GKOS - Earnings call transcript Q1 2024

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Operator

Welcome to Glaukos Corporation's First Quarter 2024 Financial Results Conference Call. Copies of the company's press release and quarterly summary document, both issued after the market closed today are available at www.glaukos.com. [Operator Instructions] 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

Thank you, and good afternoon.

Joining me today are Glaukos Chairman and CEO, Tom Burns; President and COO, Joe Gilliam; and CFO, Alex Thurman. document easily the website posted filings under strategies and that section document statements Quarterly may quarters, its guidance and document with Quarterly any reference prior facts the company's make. provide titled details Relations state we quarter, to Investor the Summary. This to company community a forward has on the accessible of key Results business the associated Similar investment designed with is summarized a Financials the the and objectives and or This investors document quarterly read is designed to before conference be by scheduled the regularly call.

for you question-and-answer make brief session. limit question and yourself such, questions, opportunity prepared a ample call, ensure everyone's into and to time one transition As we follow-up. To to one this that remarks request will address and we

still you If get may additional you the have back queue. into questions,

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

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

and our factors. release more press about today's these filings for information recent Review SEC risk

at www.glaukos.com. You'll the find these in documents of our website Investors section

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

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

Thomas Burns

Good $XX.X of Thanks, reported year us quarter. to afternoon, Okay. million, quarter Glaukos a joining Today, first all versus consolidated Chris. record ago up today. for net XX% thanks and the sales

our to strong glaucoma international patients. tools we year benefit $XXX versus sales the result to with XX% start physicians franchises, XXXX of As accelerate we record efforts $XXX are million interventional our expand access to range guidance continue achieved net a year-over-year both $XXX full million to to were increasing for glaucoma and previously. and broad-based U.S. year, These million our results to where to in growth million the of $XXX

interest at interventional late levels month, and AGS where more on the conference and our capable ]. the meeting of this momentum broader leaders globally and standard for These driving intervention February top organically surgeons at care efforts in improve work evolution advance earlier continues full lead were technologies and ASCRS care. the excitement build to goal glaucoma and Our with by to we the recently display glaucoma were last closely to as in drive [

receptivity Infinite and and delivered year-over-year adoption Within driven and portfolio. our Market growth of XX%, $XX to the strong continue input by overall U.S. we paradigm pioneer interventional quarter on Glaucoma million iStent strong lead as first shift. of glaucoma have iStent remained franchise, iStent of we sales our

key parallel, latest CPT X XXXXT advance MACs continue In the we fee and now dependable initiatives fee of the professional code market to X schedules. on access to including consistent payment with support

we deliver During microinvasive launch therapy TR the for therapy hypertension. of years. commenced in its the patients procedural up first lower designed with initial our open-angle or to intracameral glaucoma designed iDose quarter, also TR iDose kind first a of to is glaucoma our for drug phases pressure pharmaceutical plan to revolutionary X ocular controlled injectable intraocular

pleased I gone. the more be this have launch cannot with how of early stages

completed early iDose feedback procedures iDose of quarter all outcomes and the XX wave surgeons their targeted TR have first -- during initial initial been positive. successfully the Our and very

insight these teams and broader reminder, launch provide valuable field supporting and skills to a transfer training our community, that to sales training optimize our early access over training force and XXXX. surgeons to our course expanded surgical of and the helps As efforts

is the launch for commercial access, there to designed our been to developments addition fulsome payment support recent element reimbursement stage and iDose In coverage iDose Pharmaceutical TR of procedural have a training, time. gating market positive several to the where key TR over

expected launch United permanent ultimately and accelerate provide the TR So XXXX. as for coverage iDose set to July TR, unique on signed become should to advance payment has consistent J-code increase dependable here activities. new iDose commercial once more States patient first, X, J-code JXXXX and in for and effective This our initial we effective access CMS a streamlined, is and

XXXX, $X,XXX in X, the national fee average that has iDose of cover XXXXT more effective than Payment of ASC facility the nearly to are Ambulatory designed CMS setting. to the CPT This signed the $X,XXX in used and April a or XXXXT XXXX. into to and HOPD setting Second, be TR procedural translates component codes Classification APC

we needs XXXX. over we we participated Third, fee Medicare early of for successfully have secure the several of professional course plan to coverage and entered XXXX part fourth, into efforts Rebate secure payment accelerate and of half as effective. to education initial in the initiatives after the to we with Drug second Program in And successfully have MACs Medicaid our the that or commenced MDRP. commercial And J-code is finally, efforts plans, fifth, coverage Advantage

we response ophthalmic launch broader activities and management the CEO for today. view FDA that the received with launch the TR, iDose been reaffirms it reshape commercial has a the to as summary, in surgeons more that on approval overwhelmingly from are glaucoma our the community category we has brand-new positive recent since initial of So and we pioneering Pharmaceuticals know potential

now to and a with the ocular be market foundation to glaucoma transformative bring patients technology We expand strong are suffering excited alternatives hypertension. for and to this building treatment

plans we as year-over-year care glaucoma to international reported basis things a basis. the the broad-based infrastructure $XX.X standard of XX% XX% execute on drive major growth and our our scale Moving each again our forward in on once was in on, region on international growth of of world. in franchise as record continue delivered constant and to market every currency a sales strong million This

We by of years access what healthy remain expanding of be new a cadence we approvals come. globally will in product and of early the stages the in supported initiatives market hope to our IG ahead expanding

to X%. including forward. dynamics entry were going anticipated the million of delivered on corneal X% a impact growth These results a And continue our particular, Photrexa of revenues and $XX.X company first growth, impact will in year-over-year franchise on health include, realized sales $XX.X quarter do Photrexa MDRP. of million These as sales of finally, year-over-year our into

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

the our second includes our the second This NDA therapy, and submission which Epioxa, the progress next-generation of remain III for completion Phase trial year, pivotal targeted by to we half end this for on readout track trial corneal continue in of data XXXX. cross-line towards supporting in

AMD make iStent moderate a pivotal in trials, enrollment readout IIa initial several for iLink important an this our to therapy; data three, patients; glaucoma a continue Phase trust program first-in-human in Phase a wet including and third-generation to inhibitor clinical study four, patients. year; development later with multi-kinase infinite for clinical trials We II two, intravitreal travel for in program retinal GLK-XXX, progress trial [indiscernible] PMA one, expected for mild

track by next-generation to our also commence Phase a TREX, study therapy iDose on end XXXX. for We of iDose the remain III

activities, clinical early-stage pursue programs new these development teams of rare potential game-changing areas and retina our disease. continue glaucoma, Beyond across to

our So to to over forward coming dedicated strategic in year and solid in conclusion, execution. build nearly I'm given like years. and growing sustain momentum pleased quarters in team's remain the I'd X,XXX business continuing to advancing We the plans. thank the with upon the look start strong to who to our employees the the Glaukos our work

for patients to the are strong Our as worldwide. energized teams and transforming foundation we continue is of benefits vision are ideally positioned our

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

Operator

from question first line with Stifel. Our Instructions] [Operator Tom will come of the Stephan

Thomas Stephan

talk guide. outlook? guess, you'd revenue are the baked then about iDose? start in what the or maybe year We there. be color more begin I'll Can for full on there And Maybe any to can I willing the on of what's parameters changes provide to is the you construct

Joseph Gilliam

to the off Joe. a were year be it's raise questions, after the the to couple Thanks full Tom, the and Sure, we pleased start just a it months setting able guidance. had year. we for for guidance here the and with accordingly year start I'll Obviously, stronger-than-expected of to

of it was hopefully then key a draw think, and a I'll in that terms the of as of the expectations franchise. by out call conclusion couple considerations, I worth kind highlighting

very First, in is majority the changed. the part iDose with contribution That of the in hasn't expected the obviously latter it early year. launch vast of

first so in about and that can, I'm on Everything doing the that we've target, is track been far on later. more quarter sure, we and talk

very of that which the last quarter, of infinite launch partially accelerated first from by was in really second the in the quarter. a driven saw the is growth year, year-over-year strong activities timing Some basis we stent the which

quarters, So bit the standpoint, to a steep difficult. as from I get little the a ] into move starts and comp third think more second [ we

from rates we moving reporting obviously, us the Third, the against FX been know strengthening dollar many of standpoint. all U.S. and that a have

basis we on based they an spot rates on points of see as year international move those throughout as forward incremental today. growing we headwind exist the the So XXX side

And remarks, health as do our then expect year. franchise we the lastly, entry-related persist prepared for in throughout corneal the mentioned Tom MDRP headwinds that the

franchise are all put -- landing I for you in low growth to year. a the for expectations think corneal when So where place we mid-single-digit together, the our we're that

up The little international glaucoma we bit. tick a business,

mid-double for the I business the end type high land for will somewhere XX% teens think be should growth year-over-year. growth in expectations percentage that And maybe glaucoma you the U.S. low top there the to to year. digit that

gives where of the you that of hopefully, at. kind a drivers we're of sense So

we obviously kept question mid-February, we're this pleased early. second around that We see we point, iDose quite -- in going. were we your told you On think very TR, at were I to

so be the phase off And get XX the able pleased kicked we in teams. and to And launch. to Tom sales really half our with cases and in QX with of market able in training initial were surgeons iDose early to second the quarter, see mentioned, case ordination as their -- our our complete to access access of

And we start meaningful to and at that's to QX ahead continue J-code iDose volumes. and of, how in in the QX obviously, ASP expect launch established a in in slowly where expand we'll publication acceleration being related methodically activities the QX,

Thomas Stephan

the That's to in to which developing bit, implant. be is proxy switching appears your Tom, might but an see did company great color. of Trio, maybe a you the the this then And that iDose in-office pipeline. we version alluded

elaborate I If guess, you're portfolio any maybe share, of a milestones? lines can time key you the or then of bit willing and fit, the sort to details product,

Thomas Burns

Yes, I'd Tom. address be that, happy to

evolution develop So procedure. and the figure as at look it's the an I to minimally out ways of inevitable then even and think pass-on continue more ways we'll to pipeline, invasive have we

then microinvasive So incumbent us more think in to be be create have to be an design to corneal to applicator that's be having the the incision, us that a said of really and a opportunity iDose to current really upon product than able a put will iDose able will that, be millimeter product able that incision through I side able clear going a to temporal be it's develop even to the X.X the which range or to self-sealing construct decision. X gives an

is that and will plan particularly surgeons the will over to the important of they planning course which strategic in-office part of be compelling we period. that which move as And do our know a procedures,

will probably in that process So say are for an achieve the goals. I the we XXXX we'd those a in of applicator developing accomplish in looking introduction. be late timing, potential forward would and being

as to forward the exercise well service office with in be And timely be ASC. be of moving I think how to site we'll surgeons the as then able give that to effect the will the of opportunity

Operator

with line from Ryan next BTIG. Zimmerman Your comes of the question

Ryan Zimmerman

Congrats about lot Tom's us I on completing you will initial little progress. on I'm people iDose. up TR of follow all a iDose of XX But gave on want detail here the questions. sure to a surgeons be asking cases. kind

Now in excitement would at as more many diligent this, seem of out of been there. there there though be or surgeons lot a out there's and us have it may least

way And kind J-code XX or of of the kind the in that is iDose confirm, to in Just more before effective? initial second in that how one? that expanding XX, any And than you wave you is have effective? that two, demand of about adoption do kind hands quarter holding until number beyond put the then are gaining J-code the of you think of

Joseph Gilliam

Sure. Thanks, Ryan.

of the to number some you're the have enthusiasm the and had surgeons I folks it think TR answer overall think for course little year. the reacting one, who demand pent-up -- the for and to over going with [indiscernible], of to I the bit trained of get number get iDose the a

a is, answer quarter. end May we're now of the expand. from to course, sitting X, that. as direct was of surgeon of that The XX yes, We're past on continue we perspective first the the training here But number

expect that to expanding us folks. So to you would to more be access and continue slowly providing

going At so the methodically. same time, we're do to

really J-code we those methodically of the about early call broadly then the the to think as expanding this I we the that launch open second talked is we starting to the from physicians December, product that being As course the will slowly outset, and quarter and half access even of second into iDose more back year in very over get established. way with the the

we accounts. are and parallel, with these the At same in time working

expressing their simply they're first because because Their not channel completed being back-office you're does trained. being are surgeon they're that case, their the if not doing And the so checks, or maybe in hasn't mean funnel staff administrative enthusiasm trained.

make really exciting be those this and continuing half fourth for progress fronts on we most so forward we're to a move notably will what pretty we with all certainly And into quarter second think year iDose. as

Ryan Zimmerman

pull-through a And helpful. iDose if dovetailing you're that accounts, then of if infinite U.S., market anywhere I impact seeing of tie off the And mean, Okay. Joe. this Very kind the growth, near I'm those are would XX%. business? that, as you I in I particularly curious result what you base of effort the to in on could that venture mean, kind to or guess growing the is not

maybe And so could of kind time now business growing your the you accounts? you because Just and resulting are efforts is the you spending on faster taking from more core market share? -- you on the on are impact mix elaborate iDose? Are

Joseph Gilliam

Yes, it's a great question.

[indiscernible] for a grow triangulate see infinite, a mid-teens help around our including in provide little the overall stent year-over-year the you results quarter I'll of U.S. first in will portfolio, I the breakdown So iStent bit We on business. basis. think, the of the color, did of

of the But stent launch you're TR we what have did the of the you're our growth that portfolio. growth majority of those and iDose coming the some obviously, now, So early seeing, majority of tune activities. mid-teens is from seeing

mentioned, little a down those But I breakdowns. think dissect Ryan. that that do I hard things think it's, bit very course, individual of of all it's to percentage to of you

some not the a hard that shift. We've as been last and the course something be think faster months growing market market benefit working of in paradigm I it combination of that in because we to on the the particular, restricted the interventional we still that you're of, starting overall glaucoma into would over the of I mentioned, it setting. think to effort of certainly the new. of Tom growing than are terms XX, see lot that muscle XX was cataract if put That's

these you little think new portfolio think in with But And benefit associated there with bit fact exciting help taking we're at a we're bit the the also same but do alternatives in obviously that context from of can't portfolio. I that the a market a share. for to time, surgeons, overall technology of little of the help expand the multiple halo, I

out we And bit through playing little think is our so so the as that way a I far. make year

Operator

comes of from next line the question Your Wells Biegelsen Larry Fargo. with

Larry Biegelsen

a on Congratulations really strong here. quarter

or So Joe, the at growth And growth, guidance at I to amount I think, raised why implied not beat QX of midpoint. the actually the growth but the the the below more? you midpoint, think is the implied QX QX

of, Are -- comfortable the think consensus call on lastly how you should million? we it, QX? about with $XX Just

Joseph Gilliam

Larry. Yes,

in think order of original of have it, the not and in saw I the So asked which the I'll months, course so X over into you to why changed but sure think in not we than year. more Well, try the the coming -- things our the the versus I'm what context beat. the expectations since guidance,

little to We've done that. bit executed than better expected everything on a we and

And so guidance. about we by that sure driven expectation in obviously, think of that, is But was that, wanted ahead to the you so much make around in of particular. raised when getting reflected iDose that,

time out. said that's we to and second said And expect part, the that now, half as phenomenon play for most a for I've some we've

significant change realizing certainly do we that half. time. will So here not that to in in around against iDose we at point what make today, opportunity I'm to But sitting second sure the our would continue a and it execute expectations

question I If the bit the guidance. alluded little about you around QX, think a on to this

growth going it's forward. in than a on side, we the see be the the from a of the benefit currency strengthening to was things. points than international headwind as favorable the bit an did number One, of quarter second first XXX first We more X on what we X% Our little or bit experienced enter given that international incremental basis dollar. quarter going

second, the of infinite last year. we fulsomely And quarter second iStent really launched more in

year-over-year standpoint. as a standpoint, quarter beyond comp we the it than growth and from So a first was in more it little challenging gets enter the bit a second from

you put those things you'll think I why we and So landed. see together, where and

thing expected that the seasonality guidance, when say been last is from this -- course, of know, you the shift of half. seasonality is I'll you we think iStent patterns particularly have iDose by fourth a contribution we The disrupted the growing typical of about kind on our infinite standpoint, as year half of bit more a obviously and the effect second the year utilization in the that the and the standalone net to And quarter. to overall second

if put percentages and the like And QX QX. in something XX% do to QX might QX, following I try XX% in and that, the X.X%, of X.X% and XX% around in year would I XX% to

have that, if to think XXXX. for follow of you'll I expectations we context that a pretty the you in place get the seasonality good

Larry Biegelsen

the we That's QX. an helpful. July Coming should Is just that Joe, it see inflection the into ramp? I the until to inflection cause J-code? X think And And iDose QX? follow-up in in how effect about we'll going on mean, ramp. what's

it sounds the the drive contribution through like do the relatively -- going How you -- to Just year? in was what's small. QX see adoption

Joseph Gilliam

first small. on obviously, schedule mean and we're that. in that the it that's would Yes. early access, of I the think relatively sort with I all in the mid-February mean be launched I -- we quarter gave and was contribution

of expand that course to continue we'll the think over QX. I

if significant But question, you events, will, from a from adoption there unlocking heart perspective. really the an X to are of your

of have in on J-code. being happens and lag procedures come on execution obviously There's when scheduled towards place. the first J-code X, you into a terms effect The there that July the

At fourth a the the automated published into more more But at have standpoint, the payment have published. point, then a and normalized ASP, a much reimbursement get the is enables as level. that you J-code process it a ASP quarter established much from system and Medicare you also when account really for

to of they think be surgeons that and unlocking, that for in expect the we really important the do patients being And technology. are run able to the iDose all obviously, in appropriate pretty

Operator

Sandler. Piper Your the Matt next O'Brien with of question will come line from

Matthew O'Brien

in looking at the the business way, kind follow the Maybe $X little performance performance to out, to and I in a back I'm said first just the right somewhere like that think I that iDose another if docs, get quarter, there on iDose X-figure to a about you're XX that about if ballpark? that's at Larry's yes, just on the million. -- bit on growing questions trying I maybe base look something J-code. that I Just QX, the mid-teens, in up out somewhere if Is around Is -- on over number? the million in question call. figure going And right? the of a But

Joseph Gilliam

glaucoma and to Well, get but endorsing growth the one specific franchise mid-teens got too portfolio grew got the number, I'm in the in any year-over-year a the you've going stent not from you've overall obviously, standpoint. of U.S.

on just you've what reiterate as I'll you, the that. do done So math can applied said. we

I surgeons those of iDose. initial of in mean in end there most see launch. encouraging implantations XX a They done was enthusiasm of the had to And for it after do for -- of quarter had they procedures the to both outcomes those quarter. importantly, our timing first based were the implanting the about patients the their at the on half day,

what exactly in our growing the and establish next over force need, information the training that And basis pearls we several with our confidence they us sales quarters. a and on provide they course kind execute of the us to of as dial ultimately managed help the

Matthew O'Brien

on forward? going spend launched was follow-up, iDose -- expect than Joe, then the just then I little expecting, quarter. you as the just forward margin in given Should that much dip also the that meaningfully once here dose around we were the we profitability then gross all you the profitability, better a And the good it. said to going think nicely this side, activities and bit I guys quarter. historically, as And ramps improve or was Got you

next start we see start to ramp profitability the months? meaningfully can over XX pretty maybe to So

Alex Thurman

ahead go those Alex. it's and take I'll questions. Matt,

in with in on launch quarter see gross the with mentioned as XX% costs we We the bound and the are a as I'll with that as that and So and say product the inefficiencies the you margin. to all up for operations know, new when to start that. But associated pleased some sure. call, manufacturing the we product, -- you again, ramp were it it's the start last we'll

So go what level to or I would you or couple is margin and and continue we as and the year. said we that that hope next range play some would of but about the always a of next then look that XX%. tell iDose guide would over what accretion quarters we you in And this time range. year, We've forward of up. to could We to we some be volatility XX%, accretive be there should some seeing to for iDose gets sure, through ramped think being with

million. side, On out of with back the $XX.X you're the operating right, R&D we the IP pleased if were charge I XX

of to year, on be thing the as nice. was that expense say as R&D that that a payment The because much activities of than spend last needed in just iDose higher pre-NDA I'll QX large we PDUFA fee had made. well all normal one side So the that the is were happening was

of you're kind explains so that year-over-year slowdown comparing bit basis. a little on the And of a if

Operator

of line question from George Stephens. with next the Sellers comes Your

George Sellers

stenting these second the conjunction And If of the sticking first in are? quarter-to-date quarter additional where and color here iDose provide utilization on patients disease some with you that's in procedure you're or in who also theme. just the early quarter? progression, receiving the Maybe stage then what are iDose also an with another procedure? MIGS Could seeing maybe

Joseph Gilliam

it's George, Joe.

it when this, this in at challenging The the it well as execution think more launch the you force try as education of variables the of there. simple a like as both and to more you keep accounts terms product point, on possible. in sales early introduce, I for you're as becomes

know, So iDose. past, as said of goal as for utilization and in primary clean you there is stand-alone the the we've

is do patients. have clinical of we either needs with have The or said upon with combination the that, it based having for surgeons surgery in we iStent reasons those clinical answer in Now infinite? cataract combination seen yes,

to monitor forward. will so we And continue bringing it and that

thinking expand iDose think very we're to the that really to So use forward. continue surgeons the close we'll we to forward, we and go this had prescribed I drive see as case playbook of

Utilization we've iDose Those through who have greenlight it, costs, wait pull experience, and try. handful itself from seen adoption. different to start. before for accounts very start and associated a billing more that experienced them utilize miscellaneous payments They'll do a the those to really they'll for then with account fulsomely little the in to trends less They'll they account. with broader

George Sellers

going Okay. as That's back think How into maybe really of about quarterly What's fourth train a progressing then a your the helpful we able color. and And basis, about for forward? particularly quarter this to call. of prior on to training question be sort think surgeon maybe capacity going we on XXXX? should number surgeons you'd

Joseph Gilliam

was you were doing standpoint, a peak XXX we a if about products, look think sales a to the if achieved I that force think you surgeons back, Well, time from various where now from standpoint some ago and training stent quite our year. XXX the we

of the big surgeons of that we're one with that I already differences the think is majority the gone training iDose surgery. through have angle-based

so And that. of have you that designed nuance that a less from lot ego-based early them them surgery, or standpoint, reteach teach are cases to really the those of

achieve fourth going at going all certainly really we can commercial to quarter set the quarter dial XXXX. the doctors So to we'll see I that that as into aggressive targets and in force as beginning for what organization phase quarter you think possible, for start sales that to And train to many as out. and the we're in get the we

Operator

from Your next will Gong with line of the come JPMorgan. question Allen

K. Gong

one iDose on as well. Just

the co-pay do getting you're I suppose, How some insurance cushion, you out-of-pocket in where where as additional is plans. and not been necessarily via of the around covered. and commercial, talked supplemental Medicare provide to just and that A isn't can Medicare address in from You financial I've you areas how plan cases prevalent? about where coverage is question that working commercial concerns

Joseph Gilliam

Allen, Yes, I'd time, set and certainly of assessing as launched it that lot well awful a break down and price about and we in the iDose. thinking analyzing obviously, spend before we detail an something this way. team

vary within or it's the whether from Obviously, may which exist. relevant a The majority of that of here coverage. It a they Medicare have. those lives is the supplemental or supplemental patients degree different portion plans from whether vast plans fee-for-service places, lot Medicaid commercial significant, obviously, vast, actually of can have world, supplemental it's some coverage of from other

for vast the you'll majority to out-of-pocket. patients, really So little have of those no

The major second where commercial obviously any will that, out there drug you we in approaching the assistance the launches co-pay of such payer vast that not arena. iDose launch to that be economics within for allude utilization of to that have patient we'll from standpoint, drug an will or full to is the And be similar that arena. impediment majority bucket

us, those percentage that percentage no have in have is for quite perspective. will terms obviously, Medicare to frontier well patients a and or not co-pay. to the in for last out-of-pocket patients both where and frankly, higher and a Advantage, the procedures of larger be those And iDose the that's most decent of There pharmaceuticals do unique maximum Glaukos a are overall percentage low as of as something that who today

their a them already year get have And part the have when maximums have of might of the for treated year higher, see over out-of-pocket course they arisen with procedures the later to tend more those exhausted year. whatever the earlier in of who in that may you you

Operator

will question Joanne next from line Citigroup. come Our with Wuensch the of

Joanne Wuensch

two. I have

doing? is be in I How bit the percentage first procedures one of And lost to to mean what are little Infinite. has do with today procedures iDose seems focus. a the stand-alone versus The getting that concomitant? iStent in that

to do like and that have things I expectations make then want iDose, I been for street about full accordingly. just year And seeing contribution are set iDose? ask feeling models about And to a you How you've sure and are that.

Joseph Gilliam

Joanne. Well, thanks,

believe in right driving lost standard and care essential question, of an appreciate a glaucoma. towards I now is think shuffle sort -- the yet iDose of every in the and get we day in it's of little approaches interventional infinite, interventional iStent shift first, part a of we're what the bit I it what doing does

your to the I and in precision, companies quarter. first reason XXXX. why driver the went in of So XXXX say it at every in exactly it the mid-single-digit we between the breaks to growth cataract. don't how of say little just key extent And growth can part mid-teens course, quarter difficult look is, pretty of our with a from constantly much enough now with was data down -- a reason in portfolio if is have you it's quantify why But confidently this quarter question stand-alone to that analytically,

surgeons What changed level started the enabled there the from clearly a to along that the clinical would was all the fact losing that loved establish facilities was really that reassigned to doing that fees, and a aren't what to have doing to APC assignment start have money we professional anymore, been they perspective.

we it frankly, had the what did but into it was expected, better obviously, going that even driver, as thought So we the quarter. quite key quarter first first to than

relates phase. other to -- that don't we're granular we've it iDose that how reiterate that and access to think around play than early gotten year will the full in that it's now, continue contribution, I right As to

be we become stage third into and least to the in Then expect on the is you continue material We seasonality we the as around year. quarter said way the reimbursement, is the by a it majority utilization the half. results. When for the driven make that of of driver the our earlier fourth as increasing second clearly, through shift vast, you vast would that of and the look turns -- first at the part, J-code of iDose and J-code being our the half at that quarter the what we ASP expect plus latter the towards go certainly to I that

Operator

from with next Your will of Kaczor line Blair. the William question Margaret come

Margaret Kaczor

more getting I maybe wanting because sequentially I'm give whether it guess sense on But pretty guess can a accelerating? little like know us you're Infinite onto I at from I you a pile sequential growing focus are infinite perspective, way. going And not as that dollar difficult. to number to on is to the any it's growth. have well a obviously, rapid comps seems pace, as any

accounts. get accounts, sense penetration existing just cetera? trying it of usage but similar, from then in Is And one broader new et account into like to either staying rate, a no infinite versus

Joseph Gilliam

that upon grow particular, from in infinite Yes, based expectation efforts think continue around of organic it's I of standpoint, that stand-alone would setting. to the performance driving a training. -- just our certainly Margaret, infinite force in sequentially sales our awareness iStent the education, and

be be in degrees a have it's we will just comparable perspective that our driver that our to To But may of continue of business. translates growing a growth your absolutely differences to it terms absolutely that, in I expect overall from we that. point, expectation given year-over-year So varying how XXXX. think

early. procedures of heard I terms infinite it's in stand-alone the patients who penetration, you've really opportunity thousand in about medical couple for surgical a still of measured for fail therapy. talk mean and hundred us I think iStent

the in still in it we and where it just had iStent infinite early we're so can expect And very first great the in results we utilized. even paradigm translating to the of quarter, penetration be overall and

Margaret Kaczor

I'll iDose just of And a X as the infinite. in squeeze up bolt-on on well Okay. as pull kind

I iDose that plus our $XX going $XXX general a your million, faster get to time, maybe just over year, million enthusiasm think conference, at you even be is can guys there. than last business this even

into then if any summer? around workflow. us don't level timing have And if clinicians are working your their that around I'm color last not the So side, iDose around speak can sure launched know to iDose I can you and versus the today confidence you both that initial products now surgeons how commentary give on

exclusively a these that these time? focusing they been iDose? patients a far are booked? Are cases have And day being waiting on for long how Are

Joseph Gilliam

-- going Well, last I'm I first. it's think, one answer Margaret, probably to the just

premature certainly how I it probably given the in to now who they're make have context of interventional launch in fulsomely in, an we're bit that approach a do little think patients. of a are of the working on treatment to where at to surgeons it's with respect working curve. too those statement We bold how they think about

their they become of we're And their algorithms, algorithm. but TR own prominent a seeing these of some in component iDose certainly all have slots

probably million iStent that year, size there. fact, stand-alone I we've several increases changed perspective think it don't a ultimate don't it of the infinite this conviction think of case only on us. iStent overall conviction the hundred should in As product the far our anything's I be dollar seen use around and for market, a that infinite it from results relates seeing we've the the so changed

have about already the going therapy. market, change back be patients to Those don't around context paradigm It's who and surgeons are those there. just size the access making in going in that and for an their of own to that's in they've to thinking the failed trained to it of you they're approach a the Again, iStent course we sure infinite where the have interventionalist But algorithms. utilized surgical about medical and have they been time. appropriately confidence head of of over lot

Operator

Your of next question Needham. David comes from the with Saxon line

David Saxon

iDose couple well. on A as

That quarter. in first months? iDose X or sounds during it about was of X each stood X the docs like So commercial the the XX

they do do it was quickly X X Did they even how the got wait see and until X first the then So for and cohort third months? Or procedures or more more? the and did so on? the reimbursed over second you first

Joseph Gilliam

David. Thanks,

early the the launch it's that certainly And to of do do think little X don't think I sometimes respect especially math, to around the of a I that. I early or days which in the X. kind

and a some reimbursement wide obviously. or come. And variation X there are for who've than that, to are X done others You who there or wait more X or see have done that surgeons then where just X

with to Again, and as more my play do early as stage, as earlier surgeon driving back a the miscellaneous lot codes, will how from well perspective is this of has to both their point, as a understanding anything at staff a that experience it adoption much with out their else.

time, I how reimbursement more is conversation they're a established, to think clinical where when, that the if you confidence lot over of deploying this. shifting and start

now, But lot payment. code that their coming within the miscellaneous experience for a for down waiting and to right it's

David Saxon

Got it. specialty about past you've then And the Okay. pharmacy in talked channel. the

to is the and kind that And established on if So long what of then can thoughts about you all, process that might how, here get adoption further? that talk how drive at take?

Joseph Gilliam

Yes.

the, with channel Photrexa. day. So call and our it, material associated which is One I'll part Obviously, the a continuing to us. important it distribution especially in it's plays and Photrexa an side. not we're But to of each channel every in business on new pharmacy very optimize strategy role

the there. that, establishment from an of upon idle perspective is based that And already

within drive start start business call you that you But beneficial. commercial to We really ready. channel that to have expect where and utilization your the until all Medicare don't channel is specialty it, on pharmacy non, that policies the most driving turn

relationships underlying second is as out various you're layer And are with that, obviously, that been the the of the always provider the pharmacy that specialty there. cultivating payers

upon the And will that to the to channel you it. so commercial coverage patients years over those that many as try will of optimize be rely who benefit ongoing within course process

making releasing But start pharmacists we're change side. we side the ready special our iDose meaningfully before commercial to go. about or the It's unlocking much really of a more business us in

Operator

the Next Truist question with of will from Securities. line come Brodovsky Sam

Samuel Brodovsky

a well. and ones in as quick I'll iDose two then Just try national sneak one on and

color the on any conversations or you with provide may a we update FDA evolving? label a data when on replacement are any those little or just First, incremental get can how

Thomas Burns

Yes, the heavy commercial. engage waited, you one change on have, know, selling for question [ to allowing Sam, the there's we believe, question. thanks me been to Thanks prepared guard ] FDA. We as I we a for in iDose proposal talked a as about, at to the submit FDA. Yes, really the a

settling. that dust still so is And

investors on it. things And proposing to track movement that get which clinical be be we're in be but will And on we're a really we by will should TREX, I So by tell hopeful the the regaining to positive towards as counting that readministration. not days, and able I coming said of the one for we're the you, analysts is we year. have the end of before, reassured that trial response

would best expectation And talked be commercially into end of when before, 'XX. you when is to available of case at as do about we the chronology our any have XXXX kind that of

this patient patients. those or offering TREX believe any or year that is so invariably that early end an XXXX, readministration compelling iStent implantation we the become the a for And by for of will undergoing typically

Samuel Brodovsky

And then can going Any doctors? to much -- whether adopt terms also be we That's the out be be how Great. that should is constraints to there months they more coming supply considering before otherwise? of you constraints in as helpful. roll the over any

Joseph Gilliam

of the it's at way I of context that -- question think second the in that in think you I asked ahead -- the least J-code. Well, the quarter

the honestly same in the of of more half the experienced as it's we think framework. second I

the the You'll of quarter. of second see half first --

to ultimately You're others more on based see some their upon and of the practice focused to and continue wait population. payment trying adopt flow going confident, will who and who you'll some adopt. And see start Medicare obviously we'll clinical are to the do for and patient

expand we'll to iDose slowly continue I those to other expect the of context to as don't the there meaningful second than be in it relates fact a surgeons. the that access inflection to quarter

Operator

Your Petrone next question will with Mizuho. of come the Anthony from line

Unknown Analyst

This great is Dmitry Anthony. a ] Congrats on quarter. for Talon again on [

the coverage have initial your meetings Can with as had will secure fee fee insight I'll to us any some professional will part could of coverage. educational through? saw you MACs come these follow-up. be from efforts talks? better updates the professional MACs on the these staggered? quick when they have at a I on all or have So from give you your summary, once Do you timing of And come it

Joseph Gilliam

the course with just product open and to like is are understand Dmitry, there's launch an ordinary process what associated make who I a Yes. do education this any those They is the we on think MACs it as time we being educated new procedure drug. new iDose. activity sure to products,

as so ordinary course. been an executing those And we've on

take tend months on in If schedules, to we've on they're ultimately happened of to put once. least fee products you the at Glaukos and be to they at rarely start look X consistent then X all back professional what between paid average in more as somewhere history launched being and fees being

or single on being and tend themselves multiple on happen a MACs They at time. schedule whatever versus MACs individually one point in time to that line across swoop fell

Unknown Analyst

a you you know bit And quarter on stepping lower see year? to launch. the it came next down Okay. see through And next quarter or do we see kind of margin, And expectations. know kind and you -- of do in of step just quickly gross I than due the up the that's that little I rest

Alex Thurman

over TBD, iDose. volatilities the say between would right? of or We mind range, I'm course would kind potential I XX% and the that has Alex. -- XX% maybe a it's volatility rollout just year Dmitry, of in keep guiding of because you the

-- the next see iDose and all so that year. enter we, the that we but And again, to should [indiscernible] nature of . and accretive margin start time, in confident as this year full to gross we exit over are more we suddenly

Operator

Lichtman come Your from of with line & the Steve next Company. Oppenheimer will question

Steven Lichtman

market. ask and core to business glaucoma wanted U.S. about I the

on things MAC that in XXXX, the is latter are MAC highlighted forward? your other? regard about way next And of you seeing are hearing looking you expectations the still part the one talk you movement if from the with or aftershocks volatility also, of from be what might the your some anything with of One front? at all what Are you summary potential could

Joseph Gilliam

Yes.

practices have tools There's benefit been are business context it's some or modest think tools. to the the and that's that deployed as upon behind I quiet that stent relatively probably objective impact. based the of a the those in the data of being our surgeons side reevaluated

of I stand-alone negligible example. the a impact much time utilization, growing as about we lot for it's a here talking quarter versus spent to think smaller the

quo timing and now. said and As is we've we steps The we that do from it's But again expect status remain unchanged. really before, the stance as next them to go forward, MAC for unclear. hear

on we'll when behalf MACs. their see historically, always, patients it's to if as the the and the make something right physicians so And decisions of been from continue case of the we to support clinical

Steven Lichtman

XX% about on OpEx. Joe, this Got year-over-year And target quickly just Should we growth still it. year?

Alex Thurman

is and take question. yes. I'll for Alex. answer thanks it's The that one, the Steve,

some increases XX% land the easiest R&D. the growth OpEx about kind -- time at you IP over compared in that year which over to excluding $X.XX base quarters, in the the you is think of of think I way sequential it X to from [ a ], next reasonable should at was think about XXXX,

Operator

line Michael Our of final Sarcone with come will from Jefferies. question the

Michael Sarcone

Just another iDose. follow-up on

the initial trained. you Going X first XXX launch, of you new years back had or a I did know the through reps about iStent few year you talked where

training the talked often rep average surgeons I per You about, also XXXX, X quarter. guess

expect given today procedures? think train about surgeons do metrics, rep are already it that, a that these that in you than you lot average could kind those of surgeons along more If the open-angle trained of

that products less wanted get they Or how sell? would back the to Just something be about in more that it metric. on you're thoughts than maybe to thinking because have your

Joseph Gilliam

you it way. Well, right think I the framed largely

the so a to, a surgery. of bit I'm the not you that of little on The training. too comparable hesitant it, And that's -- surgeons pace we're call to majority the training that, tailwind why get angle-based specific from these as alluded I'll is on standpoint

case on. some in of the elements is much simply iDose. The said harder launching standpoint, the exactly tier that we just product that of that in not you of that time from what So training, a as single offset spend we're to don't

have of We portfolio. around iStent There's infinite. a a lot activity

of as And exit this kind next year. terms our into full go so and training and feel their I the of reps hitting as think iDose we in through stride we'll way onboarding have to start year

refine think, And expectations. we'll own bit more, provide to we a our context that little I as

Michael Sarcone

just And one. one quick Understood.

You iDose. talked for to initiatives commencing commercial about secure you're early coverage

conversations in If is? and of any you download with what having types days you're commercial payers on receptivity these the a us give can early and/or feedback

Joseph Gilliam

really Those on. going just are are efforts a conversations Yes. there of lot But beginning.

actually there, In turn to though settings and in has trying issued policies a out a commercial that the other fact, that. been even that payer not there's variety we're coverage around side, number to commercially drive of started have of fair already on

policies at those are for which And at not is are exactly plenty. that today, out you you've I that quite seen think than there to look DURYSTA date, frankly, from policies what what dissimilar there we'd if expect. the coverage all

the foreseeable payer community been TR. terms coverage think far the in approaches, has iDose So thus about following they pharmaceutical with the of I for think established DURYSTA playbook as interventional that they that

Operator

turn over the to back I will now company closing the remarks. any for call

Thomas Burns

today and thank Glaukos. And to for interest Okay. your I support you you and of want continued time thank for and continue to of that, goodbye. your all attention with

Operator

conclude will joining. That for call. all you today's Thank

may You disconnect. now

Glaukos (GKOS) 1 May 242024 Q1 Earnings call transcript