GLAUKOS Corp (GKOS)·Q2 2025 Earnings Summary

Executive Summary

• Record Q2 2025 revenue of $124.1M, up 30% YoY and 16% QoQ, with non-GAAP gross margin at ~83%; management raised FY25 net sales guidance to $480–$486M from $475–$485M, reflecting accelerating iDose TR adoption .
• Revenue beat Wall Street consensus by ~$8.6M and non-GAAP EPS loss narrowed to ($0.24) vs. consensus ($0.258), a modest beat; 14 estimates underpin both revenue and EPS consensus values (S&P Global)*.
• U.S. Glaucoma revenue surged 45% YoY to $72.3M, with iDose TR contributing ~$31M; 80% of iDose volumes came from MAC regions with established professional fees (Noridian, Novitas, First Coast), while NGS is progressing and Palmetto/WPS/CGS lag .
• Corneal Health revenue was $20.6M (+4% YoY) but management flagged a material Q4 headwind as patients defer Photrexa to await potential Epioxa approval (PDUFA Oct 20, 2025), setting up a transition dynamic .
• CMS proposed 2026 rules would modestly increase facility fees but reduce physician fees for several Category 1 ophthalmology CPT codes; Glaukos sees this reinforcing standalone interventional glaucoma procedures (iDose TR, iStent Infinite) while immunizing Category 3 codes from the proposed physician fee cuts .

What Went Well and What Went Wrong

What Went Well

• U.S. Glaucoma momentum: “We delivered record second quarter net sales of $72.3 million on strong year-over-year growth of 45% driven by growing contributions from iDose TR, which generated sales of approximately $31 million in the second quarter.”
• Reimbursement footprint expanding: “We saw over 80% of our iDose volumes come from [Noridian, Novitas, First Coast] areas in Q2… and that’s a growing percentage of the overall mix.”
• Pipeline and regulatory progress: Completed PAI for Epioxa and EU MDR clearance for iStent Infinite, enabling a European launch roadmap and strengthening global IG initiatives .

What Went Wrong

• Non-iDose U.S. Glaucoma headwinds: LCD restrictions on dual MIGS in combo cataract drove declines; management expects mid-single-digit decline in non‑iDose revenues in 2H and full year 2025 .
• Corneal Health transition risk: Q4 disruption anticipated as patients defer Photrexa pending potential Epioxa approval, implying cadence risk in 2H .
• SG&A step-up and one-time comp: GAAP SG&A rose to $83.4M (+26% YoY), including ~$4M one-time stock comp hit; full-year OpEx now guided to ~$460M with mid-teens growth .

Financial Results

Values marked with * retrieved from S&P Global.

Non-GAAP adjustments note: Q2 2025 non-GAAP reflects $5.5M amortization of Avedro developed technology and $0.2M Mobius amortization in cost of sales; excludes 2024 convertible notes exchange charges; tax effects are zero in U.S. loss positions .

Guidance Changes

Earnings Call Themes & Trends

Management Commentary

• “Our record second quarter results reflect a sustained growth acceleration in our business driven by growing iDose TR adoption and utilization along with our broader interventional glaucoma initiatives globally.” – Thomas Burns, CEO .
• “We saw over 80% of our iDose volumes come from [MACs] with a professional fee… a growing percentage.” – Joseph Gilliam, President & COO .
• “Within the total OpEx number, there’s about a $4 million one-time stock comp expense… full year [OpEx] in the $460 million range… translates to about mid-teens growth.” – Alex Thurman, CFO .
• “FDA classified our petition as an NDA supplement… PDUFA date January 28, 2026… we are not at all counting on a positive outcome” [for iDose TR readministration]. – Thomas Burns .

Q&A Highlights

• Beat-and-raise rationale: Guidance raised primarily on iDose strength; international glaucoma expected to slow to low double-digit growth; non‑iDose U.S. glaucoma mid-single-digit declines; cornea Q4 headwind from Epioxa transition .
• Reimbursement cadence: MACs paying J-codes broadly; professional fees established in Noridian/Novitas/First Coast; NGS progressing; Palmetto/WPS slower; CGS remains behind .
• Seasonality and cadence: Q3 typically down seasonally; sequential U.S. glaucoma expected positive on iDose offset; Q4 heavier for procedures .
• Cash flow and investments: Underlying CF positive ex building and Mobius; long-dated terms for iDose create lag in CF benefit .
• Epioxa roll-out: Expect patient deferrals post-approval; conversion to new system and payer policy work; J-code mid-2026 as milestone .

Estimates Context

• Q2 2025 revenue beat: Actual $124.120M vs consensus $115.4825M*; EPS (non-GAAP) beat: ($0.24) vs ($0.258); both based on 14 estimates.
• Implications: Consensus likely to move higher on revenue trajectory given iDose adoption and reimbursement broadening; EPS path benefits from gross margin accretion and opex scale, partially offset by higher SG&A investments (marketing, reimbursement execution) .
  Values marked with * retrieved from S&P Global.

Key Takeaways for Investors

• The beat-and-raise quarter is driven by accelerating iDose TR momentum, broadening reimbursement, and strengthening U.S. Glaucoma revenue mix; this is a core near-term stock catalyst .
• Non‑GAAP gross margin moved up to ~83% with further modest accretion expected as iDose mix expands, supporting EPS leverage over time .
• Watch reimbursement milestones: NGS professional fee establishment and progress in Palmetto/WPS/CGS are key for 2H iDose cadence and 2026 office setting ambitions .
• Corneal Health transition will likely depress Q4 reported revenues as patients defer to Epioxa; PDUFA Oct 20, 2025 provides a binary catalyst and sets up 2026 ramp post J-code establishment .
• Readministration for iDose TR now has a firm PDUFA (Jan 28, 2026); management is not underwriting a positive outcome, but upside is material if approved .
• OpEx will run near the top end (~$460M) in FY25 with mid‑teens growth, reflecting commercial investments; underlying CF is improving as iDose terms cycle .
• Strategic EU MDR clearance for iStent Infinite and upcoming ESCRS launch supports international glaucoma growth while competitive trialing may create transient headwinds .