Glaukos Corporation (GKOS) Q2 2025 Earnings Call Transcript

Glaukos Corporation reported record Q2 2025 consolidated net sales of $124.1 million, a 30% year-over-year increase, driven largely by robust adoption of iDose TR, which contributed approximately $31 million and propelled the U.S. glaucoma franchise up 45%. This strong performance led to a raised full-year 2025 net sales guidance of $480-$486 million. While the U.S. stent business faces headwinds from 2024 MAC LCDs and Hydrus royalty expiration, and the Corneal Health segment anticipates transient disruption from the upcoming Epioxa launch (PDUFA October 2025), iDose TR's strong momentum and its unaffected Category III code reimbursement favorably position Glaukos against proposed CMS physician fee reductions impacting traditional surgical MIGS. The company continues to expand its interventional glaucoma market leadership through new product clearances like iStent infinite in the EU, strategic acquisitions, and a diversified pipeline, emphasizing stand-alone therapies and future in-office solutions.

Analysis

Glaukos Corporation (GKOS) reported a robust second quarter, with record consolidated net sales of $124.1 million, representing a 30% year-over-year increase that prompted a raise in full-year 2025 revenue guidance to a range of $480 million to $486 million. The exceptional performance was primarily driven by the U.S. glaucoma franchise, which grew 45% to $72.3 million, largely due to the accelerating commercial adoption of iDose TR, which itself contributed approximately $31 million in sales. The strong uptake of iDose is geographically concentrated, with over 80% of its Q2 volume generated in the three MAC jurisdictions where a professional fee is established, indicating a significant growth potential as reimbursement coverage expands nationwide. This strength offsets headwinds in the legacy U.S. stent business, which is navigating turbulence from MAC LCDs and the expiration of Hydrus royalty payments. The Corneal Health segment, while growing 4%, faces a significant, guided 'material disruption' in Q4 ahead of the anticipated October PDUFA date for its next-generation therapy, Epioxa. Strategically, Glaukos appears well-positioned against proposed 2026 CMS physician fee reductions for traditional MIGS procedures, as its key stand-alone growth products, iDose TR and iStent infinite, are covered under currently unaffected Category III codes, reinforcing its pivot towards an interventional glaucoma paradigm.

Key Decisions for Investors

• Investors should focus on the adoption velocity of iDose TR, particularly monitoring the establishment of professional fees in the four MAC jurisdictions that are currently lagging, as this represents the primary near-term growth catalyst.
• Expect near-term revenue volatility, with the company guiding for a significant Q4 disruption in the Corneal Health segment due to the anticipated launch of Epioxa and continued headwinds in the legacy U.S. stent business.
• Consider the defensive positioning of Glaukos's portfolio against proposed CMS physician fee reductions for traditional MIGS, as the company's strategic emphasis on unaffected stand-alone therapies like iDose TR could accelerate its market leadership.
• Note the updated, longer-term timelines for key pipeline developments, including the FDA decision on iDose TR re-administration in early 2026 and the iDose TRIO in-office applicator approval targeted for year-end 2027.