Summary of Glaukos Conference Call Company Overview - **Company**: Glaukos Corporation - **Industry**: Medical Technology, specifically focused on glaucoma treatment and corneal health Key Financial Highlights - **Q3 Revenue**: $133.5 million, a record quarter for Glaukos - **US Glaucoma Revenue**: $81 million, representing a 57% year-over-year growth [4][5] - **International Glaucoma Revenue**: $29 million, a 20% growth rate (17% on a constant currency basis) [4] - **Corneal Health Revenue**: $23 million, a 13% year-over-year growth [4] - **Gross Margin**: Reached almost 84%, driven by the high-margin product iDose [5][57] - **Cash Balance**: $277.5 million, slightly down from the previous quarter [6] Product Performance - **iDose**: - Contributed significantly to revenue growth, with 80% of volumes coming from three MACs (Noridian, Novitas, First Coast) [7][8] - Anticipated growth as more MACs establish pro fees, with NGS added recently [8][9] - Expected to drive utilization growth as operationalization takes time [9][10] - **Epiox**: - Announced pricing at $78,500 per eye, with expected net ASP between $65,000-$70,000 after discounts [31][33] - Targeting a mix of buy-and-bill and specialty pharmacy distribution models [34][35] - Anticipated to launch in early next year, with a focus on establishing a site of care network [36][37] Market Dynamics - **Commercial Coverage**: Approximately 50% of commercial plans currently cover iDose, with a significant portion of silent coverage [18][19] - **Patient Demographics**: The patient mix for iDose trials was approximately 50% Medicare-aged and 50% commercial-aged, indicating a potential shift in commercial usage over time [19] - **Utilization Trends**: Currently focused on glaucoma patients, with potential for treating ocular hypertension patients in the future [23] Strategic Insights - **Surgeon Training**: Surgeons are being trained at a healthy pace, with no significant barriers to adoption noted [16][17] - **Market Growth**: Anticipated recovery in the core MIGS market as LCD headwinds are overcome, with a focus on iDose as a primary growth driver [50][51] - **Cannibalization Concerns**: Some cannibalization of iStent by iDose is expected, but both products are seen as complementary [53] Future Outlook - **2026 Revenue Guidance**: Preliminary guidance of $600 million-$620 million, driven by multiple revenue streams including iDose and Epiox [55][56] - **Margin Expectations**: Continued improvement in gross margins expected as iDose and Epiox become a larger part of the business [57][58] - **Investment in R&D**: Plans to maintain a robust R&D pipeline while balancing operating expenses to achieve cash flow breakeven in the near term [59] Additional Considerations - **Educational Efforts**: Ongoing education for MACs and physicians regarding the clinical evidence supporting iDose is crucial for broader adoption [24][28] - **Patient Access**: Strategies in place to ensure patient access to Epiox, including trade-in programs for existing equipment [41][44] This summary encapsulates the key points discussed during the Glaukos conference call, highlighting financial performance, product insights, market dynamics, and future strategies.