Resmed taps RLS market for accretive growth

SAN DIEGO – Resmed will buy Noctrix Health, the Pleasanton, Calif.-based developer of the Nidra Tonic Motor Activation therapy for restless leg syndrome (RLS), for $340 million in a move that leverages its existing sleep physician referral network and home medical equipment (HME) delivery channel.

Nidra, which delivers electrical stimulation to the peroneal nerves via a pair of leg-word devices, was authorized for marketing in the United States in 2023, following its designation as a “breakthrough device” by the U.S. Food and Drug Administration (FDA). It was assigned new HCPCS codes, E0743 and A4544, along with payments, by the Centers for Medicare and Medicaid Services (CMS) in 2024.

“RLS has meaningful overlap with our core market of obstructive sleep apnea,” said Resmed CEO Mick Farrell during a recent conference call to discuss the company’s third quarter fiscal year 2026 financial results. “RLS treatments from Noctrix are noninvasive, clinically proven and drug free, just like our CPAP, APAP and bi-level therapies. RLS prescriptions are written predominantly by sleep physicians, and the flagship product flows through the same HME/DME delivery channel.”

Resmed expects to close the transaction on or around June 1, 2026.

‘The market and clinical need are incredible’

Farrell said RLS is the world’s third most prevalent sleep disorder after obstructive sleep apnea (OSA) and insomnia. He said it impacts about 7% of adults globally – and around 17 million people in the United States alone.

The current therapies for RLS are often drugs with side effects, creating a “huge opportunity” for a noninvasive medical device like Nidra, he said.

“The reach of our Resmed brand among sleep physicians and HME providers, as well as our national and international distribution channel strength, makes us the best owner of this scarce asset,” he said. “The market and clinical need are incredible.”

‘We can scale it faster than anyone’

Resmed says the current annual revenue run for Noctrix is about $24 million. It will report this revenue within its Americas devices category and it expects the company to reduce non-GAAP EPS by about $0.02 for the fourth quarter of fiscal year 2026.

The company plans to put its full weight behind Noctrix, investing in research and development, sales and marketing.

“We can scale it faster than anyone,” Farrell said. “Our market access team and our knowledge of CMS, the DMACs, the DMEs, and where we can go to drive reimbursement further are going to be incredible. The run rate that they are hitting on the current quarter – multiply that by four, and we expect to do better than that as they go into this year because they are growing faster than Resmed. So, watch this space.”

Other highlights from the call, including Farrell’s take on TPAs

• Farrell said the increased use of third-party administrators (TPAs) by payers in the United States is “manageable” for HME providers. “OSA – particularly CPAP – is a very low-cost, low-acuity, high clinical and high economic return therapy,” he said. “We can show the ROI for integrated payer-providers and for payers alone. We are working closely with payers to make sure this forms part of the ecosystem. It is not a big fear for the HMEs; it is manageable.”
• Device sales in the Americas were up 6% in the quarter. Mask sales were up 14%, with double-digit growth even when excluding the VirtuOx acquisition.
• Farrel said Resmed now has real-word data that show its AirTouch N30i fabric-based mask drives 6% higher 90-day adherence compared to its silicone equivalent. “Those of you that truly understand the clinical and business relevance of adherence know that those 600 basis points of extra compliance will mean a lot as this technology expands,” he said.
• Resmed’s continuing medical education (CME) courses have now been completed more than 80,000 times by more than 45,000 unique clinicians.