Glaukos Corporation (GKOS) Q1 2026 Earnings Call Transcript
Access earnings results, analyst expectations, report, slides, earnings call, and transcript.
Overview
The earnings call highlights strong growth in Corneal Health sales and optimistic guidance, with raised sales projections. The Q&A reveals positive sentiments towards iDose and Epioxa, with plans to expand market access and awareness. Although some uncertainty exists regarding reimbursement timelines, the strategic initiatives and promising market potential for Epioxa and iDose suggest a positive stock price movement over the next two weeks.
Key Financial Performance
Consolidated Net Sales $150.6 million, up 41% on a reported basis and 39% on a constant currency basis year-over-year. The increase is attributed to strong execution across global commercial and development priorities, as well as the strength of differentiated technology platforms.
U.S. Glaucoma Franchise Net Sales $93.5 million, up 58% year-over-year. Growth driven by contributions from iDose TR, which generated $54 million in sales during the quarter. The increase is due to strong clinical outcomes, growing physician interest, and adoption of iDose TR.
International Glaucoma Franchise Net Sales $35.8 million, up 23% on a reported basis and 16% on a constant currency basis year-over-year. Growth attributed to scaling international infrastructure and driving MIGS forward as a standard of care, partially offset by competitive product trialing headwinds and currency tailwinds.
Corneal Health Franchise Net Sales $21.3 million, up 15% year-over-year. Includes $17.7 million from Photrexa and early Epioxa sales. Growth driven by the commercial availability of Epioxa, a novel advancement in corneal cross-linking for keratoconus treatment.
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Operating Highlights
iDose TR: Generated $54 million in sales in Q1 2026, showing strong clinical outcomes and driving physician interest and adoption. Supported by 22 peer-reviewed publications and active Phase IV studies.
Epioxa: Launched as a novel treatment for keratoconus, offering incision-free alternative to traditional procedures. Early commercial launch activities have been encouraging, with significant investments in patient awareness and access.
U.S. Glaucoma Franchise: Achieved record Q1 net sales of $93.5 million, a 58% year-over-year growth, driven by iDose TR.
International Glaucoma Franchise: Reported $35.8 million in net sales, a 23% year-over-year growth on a reported basis, driven by scaling international infrastructure and MIGS adoption.
Corneal Health Franchise: Reported $21.3 million in net sales, a 15% year-over-year growth, including early Epioxa sales of $17.7 million.
Market Access for Epioxa: Secured pathways for over 100 million covered commercial lives in the U.S., with CMS assigning a product-specific J-code effective July 1, 2026.
Clinical Pipeline: Advancing 13 publicly disclosed programs and additional undisclosed assets, including pivotal trials for iDose TREX, iStent infinite, and PRESERFLO MicroShunt.
Strategic Growth Drivers: Focused on iDose TR and Epioxa as transformational growth drivers, aiming to sustain momentum and diversify leadership in ophthalmology.
Capital Allocation: Prioritizing ROI-driven investments to support operating leverage and cash flow breakeven.
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Risk or Challenges
Competitive Product Trialing Headwinds: The company expects new competitive product trialing headwinds in some major international markets, which could impact sales and market share.
Currency Tailwinds Abatement: Currency tailwinds that have benefited the company are expected to abate going forward, potentially impacting financial performance.
Payer Adoption Headwinds for Epioxa: Initial patient access to Epioxa will face typical payer adoption headwinds and hurdles, which could slow down the adoption and revenue generation of this new product.
Regulatory and Reimbursement Challenges: The company anticipates measured adoption of Epioxa until a permanent J-code is in place, which could delay streamlined reimbursement and operational processes.
Underdiagnosis and Undertreatment of Keratoconus: The long-standing challenges of underdiagnosis and undertreatment of keratoconus could limit the market potential of Epioxa despite its innovative features.
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Guidance & Outlook
Full Year 2026 Net Sales Guidance: Raised to $620 million to $635 million, compared to the previous guidance of $600 million to $620 million.
Growth Drivers: Momentum expected to be sustained through the advancement of interventional glaucoma treatment paradigm with iDose TR and the launch of Epioxa for keratoconus and rare diseases.
iDose TR: Continued focus on expanding trained surgeons, increasing utilization, broadening market access, and scaling commercial investments. Supported by 22 peer-reviewed publications and active Phase IV studies.
Epioxa Launch: Commercial availability announced for the treatment of keratoconus. Investments in patient awareness, education, and access are being increased. Initial patient access will face payer adoption hurdles, but progress is being made with pathways established for over 100 million covered commercial lives in the U.S.
Epioxa Reimbursement: CMS assigned a product-specific J-code (J2789) effective July 1, 2026, expected to streamline reimbursement processes.
Pipeline Development: Advancing 13 publicly disclosed programs and additional undisclosed assets, including pivotal trials for iDose TREX, iStent infinite, and PRESERFLO MicroShunt, as well as a planned market introduction of a KC screening device later this year.
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Shareholder Return Plan
The selected topic was not discussed during the call.
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Key Q&A
Q:What are the early findings on Epioxa's initial experiences with claims and prior authorization processes, and market demand?
A:Joseph Gilliam stated that it is hard to judge too much until the post J-code period, as the current process involves a miscellaneous code, which is slower. However, they are encouraged by the sites of care coming online and the patient flow into their portal, which serves as a leading indicator of clinical demand.
Q:What are the drivers of iDose's strong performance in the quarter?
A:Joseph Gilliam highlighted broad-based performance, with expansion in established MACs like Noridian, Novitas, and First Coast, and early signs of adoption in NGS and Palmetto regions. He noted an increase in the funnel into their hub from commercial and Medicare Advantage patient flow. Noridian, Novitas, and First Coast accounted for 73% of regional volumes, down from 78% in the prior quarter, as adoption in other areas picked up.
Q:Can you break down the updated guidance for iDose, stent business, and Corneal Health?
A:Joseph Gilliam explained that the guidance was raised to $620-$635 million. For International Glaucoma, high single-digit growth is expected for the remainder of the year, translating to low double-digit growth for the full year. Corneal Health is expected to see high single-digit growth for the year, with volatility in Q2 and Q3 due to the Photrexa to Epioxa transition. U.S. Glaucoma is expected to grow in the low 30% range for the year, with flat non-iDose sales and sequential iDose expansion.
Q:What are the new initiatives planned for iDose as reimbursement reaches critical mass?
A:Joseph Gilliam mentioned plans to drive increased awareness for iDose and interventional glaucoma, including growing the commercial team and potentially exploring direct-to-consumer initiatives in the latter part of the year. Investments are being made in reimbursement and business teams to maximize patient access and awareness.
Q:What is the status of engagement with MACs and the likelihood of an LCD for iDose?
A:Joseph Gilliam stated that they continue to engage in education with MACs and are making progress with CGS and WPS. There are no signs of an LCD at this stage, and they believe it would be premature. However, the possibility remains unpredictable. Phase IV studies are being conducted to demonstrate the incremental value of iDose in combination with cataract surgery and other treatments.
Q:What is the long-term potential for Epioxa, and what does the ramp look like?
A:Joseph Gilliam expressed confidence in Epioxa as a potential $1 billion-plus franchise. They aim to grow the market beyond the 18,000-19,000 eyes treated with Photrexa by increasing awareness, detection, and access. Investments in direct-to-consumer initiatives and second-generation customized algorithms are expected to expand the market further.
Q:What is the current utilization trend for iDose among surgeons?
A:Joseph Gilliam noted that the majority of iDose procedures are still stand-alone, but the mix is shifting towards combination with cataract surgery or other MIGS. Utilization growth is seen across both mature and new surgeon cohorts.
Q:What progress has been made with commercial payers for iDose?
A:Joseph Gilliam reported that 99% of patients have an access pathway, with 50% covered by specific policies. High success rates are observed in prior authorizations submitted for patients.
Q:What are the market development efforts for Epioxa?
A:Joseph Gilliam outlined efforts focused on establishing a site of care network, engaging with payers to streamline access pathways, and dialing up physician and patient marketing efforts. Current focus is on claims prosecution and adjudication to ensure patient access.
Q:What is the timeline for the Photrexa to Epioxa transition?
A:Joseph Gilliam confirmed that Photrexa is expected to fully sunset by the end of Q3, with limited availability for specific cases thereafter.
Q:What is the potential market size for keratoconus treatment with Epioxa?
A:Joseph Gilliam estimated that 50,000-100,000 keratoconus eyes per year could be treated with Epioxa, significantly higher than the 18,000-20,000 eyes treated with Photrexa. Efforts are focused on increasing awareness, detection, and access.
Q:Review of Unclear Management Responses
A:Management avoided providing a direct answer on the specific timeline for achieving 95% coverage of the U.S. population with Epioxa, stating that progress has been accelerating but noting that some hospital systems have longer cycles for bringing on new technologies.
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GKOS Transcript
Glaukos Corporation (GKOS) Q1 2026 Earnings Call Transcript
Positive4-29
The earnings call highlights strong growth in Corneal Health sales and optimistic guidance, with raised sales projections. The Q&A reveals positive sentiments towards iDose and Epioxa, with plans to expand market access and awareness. Although some uncertainty exists regarding reimbursement timelines, the strategic initiatives and promising market potential for Epioxa and iDose suggest a positive stock price movement over the next two weeks.
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Positive2-17
The earnings call indicates strong financial performance with 12% YoY growth in Corneal Health sales and raised revenue guidance for 2025 and 2026. The launch of Epioxa and infrastructure expansion are positive indicators. The Q&A reveals no payer pushback on pricing and expected sequential growth in iDose revenue. However, the lack of clarity on certain metrics and operating expense growth are minor concerns. Overall, the positive elements outweigh the negatives, suggesting a positive stock reaction.
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