Question · Q4 2025
David Rescott inquired about the epilepsy business's 2026 guidance, noting it's higher than 2025's initial outlook. He asked if this reflects incremental tailwinds from elevated reimbursement, and how potential pricing, contracting, or utilization benefits are factored into the 2026 forecast. He also asked about the 'wiser program' and any risk of Medicare patient denials in 2026.
Answer
Vladimir Makatsaria, CEO, highlighted significant tailwinds from improved reimbursement (nearly 50% increase) and strong CORE-VNS study results, which are expected to drive long-term growth by removing penetration barriers. Alex Shvartsburg, CFO, added that price would be a short-term contributor, but increased penetration takes time. He also noted that 2/3 of U.S. epilepsy revenue comes from replacement implants, moderating the impact of new patient volume. Ahmet Tezel, Chief Innovation Officer, summarized the CORE study's positive findings on seizure reduction and SUDEP reduction. Alex Shvartsburg, CFO, later stated no denials had been observed in tracked Medicare cohorts, and Medicare Advantage plans already require prior authorization.
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