Client Login

News, Sustainable Investment Profiles

New Hope for a Better Rest

As a rule, companies arise in pursuit of opportunities in the marketplace. These opportunities can take many forms: new ideas for entertainment or consumption; new efficiencies to outpace the competition; new marketing techniques to seed demand. For some companies, however, opportunity takes the form of a very real, very specific problem to be solved.

Obstructive sleep apnea (OSA) is a disorder characterized by recurrent blockages of the upper airway during sleep—more than 30 per hour in severe cases—resulting in negatively impacted sleep quality and blood oxygen levels. According to the American Medical Association, approximately 30 million people in the United States suffer from the condition, although only 6 million have been diagnosed with it. Those who suffer from OSA may experience daytime fatigue, forgetfulness, irritability, and other symptoms, which in turn can cause secondary effects like higher rates of car accidents. Equally concerning, OSA increases the risk of hypertension (high blood pressure), heart attack, stroke and atrial fibrillation.

The most common treatment for obstructive sleep apnea is known as CPAP (continuous positive airway pressure), a system designed to prevent airway blockages by delivering air pressure through a facemask connected by a plastic hose to a machine. But as many as 40-50% of patients struggle to tolerate CPAP treatment, due to the cumbersome and restrictive aspect of the equipment.

Enter Inspire Medical. The company was spun off from Medtronic in 2007, and became publicly traded in 2018. In 2009, Inspire completed the first human implant of its Inspire II System, and in 2014, received FDA approval for the implantable neurostimulation therapy. Essentially, Inspire’s treatment involves two tiny implants, which function together to sense the beginnings of breathing difficulty and stimulate the hypoglossal nerve, in turn forcing the subject’s tongue forward and opening the airway—all without awakening. In a 2014 clinical trial, Inspire’s device was found to decrease the median number of breathing interruptions “from 29.3 events per hour to 9 events per hour” (fewer than 10 interruptions per hour is considered within the normal range), and to significantly improve quality of life as a result.

Eight years later, Inspire reports having treated more than 24,000 patients across the US and Europe, while also reducing the cost of its treatment by more than 30% since FDA approval. Still, at approximately $30,000 (including outpatient surgery), Inspire has had significant work to do to ensure its customers are able to cover the cost of treatment. Most insurers, including Medicare and Veterans Affairs (VA), will now cover the device, although patients typically need to demonstrate that CPAP treatment is not working for them before all costs will be covered. For Inspire Medical, evangelizing the device among doctors and patients continues to be the main focus.

Inspire Medical does not publish a sustainability report. The company has no disclosure or identifiable goals around carbon emissions, workforce diversity, supply chain transparency, or other issues of the day. For a four-year-old public company with fewer than 500 employees, such gaps are not unusual. And in a way, the gaps serve to clarify the company’s singular focus. For anyone seeking to understand Inspire Medical’s social benefit, the answer is resting in plain sight.

Extensive research for this article was contributed by Lucie Moore.