Disclaimer All statements other than statements of historical facts included in this presentation that address activities, events or developments that we expect, believe or anticipate will or may occur in the future are forward-looking statements. These statements are based on management's current expectations, assumptions, estimates and beliefs. Although we believe that we have a reasonable basis for forward-looking statements contained herein, we caution you that they are based on current expectations abo ...

Core Insights - The record performance in 2025 was primarily driven by the rapid adoption of iDose TR, generating approximately $136 million in its first full year [1] - U.S. glaucoma growth is attributed to the successful advancement of the interventional treatment paradigm, shifting the standard of care toward earlier surgical intervention [1] - International glaucoma net sales grew 13% on a constant currency basis in the fourth quarter, reflecting broad-based scaling of infrastructure despite competitive trialing headwinds in major markets [1] Product Developments - The FDA approval of Epioxa is seen as a 'complete reset' for the corneal health franchise, transitioning from the legacy Photrexa to a non-invasive, epithelium-on therapy [1] - The strategic positioning has evolved from a MIGS-focused company to a diversified leader across glaucoma, rare corneal diseases, and retinal health [1] Operational Strategy - Operational execution is focused on expanding the 'site of care' network, which now covers nearly 50% of the U.S. population for the upcoming Epioxa launch [1]

Core Insights - Glaukos Corporation reported a fourth-quarter 2025 adjusted loss of 28 cents per share, missing the Zacks Consensus Estimate by 0.06%, but showing improvement from a loss of 40 cents per share in the same quarter last year [1] - For the full year, the adjusted loss per share was 90 cents, reflecting a 51.6% increase from the previous year [1] - The GAAP loss per share was $2.32, compared to a loss of 60 cents in the prior-year quarter [1] Revenue Details - Glaukos achieved revenues of $143.1 million in the fourth quarter, marking a 36% year-over-year increase and surpassing the Zacks Consensus Estimate by 6% [2] - Total revenues for 2025 reached $507.4 million, up 32% year over year [2] Quarter in Detail - The company recorded net sales of $119.2 million for Glaucoma, a 42% increase year over year, while sales in Corneal Health totaled $24 million [3] Margin Analysis - Adjusted gross profit rose 40.3% year over year to $121.8 million, with an adjusted gross margin of 85.1% compared to 82.3% in the previous year [4] - Selling, general and administrative expenses increased by 37.2% year over year to $94.7 million, while research and development expenses totaled $43.7 million, up 19.5% [4] - Total operating expenses were $138.4 million, reflecting a 31% increase from the prior year [4] Financial Update - Glaukos ended the fourth quarter of 2025 with cash and cash equivalents and short-term investments of $282.6 million, up from $277.5 million at the end of the third quarter [6] 2026 Guidance - The company raised its guidance for 2026 revenues, expecting net sales in the range of $600-$620 million, with the Zacks Consensus Estimate at $610.6 million [7] - The loss per share estimate for 2026 is projected at 33 cents, indicating a 60.9% improvement year over year [7] Growth Drivers - Key growth drivers include the continued adoption of iDose TR and the launch of Epioxa, which supports long-term growth through ROI-focused investment and cash flow management [9] - U.S. glaucoma growth is driven by rapid adoption of iDose TR, broader physician utilization, and strong clinical confidence in the therapy's long-term outcomes [10] - International growth reflects broad-based strength across key regions, supported by investments in international infrastructure [11] Epioxa Launch - The recent FDA approval of Epioxa introduces a new topical cross-linking therapy for keratoconus, with drug availability expected soon [12] - The company is building out its Epioxa site-of-care network, aiming to cover nearly 50% of the U.S. population, expanding to 90% over time [12] - Payer engagement for Epioxa has begun, reaching insurers covering 50% of U.S. commercial lives [13] Overall Assessment - The quarter reinforces Glaukos' transition into a diversified ophthalmic growth company, with multiple commercial catalysts and pipeline milestones positioning it for durable double-digit revenue expansion [14] - Shares of Glaukos have gained 18.4% over the past six months, contrasting with a 7.1% decline in the industry [14]

Financial Data and Key Metrics Changes - Glaukos reported record fourth quarter consolidated net sales of $143.1 million, up 36% on a reported basis and 34% on a constant currency basis compared to the year-ago quarter [7] - For the full year of 2025, consolidated record net sales reached $507.4 million, growing 32% versus 2024 [7] - The company reaffirmed its full year 2026 net sales guidance range of $600 million to $620 million, implying over 20% year-over-year growth at the midpoint [7] Business Line Data and Key Metrics Changes - The U.S. glaucoma franchise achieved record fourth quarter net sales of $86.4 million, reflecting a strong year-over-year growth of 53%, driven by iDose TR, which generated approximately $45 million in sales during the fourth quarter [9] - The international glaucoma franchise delivered net sales of $32.8 million, with year-over-year growth of 18% on a reported basis and 13% on a constant currency basis [11] - The corneal health franchise reported net sales of $24 million, with year-over-year growth of 12%, including $21.4 million from Photrexa [12] Market Data and Key Metrics Changes - The company noted strong physician adoption of iDose TR, with sales of approximately $136 million in 2025, indicating positive clinical outcomes and growing contributions [9] - The international market is expected to face competitive product trialing headwinds in major markets, partially offset by contributions from iStent infinite following its EU MDR certification [11] Company Strategy and Development Direction - Glaukos aims to advance the interventional glaucoma treatment paradigm with iDose TR and launch Epioxa, targeting new markets in interventional keratoconus and rare diseases [8] - The company is focused on capital allocation, emphasizing ROI-driven investments and cash flow while advancing a robust industry-leading pipeline [9] - The FDA approval of Epioxa is seen as a pivotal moment, allowing the company to redefine its go-to-market approach and expand patient care access [15] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining strong growth momentum into 2026, driven by the advancements in iDose TR and the launch of Epioxa [8] - The company acknowledged potential challenges in the transition from Photrexa to Epioxa, particularly in Q2 and Q3, but expects stronger results in Q4 as the J-code becomes effective [37] - Management highlighted the importance of clinical education and payer engagement to ensure successful adoption of Epioxa [25] Other Important Information - Glaukos has invested over $1 billion in R&D since inception, focusing on chronic and rare ophthalmic diseases [21] - The company is committed to pioneering new marketplaces within ophthalmology, emphasizing innovation as a core value [22] Q&A Session Summary Question: Can you elaborate on the early positive coverage determinations for Epioxa? - Management noted that early positive outcomes have been observed with a handful of Medicaid societies and one of the larger Blue plans, with no formal pushback on pricing dynamics [25] Question: What drove the sequential deceleration in iDose revenue in Q4? - Management indicated that the mix shift towards Medicare Advantage and specific dynamics related to glaucoma procedures impacted revenue, but they expect continued growth in Q1 [29] Question: Can you provide more detail on the components of the FY 2026 guidance? - Management expects high single-digit growth internationally, with U.S. glaucoma growth driven entirely by iDose TR, while corneal health is expected to grow modestly with some volatility [35][37] Question: How do you view the interplay between iDose and TREX? - Management emphasized the goal of providing multiple treatment options for patients, with expectations for different surgeons to choose between iDose TR and TREX based on clinical profiles [49] Question: What are the expectations for operating expenses in 2026? - Management anticipates mid-teen year-over-year growth in operating expenses, aiming for around $555 million to $560 million, while maintaining operating leverage [54]

Financial Data and Key Metrics Changes - Glaukos reported record fourth quarter consolidated net sales of $143.1 million, up 36% on a reported basis and 34% on a constant currency basis compared to the year-ago quarter [7] - For the full year of 2025, consolidated record net sales reached $507.4 million, growing 32% versus 2024 [7] - The company reaffirmed its full year 2026 net sales guidance range of $600 million to $620 million, implying over 20% year-over-year growth at the midpoint [7] Business Line Data and Key Metrics Changes - The U.S. glaucoma franchise achieved record fourth quarter net sales of $86.4 million, reflecting a strong year-over-year growth of 53%, driven by iDose TR, which generated approximately $45 million in sales during the fourth quarter [9] - The international glaucoma franchise delivered net sales of $32.8 million, with year-over-year growth of 18% on a reported basis and 13% on a constant currency basis [11] - The corneal health franchise reported net sales of $24 million, with year-over-year growth of 12%, including T-Rex, which generated net sales of $21.4 million [12] Market Data and Key Metrics Changes - The company noted strong physician adoption of iDose TR, with sales of approximately $136 million in 2025, indicating positive clinical outcomes and growing contributions [9] - The international market is expected to face competitive product trialing headwinds in major markets, partially offset by growing contributions from iStent infinite following its EU MDR certification [11] Company Strategy and Development Direction - Glaukos aims to advance the interventional glaucoma treatment paradigm with iDose TR and the launch of Epioxa, targeting new markets in interventional keratoconus and rare diseases [8] - The company is focused on capital allocation, emphasizing ROI-driven investments and cash flow while advancing a robust industry-leading pipeline [9] - The FDA approval of Epioxa is seen as a significant milestone, allowing the company to redefine its go-to-market approach and expand patient care access [15] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining strong growth momentum into 2026, driven by transformational growth drivers [8] - The company anticipates continued sequential growth in iDose TR, despite being a seasonally low quarter for procedure volumes [30] - Management acknowledged potential volatility in the corneal health franchise due to the transition from Photrexa to Epioxa, expecting modest growth year-over-year [36] Other Important Information - Glaukos has invested over $1 billion in R&D since inception, focusing on chronic and rare ophthalmic diseases [21] - The company is committed to pioneering new marketplaces within ophthalmology, emphasizing innovation as a core value [22] Q&A Session Summary Question: Can you elaborate on early positive coverage determinations for Epioxa? - Management noted that early positive outcomes have been observed with a handful of Medicaid societies and one of the larger blue plans, with no formal pushback on pricing dynamics [25] Question: What drove the sequential deceleration in iDose revenue in Q4? - Management indicated that the mix shift towards Medicare Advantage and specific dynamics related to glaucoma procedures impacted revenue, but they expect continued growth in Q1 [29] Question: Can you provide more detail on the components of the FY 2026 guidance? - Management expects high single-digit growth internationally, with U.S. glaucoma growth driven entirely by iDose TR, while corneal health is expected to grow modestly with some volatility [35][36] Question: How do you view the interplay between iDose and T-Rex? - Management emphasized the goal of providing multiple treatment options for patients, with expectations for different surgeons to choose based on clinical profiles [48] Question: What are the expectations for operating expenses in 2026? - Management anticipates mid-teen year-over-year growth in operating expenses, aiming for cash flow break-even and potential cash flow generation [52]

Financial Data and Key Metrics Changes - Glaukos reported record fourth quarter consolidated net sales of $143.1 million, up 36% on a reported basis and 34% on a constant currency basis compared to the same quarter last year [5] - For the full year 2025, consolidated net sales reached $507.4 million, growing 32% versus 2024 [5] - The company reaffirmed its full year 2026 net sales guidance range of $600 million to $620 million, implying over 20% year-over-year growth at the midpoint [5] Business Line Data and Key Metrics Changes - The U.S. glaucoma franchise achieved record fourth quarter net sales of $86.4 million, reflecting a strong year-over-year growth of 53%, driven by iDose TR, which generated approximately $45 million in sales during the fourth quarter [8] - The international glaucoma franchise delivered net sales of $32.8 million, with year-over-year growth of 18% on a reported basis and 13% on a constant currency basis [10] - The corneal health franchise reported net sales of $24 million, with year-over-year growth of 12%, including T-Rex with net sales of $21.4 million [11] Market Data and Key Metrics Changes - The company noted strong physician adoption of iDose TR, with sales of approximately $136 million in 2025, reflecting positive clinical outcomes and growing contributions [9] - The international market is expected to face competitive product trialing headwinds in major markets, partially offset by contributions from iStent infinite following its EU MDR certification [11] Company Strategy and Development Direction - Glaukos aims to advance the interventional glaucoma treatment paradigm with iDose TR and the launch of Epioxa, targeting new markets in interventional keratoconus and rare diseases [7] - The company is focused on disciplined capital allocation, emphasizing ROI-driven investments and cash flow while advancing a robust industry-leading pipeline [8] - The FDA approval of Epioxa is seen as a pivotal moment, allowing the company to redefine its go-to-market approach and expand patient care access [13] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in sustaining strong growth momentum into 2026, driven by transformational growth drivers [6] - The company anticipates continued sequential growth in iDose TR, despite being in a seasonally low quarter for procedure volumes [29] - Management acknowledged potential volatility in the corneal health franchise due to the transition from Photrexa to Epioxa, expecting modest growth year-over-year [36] Other Important Information - Glaukos has invested over $1 billion in R&D since inception, focusing on chronic and rare ophthalmic diseases [19] - The company is establishing a network for Epioxa treatment, aiming to cover nearly 90% of the U.S. population [14] Q&A Session Summary Question: Can you elaborate on early positive coverage determinations for Epioxa? - Management noted that early positive outcomes have been observed with several Medicaid societies and a major blue plan, with no formal pushback on pricing dynamics [24] Question: What drove the sequential deceleration in iDose revenue in Q4? - Management indicated that the mix shifted towards Medicare Advantage, impacting revenue dynamics, but expects continued growth in Q1 [28][29] Question: Can you provide insights on the components of the FY 2026 guidance? - Management expects U.S. glaucoma growth driven by iDose TR, with modest growth in corneal health, particularly as Epioxa becomes available [34][36] Question: How will operating expenses be managed in 2026? - Management plans to balance capital investments against revenues, expecting mid-teen year-over-year growth in operating expenses [51]

Core Insights - Alger Weatherbie Specialized Fund focuses on investing in a portfolio of 50 small and mid-cap companies with promising growth potential [1] - The US equity market ended Q4 2025 positively, with the S&P increasing by 2.7%, driven by better-than-expected corporate earnings and a supportive macroeconomic environment [1] - The fund's Class A shares underperformed the Russell 2500 Growth Index in Q4 2025, with Real Estate and Consumer Staples contributing positively while Information Technology and Health Care sectors detracted from performance [1] Company Highlights - Glaukos Corporation (NYSE:GKOS) is highlighted as a key stock, focusing on novel therapies for glaucoma and other eye disorders [2][3] - Glaukos experienced a one-month return of -7.131% but a 52-week gain of 22.99%, with a market capitalization of $7.131 billion as of January 21, 2026 [2] - The company reported a revenue growth of approximately 37% year-over-year, driven by its flagship glaucoma product, iDose, and received FDA approval for its next-generation corneal health product, Epioxa, which is expected to drive further growth [3]

Summary of Glaukos Conference Call Company Overview - **Company**: Glaukos - **Industry**: Medical Supplies and Devices, specifically in ophthalmology - **Core Focus**: Innovation in ophthalmic treatments, particularly in minimally invasive glaucoma surgery (MIGS) and procedural pharmaceuticals [4][5] Key Points and Arguments Innovation and Market Leadership - Glaukos has pioneered the global MIGS marketplace and is creating new markets in procedural pharmaceuticals with products like iDose [4][5] - The company has invested approximately $800 million in R&D since 2018, resulting in 12 commercially available products and 13 in various development phases [7] Market Growth and Financial Performance - Achieved over 30% market growth in the past year, with a sustained CAGR of over 20% for the last decade [7] - Reported a record quarter with revenues of $507 million for 2025, projecting a 20% CAGR over the next 10 years [36] Product Development and Pipeline - Focus on changing treatment paradigms for glaucoma and keratoconus, with significant advancements in products like iDose TR and Epioxa [8][28] - iDose TR shows promising results, with 81% of patients off all medications after one year and 70% well-controlled after three years [12][13] - Epioxa is a new treatment for keratoconus, targeting a younger patient demographic and aiming to increase patient access [30][31] Market Dynamics and Challenges - The current treatment paradigm for glaucoma is inefficient, with 90% of patients non-adherent to medication regimens [10] - Glaukos aims to shift clinicians towards interventional approaches that provide continuous treatment [10][11] - The company faces challenges in reimbursement processes for Epioxa, which differ significantly from those for iDose due to the complexity of commercial payers [46][48] Future Vision and Strategy - Glaukos envisions a future where interventional glaucoma procedures could match the volume of cataract surgeries, projecting significant growth in this area by 2035 [27] - Plans to create a new cadre of interventional glaucoma surgeons who will integrate iDose and iStent Infinite into their practices [26][27] - Commitment to building a comprehensive product portfolio that addresses all stages of glaucoma treatment [28] Additional Important Insights - The company is expanding its manufacturing capabilities with new facilities in San Clemente and Huntsville, Alabama [37] - Glaukos is diversifying its operations internationally, now present in 17 countries with over 300 employees [36] - The management emphasizes the importance of educating physicians and patients about the benefits of new therapies to drive adoption [55][56] Conclusion Glaukos is positioned as a leader in ophthalmic innovation, with a strong focus on developing new treatment paradigms for glaucoma and keratoconus. The company is navigating challenges in market access and reimbursement while maintaining a robust growth trajectory and a commitment to expanding its product offerings.

Financial Data and Key Metrics Changes - The company has transitioned from a cash-burning phase to a cash flow break-even profile, with the convertible debt retired and a focus on capital-light operations [31][32] - Revenue growth is expected to continue, with operating margins projected in the 30% to 35% range as the company progresses towards profitability [76][77] Business Line Data and Key Metrics Changes - The core MIGS market has seen double-digit growth over the past year but is projected to decline in the mid-single digits next year, with the stent business expected to stabilize [13][16] - iDose is becoming a significant driver of revenue, with a shift towards pharmaceutical revenue potentially surpassing device revenue [9][10] Market Data and Key Metrics Changes - The reimbursement landscape for concomitant MIGS is facing low double-digit decreases, impacting professional fees while facility economics remain stable [20] - The company is currently working with four of the seven MACs that are reimbursing for professional fees, representing about 70% of Medicare lives [44] Company Strategy and Development Direction - The company aims to establish itself in the interventional glaucoma market, focusing on innovative product solutions and expanding its pipeline to include rare disease treatments like Epioxa [9][62] - The strategy includes enhancing education and awareness for rare diseases, which requires a different approach compared to more prevalent conditions like glaucoma [60][62] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, highlighting the importance of clinical outcomes and physician enthusiasm for iDose, which is expected to drive growth [28][30] - The company is focused on executing its strategies and addressing reimbursement challenges to facilitate broader adoption of its products [84][85] Other Important Information - The next-generation iDose TREX is in development, designed to carry a larger drug payload and potentially allow for longer durations of effect [55][56] - The company is also exploring in-office procedures for iDose, which could expand its market reach [57] Q&A Session Summary Question: What are the expectations for the iDose launch? - Management noted that while there were initial challenges with reimbursement, the clinical performance of iDose has exceeded expectations, leading to increased physician interest [26][28] Question: How is the company approaching profitability? - The focus remains on achieving cash flow breakeven in the short term while balancing revenue growth with necessary investments in product launches and R&D [75] Question: What is the outlook for the reimbursement landscape? - Management indicated that continued education and clinical demand are essential for expanding reimbursement coverage, with a goal of reducing the focus on reimbursement issues over time [49][50]

Financial Data and Key Metrics Changes - The company has transitioned from a cash-burning phase to a cash flow break-even profile, with the convertible debt retired and a return to normal capital spending [31][32] - Operating expenses are growing, but the company is showing leverage in its financial model as revenues increase [32][33] Business Line Data and Key Metrics Changes - The core MIGS market has seen double-digit growth over the past year but is projected to decline in the mid-single digits next year [13][16] - The introduction of iDose is cannibalizing some of the stent business, but it is also expanding the overall market opportunity [15][19] Market Data and Key Metrics Changes - The reimbursement landscape for concomitant MIGS is expected to decline in low double digits for 2026, impacting professional fees [20] - Four out of seven MACs are now reimbursing for the professional fee associated with iDose, covering about 70% of Medicare lives [44] Company Strategy and Development Direction - The company is focused on creating differentiated product solutions in large market opportunities, with a shift towards pharmaceutical revenues [9][10] - The strategy includes a strong emphasis on education and awareness for rare diseases, particularly with the launch of Epioxa [62] Management's Comments on Operating Environment and Future Outlook - Management is optimistic about the future, citing strong physician enthusiasm and positive clinical outcomes for iDose [28][30] - The company aims to shift discussions from reimbursement issues to clinical adoption and standard of care improvements in the coming year [84] Other Important Information - The next-generation iDose TREX is in development, designed to carry a larger drug payload and potentially allow for longer duration effects [55][56] - The company recognizes the challenges in treating rare diseases and is committed to transforming its approach to market access and patient education [60][62] Q&A Session Summary Question: What are the expectations for the MIGS market? - The MIGS market has grown but is expected to stabilize next year, with iDose impacting the stent business [15][16] Question: How is the reimbursement landscape evolving? - Four of the seven MACs are now reimbursing for iDose, with ongoing efforts to educate and drive demand for the remaining MACs [44][45] Question: What is the company's path to profitability? - The focus remains on achieving cash flow breakeven in the short term while aiming for operating margins of 30%-35% in the medium to long term [75][76] Question: What are the key challenges in launching Epioxa? - The company is aware of the need for education and awareness in the rare disease space, which requires significant investment and effort [60][62] Question: What will the company be discussing next year? - Management hopes to focus on clinical adoption and the opportunities associated with iDose and Epioxa, moving past reimbursement-related discussions [84]