David Saxon

David Saxon asked about engaging innovative channel partners for repeat monitoring, whether it can be standardized, and if iRhythm has internal data supporting the value of repeat monitoring after a certain period.

Answer

President and CEO Quentin Blackford stated that repeat testing discussions vary by partner (e.g., every 12 months vs. every 3 years), but most are considering it. He noted that confirmed diagnoses and treatment naturally lead to repeat testing. He also suggested that annual monitoring could be used by payers for risk assessment and program pricing, but it's too early to specify exact frequencies.

David Saxon asked about the adoption of iDose TR in commercial cases, specifically if doctors are increasingly treating this patient population or if it's a slower build. He also questioned the flat growth expectations for the iStent franchise in 2026, asking if it's due to rep incentives, market dynamics, or competitive factors.

Answer

Joe Gilliam, President and COO, noted that iDose TR commercial adoption is provider-specific, with encouraging signs in geographies with Medicare fee-for-service coverage. Glaukos is expanding this in 2026 through payer access (strong foundation with major MA payers), process optimization, and patient economics ($0 co-pay for commercial, MA patients meeting deductibles). For the iStent franchise, he acknowledged a return to growth for the non-iDose US glaucoma business in Q4 but attributed the flat 2026 assumption to rep incentives and company focus on iDose TR.

David Saxon asked about the adoption of iDose TR in commercial patient populations, inquiring if it's a trickle or building momentum. He also questioned the flat growth expectations for the iStent franchise in 2026, asking if it's due to rep incentives, market dynamics, or competitive factors.

Answer

Joe Gilliam, President and COO, Glaukos, noted that commercial/Medicare Advantage iDose TR cases are provider-specific, with expansion efforts in 2026 focusing on payer access (strong foundation with major MA payers), process optimization, and patient economics ($0 co-pay for commercial, MA patients meeting out-of-pocket). For the iStent franchise, Mr. Gilliam acknowledged non-iDose U.S. glaucoma growth in Q4 2025 but deemed it too early to call a trend, attributing the flat growth assumption for 2026 primarily to rep incentives and company focus on iDose TR.

David Saxon asked about Azenta's confidence in restoring Sample Management Solutions (SMS) gross margins, distinguishing between controllable factors and customer dynamics. He also inquired about the composition of the reiterated 300 basis points EBITDA margin expansion, specifically the gross margin (200 bps) and operating expense (100 bps) mix, and if OpEx would contribute more. Additionally, he asked for an update on capital spending conversations with academic and government customers, confidence in improvement, and its potential impact on North America demand and growth.

Answer

President and CEO John Marotta acknowledged Azenta-specific challenges like product/geo mix, margin headwinds, and quality issues in Automated Stores, alongside market factors such as slower North America growth and government shutdown impacts. He reiterated confidence in the full-year guidance, emphasizing the company's commitment despite increased difficulty. EVP and CFO Lawrence Lin detailed the Q1 adjusted EBITDA decline, attributing it to $2 million from stores' quality issues, $1 million from North America lab inefficiencies, and $700,000 in non-recurring inventory adjustments. He affirmed the 200 basis points gross profit and 100 basis points OpEx contribution, driven by anticipated second-half sales volume, Azenta Business System (ABS) productivity, and price initiatives. Regarding academic and government capital spending, Mr. Marotta noted strong momentum in Europe/Middle East and 'green shoots' in the U.S., expressing bullishness for the back half of the year based on confirmatory customer conversations.