Insmed (NASDAQ:INSM) said its BRINSUPRI launch is tracking ahead of expectations, with management pointing to payer access, patient support programs and steady new patient starts as key drivers behind early commercial momentum.
Speaking at an RBC Capital Markets fireside chat, Sara, Insmed’s chief financial officer, said the company delivered “a tremendous quarter” with 44% growth from the fourth quarter to the first quarter. She attributed the performance to years of operational preparation, including trial design, FDA interactions, disease-state awareness efforts and commercial execution.
Payer Access and Patient Support Cited as Key Launch Drivers
Insmed said payer approval has been strong early in the BRINSUPRI launch. Sara said more than 90% of payers are approving the product when patients go through specialty pharmacies.
She also said refill rates are exceeding industry averages, noting that a typical monthly prescription refill occurs around every 37 days. Insmed’s inLighten patient support program has also seen enrollment “north of 80%,” compared with what Sara described as an industry average below 50%.
“This launch could not be going better,” Sara said, adding that the payer community has been supportive of access to the product.
Company Addresses Discontinuation Questions
Sara directly addressed investor questions around BRINSUPRI discontinuation rates, saying Insmed “stubbed our toe with education” when comparing continuation metrics with statins. She said the company intended to use statins as a high benchmark but did not adequately explain the difference between clinical trial discontinuation rates and real-world experience.
She cited asthma and COPD as examples where clinical trial discontinuation can be in the high single digits to mid-teens, while real-world discontinuation after a year can be in the mid-40% range. In IPF and PPF, she said clinical trial discontinuation rates are in the mid-teens, while real-world rates are in the mid-30% range.
“There is absolutely no issue with discontinuation,” Sara said. She added that Insmed conducts monthly survey work with physicians and patients and has seen consistent feedback indicating positive patient experiences.
Sara said some physician education remains focused on ensuring patients stay on therapy long enough for BRINSUPRI to reach full effect. She said the drug takes about two to four weeks to reach full pharmacodynamic effect.
Organic Patient Growth and Market Expansion
Insmed said it is beginning to separate early “ready and waiting” patients from organic new patient growth. Sara said the company estimates true organic growth in the first quarter was around 6,300 patients and said sustaining that level of new patient additions would support the company’s path toward its $1 billion-plus revenue target.
On market size, Sara said claims data indicated about 500,000 diagnosed U.S. patients with non-cystic fibrosis bronchiectasis, with roughly half having two or more exacerbations. She said that data is about three years old and that the total addressable market may grow as awareness increases and more patients receive high-resolution CT scans, which she described as the definitive diagnostic test.
Sara also said Insmed sees potential upside from patients currently diagnosed with COPD or asthma who may also have underdiagnosed bronchiectasis. She referenced an ATS-sponsored retrospective real-world analysis across seven institutions and a recently launched awareness campaign involving Ty Pennington, whose mother has bronchiectasis.
“It’s not going to be a light switch,” Sara said, adding that Insmed believes it may begin seeing additional patients enter the top of the funnel next year.
Japan and ARIKAYCE Expansion
Asked about international strategy, Sara said Insmed sees Japan as a meaningful opportunity for BRINSUPRI, citing the company’s prior commercial success there with ARIKAYCE. However, she said investors should not expect revenue contribution from Japan in 2026, with potential revenue instead coming in 2027.
Sara also discussed ARIKAYCE following positive Phase 3 ENCORE data. She said Insmed is working with regulatory authorities in the U.S. and Japan on a potential label expansion. At the six-month mark, she said 80% of patients in ENCORE culture converted, compared with 30% in the refractory trial. She also said the ENCORE study showed a lower discontinuation rate, which she linked to treating patients earlier in the disease course.
Insmed has said ARIKAYCE could generate more than $1 billion in peak sales. Sara said the company still needs to assess factors such as treatment duration in the earlier-line setting and potential inclusion in international treatment guidelines.
TPIP Program Advances
Sara described TPIP as “probably the most underlooked program” at Insmed, with four meaningful indications either in Phase 3 or moving toward Phase 3. She said Phase 3 studies are underway in PH-ILD and PAH, while studies in PPF and IPF are expected to begin in the latter part of this year or early next year.
She said Insmed expects a one-year open-label extension readout from the PAH program in the third quarter, with the company looking for sustained signals across proBNP, functional class and safety.
About Insmed (NASDAQ:INSM)
Insmed Incorporated is a biopharmaceutical company focused on developing and commercializing therapies for patients with rare and serious diseases, with a particular emphasis on difficult-to-treat pulmonary infections. Headquartered in Bridgewater, New Jersey, the company concentrates its research and development efforts on targeted drug delivery technologies and novel formulations intended to improve clinical outcomes for patients who have limited treatment options.
The company’s principal marketed product is ARIKAYCE (amikacin liposome inhalation suspension), an inhaled liposomal formulation of the antibiotic amikacin that is approved by the U.S.
