Glaukos(US:GKOS)2025-12-03 19:45Financial Data and Key Metrics Changes - The company is transitioning towards generating more pharmaceutical revenue than device revenue, indicating a significant shift in its business model [10] - The convertible debt has been retired, and the company is returning to a normal capital spend, aiming for a cash flow break-even profile [30][31] - The company is experiencing leverage in its model, with revenues increasing while operating expenses grow, indicating improved financial health [31] Business Line Data and Key Metrics Changes - The core MIGS market has seen double-digit growth in the past year but is projected to decline in the coming year, with expectations of mid-single-digit growth [12][15] - The iDose product is cannibalizing some of the stent business, as physicians prefer it due to its clinical profile and outcomes [16][17] - The company is seeing more standalone MIGS procedures, benefiting from the expansion of procedure volumes across various technologies [20][21] Market Data and Key Metrics Changes - Reimbursement for concomitant MIGS is expected to decline in low double digits for 2026, impacting the professional fee side of the business [19] - The company has secured reimbursement from four of the seven MACs, covering about 70% of Medicare lives, with ongoing efforts to educate and push for reimbursement from the remaining MACs [42][43] Company Strategy and Development Direction - The company is focused on building a foundation for rare disease drugs, with Epioxa being the first product aimed at treating keratoconus, a rare disease [61][70] - The strategy includes expanding the iDose product line and developing next-generation products like iDose TREX, which aims to provide longer duration effects [53][54] - The company is committed to changing the standard of care in glaucoma treatment and is optimistic about future growth opportunities in the U.S. glaucoma market driven by iDose [28][80] Management's Comments on Operating Environment and Future Outlook - Management expressed optimism about the future, highlighting the importance of clinical adoption and the potential for significant growth in the interventional glaucoma market [83][84] - The company aims to shift focus from reimbursement-related issues to clinical adoption and the opportunities associated with its products [83] - Management acknowledged the challenges in establishing proper access and coverage for new treatment modalities but remains committed to navigating these complexities [47][48] Other Important Information - The company is working on a next-generation iDose product that could allow for secondary procedures and potentially in-office procedures, enhancing its treatment offerings [55] - The company is investing in education and awareness for keratoconus to improve patient detection and treatment access [60][61] Q&A Session Summary Question: What has surprised you about the iDose launch in 2025? - Management was surprised by the ongoing challenges with MACs and professional fee schedules but remains optimistic about the product's clinical performance and physician enthusiasm [25][27] Question: How do you think about profitability and reaching it? - The focus remains on achieving cash flow breakeven in the short term while aiming for profitability in the medium to long term, leveraging high gross margins [72][74] Question: What do you think investors are missing? - Management believes investors should focus on the long-term growth potential and the breadth of the company's portfolio rather than short-term fluctuations [80]