UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
 
FORM 8-K
 
CURRENT REPORT
Pursuant to Section 13 or 15(d) of
The Securities Exchange Act of 1934
 
Date of Report (Date of earliest event reported): January 5, 2024
 
INSMED INCORPORATED
(Exact name of registrant as specified in its charter)
 
Virginia
000-30739
54-1972729
(State or other jurisdiction of incorporation)
(Commission File Number)
(IRS Employer Identification No.)
 
700 US Highway 202/206
Bridgewater, New Jersey
 
08807
(Zip Code)
(Address of principal executive offices)
 
 
 
Registrant’s telephone number, including area code: (908) 977-9900
 
Not Applicable
(Former name or former address, if changed since last report.)
 
Check the appropriate box below if the Form 8-K filing is intended to simultaneously satisfy the filing obligation of the registrant under any of the following provisions (see General Instruction A.2. below):
 

Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
 

Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
 

Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
 

Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))

Securities registered pursuant to Section 12(b) of the Act:
 
Title of each class
Trading Symbol(s)
Name of each exchange on which registered
Common Stock, par value $0.01 per share
INSM
Nasdaq Global Select Market
 
Indicate by check mark whether the registrant is an emerging growth company as defined in Rule 405 of the Securities Act of 1933 (17 CFR 230.405) or Rule 12b-2 of the Securities Exchange Act of 1934 (17 CFR 240.12b-2).
 
Emerging growth company
 
If an emerging growth company, indicate by check mark if the registrant has elected not to use the extended transition period for complying with any new or revised financial accounting standards provided pursuant to Section 13(a) of the Exchange Act. ☐
 


ITEM 7.01 – Regulation FD Disclosure.

As previously announced, management of Insmed Incorporated (the “Company”) will present at the 42nd Annual J.P. Morgan Healthcare Conference on Monday, January 8, 2024 at 3:00 p.m. PT (6:00 p.m. ET). A live webcast of the presentation will be accessible through the investor relations section of the Company’s website.
 
On January 5, 2024, in connection with the presentation, the Company has issued a press release, a copy of which is attached hereto as Exhibit 99.1 and incorporated herein by reference. In addition, the slide presentation to be used during the presentation is attached hereto as Exhibit 99.2 and incorporated herein by reference.
 
The information contained herein, including the exhibits attached hereto, shall not be deemed “filed” for purposes of Section 18 of the Securities Exchange Act of 1934, as amended (the “Exchange Act”), or incorporated by reference in any filing under the Securities Act of 1933, as amended, or the Exchange Act, except as shall be expressly set forth by specific reference in such a filing.

ITEM 9.01 - Financial Statements and Exhibits.

(d) Exhibits

Exhibit
No.

Description




Press release issued by Insmed Incorporated on January 5, 2024.

Insmed Incorporated J.P. Morgan Healthcare Conference Presentation.
104

Cover Page Interactive Date File (embedded within the Inline XBRL document).


SIGNATURES

Pursuant to the requirements of the Securities Exchange Act of 1934, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.

Dated: January 5, 2024
INSMED INCORPORATED



By:
/s/ Michael A. Smith

Name:
Michael A. Smith

Title:
General Counsel and Corporate Secretary




Exhibit 99.1

Insmed Provides Business Update at 42nd Annual J.P. Morgan Healthcare Conference

—ARIKAYCE® (amikacin liposome inhalation suspension) Delivers Full-Year 2023 Revenues Exceeding the Upper End of Guidance Range with Unaudited Global Net Product Sales of Approximately $305.2 Million—

—2024 Global ARIKAYCE Revenues Expected to be Between $340 Million and $360 Million, Reflecting Double-Digit Growth Compared to 2023—

—Topline Data from the Phase 3 ASPEN Study of Brensocatib in Adult Patients with Bronchiectasis Remains on Track to Read Out in the Latter Part of Second-Quarter 2024—

—Enrollment in the Phase 2 Study of TPIP in Patients with PH-ILD Completed in November 2023; Topline Data Expected in Second-Quarter 2024—

BRIDGEWATER, N.J., Jan. 5, 2024 / PRNewswire / -- Insmed Incorporated (Nasdaq: INSM), a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases, today provided an update on the Company’s four pillars and outlook for 2024. These updates will be discussed as part of the Company’s presentation at the 42nd Annual J.P. Morgan Healthcare Conference in San Francisco on Monday, January 8, 2024, at 3:00 p.m. PT (6:00 p.m. ET).

“The year ahead will mark the most transformational period in Insmed’s history as we strive to become the next great biotechnology company,” said Will Lewis, Chair and Chief Executive Officer of Insmed. “From the readout of our highly anticipated Phase 3 ASPEN study, to our first Phase 2 topline TPIP data, to the advancement of our ARIKAYCE label expansion program, 2024 is the moment we have been waiting for. Each of these three programs, if successful, has the potential to achieve peak sales of more than $1 billion. Over the next 12 months, we have the opportunity to truly break out from the pack, delivering tangible results for our shareholders, while, more importantly, making a meaningful impact in the lives of patients with serious and rare diseases.”

Preliminary Full Year 2023 Global Net Product Sales (Unaudited)

Based on preliminary unaudited financial information, the Company expects total global net product sales of ARIKAYCE to be approximately $305.2 million for the full year 2023, with net sales across the United States, Japan, and Europe as follows. This represents 24% year-over-year growth from the full year 2022, including growth in the U.S. of 21% and in Japan of 16%.

Preliminary Unaudited Full Year 2023 Global Net Product Sales by Region

United States

$224.2 million

Japan

$65.7 million

Europe

$15.3 million

Total

$305.2 million

These preliminary unaudited results are subject to adjustment. Insmed will report its final and complete fourth-quarter and full-year 2022 financial results in late February 2024, and the actual results could be materially different from these preliminary unaudited financial results.


Progress and Anticipated Milestones by Pillar:

Pillar 1: ARIKAYCE

Insmed anticipates 2024 global ARIKAYCE revenues to be between $340 million and $360 million, representing 15% year-over-year growth at the midpoint compared to 2023.

The Company has completed its original target enrollment of 250 patients in the ENCORE trial in patients with newly diagnosed or recurrent nontuberculous mycobacterial lung infection caused by Mycobacterium avium complex (MAC) who had not started antibiotics. Enrollment in the study remains ongoing.

Insmed received encouraging written feedback from the U.S. Food and Drug Administration (FDA) on the patient-reported outcome data produced in the Phase 3 ARISE study in December 2023. As expected, the Company will seek a meeting with the Agency in the coming months to gain additional insights and guidance, from which it will finalize its statistical plans for the Phase 3 ENCORE study, including an updated enrollment target for the study.

The Company continues to anticipate a topline readout for ENCORE in 2025.

Pillar 2: Brensocatib

Insmed expects topline data from the Phase 3 ASPEN study of brensocatib in adult patients with non-cystic fibrosis bronchiectasis in the latter part of the second quarter of 2024. If successful, the Company anticipates a launch in the U.S. in mid-2025, followed by launches in Europe and Japan in the first half of 2026.

The Data Safety Monitoring Committee for the ASPEN study held its fifth and final meeting in November 2023. No new safety signals were identified, and the Committee unanimously recommended that the trial continue as planned.

Insmed anticipates providing topline data from the Phase 2b BiRCh trial of brensocatib in patients with chronic rhinosinusitis without nasal polyps (CRSsNP) in 2025.

The Company expects to initiate a Phase 2 study of brensocatib in patients with hidradenitis suppurativa (HS) in the second half of 2024.

Pillar 3: TPIP

Insmed has completed enrollment in the Phase 2 study of treprostinil palmitil inhalation powder (TPIP) in pulmonary hypertension associated with interstitial lung disease (PH-ILD). The Company exceeded its enrollment target of 32 patients, with 39 patients enrolled. Topline data from the study are anticipated ahead of Phase 3 ASPEN data in the second quarter of 2024.

Enrollment in the Phase 2 study of TPIP in pulmonary arterial hypertension (PAH) remains ongoing. The Company anticipates enrolling 99 patients in the study, 45 of whom had been enrolled by year-end 2023, with topline results expected in 2025.

Pillar 4: Early-Stage Research

Insmed's early-stage research efforts include more than 30 identified pre-clinical programs in development, all of which have the potential to become first-in-class or best-in-class therapies.

The Company continues to anticipate that the totality of its early-stage research programs will comprise less than 20% of overall spend.


Presentation at the 42nd Annual J.P. Morgan Healthcare Conference

Will Lewis, Chair and Chief Executive Officer of Insmed, will present at the 42nd Annual J.P. Morgan Healthcare Conference on Monday, January 8, 2024, at 3:00 p.m. PT (6:00 p.m. ET). A live audio webcast of the presentation will be available on the Investor Relations section of the Company’s website at www.insmed.com. A replay will also be archived for a period of 30 days following the conclusion of the live event.

About ARIKAYCE

ARIKAYCE is approved in the United States as ARIKAYCE® (amikacin liposome inhalation suspension), in Europe as ARIKAYCE® Liposomal 590 mg Nebuliser Dispersion, and in Japan as ARIKAYCE® inhalation 590 mg (amikacin sulfate inhalation drug product). Current international treatment guidelines recommend the use of ARIKAYCE for appropriate patients. ARIKAYCE is a novel, inhaled, once-daily formulation of amikacin, an established antibiotic that was historically administered intravenously and associated with severe toxicity to hearing, balance, and kidney function. Insmed's proprietary PULMOVANCE® liposomal technology enables the delivery of amikacin directly to the lungs, where liposomal amikacin is taken up by lung macrophages where the infection resides, while limiting systemic exposure. ARIKAYCE is administered once daily using the Lamira® Nebulizer System manufactured by PARI Pharma GmbH (PARI).

About PARI Pharma and the Lamira® Nebulizer System

ARIKAYCE is delivered by a novel inhalation device, the Lamira® Nebulizer System, developed by PARI. Lamira® is a quiet, portable nebulizer that enables efficient aerosolization of ARIKAYCE via a vibrating, perforated membrane. Based on PARI's 100-year history working with aerosols, PARI is dedicated to advancing inhalation therapies by developing innovative delivery platforms to improve patient care.

About Brensocatib

Brensocatib is a small molecule, oral, reversible inhibitor of dipeptidyl peptidase 1 (DPP1) being developed by Insmed for the treatment of patients with bronchiectasis and other neutrophil-mediated diseases. DPP1 is an enzyme responsible for activating neutrophil serine proteases (NSPs), such as neutrophil elastase, in neutrophils when they are formed in the bone marrow. Neutrophils are the most common type of white blood cell and play an essential role in pathogen destruction and inflammatory mediation. In chronic inflammatory lung diseases, neutrophils accumulate in the airways and result in excessive active NSPs that cause lung destruction and inflammation. Brensocatib may decrease the damaging effects of inflammatory diseases such as bronchiectasis by inhibiting DPP1 and its activation of NSPs. Brensocatib is an investigational drug product that has not been approved for any indication in any jurisdiction.

About TPIP

Treprostinil palmitil inhalation powder (TPIP) is a dry powder formulation of treprostinil palmitil, a treprostinil prodrug consisting of treprostinil linked by an ester bond to a 16-carbon chain. Developed entirely in Insmed's laboratories, TPIP is a potentially highly differentiated prostanoid being evaluated for the treatment of patients with PAH, PH-ILD, and other rare and serious pulmonary disorders. TPIP is administered in a capsule-based inhalation device. TPIP is an investigational drug product that has not been approved for any indication in any jurisdiction.


IMPORTANT SAFETY INFORMATION FOR ARIKAYCE IN THE U.S.


WARNING: RISK OF INCREASED RESPIRATORY ADVERSE REACTIONS

ARIKAYCE has been associated with an increased risk of respiratory adverse reactions, including hypersensitivity pneumonitis, hemoptysis, bronchospasm, and exacerbation of underlying pulmonary disease that have led to hospitalizations in some cases.

Hypersensitivity Pneumonitis has been reported with the use of ARIKAYCE in the clinical trials. Hypersensitivity pneumonitis (reported as allergic alveolitis, pneumonitis, interstitial lung disease, allergic reaction to ARIKAYCE) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (3.1%) compared to patients treated with a background regimen alone (0%). Most patients with hypersensitivity pneumonitis discontinued treatment with ARIKAYCE and received treatment with corticosteroids. If hypersensitivity pneumonitis occurs, discontinue ARIKAYCE and manage patients as medically appropriate.

Hemoptysis has been reported with the use of ARIKAYCE in the clinical trials. Hemoptysis was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (17.9%) compared to patients treated with a background regimen alone (12.5%). If hemoptysis occurs, manage patients as medically appropriate.

Bronchospasm has been reported with the use of ARIKAYCE in the clinical trials. Bronchospasm (reported as asthma, bronchial hyperreactivity, bronchospasm, dyspnea, dyspnea exertional, prolonged expiration, throat tightness, wheezing) was reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (28.7%) compared to patients treated with a background regimen alone (10.7%). If bronchospasm occurs during the use of ARIKAYCE, treat patients as medically appropriate.

Exacerbations of underlying pulmonary disease has been reported with the use of ARIKAYCE in the clinical trials. Exacerbations of underlying pulmonary disease (reported as chronic obstructive pulmonary disease (COPD), infective exacerbation of COPD, infective exacerbation of bronchiectasis) have been reported at a higher frequency in patients treated with ARIKAYCE plus background regimen (14.8%) compared to patients treated with background regimen alone (9.8%). If exacerbations of underlying pulmonary disease occur during the use of ARIKAYCE, treat patients as medically appropriate.

Anaphylaxis and Hypersensitivity Reactions: Serious and potentially life-threatening hypersensitivity reactions, including anaphylaxis, have been reported in patients taking ARIKAYCE. Signs and symptoms include acute onset of skin and mucosal tissue hypersensitivity reactions (hives, itching, flushing, swollen lips/tongue/uvula), respiratory difficulty (shortness of breath, wheezing, stridor, cough), gastrointestinal symptoms (nausea, vomiting, diarrhea, crampy abdominal pain), and cardiovascular signs and symptoms of anaphylaxis (tachycardia, low blood pressure, syncope, incontinence, dizziness). Before therapy with ARIKAYCE is instituted, evaluate for previous hypersensitivity reactions to aminoglycosides. If anaphylaxis or a hypersensitivity reaction occurs, discontinue ARIKAYCE and institute appropriate supportive measures.


Ototoxicity has been reported with the use of ARIKAYCE in the clinical trials. Ototoxicity (including deafness, dizziness, presyncope, tinnitus, and vertigo) were reported with a higher frequency in patients treated with ARIKAYCE plus background regimen (17%) compared to patients treated with background regimen alone (9.8%). This was primarily driven by tinnitus (7.6% in ARIKAYCE plus background regimen vs 0.9% in the background regimen alone arm) and dizziness (6.3% in ARIKAYCE plus background regimen vs 2.7% in the background regimen alone arm). Closely monitor patients with known or suspected auditory or vestibular dysfunction during treatment with ARIKAYCE. If ototoxicity occurs, manage patients as medically appropriate, including potentially discontinuing ARIKAYCE.

Nephrotoxicity was observed during the clinical trials of ARIKAYCE in patients with MAC lung disease but not at a higher frequency than background regimen alone. Nephrotoxicity has been associated with the aminoglycosides. Close monitoring of patients with known or suspected renal dysfunction may be needed when prescribing ARIKAYCE.

Neuromuscular Blockade: Patients with neuromuscular disorders were not enrolled in ARIKAYCE clinical trials. Patients with known or suspected neuromuscular disorders, such as myasthenia gravis, should be closely monitored since aminoglycosides may aggravate muscle weakness by blocking the release of acetylcholine at neuromuscular junctions.

Embryo-Fetal Toxicity: Aminoglycosides can cause fetal harm when administered to a pregnant woman. Aminoglycosides, including ARIKAYCE, may be associated with total, irreversible, bilateral congenital deafness in pediatric patients exposed in utero. Patients who use ARIKAYCE during pregnancy, or become pregnant while taking ARIKAYCE should be apprised of the potential hazard to the fetus.

Contraindications: ARIKAYCE is contraindicated in patients with known hypersensitivity to any aminoglycoside.

Most Common Adverse Reactions: The most common adverse reactions in Trial 1 at an incidence ≥5% for patients using ARIKAYCE plus background regimen compared to patients treated with background regimen alone were dysphonia (47% vs 1%), cough (39% vs 17%), bronchospasm (29% vs 11%), hemoptysis (18% vs 13%), ototoxicity (17% vs 10%), upper airway irritation (17% vs 2%), musculoskeletal pain (17% vs 8%), fatigue and asthenia (16% vs 10%), exacerbation of underlying pulmonary disease (15% vs 10%), diarrhea (13% vs 5%), nausea (12% vs 4%), pneumonia (10% vs 8%), headache (10% vs 5%), pyrexia (7% vs 5%), vomiting (7% vs 4%), rash (6% vs 2%), decreased weight (6% vs 1%), change in sputum (5% vs 1%), and chest discomfort (5% vs 3%).

Drug Interactions: Avoid concomitant use of ARIKAYCE with medications associated with neurotoxicity, nephrotoxicity, and ototoxicity. Some diuretics can enhance aminoglycoside toxicity by altering aminoglycoside concentrations in serum and tissue. Avoid concomitant use of ARIKAYCE with ethacrynic acid, furosemide, urea, or intravenous mannitol.

Overdosage: Adverse reactions specifically associated with overdose of ARIKAYCE have not been identified. Acute toxicity should be treated with immediate withdrawal of ARIKAYCE, and baseline tests of renal function should be undertaken. Hemodialysis may be helpful in removing amikacin from the body. In all cases of suspected overdosage, physicians should contact the Regional Poison Control Center for information about effective treatment.


U.S. INDICATION

LIMITED POPULATION: ARIKAYCE® is indicated in adults, who have limited or no alternative treatment options, for the treatment of Mycobacterium avium complex (MAC) lung disease as part of a combination antibacterial drug regimen in patients who do not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. As only limited clinical safety and effectiveness data for ARIKAYCE are currently available, reserve ARIKAYCE for use in adults who have limited or no alternative treatment options. This drug is indicated for use in a limited and specific population of patients.

This indication is approved under accelerated approval based on achieving sputum culture conversion (defined as 3 consecutive negative monthly sputum cultures) by Month 6. Clinical benefit has not yet been established. Continued approval for this indication may be contingent upon verification and description of clinical benefit in confirmatory trials.

Limitation of Use: ARIKAYCE has only been studied in patients with refractory MAC lung disease defined as patients who did not achieve negative sputum cultures after a minimum of 6 consecutive months of a multidrug background regimen therapy. The use of ARIKAYCE is not recommended for patients with non-refractory MAC lung disease.

Patients are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch, or call 1800FDA1088. You can also call the Company at 1-844-4-INSMED.

Please see Full Prescribing Information.

About Insmed

Insmed Incorporated is a global biopharmaceutical company on a mission to transform the lives of patients with serious and rare diseases. Insmed's first commercial product is a first-in-disease therapy approved in the United States, Europe, and Japan to treat a chronic, debilitating lung disease. The Company is progressing a robust pipeline of investigational therapies targeting areas of serious unmet need, including neutrophil-mediated inflammatory diseases and rare pulmonary disorders. Insmed is also advancing an early-stage research engine encompassing a wide range of technologies and modalities, including artificial intelligence-driven protein engineering, gene therapy, and protein manufacturing. Insmed is headquartered in Bridgewater, New Jersey, with additional offices and research locations throughout the United States, Europe, and Japan. Visit www.insmed.com to learn more.

Forward-looking Statements

This press release contains forward-looking statements that involve substantial risks and uncertainties. "Forward-looking statements," as that term is defined in the Private Securities Litigation Reform Act of 1995, are statements that are not historical facts and involve a number of risks and uncertainties. Words herein such as "may," "will," "should," "could," "would," "expects," "plans," "anticipates," "believes," "estimates," "projects," "predicts," "intends," "potential," "continues," and similar expressions (as well as other words or expressions referencing future events, conditions or circumstances) may identify forward-looking statements.


The forward-looking statements in this press release are based upon the Company's current expectations and beliefs, and involve known and unknown risks, uncertainties and other factors, which may cause the Company's actual results, performance and achievements and the timing of certain events to differ materially from the results, performance, achievements or timings discussed, projected, anticipated or indicated in any forward-looking statements. Such risks, uncertainties and other factors include, among others, the following: failure to obtain, or delays in obtaining, regulatory approvals for ARIKAYCE outside the U.S., Europe or Japan, or for the Company's product candidates in the U.S., Europe, Japan or other markets, including separate regulatory approval for the Lamira® Nebulizer System in each market and for each usage; failure to successfully commercialize ARIKAYCE, the Company's only approved product, in the U.S., Europe or Japan (amikacin liposome inhalation suspension, Liposomal 590 mg Nebuliser Dispersion, and amikacin sulfate inhalation drug product, respectively), or to maintain U.S., European or Japanese approval for ARIKAYCE, or failure to successfully commercialize any of the Company's product candidates in the future; business or economic disruptions due to catastrophes or other events, including natural disasters or public health crises; impact of the COVID-19 pandemic and efforts to reduce its spread on the Company's business, employees, including key personnel, patients, partners and suppliers; risk that brensocatib or TPIP does not prove to be effective or safe for patients in ongoing and future clinical studies, including, for brensocatib, the ASPEN study; uncertainties in the degree of market acceptance of ARIKAYCE by physicians, patients, third-party payors and others in the healthcare community; the Company's inability to obtain full approval of ARIKAYCE from the FDA, including the risk that the Company will not successfully or in a timely manner validate a PRO tool and complete the confirmatory post-marketing clinical trial required for full approval of ARIKAYCE; inability of the Company, PARI or the Company's other third-party manufacturers to comply with regulatory requirements related to ARIKAYCE or the Lamira® Nebulizer System; the Company's inability to obtain adequate reimbursement from government or third-party payors for ARIKAYCE or acceptable prices for ARIKAYCE or for the Company's other product candidates; development of unexpected safety or efficacy concerns related to ARIKAYCE, brensocatib, TPIP or the Company's other product candidates; inaccuracies in the Company's estimates of the size of the potential markets for ARIKAYCE, brensocatib, TPIP or the Company's other product candidates or in data the Company has used to identify physicians, expected rates of patient uptake, duration of expected treatment, or expected patient adherence or discontinuation rates; the risks and uncertainties associated with, and the perceived benefits of, the Company's secured senior loan with certain funds managed by Pharmakon Advisors, LP and the Company's royalty financing with OrbiMed Royalty & Credit Opportunities IV, LP, including the Company's ability to maintain compliance with the covenants in the agreements for the senior secured loan and royalty financing and the perceived impact of the restrictions on the Company's operations under these agreements; the Company's inability to create an effective direct sales and marketing infrastructure or to partner with third parties that offer such an infrastructure for distribution of ARIKAYCE or any of the Company's product candidates that are approved in the future; failure to obtain regulatory approval to expand ARIKAYCE's indication to a broader patient population; risk that the Company's competitors may obtain orphan drug exclusivity for a product that is essentially the same as a product the Company is developing for a particular indication; failure to successfully predict the time and cost of development, regulatory approval and commercialization for novel gene therapy products; failure to successfully conduct future clinical trials for ARIKAYCE, brensocatib, TPIP and the Company's other product candidates due to the Company's limited experience in conducting preclinical development activities and clinical trials necessary for regulatory approval and its potential inability to enroll or retain sufficient patients to conduct and complete the trials or generate data necessary for regulatory approval, among other things; risks that the Company's clinical studies will be delayed, that serious side effects will be identified during drug development, or that any protocol amendments submitted will be rejected; risks that interim or partial data sets are not representative of a complete or larger data set or that blinded data will not be predictive of unblinded data; failure of third parties on which the Company is dependent to manufacture sufficient quantities of ARIKAYCE or the Company's product candidates for commercial or clinical needs, to conduct the Company's clinical trials, or to comply with the Company's agreements or laws and regulations that impact the Company's business or agreements with the Company; the Company's inability to attract and retain key personnel or to effectively manage the Company's growth; the Company's inability to successfully integrate its recent acquisitions and appropriately manage the amount of management's time and attention devoted to integration activities; risks that the Company's acquired technologies, products and product candidates are not commercially successful; the Company's inability to adapt to its highly competitive and changing environment; risk that the Company is unable to maintain its significant customers; risk that government healthcare reform materially increases the Company's costs and damages its financial condition; deterioration in general economic conditions in the U.S., Europe, Japan and globally, including the effect of prolonged periods of inflation, affecting the Company, its suppliers, third-party service providers and potential partners; the Company's inability to adequately protect its intellectual property rights or prevent disclosure of its trade secrets and other proprietary information and costs associated with litigation or other proceedings related to such matters; restrictions or other obligations imposed on the Company by agreements related to ARIKAYCE or the Company's product candidates, including its license agreements with PARI and AstraZeneca AB, and failure of the Company to comply with its obligations under such agreements; the cost and potential reputational damage resulting from litigation to which the Company is or may become a party, including product liability claims; risk that the Company's operations are subject to a material disruption in the event of a cybersecurity attack or issue; the Company's limited experience operating internationally; changes in laws and regulations applicable to the Company's business, including any pricing reform, and failure to comply with such laws and regulations; the Company's history of operating losses, and the possibility that the Company may never achieve or maintain profitability; goodwill impairment charges affecting the Company's results of operations and financial condition; inability to repay the Company's existing indebtedness and uncertainties with respect to the Company's ability to access future capital; and delays in the execution of plans to build out an additional third-party manufacturing facility approved by the appropriate regulatory authorities and unexpected expenses associated with those plans.


The Company may not actually achieve the results, plans, intentions or expectations indicated by the Company's forward-looking statements because, by their nature, forward-looking statements involve risks and uncertainties because they relate to events and depend on circumstances that may or may not occur in the future. For additional information about the risks and uncertainties that may affect the Company's business, please see the factors discussed in Item 1A, "Risk Factors," in the Company's Annual Report on Form 10-K for the year ended December 31, 2022 and any subsequent Company filings with the Securities and Exchange Commission (SEC).

The Company cautions readers not to place undue reliance on any such forward-looking statements, which speak only as of the date of this press release. The Company disclaims any obligation, except as specifically required by law and the rules of the SEC, to publicly update or revise any such statements to reflect any change in expectations or in events, conditions or circumstances on which any such statements may be based, or that may affect the likelihood that actual results will differ from those set forth in the forward-looking statements.

Contact:

Investors:

Bryan Dunn
Executive Director, Investor Relations
Insmed
(646) 812-4030
bryan.dunn@insmed.com


Eleanor Barisser
Associate Director, Investor Relations
Insmed
(718) 594-5332
eleanor.barisser@insmed.com

Media:

Mandy Fahey
Executive Director, Corporate Communications
Insmed
(732) 718-3621
amanda.fahey@insmed.com




Exhibit 99.2

 J.P. Morgan Healthcare Conference  January 2024 
 

 Forward Looking Statement  Forward-Looking Statements  This presentation contains forward-looking statements that involve substantial risks and uncertainties. "Forward-looking statements," as that term is defined in the Private Securities Litigation Reform Act of 1995, are statements that are not historical facts and involve a number of risks and uncertainties. Words herein such as "may," "will," "should," "could," "would," "expects," "plans," "anticipates," "believes," "estimates," "projects," "predicts," "intends," "potential," "continues," and similar expressions (as well as other words or expressions referencing future events, conditions or circumstances) may identify forward-looking statements.  The forward-looking statements in this presentation are based upon the Company's current expectations and beliefs, and involve known and unknown risks, uncertainties and other factors, which may cause the Company's actual results, performance and achievements and the timing of certain events to differ materially from the results, performance, achievements or timings discussed, projected, anticipated or indicated in any forward-looking statements. Such risks, uncertainties and other factors include, among others, the following: failure to obtain, or delays in obtaining, regulatory approvals for ARIKAYCE outside the United States (U.S.), Europe or Japan, or for the Company's product candidates in the U.S., Europe, Japan or other markets, including separate regulatory approval for the Lamira® Nebulizer System in each market and for each usage; failure to successfully commercialize ARIKAYCE, the Company's only approved product, in the U.S., Europe or Japan (amikacin liposome inhalation suspension, Liposomal 590 mg Nebuliser Dispersion, and amikacin sulfate inhalation drug product, respectively), or to maintain U.S., European or Japanese approval for ARIKAYCE, or failure to successfully commercialize any of the Company's product candidates in the future; business or economic disruptions due to catastrophes or other events, including natural disasters or public health crises; impact of the COVID-19 pandemic and efforts to reduce its spread on the Company's business, employees, including key personnel, patients, partners and suppliers; risk that brensocatib or TPIP does not prove to be effective or safe for patients in ongoing and future clinical studies, including, for brensocatib, the ASPEN study; uncertainties in the degree of market acceptance of ARIKAYCE by physicians, patients, third-party payors and others in the healthcare community; the Company's inability to obtain full approval of ARIKAYCE from the U.S. Food and Drug Administration, including the risk that the Company will not successfully or in a timely manner validate a PRO tool and complete the confirmatory post-marketing clinical trial required for full approval of ARIKAYCE; inability of the Company, PARI or the Company's other third-party manufacturers to comply with regulatory requirements related to ARIKAYCE or the Lamira® Nebulizer System; the Company's inability to obtain adequate reimbursement from government or third-party payors for ARIKAYCE or acceptable prices for ARIKAYCE or for the Company's other product candidates; development of unexpected safety or efficacy concerns related to ARIKAYCE, brensocatib, Treprostinil Palmitil Inhalation Powder (TPIP) or the Company's other product candidates; inaccuracies in the Company's estimates of the size of the potential markets for ARIKAYCE, brensocatib, TPIP or the Company's other product candidates or in data the Company has used to identify physicians, expected rates of patient uptake, duration of expected treatment, or expected patient adherence or discontinuation rates; the risks and uncertainties associated with, and the perceived benefits of, the Company's secured senior loan with certain funds managed by Pharmakon Advisors, LP and the Company's royalty financing with OrbiMed Royalty & Credit Opportunities IV, LP, including the Company's ability to maintain compliance with the covenants in the agreements for the senior secured loan and royalty financing and the perceived impact of the restrictions on the Company's operations under these agreements; the Company's inability to create an effective direct sales and marketing infrastructure or to partner with third parties that offer such an infrastructure for distribution of ARIKAYCE or any of the Company's product candidates that are approved in the future; failure to obtain regulatory approval to expand ARIKAYCE's indication to a broader patient population; risk that the Company's competitors may obtain orphan drug exclusivity for a product that is essentially the same as a product the Company is developing for a particular indication; failure to successfully predict the time and cost of development, regulatory approval and commercialization for novel gene therapy products; failure to successfully conduct future clinical trials for ARIKAYCE, brensocatib, TPIP and the Company's other product candidates due to the Company's limited experience in conducting preclinical development activities and clinical trials necessary for regulatory approval and its potential inability to enroll or retain sufficient patients to conduct and complete the trials or generate data necessary for regulatory approval, among other things; risks that the Company's clinical studies will be delayed, that serious side effects will be identified during drug development, or that any protocol amendments submitted will be rejected; risks that interim or partial data sets are not representative of a complete or larger data set or that blinded data will not be predictive of unblinded data; failure of third parties on which the Company is dependent to manufacture sufficient quantities of ARIKAYCE or the Company's product candidates for commercial or clinical needs, to conduct the Company's clinical trials, or to comply with the Company's agreements or laws and regulations that impact the Company's business or agreements with the Company; the Company's inability to attract and retain key personnel or to effectively manage the Company's growth; the Company's inability to successfully integrate its recent acquisitions and appropriately manage the amount of management's time and attention devoted to integration activities; risks that the Company's acquired technologies, products and product candidates are not commercially successful; the Company's inability to adapt to its highly competitive and changing environment; risk that the Company is unable to maintain its significant customers; risk that government healthcare reform materially increases the Company's costs and damages its financial condition; deterioration in general economic conditions in the U.S., Europe, Japan and globally, including the effect of prolonged periods of inflation, affecting the Company, its suppliers, third-party service providers and potential partners; the Company's inability to adequately protect its intellectual property rights or prevent disclosure of its trade secrets and other proprietary information and costs associated with litigation or other proceedings related to such matters; restrictions or other obligations imposed on the Company by agreements related to ARIKAYCE or the Company's product candidates, including its license agreements with PARI and AstraZeneca AB, and failure of the Company to comply with its obligations under such agreements; the cost and potential reputational damage resulting from litigation to which the Company is or may become a party, including product liability claims; risk that the Company's operations are subject to a material disruption in the event of a cybersecurity attack or issue; the Company's limited experience operating internationally; changes in laws and regulations applicable to the Company's business, including any pricing reform, and failure to comply with such laws and regulations; the Company's history of operating losses, and the possibility that the Company may never achieve or maintain profitability; goodwill impairment charges affecting the Company's results of operations and financial condition; inability to repay the Company's existing indebtedness and uncertainties with respect to the Company's ability to access future capital; and delays in the execution of plans to build out an additional third-party manufacturing facility approved by the appropriate regulatory authorities and unexpected expenses associated with those plans.  The Company may not actually achieve the results, plans, intentions or expectations indicated by the Company's forward-looking statements because, by their nature, forward-looking statements involve risks and uncertainties because they relate to events and depend on circumstances that may or may not occur in the future. For additional information about the risks and uncertainties that may affect the Company's business, please see the factors discussed in Item 1A, "Risk Factors," in the Company's Annual Report on Form 10-K for the year ended December 31, 2022 and any subsequent Company filings with the Securities and Exchange Commission (SEC).  The Company cautions readers not to place undue reliance on any such forward-looking statements, which speak only as of the date of this presentation. The Company disclaims any obligation, except as specifically required by law and the rules of the SEC, to publicly update or revise any such statements to reflect any change in expectations or in events, conditions or circumstances on which any such statements may be based, or that may affect the likelihood that actual results will differ from those set forth in the forward-looking statements. 
 

 Brensocatib ASPEN Readout in Bronchiectasis   First Phase 2 TPIP Readout in PH-ILD  Advance ARIKAYCE® Toward Label Expansion  Continued Progress on Cutting-Edge Early Pipeline  The Stage is Set for a Breakout Year Rarely Seen in Biotech  2024: The Year of Insmed’s Transformation 
 

 Three Programs with Peak Sales Potential > $1 Billion Each  1  2  3  4  ARIKAYCE  Brensocatib  TPIP*  Early-Stage Research  <20% OF EXPENDITURES  >80% OF EXPENDITURES  *TPIP: Treprostinil Palmitil Inhalation Powder. Peak revenue projection assumes that future unblinded datasets continue to support TPIP’s potential to become the prostanoid of choice for patients with pulmonary arterial hypertension (PAH) and pulmonary hypertension associated with interstitial lung disease (PH-ILD).   4  >30 preclinical programs in development 
 

 ARIKAYCE Expected to Continue to Deliver Strong Double-Digit Revenue Growth Globally in 2024  ARIKAYCE  Full-Year 2024 Revenue Guidance  ($340M - $360M)  *  Slower Growth Period During COVID-19 Pandemic  Growth Reacceleration  2024 Guidance Represents ~15% YoY Growth at the Midpoint  ($20-$30M sales growth/year)  Launch (Q4 2018)  First Full Year of Revenues  *Revenues for 2023 are unaudited. 
 

 ARIKAYCE Expected to be a >$1 Billion Peak Sales Product Assuming Label Expansion to Include All Patients with MAC Lung Disease  Newly diagnosed NTM MAC could expand the ARIKAYCE commercial opportunity by 3-5 times  ARIKAYCE  Refractory MAC Lung Patients  ~1,400*  EU**  *Source: Internal analysis of published NTM epidemiology, primary market research with treating HCPs, and anonymized patient level claims data in US. **EU: European 5 comprised of France, Germany, Italy, Spain and the United Kingdom.   Refractory MAC Lung Patients  12-17K*  Total MAC Lung Patients  95-115K*  U.S.  Japan   Refractory MAC Lung Patients  15-18K*  Total MAC Lung Patients  125-145K*  Total MAC Lung Patients  14K*  3-5x  3-5x  3-5x 
 

 Brensocatib: ASPEN on Track to Read Out in 2Q24  Need One Dose to Win for Regulatory and Commercial Success  Clear Win  5th and Final DSMC4 Meeting Held in November 2023 ​  ONE DOSE (either 10mg or 25mg) achieves a p-value1 < 0.01  Anticipated commercial launch timing: Mid-20252  Brensocatib  Can File3  ONE DOSE (either 10mg or 25mg) achieves a p-value1 < 0.05  1Refers to the p-value for the primary endpoint, adjusted for multiplicity. 2Timing assumes one dose (either 10mg or 25mg) achieves a p-value <0.01. Brensocatib has been granted Breakthrough Therapy Designation in the US and PRIME designation in the EU. 3FDA indicated that this data result could be filed for review. 4DSMC: Data Safety Monitoring Committee. 
 

 If ASPEN Succeeds, Brensocatib Expected to Become a $5+ Billion Peak Sales Product  Brensocatib  Timeline for Next Steps  BiRCh P2 Trial Readout (CRSsNP)  ASPEN P3 Trial Readout (Bronchiectasis)  P2 Trial Initiation (HS)  Launch (Bronchiectasis)  1Assumes indication for non-cystic fibrosis bronchiectasis and approval in US, European 5, and Japan. 2Weycker, et al. Prevalence and incidence of NCFBE among US adults in 2013. Chronic Respiratory Disease. 2017. 3Insmed: Patient Level Claims Data Analysis and Internal Market Research. 3Ex-US estimates based on published epidemiology research, Insmed market research, and extrapolation of US-focused claims and epi data analysis (sourced from swoop/ipm.ai). 4Cho et. al, Chronic Rhinosinusitis without Nasal Polyps J Allergy Clin Immunol Pract. 2016 ; 4(4): 575–582. doi:10.1016/j.jaip.2016.04.015. 5Benjamin et. al, Clinical Characteristics of Patients with Chronic Rhinosinusitis without Nasal Polyps in an Academic Setting, J ALLERGY CLIN IMMUNOL PRACT VOLUME 7, NUMBER 3, MARCH 2019. 6Patient level claims data analysis US ONLY (Komodo Health), proportion of actively managed CRS patients with no Dx codes for Nasal Polyps in patient history; Extrapolated to European 5 and Japan. 7Patient level claims data analysis US ONLY (Komodo Health), proportion of actively managed CRSsNP patients with ESS; Extrapolated to European 5 and Japan. 8Phan et al, Global prevalence of hidradenitis suppurativa and geographical variation—systematic review and meta-analysis Biomedical Dermatology (2020) 4:2. 9Puri, Ajay: Hidradenitis Suppurativa Executive Insights, DRG Nov 2019.  Total Addressable Market (global)  Current Treatment Landscape  Bronchiectasis1,2,3  ~1M  No approved treatments  Chronic Rhinosinusitis w/o Nasal Polyps (CRSsNP)4,5,6,7  ~400K  Hidradenitis Suppurativa (HS)8,9  ~250K  Treatment includes multiple therapies and/or surgery  2024  2025 
 

 TPIP  TPIP: Multiple Clinical Readouts Expected in 2024 and 2025  PAH  45 patients enrolled in Phase 2 study (YE 2023)  ~47% average PVR reduction among responders*  Phase 2 topline data in 2025  Doubling dose ceiling to 1,280μg from 640μg  PH-ILD  Phase 2 study fully enrolled (Nov. 2023)  Topline readout expected pre-ASPEN (Q2 2024)  *Based on blinded data shared on 10/26/2023. KOL: Key Opinion Leader. PVR: Pulmonary Vascular Resistance. PAH: Pulmonary arterial hypertension. PH-ILD: Pulmonary hypertension associated with interstitial lung disease.  “The hemodynamic changes are stunning…” KOL comment on the blinded results shared in Oct. 2023  >80% of all study participants reached the maximum dose in just 5 weeks* 
 

 TPIP: Upcoming Phase 2 Data in PH-ILD Primarily Meant to Characterize Safety Profile  Favorable tolerability profile in patients with PH-ILD  Highest dose (640μg) achieved in majority of patients​  ​Treatment-emergent adverse events consistent with underlying disease​  Pharmacokinetic exploratory endpoints are consistent with preclinical data​​ (not to be included with topline results)  TPIP  The PH-ILD Phase 2 is a SAFETY study   and is not powered to show statistical differences​  Clear Win 
 

 TPIP Has the Potential to be the Prostanoid of Choice in the Multi-Billion Dollar PH-ILD and PAH Markets  TPIP  TPIP  Remodulin®  Tyvaso®  Yutrepia®  Orenitram®  Uptravi®  Route of administration  Inhaled (dry powder)  IV orSubcutaneous  Inhaled (nebulized  and dry powder)  Inhaled (dry powder)  Oral  Oral  Dosing frequency  Once daily  Continuous  4x per day  4x per day  2x or 3x per day  2x per day  Favorable tolerability for expanded / higher dose  Yes**  Yes  No  No  No  No  Efficacy in PAH (WHO Group 1)  To be evaluated   in Phase 2 and Phase 3   Yes  Yes  Yes  Yes  Yes  Efficacy in PH-ILD (WHO Group 3)  Pursuing in parallel to PAH  No data  Yes  Yes  No data  No data  EU: European 5 comprised of France, Germany, Italy, Spain and the United Kingdom; *Coultas DB et al, “The epidemiology of interstitial diseases”, Am J Repir Crit Care Med, 1994; Ryu et al., “Pulmonary hypertension in patients with interstitial lung disease.” Mayo Clinic Proceedings, 2007; Anderson et al., “Pulmonary hypertension in interstitial lung disease: prevalence, prognosis and 6 min walk test.” Respir Med, 2012; Kirson N et al, “Prevalence of pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension in the United States”, Jul 2011; Analysis of Compile Health claims; Meta-analysis of several Japan-based publications relating to interstitial lung diseases; Japan’s Intractable Disease Database and Insmed internal analysis; Insmed Primary Quantitative Market Research Fielded September 2021; Duchemann et al., “Prevalence and incidence of interstitial lung diseases in a multi-ethnic county of Greater Paris.” European Respiratory Journal, 2017; 2019 National Audit of Pulmonary Hypertension Great Britain; Humbert M et al, “Pulmonary arterial hypertension in France: results from a national registry”, Feb 2006; Hoeper M et al, “Incidence and prevalence of pulmonary arterial hypertension in Germany”, Nov 2015; Escribano-Subias P et al, “Survival in pulmonary hypertension in Spain: insights from the Spanish registry”, 2012. **Safety analysis based on data available as of the most recent data disclosure (October 23, 2023).  65K 
 

 LOW UPFRONT COSTS  to acquire the technologies  HIGH POTENTIAL IMPACT  >30 pre-clinical programs  LOW ONGOING EXPENSE  <20% of expenditures  Early-Stage Research: An Assembly of Complementary Platform Technologies to Answer the Question: “What’s Next?”  MULTIPLE CUTTING-EDGE TECHNOLOGIES UNDERPIN INSMED’S EARLY-STAGE PIPELINE  Deimmunized Protein Engineering Using AI  RNA End-Joining  Algae-Based Protein Manufacturing  Targeting diseases caused by larger genes  Lower cost, higher yield; Potential for licensing  Synthetic Rescue  Gene Therapy Using Intrathecal Delivery  Increased safety with decreased viral load  Re-design / re-dose immunogenic drugs  Addressing previously untreatable diseases  Early Research 
 

 Key Catalysts Set to Transform Insmed in 2024**  Gain regulatory feedback and finalize statistical plan for ENCORE  ENCORE Phase 3 full enrollment  13  *Treprostinil Palmitil Inhalation Powder. **Timing for all catalysts are estimated and subject to change.  1  2  3  4  ARIKAYCE  Brensocatib  TPIP*  Early-Stage Research  <20% OF EXPENDITURES  >80% OF EXPENDITURES  ASPEN Phase 3 topline readout  Initiate Phase 2 trial in hidradenitis suppurativa (HS)  Phase 2 topline readout in pulmonary hypertension associated with interstitial lung disease (PH-ILD)  Updates from Phase 2 study in pulmonary arterial hypertension (PAH)  Key advancements expected across multiple platforms   Gene therapy  RNA end-joining  Next-gen manufacturing with algae  First deimmunized protein candidate selection  First IND filing 
 

 …with Many More Important Catalysts Expected in 2025**  14  *Treprostinil Palmitil Inhalation Powder. **Timing for all catalysts are estimated and subject to change.  ENCORE Phase 3 study topline readout  1  2  3  4  ARIKAYCE  Brensocatib  TPIP*  Early-Stage Research  <20% OF EXPENDITURES  >80% OF EXPENDITURES  BiRCh Phase 2 topline readout in patients with chronic rhinosinusitis without nasal polyps (CRSsNP)  First commercial launch of brensocatib in bronchiectasis  Phase 2 topline readout in patients with PAH  Initiate Phase 3 program  First clinical readouts  Additional IND filings 
 

 Shareholder Value Will Be Key Consideration  Current Cash Position Offers Insmed Flexibility on the Timing and Form of Any Future Capital Raise  Rich event pipeline in next two years  Financing options available under all scenarios  Convert or Issue Debt  Sell Royalty  Equity Raise  Monetize TPIP  Many Financing Options Exist, Regardless of ASPEN Result 
 

 Our Purpose and Values Define our Culture at Insmed Where Employees Are Empowered to do their Best Work on Behalf of Patients in Need  “I am proud to work at Insmed.”  “I am inspired by the work we do.”  “I understand how my job helps Insmed achieve success.”  “I believe Insmed will be successful in the future.”  In a recent survey*  >90% of employees responded that…  *The 2023 annual Insmed Pulse Survey included 91% participation across the organization.  #1 on Science’s Top Biopharma Employers List (3rd Year in a Row)  Certified as a Great Place to Work (3rd Year in a Row) 
 

 


v3.23.4
Document and Entity Information
Jan. 05, 2024
Cover [Abstract]  
Document Type 8-K
Amendment Flag false
Document Period End Date Jan. 05, 2024
Entity File Number 000-30739
Entity Registrant Name INSMED INCORPORATED
Entity Central Index Key 0001104506
Entity Incorporation, State or Country Code VA
Entity Tax Identification Number 54-1972729
Entity Address, Address Line One 700 US Highway 202/206
Entity Address, City or Town Bridgewater
Entity Address, State or Province NJ
Entity Address, Postal Zip Code 08807
City Area Code 908
Local Phone Number 977-9900
Title of 12(b) Security Common Stock, par value $0.01 per share
Trading Symbol INSM
Security Exchange Name NASDAQ
Entity Emerging Growth Company false
Written Communications false
Soliciting Material false
Pre-commencement Tender Offer false
Pre-commencement Issuer Tender Offer false

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