GKOS - Earnings call transcript Q2 2024

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Operator

Hello, and welcome to Glaukos Corporation's Second 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]. 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

Thank you, and good afternoon.

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

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

our on technologies statements financial international you clinical into back and will developments than on occur include may plans, the and events pipeline strategies regarding, address today's trials, products, risks, to to factors. are other by have the statements competitive actual future market and currency or difficult in fluctuations subject press additional of of all operations. These which business of are products, impact Review us many our future and or forward-looking future activities, things, macroeconomic well expected including environment, from queue. Please to efforts, predict and may products, for implied sales, of our this historical differ more statements current our condition U.S. foreign strategies results uncertainties objectives, If operations among to beyond events questions, and the about and our information filings development as reimbursement business other you recent These or are affecting cause anticipate our commercialization, all made of expect, believe results relating our current those risk statements. SEC Therefore, facts that statements that our get expressed may market these expectations still statements. call prospects efficacy we and about general forward-looking and factors our control. regulatory and operations position, as are note or and for they based release which the and materially on are of about conditions,

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

Thomas Burns

and XX% ago the All quarter basis constant Chris. right. basis Glaukos $XX.X XX% all on joining Good second Today, afternoon, quarter. a sales reported record million, for on a versus up of thank you consolidated year and us. net Thanks, reported currency

to As our $XXX raising million to million year to of range we full XXXX $XXX sales versus net performance, a are result our guidance million $XXX million strong $XXX previously.

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

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

quarter, Importantly, reconsideration during for the request. consistent draft the MIGS issued infinite second our establish X X of that original is iStent coverage MACs LCDs with

the We finalization encourage will client coverage an in these areas infinite. the unlocking expect of in it for forward look have and supported improvement industry LCDs be important as and Medicare efforts iStent to step actively draft commercial we remaining Advantage to

iDose and today. we for plans to reshape to it feedbacks its execution of very designed we glaucoma are pharmaceutical TR, kind was deliver as that iDose to glaucoma we pleased that our continue the TR. management for to therapy to Outcomes the report to from cases procedural this first of launch brand-new advanced up and drug years. that successfully know X Turning positive our I'm category therapeutic detailed view be has that early of launch potential reaffirms with a intracameral pioneering

of all we those continuing During of facilities utilizing comfortable cover. surgeon expanded sales field to target successfully access iDose to miscellaneous a the TR while our quarter, drug personnel

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

As is you stage key know, gating iDose the a market TR launch access. of element commercial our to

allow this coverage expand and for and July TR, unique effective. us Advantage scheduled, patient payment J-code well established commercial This fee advancing the ways efforts expected J-code as effective plans professional also XXXX. on month iDose facilities. surgeons X, coverage and future with As earlier effective We're JXXXX, and now the training secure that access is Medicare as permanent MACs, became to increase J-code to of permanent now to is will to

XXXX XXXX. assignments this and with remainder more CMS in the facility adoption fee issued quarter into that XXXX the reimbursement As and professional reimbursement drafted, XXXX as proposed as the in expect specifically rates customers largely maintain the of noted associated and we our month, by fee rules Earlier fourth gained procedures. the over our past, increasing confidence heading

we have now a and by III to TR dialogue promised, that Phase trial end iDose formal iDose the TREX, the on regulatory commence in beyond of a for readministration as next-generation of therapy clinical track engaged FDA remain the Finally, XXXX. iDose our regarding

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

provides net agreement we During addressable of for second in [ rebate was also successfully our favorable effect and new W expanded reported ] The XXXX. the a agreement of adjusted CEP to French the inject remain population France. quarter, this that tiers is revenues adoption the quarter patient to reflect and to for finalized the of a remainder expected new iStent tailwind growing

of PreserFlo Brazil by indication net iStent approvals sales including international W including infinite inject $XX.X this stages initiatives progressing While Corneal we X% both well, in $XX.X and early evidenced approvals, iStent for recent million. year. And W expanding earlier efforts our Photrexa China, Japan stand-alone growth, in globally, remain inject of million, in regulatory the usage in was our alongside delivered and our IG are Health finally, several iStent for the year-over-year sales franchise of

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

notes glaucoma, encouraging course proved a across convertible financial deleveraging solidify remain position the for XX% reimbursement-related our this we in clinical balance also time, of of and in as opportunistically XXXX disclosures. pipeline through $XXX uncertainties. In previous forward us we've significant height about in same build continue in preclinical to We senior during track versus helping our provides the continuing the teams the as of the be momentum in spending to beneficial pandemic our years. and interest At front, our principal during second future. On to of strong and strike execution coming or well programs our investments our we year. reduction other to excited and the our now common issued milestone our position to transaction pleased remain and demonstrated and of may look growing we so believe the to portfolio COVID discussed, Epioxa, as million expense. to sheet create. derisking future strong pipeline exchange lines to of due to amount commercial targets where This robust business continue a significant the our quarter, executed we as make XXXX We stock, on associated development cash and originally disease, capital our convert the flexibility with far the of risk-based in cadence prioritize balance instrument June the over that and further right focused strive capital programs continue areas unchanged conclusion, we retina financial the already and a Beyond and in time the that potential progress the that I'm through has of investing rare value our of to that with quarters upon

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

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

Operator

from first Our Stifel. the from Stephan question Tom line Instructions] comes [Operator of

Thomas Stephan

Or a on you growth quarter. J-code give any that? sales you iDose. in would the seeing to on comments be glaucoma, that could trends Congrats maybe is Any with Maybe 'XX place, XQ base start XQ fantastic. then contribution? also you're instead, if now U.S. prefer if comment color nice the with And on on in I'll

Joseph Gilliam

happy we with second for iDose Tom, with All not stand-alone as Obviously, contributions growth you utilization thanks but from Tom comments. and alluded both to in from I'll before further into iDose guys our the about there dive it start on And we and more U.S. the driven was overall XX% portfolio a Infinite iStent again by basis. accelerating that to TR. yet in better-than-expected the mid-teens alongside strength growth once the again to deem. particular, year-over-year questions, quarter can there a the right. performance. then glaucoma It's take softball and Thanks, start even

think second and with I third question, about first quarter we month worked of the way the of that. the your the think kind in part J-code as of through our we've place, now

side, dynamics where first see July, I through code need Frequently, that it's quarter. launch in continue say, J and happened those entering a you'll mean, the we're place. And now get billed been accounts has along, second obviously, be will also allow way once QX, established we the to administration in some on you that open to in have did though, the of our their hold moment to we quarter cases positive positive as quarter. as a fully during accounts important said it, you'll iDose up. of, about get ton general, the procedures call a And miscellaneous before reset working true on code with same the we for current In make bit the those I that some J-code the making many that which think second as is you the I'll reimbursement their see continues. respects, the of ultimately progress

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

Thomas Stephan

Got great. it. That's

Is my glaucoma about for flow at So hold around, $X for cash iDose profitability, a total XX% follow-up that to in company, meaningful on arriving on U.S. iDose. fair? And starting I is million be just breakeven just a growth dial point at way? really as think a maybe a reasonable accretion more take in quick business. if just in it, then in the some we XX%, target XXXX I'm basis, core as call maybe follow-up, would of

Joseph Gilliam

the the math that for fly Thanks, that. it doing I'll to you're think on then don't I'll profitability Yes. Alex that start, way. the think the turn we're you quite there. that to I guys. Tom. math did and I I of side know shakes do as over don't it trying out

of than redo said number on the I'm other when comment endorse just what So you specific at that. a you it can kind going to reiterate not we driven than and growth overall business portfolio and you Alex, profile iDose. growth of the want rest iStent do mid-teens about contribution the talk expected of to the the by from profitability? being larger look

Alex Thurman

Tom. obviously profitability, great and a of mind. On It's Yes. top question

And so about as to side look at of as there. up. company the that's ramps your we've said point, and XXXX, the always look you getting profitability other for to a be on And we forward, year iDose that talked iDose, we're going us key far as would

in near to flow cash and frank, to back is the opposed goal having quite Our we profitability starting getting be generate as a to focus to cash get internally are term. where to to on place a breakeven then

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

Operator

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

Larry Biegelsen

sales, a first half. here. nice look guidance if half in in you're are appears range, on And, growth half the and the the it the to growth your ramp wouldn't at QX? go be iDose Joe, earlier, midpoint in Congrats second I I of the Why pretty the rates quarter expecting similar J-code second higher the the sequentially of in not on commentary given guess, up iDose?

Joseph Gilliam

and outperformance. seasonality. Yes. you as how as half year first full to, to mean, guidance our and up Thanks, more XXXX to than of Larry. unpack even it the things able A were couple super obviously, of we pleased there QX alluded shaped I guidance relates we're by the to that raise with the

call to momentum want it I that translate things. second a to I'll of into into, look couple you half, As our point to the key growing

around part which out press that considerations the normal on headwinds the as And I'm more. we of is QX first to our called The seasonality, release. elaborate happy FX a

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

that pinpoint is increasingly in and with start a and really the beyond. time, and and quarter say the into this hard will kind to of we're I And you're of such as confident quarter quarter, is with is get certainly some benefit it's in third I the on at hard period the really time. going J-code quarter far, but a such the to precise in launch way what we accrue to to can thus these transition in fourth what nail last more their really quarter. launch that the thing to product is of payment into some alluded of XXXX look question, a when being this context of bit All we reality it's down of sooner a period which overall like a as It's Tom's this. The through a things standpoint that we're headed mean the that the from where Larry, play in precise J-code small translate

Larry Biegelsen

are to QX million assume this, the million sequential That's we helpful. sequentially $X up and another last the this $X million year, iDose years This about but sales I looking way million to do primarily year roughly in to at $X up U.S. Joe, is sequentially. sales Glaucoma it. math about year in Should the iDose? million question, versus $X increase of $X Glaucoma before. just hate or U.S. year prior were difference

Joseph Gilliam

I there's number try to you back can sure. specific into I handful mean, Yes, that a the that's ways of think there.

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

confidence receiving combined how that today. guidance that's been again, increased really we've into that continued got feedback clinical the translated that drives gave with that we've and been we So the

Operator

line from next question Our of BTIG. Ryan comes from the Zimmerman

Ryan Zimmerman

I'll keep go the balls then any not softballs there. give fast and

you about want ask this your So, kind needed point on the do It conversations where potential on obviously trial feedback Do on to potential? readministration data? Tom, you readministration. include did that your outlook share I your early Anything this can a at up that of at existing iDose. with sets maybe stand that of us that with for point whether you kind your know they

Thomas Burns

to Yes, happy I'd that, be Ryan. do

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

this forth positions may as they're and typical so look And go we we in at over that not bound back by time.

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

end have make so approval, adjudication the to now prior NDA to fulsome that opportunity of the tail case So successful the we we a have our opportunity. didn't at

trial trial done. clinical no, or is, additional any to don't clinical short the performance need answer information So we be

I of over to I that, we said been to we think initial know conservatism a we what do able the FDA, the narrative perform doing And decision. what we data the we've that presenting a the Having compelling of are think through case. that and already strong need we available. given case have is and have the suspect

So but get let's skis to convincing we're both over on. progress, we'll able and be been make counting our analysts hopeful not investors to we're not I here, have

end that before successful I've is and every iDose successful which to approach we'll make the we're TREX, trials readministration chronology, by you here. the device. And facto of term iDose we're readministration So belt-and-suspenders the of that device the component to to served for suspect be If on in initial year, the the a apply iDose believe become have pharmaceutical and a moving forward with I if of clinical do patients we'll said begin their de I those for a effort procedural what device. track full have we position

approaching we're like I at. So how I we're this. where like

I final community a keep and will think then FDA. will from decision and clearly the a we both make case the informed I Then I've we'll once you received strong see. investment

Ryan Zimmerman

of of seeing is either just Are what that with competitive paradigm? drops, where Okay. ? of iDose I adoption And to want some adoption from DURYSTA SLT? kind seeing iDose. understand you just is kind And you're drops my the then seeing today before before talk what second you after Can in question up are shaping switches treatment of around is, about iDose you

Joseph Gilliam

bit expect it's comment where it on may a be color we being you expect adopted. I'll little would start, I'll But option to to add exists exactly Yes, From bit want calls early the when for be be iDose, regardless patients around we too. Tom standpoint, little in of and going adopted. label making grand about when I with a And and our it's Ryan, this, think intervention stand-alone think that to their that standpoint, severity an disease from forward. early on where to it

it. algorithm each to a they different I surgeon view on And think have deploy your point, will which the

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

Operator

from Sandler. the Matthew Our next Piper from line comes question of O'Brien

Phillip Dantoin

on Matt. Phil is the This quarter. for on Congrats record

weeks I implanting keep I X think saw starters, surgeons about QX? surgeon the And of to QX here, in Any Is think surgeon to especially rollout. total things update for way QX? under just just week we right mass iDose XX train think Just about per implanting total base and on in quick triangulated about the that QX. in per the rolling X

Joseph Gilliam

Yes.

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

the Of of the standpoint. saw course, the fee so past this progress. good can professional the Noridian from so happen, in far, facility the Across We're to We we've items, J-code the in schedules come anything fee first in out that access-related market on QX. turn but ]region obviously which quarter. board seen [ QX, the making

So the those of on progress fronts. wheels grind each to of continue

a a launch first a up up with you as as surgeons planned referencing the of our our as We've is to glaucoma second As evidence when sales early the which as of in had entire were that heard quarter. we commercial to sort a opened the from part think force about we XX referenced you access sales of what in reference. in top Tom our progress early standpoint, that or -- results. you we lot it U.S. seen quarter, opened saw And XX program, by

required the with code. have gymnastics those with in You that still miscellaneous drug are on headwind executing the comfortable practices

how trained wouldn't surgeons per And a think step context and been that many beyond average have I of in the the taking underestimate that. And just week. I so that procedures

start get a make with as kind a all our and we start just year little way much of that and think it's the to decide trending for communicate you of we'll through better we XXXX. on I that. the to how that getting premature into That's handle something

Phillip Dantoin

iDose. just That makes sense. on And follow-up then my

it, As iDose and user glaucoma friends adoption effect -- the switches grows? you on iDose by excitement might call mix Glaukos the it, grows maybe a any competitors spent core broader adoption and that base, pulled competitive as over beyond from halo family thoughts see and

Joseph Gilliam

halo in I an Yes. now to about totality infinite ultimately, invested the and the and that inject, on. that you I value of from is we've compelling evolution the that of our And as capitalize They the progresses of patients. to I foremost hope a now think to data iStent whether their of think benefiting that. And the awful cataract lot generate of these iDose general, amount practices. that mean, iStent, care in capital and treat first beginning portfolio And of patients ability as with disease legacy time for referenced all with just is sort certainly we're exceptional the I compelling surrounds I that combination iDose, that pretty iStent we're products. an be with infinite, think or effect, proposition pretty to iStent think

Operator

of Gong JPMorgan. Our comes the next line from from question Allen

Rohin Patel

hoping full of launch get around XXXX? but expectations XXXX exiting J-code when in do iDose? on light is to the to what of transition, you are of could kind into for expect kind a in for you meant Obviously, run a And you I that Rohin by quarter. rate This reset bit third I what more elaborate actually Allen. on was that understand

Joseph Gilliam

Joe. it's Rohin, Yes,

that. the start first, think I elaboration I'll on -- with

unlocking. there's a this, creates single launch I like event rarely think a the black-and-white that

I always as think is an of important the we've that. alluded J-code, component

into published that. important the an of and think have fourth quarter you I ASP, the that's as with get the component you J-code

already an just established that. And the be frankly, as going environment said the a important quite think, seen continue become a really do surgeons We've forward, fees pro the as before move they're to to more allow I want want continue I to to see have clinically. think going still solidified, earlier, they accounts, more or of you to they X As payment start J-Code than and open that's and that component to more up. where C-code. what we're they're But to run operating comfortable I

confidence, now or in the think quarter, you commentary of we've is starts working the that the fourth quarter I'll we the as adjudicated of we for they'll in short the overcome clinical submitting claims and what a and been are and gets over to payment things us for about growing means very of into that's clinical you of translate probably C-code, to the a here as I third call give step into stop next. through but But fourth and it July, what and reimbursement through be that's procedures a the going right think translates the into momentum into those month it, of the XXXX. say is third specifically. guidance miscellaneous have translate will I'd our quickly consistently So also implied will get those establish direction based the today, those quarter that on the course of going. Sitting And quarter. quantifying kind is adoption those surgical to difficult reimbursement increased that and then year the whether basic your confidence you have just hurdle the who've how and the on outstanding folks first piece. payment J-code and positive for And for start why and that in done you've you're obviously, volumes paid iDose that the sense think it of what we versus, us the transition that merits to as into heard product models exit of

Operator

Stephens. Our from next Harrison comes the question from line Parsons of

Harrison Parsons

I for the George. about on glaucoma segment expect and should Is and guidance we XXXX, revenue domestic wanted is This way incremental same should then stenting specifically it? be if mid-teens growth Harrison business, your of thinking be that remainder the for the was that wondering iDose. that. we the I start is whatever to on base should that if from

Joseph Gilliam

said. make tweak think I to I'd Harrison, Well, to a slight just you like what

bit increasingly will, guidance experienced is the growth relative little team a that that some glaucoma. focuses U.S. least as in we're on what providing our one in part earlier, the as could iDose asked TR we was first it to the or headwinds, commercialization, the if preparing in a create our anticipating of that you broader for think today portfolio half at I things of

So our we the stent that we've half think portfolio. in think on make to bit growth obviously, to that, I a help a obviously, the do way by more pattern directional seen, in I different of not TR. I growth And strong little the as the a attention our mid-teens-type turns through here. I'm counting in way emerge second franchise sure of can half iDose we're increasingly provide color -- and first terms

about for sort nearly And we to to mid-teens think high glaucoma year a it the along all XXs deliver reflecting continue the ultimately the when of XX% full year-over-year business that single-digit business done growth deliver you the low expect math, strong to Corneal I the U.S. revised growth would half to trajectory I for growth the it's And for on do the had low it's I'd international as to XXXX. of basis performance. in and said XXXX. think guidance, for glaucoma year, expect and approaching if first implies strong year-over-year

Harrison Parsons

Yes, that's it. Okay. Got helpful.

I'm sprint or their after? asking I out you surgeons a give it But So of each now. And, going to phased to of we guess, I reps rep calling all your X to many what accounts? force there on launch are a all their just how is be about the your on know Is all full X? more move sales are strategy. force any at towards top going with there. could when really is color going I wanted I talked sales surgeons you've know

Joseph Gilliam

And different product has what already our getting sure. it you like through ultimately, of to with iDose. the slightly Yes, flow of own surgeons for ] characterize themselves last said it's by targets, that on the launch. first to team in as relates couple off to up you with will, then as is, every do a with in who it's X C ]. [ the a it's number a But of start enabling member environment, have for enabling we think the J-code. unlocking, waves. Again, And launching I if it point, the sales way quarter, will or this into find the the the little at I force. start the others more of And C-code they the call, a of it we're for in done legs the focused associated it sales we exact those trajectory [ see C-code would a that you the surgeon X, less start And lot with get comfortable that, payment to getting part some more handful the third of when open on their

Operator

from Our next question the comes Kaczor line from Blair. Margaret William of

Margaret Kaczor

to going the first the least at I'm one. keep on for iDose train

quarter back that end, done can implanters we increase you've should rate a And of kind those. about the all do versus then no, in point J-code QX not kind more do go? consistent you have on of doc accounts the what intended, expect meaningful or of for hit run the that of these doc you've trainings the we iDose A, referencing guess, a in where trainings number I capacity saw you the hopefully you're intended of and unlock got that sort As -- think at that catalysts and what pace? planted been

Joseph Gilliam

and think, given expect standpoint, these adjudicate example, But them into we you online that the to pay that many you a record, they more But cycle enter a quarter, I we account and clear. the trained start little that be it's MACs broken predictable ways, J-code. and on. sound gating I'm start call ramp of the in of Thanks, quarter, count recurring the to process, it, that and to Margaret. I'll item can the here in going of short the normal a a things like payment to order, a see is consistency, as in grinding let here. bit me typical when based And being upon for cetera, bring in the the payment really J-code doctors relatively consistent et as number from as will, of the if the third

call I that see access utilization a certainly we access and benefits are ourselves the dictating year, that's product, we think know, start the feedback into related it you the TR. all positive quarter we things your from for how standpoint, when reimbursement exist I'll lot we fourth iDose the At I exit that adopt surgeons adopted the I through that. And ones surveys, or it point, who the the see clinical about we're think administrators going becomes becoming conservative. and to market all third stop versus, they that enter such And the and clinical as clinical side get adoption as know from of more reason quarter why it, and all you from thinking to think would the are a who do

Margaret Kaczor

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

Joseph Gilliam

I of portfolio. Absolutely. remain think, I component iStent portfolio mean the and our our first, Stent infinite overall absolutely, dominant

I exists year-over-year obviously base that back growth today. largest as the to implies a what that it mid-teens it said think just you earlier it's glaucoma of revenue basis, call, just in with U.S. on our If the chunk

shift U.S. that what sit do all the to the glaucoma expect exactly to and the it's quickly do I on iDose portfolio as we Infinite we here expect think intended ramp. will for. today, driving here pretty largest overall as I continues is still contributor But it? Now side. What's it's

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

Operator

Our line next from of comes Saxon question David the from Needham.

Joseph Conway

Joseph and of gross of improvement, could margin for is on the And This the maybe throughout how back was on them maybe portfolio iDose? by I'll ask just on I on there launch? towards plans rest Two hiring questions, just then much guess, driven like there. You David. mentioned iDose, the the In is quarter, had together. any looking that attention from the launch year, headwinds iDose some the of the see broader that the

I wondering was contemplated that plan. just was if So in the

Alex Thurman

the margin. on take the Alex. question this Joseph, I'll first is

margins. bit It little of XX%. of we increase a So fell a have year-over-year to did our range XX% modest within expected in

driver of I major was so wouldn't a that. And say iDose

we quite to turned you manufacturing fact, honestly, we now tend that to these on headwind launches. see product scale facility to as right in iDose tends margin a be on production up as our these the inefficiencies In

course margin So fully the at launches. it on the iDose this over expand point, we expect year to of to see continue the accretion back as of next the

Joseph Gilliam

I opportunities And that to we've plans, force always it look been our we're how a to where makes a long to force. and now, for as is we've at this, which and sales same it the always hiring stay time and scale consistent the going true sales in sense get grow territories had to we approach evaluating to think we're relates territories

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

Joseph Conway

congrats Okay. and us, Great. record That's from on quarter. all the

Operator

next Wuensch the comes Citibank. Our line from Joanne from of question

Joanne Wuensch

you initial the half ex memory kind just guidance, call bit problem? curious to OUS what Congrats it, when need little I growth. going on XX%-plus to of updated be gave my Seems is really up to was have the a driving, let's or revenue correct, it that to if I'm an shift is like be that And to quarter. for low is mid-teens. gears second want might XXXX on FX that's there MIGS. also, a segment

Joseph Gilliam

expect international what first. growth that to year, mid-teens on business. or last on said this Yes. call on the low call the Joanne, I'll referenced should that start I to the And mid-double-digit started you latter low from we we When today, release growth. was

couple fact, So the things. profile. growth does to a year, I step-up imply for the can in overall that in a point of

approvals U.S. of market the Tom our heard interventional reference relatively combination on of just the blocking to the these there. think that these patients the out as beginning heard opportunity in of areas. And with be reference of obviously, early You we're as markets as care teams you We're increasing doing thing to innings standard just the the the across in agreement. cataract the French the continues in still of But new changing and care that now in I there in follow many tackling starting glaucoma here we're biggest introductions to turn focus Tom product well on proactively stand-alone and

I currency you've we said So States be to these about enthusiastic continue opportunity the United of markets. Having and in considerations got think there. the international outside always that,

launches. have for dealing competitive We years. of been that the We've couple with last

in as and come to try the ultimately Glaukos to that continue portfolio. products takes back to hopefully work and and that through We they know folks trial and see now, trust time

franchise, about headed where in that reflects confident I and feel decreased we that. guidance So think the with that we're area

Joanne Wuensch

the time bringing the line that be? would And for iDose States, what outside United

Joseph Gilliam

United thing that things the complex exist. pricing case iDose an you the there, as that first then evaluating in the and approval That's world do focus. was shift to of context your get you like internationally. the our in from various in Yes, States, the know, you a the and attention markets environment, from standpoint, Joanne. we're Thanks, reference is And

make the and outside iDose now, we about that we'll continue timing any cautious U.S. TR we think you on of market updated but be approach evaluation. for keep as I progress the to so we'll how entries And

Operator

from comes Newitter question Securities. of from next line the Truist Our Rich

Richard Newitter

the of going back just old range the from new. guidance bridge, to Maybe the over components

color. You gave bit like the glaucoma correct. call It pieces has to some make I getting sure all up. international a sounds just want I'm of a

incremental of iDose low maybe right? Did up call Can said the the rest digits just anything too, below get XX% double contribution masked by those? in You trade-off high I the that's getting time is to to your of but the it glaucoma commercial the sales, that pieces obviously, put any you some sounds and mid-teens. a around And you're quantification XX%, like U.S. Is there? not glaucoma portfolio. there but else distraction, from low

Joseph Gilliam

Yes.

So I first back, of think what taking to the part a said. confirm just you step

think I I about think at up it, the the a the And macro It's by our million. on we side. in up guidance $XX $X on if midpoint, the quarter, look you something guiding It's by is we from guiding revised glaucoma guidance. And the the raised international punchline you side. million. like standpoint, U.S. when think, beat

related profile as incremental really our cornea to overall Drug probably growth the about low to digit previous Medicaid the the down from And business. From the is Program, the which think on a all calls. side, at where single of Rebate about were we've prior talked we so all we our tick of that entry calls, is on

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

Richard Newitter

really that like if would number Got a iDose and or of ideal an it spread be, world, XQ, it, a $X giving were it? but uptick see might sequential help whatever whatever or it. there, relative number in call whatever then major help it it bit million, just you you're might not That's ideally calibrate want XQ. shoes, you directional to consensus for uptick may little us helpful. XQ, roughly modeling And is, appreciate million, specific the our in out flattish any kind you Can you uptick get consensus kind of to a big -- where slight in XQ

Joseph Gilliam

I mean I question. Yes. think a good it's

mind, in zero-in if So product not and just with on but seasonality, any focus just you seasonality the specific of business.

QX this to I the think QX procedure ophthalmology million several in QX QX line starting favor we've As a step be you the year. QX to we know, underlying in and QX to sequential trend and over of tends that years, general. seen demand In dollars. least would And down again recent at expect

be the me iDose an time. is to more up you've leg from likely relative heard say, for towards we've growth indicated some standpoint QX next weighted as As

hard the that I way the the in versus the so accrue lines mentioned, really the what of quarter As will you're up fourth. precise be it's to -- third when quite context in launch also exactly

little be while to optimistic think more planning obviously us And it quarter as standpoint, outcome, including sense a for fourth. conservative as we're I from bit well so for for that makes both the the third

Operator

line the next from Lichtman question from of Steve comes Our Oppenheimer.

Steven Lichtman

guidance. of as you how as the Do that all past get I So to Or after this? anniversary wanted you move U.S. Epi-On? to think it that we on device-related MDRP? appreciate be Health, we business we anticipate picking actually should closer some Corneal the about do just headwinds ask up? How about on thinking you you have year -- I full

Joseph Gilliam

Yes. a Steve. It's good question,

I Health up think from correctly. you said side, it Corneal the

do Drug Rebate you first have The headwinds. of thing some the entry sunset to is Program Medicaid

should of adoption in or franchise expected growth dynamic the saw that that than is into But alongside I'll to the as Some you XXXX. past grow back expectation we've that arena what kind in as returning our a, continues that standpoint, the that adjustment underlying exceeding in them. persist those of business from it, be ex net XXXX get to to the past of that could well as from the gross we call rebates and Medicaid grow

and Ultimately, preparation XXXX of XXXX. a we product that as in be do for enter are lot Epioxa will exit launch doing of anticipation a would the into the and we important activities in very

Steven Lichtman

then you it, apologize OpEx year? That's if growth helpful. Okay. I for the And how missed about thinking but from XQ here are I exiting now

Alex Thurman

trying we along Steve, And question. it's were Alex. to our the is it exactly I'll trending the guide year. for OpEx again, take OpEx how

$XXX we That year around first OpEx and around last had XX% to at up a $XXX If to about of expect said million. a you puts recall, from spent $XXX million million. base you full OpEx year Through have half, this grow we the year.

can you that's you a the million, take just for and expect if the sequentially what quarters, modest we'd So the get over step-up to next year. $XXX little X

Operator

And of the Anthony our line last comes Petrone from from question Mizuho.

Anthony Petrone

and question instance sticker stay bit a a stents. shock with I'll to have where there there's just doing on on X the strategy the and patients you checks first out-of-pocket fee-for-service obviously, use the would in theme the iDose here, be little XX% out the for some for of, Medicare patients those

a sort to close that sheet Medicare of there So fee-for-service? donut is that hole balance strategy XX% in

leverage sales potentially we in that? for the adds that in a is some But you look middle force and of 'XX sort of And right to frame is time once start benefit scenario we and level out P&L? into its sort really to $XXX And the see into iDose of 'XX, the terms as as get million. getting launch, the -- then addition certainly curve mentioned the off that sales the you just of this could S product force

Joseph Gilliam

Yes. Thanks, Anthony.

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

fee-for-service, Medicare XX% think to I you're what that's traditional For referencing the comment.

no vast, coverage. For insurance of secondary because them of to actually out-of-pocket those patients, majority have vast the low

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

balance is et companies referencing all drugs those on patients priced assistance that off -- group the should were program insurance. commercial we focus population. expect table a to co-pay that, the -- where will I'll like second burden have And commercial of The take the cetera, a that, you similarly yes, for you payer patient for think commercial sheet, have that we I drug that

more be will be So from that through where to payers of that last that portion those their access out-of-pocket not well referencing. The so those companies the any to will patients, there, eaten the significant the the year. you you're group through high by policy for both procedures of burden the device gated plans. not versus stage and other restrictions much get see of And maximums pharmaceutical Medicare will That's out the coverage relatively treated us as to to or the unusual out-of-pocket them when and standpoint, other the be Advantage. subject off policies actually as those deductible to a dynamics later patients, not in much tend years they've earlier more than in

fiscal back to population And year. expect so half more given that for any towards wait of we'd patient the

nothing I do quite it us wholesale. and want think organic As surgical When Ophthalmology talk ads in about ophthalmology, there, bit sales iDose relates mean to certainly, in something that. a of force, clarify I in I leveragability really general, I maybe to for there's there.

or smart launch. supplementing scales talking to infinitely resource rapidly about overnight we're be iDose the about prudent not that needed country, changes where the we'll continue So while it's that throughout and something alongside that

that will, to the the our of So if later launch asked start relates rather be than in see would as it the think leverage, question way our sooner the expectation the you I would force. you iDose you to sales

Operator

remarks. would back closing I it for now to at Right. team our over like turn to Glaukos

Thomas Burns

to support Okay. your you you all and And attention goodbye. Glaukos. for time today. and your and I in everybody. Thanks continued want for thank thank interest Thank

Operator

That pleasant conference call. Have concludes today's day. a

Glaukos (GKOS) 31 Jul 242024 Q2 Earnings call transcript