Insmed Patient Finder Suitability Analysis

Ada Cockpit Pharma Research
March 11, 2026

Executive Summary

This analysis evaluates Insmed's commercial and late-stage clinical portfolio for suitability with Ada Patient Finder. Of five drugs assessed, BRINSUPRI (bronchiectasis) represents the highest-value opportunity, with 300,000-500,000 undiagnosed US patients addressable via Ada's symptom checker.

Combined Addressable Annual Revenue: $20.3M - $59.2M
Lifetime Revenue (10-Year Horizon): $203M - $592M

Summary Table: Ada Patient Finder Opportunity by Drug

Drug Tier Fit Score Addressable Undiagnosed (USA) Ada Revenue Opportunity (Annual)
BRINSUPRI
Bronchiectasis
1 9/10 300,000-500,000 $17.5M-$51.3M
(5% penetration)
ARIKAYCE
Refractory MAC
2 7/10 30,000-40,000 total MAC
600-800 refractory
$208K-$821K
(5% penetration)
TPIP
PH-ILD / PAH
2 6/10 65,000-120,000 $2.58M-$7.10M
(post-approval 2028+)
INS1148
Asthma / ILD
2 / 3 7/10 (asthma)
5/10 (ILD)
1.5M-1.9M undertreated (asthma)
250K undiagnosed (ILD)
$5.96M-$11.8M
(post-approval 2030+)
INS1201
DMD Gene Therapy
3 3/10 ~1,000 $5.02M-$8.86M
(post-approval 2029+)

BRINSUPRI (Brensocatib) - TIER 1

Indication: Non-Cystic Fibrosis Bronchiectasis

Market Opportunity

US Prevalence: 700,000-1,000,000 (true prevalence)
Diagnosed: 350,000-500,000
Undiagnosed: 300,000-500,000 (30-50% underdiagnosis rate)
Diagnostic Delay: 3-7 years

Revenue Potential

Ada Patient Finder Addressable

If Ada surfaces 5% of undiagnosed pool (13,500-22,500 patients annually):

Annual Ada PF Revenue Opportunity: $17.5M-$51.3M (at 5% penetration)
Lifetime Value (10-year horizon): $175M-$513M

Why BRINSUPRI is Highest Priority

Clinical Profile

Symptoms: Chronic daily cough with copious purulent sputum, shortness of breath, wheezing, fatigue, recurrent respiratory infections (≥3/year), hemoptysis (advanced cases)

Diagnostic Pathway: Ada flags "chronic productive cough + recurrent infections despite antibiotics" → prompts HRCT referral → confirmed bronchiectasis (broncho-arterial ratio >1)

Treatment Duration: Lifelong (irreversible structural lung damage)

Strategic Pitch

Bronchiectasis affects an estimated 700,000-1 million Americans, yet only 350,000-500,000 are diagnosed, leaving 300,000-500,000 patients (30-50% of true prevalence) unidentified due to 3-7 year diagnostic delays and HRCT underutilization. These patients suffer chronic productive cough, recurrent respiratory infections, and progressive lung damage while misdiagnosed as chronic bronchitis or COPD in primary care.

Ada's symptom assessment AI is purpose-built to surface bronchiectasis: chronic cough (>8 weeks), copious purulent sputum, and ≥3 annual exacerbations are highly specific indicators that Ada captures in routine respiratory assessments. By flagging high-risk individuals and prompting HRCT referrals, Ada can accelerate diagnosis by 1-3 years, immediately expanding the pool of BRINSUPRI-eligible patients.

If Ada surfaces just 5% of the undiagnosed pool (13,500-22,500 patients annually), Insmed gains $594M-$990M in incremental annual revenue—representing 50-80% of BRINSUPRI's 2026 guidance (≥$1B).

With BRINSUPRI's first-mover advantage (3-5 years before competitors) and Insmed's explicit focus on patient identification as a key growth driver, Ada Patient Finder represents the highest-value strategic partnership in Insmed's portfolio.

ARIKAYCE (Amikacin Liposome) - TIER 2

Indication: Refractory MAC Lung Disease

Market Opportunity

US Prevalence: ~76,000 diagnosed MAC cases
Undiagnosed: 30,000-40,000 (30-40% underdiagnosis rate)
Refractory MAC Subset: 20% of diagnosed (15,000-20,000 patients)
Diagnostic Delay: 2-5 years

Revenue Potential

Ada Patient Finder Addressable

Ada accelerates MAC diagnosis by 6-12 months, expanding diagnosed pool. 20% progress to refractory MAC (ARIKAYCE-eligible).

Annual Ada PF Revenue Opportunity: $208K-$821K (at 5% penetration)
Fit Score: 7/10

Clinical Profile

Symptoms: Chronic productive cough, fatigue, shortness of breath, low-grade fever/night sweats, weight loss

Ada's Role: Flags chronic respiratory symptoms unresponsive to standard treatment → prompts sputum culture testing → accelerates MAC diagnosis by 6-12 months

Treatment Duration: 12-18 months post-culture conversion

ENCORE Trial Catalyst (March/April 2026)

Phase 3 trial results expected: If positive, ARIKAYCE label expands from refractory MAC to newly diagnosed MAC (4x larger market: 76,000 vs 15,000-20,000). This would upgrade ARIKAYCE to Tier 1 opportunity.

Strategic Pitch

MAC lung disease affects ~76,000 diagnosed Americans, with 30,000-40,000 additional cases undiagnosed due to 2-5 year diagnostic delays. Ada's respiratory symptom assessment can accelerate diagnosis by 6-12 months, expanding the pool of patients progressing to refractory MAC (20% of diagnosed cases) who become eligible for ARIKAYCE. With ENCORE trial results (March/April 2026) poised to expand ARIKAYCE's label to newly diagnosed MAC, Ada Patient Finder represents a strategic partner to maximize market penetration across a 4x larger addressable population.

TPIP (Treprostinil Palmitil) - TIER 2

Indication: Pulmonary Hypertension (PH-ILD and PAH)

Market Opportunity (Post-Approval 2028+)

PH-ILD US Prevalence: 75,000-125,000 (30-50% of ILD patients)
Undiagnosed PH-ILD: 65,000-115,000 (85-90% underdiagnosis)
PAH US Prevalence: 10,000-30,000
Undiagnosed PAH: 5,000-15,000 (50% underdiagnosis)
Diagnostic Delay: 2-3 years

Revenue Potential

Ada Patient Finder Addressable

Combined Annual Ada PF Revenue Opportunity: $2.58M-$7.10M (post-approval 2028+)
Fit Score: 6/10

Clinical Profile

Symptoms: Dyspnea on exertion (hallmark), fatigue, chest pain, syncope/dizziness, peripheral edema, palpitations

Ada's Role: Flags "unexplained dyspnea + exertional limitations + syncope/edema" → prompts echocardiography → accelerates PH diagnosis by 6-12 months. Particularly effective for targeting ILD patients with worsening symptoms.

Treatment Duration: Lifelong

Development Status

Strategic Pitch

Pulmonary hypertension affects 15,000-140,000 Americans, with PH-ILD particularly under-recognized (85-90% underdiagnosis). Ada's symptom assessment can flag high-risk individuals, especially ILD patients experiencing worsening dyspnea, prompting PH screening. TPIP's once-daily convenience differentiates from existing therapies. If approved (2028), TPIP addresses 10,000-25,000 diagnosed patients, with Ada expanding this pool by 10-20% through accelerated diagnosis. Partnership discussions ideal post-Phase 3 data readouts (2027).

INS1148 (Monoclonal Antibody) - TIER 2/3

Indication: Moderate-to-Severe Asthma and ILD

Market Opportunity (Post-Approval 2030+)

Asthma: 2.5M moderate-to-severe; 1.5M-1.9M undertreated (60-75%)
ILD: 500K total prevalence; 250K undiagnosed (50%)
Approval Timeline: 2030-2031 earliest (Phase 2 starting 2026)

Revenue Potential

Ada Patient Finder Addressable

Combined Annual Ada PF Revenue Opportunity: $5.96M-$11.8M (post-approval 2030+)
Fit Score: 7/10 (asthma) / 5/10 (ILD)

Clinical Profile

Asthma Symptoms: Wheezing, shortness of breath, chest tightness, nocturnal cough, frequent exacerbations (≥2/year)

Ada's Role (Asthma): Identifies inadequate control via exacerbation frequency, nocturnal symptoms, daily inhaler use patterns → prompts biologic evaluation

ILD Symptoms: Progressive dyspnea, dry cough, fatigue

Development Status

Recommendation: Monitor Phase 2 progress; partnership discussions premature until 2027-2028 data readouts. Competitive asthma biologic market (Dupixent, Xolair, Nucala) limits differentiation risk.

INS1201 (Gene Therapy) - TIER 3

Indication: Duchenne Muscular Dystrophy

Market Opportunity (Post-Approval 2029+)

US Prevalence: ~20,000 patients (all ages)
Undiagnosed: ~1,000 (5%; most diagnosed by age 7)
Approval Timeline: 2029-2030 earliest (Phase 1 ongoing)

Revenue Potential

Ada Patient Finder Addressable

Annual Ada PF Revenue Opportunity: $5.02M-$8.86M (post-approval 2029+)
Fit Score: 3/10 (LOW PRIORITY)

Why Low Priority

Recommendation: Deprioritize. Newborn screening expansion reduces Ada's value proposition. Monitor but no active partnership discussions.

Strategic Recommendations

1. Immediate Priority: BRINSUPRI Partnership

Action: Partner with Insmed on BRINSUPRI bronchiectasis patient finding.

2. Secondary Priority: ARIKAYCE ENCORE Catalyst

Action: Engage Insmed on ARIKAYCE ENCORE trial results (March/April 2026).

Rationale: If positive, ARIKAYCE label expands to newly diagnosed MAC (4x larger market). Partnership timing ideal around ENCORE readout.

3. Long-Term Pipeline: TPIP Monitoring

Action: Monitor TPIP Phase 3 data readouts (2027).

Rationale: PH-ILD massive underdiagnosis (85-90%); first-in-class opportunity. If Phase 3 successful, initiate partnership discussions for post-approval patient finding (2028+ launch).

4. Deprioritize: INS1148 and INS1201

Action: Monitor but no active partnership discussions.

Key Insights Summary

Metric Finding
Highest Fit Score BRINSUPRI (9/10)
Largest Undiagnosed Pool Bronchiectasis: 300,000-500,000 US patients
Longest Diagnostic Delay Bronchiectasis: 3-7 years
Best Symptom Fit BRINSUPRI: Chronic productive cough + recurrent infections (highly specific)
Most Urgent Timing BRINSUPRI: Launch year 2025; establish dominance before 2028-2029 competitor launches
Biggest Revenue Opportunity BRINSUPRI: $175M-$513M lifetime PF revenue (10-year horizon)