Inogen Q4 Earnings Call Highlights

25 Feb 2026, 05:08 by Mitch Edgeman · The Markets Daily

Inogen (NASDAQ:INGN) executives highlighted improving profitability, international momentum, and a broadened product portfolio during the company’s fourth-quarter 2025 earnings call held February 24, 2026. Management also introduced 2026 revenue guidance and disclosed a new $30 million share repurchase authorization to be executed across 2026 and 2027.

Revenue growth led by international; U.S. sales pressured by order timing and mix

Inogen reported fourth-quarter revenue of $81.7 million, up 2% year-over-year, and full-year 2025 revenue of $348.7 million, up 4% year-over-year. CEO Kevin Smith said the company met its goal of “mid-single digit growth” for 2025, while noting that some large customer orders shifted from the fourth quarter into the first half of 2026 due to customer capital and budget timing. CFO Mike Bourque emphasized the shift was not due to lost customers.

Smith said unit volumes grew more than 20% year-over-year in the fourth quarter and for the full year, citing continued demand and ongoing conversion from portable oxygen tanks to portable oxygen concentrators (POCs).

Inogen also updated its revenue reporting structure to three categories: U.S. sales, International sales, and U.S. rentals. Bourque said the change is intended to better reflect the company’s evolution into a diversified respiratory care platform spanning multiple disease states, noting that “not all products are sold in all channels.”

U.S. sales: $36.1 million in Q4, down 5.1% from $38.0 million a year earlier, which management attributed in part to delayed large customer orders and ongoing channel dynamics.
International business: Smith said international revenue was $32.5 million in Q4, up 15% year-over-year, calling it a “bright spot.” Bourque added full-year growth was driven primarily by higher international POC sales growth of 18.4%.
U.S. rentals: rental revenue was $13.1 million in Q4, down 4.5% year-over-year, driven by a higher mix of lower private payer reimbursement rates and fewer patients on service.

During Q&A, management discussed broader market changes affecting channel mix. Smith said Inogen estimates 59% of new long-term oxygen therapy patients now start with a POC (provided through HMEs or manufacturers), compared with lower adoption in earlier years. Management expects this trend to drive higher growth in the business-to-business channel, while creating headwinds in other areas such as direct-to-consumer and rentals.

Profitability turnaround: positive adjusted EBITDA and reduced losses

Management described 2025 as a turning point for profitability. Inogen delivered positive adjusted EBITDA of $2.7 million for the full year, its first year of adjusted EBITDA profitability since 2021. Fourth-quarter adjusted EBITDA was negative $1.7 million, improving from negative $3.6 million in the prior-year quarter.

Inogen posted a Q4 net loss of $7.1 million, a 27% improvement year-over-year. Adjusted net loss in Q4 was $4.0 million, compared with an adjusted net loss of $5.8 million in Q4 2024. Loss per diluted share was -$0.26, while adjusted loss per diluted share was -$0.15.

For the full year, Inogen reported a GAAP net loss of $22.7 million, improving from $35.9 million in 2024. Adjusted net loss was $8.0 million, improving from $20.4 million in 2024. Smith stated adjusted net loss narrowed 61% year-over-year.

Gross margin was 43.1% in Q4, down 220 basis points year-over-year, which Bourque attributed primarily to channel mix, with a higher proportion of POC sales shifting to business customers. Full-year gross margin was 44.2%, down 190 basis points year-over-year.

Balance sheet strength and a new $30 million buyback authorization

Inogen ended 2025 with $120.9 million in cash equivalents, marketable securities, and restricted cash and no debt outstanding. Bourque said cash increased $3.4 million versus year-end 2024.

Smith said the balance sheet provides flexibility to invest in growth initiatives while also returning capital to shareholders. The company announced its board authorized a $30 million share repurchase program, with buybacks planned over 2026 and 2027 or until the authorized amount is used.

Innovation and diversification: Simeox, Voxi 5, Aurora CPAP masks, and a patient portal

Smith emphasized that Inogen is expanding beyond its historical focus on POCs into a multi-product portfolio across oxygen therapy, sleep therapy, airway clearance, and digital health solutions. He said the company’s estimated total addressable market expanded from about $400 million for POCs to over $3 billion across its combined portfolio.

Key product updates included:

Simeox airway clearance: Inogen began a limited U.S. market release and said a U.S. trial to support reimbursement has started and is actively enrolling. Smith said the company expects to gather enough data to present a reimbursement case to CMS “in the near future.” In China, Inogen initiated a clinical study and said it is nearing completion and could support a commercial launch in the second half of the year, pending NMPA clearance. Management also cited strong commercial traction in Europe. Bourque said Simeox generated over $6 million in global revenue in 2025. In Q&A, management said revenue was primarily outside the U.S. and noted one contribution was an Eastern European tender in the first half of the year for disposable sets.
Voxi 5 stationary oxygen concentrator: Smith said the product expands the addressable market by an incremental $300 million and addresses a portfolio gap for providers that furnish both stationary and portable units. Bourque said Voxi showed strong sequential growth from Q3 and early commercial traction.
Aurora CPAP masks: Inogen entered sleep therapy with Aurora masks developed with UL. Smith described the U.S. CPAP mask market as a $2.2 billion total addressable market growing at a high single-digit rate and noted a 20%–30% overlap between COPD and obstructive sleep apnea patients. Management said the portfolio includes three FDA 510(k) cleared mask options (F1 full face, N1 nasal cushion, and P1 nasal pillows) and cited patient satisfaction data as supportive of adoption. In Q&A, management said mask revenue contribution is expected to be limited early in 2026 and more “back-end loaded,” with go-to-market primarily through the B2B channel.
Inogen Patient Portal: Smith said the company launched a self-service portal designed to improve the patient experience by enabling insurance management, accessory ordering, and on-demand support tools, while also reducing service costs over time.

2026 outlook: mid-single-digit revenue growth and continued positive adjusted EBITDA

Inogen initiated full-year 2026 revenue guidance of $366 million to $373 million, which Bourque said represents approximately 6% year-over-year growth at the midpoint. Management said it expects stronger growth in the back half of 2026 than the first half, reflecting new product contributions and expected POC demand.

For the first quarter of 2026, Inogen expects revenue to be in line with Q1 2025, driven by POC unit growth offset by channel mix and declining rental revenue tied to reimbursement mix and fewer customers on service.

On profitability, Bourque said the company expects to deliver positive adjusted EBITDA again in 2026, while also planning additional investments, including increased R&D spending to support diversification efforts. During Q&A, he noted that quarterly cadence typically follows historical seasonality, with Q2 and Q3 often stronger than Q1 and Q4.

Smith also shared long-term targets, stating the company sees a path to high single-digit revenue growth and 10% or better adjusted EBITDA over the next three to five years, alongside a goal of launching at least one new product 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.