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InspireMD(NSPR) - 2024 Q4 - Annual Report

Revenue and Profitability - For the twelve months ended December 31, 2024, revenue increased by 804,000,or13.0804,000, or 13.0%, to 7,009,000 from 6,205,000in2023,drivenbygrowthinexistingandnewmarkets[323].Grossprofitdecreasedby16.76,205,000 in 2023, driven by growth in existing and new markets[323]. - Gross profit decreased by 16.7%, or 301,000, to 1,506,000,withgrossmargindroppingto21.51,506,000, with gross margin dropping to 21.5% from 29.1% in 2023, primarily due to a 1,105,000 increase in cost of goods sold[325]. - Net loss rose by 12,089,000,or60.712,089,000, or 60.7%, to 32,005,000 for the twelve months ended December 31, 2024, driven mainly by a 12,059,000increaseinoperatingexpenses[332].ExpensesResearchanddevelopmentexpensesincreasedby70.812,059,000 increase in operating expenses[332]. Expenses - Research and development expenses increased by 70.8%, or 5,653,000, to 13,634,000,mainlyduetoincreasedcompensationandcostsassociatedwiththedevelopmentofSwitchGuardNPSandclinicaltrials[326].Sellingandmarketingexpensesroseby57.013,634,000, mainly due to increased compensation and costs associated with the development of SwitchGuard NPS and clinical trials[326]. - Selling and marketing expenses rose by 57.0%, or 2,204,000, to 6,069,000,drivenbyincreasedcompensationexpensesasthecompanybuildsitscommercialsalesforceinanticipationofFDAapproval[328].Generalandadministrativeexpensesincreasedby37.86,069,000, driven by increased compensation expenses as the company builds its commercial sales force in anticipation of FDA approval[328]. - General and administrative expenses increased by 37.8%, or 4,202,000, to 15,306,000,primarilyduetoariseinsharebasedcompensationandsalaryexpenses[329].MarketandProductDevelopmentTheaddressablemarketfortheCGuardCarotidStentSystemandSwitchGuardNPSisestimatedtobeapproximately15,306,000, primarily due to a rise in share-based compensation and salary expenses[329]. Market and Product Development - The addressable market for the CGuard Carotid Stent System and SwitchGuard NPS is estimated to be approximately 1.3 billion, with a total available market of approximately 9.3billionassumingfullpenetration[314].TheCGUARDIANStrialenrolled316patientsacross24trialsites,witha30dayDSMIrateof0.959.3 billion assuming full penetration[314]. - The C-GUARDIANS trial enrolled 316 patients across 24 trial sites, with a 30-day DSMI rate of 0.95% and a one-year follow-up rate of 1.95%[311]. - The company received FDA approval for the IDE to initiate the CGUARDIANS II pivotal study of its CGuard Prime 80cm Carotid Stent System in October 2024[312]. - The company is seeking strategic partners for the potential launch of CGuard EPS in Japan and other Asian countries following its CE mark recertification in January 2024[308]. Financial Position - Cash and cash equivalents were 18,916,000 and marketable securities were 15,721,000asofDecember31,2024,comparedto15,721,000 as of December 31, 2024, compared to 9,640,000 and 29,383,000respectivelyin2023[338].Netcashusedinoperatingactivitiesincreasedby29,383,000 respectively in 2023[338]. - Net cash used in operating activities increased by 5,492,000 to 21,868,000forthetwelvemonthsendedDecember31,2024,from21,868,000 for the twelve months ended December 31, 2024, from 16,376,000 in 2023[339]. - Cash provided by financing activities was 18,452,000forthetwelvemonthsendedDecember31,2024,downfrom18,452,000 for the twelve months ended December 31, 2024, down from 37,534,000 in 2023, with the primary source being proceeds from warrant exercises[341]. - The company had an accumulated deficit of 254millionasofDecember31,2024,andexpectstocontinueincurringlossesandnegativecashflowsuntiltheproductCGuardEPSreachescommercialprofitability[333].Thecompanyraisedapproximately254 million as of December 31, 2024, and expects to continue incurring losses and negative cash flows until the product CGuard EPS reaches commercial profitability[333]. - The company raised approximately 42.2 million from a Private Placement Offering in May 2023, with potential additional proceeds of 71.4millionifwarrantsarefullyexercised[335].ThecompanyenteredintoanEquityDistributionAgreementallowingforthesaleofupto71.4 million if warrants are fully exercised[335]. - The company entered into an Equity Distribution Agreement allowing for the sale of up to 17 million in common stock, with 2,199,395raisedasofthereportdate[337].FutureOutlookFutureoperatingresultsmaybeaffectedbyvariousfactors,includingregulatoryapprovals,clinicaltrialphases,andeconomicconditionsimpactingcustomerdemand[344].Thetotalfuturepaymentsforoperatingleaseobligationswereapproximately2,199,395 raised as of the report date[337]. Future Outlook - Future operating results may be affected by various factors, including regulatory approvals, clinical trial phases, and economic conditions impacting customer demand[344]. - The total future payments for operating lease obligations were approximately 2,939,000 as of December 31, 2024[342].