Inogen (INGN) Q3 2026 Earnings Call: U.S. Growth Returns, $20M Cost Plan

Key Takeaways

• Revenue from continuing operations fell 2.4% year over year to $77.2 million, or 3.2% on a constant-currency basis, as weaker European demand offset higher portable oxygen concentrator volume.
• U.S. sales increased 3.8% to $42.2 million, marking the first year-over-year growth since Q4 2024. New products contributed approximately 250 basis points to growth.
• International sales declined 9% to $34.9 million, mainly due to softer capital spending and inventory management among several large European customers.
• Portable oxygen concentrator volume rose nearly 6% year over year to 51,900 units and increased 9.5% year to date.
• Inogen announced a cost-reduction program targeting approximately $20 million in annualized savings by the end of 2027, including the first $10 million before the end of 2026.
• Management expects Q4 2026 revenue of $65 million to $68 million and full-year revenue from continuing operations of $298 million to $301 million.

Key Financial Data

Business and Operating Performance

U.S. sales returned to growth as distributor demand improved and newer products gained traction. Management said distributors increased the number of new patients starting on portable oxygen concentrators. New products accounted for approximately 250 basis points of quarterly growth.

International performance weakened after strong demand in the first half of 2026. Management attributed the 9% decline mainly to reduced capital spending and inventory management by several large European customers. Inogen said it remains focused on expanding beyond Europe, particularly in Asia Pacific and Latin America.

Adjusted gross margin contracted by 170 basis points to 44.2%, primarily because of lower international sales, partially offset by improved manufacturing costs.

Inogen completed the divestiture of its U.S. oxygen rental business on November 2. Total estimated cash consideration is up to $24.8 million, which the company expects to receive in the first half of 2027. The business is classified as discontinued operations.

Management said portable oxygen remains Inogen’s foundation, while Aurora and Voxi are beginning to contribute growth in the adjacent sleep and airway-clearance markets.

Management Guidance

Management expects Q4 2026 revenue of $65 million to $68 million. The company anticipates accelerating U.S. growth will help offset continued international softness.

Full-year 2026 revenue from continuing operations is expected to range from $298 million to $301 million. Full-year adjusted net loss from continuing operations is projected at $7 million to $8 million.

The new cost program is expected to deliver approximately $20 million in annualized savings by the end of 2027 relative to annualized year-to-date operating expenses. Inogen expects to complete the first $10 million of savings before the end of 2026, primarily through SG&A reductions.

Together with the rental divestiture, management expects more than $40 million in annualized operating expense savings compared with the company’s run rate before the divestiture.

Risks and Watchpoints

• Management expects softer capital spending and inventory management among large European customers to continue into Q4 2026.
• Lower international sales pressured adjusted gross margin during the quarter.
• Operating cash flow was negative due to higher working capital.
• Delivering sustainable profitability depends on executing the cost program while preserving investment in new products, clinical evidence and commercial growth.
• The timing and amount of divestiture proceeds remain subject to the company’s estimate of up to $24.8 million, expected in the first half of 2027.

Full Earnings Call Transcript

Complete Earnings Call Transcript

Management Remarks

Operator

Welcome to Inogen's third quarter 2026 earnings conference call. [Operator Instructions] As a reminder, this conference is being recorded today, November 5, 2026. And now I would like to turn the call over to Lorna Williams, Senior Vice President of Investor Relations and Strategic Planning.

Lorna Williams

Thank you all for participating in today's call. Joining me are President and Chief Executive Officer Andy Reding and Chief Financial Officer Jason Richardson. Earlier today, Inogen released financial results for the third quarter of 2026. The earnings release is available in the Investor Relations section of the company's website, along with the supplemental financial package. During today's call, we will be discussing non-GAAP financial measures that we believe will provide useful information for investors. The information is not intended to be considered in isolation or as a substitute for GAAP financial information. Reconciliations for these non-GAAP measures to the most directly comparable GAAP measures are included in today's earnings release and supplemental financial package, each of which is available in the Investor Relations section of our website.

In addition, our discussion today will include forward-looking statements, including but not limited to expectations about our future financial and operating performance. We make these statements based on current expectations and reasonable assumptions. However, our actual results could differ due to risks and uncertainties. Please review our annual report and other SEC filings for a discussion of risk factors that could cause our actual results to differ materially from any forward-looking statements made today. Forward-looking statements made on today's call speak only as of today, and Inogen undertakes no obligation to update or revise these statements except as required by law. The company has not provided a reconciliation of forward-looking adjusted earnings metrics to the most directly comparable GAAP measures because certain items that impact net income are uncertain or outside the company's control and cannot be reasonably predicted without unreasonable effort. With that, I will turn the call over to Inogen's President and CEO, Andy Reding.

Unknown Speaker

Thank you, Lorna. Good afternoon, everyone, and thank you for being with us for Inogen's third quarter 2026 earnings call. I'm pleased to speak to you today as Inogen's new CEO. Before I turn to the results, I'd like to share why I joined Inogen and why I'm excited about what lies ahead. I came to Inogen as Chief Operating Officer in July, after more than 30 years in medical technology, including a number of years in respiratory care. The common thread throughout my career has been growth, building commercial organizations, bringing new products to market, and scaling businesses that make a difference in the lives of patients. Most recently, I spent more than 6 years as Chief Commercial Officer of Viant Medical, where I led commercial teams as the company grew to 25 facilities and hundreds of medical device customers, including many of the industry's largest. Before that, as Vice President and General Manager of Hillrom Respiratory Health, I was responsible for sales, marketing, R&D, and reimbursement.

These experiences shaped my approach to Inogen: identify the opportunities with the greatest potential, align the organization around clear priorities, and hold ourselves accountable for results. That is how I intend to lead. What drew me to Inogen was its important mission and significant untapped potential, supported by a market-leading core business, differentiated portfolio, deep customer relationships, and talented associates. Over the past several months, I've spent time with our employees, customers, and distributors. I've seen numerous unsolicited emails from patients who praise our products and the support they receive from our associates. I've spoken to physicians and healthcare teams who state that patients ask for our product by name.

And I've met with partners who appreciate the quality of our products. All of this feedback reinforces my conviction in the opportunity ahead. When I joined, my mandate was to improve commercial and operational performance, align priorities across the organization, and translate our strategy into efficient, measurable outcomes. The U.S. oxygen rental business quickly emerged as an opportunity to streamline our operating model, sharpen our commercial focus, and strengthen our financial profile. We've now completed that divestiture, an important step toward a simpler Inogen that can direct its resources to where we are strongest. Importantly, U.S. sales returned to year-over-year growth in the third quarter for the first time since the fourth quarter of 2024, driven by distributor demand and contributions from new products. We are on our way to creating a more focused organization and a stronger foundation.

As CEO, I will build on that foundation, improve performance across the business, and turn our priorities into consistent, sustainable results. With that, I want to turn to our results for the quarter at a high level. Jason will share more detail shortly, but the headlines are as follows. Total revenue was $77.2 million, excluding the rental business. U.S. sales were $42.2 million, increasing 3.8% year-over-year, driven by distributor demand and new product contribution of approximately 250 basis points of growth. International sales were $34.9 million, decreasing 9%, driven by softness in capital spending of a few large European customers. Overall POC unit volume increased nearly 6% year-over-year to 51,900 units and increased 9.5% year-to-date, reflecting continued demand for our core products.

Adjusted net loss from continuing operations was $0.4 million in the third quarter of 2026. We announced an additional $20 million cost savings program to accelerate profitability. I want to be clear, these results are not where they need to be and we're taking action to improve them. In the near term, our work is centered on growing our commercial team and improving performance in our 2 channels, advancing the products that can drive growth, and maintaining a rigorous focus on operating performance. Together, these priorities are intended to put Inogen on a stronger path towards sustainable growth and profitability. Over the next several months, I will continue spending time with customers, partners, and associates, as well as engaging closely with our shareholders as we refine our priorities and transform Inogen. I look forward to speaking with many of you in the coming weeks. With that, Jason will take you through the results and the drivers behind them in more detail. Jason.

Jason Richardson

Thank you, Andy, and congratulations on your new role. Good afternoon, everyone. Let me start with an update on the U.S. oxygen rental divestiture. The transaction closed on November 2 for a total estimated cash consideration of up to $24.8 million, which we expect to receive in the first half of 2027. The divestiture represents an important step in simplifying our business, improving cash capital efficiency, and allowing us to direct resources to the highest priority opportunities, while at the same time improving patient access to our market-leading POCs. We have classified the rental divestiture as discontinued operations for the third quarter, and we have recast the prior comparable periods in our 10-Q and earnings release. Unless noted otherwise, the results, non-GAAP measures, and guidance I will discuss reflect continuing operations. Now moving to third quarter results.

Total revenue in the third quarter of 2026 was $77.2 million, a decrease of 2.4% from $79.1 million in the prior year period, or a decrease of 3.2% on a constant currency basis. Strong POC unit volume increased nearly 6% and contributions from new products added approximately 250 basis points of growth, but were not enough to offset softer capital spending in our European markets. U.S. sales were $42.2 million, up 3.8%, reflecting distributor demand and new product contributions. We're encouraged to see U.S. sales return to growth as our new products gain traction and distributors increase the number of new patients starting on POCs. We see an attractive opportunity to build on this momentum with our recent channel changes, strengthening commercial operations, and strategically partnering with our distributors. International sales declined 9% in the third quarter, driven primarily by softer capital spending and inventory management among several large European customers. We expect the same trend to continue into the fourth quarter, following strong demand in the first half of the year.

Despite the near-term decline, Inogen remains a clear market leader in Europe with significant growth over the past 2 years. In addition, we are increasingly focused on leveraging our leadership position to expand our international opportunities beyond Europe, particularly across Asia Pacific and Latin America. Adjusted gross margin was 44.2% in the third quarter compared to 45.9% in the prior year period. Year-over-year change primarily reflects lower international sales, partially offset by improvements in manufacturing costs. Adjusted operating expenses for the third quarter of 2026 were $35.3 million, a decrease of 4.4% compared to the prior year period, and declining sequentially, reflecting cost management efforts. Adjusted R&D expense was $4.4 million, an increase of 13.3% compared with the prior year period, reflecting investment in clinical evidence generation and new product development to support long-term differentiation and growth. Adjusted SG&A expense was $30.9 million, a decrease of 6.5% compared with the prior year period, as investments supporting new products and our U.S. sales channel were more than offset by cost reductions and operating efficiencies.

In addition, we announced starting in the fourth quarter, we are implementing a cost reduction program to simplify our organization and align costs with our strategic priorities. We expect to generate approximately $20 million of annualized savings by the end of 2027 relative to annualized year-to-date operating expenses, with the first $10 million being completed before the end of 2026. Most savings will come from SG&A and will be incremental to expense reductions already included in discontinued operations. Together, this cost reduction program and the divestiture are expected to be more than $40 million in annualized operating expense savings when compared to our run rate prior to the divestiture. We are taking these actions collectively to create a leaner organization while preserving investments in areas with the greatest potential for growth.

Moving to earnings and cash flow, GAAP loss from continuing operations was $14.8 million in the third quarter compared to $3.6 million in the prior year period. During the quarter, we recorded a $10.6 million non-cash goodwill impairment, which is included in our GAAP results. The charge primarily reflects a decline in our stock price during the quarter that resulted in our market capitalization falling below our stockholders' equity. The impairment does not affect our cash position or liquidity. Adjusted net income from continuing operations was $0.4 million in the third quarter compared to adjusted net earnings of $1.2 million in the prior year period. Adjusted net loss per diluted share from continuing operations was $0.02 in the third quarter, compared with earnings of $0.04 in the prior year. We reported negative operating cash flow of $4.5 million in the third quarter of 2026 due to an increase in working capital. We ended the quarter with $97.7 million in cash, cash equivalents, marketable securities, and restricted cash with no debt outstanding. We have repurchased 1.8 million shares of common stock for $11.2 million year to date under the share repurchase program announced in the first quarter of 2026. In conjunction with the close of the rental divestiture, we increased our existing share repurchase authorization by $15 million, bringing the total authorization to $45 million.

We continue to believe our stock is undervalued relative to the fundamentals of the business and the long-term strategic opportunity. Our balance sheet provides us with the flexibility to return capital to shareholders while continuing to invest in growth, and we intend to remain disciplined in our approach to capital allocation. Now let's turn to our fourth quarter and full year 2026 outlook. We expect fourth quarter 2026 revenue to be in the range of $65 million to $68 million. We expect continued acceleration of U.S. growth to offset projected softness in international, as discussed previously. This results in full year 2026 revenue from continuing operations of $298 million to $301 million. Following the rental divestiture, we are changing our earnings metric away from adjusted EBITDA. We believe adjusted net earnings now provides a more meaningful measure of our profitability progress. We expect full year 2026 adjusted net loss from continuing operations to be in the range of $7 million to $8 million. With that, I will turn the call back to Andy for closing remarks.

Unknown Speaker

Thank you, Jason. Portable oxygen is the foundation of Inogen, and we are building on that leadership position. We're expanding into large, growing adjacent respiratory markets, including sleep and airway clearance, where Aurora and Voxi are starting to contribute growth. Over time, we believe this broader respiratory portfolio will open new paths to sustainable, profitable growth and shareholder value. Our task now is to convert these opportunities into stronger, more consistent financial results.

That will take urgency, focus, and disciplined execution. We will direct our resources to the opportunities with the greatest potential for growth and profitability. We will keep patients, providers, and partners at the center of everything we do. I'm excited to lead Inogen into this next chapter and am confident in the opportunity ahead. Operator, please open the call for questions.

Operator

[Operator Instructions]

Unknown Speaker

Actually, Joe, given that this is my first earnings call, we're not going to take live Q&A today. Instead, I look forward to connecting with folks in the coming weeks. But I will share that as we enter this next chapter as a more focused company with a clear set of priorities, strengthening that execution, returning the business to profitable growth, and improving sustained profitability, we have strong assets to build from, and our focus now is translating those strengths into better and more consistent results. I want to thank our employees for their hard work, dedication, and resilience. Their commitment to our patients, customers, and partners is what makes our progress possible. Together we're focused on building a stronger, more focused Inogen and creating sustainable value for our patients, providers, and shareholders. We look forward to updating you on our progress next quarter.

Thank you.

Operator

Thank you. This does conclude today's conference. You may disconnect your lines at this time, and we thank you for your participation.

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