iDose Ramp and Revenue Outlook
Q: How will iDose adoption drive revenue growth?
A: The company expects iDose to become a significant revenue driver in the second half, especially in Q4 when the J-code and ASP are established. " " " Early access has expanded beyond the initial 15 surgeons, and excitement is high. " " However, the initial contribution in Q1 was small, as most adoption is expected after reimbursement mechanisms are in place. " "

Guidance and Conservative Raise
Q: Why not raise guidance more given the Q1 beat?
A: Despite a strong start, the company maintained a conservative approach, noting that much of iDose's contribution will occur in the second half. " Factors such as foreign exchange headwinds and tougher comps ahead also influenced guidance. " "

Profitability and Gross Margins with iDose
Q: Will iDose affect margins and profitability?
A: Gross margins may fluctuate between 82% and 84% due to iDose launch inefficiencies. " " Over time, iDose is expected to be accretive to margins, boosting profitability into next year. " "

Patient Co-pay and Reimbursement
Q: How will you address patient co-pays in Medicare and commercial plans?
A: For Medicare, most patients have supplemental coverage reducing out-of-pocket costs. " " In the commercial segment, the company plans to offer full co-pay assistance to minimize patient financial burden. " "

iDose Label and FDA Discussions
Q: Any updates on getting a replacement label from the FDA?
A: The company plans to propose moving towards readministration and hopes for a positive FDA response soon, though timing is uncertain. They expect the TREX clinical trial to regain by year-end, aiming for commercial availability around 2027-2028.

Impact of iDose on Base Business
Q: Is iDose affecting your core business and market share?
A: The iDose launch is enhancing the base business, contributing to mid-teens growth in the stent portfolio. " " The company believes it is both growing the market and taking share due to increased enthusiasm and portfolio expansion. " "

Surgeon Training Capacity
Q: How will surgeon training progress going forward?
A: Training will expand methodically, with aggressive targets set for the commercial team. " " While past training peaked at 700-800 surgeons per year, the focus now is on surgeons already experienced with angle-based surgery, potentially increasing training efficiency. "

iStent Infinite Performance
Q: How is iStent Infinite performing?
A: iStent Infinite is a key growth driver, contributing to mid-teens growth in the stent portfolio. The company expects sequential growth to continue and remains confident it can become a several hundred million dollar product over time.

Rollout Constraints for iDose
Q: Are there any constraints in iDose adoption?
A: No significant supply constraints are expected. Adoption ahead of the J-code may vary based on surgeons' experience with miscellaneous codes and reimbursement confidence. "

Specialty Pharmacy Channel
Q: What's the plan for the specialty pharmacy channel?
A: The specialty pharmacy setup is ready, leveraging experience from Photrexa. The channel will be utilized more as commercial payer coverage for iDose expands.

Gross Margin Expectations
Q: Will gross margins change next quarter?
A: Gross margins may show volatility due to iDose ramp-up but are expected to remain in the 82%-84% range this year.

U.S. Glaucoma Business and MACs
Q: What's the impact of MAC movements on the glaucoma business?
A: The impact has been minimal, with a modest benefit to the stent side. The company expects to hear more from MACs but continues to support physicians' clinical decision rights.

Operating Expense Growth
Q: Is OpEx growth still expected at 10%?
A: Yes, the company anticipates about a 10% year-over-year increase in operating expenses.

iDose Surgeon Adoption Patterns
Q: How quickly are surgeons adopting iDose?
A: Adoption varies; some surgeons proceed after initial cases, while others wait for reimbursement confirmation.

Reimbursement with MACs
Q: Any updates on professional fee coverage from MACs?
A: Educational efforts are ongoing; coverage typically takes 6 to 9 months to become consistent and usually occurs gradually, not all at once.

iStent Infinite Market Potential
Q: Are you confident iStent Infinite can be a $50-100M business?
A: The company remains confident, seeing strong results and early penetration indicating significant future potential.

Training Rate for Reps
Q: Can reps train more surgeons given prior experience?
A: While many surgeons are already experienced, reps also balance multiple products, so training rates will be assessed as the rollout progresses.

Early iDose Utilization
Q: How is iDose being used initially?
A: Early use focuses on stand-alone procedures, with some use in combination based on clinical needs. " " Patient selection varies, and utilization patterns differ among surgeons. " "