Introduction

Wolfpack is short Inspire Medical Systems (INSP). The annual market opportunity promoted by its management is so preposterous that it must be disingenuous, leaving investors holding the bag of this terminally unprofitable business. It turns out that Inspire can barely even give their device away: It has been available to ~9 million enrolled U.S. Veterans for free since 2014, but data from the VA hospital system show only 387 total patients have opted for Inspire’s surgery. Our research shows Inspire can’t even sell 20,000 units in a year, much less the 500,000 units claimed by management. Inspire’s surgically implanted device comes with a long list of onerous lifestyle restrictions and insufferable side-effects that permanently haunt past patients and drive off potential patients. Insiders have pocketed more than $340 million from stock sales, nearly 3x the company’s total revenue since the 2018 IPO. Inspire is only good at selling two things: this ridiculous growth story and their stock.

Summary

Inspire’s device is far too invasive and restrictive to ever gain traction in a market with numerous non-invasive alternatives.

Inspire promotes itself as a minimally-invasive and more convenient solution for Obstructive Sleep Apnea (“OSA”). We found that Inspire’s surgery is anything but minimally-invasive. It carries serious risks such as laceration of the jugular, paralysis and leaves large visible scars on the patient’s neck and chest. Further, Inspire’s device requires additional surgeries to replace the battery every 7-10 years for the rest of your life, which is a shit sandwich in-and-of itself.

In the years between these surgeries, Inspire’s device can cause serious injury if the patient has a pacemaker, undergoes an MRI, or requires defibrillation during a cardiac event.[1] All Inspire patients have to live with a nightmarish list of restrictions that make Inspire’s “therapy” as inconvenient as we could possibly imagine. They must worry about every day activities like answering their cell phone, using a computer or power tools, going to the store and going through airport security because Inspire’s device can be damaged by any one of these activities, requiring yet another surgery.

Would you be willing to take on all of these risks and restrictions to “ease the symptoms” of a condition that has numerous non-surgical treatment options?