Inogen Q1 Earnings Call Highlights

Key Points

• Inogen reported Q1 revenue of $85.1 million (+3.4% YoY), with strong international growth (+18% to $37.7M) offsetting a 5% decline in U.S. sales as the market shifts toward portable oxygen concentrators (POCs).
• Adjusted gross margin edged up to 44.7%, but the company posted a GAAP net loss of $8.3 million and adjusted EBITDA of negative $1.4M, driven by planned incremental R&D and commercial investments.
• Product and capital priorities include encouraging early results from the Aurora CPAP launch, the start of the Simeox reimbursement trial targeting a ~$500M U.S. opportunity, and a strong balance sheet with $111.5M cash, zero debt, initiated buybacks, and reaffirmed 2026 revenue guidance of $366–$373M (~6% growth).

Inogen NASDAQ: INGN reported first-quarter 2026 revenue of $85.1 million, up 3.4% year over year and “ahead of our expectations,” President and CEO Kevin Smith said on the company’s earnings call. Management pointed to continued strength internationally, partially offset by ongoing pressure in U.S. direct-to-consumer and rental channels as the U.S. long-term oxygen therapy market continues shifting toward portable oxygen concentrators (POCs).

Leadership changes and governance update

Smith opened the call by highlighting several leadership and governance updates. Jason Richardson joined during the quarter as chief financial officer, bringing more than 25 years of experience, “mostly in large, complex global medical device companies,” Smith said. Inogen also appointed Dominic Hulton as chief marketing officer, reporting to Smith, as the company expands across oxygen therapy, sleep, airway clearance, and digital health.

In addition, Smith said Vafa Jamali will join Inogen’s board of directors effective June 5, 2026. The board is also asking shareholders to approve declassifying board members, beginning with the 2027 annual meeting, which Smith described as an effort to align governance with long-term shareholder interests.

Quarterly results: international growth offsets U.S. declines

Smith said first-quarter unit volumes grew 14% year over year, while international revenue was a “clear standout.” International sales rose 18% to $37.7 million, which management attributed to commercial execution, deeper relationships with home medical equipment (HME) partners, international tenders, and expansion into new geographies including Eastern Europe, Latin America, and Asia Pacific.

U.S. sales declined 5% to $34.7 million. Smith said Inogen estimates about 60% of new long-term oxygen therapy patients in the U.S. now start on a POC, up from under 40% a few years ago. He said that shift benefits the company’s business-to-business channel but creates a headwind for direct-to-consumer and rentals, where patients previously sought an alternative to oxygen tanks supplied by HMEs.

CFO Jason Richardson added that total sales revenue increased 5.7% in the quarter, driven primarily by international POCs and favorable foreign exchange rates, which “more than offset lower U.S. sales.” He said foreign exchange provided a positive 460 basis point impact on total revenue.

U.S. rentals were $12.7 million, down 8% year over year. Richardson said both U.S. direct sale businesses were impacted by the continued channel mix shift and reduced patient counts discussed by Smith.

Margins, expenses, and profitability

Richardson said adjusted gross margin was 44.7%, up 30 basis points from 44.4% a year ago, “primarily the result of cost improvements.” He called gross margin expansion critical to the company’s profitability goals.

Adjusted operating expenses were $43.0 million, up 5.1% from $40.9 million in the prior-year period. Adjusted R&D increased to $4.1 million, up $0.9 million year over year, as Inogen invests in clinical evidence generation and new product development. Adjusted SG&A rose 3.1% to $39.0 million, driven by commercial investments tied to new product launches and the timing of advertising spend.

On a GAAP basis, Inogen reported a net loss of $8.3 million versus a GAAP net loss of $6.2 million a year earlier. Adjusted net loss was $4.0 million compared to an adjusted net loss of $2.9 million, and adjusted EBITDA was negative $1.4 million versus approximately break-even in the prior-year quarter. Richardson attributed the year-over-year increase in losses to the timing of planned incremental R&D and commercial investments.

Product pipeline and launches: Aurora, Rove 6 in Brazil, and Simeox trial

Smith emphasized Inogen’s portfolio expansion beyond POCs, saying the company has moved from a POC-focused addressable market of roughly $400 million to operating across oxygen therapy, sleep therapy, airway clearance, and digital health with an estimated combined total addressable market of more than $3.4 billion.

Key updates discussed on the call included:

• Aurora CPAP mask family launch (U.S.): Smith said early results are “highly encouraging.” He cited a 90-day in-home evaluation with experienced CPAP users in which participants—who were already satisfied with their existing masks—preferred the Aurora mask, particularly the full-face version. Smith said Inogen plans to present full results at SLEEP 2026 in Baltimore in June. He characterized Aurora revenue as likely “more back-half weighted” as adoption builds. In the Q&A, Smith said the launch is meeting and exceeding expectations, with “extremely high reorder rates” among customers trialing the product.
• Rove 6 launch in Brazil: Smith said Inogen entered Brazil as a premium brand and is working with local HME partners familiar with positioning Inogen products. He noted Inogen has not quantified the size of the Brazilian COPD market and said market development will take time as access expands. He added that there is an existing base of both tanks and POCs in Brazil and that Inogen is not the first entrant.
• Simeox reimbursement trial milestone: Smith said patient enrollment began in “IMPACTs 200,” which he described as Inogen’s first reimbursement trial for Simeox and a step toward building evidence for CMS, private payers, and health economic arguments. He estimated the U.S. opportunity for Simeox at a $500 million total addressable market in non-cystic fibrosis bronchiectasis and highlighted a disposable component that could create recurring revenue.

Smith also reiterated the company’s view that its Rove 4 and Rove 6 POCs have an eight-year useful life compared with a five-year useful life for other POCs, alongside “best-in-class serviceability” and a “growing body of outcomes data,” which he said supports premium positioning amid pricing pressures.

Cash position, buyback activity, and 2026 guidance

Richardson said Inogen ended the quarter with $111.5 million in cash equivalents, marketable securities, and restricted cash, and “0 debt outstanding.” He also said the company began executing its stock repurchase program, purchasing about 298,000 shares for nearly $1.9 million. Richardson said management believes the stock is undervalued relative to the company’s fundamentals and strategic opportunity, and that Inogen intends to return capital while also investing in growth “thoughtfully over the course of the program.”

Looking ahead, Richardson said the company expects the second and third quarters to be its strongest for profitability, consistent with historical seasonality, and reiterated expectations for adjusted EBITDA growth for the full year.

Inogen reaffirmed full-year 2026 revenue guidance of $366 million to $373 million, representing roughly 6% growth at the midpoint. Richardson said guidance reflects continued trends in the core POC business, growing international contribution, and scaling of Aurora and Voxi 5 “particularly in the second half,” partially offset by mix pressures in direct-to-consumer and rentals. For the second quarter, the company expects reported revenue of $94 million to $97 million, implying approximately 3.5% growth at the midpoint versus the second quarter of 2025.

During the Q&A, Smith said the company is seeing early “pull-through and attachment rates” with HMEs bundling Voxi 5 alongside POCs and described the feedback as “very good.” He also said pressure in the U.S. rental channel is expected to continue, driven by the shift from tanks to POCs.

Management also addressed macro questions around elevated oil prices. Smith said the company has not seen an outsized impact so far, though logistics surcharges could increase if higher prices persist. He noted Inogen has supply agreements in place that protect it in the near term from resin-related material impacts. Smith also said Inogen does have business in the Middle East, though the majority of international revenue comes from Europe, and said there has not been a negative impact to date. Richardson added that, based on scenario planning, the company expects it would be able to offset impacts at current oil price levels for 2026.

In closing remarks, Smith said Inogen is “executing against the plan,” with an emphasis on innovation and a goal of at least one new product launch per year.

About Inogen NASDAQ: INGN

Inogen, Inc NASDAQ: INGN is a medical device company specializing in the development, manufacture and marketing of innovative oxygen therapy solutions. The company's core focus is on portable oxygen concentrators (POCs) designed to support patients with chronic respiratory conditions such as chronic obstructive pulmonary disease (COPD). Inogen's offerings aim to provide users with mobility and independence by reducing reliance on traditional compressed-gas cylinders and enabling oxygen therapy on the go.

Inogen's flagship product line, including the Inogen One family of portable oxygen concentrators, leverages proprietary flow technology to deliver continuous and pulse-dose oxygen.

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