INSM · investment memo
BUILT through the opex bridge, not assumed and not a peer median: 82.0% terminal gross - 21.0% R&D - 28.0% S&M+G&A - 0.2% amortisation = 32.8%, stated as 32.0%. Admissible as a Tier-2 loss-maker judgement because product (BRINSUPRI), approval (FDA 2025-08-12) and launch curve all exist. Evidence grade C: the gross leg is grade A (24 quarters filed), the opex leg has NO Insmed precedent at scale. Range 25-38%. UNIT: percent (sibling key terminal_margin carries 0.32 as a fraction).
Four distinct questions, one field each. A price is not a thesis: the trigger below forces a re-underwrite and freezes further purchases — it is never an automatic sell.
A daily close below $90.78 triggers a mandatory re-underwrite and freezes further purchases. It is not an automatic sell unless a separate fundamental invalidation condition has been breached.
Fundamental and falsifiable, never price-based. If one is satisfied the thesis is marked dead and the position is retained only by explicit decision.
Cause: the reimbursable bronchiectasis population is materially narrower than the 500,000 diagnosed US patients, and the company's own foreign labels are the evidence. The FDA label covers NCFB in patients 12 and older. The EC label is restricted to patients "with two or more exacerbations in the prior 12 months", and the MHRA label to patients with "two or more flare-ups or worsening of symptoms in the past 12 months." Two independent regulators looked at the same ASPEN dataset and narrowed the population to the frequent-exacerbator subset. US payers reviewing an oral chronic therapy against