Q2 2024 Glaukos Corp Earnings Call

Unknown Executive: Hello, and welcome to Glaukos Corporation's second quarter 2024 Financial Results Conference. Copies of the Company's Press Release and Quarterly Summary Document, both issued after the market closed today, are available at www.glaukos.com. All participants are currently in a listen-only mode. Later, we will conduct a question-and-answer session. To ask a question, please press star 1 on your telephone keypad. To note, this call is being recorded.

Unknown Executive: Hello and welcome to Glaukos Corporation's second quarter, 2024 financial results conference call. Cops of the company's press release and quarter summary document. Both issued after the market close today are available at www.glaukos.com.

Unknown Executive: An archived replay will be available online in the Investor Relations section at www.glaukos.com. I will now turn the call over to Chris Lewis, Vice President of Investor Relations and Corporate Affairs. Thank you.

Speaker Change: Hello and welcome to Glaukos Corporation's second quarter 2024 financial results conference call.

Speaker Change: Copies of the company's press release and quarterly summary document.

Speaker Change: Both issued after the market closed today are available at www.glaukos.com

Unknown Executive: All participants are currently in a listen-only mode. Later, we will conduct a question in the answer session. To ask a question, please press star one on your telephone keypad. To note, this call is being recorded. Then, archived replay will be available online in the Investor Relations section at www.glaukos.com.

Speaker Change: All participants are currently in a listen-only mode.

Speaker Change: Later we will conduct a question and answer session.

Speaker Change: To ask a question, please press star 1 on your telephone keypad.

Speaker Change: To note, this call is being recorded and an archived replay will be available online in the Investor Relations section at www.glaukos.com. I will now turn the call over to Chris Lewis, Vice President of Investor Relations and Corporate Affairs.

Christopher Lewis: I will now turn the call over to Chris Lewis, President of Investor Relations and Corporate Affairs.

Christopher Lewis: Thank you and good afternoon. Joining me today are Glaukos Chairman and CEO Tom Burns, President and CEO of Jo Gilliam, and CEO of Alex Thurman.

Christopher William Lewis: Joining me today are Glaukos Chairman and CEO Tom Burns, President and COO Joe Gilliam, and CFO Alex Thurman. Similar to prior quarters, the company has posted a document on its investor relations website under the financials and filings quarterly results section titled quarterly summer. This document is designed to provide the investment community with a summarized and easily accessible reference document that details the key facts associated with the quarter, the state of the company's business objectives and strategies, and any forward statements or guidance we may make.

Christopher William Lewis: Thank you and good afternoon.

Speaker Change: Joining me today are Glaukos Chairman and CEO Tom Burns, President and COO Joe Gilliam, and CFO Alex Thurman. Similar to prior quarters, the company has posted a document on its investor relations website under the financials and filings quarterly results section titled quarterly summary.

Christopher Lewis: Similar to prior quarters, the company has posted a document on its Investor Relations website under the Financials and Filings Quarterly Results section titled Quarterly Summary. This document is designed to provide the investment community with a summarized and easily accessible reference document that details the key facts associated with the quarter, the state of the company's business objectives and strategies, and any forward statements for guidance we may make. This document is designed to be read by investors before the weekly scheduled quarterly conference call. As such, for this call, we will make prepared remarks and transition into a question-and-answer session.

Speaker Change: This document is designed to provide the investment community with a summarized and easily accessible reference document that details the key facts associated with the quarter, the state of the company's business objectives and strategies, and any forward statements or guidance we may make.

Christopher William Lewis: This document is designed to be read by investors before the regularly scheduled quarterly conference call. As such, on this call, we will make brief prepared remarks and transition into a question and answer session. To ensure ample time and opportunity to address everyone's questions, we request that you limit yourself to one question and one follow-up. If you still have additional questions, you may get back into the queue.

Speaker Change: This document is designed to be read by investors before the regularly scheduled quarterly conference call. As such, for this call, we will make brief prepared remarks and transition into a question and answer session.

Christopher Lewis: To ensure ample time and opportunity to address everyone's questions, we request that you let me yourself do one question and one follow-up. If you still have additional questions, you may get back into the queue.

Speaker Change: To ensure ample time and opportunity to address everyone's questions, we request that you limit yourself to one question and one follow up. If you still have additional questions, you may get back into the queue.

Christopher Lewis: Please note that all statements, other than statements of historical facts made on this call, that address activities, events, or developments we expect, believe, or anticipate will or may occur in the future, are forward-looking statements. These include statements about our plans, objectives, strategies, and prospects regarding, among other things, our sales, products, pipeline technologies, and clinical trials, U.S. and international commercialization, market development efforts, the efficacy of our current and future products, competitive market position, regulatory strategies, and reimbursement for our products, financial condition, and results of operations, as well as the expected impact of general macroeconomic conditions, including foreign currency fluctuations, on our business and operations.

Unknown Executive: Please note that all statements other than statements of historical facts made on this call that address activities, events, or developments we expect, believe, or anticipate will or may occur in the future are forward-looking statements. These include statements about our plans, objectives, strategies, and prospects regarding, among other things, our sales, products, pipeline technologies, and clinical trials, U.S. and international commercialization, market development efforts, the efficacy of our current and future products, competitive market position, regulatory strategies, and reimbursement for our products, financial condition, and results of operations, as well as the expected impact of general macroeconomic conditions, including foreign currency fluctuations, on our business and operations.

Speaker Change: Please note that all statements other than statements of historical facts made on this call that address activities, events, or developments we expect, believe, or anticipate will or may occur in the future are forward-looking statements.

Speaker Change: These include statements about our plans, objectives, strategies, and prospects regarding, among other things, our sales, products, pipeline technologies, and clinical trials, U.S. and international commercialization, market development efforts, the efficacy of our current and future products,

Speaker Change: Competitive Market Position, Regulatory Strategies and Reimbursement for Our Products, Financial Condition and Results of Operations, as well as the expected impact of general macro economic conditions, including foreign currency fluctuations on our business and operations.

Christopher Lewis: These statements are based on current expectations about future events affecting us and our subject to risks, uncertainties, and factors relating to our operations and business environment, all in which are difficult to predict and many of which are beyond our control. Therefore, they may cause our actual results to differ materially from those expressed or implied by forward-looking statements.

Unknown Executive: These statements are based on current expectations about future events affecting us and are subject to risks, uncertainties, and factors relating to our operations and business environment, all of which are difficult to predict and many of which are beyond our control. Therefore, they may cause our actual results to differ materially from those expressed or implied by forward-looking statements. Review today's press release and our recent SEC filing for more information about these risk factors. You'll find these documents in the investor relations section of our website at www.glaukos.com.

Speaker Change: These statements are based on current expectations about future events affecting us and are subject to risks, uncertainties, and factors relating to our operations and business environment.

Speaker Change: All of which are difficult to predict, and many of which are beyond our control. Therefore, they may cause our actual results to differ materially from those expressed or implied by forward-looking statements. Review today's press release and our recent SEC filing for more information about these risk factors.

Christopher Lewis: Reviewed today's press release and our recent SEC filing for more information about these risk factors. You'll find these documents in the Investor Relations section of our website at www.cloudcoast.com.

Speaker Change: You'll find these documents in the investor relations section of our website at www.glaukos.com.

Christopher Lewis: Finally, please note that during today's call, we will also discuss certain non-GAAP financial measures, including results on an adjusted basis. We believe these financial measures can facilitate a more complete analysis and greater transparency in the glucose's ongoing results of operations, particularly when comparing to underlying results from period to period. Please report it in tables and earnings press release, available in the investor relations section of our website, or reconciliation of these measures for the most directly comparable GAAP financial.

Unknown Executive: Finally, please note that during today's call, we will also discuss certain non-GAAP financial measures, including results on an adjusted basis. We believe these financial measures can facilitate a more complete analysis and greater transparency into Glaukos' ongoing results of operations, particularly when comparing underlying results from period to period. Please refer to the tables in our earnings press release available in the investor relations section of our website for reconciliation of these measures for the most directly comparable GAAP financial models.

Speaker Change: Finally, please note that during today's call, we will also discuss certain non-GAAP financial measures, including results on an adjusted basis.

Speaker Change: We believe these financial measures can facilitate a more complete analysis and greater transparency into Glaukos' ongoing results of operations, particularly when comparing underlying results from period to period.

Speaker Change: Please report in the tables at our earnings press release available in the investor relations section of our website for reconciliation of these measures for the most directly comparable GAAP financial measure.

Unknown Executive: with that.

Thomas William Burns: With that, I will turn the call over to Glaukos Chairman and CEO, Tom Burns. All right, thanks, Chris. Good afternoon, and thank you all for joining us. Today, Glaukos reported record second quarter consolidated net sales of $95.7 million, up 19% on a reported basis and 20% on a constant currency basis compared to the Yerko Corridor.

Thomas Burns: I will turn the call over to Glaukos Chairman and CEO, Tom Burns.

Thomas William Burns: As a result of our strong performance, we are raising our full year 2024 net sales guidance range to $370 to $376 million versus $357 to $365 million previously. Our second quarter record results were broad-based, with growth being driven by both our U.S. and international glaucoma franchises, where we continue to accelerate efforts to expand access to interventional glaucoma tools for the benefit of physicians and patients. Our goal to advance and improve glaucoma care by driving earlier intervention continues to build momentum as we lead and work closely with surgeons and thought leaders globally to organically drive this broader evolution in the standard of care.

Thomas Burns: All right, thanks, Chris.

Speaker Change: With that, I will turn the call over to Glaukos Chairman and CEO , Tom Burns.

Thomas Burns: Good afternoon, and thank you all for joining us. Today Glaukos reported a record second quarter consolidated net sales of $95.7 million, of 19% on a reported basis and 20% on a constant currency basis versus the year go quarter. As a result of our strong performance, we are raising our full year 2024 net sales guidance range to 370 to 376 million versus 357 to 365 million previously. Our second quarter record results were broad based with growth being driven by both our U.S. and international glaucoma franchises where we continue to accelerate efforts to expand access to international glaucoma tools for the benefit of physicians and patients.

Thomas William Burns: All right. Thanks, Chris. Good afternoon and thank you all for joining us.

Thomas William Burns: Today, Glaukos reported a record second quarter consolidated net sales of $95.7 million, up 19% on a reported basis and 20% on a constant currency basis.

Speaker Change: As a result of our strong performance, we are raising our full year 2024 Net Sales Guidance Range to $370 to $376 million versus $357 to $365 million previously.

Speaker Change: Our second quarter record results were broad-based, with growth being driven by both our U.S. and international glaucoma franchises, where we continue to accelerate efforts to expand access to interventional glaucoma tools for the benefit of physicians and patients.

Thomas Burns: Our goal to advance and improve glaucoma care by driving earlier and earlier intervention continues to build momentum as we lead and work closely with surgeons and thought leaders globally to organically drive this broader evolution in the standard of care. Within our U.S. glaucoma franchise we delivered record second quarter sales of $49.8 million on strong year-over-year growth of 26%. If you have been once again by strong growth within our overall I sent portfolio led by I sent infinite along with early but growing contributions from I do is TR. The utilization of I sent infinite for glaucoma patients that have failed medical and surgical therapy continues to expand as our ongoing clinical education efforts and improving market access landscape takes hold.

Speaker Change: Our goal to advance and improve glaucoma care by driving earlier intervention continues to build momentum as we lead and work closely with surgeons and thought leaders globally to organically drive this broader evolution in the standard of care.

Thomas William Burns: Within our U.S. glaucoma franchise, we delivered record second-quarter sales of $49.8 million on strong year-over-year growth of 26 percent, driven once again by strong growth within our overall ISTN portfolio, led by ISTN Infinite, along with early but growing contributions from IDOS-TR. Utilization of ISDN Infinite for glaucoma patients that have failed medical and surgical therapy continues to expand as our ongoing clinical education efforts and improving market access landscape take hold.

Speaker Change: Within our U.S. glaucoma franchise, we delivered record second-quarter sales of $49.8 million.

Speaker Change: on strong year-over-year growth of 26%, driven once again by strong growth within our overall ISTN portfolio, led by ISTN Infinite, along with early but growing contributions from IDOS-TR.

Speaker Change: Utilization of ICD-9 for glaucoma patients that have failed medical and surgical therapy continues to expand as our ongoing clinical education efforts and improving market access landscape takes hold.

Thomas Burns: Importantly during the second quarter by the 7 max issued draft mix LCDs that establish coverage for I sent infinite that is consistent with our original reconsideration request. We have actively supported industry efforts to encourage areas of improvement in these draft LCDs on the floor to their finalization, as we expect it will be an important step in unlocking the remaining Medicare Advantage and commercial plan coverage for I sent infinite. Turning to I does TR, I'm pleased to report that we successfully advance execution of our detailed launch plans for this first of its kind intracamma procedural pharmaceutical that was designed to deliver glaucoma drug therapy for up to three years.

Thomas William Burns: Importantly, during the second quarter, five of the seven MACs issued draft MIGs LCDs that established coverage for ISDN Infinite that is consistent with our original reconsideration request. We have actively supported industry efforts to encourage areas of improvement in these draft LCDs and look forward to their finalization, as we expect it will be an important step in unlocking the remaining Medicare Advantage and Commercial Plan coverage for ice and infinite. Turning to IDOS-TR, I'm pleased to report that we successfully advanced the execution of our detailed launch plans for this first-of-its-kind intracameral procedural pharmaceutical designed to deliver glaucoma drug therapy for up to three years.

Speaker Change: Importantly, during the second quarter, five of the seven MACs issued draft MIGs LCDs that established coverage for I-State Infinite that is consistent with our original reconsideration request.

Speaker Change: We have actively supported industry efforts to encourage areas of improvement in these draft LCDs and look forward to their finalization as we expect it will be an important step in unlocking the remaining Medicare Advantage and Commercial Plan coverage for ISN Infinite.

Speaker Change: Turning to IDOS-TR, I'm pleased to report that we successfully advanced execution of our detailed launch plans for this first-of-its-kind intracameral procedural pharmaceutical that was designed to deliver glaucoma drug therapy for up to three years.

Thomas Burns: Outcomes and feedbacks from early cases continue to be very positive and reaffirms our view that with a launch of I does TR we are pioneering a brand new therapeutic category that has the potential to reshape glaucoma management as we know it today. During the order, we successfully expanded access of I does TR to all of our sales field personnel. What continue to target those surgeries so he's comfortable utilizing a miscellaneous drug cover. In addition to our commercial efforts, the launch has been supported by a growing set of clinical literature now consisting of seven different peer review publications highlighting I does TR as a transformative new treatment alternative for patients suffering with glaucoma and actuar hypertension.

Thomas William Burns: Outcomes and feedback from early cases continue to be very positive and reaffirm our view that with the launch of IDOS-TR, we are pioneering a brand new therapeutic category that has the potential to reshape glaucoma management as we know it today. During the quarter, we successfully expanded access to IJOST-TR to all of our sales field personnel while continuing to target those surgeon facilities comfortable utilizing a miscellane In addition to our commercial efforts, the launch has been supported by a growing set of clinical literature, now consisting of seven different peer-reviewed publications, highlighting IDOS-TR as a transformative new treatment alternative for patients suffering with glaucoma and ocular hypertension.

Speaker Change: Outcomes and feedbacks from early cases continue to be very positive and reaffirms our view that with the launch of ISTR, we are pioneering a brand new therapeutic category that has the potential to reshape glaucoma management as we know it today.

Speaker Change: During the quarter, we successfully expanded access of ITOS-TR to all of our sales field personnel while continuing to target those surgeon facilities comfortable utilizing a miscellaneous drug coven.

Speaker Change: In addition to our commercial efforts, the launch has been supported by a growing set of clinical literature, now consisting of seven different peer-reviewed publications highlighting IDOS-TR as a transformative new treatment alternative for patients suffering with glaucoma and ocular hypertension.

Thomas Burns: As you know, a key element to the stage gating of our I does TR commercial launch is market access. As scheduled, the unique permanent J code for I does TR J7355 became effective earlier this month by July 1, 2024. This now-effective J-code is expected to increase patient access and will allow us to expand training plans to future ways of surgeons and facilities. We're also advancing efforts to secure professional meat coverage and payment with VACS, as well as establish commercial and Medicare-advanced coverage now that the permanent J-code is effective. As noted in the past, we expect increasing adoption as reimbursement confidence gained by our customers over the remainder of 2024 and, more specifically, in the fourth quarter heading into 2025.

Thomas William Burns: As you know, a key element to the stage gating of our Eidos TR commercial launch is market access. As scheduled, the unique permanent J code for Eidos TR, J7355, became effective earlier this month on July 1st, 2024.

Speaker Change: As you know.

Speaker Change: A key element to the stage gating of our IDOS-TR commercial launch is market access. As scheduled, the unique permanent J code for IDOS-TR, J7355, became effective earlier this month on July 1st, 2024.

Thomas William Burns: This now-effective J-code is expected to increase patient access and will allow us to expand training plans to future waves of surgeons and facilities. We're also advancing efforts to secure professional fee coverage and payment with VACs, as well as establish commercial and Medicare Advantage coverage now that the Permanent J Code is effective. As noted in the past, we expect increasing adoption as reimbursement confidence is gained by our customers over the remainder of 2024 and, more specifically, in the fourth quarter heading into 2025.

Speaker Change: This now effective J-code is expected to increase patient access and will allow us to expand training plans to future waves of surgeons and facilities.

Speaker Change: We are also advancing efforts to secure professional fee coverage and payment with BACs, as well as establish commercial and Medicare Advantage coverage now that the Permanent J-Code is effective.

Speaker Change: As noted in the past, we expect increasing adoption as reimbursement confidence is gained by our customers over the remainder of 2024, and more specifically in the fourth quarter heading into 2025.

Thomas William Burns: Earlier this month, CMS issued their proposed 2025 facility fee and professional fee rules that, as drafted, largely maintain the 2024 reimbursement assignments and rates associated with our procedures. Finally, as promised, we have now engaged the FDA in a formal regulatory dialogue regarding the re-administration of IDOS-TR, and beyond that, remain on track to commence a phase three clinical trial for IDOS-TREX, our next generation IDOS therapy, by the end of Moving on, our international glaucoma franchise delivered record sales of $26.1 million, a year over year growth of 17% on a reporting basis and 21% on a constant currency basis.

Thomas Burns: Earlier this month, CMS issued their proposed 2025 SODB and professional fee rules that, as drafted, largely maintained in 2024 reimbursement assignments and rates associated with our procedures. Finally, as promised, we have now engaged the FDA in a formal regulatory dialogue regarding the administration of I-DOS-TR, and beyond that, remain on track to commence phase three clinical trial for I-DOS-T Rex, our next generation I-DOS, thereby by the end of 2024. Moving on, our international glaucoma franchise delivered record sales of $26.1 million, year-over-year growth of 17% on a reporting basis, and 21% on a constant currency basis. This strong growth was once again broad-based as we continued to scale our international infrastructure and execute our plans to drive makes for it as a standard of care in each region and major market in the world.

Speaker Change: Earlier this month, CMS issued their proposed 2025 Facility Fee and Professional Fee rules that, as drafted, largely maintain the 2024 reimbursement assignments and rates associated with our procedures. Finally,

Speaker Change: As promised, we have now engaged the FDA in a formal regulatory dialogue regarding the re-administration of IDOS-TR, and beyond that, remain on track to commence a Phase III clinical trial for IDOS-TREX, our next-generation IDOS therapy, by the end of 2024.

Speaker Change: Moving on, our international glaucoma franchise delivered record sales of $26.1 million dollars on year-over-year growth of 17% on a reporting basis and 21% on a constant currency basis.

Thomas William Burns: The strong growth was once again broad-based as we continue to scale our international infrastructure and execute our plans to drive MAKES Forward as a standard of care in each region and major market in the world. During the quarter, we also finalized a new French CEPS agreement that provides for adjusted rebate tiers and successfully expanded the addressable patient population to reflect the growing adoption of ISTEDTJW in France. The net effect of this new agreement was favorable to our second quarter reported revenues and is expected to remain a tailwind for the remainder of 2024.

Speaker Change: The strong growth was once again broad-based as we continue to scale our international infrastructure and execute our plans to drive MAKES Forward as a standard of care in each region and major market in the world.

Thomas Burns: During the quarter, we also finalized a new French C-E-P-S agreement that provides for adjusted rebate tiers and successfully expanded the addressable patient population to reflect the growing adoption of I-S-T-J-W and France. The net effect of this new agreement was favorable to our second quarter reported revenues and was expected to remain a tailwind for the remainder of 2024. While we remain in the early stages of expanding our IG initiatives globally, our efforts are progressing well, evidenced by several recent international regulatory approvals, including for I-S-T-J-W in China and stand-alone usage indication for I-S-T-J-W in Japan, alongside the approvals of both I-S-T-Infinite and President-Well in Brazil earlier this year.

Speaker Change: During the quarter, we also finalized a new French CEPS agreement that provides for adjusted rebate tiers and successfully expanded the addressable patient population to reflect the growing adoption of iSpentInject W in France.

Speaker Change: The net effect of this new agreement was favorable to our second quarter reported revenues and is expected to remain a tailwind for the remainder of 2024.

Thomas William Burns: While we remain in the early stages of expanding our IGE initiatives globally, our efforts are progressing well, evidenced by several recent international regulatory approvals, including for ISTEDD to JEC-W in China and standalone usage indication for ISTEDD to JEC-W in Japan, alongside the approvals of both ISTEDD Infinite and Preservlo in Brazil earlier this year. And finally, The Cornell Health Franchise delivered sales of $19.8 million on 7% year-over-year growth, including Fortrex, and then sales of $16.7 million.

Speaker Change: While we remain in the early stages of expanding our IGE initiatives globally, our efforts are progressing well, evidenced by several recent international regulatory approvals, including for ISTEDT to JEC-W in China, and standalone usage indication for ISTEDT to JEC-W in Japan.

Speaker Change: Alongside the approvals of both IFIN Infinite and Preservlo in Brazil earlier this year. And finally...

Thomas Burns: Finally, our Cornell Health franchise delivered sales of $19.8 million on a 7% year-over-year growth, including for trucks and net sales of $16.7 million. As discussed, our second quarter results reflect the impact of for trucks and realized revenues as a result of our entry as a company into NDRP.

Speaker Change: A corneal health franchise delivered sales of $19.8 million on 7% year-over-year growth, including for TREX and then sales of $16.7 million.

Thomas William Burns: As discussed last quarter, our second quarter results reflect the impact of Fortrex on realized revenues as a result of our entry as a company into MDRP. Shifting gears, we continue to prudently invest in and successfully advance our pipeline of novel, promising platform technology that we believe has the ability to significantly expand our addressable markets and fundamentally transform our company over time. This concludes Epioxa, our next generation corneal cross-linking therapy, for which we continue to progress towards data readout in the second half of this year for the second phase three pivotal study, supporting our NDA submission that remains on target for the end of 2024.

Speaker Change: As discussed last quarter, our second quarter results reflect the impact of Fortrex on realized revenues as a result of our entry as a company into MDRP.

Thomas Burns: Chifting gears, we continue to prudently invest in and successfully advance our pipeline of novel, promising platform technologies that we believe have the ability to significantly expand our addressable markets and fundamentally transform our company over time. This includes at the AXA, our next-generation Corione Cross-Linke Therapy, for which we continue to progress towards data readout in the second half of this year for the second Phase III pivotal study, supporting our NDR submission that remains on target for the end of 2024. Beyond Epionxil, we also continue to make incursion progress across our robust portfolio of clinical and preclinical programs focused in the areas of glaucoma, retina, and rare disease, where our milestone targets and associated timelines remain on track and unchanged versus previous disclosures.

Speaker Change: Shifting gears, we continue to prudently invest in and successfully advance our pipeline of novel, promising platform technologies that we believe have the ability to significantly expand our addressable markets and fundamentally transform our company over time.

Speaker Change: This includes Epioxa, our next-generation corneal cross-linking therapy, for which we continue to progress towards data readout in the second half of this year for the second Phase III pivotal study, supporting our NDA submission that remains on target for the end of 2024.

Thomas William Burns: Beyond epiaxia, we also continue to make encouraging progress across our robust portfolio of clinical and preclinical programs focused in the areas of glaucoma, retina, and rare diseases, where our milestone targets and associated timelines remain on track and unchanged versus previous disclosure. We remain excited about the significant potential value that we believe our pipeline programs may create. At the same time, as we've discussed, we continue to prioritize the cadence of our investments as we strive to strike the right balance of risk-based spending and our capital position now and in the future.

Speaker Change: Beyond Epioxa, we also continue to make encouraging progress across our robust portfolio of clinical and preclinical programs.

Speaker Change: Focused in the areas of glaucoma, retina, and rare disease, where our milestone targets and associated timelines remain on track and unchanged versus previous disclosures.

Thomas Burns: We remain excited about the significant potential value that we believe our pipeline programs may create. At the same time as we discussed, we continue to prioritize the cadence of our investments, as we strive to strike the right balance of risk-based spending in our capital position now and in the future. On that for undoing the second quarter, we opportunistically executed a transaction to exchange $230 million in principal amount, or 80% of our convertible senior notes due 2027 for common stock, helping to further solidify our already strong capital position, through a de-leveraging and de-risking of our balance sheet, as well as significant reduction in future cash interest expense.

Speaker Change: We remain excited about the significant potential value that we believe our pipeline programs may create.

Speaker Change: At the same time, as we've discussed, we continue to prioritize the cadence of our investments as we strive to strike the right balance of risk-based spending and our capital position now and in the future.

Thomas William Burns: On that front, during the second quarter, we opportunistically executed a transaction to exchange $230 million in principal amount, or 80% of our convertible senior notes due 2027 for common stock, helping to further solidify our already strong capital position through a deleveraging and de-risking of our balance sheet, as well as a significant reduction in future cash interest expense.

Speaker Change: On that front, during the second quarter, we opportunistically executed a transaction to exchange $230 million in principal amount, or 80% of our convertible senior notes due 2027 for common stock, helping to further solidify our already strong capital position.

Speaker Change: through a deleveraging and de-risking of our balance sheet, as well as significant reduction in future cash interest expense.

Thomas Burns: This convert, originally issued in June 2020 during the height of the pandemic, has proved to be a beneficial financial instrument that provides us with a financial flexibility to continue investing on our pipeline through COVID and other reimbursement-related uncertainties. In conclusion, I'm pleased with the strong commercial development execution of our teams that have demonstrated so far this year. We look forward to continue to build upon the growing momentum in our business over the course of becoming quarters and years.

Speaker Change: This convert, originally issued in June 2020 during the height of the pandemic, has proved to be a beneficial financial instrument that provides us with the financial flexibility to continue investing in our pipeline through COVID and other reimbursement-related uncertainties.

Speaker Change: In conclusion, I'm pleased with the strong commercial development execution of our teams.

Speaker Change: that have demonstrated so far this year.

Speaker Change: We look forward to continue to build upon the growing momentum in our business over the course of the coming quarters and years. Our foundation is strong and we are ideally positioned to continue transforming vision for the benefit of patients worldwide.

Thomas Burns: Our foundation is strong, and we are ideally positioned to continue transforming vision for the benefit of patients worldwide.

Thomas Burns: So, with that, I'll open the call for questions.

Thomas William Burns: This convert originally issued in June 2020 during the height of the pandemic has proved to be a beneficial financial instrument that provided us with the financial flexibility to continue investing in our pipeline through COVID and other reimbursement related uncertainties. In conclusion, I'm pleased with the strong commercial development execution of our team that we have demonstrated so far this year. We look forward to continuing to build upon the growing momentum in our business over the course of the coming quarters and years. Our foundation is strong, and we are ideally positioned to continue transforming vision for the benefit of patients worldwide. So with that, I'll open the call for questions. Operator.

Unknown Executive: All right. And just as a reminder to ask a question, please press star, followed by the number one, under the telephone keypad.

Unknown Executive: All right. And just as a reminder, to ask a question, please press star followed by the number one on your telephone keypad. Our first question comes from the line of Tom Stephan from Stifle. Please go ahead.

Speaker Change: So with that, I'll open the call for questions. Operator?

Speaker Change: All right, and just as a reminder to ask a question, please press star followed by the number one on your telephone keypad.

Ryan Zimmerman: Our first question comes from the line of Tom Steffen from Stifel. Please go ahead.

Speaker Change: Our first question comes from the line of Tom Stephan from Stifle. Please go ahead.

Ryan Zimmerman: Great, hey guys, thanks for the questions, and congrats on a nice quarter. Maybe I'll start with Ido's. Any comments on 2Q24 sales contribution? Or instead, maybe any color on the basis growth in US Qualcomm if you prefer to give that.

Unknown Speaker: Great. Hey, guys, thanks for the questions and congrats on a nice quarter. Maybe I'll start with Eidos.

Unknown Speaker: Any comments on 2Q24 sales contribution? Or, instead, maybe any color on the base business growth in U.S. glaucoma if you prefer to give that? And then if you could also comment on 3Q trends you're seeing with the J code now in place, that'd be fantastic. All right, Tom. And thanks for the comments.

Thomas M. Stephan: Great. Hey guys, thanks for the questions and congrats on a nice quarter. Maybe I'll start with IDO's.

Thomas M. Stephan: Any comments on 2Q24 sales contribution? Or instead, maybe any color on the base biz?

Ryan Zimmerman: And then if you could also comment on 3Q trends you're seeing with the J code now in place, that'd be fantastic.

Speaker Change: growth in U.S. glaucoma if you prefer to give that. And then if you could also comment on three Q trends you're seeing with the J code now in place that'd be fantastic.

Thomas Burns: All right, thanks, Tom. And thanks for the comments.

Unknown Speaker: It's not even a softball warm-up before we dive into the iDOS questions, but I'm happy to start there and then we can take it further as you guys deem. I'll start with the overall U.S. glaucoma performance. Obviously, Tom alluded to the strength there, with growth once again accelerating in the second quarter to 26 percent on a year-over-year basis. And that was driven both by mid-teens growth yet again from our iCent portfolio and infinite standalone utilization in particular, alongside better-than-expected contributions from iDOS TR.

Alex Thurman: Not even a softball warm-up before you dive into the Ido's questions, but I'm happy to have you to start there. And then we can take it further as you guys a team. I'll start with the overall US Qualcomm performance. Obviously, Tom alluded to the strength there, with growth once again accelerating in the second quarter to 26% on a year-over-year basis. And that was driven both by mid-teens growth yet again from our ice and portfolio and infinite standalone utilization in particular, alongside better than expected contributions from Ido's TR. I think the second part of your question is we think about the third quarter with the J code in place, and now we've kind of worked our way through the first month of that.

Speaker Change: All right, thanks, Tom, and thanks for the comments.

Speaker Change: Not even a softball warm-up before we dive into the IDOS questions, but happy to start there and we can take it further as you guys deem.

Speaker Change: I'll start with the overall U.S. glaucoma performance. Obviously, Tom alluded to the strength there, with growth once again accelerating in the second quarter to 26% on a year-over-year basis.

Speaker Change: And that was driven both by mid-teens growth, yet again, from our iCent portfolio, and infinite stand-alone utilization in particular, alongside better-than-expected contributions from Eidos TR.

Unknown Speaker: I think the second part of your question is, we think about the third quarter with the J-code in place, and now we've kind of worked our way through the first month of that. I think it's important to say, I mean obviously we continue to be positive about the progress we're making with the iDOS launch in general, a ton of which happened in the second quarter as we make our way through July.

Speaker Change: I think the second part of your question is we think about the third quarter with the J-code in place.

Alex Thurman: I think it's important to say I mean, obviously, we continue to be positive about the progress we're making with Ido's launch in general. A ton of which happened in the second quarter as we make our way through July that continues.

Speaker Change: and now we've kind of worked our way through the first month of that.

Speaker Change: I think it's important to say, I mean, obviously, we continue to be

Speaker Change: positive about the progress we're making with iDOS launch in general, a ton of which happened in the second quarter. As we make our way through July, that continues. In some respects, Q3, as we've said all along, is a bit of a, I'll call it a reset moment as you get the JCODE in place.

Unknown Speaker: In some respects, Q3, as we've said all along, is a bit of a, I'll call it, a reset moment as you get the J-code in place. And on the positive side, you'll have some accounts where their administration will now allow those first cases once the J-code has been established during the quarter. Frequently, though, you'll also need to see that get billed and, ultimately, reimbursement working before you'll fully open that up.

Alex Thurman: In some respects, Q3, as we've said all along, is a bit of a, I'll call it a recent moment, as you get the J code in place. And on the positive side, you'll have some accounts where their administration will now allow those first cases once the J code has been established entering the corner. You know frequently, though you also need to see that get billed and ultimately see reimbursement working before you'll fully open that up. And those same dynamics hold true for many of the accounts that did their work procedures on the business latest code during the second quarter.

Speaker Change: And on the positive side, you'll have some accounts.

Speaker Change: Where the administration will now allow those first cases, once the J-code has been established, entering the quarter.

Speaker Change: You know, frequently, though, you also need to see that get billed and ultimately see reimbursement working before you'll fully open that up.

Unknown Speaker: And those same dynamics hold true for many of the accounts that did their HERT procedures on a miscellaneous code during the second quarter. So I think as we make our way through here, you hope to continue knocking down those hurdles and really see that momentum build from where we were at, certainly in the first half of the year.

Alex Thurman: So I think as we make our way through here, you hope to continue knocking down those hurdles and really see that moment of build from where we were at certainly in the first half of the year.

Speaker Change: And those same dynamics hold true for many of the accounts that did their HEARTH procedures under Miscellaneous Code during the second quarter. So I think as we make our way through here, you hope to continue knocking down those hurdles and really see that momentum build from where we were at certainly in the first half of the year.

Unknown Executive: Got it, that's great.

Unknown Speaker: That's great. So just as a quick follow-up, if I dial in maybe 16-17% growth in the core U.S. glaucoma business, I'm arriving at around $ 9 million for IDOS. Is that fair?

Ryan Zimmerman: So just as a quick follow-up, if I dial in maybe 16, 17% growth in the core US cloud coma business, I'm arriving at around, call it 9 million of idoses, is that fair?

Speaker Change: Got it, that's great. So just as a quick follow-up, if I dial in maybe 16-17% growth in the core U.S. Glaucoma business, I'm arriving at around

Unknown Speaker: And then my follow-up would just be on profitability for breakeven on a cash flow basis. Is it some point in 2025 for the total company? Maybe a reasonable target as we think about IDOS secretion, you know, really starting to take hold in a more meaningful way.

Alex Thurman: And then my follow-up would just be, just unprofitability for break even on a cash low basis, is at some point in 2025 for a total company, maybe a reasonable target as we think about high-dose accretion, you know, really starting to take hold in a more meaningful way. Thanks for taking the questions. Yes, thanks, Tom. I'll start, and then I'll turn over to Alex for the probability side of that. I don't think the math that you did there. I know you're trying to do it on the fly, as we're doing that, guys. I don't think the math quite shakes out that way, so you can redo that.

Speaker Change: Call it 9 million of IDOS. Is that fair? And then my follow-up would just be

Speaker Change: just on profitability for breakeven.

Speaker Change: On a cash flow basis, is it some point in 2025 for total company?

Speaker Change: Maybe a reasonable target as we think about idosecretion, you know, really starting to take hold in a more meaningful way. Thanks for taking the questions.

Unknown Speaker: Thanks for taking the question. Yeah, thanks, Tom. I'll start, and then I'll turn it over to Alex for the profitability side of that. I don't think the math that you did there, I know you're trying to do it on the fly as we're giving that guide, but I don't think the math quite shakes out that way. So you can redo that.

Speaker Change: Thanks, Tom. I'll start and then I'll turn it over to Alex for the profitability side of that. I don't think the math that you did there, I know you're trying to do it on the fly as we're giving that guide, I don't think the math quite shakes out that way, so you can redo that. I'm not going to comment and endorse a specific number on it, other than just to reiterate what we said, when you kind of look at the overall growth profile of the business, driven by mid-teens growth from ISET portfolio and the rest.

Unknown Speaker: I'm not going to comment on or endorse a specific number on it, other than just to reiterate what we said, when you kind of look at the overall growth profile of the business, driven by mid-teens growth in my portfolio and the rest being, you know, larger than expected contributions from Eidos. Alex, do you want to talk about profitability? Yeah, on profitability, Tom, it's obviously a great question and top of mind. And so as we've looked forward, we've always said that the company would look at profitability, and on the other side of Eidos, we're getting there.

Alex Thurman: I'm not going to comment and endorse a specific number on it, other than just to reiterate what we said, when you kind of look at the overall growth profile of the business driven by 15th growth and I say portfolio and the rest being, you know, larger than expected contribution for Midos.

Alex Thurman: Alex, you want to talk about profitability? Yeah, profitability, Tom, it's obviously a great question and top of mind, and so as we look forward, we've always said that the company would look at profitability on the other side of Idos. We're getting there, and to your point, you talked about 2025, and our goal internally, to be quite frank, is to get back to a place where we are getting to cash flow break even, and then starting to generate cash as opposed to having to focus on profitability in the near term.

Alex: being, you know, larger than expected contributions from IDOS.

Alex: Alex, you want to talk about profitability? Yeah, on profitability, Tom, it's obviously a great question and top of mind. And so, as we've looked forward, we've always said that the company would look at profitability on the other side of Eidos. We're getting there.

Unknown Speaker: And to your point, you talked about 2025, and that's going to be a key year for us as far as IDOS ramps up. You know, our goal internally, to be quite frank, is to get back to a place where we are getting to cash flow break even and then starting to generate cash as opposed to having a focus on profitability in the near term. As Tom mentioned in his opening remarks, we've got a rich pipeline, there's a lot of value there, there's lots of investments to be made, but we really would like to get back to cash flow break even and then, you know, start to build up that cash flow over time. And I do think in 2025, we should start to see some of that happen. I got it.

Speaker Change: And to your point, you talked about 2025, and that's going to be a key.

Tom: year for us as far as iDOS ramps up.

Speaker Change: You know, our goal internally, to be quite frank, is to get back to a place where we are getting to cash flow break-even and then starting to generate cash as opposed to having a focus on profitability in the near term.

Unknown Executive: As Tom mentioned in his opening remarks, we've got a rich pipeline; there's a lot of value there, there's lots of investments to be made, but we really would like to get back to cash flow break-even, and then start to build up that cash flow over time. I do think in 2025 we should start to see some of that occur. Got it. Okay.

Speaker Change: As Tom mentioned in his opening remarks, we've got a rich pipeline, there's a lot of value there, there's lots of investments to be made, but we really would like to get back to cash flow breakeven and then start to build up that cash flow over time, and I do think in 2025 we should start to see some of that occur.

Lawrence Biegelsen: Sorry, I'm going to cut you off a little bit, but our next question comes from the line of Larry Degelsen from Wells Fargo. Please go ahead.

Unknown Speaker: Okay. Sorry, I'm going to cut you off a little bit, but our next question comes from the line of Larry Biegelsen from Wells Fargo. Please go ahead. Hey, good afternoon.

Speaker Change: Got it, okay.

Speaker Change: Sorry, I'm going to cut you off a little bit, but our next question comes from the line of Larry Biegelsen from Wells Fargo. Please go ahead.

Lawrence Biegelsen: Hey, good afternoon. Thank you for taking the question, and congrats on a nice quarter here. Joe, if I look at the midpoint of the guidance range, it appears, you know, the growth rates are pretty similar in the first half and second half. Why wouldn't growth be higher in the second half, given the ramp of high dose? And I guess is your commentary on the J-code earlier that I do say that you're not expecting to go up sequentially in Q3?

Unknown Speaker: Thanks for taking the question and congrats on a nice quarter here. Joe, if I look at the midpoint of the guidance range, it appears, you know, the growth rates are pretty similar in the first half and second half. Why wouldn't growth be higher in the second half, given the ramp of high dose?

Lawrence H. Biegelsen: Hey, good afternoon. Thanks for taking the question and congrats on a nice quarter here.

Lawrence H. Biegelsen: Joe, if I look at the midpoint of the guidance range, it appears, you know, the growth rates are pretty similar in the first half and second half.

Lawrence H. Biegelsen: Why wouldn't growth be higher in the second half given the ramp of I-dose and I guess is your commentary on the J-code earlier that I-dose sales, you're not expecting to go up sequentially in Q3?

Lawrence Biegelsen: Thanks.

Alex Thurman: Yeah, thanks, Larry. A couple of things to unpack there, you know, as it relates to the guidance and seasonality. I mean, obviously, as you alluded to, we're super pleased with how the first half of 2024 shaped up, and then we were able to raise our, you know, full-year guidance by even more than the Q2 outperformance.

Unknown Speaker: And I guess your commentary on the J code earlier, that I do sales. You're not expecting it to go up sequentially in Q3? Thanks. Yeah, thanks, Larry. A couple things to unpack there, you know. Is it really guidance and seasonality? I mean, obviously, as you alluded to, we're super pleased with how the first half of 2024 shaped up and that we were able to raise our, you know, full year guidance by even more than the Q2 outperformance.

Joe: Yeah, thanks, Larry. A couple things to unpack there, you know, as it relates to the guidance and seasonality, I mean...

Speaker Change: Obviously, as you alluded to, we're super pleased with how the first half of 2024 shaped up, and that we were able to raise our full-year guidance by even more than the Q2 outperformance.

Alex Thurman: As you look to translate that into, you know, we'll call it our growing momentum into the second half, I want to point to a couple key things. The first, the normal considerations around Q3, CNET, seasonality, which I'm happy to elaborate on more, and the FX headwinds that we called out as a part of our press release.

Unknown Speaker: As you look to translate that into, I'll call it, our growing momentum into the second half, I want to point to a couple of key things. First, the normal considerations around Q3 seasonality, which I'm happy to elaborate on more, and the FX headwinds that we called out as part of our press release.

Speaker Change: As you look to translate that into, I'll call it our growing momentum into the second half, I want to point to a couple of key things. First, the normal considerations around Q3 seasonality, which I'm happy to elaborate on more, and the FX headwinds that we called out as a part of our press release.

Unknown Speaker: You're also fairly aware of the continued impact of the MDRP as a headwind to our cornea franchise, with the most significant of that impact likely expected in the fourth quarter. When you think about IDOS-TR and the growing focus on our commercialization there, we want to be a little bit cautious that as we clear the expected market access headwinds and hurdles, if you will, it may dampen some of the performance we've seen out of the Stint portfolio in the first half, as our sales organization leans further and further into, obviously, the IDOS launch.

Alex Thurman: You're also fairly aware of the continued impact of the MBRP as a headwind to our cornea franchise, with the most significant of that impact likely expected in the fourth quarter. When you think about Ido's TR and the growing focus on our commercialization there, we want to be a little bit cautious that, as we clear the expected market access headwinds and hurdles, if you will, it may dampen some of the performance we've seen out of the Stent portfolio in the first half as our sales organization leans further and further into, obviously, the Ido's launch.

Speaker Change: You are also fairly aware of the continued impact of the MDRP as a headwind to our cornea franchise, with the most significant of that impact likely expected in the fourth quarter.

Speaker Change: When you think about IDOS-TR and the growing focus on our commercialization there.

Speaker Change: We want to be a little bit cautious that...

Speaker Change: As we clear the expected market access headwinds and hurdles, if you will, it may dampen some of the performance we've seen out of the Stint portfolio in the first half as our sales organization leans further and further into, obviously, the IDOS launch.

Unknown Speaker: And the last thing really is kind of what I alluded to with Tom's question, which is the third quarter being a bit of a JCO transition quarter. It's really hard to pinpoint in such a small and precise period of time, you know, Larry, when you're in a launch like this. You know, the reality is that the sooner some of these things start to play their way through from a payment standpoint on the JCO in the quarter, we'll accrue some more benefit this quarter. But it's hard to nail that down in the context of such a precise period of time.

Alex Thurman: And the last thing really is just kind of what I alluded to with Tom's question, which is the third quarter being a bit of a Jacob transition quarter. It's really hard to pinpoint; it's such a small and precise period of time, you know, Larry, when you're in a launch like this. You know, the reality is that the sooner some of these things start to play their way through from a payment standpoint on the Jacob in the quarter, we'll accrue some more benefit in this quarter, but it's hard to nail that down in the context of such a precise period of time.

Speaker Change: And the last thing really is kind of what I alluded to with Tom's question, which is the third quarter being a bit of a JCO transition quarter. It's really hard to pinpoint in such a small and precise period of time, you know, Larry, when you're in a launch like this.

Lawrence H. Biegelsen: You know, the reality is that the sooner some of these things start to play their way through from a payment standpoint on the J-code in the quarter, we'll accrue some more benefit in this quarter.

Unknown Speaker: All I can really say is that as we look at the overall launch thus far, we're increasingly confident in where we're headed with this product and what it's going to mean, certainly, as we get into the fourth quarter and translate that into 2025. That's helpful.

Alex Thurman: All I can really say is that as we look at the overall launch thus far, we're increasingly confident in where we're headed with this product and what it's going to mean, certainly as we get into the fourth quarter and translate that into 2025.

Lawrence H. Biegelsen: But it's hard to nail that down in the context of such a precise period of time. All I can really say is that as we look at the overall launch thus far, we're increasingly confident in where we're headed with this product and what it's going to mean, certainly as we get into the fourth quarter and translate that into 2025 and beyond.

Unknown Executive: Beyond.

Unknown Executive: That's helpful.

Unknown Speaker: Another way of looking at it, you know, U.S. glaucoma sales were up about 4 to 5 million sequentially in Q2 last year and the year before. This year, U.S. glaucoma sales are up about 8 million sequentially. Should we just assume the difference this year versus prior years is primarily an I-dose or roughly 3 to 4 million sequential increase in I-dose? Thanks for taking the question. Yeah, sure. I mean, I think there are a handful of ways that you could try to back into the specific number that's there.

Lawrence Biegelsen: I hate to do this, but a math question, Jo. Another way of looking at it, you know, U.S. God, Colman sales were up about four to five million sequentially in Q2 last year and the year before. This year, U.S. God, Colman sales are up about eight million sequentially. She would just assume the difference this year versus prior years is primarily, you know, idols, or roughly three to four million sequentially increased in idols.

Speaker Change: That's helpful.

Speaker Change: I hate to do this, but a math question, Joe, another way of looking at it.

Joe: You know, U.S. glaucoma sales were up about $4 to $5 million sequentially in Q2 last year and the year before. This year, U.S. glaucoma sales are up about $8 million sequentially. Should we just assume the difference this year versus prior years is primarily, you know, eye dose or roughly $3 to $4 million sequential increase in eye dose? Thanks for taking the question.

Alex Thurman: Thanks for taking the question. Yeah, sure. I mean, I think there's a handful of ways that you could try to back into the specific number that's there. I think that where you're headed on that is probably closer to reality than, you know, I think the early map that was suggested before. But most importantly, is that we make significant progress in the second quarter with idols. And that's while having, obviously, an infosition of misslling a C code in that environment there. So again, that combined with the continued clinical feedback that we've been receiving really drives that confidence we've got and how that been translated into the increased guidance that we gave today.

Speaker Change: Yeah, sure. I mean, I think there's a handful of ways that you could try to back into the specific number that's there. I think that where you're headed on that is probably closer to reality than, you know, I think the early map that was suggested before.

Unknown Speaker: I think that where you're headed on that is probably closer to reality than, you know, I think the early map that was suggested before. But most importantly, is that we made significant progress in the second quarter with IDOS. And that's while obviously having the imposition of miscellaneous C code in that environment there.

Speaker Change: But most importantly is that we made significant progress in the second quarter with IDOS and that's while having obviously the imposition of miscellaneous C code in that environment there.

Unknown Speaker: So, again, that combined with the continued clinical feedback that we've been receiving really drives that confidence we've got and how that's been translated into the increased guidance that we gave today. Thanks for taking the question. Alright, our next question comes from the line of Ryan Zimmerman from BTIG. Please go ahead. Hey, guys. I'll keep the fastballs going and not give any softballs here.

Speaker Change: Again, that combined with the continued clinical feedback that we've been receiving really drives that confidence we've got and how that then translated into the increased guidance that we gave today.

Unknown Executive: Thanks for taking the question.

Matthew O'brien: All right, our next question comes from the line of Ryan Zimmerman from BTIG. Please go ahead.

Unknown Speaker: So, you know, Tom, I want to ask about your conversations, your early feedback on the re-administration potential of IDOS. Do you know at this point whether you need a trial for that? Kind of where do they stand on your existing data? It did include, obviously, re-administration. Anything that you can kind of share with us at this point that maybe, you know, you know, sets up your outlook on that potential? Yeah, I'd be happy to do that, Ryan.

Speaker Change: Thanks for taking the question.

Speaker Change: Clark

Speaker Change: All right, our next question comes from the line of Ryan Zimmerman from BTIG. Please go ahead.

Matthew O'brien: Hey, guys, I'll keep the fastballs going and not give eight softballs here. So, you know, Tom, I want to ask about your conversations, your early feedback on the re-administration potential with idols. Do you know at this point whether you needed a trial for that kind of? Where do they stand on your existing data? Did include obviously re-administration? Anything that you can kind of share with us at this point that maybe, you know, sets up your outlook on that potential? Yeah, I'd be happy to do that, Ryan. So, as you know, we've talked about, we've submitted the reconsideration request.

Ryan Benjamin Zimmerman: Hey guys, I'll keep the fastballs going and not give you any softballs here.

Ryan Benjamin Zimmerman: So, you know, Tom, I want to ask about your conversations, your early feedback on the re-administration.

Speaker Change: with IDOS. Do you know at this point whether you needed a trial for that, kind of where do they stand on your existing data? They include obviously re-administration. Anything that you can kind of share with us at this point that maybe, you know...

Unknown Speaker: So, as you know, we've talked about, and we've submitted the reconsideration request. We will begin an active dialogue with the FDA, which I presume will be over the next several months. They do not have a statutory obligation to respond to us in a specific period of time.

Speaker Change: You know, sets up your outlook on that potential.

Speaker Change: Yeah, I'd be happy to do that, Ryan. So as you know, we've talked about, we've submitted the reconsideration request. We'll begin an active dialogue.

Thomas Burns: We'll begin an active dialogue with the FDA, which I presume will be over the next several months. They don't have a statutory allegation to respond to us in a specific period of time. And so they're not bound by typical impositions that we may go back and forth as we look at this over time. I think, as I've talked about before, it was kind of a late stage in our mind decision by the FDA to restrict us to a single administration. So we didn't have the opportunity to make the full sum case at the tail end of the NDA adjudication prior to our successful approval.

Speaker Change: with the FDA, which I presume will be over the next several months. They don't have a statutory obligation to respond to us.

Unknown Speaker: And so they're not bound by typical impositions, and we may go back and forth as we look at this over time. I think, as I've talked about before, it was kind of a late stage decision by the FDA to restrict this to a single administration. So we didn't have the opportunity to make the fullsome case at the tail end of the NDA adjudication prior to our successful approval.

Speaker Change: in a specific period of time and so they're not bound by typical

Speaker Change: in positions and we may go back and forth as we look at this over time.

Speaker Change: I think as I've talked about before, it was kind of a late stage, in our mind, the decision by the FDA to restrict us to a single administration.

Speaker Change: We didn't have the opportunity to make the Folsom case at the tail end of the NDA adjudication.

Thomas Burns: So now we have that opportunity. So the short answer is no, we don't need any additional clinical trial information or clinical trial performance to be done. I think what we need to do and what we are doing is presenting the narrative and a compelling case, given the data that we've already been able to perform and have available. And I think we have a strong case. Having said that, we know that the overt conservatism of the FDA, we suspect, through the initial decision. So I have been counseling both investors analysts to let's not get over our skis here, where we're hopeful we may be able to make progress, but we're not counting on.

Unknown Speaker: Now we have that opportunity. So the short answer is no; we don't need any additional clinical trial information or clinical trial performance to be done. I think what we need to do and what we are doing is presenting the narrative in a compelling case, given the data that we've already been able to perform and have available. And I think we have a strong case. Having said that, we know that the overt conservatism of the FDA, we suspect, drew the initial decision.

Speaker Change: Prior to our successful approval. So now we have that opportunity. So the short answer is no, we don't need any additional clinical trial information or clinical trial performance to be done.

Speaker Change: I think what we need to do, and what we are doing.

Speaker Change: It's presenting the narrative in a compelling case given the data that we've already been able to

Speaker Change: to perform.

Speaker Change: and have available. And I think we have a strong case. Having said that, we know that the overt conservatism of the FDA, we suspect, drew the initial decision. So

Unknown Speaker: So I have been counting, you know, counting both investors and analysts to let's not get ahead of ourselves here. We're hopeful we may be able to make progress, but we're not counting on it. So we'll make every successful effort to apply for re-administration of the IDOS device. And what I've said before, and I believe, is that we have a belt and suspenders approach here. If we're successful moving forward with IDOS T-Rex, which we're on track to begin clinical trials by the end of the year, if you do the chronology.

Speaker Change: I have been counting, you know, counting both investors and analysts to let's not get over our skis here. We're hopeful, we may be able to make progress, but we're not counting on it.

Thomas Burns: So we'll make every successful effort to apply for me to re administration of the I just device. And what I've said before and I believe is that we have a belt spenders approach here. If we're successful moving forward with I just directs of which were our track to begin the clinical trials by the end of the year to do the chronology. G, I suspect we'll be in a position to become a deep factor of device and procedural pharmaceutical re-administration component for those patients that have served the full term of their initial Idosa device.

Speaker Change: So we'll make every successful effort to apply for re-administration of the iDOS device.

Speaker Change: And what I've said before, and I believe, is that we have a belt and suspenders approach here. If we're successful moving forward with IDOS-T-Rex, which we're on track to begin the clinical trials by the end of the year, if you do the chronology,

Unknown Speaker: I suspect we'll be in a position to become a de facto device and procedural pharmaceutical re-administration component for those patients that have served the full term of their initial I-dose device. So I like where we're at. I like how we're approaching this. I think we will make a strong case, and then we'll see, and I will clearly keep both you and the investment community informed once I've received a final decision from the FDA. Okay, and then my second question is just around what you're seeing today with the adoption of IDOS. And what I want to understand is, are you seeing competitive switches from Dorista?

Speaker Change: I suspect we'll be in a position to become a de facto device and a procedural pharmaceutical re-administration component for those patients that have served the full term of their initial IDOS device.

Thomas Burns: So I like where we're at, I like how we're approaching this, I think we will make a strong case, and then we'll see, and I clearly will keep both of you and the investment community informed once I've received a final decision from the FDA.

Speaker Change: So I like where we're at. I like how we're approaching this. I think we will make a strong case, and then we'll see. And I clearly will keep both you and the investment community informed once I have received a final decision from the FDA.

Alex Thurman: Okay, and then my second question is just around what you're seeing today with adoption of IDOs, and what I want to understand is are you seeing competitive switches from Dorista, are you seeing the adoption of IDOs either before drops, after drops, before SLT, can you just kind of talk about where IDOs is shaping up in kind of that treatment paradigm? Thank you for taking the questions.

Speaker Change: Okay, and then my second question is just around what you're seeing today with adoption of IDOS.

Speaker Change: And what I want to understand is, are you seeing competitive switches from Dorista? Are you seeing the adoption of IDOS either before drops, after drops, before SLT? Can you just kind of talk about where IDOS is shaping up in kind of that treatment paradigm? Thank you for taking the question.

Alex Thurman: Yeah, Ryan, I'll start, and Tom may want to add color on this too. From our standpoint, I think it's a little bit early to be making brand calls around exactly when and where it's being adopted, but I'll come in a little bit on where we expected to be adopted. And from that standpoint, when you think about the label that exists with idos, we would expect it to be an early option for intervention and stand-alone patients regardless of their disease severity going forward. And to your point, I think each surgeon will have a different view on the outer than which they deploy it.

Unknown Speaker: Are you seeing the adoption of IDOS either before drops, after drops, or before SLT? Can you just kind of talk about where IDOS is shaping up in kind of that treatment paradigm? Thank you for taking the question. Yeah, Ryan, I'll start, and Tom may want to add color to this, too.

Unknown Speaker: You know, from our standpoint, I think it's a little bit early to be making, you know, grand calls around exactly when and where it's being adopted. But I'll comment a little bit on where we expect it to be adopted. And from that standpoint, you know, when you think about the label that exists with IDOS, we would expect it to be an early option for intervention in standalone patients, regardless of their disease severity going forward. And to your point, I think each surgeon will have a different view on the algorithm in which they deploy it. Some will likely, you know, follow SLT. Some will follow DRISTA.

Speaker Change: Yeah, Ryan, I'll start and Tom may want to add color on this, too. From our standpoint, I think it's a little bit early to be making grand calls around exactly when and where it's being adopted, but I'll comment a little bit on where we expect it to be adopted. And from that standpoint, when you think about the label that exists with IDOS,

Alex Thurman: Some will likely follow SLT, some will follow Dorista, some will put it in front of that. But I think in general, what you're seeing with the overall interventional glaucoma shift is a mindset towards more proactive therapy for these patients, and not relying on disease progression following years of increasing drop therapy. And I think all parties will benefit from that, and in particular, Idos CR and Glaucus.

Tom: view on the algorithm in which they deploy it.

Tom: Some will likely, you know, follow SLT, some will follow DRISTA, some will put it in front of that.

Unknown Speaker: Some will put it in front of that. But I think, in general, what you're seeing with the overall interventional glaucoma shift is a mindset towards more proactive therapy for these patients and not relying on disease progression following years of increasing drop therapy. And I think all parties will benefit from that. And, in particular, IDOS-TR and glaucoma.

Tom: But I think, in general, what you're seeing with the overall interventional glaucoma shift is a mindset towards more proactive...

Speaker Change: Therapy for these patients and not relying on disease progression.

Speaker Change: following years of increasing drop therapy. And I think all parties will benefit from that, and in particular, IDOS-TR and Glaukos.

Unknown Executive: Thanks, guys.

Unknown Speaker: Thanks, guys. Our next question comes from the line of Matthew O'Brien from Piper Sandler. Please go ahead. Hey, this is Phil Han for Matt.

Matthew O'brien: Our next question comes from the line of Matthew O'Brien from Piper Stanley. Please go ahead.

Speaker Change: Thanks, guys.

Speaker Change: Our next question comes from the line of Matthew O'Brien from Piper Sandler. Please go ahead.

Matthew O'brien: Hey, this is Phil from Matt. Thanks for taking our questions, and congrats on the record quarter.

Unknown Speaker: Thanks for taking our questions and congrats on the record quarter. Just for starters, I think Q1 saw 15 total implanting surgeons with about six weeks of total rollout. Any update on the implanting surgeon base in Q2? And just to keep the quick math train rolling here, I think we triangulated about just under one eye dose per surgeon per week in Q1. Is that the right way to think about things and, especially in Q2?

Matthew O'brien: Just for starters, I think Q1 saw 15 total implanting surgeons with about six weeks total of rollout. Any update on the implanting surgeon base in Q2? And just to keep the quick mass train rolling here, I think we triangulated about just under one idos per surgeon per week. And Q1, is that the right way to think about things, especially in Q2? Yeah, so I think Phil, what I would say there is that as we, pretty much everything with a launch has gone exactly as we planned and exactly as we told you we intended to execute.

Speaker Change: Hey, this is Phil on format. Thanks for taking our questions and congrats on the record quarter.

Phil Han: Just for starters, I think Q1 saw 15 total implanting surgeons with about six weeks total of rollout. Any update on the implanting surgeon base in Q2? And just to keep the quick math train rolling here, I think we triangulated about just under one eye dose per surgeon per week in Q1. Is that the right way to think about things, especially in Q2?

Unknown Speaker: Yeah, so I think, Phil, what I would say there is that as far as we get, pretty much everything with a launch has gone exactly as we planned. And exactly as we told you, we intended to. Of course, anything can happen, but so far, so good from that standpoint, you know, across the board on the market access related items, you know, we've seen the facility fee turn on obviously in Q2, the JCODE in Q3, and we're making, you know, professional fee progress. We saw the first of these schedules for the Norinian region come out this past quarter.

Speaker Change: Yeah, so I think, Phil, what I would say there is that pretty much everything with the launch has gone exactly as we planned and exactly as we told you we intended to execute.

Alex Thurman: Of course, anything can happen, but so far, so good from that standpoint. Across the board on the market access related items, we've seen the facility return obviously in Q2, the J-code in Q3, we're making professional fee progress. We saw the first of which to the schedules in the Naridian region come out this past quarter. So the wheels of progress can need to grind on each of those fronts. As you think about it from a commercial sales standpoint, we opened up, you know, our early access program is what you were referencing when we had a planned sort of launch with the top 10 to 15 surgeons in the first quarter.

Speaker Change: Of course anything can happen, but so far so good from that standpoint.

Speaker Change: You know, across the board on the market access related items, you know, we've seen the facility fee turn on obviously in Q2, the J code in Q3, we're making, you know, professional fee progress. We saw the first of which the schedules in the Norinian region.

Speaker Change: come out this past quarter. So the wheels of progress continue to grind on each of those fronts.

Unknown Speaker: So the wheels of progress continue to grind on each of those fronts. As you think about it from a commercial sales standpoint, we opened up, you know, our early access program, which is what you were referencing when we had a planned sort of launch with the top 10 to 15 surgeons in the first quarter. We've opened that up to our entire U.S. glaucoma sales force in the second quarter, as you heard Tom mention.

Speaker Change: As you think about it from a commercial sales standpoint, we opened up, you know, our early access program, which is what you were referencing when we had a planned sort of launch with the top 10 to 15 surgeons in the first quarter. We've opened that up to our entire U.S. glaucoma sales force in the second quarter, as you heard Tom reference.

Alex Thurman: We've opened that up to our entire US glaucoma sales force in the second quarter, as you heard Tom reference, and we saw a lot of progress as a part of that, as referenced, are seen in our evidence by our early our results.

Unknown Speaker: And we saw a lot of progress as a part of that, as referenced or as seen in our evidence by our early results. But you still have the headwind in practices that are comfortable with the gymnastics required to execute against a miscellaneous drug code.

Tom: And we saw a lot of progress as a part of that, as referenced or as seen in our evidence by our early results.

Alex Thurman: You still have the headwind and practices that are comfortable with the gymnastics that are required with executing in the mid-cellaneous drug code, and so I wouldn't underestimate that. I just think that taking a step beyond that in the context of how many surgery have been trained and the average procedure is per week, and then it's just a little premature for that.

Unknown Speaker: And so I wouldn't underestimate that. And I just think that taking a step beyond that in the context of how many surgeons have been trained and the average number of procedures per week, I think it's just a little premature for that. That's something that we'll start to get a much better handle on the trends of and decide how we communicate that to you all as we kind of make our way through the year and start heading into 2025.

Speaker Change: Yeah, you still have the headwind of practices that are comfortable with the gymnastics required with executing against a miscellaneous drug code, and so I wouldn't underestimate that.

Speaker Change: And I just think that taking a step.

Speaker Change: Beyond that, in the context of how many surgeons have been trained and the average procedures per week, I think it's just a little premature for that. That's something that we'll start to get a much better handle on the trending of and decide how we communicate with that to you all as we kind of make our way through the year and start heading into 2025.

Alex Thurman: That's something that will start to get a much better handle on the trending of and decide how we communicate with that to you all as we kind of make our way through the year and start heading into 2025.

Unknown Executive: I make sense.

Unknown Speaker: Thank you. And then just my follow up on IDOS as the excitement grows beyond it, call it friends and family and the broader Glaukos user base. Any competitive MIGS switches pulled over by IDOS adoption from competitors and thoughts on maybe a core spent halo effect that you might see as IDOS adoption grows?

Unknown Executive: Thank you.

Matthew O'brien: And then just my follow-up on I do so the excitement grows beyond it called friends and family and in the broader glaucoma a glauco user base any competitive competitive mix switches pulled over by I do adoption from competitors and and thoughts on maybe a core spent halo effect that you might see as I do adoption grows. Yeah, I mean I think that in general we've invested an awful lot of capital and time to generate an exceptional amount of data that surrounds all of our products, and whether that be the the legacy you know ice and ice and inject in combination with cataract or ice and infinite now, I do think the totality of that portfolio is pretty compelling to practices they think about the evolution of their care.

Speaker Change: That makes sense, thank you. And then just my follow-up on Eidos, as the excitement grows beyond it, call it friends and family and the broader Glaukos user base, any competitives?

Speaker Change: Competitive Niggs

Speaker Change: Switches, pulled over by iDose adoption from competitors, and thoughts on maybe a core stent halo effect that you might see as iDose adoption grows.

Unknown Speaker: Yeah, I mean, I think that in general, we've invested an awful lot of capital and time to generate an exceptional amount of data that surrounds all of our products. And whether that be the legacy Icetin, Icetin Inject, in combination with Cataract, or Icetin Infinite and now IDOS, I think the totality of that portfolio is pretty compelling to practices as they think about the evolution of their care for these patients.

Speaker Change: Yeah, I mean, I think that, in general...

Speaker Change: We've invested an awful lot of capital and time to generate an exceptional amount of data that surrounds all of our products, and whether that be the legacy, you know, Eistin, Eistin Inject,

Speaker Change: In combination with Cataract, 4-Isodine Infinite, and now IDOS, I think the totality of that portfolio is pretty compelling to practices as they think about the evolution of their care for these patients. And I certainly hope that we're benefiting from that. And as you referenced, the sort of halo effect.

Thomas Burns: For these patients, and I certainly hope that we're benefiting from that, and as you reference the sort of halo effect, the ability to treat patients first and foremost with idols and ultimately, as the disease progresses, with ice and infinite is a pretty compelling value proposition that I think we're just now beginning to capitalize on.

Unknown Speaker: And I certainly hope that we're benefiting from that. And as you referenced, the sort of halo effect, the ability to treat patients first and foremost with IDOS, and ultimately, as the disease progresses, with Icetin Infinite, is a pretty compelling value proposition that I think we're just now beginning to capitalize on. Thanks so much.

Speaker Change: The ability to treat patients first and foremost with IDOS and ultimately as the disease progresses with ICID-infinite is a pretty compelling value proposition that I think we're just now beginning to capitalize on.

Unknown Executive: Thanks a lot.

Rohan: All right, our next question comes from a line of Alan Gongs and JP Morgan. Please go ahead. Hi, this is actually Rohan on for Alan.

Unknown Speaker: All right, our next question comes from the line of Alan Gong from J.P. Morgan. Please go ahead. Hi, this is actually Rohan speaking on behalf of Alan.

Speaker Change: Thanks so much.

Speaker Change: All right, our next question comes from the line of Alan Gong from J.P. Morgan. Please go ahead.

Unknown Speaker: Thanks for taking our question. I was hoping that you could elaborate a bit more on what you meant by the reset in the third quarter. Obviously, I understand the J code transition.

Rohan: Thanks for taking our question. I was hoping that you could elaborate a bit more on what you meant by reset in third quarter. Obviously, I understand the J code transition.

Speaker Change: Hi, this is actually Rohan on for Alan. Thanks for taking our question.

Rohan: I was hoping that you could elaborate a bit more on what you meant by reset in third quarter. Obviously, I understand the J-code transition.

Alex Thurman: But in light of that, when do you kind of expect to get through a full launch for idols, and what are kind of expectations around run rate exiting 2024 into 2025. Yeah, Ronan, it's it's show. I think first I'll start to the elaboration on I think a launch like this. There's rarely a single black and white event that creates the unlocking. I think the J code, as we've always alluded, is an important component of that. I think as you get into the fourth quarter and you have the J code with the published ASP, that's an important component of that. As the pro fees continue to be established and become more solidified, that's an important component of that.

Unknown Speaker: But in light of that, when do you kind of expect to get to a full launch for IDOS? And what are the expectations around run rate exiting 2024 into 2025? Yeah, Ronan. It's Joe.

Rohan: But in light of that, when do you kind of expect to get to a full launch for iDOS? And what are kind of expectations around run rate exiting 2024 into 2025?

Unknown Speaker: I think, first, I'll start the elaboration on it. I think in a launch like this, there's rarely a single black and white event that creates the unlocking. I think the J-code, as we've always alluded, is an important component of that. I think as you get into the fourth quarter, and you have the J-code with the published ASP, that's an important component of that. As professional fees continue to be established and become more solidified, that's an important component of that.

Rohan: Yeah, Rowan, it's Joe. I think, first, I'll start the elaboration on it. I think...

Joe: A launch like this, there's rarely a single black and white event that creates the unlocking. I think the J-code, as we've always alluded, is an important component of that. I think as you get into the fourth quarter and you have the J-code with the published ASP, that's an important component of that. As the pro fees continue to be established and become more solidified, that's an important component of that.

Unknown Speaker: I think as you continue to move forward, quite frankly, as I said earlier, we're going to have more accounts start to open up. We've already seen that, where they're just more comfortable operating in a J-code environment than a C-code.

Alex Thurman: And I think as you continue to move forward, quite frankly, as I said earlier, you know we're going to have more accounts I think start to open up. We've already seen that where they're just more comfortable operating the J code environment than a Seaco. But they're still going to want to see a payment or two before they really allow the surgeons to run and do what they want clinically. So you have to kind of overcome that that first basic hurdle and establish reimbursement confidence, whether that's through the payment of the Missley and C code and those claims are outstanding or it's the payment of the J code as we get going.

Joe: And I think as you continue to move forward, quite frankly, as I said earlier, you know, we're going to have more accounts, I think, start to open up. We've already seen that where they're just more comfortable operating in a J-code environment than a C-code.

Unknown Speaker: But they're still going to want to see a payment or two before they really allow the surgeons to run and do what they want clinically. So you have to kind of overcome that first basic hurdle and establish reimbursement confidence, whether that's through the payment of the miscellaneous C code when those claims are outstanding, or it's the payment of the J code as we get going. Sitting here today, obviously, and for those folks who've done procedures in the month of July, they'll have just now been submitting those, and those things will start to be adjudicated and paid over the course of the quarter.

Joe: But they're still going to want to see a payment or two before they really allow the surgeons to run and do what they want clinically.

Joe: So you have to kind of overcome that first basic hurdle and establish reimbursement confidence, whether that's through the payment of the miscellaneous C code, and those claims are outstanding, or it's the payment of the J code as we get going.

Alex Thurman: Sitting here today, obviously, and for those folks who've done procedures the month of July, they'll have just now been submitting those, and those things will start to be adjudicated and paid over the course of the quarter. And it gets very difficult for us to then translate how quickly that also translates into increased surgical volumes and clinical adoption based on the clinical merits of the product versus the call of the reimbursement confidence piece. And that's why you first consistently say that the third quarter is a positive step in the right direction, but it is a transition into what we think will translate into the growing momentum of the fourth quarter.

Joe: Sitting here today, obviously, for those folks who've done procedures in the month of July , they'll have just now been submitting those and those things will start to be adjudicated and paid over the course of the quarter.

Unknown Speaker: And it gets very difficult for us to then translate how quickly that also translates into increased surgical volumes and clinical adoption based on the clinical merits of the product versus the reimbursement confidence piece. And that's why you've heard us consistently say that the third quarter is a positive step in the right direction, but it is a transition into what we think will translate into growing momentum in the fourth quarter and into 2025.

Joe: And it gets very difficult for us to then translate how quickly that also translates into increased surgical volumes and clinical adoption based on the clinical merits of the product versus the, I'll call it the reimbursement confidence piece. And that's why you've heard us consistently say that the third quarter is a positive step in the right direction.

Alex Thurman: We're going into 2025. I probably stop short of quantifying that specifically, but as you think about your models and you're working on, you know, our guidance and what we've implied through the commentary for the third and fourth quarter, I think that starts to give you a sense of what that means for I do says we exit the year and in or next.

Joe: But it is a transition into what we think will translate into growing momentum in the fourth quarter, going into 2025. I'd probably stop short of quantifying that specifically, but as you think about your models and you're working on our guidance and what we've implied,

Joe: Through the commentary for the third and fourth quarter, I think that starts to give you a sense of what that means for Eidos as we exit the year and enter next.

Harrison Parsons: Our next question comes from the line of Harrison Parsons from Stevens. Please go ahead. Hi, good afternoon. This is Harrison on for George, and thanks for taking the questions. I wanted to start on your guidance and specifically the domestic glaucoma revenue segment of that. I was I was wondering if for the remainder of 2024, if you know the base denting business, we should expect that same mid-teens growth and then, you know, whatever is incremental that that should be from I do says that the way we should be thinking about it. Well, here's I think I might make a slight tweet to what you just said.

Unknown Speaker: I probably stopped short of quantifying that specifically, but as you think about your models and you're working on, you know, our guidance and what we've implied through the commentary for the third and fourth quarters, I think that starts to give you a sense of what that means for Eidos as we exit the year and enter now. Great, thank you. Our next question comes from the line of Harrison Parsons from Stevens. Please go ahead. Hi, good afternoon. This is Harrison.

Speaker Change: Great, thank you.

Speaker Change: Our next question comes from the line of Harrison Parsons from Stevens. Please go ahead.

Unknown Speaker: I'm for George and thanks for taking the question. I wanted to start on your guidance and specifically the domestic glaucoma revenue segment of that. I was wondering if for the remainder of 2024, if you know the base stinting business, we should expect that, yeah. Same mid-teen growth and then, you know, whatever is incremental that should be for my dose. Is that the way we should be thinking about it? Well, Harrison, I think I might make a slight tweak to what you just said. I think it was asked a little bit earlier.

Speaker Change: Hi, good afternoon. This is Harrison Umpergeorge, and thanks for taking the questions.

Harrison Umpergeorge: I wanted to start on your on your guidance and specifically the domestic glaucoma revenue segment of that I was I was wondering if for the remainder of 2024 if you know the base stinting business we should expect that

Speaker Change: Same mid-teens growth and then, you know, whatever is incremental that that should be for my dose. Is that the way we should be thinking about it?

Unknown Speaker: One of the things that we're anticipating, or at least preparing for as a part of providing guidance today, is that as our team increasingly focuses on the IDOS-TR, you know, commercialization, that could create some growth headwinds, if you will, relative to what we experienced in the first half of the year in our broader portfolio in the U.S. glaucoma. So, said another way, I think we've seen, obviously, a strong pattern emerge in the first half of mid-teens type growth in our SNP portfolio, and I'm not sure that we're counting on that, obviously, as we make our way through the second half and the attention increasingly turns to IDOS-TR.

Harrison Parsons: I think it was that a little bit earlier. One of the things that we're anticipating or at least preparing for is a part of providing guides today is that as our team increasingly focuses on the I does TR, you know, commercialization. You know, that could create some growth headwinds, if you will, relative to what we experienced the first half in our portfolio in the US glaucoma. So set a different way. I think we've seen obviously a strong pattern emerged in the first half of mid-teens type growth in our set portfolio. And I'm not sure that we're counting on that.

Speaker Change: Well, Harrison, I think I might make a slight tweak to what you just said. I think it was asked a little bit earlier. One of the things that we're anticipating or at least preparing for as a part of providing guidance today is that as our team increasingly focuses on the Eidos-TR, you know, commercialization, you know, that could create some...

Speaker Change: [inaudible]

Speaker Change: Headwinds, if you will, relative to what we experienced in the first half.

Speaker Change: In our broader portfolio in the U.S. glaucoma, so set a different way. I think we've seen obviously a strong pattern emerge in the first half of mid-teens type growth in our portfolio.

Alex Thurman: Obviously, as we make our way through the second half and the attention increasingly turns to I does TR. I do think I can provide a little bit more color in terms of the directional growth, you know, by franchise to help here. I think, as we think about it for the full year and the revised guidance. I would expect the cornea business to deliver low single-digit growth for 2024. And I'd expect the international glaucoma business to continue along the strong trajectories had and ultimately deliver low to mid-teens growth for the year, reflecting the strong first half performance.

Speaker Change: And I'm not sure that we're counting on that, obviously, as we make our way through the second half and the attention increasingly turns to Eidos-TR. I do think I can provide a little bit more color in terms of the directional growth.

Unknown Speaker: I do think I can provide a little bit more color in terms of the directional growth, you know, by franchise to healthier, I think, as we think about it for the full year and the revised guidance. I would expect the cornea business to deliver low single-digit growth for 2024. And I'd expect the international glaucoma business to continue along the strong trajectory it's had and to ultimately deliver low to mid-teens growth for the year, reflecting the strong first half performance. And if you do the math, it implies U.S. glaucoma year-over-year growth of sort of the high 20s to approaching nearly 30% on a year-over-year basis when it's all said and done for 20 Okay, I got it.

Speaker Change: you know, by franchise to healthier, I think, as we think about it for the full year and the revised guidance, I would expect the cornea business to deliver low single-digit growth for 2024.

Speaker Change: And I'd expect the international glaucoma business to continue along the strong trajectory it's had and to ultimately deliver low to mid-teens growth for the year, reflecting the strong first half performance.

Alex Thurman: And if you do that map, that it implies US glaucoma year of year growth of sort of the high 20s to approaching nearly 30% on a year of your basis when it's all said and done for 2024.

Speaker Change: And if you do that math, it implies U.S. glaucoma year-over-year growth of sort of the high 20s to approaching nearly 30% on a year-over-year basis when it's all said and done for 2024.

Unknown Executive: Okay, got it. Yeah, that's hopeful.

Alex Thurman: So I wanted to move towards the Salesforce strategy. I know you've talked about a phased launch there. I know all of your reps are calling on surgeons now, but could you give any more color on how many surgeons each rep is going after? Is it just their top one or two? And I guess what I'm really asking is when we're going to be at a full spread? We're different there with all of your Salesforce going out to all of their accounts. Yes, sure. And every member of our sales team will find themselves in a slightly different part of their own trajectory as a voice of the launch.

Unknown Speaker: Yeah, that's, that's helpful. So I wanted to move towards the Salesforce strategy. I know you've talked about a phased launch there. I know all of your reps are calling on surgeons now, but could you give any more color on how many surgeons each rep is going after? Is it just their top one or two? Yeah, sure. And every member of our sales team will find themselves in a slightly different part of their own trajectory as it relates to the launch. But the way I would characterize it is what we said on the last call. You start off by enabling the first handful.

Speaker Change: Okay, got it. Yeah, that's, that's helpful.

Speaker Change: So I wanted to move towards the Salesforce strategy. I know you've talked about a phased

Speaker Change: I know all of your reps are calling on surgeons now, but could you give any more color on how many surgeons each rep is going after? Is it just their top one or two? And I guess what I'm really asking is, when are we going to be at a full sprint there with all of your sales force going out to all of them?

Speaker Change: All of their accounts.

Speaker Change: Yes, sure, and every member of our sales team will find themselves in a slightly different part of their own trajectory as it relates to the launch, but the way I would characterize it is what we said in the last call. You start off by enabling the first handful, for some it's one or two, for others it's a couple more of surgeon targets.

Alex Thurman: But the way I would characterize it is what we said in the last call. You start off by enabling the first handful; for some, it's one or two; for others. It's a couple more surgeon targets getting comfortable with that, getting the sea legs associated with launching a product like I does. And then ultimately, as we get into the third quarter, you start to open that up in waves. Again, I'm at this point. It's a little less focus on the exact number of surgeons that were enabling with the Salesforce. And then I think the unlocking, if you will, of it has a lot more to do with when they start to see the payment flow through the J code and for those who've already done it on the business, like a C code environment, the C code.

Unknown Speaker: For some, it's one or two. For others, it's a couple more of certain targets, getting comfortable with that, and getting the sea legs associated with launching a product like Eidos. And then ultimately, as we get into the third quarter, you start to open that up in waves. Again, at this point, it's a little less focused on the exact number of surgeons that we're enabling with the sales force. And I think the unlocking, if you will, of it has a lot more to do with when they start to see the payment flow through the J code, and for those who've already done it under the miscellaneous C code environment, the C code.

Speaker Change: Getting comfortable with that, getting the sea legs associated with launching a product like Eidos.

Speaker Change: And then ultimately, as we get into the third quarter, you start to open that up in waves.

Speaker Change: Again, at this point, it's a little less focus on the exact number of surgeons that we're enabling with the sales force.

Speaker Change: And I think the unlocking, if you will, of it has a lot more to do with when they start to see the payment flow through of the J code, and for those who've already done it under the miscellaneous C code environment, the C code.

Alex Thurman: Great.

Unknown Executive: Thanks for taking the questions.

Margaret Kexor: Our next question comes from a line of Margaret Kex or from William and Blair. Please go ahead. Hi guys, good afternoon. Thanks for taking the questions. I'm going to keep on the IDOS train, at least for the first one. You know, as we think about the number of accounts that have implanted IDOS and adopt trainings that you've done on the back end. You're sort of referencing the J code and all these catalysts that should, you know, hopefully unlock more of those. I guess, AD, you expect a meaningful increase in planners versus kind of what we saw in the Q2 pace.

Unknown Speaker: Great, thanks for taking the question. Our next question comes from the line of Margaret Caxor from William and Blair. Please go ahead.

Speaker Change: Great, thanks for taking the questions.

Speaker Change: Our next question comes from the line of Margaret Caxor from William and Blair. Please go ahead.

Unknown Speaker: Hey guys, good afternoon. Thanks for taking the questions. I'm going to keep on the IDOS train, at least for the first one, you know, as we think about the number of accounts that have implanted IDOS and the doctor trainings that you've done on the back end, you know, you're sort of referencing the JCODE and all these catalysts that should, you know, hopefully unlock more of those. I guess, A. Do you expect a meaningful increase in implanters versus kind of what we saw in the Q2 pace?

Margaret Cagsore: Hey guys, good afternoon. Thanks for taking the questions.

Margaret Cagsore: I'm going to keep on the IDOS train, at least for the first one, you know, as we think about the number of accounts that have implanted IDOS and the doc trainings that you've done on the back end, you know, you're sort of referencing the JCODE and all these catalysts that should, you know, hopefully unlock more of those, I guess.

Speaker Change: A, do you expect a meaningful increase in implanters versus kind of what we saw in the Q2 case? And then at what point do you hit a consistent quarter run rate for doc training? Or, you know, you've got kind of infinite capacity, no pun intended, on where that can go.

Margaret Kexor: And then at what point do you hit a consistent quarter run rate for doc trainings, or, you know, you've got kind of internet capacity, you know, no pun intended for that can go. Thanks, Margaret. I'm going to sound a little bit like a broken record, I think, here.

Unknown Speaker: And then at what point do you hit a consistent quarter run rate for doc training? Or, you know, you've got kind of an infinite capacity, no pun intended, where that can go? Thanks, Margaret. I'm going to sound a little bit like a broken record, I think, here.

Unknown Speaker: But in many ways, the gating item here to that consistency, I'll call it the ramp and the number of doctors being trained in any given quarter, etc., is really based upon when we start to see the consistent and recurring and predictable payment of the J-code. And we expect that in relatively short order. And I think as we get ourselves through the third quarter and certainly as we enter into the fourth quarter and exit the year, I think we're going to start to see a lot more clinical adoption versus, you know, what I'll call market access or reimbursement-related conservatism.

Thomas Burns: But in many ways, the gating item here to that consistency, I'll call you to call it up the ramp and the number of doctors being trained in the given quarter, et cetera, is really based upon when we start to see the consistent and recurring and predictable. Payment of the J code, and we expect that in, you know, relatively short order. It'll maybe clear. But from that standpoint, as you enter into the third quarter, it's a normal grinding of the process, if you will, as the Max, for example, brings the J code online. As they start to adjudicate these things and pay them in a more typical payment cycle that the account can count on.

Speaker Change: Thanks, Margaret. I'm going to sound a little bit like a broken record, I think, here, but in many ways, the gating item here to that consistency, I'll call it, of the ramp and the number of doctors being trained in any given quarter, etc.,

Speaker Change: is really based upon when we start to see...

Speaker Change: The Consistent and Recurring and Predictable Payment of the J-Code. And we expect that in relatively short order, let me be clear. But from that standpoint, as you enter into the third quarter, it's a normal grinding of the process, if you will. As the match, for example, bring the J-Code online, as they start to adjudicate these things and pay them in a

Thomas Burns: At that point, administrators stop becoming the ones who are dictating access to the product, and it becomes adopted from the clinical side, and the things that we all know, the benefits that we all know exist for utilization of light of CR. And that's the reason why I think when you all do your surveys, you see such positive feedback from the surgeons who are thinking about it from a clinical standpoint, how they would adopt that.

Speaker Change: You know, more typical payment cycle that the account can count on.

Speaker Change: At that point...

Speaker Change: Administrators stop becoming the ones who are dictating access to the product and it becomes adopted from the from the clinical side and the things that we all know the benefits that we all know exist for utilization of IDOS-TR and that's the reason why I think when you all do your surveys

Thomas Burns: And I think as we get ourselves through the third quarter, and certainly as we enter into the fourth quarter and exit the year, I think we're going to start to see a lot more clinical adoption versus, you know, call it market access or reimbursement-related conservative.

Speaker Change: You see such positive feedback from the surgeons who are thinking about it from a clinical standpoint, how they would adopt that. And I think as we get ourselves, you know, through

Speaker Change: through the third quarter and certainly as we enter into the fourth quarter and exit the year, I think we're going to start to see a lot more

Speaker Change: Clinical Adoption versus, you know, I'll call it market access or reimbursement-related conservatism.

Thomas Burns: Okay, and then, you know, I'll put you over to Infinite because you guys, you know, you keep referencing the success of that.

Unknown Speaker: Okay, and then, you know, I'll switch over to Infinite because you guys, you keep referencing the success of that. Is it fair to assume that Infinite still remains larger than IDOS at this point, or not?

Speaker Change: Okay, and then, you know, I'll switch over to Infinite because you guys, you know, you keep referencing the success of that. Is it fair to assume that Infinite still remains larger than IDOATS at this point or not? And then, you know, as we think about what's driving that interest for Infinite at this point, can you talk to, you know, types of accounts, number of accounts that have adopted, and how or what is in your guidance over the course of the year that's implied? Thanks.

Thomas Burns: Is it fair to assume that Infinite still remains larger than I do at this point or not?

Thomas Burns: And then, you know, as we think about what's driving that interest for Infinite at this point, can you talk to, you know, types of accounts, number of accounts that have adopted and how or what is in your guidance over the course of the year that's implied. Thanks. Absolutely. I mean, I think for the first absolutely our central folio, and I said Infinite remain the dominant component of our overall portfolio. If you just think back to what I said earlier in the call, with mid-teens growing on a year-over-year basis, that that that it just implies that it's obviously the largest chunk of our U.S.

Unknown Speaker: And then, you know, as we think about what's driving that interest for Infinite at this point, can you talk about types of accounts, number of accounts that have been adopted, and how or what is in your guidance over the course of the year that's implied? Thanks. Absolutely. I mean, first and foremost, our Stent Portfolio and iStent Infinite remain the dominant components of our overall portfolio. If you just think back to what I said earlier in the call, with mid-teens growth on a year-over-year basis, that just implies that it's obviously the largest chunk of our U.S. glaucoma revenue base that exists today.

Speaker Change: Absolutely. I mean, I think first, absolutely, our STIN portfolio and iSTIN Infinite remain the dominant component of our overall portfolio. If you just think back to what I said earlier in the call, with mid-teens growing on a year-over-year basis, that just implies that it's obviously the largest chunk of our U.S. glaucoma revenue base as it exists today. Now, I do expect, and we all do expect, that will shift pretty quickly here as IDOS continues to ramp. But as we sit here today, Infinite is still the largest contributor to the overall portfolio on the U.S. glaucoma side.

Unknown Speaker: Now, I do expect, and we all do expect, that will shift pretty quickly here as IDO's continue to ramp up. But as we sit here today, Infinite is still the largest contributor to the overall portfolio on the U.S. glaucoma side. You know, what's driving it?

Thomas Burns: glaucoma revenue basis that exists today. Now, I do expect, and we all do expect, that will ship pretty quickly. Here is I does continue to ramp. But as we sit here today, Infinite is still the largest contributor to the overall portfolio in the U.S. glaucoma side.

Unknown Speaker: I think it's exactly what it's intended for, you know, as as we entered into this year, and coverage was there and established in a much more predictable, recurring way. Our customers started to focus on the intended use case of the product, which is for those patients who failed, you know, surgical medical therapy. And if you think about it, for those patients, it just makes sense to intervene first with minimal intervention before moving on to more invasive procedures is what you'd want for your family member in the same situation.

Thomas Burns: You know, what's driving it? I think it's exactly what it's intended for, you know, as we entered into this year and coverage was there and established in a much more predictable and recurring way. Our customers start to focus on the intended use case of the product, which is for those patients who fail, you know, surgical medical therapy. And if you think about it, for those patients, that just makes sense to intervene first with Infinite before moving on to more invasive procedures is what you'd want for your family member in the same situation. I think as our sales force is able to have that clinical conversation with these customers, you see more and more adoption of our surgeons utilizing exactly as it was intended.

Speaker Change: You know, what's driving it?

Speaker Change: I think it's exactly what it's intended for, you know, as we entered into this year and coverage was there and established in a much more predictable recurring way, our customers started to focus on the intended use case of the product, which is for those patients who failed surgical medical therapy.

Speaker Change: And if you think about it, for those patients, it just makes sense to intervene first with Infinite before moving on to more invasive procedures is what you'd want for your family member in the same situation. I think as our sales force is able to have that clinical conversation.

Unknown Speaker: And I think, as our sales force is able to have that clinical conversation with these customers, you see more and more of our surgeons using it exactly as it was intended. Okay, thank you. Our next question comes from the line of David Saxon from Needham. Please go ahead.

Speaker Change: With these customers, you see more and more adoption of our surgeons utilizing exactly as it was intended.

Unknown Executive: Okay. Thank you, guys.

Joseph: Our next question comes from a line of David Saxon for Needham. Please go ahead.

Speaker Change: Okay, thank you guys.

Speaker Change: Our next question comes from the line of David Saxon from Needham. Please go ahead.

Joseph: Hey, guys. This is Joseph on for David. Two questions, I guess on I does and I'll just ask them together.

Unknown Speaker: Hey guys, this is Joseph on behalf of David. Two questions, I guess on the high dose and I'll just ask them together in the quarter gross margin improvement, how much of that was maybe driven by ideas? And then looking just like towards the launch throughout the rest of the year, are there any plans on, you know, hiring on the back of the Eidos launch you had mentioned, maybe that? Transcripts provided by Transcription Outsourcing, LLC. Okay, hey Joseph, it's Alex.

Joseph: Hey guys, this is Joseph on for David. Um, two questions, I guess on the high dose and I'll just ask them together. Um, in the quarter, gross margin improvement, how much of that was maybe driven by high dose?

Alex Thurman: In the quarter, gross margin improvement; how much of that was maybe driven by I does. And then looking just like towards launch throughout the rest of the year, is there any plans on, you know, hiring on the back of the I does launch? You had mentioned maybe that the broader portfolio could see some head ones from attention there. So I was just wondering if that was, you know, contemplated in the plan. Okay.

Speaker Change: And then looking just like towards the launch throughout the rest of the year. Is there any plans on, you know, hiring on the back of the Eidos launch? You had mentioned maybe that

Speaker Change: The broader portfolio could see some headwinds from attention there. So I was just wondering if that was You know contemplated in the plan

Unknown Speaker: I'll take the first question on the margin. So we did have a little bit of a modest year over year increase in margin, but it fell within our expected range of 82-84%. And so I wouldn't say IDOS was a major driver of that.

Alex Thurman: Hey, Joseph is Alex. I'll take the first question on the margin. So we did have a little bit of on modest year-over-year increase in margin. It fell within our expected range of 82%, and so I wouldn't say I dose was a major driver of that. In fact, quite honestly, you know, the I dose facility that we turned on tends to be right now ahead when to our margin. And as we intend to see these inefficiencies in manufacturing as you scale up production on these product launches. So at this point, we expect to see the margin creation continued to expand over the course of next year on the back of the I does visit fully launches.

Alex: Okay, hey Joseph, it's Alex. I'll take the first question on the margin. So, we did have a little bit of a modest year-over-year increase in margin.

Speaker Change: It fell within our expected range of 82-84%, and so I wouldn't say IDOS was a major driver of that. In fact, quite honestly, you know, the IDOS facility that we turned on tends to be right now a headwind to our margin.

Unknown Speaker: In fact, quite honestly, you know, the IDOS facility that we turned on tends to be a headwind to our margin right now as we tend to see these inefficiencies in manufacturing as you scale up production on these product launches. So at this point, we expect to see margin accretion continue to expand over the course of next year on the back of the IDOS platform as it fully launches. And as it relates to the sales force and hiring plans, I think we've always been consistent in how we look at this, and we're going to stick with, and stay true to, the same approach we've had for a long time now, which is that we're always evaluating territories and opportunities where territories get to a scale where it makes sense to grow our sales force.

Speaker Change: As we tend to see these inefficiencies in manufacturing as you scale up production on these product launches. So at this point, we expect to see the margin creation continue to expand over the course of next year on the back of the I-dose as it fully launches.

Alex Thurman: And as it relates to the sales force and hiring plans, I think we've always been consistent how we look at this, and we're going to stay true to the same approach we've had for a long time now, which is. We're always evaluating territories and opportunities where territories get to a scale that it makes sense to grow our sales force. We have no plans, as it stands here today, to make wholesale changes to the size of the structure of our force, but I would expect it, over time, organically.

Speaker Change: And as it relates to the sales force and hiring plans, I think we've always been consistent in how we look at this and we're going to stick, stay true to.

Speaker Change: The same approach we've had for a long time now, which is we're always evaluating territories and opportunities where territories get to a scale that it makes sense to grow our sales force.

Unknown Speaker: We have no plans, as it stands here today, to make wholesale changes to the size of the structure of our force, but I would expect that, over time, organically, we'll be adding folks to support the needs of the glaucoma business. Okay, great.

Speaker Change: We have no plans, as it stands here today, to make wholesale changes to the size or the structure of our force, but I would expect that over time, organically, we'll be adding folks to support the needs of the glaucoma business.

Unknown Executive: We will be we'll be adding folks to support the needs of the glaucoma business. Okay, great.

Unknown Executive: Now that that's all from us, and congrats on the record quarter. Thank you.

Speaker Change: Okay, great. Yeah, that's all from us and congrats on the record quarter.

Joanne Wuensch: Our next question comes from the line of Joanne Wuensch from Citibank. Please go ahead. Good afternoon, and thanks for taking the question, and congrats on the quarter.

Unknown Speaker: Yeah, that's all from us and congrats on the record quarter. Thank you. Our next question comes from the line of Joanne Wuensch from Citibank. Please go ahead. Good afternoon, and thanks for taking the question. And congratulations on the quarter. I want to shift gears just a little bit to OUS MIGS.

Speaker Change: Thank you.

Speaker Change: Our next question comes from the line of Joanne Wuensch from Citibank. Please go ahead.

Joanne Wuensch: I want to shift yours just a little bit to OUS Miggs. I'm curious what is going on there that's driving, you know, let's call it XFFX 20% plus kind of growth. And also, if my memory is correct, when you gave an initial 2024 revenue guidance, it was for that segment to be uploaded mid-teens; seems like that may need to be updated, or the second half is really not a problem. Thank you.

Joanne Karen Wuensch: Good afternoon and thanks for taking the question and congrats on the quarter. I want to shift gears just a little bit to OUS-MIGS.

Unknown Speaker: I'm curious what is going on there that's driving, you know, let's call it XFX 20% plus kind of growth. And also, if my memory is correct, when you gave initial 2024 revenue guidance, it was for that segment to be up low to mid-teens. It seems like that may need to be updated or the second half is going to have a problem. Thank you. Yeah, hi, Joanne.

Joanne Karen Wuensch: I'm curious what is going on there that's driving, you know, let's call it XFX 20% plus kind of growth. And also if my memory is correct, when you gave initial 2024 revenue guidance, it was for that segment to be up low to mid-teens.

Speaker Change: Seems like that may need to be updated or the second half is really going to have a problem. Thank you.

Alex Thurman: Yeah, hi Joanne. I'll start in on the latter first. When we started the year, what we said, or at least on the last call, was that you should expect low to mid double-digit growth from that Internet. And on this call today, I referenced low to mid teens growth. So, in fact, there for the year that does imply a step up in the overall growth profile. You know, I can point to a couple things. You heard Tom reference, obviously, the French Agreement. But I think the biggest thing there continues to be the blocking and tackling of our teams across the markets out there.

Unknown Speaker: I'll start on the latter first. When we started the year, what we said, or at least on the last call, was that you should expect low to mid double-digit growth from that international business. And on this call today, I referenced low to mid-teens growth. So, for the year, that does imply a step up in the overall growth profile. You know, I can point to a couple things.

Speaker Change: Yeah, hi, Joanne. I'll start on the latter first.

Speaker Change #101: When we started the year, what we said, or at least on the last call, was that you should expect low to mid-double digit growth from that international business.

Speaker Change: And on this call today, I referenced, you know, low to mid-teens growth. So, in fact, for the year, that does imply a step up in the overall growth profile. You know, I can point to a couple things.

Unknown Speaker: You heard Tom reference, obviously, the French agreement, but I think the biggest thing there continues to be the blocking and tackling of our teams across the markets out there. We're still in the relatively early innings of changing the standard of care in the combination cataract market in many of these areas. And we're just now starting to turn on new product introductions and approvals that you heard Tom reference, as well as beginning to follow that with increasing focus on the interventional glaucoma opportunity and standalone care of these patients proactively, just as we're doing here in the U.S. So, I think we continue to be enthusiastic about the opportunity outside of the United States and in these international markets. Having said that, you've always got currency considerations there.

Speaker Change: You heard Tom reference, obviously, the French agreement, but I think the biggest thing there continues to be the blocking and tackling of our teams across the markets out there. We're still in the relatively early innings of changing the standard of care.

Alex Thurman: We're still in the relatively early innings of change. We're changing the standard of care in the combination cataract market in many of these areas. And we're just now starting to turn on new product introductions and approvals that you heard Tom reference, as well as beginning to follow that with increasing focus on the intervention of all comb opportunity and standalone care of these patients proactively, just as we're doing here in the US. So I think we continue to be enthusiastic about the opportunity outside of the United States and in these international markets. Having said that, you've always got currency considerations there.

Speaker Change: in the combination cataract market in many of these areas.

Speaker Change: And we're just now starting to turn on new product introductions and approvals that you heard Tom reference.

Speaker Change: as well as beginning to follow that with increasing focus on the interventional glaucoma opportunity and standalone care of these patients proactively, just as we're doing here in the U.S. So, I think we continue to be enthusiastic about the opportunity outside of the United States and in these international markets.

Unknown Speaker: We have competitive launches. We've been dealing with that for the last couple of years. We continue to see that now, and that takes time to work through as folks try and trial and hopefully ultimately come back to products they know and trust in the Glaukos portfolio. So, we feel confident about where we're headed with that franchise, and I think the increased guidance in that area reflects that. Thank you for that. And what would the timeline be for bringing IDIS outside the United States? And have a great evening!

Alex Thurman: We have competitive launches. We've been dealing with that for the last couple of years. We continue to see that now. And that takes time to work through as folks try and trial and hopefully ultimately come back to products they know and trust in the gloves portfolio. So we feel confident about what we're headed with that franchise. And I think the increased guidance in that area reflects that. Thank you for that.

Speaker Change: Having said that, you've always got currency considerations there. We have competitive launches. We've been dealing with that for the last...

Speaker Change: A couple of years, we continue to see that now, and that takes time to work through as folks try and trial and hopefully ultimately come back to products they know and trust in the Glaukos portfolio. So we feel confident about where we're headed with that franchise, and I think the increased guidance in that area reflects that.

Thomas Burns: And the timeline for bringing I do outside the United States. What would that be, and have a great evening? Thanks, Joanne. Yeah.

Speaker Change: Thank you for that. And the timeline for bringing IDOS outside the United States, what would that be? And have a great evening.

Unknown Speaker: Thanks, Joanne. Yeah, from an EIDO standpoint, the first thing you do is get approval in the United States, and that was the focus. And then from there, you shift your attention, in our case, to evaluating various markets internationally. That's a complex environment, as you know, in the context of the world where reference pricing and things like that exist. And so I think we'll be cautious about how we approach EIDO's TR and the timing of any market entry outside the U.S. for now.

Thomas Burns: From an I do standpoint, the first thing you do is get approval in the United States. And that was the focus. And then from there you shift your attention, in our case, to evaluating various markets internationally. That's a complex environment, as you know, in the context of the world where reference pricing and things like that exist. And so I think we'll be cautious about how we approach I does TR and the timing of any market entries outside the US for now. But we'll keep you updated as we continue to progress on that evaluation.

Speaker Change #104: Thanks, Joanne. Yeah, from an EIDL standpoint, the first thing you do is get the approval in the United States and that was the focus.

Speaker Change #100: From there, you shift your attention, in our case, to evaluating various markets.

Speaker Change: That's a complex environment, as you know, in the context of the world where reference pricing and things like that exist, and so I think we'll be cautious about how we approach IDOS-TR and the timing of any market entries outside the U.S. for now, but we'll keep you updated as we continue to make progress on that evaluation.

Unknown Speaker: But we'll keep you updated as we continue to make progress on that evaluation. Our next question comes from the line of Rich Newitor from Truist Securities. Please go ahead.

Rich Newiter: Our next question comes from a line of rich new iter from Tourist Securities. Please go ahead. Hi, excuse me. Thanks for taking the questions. Maybe just going back over the component of the, you know, the bridge, the guidance range from old to new. You gave some color that I just want to make sure I'm getting all the pieces correct. It sounds like International Glaucoma has a bit of a call up. You just said low double digits to low to mid teams. And obviously your US glaucoma is now high, high 20% to low 30, and that's a call up to, but it sounds like that.

Unknown Speaker: Hi. Thanks for taking the questions. Maybe just going back over the components of the, you know, the bridge, the guidance range from old to new. You gave some color there.

Unknown Speaker: I just want to make sure I'm getting all the pieces correct. It sounds like international glaucoma has a bit of a call center. You just said low double digits to low to mid teens. And obviously, your U.S. glaucoma is a high 20 percent to low 30. And that's a call up, too. But it sounds like that, You know, you're getting some of the maybe the incremental eye dose contribution masked by, you know, commercial sales, not distraction, but time trade-off from the rest of the glaucoma portfolio. Is there anything else in there? Did I get all the pieces?

Speaker Change #106: And obviously your U.S. glaucoma is now high 20% to low 30% and that's a call up too, but it sounds like that's...

Alex Thurman: But you know, you're getting some of the maybe the incremental I those contribution masked by, you know, commercial sales, not distraction, but the time trade off from the rest of the glaucoma portfolio. Is there anything else in there? Did I get the pieces right? Can you put any quantification around those?

Speaker Change #108: You know, you're getting some of the maybe the incremental eye dose contribution masked by, you know,

Speaker Change #109: Commercial sales, not distraction, but time trade-offs from the rest of the Glaucoma portfolio. Is there anything else in there? Did I get the pieces right? Can you put any quantification around those?

Alex Thurman: Yeah, so I think taking a step back, just to confirm, in the first part of what you said, I think the punchline is in the revised guidance; it's guiding up on the international side, it's guiding up on the U.S. about Koma side. And, you know, from a macro standpoint, if you think about it, we beat the quarter, I think, by something like 7 million. And when you look at the midpoints, we raised our guidance by 12. And so I think all of that is incremental, as we think about the overall growth profile of the business. You know, from the cornia side, the low single digit is probably a takedown from where we were at on our prior calls, all really related to our entry into the Medicaid drip rebate program, which we've talked about on previous calls.

Unknown Speaker: Right? Can you put any quantification around those? Yeah, so I think taking a step back, just to confirm the first part of what you said, I think the punchline is in the revised guidance, it's guiding up on the international side, it's guiding up on the US Vodkoma side. And, you know, from a macro standpoint, if you think about it, we beat the quarter, I think by something like 7 million. And when you look at the midpoints, we raised our guidance by 12.

Speaker Change #132: Yeah, so I think taking a step back, just to confirm the first part of what you said, I think...

Speaker Change #105: It's guiding up on the international side, it's guiding up on the U.S. Vodkoma side.

Unknown Speaker: And so I, all of that is incremental. As we think about the overall growth profile of the business, you know, from the cornea side, the low single digit is probably a tick down from where we were on our prior calls, all really related to our entry into the Medicaid drug rebate program, which we've talked about on previous calls. I think from a US standpoint, you largely captured that right; what I said was, you know, as you can imagine, our sales force is going to be increasing leading into the Eidos TR launch; it's going to take an increasing amount of their time as they're turning on and training surgeons as we make our way to the second half. And while I hope this doesn't happen, we're preparing for, financially, some dampening of I got it.

Speaker Change #103: And when you look at the midpoints, we raised our guidance by 12.

Speaker Change #111: All of that is incremental as we think about the overall growth profile of the business. From the cornea side,

Speaker Change #103: The low single digit is probably a tick down from where we were at on our prior calls, all really related to our entry into the Medicaid drug rebate program, which we've talked about on previous calls.

Alex Thurman: I think from a U.S. standpoint, you largely captured that right, what I said was, you know, as you can imagine, our sales force is going to be increasing leading into the I.D.O.S.T.R launch, it's going to take an increasing amount of their time as they're turning on and training surgeons as we make our way to the second half. And while I hope this doesn't happen, we're preparing for financially in our guidance, some dampening of the growth profile that we saw the first half in our Stanford volume.

Speaker Change #114: I think from a U.S. standpoint, you largely captured that right. What I said was, you know,

Speaker Change #113: It's going to take an increasing amount of their time as they're turning on and training surgeons as we make our way to the second half. And while I hope this doesn't happen, we're preparing for, financially, in our guidance, some dampening of the growth profile that we saw in the first half in our STEM portfolio.

Alex Thurman: God, that's really helpful. And, you know, appreciate you're not giving us a specific I.D.O.S. number for 2Q, but, you know, whatever that number is, you know, call it 4 or whatever, you know, whatever it may be. You know, in an ideal world, if you were in our shoes, would you ideally like to see the consensus modeling roughly flatish, kind of sequential, and then did a big uptick in 4Q or spread it out a little bit, flight up to 3Q, bigger uptick 4Q? Can you just, you know, any kind of directional health there, it might help calibrate consensus, as well as into where you might want it.

Unknown Speaker: That's really helpful. And, you know, appreciate you're not giving us a specific IDOS number for 2Q, but, you know, whatever that number is, you call it 4 or whatever, whatever it may be, in an ideal world, if you were in our shoes, would you ideally like to see the consensus modeling roughly flattish kind of sequential and then get a big uptick in 4Q or spread it out a little bit, slight uptick 3 Can you just give me, you know, any kind of directional help there? It might help calibrate consensus relative to where you might want it. Yeah, I mean, I think it's a good question.

Speaker Change #123: Got it. That's really helpful.

Speaker Change #115: You know, appreciate you're not giving us a specific IDOS number for 2Q, but

Speaker Change #107: You know, whatever that number is, you know, call it four, whatever million, whatever it may be.

Speaker Change #118: In an ideal world, if you were in our shoes, would you ideally like to see the consensus modeling roughly...

Speaker Change: [inaudible]

Alex Thurman: Yeah, I mean, I think it's a good question. So, if you just focus and zero in on seasonality, not within each specific product in mind, but just seasonality of the business. As you know, the underlying procedure demand tends to favor Q2 and Q4 over Q1 and Q3 in alpha mileage in general. In recent years, we've seen a sequential Q2 and Q3 step down of several million dollars. And I think we would expect that at least to be the starting trend line. Again, this year, as you heard me say, the relative next leg up from an I-dose growth standpoint is likely to be weighted more towards Q4, as we've indicated, you know, for some time.

Unknown Speaker: So if you just focus and zero in on seasonality, not with any specific product in mind, but just seasonality of the business, as you know, the underlying procedure demand tends to favor Q2 and Q4 over Q1 and Q3 and ophthalmology in general. In recent years, we've seen a sequential Q2 to Q3 step down of several million dollars. And I think we would expect that at least to be the starting trend line again this year.

Speaker Change #120: Yeah, I mean, I think it's a good question. So if you just focus and zero in on seasonality, not with any specific product in mind, but just seasonality of the business.

Speaker Change #110: As you know, the underlying procedure demand tends to favor Q2 and Q4 over Q1 and Q3 in ophthalmology in general.

Speaker Change: In recent years, we've seen a sequential Q2 to Q3.

Speaker Change: stepped down of several million dollars and

Unknown Speaker: As you've heard me say, the relative next leg up from an IDOS growth standpoint is likely to be weighted more towards Q4, as we've indicated for some time. But as I also mentioned, it's really hard when you see the way that the launch lines up to be quite so precise in the context of exactly what will accrue in the third quarter versus the fourth. And so I think from that standpoint, it makes sense for us to be a little bit conservative, while we're obviously planning for, you know, more optimistic outcomes, both in the third quarter as well as including the fourth. Okay, thanks. Congratulations on the quarter. Our next question comes from the line of Steve Lichtman from Oppenheimer. Please go ahead.

Speaker Change: And I think we would expect that at least to be the starting trend line again this year. As you've heard me say, the relative next leg up from an IDOS growth standpoint is likely to be weighted more towards Q4, as we've indicated for some time.

Alex Thurman: As I also mentioned, it's really hard when you're the way that the launch lines up to be quite so precise in the context of exactly what will occur in the third quarter versus the fourth. And so, I think from that standpoint, it makes sense for us to be a little bit conservative while we're obviously planning for, you know, more optimistic outcome both of the third quarter as well as clue in the fourth.

Speaker Change: As I also mentioned, it's really hard when the way the launch lines up to be quite so precise in the context of exactly what will occur in the third quarter versus the fourth.

Speaker Change: And so I think from that standpoint, it makes sense for us to be a little bit conservative while we're obviously planning for, you know, more optimistic outcomes, also third quarter, as well as including the fourth.

Unknown Executive: Okay, thanks. We're going to have to record it. Thank you.

Steven Lichtman: Our next question comes to the line of Steve Lickman from Oppenheimer. Please go ahead.

Speaker Change #116: Okay, thanks, congrats on the quarter.

Speaker Change #128: Thank you.

Speaker Change #112: Our next question comes from the line of Steve Lichtman from Oppenheimer. Please go ahead.

Steven Lichtman: Thank you.

Unknown Speaker: Thank you. Evening, guys. I wanted to actually ask about just U.S. corneal health.

Alex Thurman: Evening, guys. One to actually ask on just on US corneal health. Appreciate all of the full year guidance. How should we be thinking about that business after your anniversary, the MDRP? Do you anticipate it picking up, or do you have some device-related headwinds as we get closer to Epion? How do you think about that as we move past this? It's a good question, Steve. I think from the Cornell Health side, you set it up correctly. The first thing you have to do is sunset some of the Medicaid Drug Rebate Program entry headwinds. Some of those could persist into 2025 as well.

Steven Michael Lichtman: Thank you. Evening, guys. I wanted to actually ask on just on U.S. corneal health, appreciate all of the

Steven Michael Lichtman: The Full Year of Guidance. How should we be thinking about that business after you anniversary the MDRP?

Speaker Change #124: Do you anticipate it picking up, or do you have some device-related headwinds as we get closer to Epion? How do you think about that as we move past this?

Unknown Speaker: I appreciate all of the full-year guidance. How should we be thinking about that business after you anniversary the MDRP? Do you anticipate it picking up, or do you have some device-related headwinds, you know, as we get closer to Epion? How do you think about that, you know, as we move past that? Yeah, it's a good question, Steve. I think from the corneal health side, you set it up correctly.

Speaker Change #124: Yeah, it's a good question, Steve. I think from the corneal health side, you

Unknown Speaker: The first thing you have to do is sunset some of the Medicaid drug rebate program entry headwinds. Some of those could persist into 2025 as well, as adoption in the Medicaid arena continues to grow, and the rebates grow alongside of them. But as we get past that, from a, I'll call it, a growth to net adjustment standpoint, our expectation is that the underlying business X that dynamic should be returning back to or exceeding the kind of growth that we've expected in the past from that franchise and what you saw in 2023.

Speaker Change #127: You set it up correctly. The first thing you have to do is sunset.

Speaker Change #127: Some of the Medicaid drug rebate program entry headwinds.

Alex Thurman: As that adoption and the Medicaid arena could use a grow, and the rebate grow alongside of them. But as we get past that, from a call to growth and that adjustments standpoint, our expectation is that the underlying business X, that dynamic should be returning back to or exceeding the kind of growth that we've expected in the past from that franchise and what you saw in 2023. Ultimately, a lot of the activities that we are doing and we'll do would be an anticipation of preparation for a very important launch and that the OXA product as we exit 2025 enter into 2026.

Speaker Change #124: Some of those could persist into 2025 as well as that adoption in the Medicaid arena continues to grow and the rebates grow alongside of them.

Speaker Change #124: But as we get past that, from a growth net adjustment standpoint, our expectation is that the underlying business x that dynamic.

Unknown Speaker: Ultimately, a lot of the activities that we are doing and will do would be in anticipation of preparation for a very important launch of the OXA product as we exit 2025 and enter into 2026. Thank you, that's helpful. And then, pardon if I missed it, but how are you thinking about OPEX growth now that you're exiting here from 2Q for the year? Hey, Steve, it's Alex.

Speaker Change #124: should be returning back to or exceeding the kind of growth that we've expected in the past from that franchise and what you saw in 2023.

Speaker Change #124: Ultimately, a lot of the activities that we are doing and will do would be in anticipation of preparation for a very important launch in the Epioxa product as we exit 2025 and enter into 2026.

Alex Thurman: Okay, that's helpful.

Alex Thurman: And then positive, I missed it, but how are you thinking about OX growth? You know, now you're exiting here for two Qs for the year. Thanks.

Speaker Change #139: Okay, that's helpful. And then, positive I missed it, but how are you thinking about OPEX growth, you know, now, you know, exiting here to Q for the year? Thanks.

Alex Thurman: Hey, Steve, it's Alex. I'll take the OXA question, and again, you know, our OXA is trending along exactly how we were trying to guide it for the year. If you recall, we had said to expect OX to grow this year around 10% off a base of about 360 million last year. That puts you at a full year OX around 400 million. Through the first half, we have spent 192 million. So if you just sequentially take a little mod of step up over the next two quarters, you can get to the 400 million. And that's what we expect for the year.

Unknown Speaker: I'll take the OPEX question. And again, you know, our OPEX is trending along exactly how we were trying to guide it for the year. If you recall, we had said to expect OPEX to grow this year by around 10% off a base of about $360 million from last year. That puts you at a full year OPEX of around $400 million. Through the first half, we have spent $192 million.

Speaker Change #124: Hey Steve, it's Alex. I'll take the OPEX question.

Alex: Again, you know, our OPEX is trending along exactly how we were trying to guide it for the year. If you recall, we had said to expect OPEX to...

Speaker Change #126: to grow this year around 10% off a base of about $360 million from last year. That puts you at a full year off X around $400 million.

Speaker Change #126: Through the first half we have spent $192 million so if you just sequentially take a little modest step up over the next two quarters you can get to the $400 million and that's what we'd expect for the year.

Unknown Speaker: So if you just sequentially take a little modest step up over the next two quarters, you can get to $400 million, and that's what we'd expect for the year. Thank you, guys. All right, and our last question comes from the line of Anthony Petrone from Mizzou. Please go ahead.

Unknown Executive: Got it.

Unknown Executive: Thank you, guys.

Anthony Petrone: All right, now our last question comes from the line of Anthony Patrone from Izouho. Please go ahead.

Speaker Change #121: Got it. Thank you guys.

Steven Michael Lichtman: Thanks, Steve.

Speaker Change #117: Our last question comes from the line of Anthony Petrone from Mizzou. Please go ahead.

Unknown Speaker: Thanks, I'll stay on the iDose theme here, and my first question will be on the strategy for the 20% Medicare fee-for-service patients out there just doing some checks, and there's a little bit of sticker shock with the out-of-pocket for those patients, in the instance where you have to use two stents. So is there a balance sheet strategy to sort of close that donut hole in that 20% Medicare fee And then just as we look out in terms of iDose getting into the S-curve with its product launch, you mentioned potentially some Salesforce ads, the 400 million, but is this a scenario once we get to 25 and certainly into 26?

Anthony Petrone: Thanks. I'll stay on the Ido theme here. And first question will be on the strategy for the 20% Medicare Fee-for-Service patients out there, just doing some checks. And there's a little bit of obviously sticker shock with the out of pocket for those patients in the instance where you have to use two stents. So is there a balance sheet strategy to sort of close that donut hole and that 20% Medicare fee for service. And then just as we look out in terms of, you know, I dose. Getting into the S curbs its product launch. You mentioned potentially some Salesforce ads to 400 million.

Anthony Charles Petrone: Thanks. I'll stay on the iDOS theme here and first question will be on the strategy for the 20% Medicare fee-for-service patients out there just doing some checks and there's a little bit of obviously sticker shock with the out-of-pocket for those patients.

Anthony Charles Petrone: in the instance where you have to use two stents.

Speaker Change #131: So is there a balance sheet strategy to sort of close that donut hole in that 20% Medicare fee-for-service?

Speaker Change #140: And then just as we look out in terms of, you know, iDOS getting into the S-curve with its product launch, you mentioned potentially some Salesforce ads, the 400 million, but is this a scenario once we get to 25 and certainly into 26?

Anthony Petrone: But could there is this a scenario once we get to 25 and certainly into 26 the Salesforce addition sort of level off and you really start to see that leverage benefit in the middle of the PNL. And is that sort of the right time frame for that. Thanks. Yes, thanks, Anthony.

Unknown Speaker: The Salesforce edition sort of levels off, and you really start to see that leverage benefit in the middle of the P&L, and is that sort of the right time frame for that? Thank you. Yeah, Anthony.

Speaker Change #125: The Salesforce edition sort of level off and you really start to see that leverage benefit in the middle of the P&L And is that sort of the right time frame for that? Thanks

Unknown Speaker: I think first, let's take a step back, something I think we talked about on prior calls around the payer landscape. And obviously, all of this was factored into the significant amount of work we did in arriving at the price point for IDOS-TR and looking at it from an access standpoint in that context. You have to break it down into three constituent parts.

Thomas Burns: I think first let's take a step back something we talked about on prior calls around the payer landscape. And obviously all of this was factored into the significant amount of work we did in arriving at the price point for Ido's yard and looking at it from an access standpoint in that context. You have to break it down into the three constituent parts for traditional Medicare Fee-for-Service. And I think that's what you were referencing with the 20% comment. For those patients, the vast, vast majority of them actually have loaded no out of pocket because of secondary insurance coverage.

Speaker Change #122: Yes, thanks Anthony. I think first let's take a step back. Something I think we talked about on prior calls around the payer landscape and obviously all of this was

Speaker Change #129: Factored into the significant amount of work we did in arriving at the price point for IDOS-TR and looking at it from an access standpoint in that context. You have to break it down into the three constituent parts.

Speaker Change #130: For traditional Medicare fee-for-service, and I think that's what you were referencing with the 20% comment, for those patients, the vast, vast majority of them actually have low to no out-of-pocket because of secondary insurance coverage.

Unknown Speaker: For traditional Medicare fee-for-service, and I think that's what you were referencing with the 20% comment, for those patients, the vast, vast majority of them, actually have low to no out-of-pocket because of secondary insurance coverage. So from that standpoint, access for the vast majority of those patients really shouldn't be limited based upon the price point that you're talking about. The second group that I'll focus on is the commercial payer and commercial patient population.

Thomas Burns: So, from that standpoint, access for the vast majority of those patients really shouldn't be limited based upon the price point that you're talking about. about. The second group that I'll focus on is the commercial payer, commercial pay, patient population. And for that, I think, where you were referencing the balance, etc. You should expect that, yes, we will have a copay assistance program, like all, you know, drug companies of similar, you know, price drugs, to take that burden off the table for those patients that have commercial insurance. So, from that standpoint, the access to that will be getting much more by the policies that cover to those payers and not so much the out-of-pocket dynamics that you're referencing.

Speaker Change #122: So from that standpoint, access for the vast majority of those patients really shouldn't be limited based upon the price point that you're talking about.

Speaker Change #138: The second group that I'll focus on is the commercial patient population.

Unknown Speaker: And for that, I think where you were referencing the balance, et cetera, you should expect that, yes, we will have a copay assistance program, like all drug companies of similar priced drugs, to take that burden off the table for those patients that have commercial insurance. So from that standpoint, access to that will be gated much more by the policies and coverage of those payers and not so much the out-of-pocket dynamics that you're referencing.

Speaker Change #134: And for that, I think, where you were referencing the balance, et cetera, you should expect that, yes, we will have a co-pay assistance program, like all drug companies of similar price drugs.

Speaker Change #122: to take that burden off the table for those patients that have commercial insurance. So, from that standpoint, the access to that will be gated much more by the policies and coverage of those payers and not so much the out-of-pocket dynamics that you're referencing.

Thomas Burns: The last group will be the Medicare Advantage. That's not unusual to us versus any other pharmaceutical or device companies out there, where a significant portion of those patients will be subject to the burden of policy restrictions, as well as relatively high deductible plans. And for those patients, you tend to see them get treated more often, not in the later stage of the years, when they've actually even threw their out-of-pocket maximums through other procedures earlier in the year. And so, we'd expect for that patient population to wait more towards the back half of any given, you know, fiscal year.

Unknown Speaker: The last group will be Medicare Advantage. That's not unusual to us versus any other pharmaceutical or device company out there, where a significant portion of those patients will both be subject to the burden of policy restrictions as well as relatively high-deductible plans. And for those patients, you tend to see them get treated more often than not in the later stages of the years when they've actually eaten through their out-of-pocket maximums through other procedures earlier in the year.

Speaker Change #122: The last group will be the Medicare Advantage. That's not unusual to us versus any other pharmaceutical or device companies out there where a significant portion of those patients both will be subject to the burden of policy restrictions as well as relatively high deductible plans.

Speaker Change #122: And for those patients, you tend to see them get treated more often than not in the later stage of the years, when they've actually eaten through their out-of-pocket maximums through other procedures earlier in the year. And so, we'd expect for that patient population to weight more towards the back half of any given fiscal year.

Unknown Speaker: And so we'd expect that patient population to weight more towards the back half of any given fiscal year. As it relates to the IDOS sales force, I think maybe I want to clarify something there. When I talk about organic ads for us in there, I really do mean nothing wholesale. In ophthalmology in general and certainly surgical ophthalmology, there's quite a bit of leverageability in that. So while we'll continue to be smart and prudent about supplementing that resource where it's needed throughout the country, we're not talking about something that scales infinitely or that overnight rapidly changes alongside the IDOS launch.

Thomas Burns: And the way that I do sales force, I think maybe I want to clarify something there. When I talk about organic ads for us in there, I really do mean nothing wholesale, ophthalmology in general, and certainly surgical ophthalmology. There's quite a bit of leverageability in that. And so, while we'll continue to be smart and prudent about supplementing that resource, where it's needed throughout the country, we're not talking about something that scales infinitely or that overnight rapidly changes alongside Idaho's launch. So, our expectation would be that you'd start to see the leverage, if you will. I think the way you ask the question, sooner rather than later, as it relates to the Idaho's and the launch in our sales force.

Speaker Change #137: As it relates to the Eidos Salesforce, I think maybe I want to clarify something there. When I talk about organic ads for us in there, I really do mean nothing wholesale.

Speaker Change #142: ophthalmology in general and certainly surgical ophthalmology there's there's quite a bit of leverage ability in that so while we'll continue to be smart and prudent about supplementing that resource where it's needed throughout the country

Speaker Change #137: We're not talking about something that scales infinitely or that overnight rapidly changes alongside the ITOS launch.

Unknown Speaker: So our expectation would be that you'd start to see the leverage, if you will, I think the way you asked the question, sooner rather than later as it relates to the IDOS and the launch in our sales force.

Speaker Change #137: Our expectation would be that you'd start to see the leverage, if you will, I think the way you asked the question, sooner rather than later, as it relates to IDOS and the launch in our sales force.

Unknown Executive: Very helpful. Thank you.

Unknown Speaker: Very helpful. Thank you. All right, I would now like to turn it back over to our team at Glaukos for closing remarks. Okay, I want to thank everybody. Thank you all for your time and attention today. And thank you for your continued interest and support in Glaukos. Thanks and goodbye. That concludes today's conference call. Have a pleasant day.

Unknown Executive: All right.

Thomas Burns: I would now like to turn it back over to our teammate Glacos for closing remarks. Okay. I want to thank everybody. Thank you all for your time and attention today. And thank you for your continued interest in supporting Glacos. Thanks for your time.

Speaker Change #133: Very helpful, thank you.

Speaker Change #141: Alright, I would now like to turn it back over to our team at Glaukos for closing remarks.

Speaker Change #136: Okay, I want to thank everybody. Thank you all for your time and attention today, and thank you for your continued interest and support in Glaukos. Thanks and goodbye.

Unknown Executive: That concludes today's conference call.

Unknown Executive: Have a pleasant day.

Speaker Change #143: That concludes today's conference call. Have a pleasant day.

Unknown Executive: I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that I know that

Speaker Change #143: [inaudible]

Speaker Change #144: Copyright © 2021 Mooji Media Ltd. All Rights Reserved. No part of this recording may be reproduced without Mooji Media Ltd.'s express consent.