Inogen, Inc

Welcome to Inogen's fourth quarter 2025 earnings conference call. At this time, all participants are in listen-only mode. Following management's prepared remarks, we will hold a Q&A session. To ask a question at that time, please press star, followed by the number one on your touchtone phone. If anyone has difficulty hearing the conference, please press star zero for operator assistance. As a reminder, this conference is being recorded today, February 24, 2026. I would now like to turn the call over to Lorna Williams, Senior Vice President, Investor Relations and Strategic Planning.

Thank you for participating in today's call. Joining me are President and CEO Kevin Smith and CFO Mike Bork. Earlier today, Inogen released financial results for the fourth quarter and full year 2025. The earnings release is available in the Investor Relations section of the company's website, along with a supplemental financial package. Please note we have also published a new investor presentation on our investor website, which contains forward-looking statements and long-term financial goals. As a result, the information presented today will include forward-looking statements, including, without limitation, statements about our growth prospects and strategy for 2026 and beyond, expectations related to our financial results for the first quarter and full year 2026, progress on our strategic initiatives including innovation, our expectations regarding the market for our products and our business, and supply and demand for our products in both the short-term and long-term. The forward-looking statements in this call are based on information currently available to us as of today's date, February 24th, 2026. These forward-looking statements are only predictions and involve risks and uncertainties that are set forth in more detail in our most recent periodic reports filed with the Security and Exchange Commission. Actual results may vary, and we disclaim any obligations to update these forward-looking statements except as may be required by law. During the call, we will also present certain financial information on a non-GAAP basis. Management believes that non-GAAP financial measures taken in conjunction with U.S. GAAP financial measures, provide useful information for both management and investors by excluding certain non-cash items and other expenses that are not indicative of Inogen's core operating results. Management uses non-GAAP measures internally to understand, manage, and evaluate our business and make operating decisions. Reconciliations between U.S. GAAP and non-GAAP results are presented in tables within our earnings relief. With that, I will turn the call over to Imogen's President and CEO, Kevin Smith.

Good afternoon, and thank you for joining our fourth quarter 2025 conference call. I want to use today's call to recap our 2025 success, outline progress on our strategic initiatives, and share why I am confident in delivering improving performance in 2026 and beyond. Our focus remains anchored on three priorities, driving top line growth, advancing profitability, and expanding our innovation pipeline. Let me start by discussing our recent results. We delivered approximately $82 million in total revenue in the fourth quarter and nearly $349 million for the full year, reflecting 4% year-over-year growth and meeting our goals to deliver mid-single-digit growth for 2025. Although we experienced a shift in the timing of a few orders from the fourth quarter into the first half of 2026, due in part to capital and budgeting constraints from certain customers, it was not a loss of customers, and our underlying market fundamentals remain encouraging. Unit volumes grew more than 20% year over year in the fourth quarter and for the full year, driven by continued demand for our products and the conversion from traditional portable oxygen tanks to POCs. Looking forward, We are well positioned to continue building on the progress made in 2025 to drive revenue growth and penetrate the substantial market opportunities in front of us. In the U.S., we're investing deliberately to educate both patients and providers on the economic and clinical benefits of antigen products. Our products are engineered to a fundamentally different standard than competing POC manufacturers and oxygen tanks. We believe our superior reliability, extended life cycles, and better patient outcomes justify our premium positioning today and going forward. We are also seeing positive early traction with our newer products in the U.S., including Voxy 5, Semiox, and our Aurora CPAP masks, which I will touch on shortly. Growth from international customers is also central to our strategy. Our international business delivered $32.5 million in Q4 revenue, representing 15% year-over-year growth. and a clear bright spot in our recent results. The team has executed well in deepening HME relationships and securing key international tenders, which is expanding our brand visibility and reinforcing our position as a trusted global partner in oxygen therapy. This performance underscores why international expansion remains central to our long-term growth strategy. The global COPD market is both large and underpenetrated. with long-term oxygen therapy remaining significantly underutilized in many regions. We see substantial opportunity to leverage our portfolio breadth, brand reputation, and local partnerships to reach more patients worldwide. As healthcare systems continue shifting care into the home, international markets represent a sustained multi-year growth driver for Imogen. Moving on, I'm proud to report meaningful progress on our second strategic priority, advancing profitability. Through operational excellence and disciplined cost management, we fundamentally strengthened our financial foundation. 2025 represented a turning point for Integers. We delivered positive adjusted EBITDA of 2.7 million for the full year. This is our first year of adjusted EBITDA profitability since 2021. This significant milestone demonstrates the operational leverage in our business model and validates the efficiency initiatives we've implemented over the past two years. This improvement extends across our P&L. Net loss for the full year 2025 was $23 million. Our adjusted net loss narrowed to $8 million, a 61% reduction from $20 million in 2024. Equally important is the strength of our balance sheet. We ended the year with $120.9 million in cash, cash equivalents, marketable securities, and restricted cash with zero debt outstanding. This financial flexibility is critical as it allows us to invest in the growth drivers outlined earlier, develop our innovation pipeline, and execute our international expansion strategy. In addition to investing back in the business, our strong balance sheet and cash flow enables us to pursue a share repurchase program. We announced today that our board of directors has authorized a $30 million share repurchase program And we intend to execute those buybacks over the course of 2026 and 2027 or until the maximum authorized dollar amount has been utilized. The share repurchase program reflects our confidence in our strategy, our flexibility to deploy capital, and our commitment to enhance shareholder value. The trajectory is clear. We've returned to adjusted EBITDA profitability, dramatically reduced our losses, and strengthened our cash positions. As we drive improved revenue performance in 2026, we expect to see meaningful operating leverage flow through to the bottom line. We're building a sustainably profitable business. Turning to our third strategic priority, expanding our innovation pipeline, where our team delivered transformative progress in 2025. For years, Inogen was synonymous with portable oxygen concentrators. While that remains our core strength, we've now established a multi-product portfolio spanning four distinct areas of respiratory care, oxygen therapy, sleep therapy, airway clearance, and digital health solutions. This diversification significantly expands our addressable market, de-risks our business model, and positions us to better serve patients across the full respiratory continuum. We have now initiated a limited market release in the United States of Semiox, our airway clearance device for effective bronchial decongestion. The methodical approach of a limited release allows us to build clinical evidence, establish reimbursement pathways, and refine our commercial strategy before a broader launch. We've already achieved an important milestone. Our U.S. trial to support reimbursement has kicked off and is actively enrolling its first patients. marking a critical step towards securing coverage and competing meaningfully in this market. We expect to gather enough data to provide CMS with a compelling case in the near future. Simultaneously, we initiated a clinical study in China. We are nearing completion of the trial, which we expect to support our commercial launch, anticipated in the second half of this year, pending NMPA regulatory clearance. Meanwhile, we are seeing strong commercial traction and enthusiastic customer feedback for Semiox in Europe, which reinforces our conviction in its clinical differentiation and potential to become a meaningful contributor to both our portfolio diversification and long-term growth. Semiox represents a clear and strategic expansion into an underserved area of respiratory care. Over time, we believe this will position us to offer a differentiated solution that enhances patient outcomes, deepens clinician engagement, and extends our leadership across the respiratory care spectrum. As a reminder, we see an incremental 500 million total addressable market opportunity in the U.S. airway clearance. Importantly, airway clearance devices carry attractive gross margins, making SEMIACS a key driver of our strategy to grow at or above market rates while simultaneously expanding profitability over time. Shifting to our other innovations, In oxygen therapy, we introduced VOXI5, our newest stationary oxygen concentrator, expanding our addressable market by an incremental 300 million. This launch is strategically important for several reasons. First, it addresses the significant gap in our portfolio. HME providers typically furnish new patients with both stationary and portable units. And until the launch, we can only compete for half of that equation. Voxy5 allows us to capture the full scope of patient requirements and deepen partnerships with our existing distribution network. Early market reception has been positive. More importantly, Voxy5 demonstrates our ability to extend our oxygen therapy leadership into adjacent product categories with high-quality, cost-effective solutions. Our most significant portfolio expansion in early 2026 is our entry into sleep therapy with Aurora CPAP masks. developed in partnership with UL. This marks a natural and meaningful extension beyond oxygen therapy into the large and growing sleep apnea market, which represents a 2.2 billion total addressable market growing at a high single digit rate. We believe this expansion will be a key driver in sustaining a return to double digit growth over time. The strategic rationale is compelling. There is a substantial patient overlap of 20 to 30% between COPD and obstructive sleep apnea, which means we can leverage our existing brand recognition, commercial infrastructure, and trusted patient relationships to reach an adjacent high-volume market. Aurora allows us to access new revenue through distribution channels and clinical partnerships we already serve. The Aurora portfolio includes three mask options. the F1 full face, N1 nasal cushion, and P1 nasal pillows, all designated to meet diverse patient needs and facial structures, and are FDA 510K cleared. Importantly, Aurora is supported by patient use data showing high satisfaction rates, which give us confidence in both clinical acceptance and commercial viability. This is a scalable, synergistic growth opportunity that meaningfully broadens our addressable markets and reinforces our position across the respiratory care continuum. Finally, we launched the Inogen patient portal to enhance our digital health capabilities and improve the patient experience. The self-service platform empowers patients to manage insurance details, order accessories, and access on-demand support tools seamlessly. As healthcare continues its digital transformation, tools like this strengthen patient engagement, reduce service costs, and differentiate our offerings. Collectively, these launches represent a fundamental transformation in what Inogen is and what markets we can address. We've moved from a single product company dependent on one market to a diversified respiratory care platform with multiple growth factors. From a market opportunity perspective, this transformation is substantial. Our estimated TAM has expanded from approximately 400 million in POC concentrators alone to a market growing low single digits to over $3 billion across our combined portfolio, with the broader opportunity growing high single digits. This six-fold expansion in the estimated TAM, coupled with accelerated growth rates, has the potential to change our financial trajectory in long-term value creation. Going forward, we are committed to launching at least one new product per year, and critically, we expect these new launches to be gross margin accretive, as we increasingly focus on higher margin, clinically differentiated solutions that address unmet needs across the respiratory care continuum. With that, I will pass the call over to Mike for an overview of our financial results. Mike?