INSM · Insmed Incorporated

Biotechnology · mkt cap $22.5B · calls: Q1 FY2026 vs Q4 FY2025

26.0 conviction · conf-adj 26

conf –

enthusiasm:15.0 · trend:8 · quantifies:0 · impact:0 · under_radar:0 · credibility:0 · business_impact:4 · disruption:0 · commitment:-4 · confirmation:3

Enthusiasm latest 5 / prev 2 (rising)

Insmed's AI story is narrow and commercial, not R&D: management ties AI to finding undiagnosed bronchiectasis (especially among COPD/asthma patients) to expand the BRINSUPRI funnel via retrospective CT review and EHR/patient-record audits. Enthusiasm rose from implicit data/CT initiatives in Q4 FY2025 to explicit AI language in Q1 FY2026, but only after an analyst prompt—no dollars, timelines, or patient/revenue lift attributable to AI were quantified, so credibility rests on intent and third-party ATS EHR work rather than demonstrated impact.

PAST (realized)

Q4 FY2025 — William Lewis: "This effort will be supported by evidence generation in several large respiratory centers who intend to use retrospective data to identify bronchiectasis in patients diagnosed with COPD and asthma who are still exacerbating."
Q4 FY2025 — William Lewis: "So there is advantage in going back and looking at existing CT scans and doing a definitive assessment of whether there's bronchiectasis in evidence."
Q1 FY2026 — Graig Suvannavejh (analyst reference): "past comments that you've made around how maybe AI can help with increasing diagnosing of patients" (no verbatim prior-call AI quote appears in the Q4 FY2025 transcript provided)

CURRENT (now)

Q1 FY2026 — William Lewis: "This ATS initiative will analyze electronic health records across 7 large academic medical systems to identify potential patterns of misdiagnosis."
Q1 FY2026 — William Lewis: "Based on these insights, the ATS initiative intends to pilot scalable solutions such as electronic health record-based prompts that automatically flag potential signs of bronchiectasis..."
Q1 FY2026 — William Lewis: "With regard to AI, we are looking at a number of different ways to bring that to bear, most prominently in the area of examining historic CT scans and also doing sort of audits of patients -- patient records..."

FORWARD (guidance)

Q1 FY2026 — William Lewis: "...to try to understand what the diagnosis rate and identification of these patients might be able to be in a world where we bring that to bear in a more broad basis."
Q1 FY2026 — William Lewis: "I think you could expect us to be talking about a lot of different programs running in parallel to try to raise awareness and identify the appropriate patient and help with the diagnosis."
Q1 FY2026 — William Lewis: "And AI certainly is going to play an important part in that, not just for bronchiectasis, but generally. Hospitals are looking to bring that into the radiography field to help them get to more accurate and timely diagnosis."

TRACK RECORD — PROMISE vs DELIVERY

—/100 (no quantified promises) no-quantified-promises 6 calls reviewed

Across six calls (Q4 FY2024–Q1 FY2026) Insmed mentioned an AI-based protein de-immunization platform only once (Q2 FY2025), with no numeric target or dated milestone; general pipeline goals (e.g., 1–2 INDs/year) were not framed as AI deliverables, so AI promise credibility is not scoreable.

PRICED-IN (REFINED)

HIGH (already in)

Est. revisions rising · Fwd P/E -17.7 · EV/Sales 27.6x

AI claim maps to Reportable Segment, UNITED STATES, Non-US

Analyst sentiment is migrating up (strongBuy rose from 2 to 5 since Jan 2026, holds fell to zero) while forward consensus already embeds steep growth (revenue ~$582M to ~$1.7B to ~$2.8B by 2027). EV/Sales ~27.6x and P/S ~27.4x are rich versus typical commercial biotech, so much pipeline and scaling upside is in the multiple despite negative forward EPS. Any AI-driven commercial or R&D efficiency would most plausibly affect the single Reportable Segment line, dominated by U.S. revenue. Rising revisions plus stretched valuation imply AI upside is largely already reflected.

COVERAGE — ENTHUSIASM TRAJECTORY + CATALYSTS

2Q4 FY20242Q1 FY20255Q2 FY20252Q3 FY20252Q4 FY20252Q1 FY2026

AI enthusiasm across 6 calls — trend → flat

One call cited NH AI de-immunization platform; otherwise no AI/ML driver narrative.

BUSINESS IMPACT - QUALITATIVE MATERIALITY

5/10 qualitative impact moderate medium-term · soft evidence

Where AI matters: commercial diagnosis and patient identification for bronchiectasis

AI is tied to a real revenue lever—finding undiagnosed bronchiectasis via retrospective CT and EHR audits to grow the BRINSUPRI funnel—but management only elaborated after an analyst prompt, with ATS pilots and no quantified patients, revenue, or timelines.

Caveats: No dollars, patient counts, or revenue attribution despite rising AI rhetoric; Core upside depends on hospital/system adoption of tools Insmed does not control; Single fleeting R&D AI mention (de-immunization) with no milestones or proof of pipeline impact; Competitors could use similar AI for patient finding or faster discovery, but that is indirect versus Insmed's near-term disclosed use case

AI DISRUPTION / CANNIBALIZATION RISK tailwind · 1/10

Insmed earns from patent-protected specialty drugs, not billable labor or content; AI-assisted radiography and record review mainly expand diagnosis and demand rather than commoditizing the molecule or pricing power.

OPTIONS / MARKET STRUCTURE

option liquidity: good

ATM IV

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TYPICAL BID-ASK

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OPEN INTEREST

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proxy inputs — dollar-ADV $333M · beta 0.894 · px $103.73

source: proxy (no options chain on FMP)
FMP /stable/ exposes no options-chain endpoint on this key, so ATM IV, bid-ask spread and open interest are unavailable. Liquidity below is a PROXY from dollar-ADV, beta and price level (a stand-in for option depth), not measured option-market data.

CONFIRMATION — INSIDERS · 13F · LANGUAGE

Mixed — insiders selling, institutions adding, management language 1/10 hedged.

INSIDERS selling 46 open-market sell(s) vs 0 buy(s) — net distribution

INSTITUTIONS (13F) adding as of 2026-03-31: 98 new / 111 closed positions; 394 increased / 206 reduced; institutional ownership +0.89pp; -26 net 13F holders

MGMT LANGUAGE 1/10 hedged Provided Q1 FY2026 excerpt has no AI/ML/automation statements for Insmed's business.

VERBATIM AI QUOTES

“This ATS initiative will analyze electronic health records across 7 large academic medical systems to identify potential patterns of misdiagnosis. Based on these insights, the ATS initiative intends to pilot scalable solutions such as electronic health record-based prompts that automatically flag potential signs of bronchiectasis and continuing medical education modules for physicians to help improve the detection of bronchiectasis.”
— William Lewis, Q1 FY2026

“With regard to AI, we are looking at a number of different ways to bring that to bear, most prominently in the area of examining historic CT scans and also doing sort of audits of patients -- patient records to try to understand what the diagnosis rate and identification of these patients might be able to be in a world where we bring that to bear in a more broad basis.”
— William Lewis, Q1 FY2026

“I think you could expect us to be talking about a lot of different programs running in parallel to try to raise awareness and identify the appropriate patient and help with the diagnosis.”
— William Lewis, Q1 FY2026

“And AI certainly is going to play an important part in that, not just for bronchiectasis, but generally. Hospitals are looking to bring that into the radiography field to help them get to more accurate and timely diagnosis.”
— William Lewis, Q1 FY2026

“We are currently working on a number of different programs to advance the exploration and quantification of these patients. This effort will be supported by evidence generation in several large respiratory centers who intend to use retrospective data to identify bronchiectasis in patients diagnosed with COPD and asthma who are still exacerbating.”
— William Lewis, Q4 FY2025

“So there is advantage in going back and looking at existing CT scans and doing a definitive assessment of whether there's bronchiectasis in evidence.”
— William Lewis, Q4 FY2025

ANALYST QUESTIONS ON AI

Q (Q1 FY2026, Graig Suvannavejh (Mizuho)): I know that the ATS put out a statement just on new efforts to improve diagnosing of patients. I was wondering if you could comment just on how much of a potential springboard ATS might be, particularly from a prescribing perspective. And if you could also remind us of past comments that you've made around how maybe AI can help with increasing diagnosing of patients?
A: With regard to AI, we are looking at a number of different ways to bring that to bear, most prominently in the area of examining historic CT scans and also doing sort of audits of patients -- patient records to try to understand what the diagnosis rate and identification of these patients might be able to be in a world where we bring that to bear in a more broad basis. I think you could expect us to be talking about a lot of different programs running in parallel to try to raise awareness and identify the appropriate patient and help with the diagnosis. And AI certainly is going to play an important part in that, not just for bronchiectasis, but generally. Hospitals are looking to bring that into the radiography field to help them get to more accurate and timely diagnosis.