GKOS — Glaukos Corporation

Glaukos Corporation Q1 2026 Earnings Call Summary

1. Key Financial Results and Metrics

• Net Sales: Glaukos reported record consolidated net sales of $150.6 million, a 41% increase year-over-year (39% on a constant currency basis).
• U.S. Glaucoma Franchise: Achieved $93.5 million in net sales, up 58% year-over-year, driven by iDose TR sales of approximately $54 million.
• International Glaucoma Franchise: Recorded $35.8 million in net sales, a 23% increase year-over-year (16% constant currency).
• Corneal Health Franchise: Generated $21.3 million in net sales, a 15% increase year-over-year, including early sales of Epioxa at $17.7 million.
• Guidance Update: Full-year 2026 net sales guidance raised to $620 million to $635 million, up from $600 million to $620 million.

2. Strategic Updates and Business Highlights

• iDose TR: Continued strong clinical outcomes and growing physician adoption, supported by a robust body of clinical evidence (22 peer-reviewed publications).
• Epioxa Launch: Commercial availability announced, with a focus on expanding patient access and awareness. Initial feedback from surgeons has been positive, and the company is establishing a broad site of care network.
• Market Access: Achieved access pathways for Epioxa covering over 100 million commercial lives in the U.S., with a new product-specific J-code (J2789) effective July 1, 2026.
• Pipeline Development: Ongoing clinical trials across multiple platforms, including pivotal trials for iDose TREX and iStent Infinite.

3. Forward Guidance and Outlook

• Sales Growth: Anticipated continued momentum in the U.S. glaucoma franchise, with expectations of low 30% growth for the year, while international glaucoma is expected to see high single-digit growth.
• Corneal Health: Expected to achieve high single-digit growth for the year, with some volatility anticipated due to the transition from Photrexa to Epioxa.
• Profitability Path: Near-term focus on cash flow breakeven, with a clear line of sight toward profitability over the next few years as commercial launches ramp up.

4. Bad News, Challenges, or Points of Concern

• Market Competition: Anticipated competitive product trialing headwinds in international markets could impact growth.
• Reimbursement Challenges: Initial patient access for Epioxa may be gated by payer adoption hurdles, with the transition to a permanent J-code expected to streamline this process.
• Flat Growth in Non-iDose Glaucoma: While there was a restoration of growth in the U.S. glaucoma business, management remains cautious, projecting flat growth in this segment for Q2 and the year until sustained trends are established.

5. Notable Q&A Insights

• Epioxa Launch: Initial claims adjudication is slower due to the miscellaneous code, but early indicators show positive trends in patient flow and claims processing.
• iDose Utilization: Continued strong growth in both standalone and combination procedures with cataract surgery; however, the company is cautious about projecting stabilization in surgeon utilization.
• Commercial Payer Engagement: Approximately 99% of patients have access pathways in commercial and Medicare Advantage plans, with a high success rate in prior authorizations.
• Long-term Potential for Epioxa: Management believes Epioxa could represent a $1 billion-plus franchise, with ongoing investments aimed at increasing awareness and treatment access for keratoconus patients.

Overall, Glaukos demonstrated strong financial performance in Q1 2026, with positive momentum in both its glaucoma and corneal health franchises, while also navigating challenges related to market competition and reimbursement processes.