Glaukos (GKOS) 2024 Truist Securities MedTech Conference summary

Market positioning and product strategy

• iDose and iStent Infinite are positioned as foundational products to shift glaucoma treatment from drops to interventional solutions, aiming to change the standard treatment paradigm over time.

• Early launch of iDose focused on a small cohort of surgeons, with a methodical, wave-based expansion planned throughout the year.

• Initial focus is on standalone use in Medicare fee-for-service patients to streamline claims, with combination use expected to grow as reimbursement stabilizes.

• Surgeon training is expected to accelerate in the second half of the year, with each wave of new users growing larger.

• Clinical feedback and receptivity to iDose have been strong, with high interest from surgeons beyond the initial cohort.

Reimbursement and market access

• J-code for iDose becomes effective July 1, with full streamlined reimbursement expected by Q4 after CMS publishes the ASP.

• Professional fee establishment is a 6–9 month process, with consistent rates expected by late 2024 or early 2025.

• Initial market focus is on Medicare fee-for-service, which represents about 40% of the patient base, with commercial and Medicare Advantage coverage expanding later.

• Copay assistance will be provided for commercial patients, and patient counseling will support optimal insurance choices.

• No major reimbursement surprises have occurred; efforts will accelerate into commercial and Medicare Advantage as J-code and ASP are established.

Financial outlook and operational impact

• iDose is expected to be accretive to gross margin by 2025 as scale increases and manufacturing costs are absorbed.

• Contribution margin will support funding a rich R&D pipeline, with a near-term goal to return to cash flow breakeven by 2025.

• Long-term, the business could achieve a 30% operating margin, balanced against continued investment in pipeline development.