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]

Glaukos (NYSE:GKOS) Q4 2025 Earnings call February 17, 2026 04:30 PM ET Speaker11Hello, and thank you for standing by. My name is Tiffany, and I will be your conference operator today. At this time, I would like to welcome everyone to Glaukos's fourth quarter and full year 2025 financial results conference call. All lines have been placed on mute to prevent any background noise. After the speaker's remarks, there will be a question and answer session. If you would like to ask a question during that time, si ...

Financial Data and Key Metrics Changes - Glaukos Corporation reported record third quarter consolidated net sales of $133.5 million, up 38% on a reported basis or 37% on a constant currency basis compared to the same quarter last year [7] - The company raised its full year 2025 net sales guidance range to $490 million-$495 million from the previous range of $480 million-$486 million [7][26] Business Line Data and Key Metrics Changes - The U.S. glaucoma franchise achieved record third quarter net sales of $80.8 million, reflecting a strong year-over-year growth of 57%, driven by iDose TR, which generated approximately $40 million in sales [8] - The international glaucoma franchise delivered net sales of $29.4 million, representing a year-over-year growth of 20% on a reported basis and 17% on a constant currency basis [9] - The corneal health franchise reported net sales of $23.3 million, with Photrexa net sales contributing $20.3 million, reflecting a year-over-year growth of 13% [10] Market Data and Key Metrics Changes - Surgeons showed high initial interest in iStent infinite during its commercial launch activities in key European markets, indicating strong potential for growth in the international market [9] - The company continues to scale its international infrastructure to drive growth as a standard of care in major markets worldwide [9] Company Strategy and Development Direction - Glaukos is focused on advancing its strategic priorities, evolving into a diversified ophthalmic leader with growth drivers across multiple geographies and disease states [11] - The FDA approval of Epioxa marks a significant milestone, introducing a new standard of care for keratoconus patients and practitioners [12] - The company plans to increase investments in patient awareness and access to address the challenges of underdiagnosis and under-treatment in keratoconus [18][19] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in the potential of Epioxa to deliver exceptional value to patients and the healthcare system, emphasizing the importance of education and awareness in driving patient access [22] - The company anticipates Epioxa will be commercially available in the first quarter of 2026, with a focus on establishing a site of care network and addressing payer adoption challenges [24] - A preliminary revenue guidance range of $600 million-$620 million for 2026 was introduced, reflecting expectations for continued growth from iDose TR and the launch of Epioxa [26][27] Other Important Information - Glaukos has invested over $1 billion in R&D to develop a robust pipeline focused on chronic and rare ophthalmic diseases [21] - The company is transitioning from Photrexa to Epioxa, with plans to discontinue Photrexa's commercial availability in 2026 while ensuring continuity of care for existing patients [25] Q&A Session Summary Question: Discussion on iDose and CAC meeting - Management discussed the rationale behind the CAC meeting, emphasizing the need to educate MACs on the unmet need that iDose addresses and the robust data supporting its utilization [30][31] Question: Confidence in Epioxa pricing and 2026 outlook - Management expressed confidence in executing the pricing strategy for Epioxa, highlighting the importance of educating payers on the therapy's benefits and the cost implications of untreated keratoconus [36][37] Question: iDose performance and future growth - Management provided insights into iDose's performance, noting broad-based growth and the importance of establishing reimbursement structures to support future adoption [44][46] Question: Epioxa's market development and education efforts - Management outlined targeted awareness and education campaigns to identify and reach keratoconus patients earlier in their disease journey, emphasizing the need for a comprehensive approach [77]