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Sight Sciences, Inc. (SGHT) Q1 2024 Earnings Summary

Executive Summary

  • Q1 2024 revenue was $19.3M (+2% YoY), gross margin 86%, net loss of $16.3M (-$0.33 EPS); surgical glaucoma grew 5% while dry eye declined 32% .
  • Management reaffirmed FY 2024 guidance: revenue $81–$85M and adjusted operating expenses $107–$110M; gross margin expected in the mid-80s .
  • Sequential momentum: surgical glaucoma revenue +6% vs Q4; Q2 2024 expected to be “low double-digit” sequential revenue growth, despite YoY headwinds vs a tough comp .
  • A $34M jury verdict against Alcon (willful infringement) is a potential catalyst; damages included $5.5M lost profits and $28.5M royalties; remedies and appeals remain pending .
  • Street consensus from S&P Global was unavailable at time of analysis; estimate comparisons could not be provided (S&P Global data not retrieved).

What Went Well and What Went Wrong

What Went Well

  • Surgical glaucoma utilization improved across existing accounts; revenue reached $18.3M (+5% YoY; +6% QoQ). “OMNI is positioned as an important MIG technology… our recovery trajectory [is] tracking to our expectations.” .
  • Gross margin expanded to 86% (vs 84% prior year), driven by surgical glaucoma margin rising to 88% (benefiting from prior-year inventory scrap normalization) .
  • Operating discipline: adjusted operating expenses declined 11% YoY to $26.6M; cash used fell to $10.8M vs $17.7M in Q1 2023, even including $3.2M debt restructuring costs .
  • Legal win: jury found willful infringement; $34M damages awarded, reinforcing IP protection. “We have a duty… to safeguard our intellectual property portfolio, and we are pleased with the jury’s verdict.” .

What Went Wrong

  • Dry eye revenue fell 32% YoY to $1.0M, reflecting reduced sales infrastructure and a strategic shift toward market access rather than new account placements .
  • Overhead per unit increased due to lower production volumes, compressing dry eye gross margin to 42% (vs 54% prior year) .
  • Lingering account attrition from 2H’23 LCD uncertainty (net ~6%) necessitates reengagement capacity; Q2 revenue expected below prior-year period due to tough comps, despite sequential growth guidance .

Financial Results

MetricQ3 2023Q4 2023Q1 2024
Revenue ($USD Millions)$20.0 $18.8 $19.3
Gross Margin (%)86.6% 85% 85.5%
Total Operating Expenses ($USD Millions)$30.7 $27.1 $31.2
Operating Income ($USD Millions)$(13.4) $(11.1) $(14.7)
Net Loss ($USD Millions)$(13.0) $(10.7) $(16.3)
EPS ($USD)$(0.27) $(0.22) $(0.33)
Cash & Cash Equivalents ($USD Millions)$144.5 $138.1 $127.3

Segment breakdown (Q1 2024 vs Q1 2023):

MetricQ1 2023Q1 2024
Surgical Glaucoma Revenue ($USD Millions)$17.334 $18.257
Dry Eye Revenue ($USD Millions)$1.490 $1.008
Surgical Glaucoma Gross Margin (%)86.4% 87.9%
Dry Eye Gross Margin (%)54.0% 42.1%
Total Gross Margin (%)83.8% 85.5%

KPIs across quarters:

KPIQ3 2023Q4 2023Q1 2024
Surgical Glaucoma Active Customers>1,100 1,064 1,073
Dry Eye Active Customers318 327 288
Dry Eye Lid Treatment Units Sold5,090 >5,200 4,011

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
RevenueFY 2024$81–$85M $81–$85M Maintained
Adjusted Operating ExpensesFY 2024$107–$110M $107–$110M Maintained
Gross MarginFY 2024Mid-80s Mid-80s Maintained
Q2 Revenue (Sequential)Q2 2024N/ALow double-digit sequential vs Q1 Introduced (qualitative)
Dry Eye RevenueFY 2024Significant decline vs 2023 Significant decline vs 2023 Maintained

Earnings Call Themes & Trends

TopicPrevious Mentions (Q3 2023)Previous Mentions (Q4 2023)Current Period (Q1 2024)Trend
LCDs/Market Access (Glaucoma)WPS final LCD negative; industry pushback; IRIS/GEMINI2 data to support coverage LCDs withdrawn late Dec; plan to reengage accounts, utilization first Reengagement ongoing; utilization improving; confident in coverage sufficiency; expect continued payer engagement Improving/stabilizing
Surgical Glaucoma UtilizationUtilization down sequentially amid LCD uncertainty Resilient utilization; plan to rebuild funnel +6% QoQ; +5% YoY; utilization up ~10% vs Q4 and ~5% vs Q1’23 Recovering
Dry Eye (TearCare) StrategyShift to market access; SAHARA 6-month success Market access focus, payer team active SAHARA 12-month crossover results; budget impact model; early claims traction; coverage wins targeted for 2025 Building toward 2025
Clinical EvidenceIRIS registry large-scale MIGS outcomes; GEMINI2 sustained efficacy Plan to publish more studies; meta-analysis; minority outcomes Publication of large-scale real-world MIGS study; SAHARA phase 2 crossover Expanding
Legal/RegulatoryLCD remediation efforts LCDs withdrawn; guidance framed prudently $34M patent verdict; post-trial briefings/appeal pending Positive legal outcome (uncertain timing)
FinancingCost controls; reduced cash burn New $65M Hercules facility; $35M funded Cash used $10.8M; cash $127.3M; debt $35M Balanced liquidity

Management Commentary

  • “Our first quarter performance represents an encouraging start to the year… strong gross margins and disciplined expense management… 2024 is expected to be a foundational year for the next phase of Sight Sciences’ growth…” — CEO Paul Badawi .
  • “We plan on achieving cash flow breakeven without the need to raise additional equity capital…” — CFO Alison Bauerlein .
  • On surgical glaucoma: “Growth… driven primarily by increased utilization from existing accounts of OMNI and SION… we expect returning accounts to contribute toward further regaining momentum in the second quarter…” .
  • On TearCare: “Our goal is to begin receiving positive coverage decisions from payers starting in 2025… early positive traction with our customers’ claims.” .
  • On litigation: “The jury found that Sight Sciences’ asserted patents were willfully infringed and awarded monetary damages…” .

Q&A Highlights

  • Guidance discipline: Despite momentum, management chose not to raise FY guide yet; seeks more consistent traction before revisiting .
  • Q2 cadence: Expect “low double-digit” sequential revenue growth vs Q1; Q2 YoY lower due to tough comp; typical seasonality with stronger Q2/Q4 utilization .
  • Dry Eye reimbursement: Early claims feedback encouraging; economic model suggests favorable reimbursement for providers and payers; broader promotion to be evaluated alongside market access .
  • Account reengagement: Engagement positive; capacity build in sales organization to support utilization, new accounts, and surgeon training .
  • Competition & pipeline: Healthy MIGS market; OMNI well positioned for combo cataract and stand-alone; pipeline includes intracanalicular scaffold (“Helix” stent in animals), sustained release programs with milestones later in 2024 .

Estimates Context

  • Wall Street consensus (S&P Global) for Q1 2024 revenue/EPS and FY 2024 was unavailable at time of analysis due to data access limits; comparisons to Street estimates are not provided.
  • Analyst tone suggested results/trajectory tracking toward high end of guide, prompting questions about why guidance was not raised .

Key Takeaways for Investors

  • Sequential rebound in surgical glaucoma utilization should support “low double-digit” sequential revenue growth in Q2; H2 set up for double-digit YoY growth if utilization and account reengagement continue .
  • Gross margins remain strong in the mid-80s, aided by surgical glaucoma mix; watch dry eye volume normalization to relieve overhead per unit pressures .
  • The $34M patent verdict is a favorable legal milestone; timing and magnitude of any enhanced damages or remedies remain uncertain pending post-trial and appeals .
  • Liquidity and debt profile improved with Hercules facility; management targets cash flow breakeven without equity raise, contingent on execution .
  • Dry Eye is an option value for 2025+: SAHARA clinical evidence and budget impact analyses underpin payer discussions; early claims traction encouraging .
  • Near-term trading: focus on Q2 sequential growth delivery, H2 visibility on double-digit YoY growth, and any updates on litigation outcomes or payer policy progress .
  • Medium-term thesis: Dual-platform leverage (MIGS and Dry Eye) with expanding clinical evidence and market access initiatives positions SGHT to reaccelerate growth and improve operating leverage .

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