know when we think about the revised guidance is the IV inventory arguably cleaned up or depleted, if you would, Tim, in your opinion, by the end of 2025, and then I'll just try to ask a follow up?

謝謝大家，下午好。也許只是為了將其分開，您是否打算在 2026 年在美國銷售 Inspire，並且您知道當我們考慮修訂後的指南時，IV 庫存是否可能已被清理或耗盡，如果您願意的話，蒂姆，您認為到 2025 年底，然後我會嘗試問一個後續問題？

Yeah, well, we're going to continue to have Inspire4s available both in Europe and in Asia and in the United States for Slack sites that would like to remain using Inspire IV, so it is going to be available. The real challenge is managing the inventory in Europe because remember how long it takes to be able to get the EU MDR approval.

是的，我們將繼續在歐洲、亞洲和美國為希望繼續使用 Inspire IV 的 Slack 網站提供 Inspire4，因此它將可供使用。真正的挑戰是管理歐洲的庫存，因為要記住獲得歐盟 MDR 批准需要多長時間。

And so that's really the number one reserve we have with that inventory and then we'll monitor in '26 how much inventory we even have, to be able to use in the US and we'll have better answers and more clarity around that, as we work through the year.

因此，這實際上是我們擁有的最重要的庫存儲備，然後我們將在 26 年監控我們有多少庫存，以便能夠在美國使用，隨著我們全年的工作，我們將對此有更好的答案和更清晰的認識。

Okay, thanks for that. And then Rick, I'll take a third shot at the EPS. So the way I look at it is that the GAAP EPS is essentially flat year-to-date, essentially, and then you've got a $0.40 to $0.50 guide and GAAP EPS for the year. So you have interest income. I'm backing into I call it low single digit EBIT margins in the back part of 2025.

好的，謝謝。然後，里克，我將第三次嘗試 EPS。因此，我的看法是，今年迄今為止的 GAAP EPS 基本持平，因此今年的指導價和 GAAP EPS 為 0.40 美元至 0.50 美元。所以你有利息收入。我預計 2025 年下半年息稅前利潤率將降至低個位數。

The gross margins are unchanged. The guide, so is it just op as a percent of sales that moves much higher and to age 25, I guess that's part one, is that correct? And then is that also what's going to drive Tim in your view, the 2026 revenue acceleration because there's a good amount going into SG&A DTC, etc. As we exit the back part of this year. Hope that made sense. Thanks guys.

毛利率維持不變。該指南是否只是佔銷售額的百分比，並且隨著年齡的增長而大幅上升，到 25 歲時，我想這是第一部分，對嗎？那麼，在您看來，這也是推動提姆發展的因素嗎？ 2026 年的營收加速成長，因為今年下半年將有大量資金投入 SG&A DTC 等。希望這是有意義的。謝謝大家。

Yeah, John, that driver is really increased operating expenses. With our previous guidance, operating expenses increased about 16% over 2024. Now with our revised earnings per share, if you work backwards, that overall OpEx growth inclusive of the, a couple adjusted items, is 18%.

是的，約翰，這個驅動因素確實增加了營運費用。根據我們先前的指導，2024 年的營運費用將增加約 16%。現在，根據我們修正後的每股盈餘，如果反向推算，包括幾個調整項目在內的整體營運支出成長率為 18%。

And yes, I think the increase in our marketing and increase of the footprint is exactly the way you described to be able to continue to excite patient flow and move forward into 2026 and yes, we, fully, we remain committed to profitability.

是的，我認為我們行銷的增加和足跡的擴大正是您所描述的，以便能夠繼續激發患者流量並邁向 2026 年，是的，我們全力以赴，仍然致力於盈利。

Thank you.

謝謝。

Thanks John.

謝謝約翰。

Brett Fishbin, KeyBanc Capital Markets, Inc

KeyBanc Capital Markets, Inc. 的 Brett Fishbin

Hey guys, thanks for taking the questions and for fitting me in here. Just, I'll have to follow up to this EPS topic. So mentioned that part of the revision has to do with investments in both marketing and footprint expansion.

嘿夥計們，感謝你們回答問題並讓我參與其中。只是，我必須跟進這個 EPS 主題。所以提到修訂的部分內容與行銷和足跡擴張的投資有關。

Was just curious if you could provide a little bit more specific color on what spending in those buckets is incremental versus the prior range, like what's being added to the budget versus what was previously assumed, coming out of one queue? Thank you.

我只是好奇，您是否可以提供更具體的細節，說明這些桶中的支出與之前的範圍相比是增量的，例如添加到預算中的支出與之前假設的支出相比，是否來自一個隊列？謝謝。

Yeah, Brett, the real driver there is that we want to continue to build patient awareness and so it's going to be our DTC spend that we're going to have increased awareness, to really take advantage of the launch and kind of amplify our messaging as we said in our prepared remarks we did intentionally hold off on DTC in the first half of the year and just to focus on the launch.

是的，布雷特，真正的驅動力是我們希望繼續提高患者的認知度，因此我們將在 DTC 上投入資金，以提高患者的認知度，真正利用此次發布的機會，並擴大我們的信息傳遞範圍，正如我們在準備好的發言中所說的那樣，我們確實有意在上半年推遲了 DTC 的發布，而只專注於發布。

But so now we're ramping up those efforts here in the second half of the year. We are still going to do some other, spending on other marketing areas as well and we're going to continue to add territories as we've done in the past and so those are the continued investments that we want to make. So we are, we, like, as Tim said, we remain committed to improving long term profitability.

但現在我們正在下半年加大這些努力。我們仍將在其他行銷領域進行一些其他投資，並且我們將像過去一樣繼續擴大市場範圍，這些都是我們想要進行的持續投資。因此，正如蒂姆所說，我們仍然致力於提高長期盈利能力。

Mike Polark, Wolfe Research LLC

麥克·波拉克（Mike Polark），Wolfe Research LLC

Hey, good afternoon, for the, probably for Rick, for the full year, the updated full year guidance $905 million at the point at the midpoint. What is the net inventory destocking headwind in that number? So IV comes down centers that start on V ramp those units back up a little bit, but it sounds like there's a net negative impact in this updated guidance and I'm wondering what that number is for the full year?

嘿，下午好，對於 Rick 來說，對於全年而言，更新後的全年指導價中位數為 9.05 億美元。這個數字中的淨庫存去庫存逆風是多少？因此，IV 下降，從 V 開始的中心將這些單位稍微增加一點，但這聽起來像是在這個更新的指南中產生了淨負面影響，我想知道全年的這個數字是多少？

Yeah, we have not factored that into our guidance at all. We have increased our inventory balances because we want to have Inspire V fully available and so.

是的，我們根本沒有將這一點納入我們的指導中。我們增加了庫存餘額，因為我們希望 Inspire V 能夠充分供應。

So destocking is factored into our updated back half guidance. We did not quantify it, and it would be very difficult to do so. Keep in mind there's also a timing element here. So depending on when that center transitions to Inspire V and destocks, therefore, their Inspire IV there could be some timing element, but that is factored into the outlook we gave for the back half of the year.

因此，去庫存已納入我們更新後的下半年指引中。我們沒有對其進行量化，而且這樣做會非常困難。請記住這裡也有一個時間因素。因此，取決於該中心何時過渡到 Inspire V 並減少庫存，因此，他們的 Inspire IV 可能會有一些時間因素，但這已計入我們對下半年的展望中。

Yeah, and that's what I was driving to. I can understand for 2H why there would be a headwind on the timing, but at some point, it'll work it's, I would think it works its way back to neutral. So if there's a number you wanted to call out for the full year, I'd be happy to receive it and where I'm going is that I'm trying to visualize the path back to higher than 12% to 13% growth in 2026 and one of the things that might not recur next year that that is impairing growth this year is this item and if there was a quantification of it, it'd be helpful to envision the re-acceleration.

是的，這就是我要去的地方。我可以理解為什麼 2H 在時間上會有阻力，但在某些時候，它會起作用，我認為它會回到中性。因此，如果您想說出全年的數字，我很樂意收到，而我的目標是，我試圖想像到 2026 年經濟增長率將回升至 12% 至 13% 以上的路徑，而明年可能不會再次出現、並且會損害今年經濟增長的因素之一就是這個，如果對其進行量化，那麼預見重新加速將會很有幫助。

Understood, we're not prepared to give that number at this time, but we'll take that under consideration as we provide guidance for next year.

可以理解，我們目前還沒有準備好給出這個數字，但我們會在為明年提供指導時考慮到這一點。

Okay, I appreciate that. If I can sneak one more in, I know this is a number you're not giving, but again, I think it could be helpful for kind of the new vision from here after the reset. So, would you be willing to share at June 30 how many centers were active in planting in the US?

好的，我很感激。如果我可以再偷偷加一個，我知道這是你不會給出的數字，但同樣，我認為這可能對重置後的新願景有所幫助。那麼，您願意分享截至 6 月 30 日美國有多少個中心正在積極進行種植活動嗎？

I know, the last number we got was 1,435 at 12:31, just be great to understand like how much center activation was really suppressed, in the first part of the year due to all the launch activities?

我知道，我們得到的最新數字是 12:31 時的 1,435，很想知道由於所有的發射活動，今年上半年中心激活到底受到了多少抑制？

It is slightly, let's just say it's a little over 1,500 right now, so we did still continue to open new centers in the early part of this year but not at the same rate that we did in 2024. Again with the Inspire V transition underway, we did not want new center openings to distract the field, but we did continue to add centers just not at the same rate and Mike, congratulations on your first born.

目前數量略多於 1,500 個，因此我們在今年年初仍繼續開設新的中心，但速度不如 2024 年那麼快。再次，隨著 Inspire V 過渡的進行，我們不希望新的中心開放分散該領域的注意力，但我們確實繼續增加中心，只是速度不一樣，邁克，祝賀你的第一個孩子出生。

Thank you.

謝謝。

Very good, thanks Mike. As always, I'm grateful to the growing team of dedicated inspired employees for their enthusiasm, hard work, and continued motivation to achieve successful and consistent patient outcomes. Teams’ commitment to patients remains unmatched and is the most important element to our success.

非常好，謝謝邁克。像往常一樣，我感謝不斷成長的團隊，感謝他們的熱情、辛勤工作和持續的動力，為患者帶來了成功和一致的治療效果。團隊對患者的承諾無與倫比，這是我們成功的最重要因素。

I wish to thank all of our employees as well as the healthcare teams for their continued efforts as we remain focused on further expanding our business in the US, in Europe, and in Asia. For all of you on the call, we appreciate your continued interest in and support of Inspire and look forward to providing you with further updates in the months ahead.

我要感謝我們所有的員工以及醫療團隊的持續努力，我們將繼續專注於進一步擴大我們在美國、歐洲和亞洲的業務。對於電話會議中的所有人，我們感謝您對 Inspire 的持續關注和支持，並期待在未來幾個月為您提供進一步的更新。

Thank you. This concludes today's conference call. You may now disconnect.

謝謝。今天的電話會議到此結束。您現在可以斷開連線。