Key Takeaways GKOS posted a narrower-than-expected Q2 loss and 29.7% revenue growth, beating the consensus estimate.Revenues were driven by strong uptake of iDose TR and solid performance from Photrexa in corneal health.The company raised 2025 revenue guidance but faces pressure from procedural bundling and coverage limits.Glaukos Corporation (GKOS) reported second-quarter 2025 adjusted loss of 24 cents per share, which was narrower than the Zacks Consensus Estimate of a loss of 26 cents. The figure also im ...

Financial Data and Key Metrics Changes - Glaukos reported record second quarter consolidated net sales of $124.1 million, up 30% on a reported basis or 29% on a constant currency basis compared to the same quarter last year [8] - The company raised its full year 2025 net sales guidance range to $480 million to $486 million, compared to the previous range of $475 million to $485 million [8] Business Line Data and Key Metrics Changes - The U.S. Glaucoma franchise achieved record second quarter net sales of $72.3 million, reflecting a strong year-over-year growth of 45%, driven by contributions from iDoseTR, which generated approximately $31 million in sales [10] - The international glaucoma franchise delivered record net sales of $31.3 million, with year-over-year growth of 20% on a reported basis and 15% on a constant currency basis [13] - The corneal health franchise reported net sales of $20.6 million, with a year-on-year growth of 4%, including Photrexa net sales of $17.9 million [15] Market Data and Key Metrics Changes - The U.S. market faced turbulence due to five MAC LCDs implemented in 2024, affecting the MIGS market, which is expected to continue into 2025 [11] - CMS proposed rules for 2026 largely maintained 2025 APC assignments and modestly increased facility fee rates, but proposed reductions in physician fee reimbursement for several category one CPT codes across ophthalmology [12] Company Strategy and Development Direction - The company is focused on driving new standalone intervention therapies designed to slow disease progression and reduce drug burden, particularly through the adoption of iDoseTR [9] - Glaukos plans to commence commercial launch activities for iStent Infinite in key European markets at the upcoming ESCRS Annual Meeting in September [15] - The company is advancing several important clinical programs across its five novel therapeutic platforms, including iDose and ILUTION [19] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the increasing clinical interest in interventional glaucoma therapies and the potential to reshape glaucoma management [10] - The transition from Photrexa to Epioxa is expected to create a material disruption headwind in Q4, as patients may defer procedures until Epioxa is available [27] - Management emphasized the importance of educating CMS on the proposed methodology shift regarding physician fees [12] Other Important Information - The company completed a small acquisition of Mobius Therapeutics, which solidifies its supply chain and supports broader glaucoma tertiary care efforts [20] - The company’s operational cash and equivalents grew by more than $4 million in the second quarter, excluding one-time investments [21] Q&A Session Summary Question: Clarification on 2025 sales guidance - Management acknowledged the exceptional second quarter performance but noted that guidance was raised conservatively due to less visibility in the second half, particularly in corneal health and U.S. glaucoma segments [24][25] Question: State of interventional glaucoma efforts - Management highlighted significant progress in building the standalone market opportunity for interventional glaucoma, with increasing traction and adoption of iDoseTR and iStent Infinite [28][30] Question: Comparison of geographic MAC coverage for iDose - Management indicated that growth was faster in MAC regions with established professional fees, and they are optimistic about progress in lagging MACs [35][36] Question: Impact of proposed reimbursement changes - Management expressed that the proposed facility fee increases are generally positive, but the overall impact on Glaukos is expected to be neutral to slightly positive [48] Question: SG&A growth expectations - Management noted a step-up in SG&A due to a one-time stock compensation expense, but overall operational expenses are expected to grow in the mid-teens [50][52] Question: iDose reimplantation decision timeline - Management clarified that the FDA has set a PDUFA date of January 28, 2026, for the iDose reimplantation petition, which reflects a change in timing [77] Question: Epioxa rollout strategy - Management indicated that the rollout of Epioxa will involve transitioning from Photrexa, with expectations of patient education and demand increasing post-approval [67][72]

Financial Data and Key Metrics Changes - Glaukos reported record second quarter consolidated net sales of $124.1 million, up 30% on a reported basis or 29% on a constant currency basis compared to the same quarter last year [6] - The company raised its full year 2025 net sales guidance range to $480 million to $486 million, up from the previous range of $475 million to $485 million [6] Business Line Data and Key Metrics Changes - The U.S. Glaucoma franchise achieved record second quarter net sales of $72.3 million, reflecting a strong year-over-year growth of 45%, driven by contributions from iDoseTR, which generated approximately $31 million in sales [9] - The international glaucoma franchise delivered record net sales of $31.3 million, with year-over-year growth of 20% on a reported basis and 15% on a constant currency basis [12] - The corneal health franchise reported net sales of $20.6 million, with a year-on-year growth of 4%, including Photrexa net sales of $17.9 million [13] Market Data and Key Metrics Changes - The U.S. market faced turbulence due to five MAC LCDs implemented in 2024, affecting the MIGS market, which is expected to continue into 2025 [10] - CMS proposed rules for 2026 largely maintained 2025 APC assignments and modestly increased facility fee rates, while proposing reductions in physician fee reimbursement for several ophthalmology codes [11] Company Strategy and Development Direction - The company is focused on driving new standalone intervention therapies designed to slow disease progression and reduce drug burden [7] - Glaukos aims to maintain and grow its presence in Europe with the recent EU MDR clearance for iStent Infinite, which is indicated for all stages of open-angle glaucoma [13] - The company completed a small acquisition of Mobius Therapeutics to solidify its supply chain and support its glaucoma tertiary care efforts [19] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the increasing clinical interest in interventional glaucoma therapies and the potential to reshape glaucoma management [8] - The company anticipates some transient disruption in the U.S. corneal health franchise as it transitions from Photrexa to Epioxa following targeted approval [16] - Management highlighted the importance of educating CMS on proposed methodology shifts affecting reimbursement [11] Other Important Information - The company is advancing several clinical programs across its therapeutic platforms, including iDose and ILUTION, with various trials and regulatory reviews ongoing [17][18] - The company expects to launch Epioxa in 2026, which will provide a new treatment option for keratoconus patients [15] Q&A Session Summary Question: Can you discuss the components of this year's revenue guidance? - Management noted that the guidance was raised due to exceptional second quarter performance, particularly driven by iDose, with expectations for low double-digit growth in international glaucoma and flat to low single-digit growth in corneal health [22][25] Question: What is the state of interventional glaucoma and the long-term opportunity? - Management highlighted a significant shift towards interventional approaches in glaucoma care, with increasing traction for iDoseTR and iStent Infinite, indicating a bright future for the company [26][30] Question: How are professional fees impacting the legacy MIGS business? - Management discussed the relativity of professional fees and the shift towards standalone glaucoma therapy as a viable pathway for practices facing reduced cataract surgery fees [38][41] Question: What are the implications of the proposed reimbursement changes? - Management expressed that the proposed facility fee increases are generally positive, while the impact on physician fees is more neutral [46] Question: What is the expected growth for SG&A expenses? - Management indicated that total OpEx would grow in the mid-teens, with a notable one-time stock comp expense affecting the quarter's results [48][50] Question: How will the rollout of Epioxa be managed post-approval? - Management stated that the transition from Photrexa to Epioxa will impact sales, with expectations for a significant portion of patients to defer to the new treatment [66][72]