Glaukos Corp (GKOS) Q4 2025 Earnings Call Highlights: Record Sales and Strong Growth Outlook

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Wed, February 18, 2026 at 2:01 PM GMT+9 4 min read

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**Fourth-Quarter Net Sales:** $143.1 million, up 36% on a reported basis and 34% on a constant currency basis year-over-year.

**Full-Year 2025 Net Sales:** $507.4 million, a growth of 32% compared to 2024.

**2026 Net Sales Guidance:** $600 million to $620 million, implying over 20% year-over-year growth at the midpoint.

**US Glaucoma Franchise Sales:** $86.4 million in Q4, with iDose TR contributing approximately $45 million.

**iDose TR Sales for 2025:** Approximately $136 million.

**International Glaucoma Franchise Sales:** $32.8 million in Q4, up 18% on a reported basis and 13% on a constant currency basis year-over-year.

**Corneal Health Franchise Sales:** $24 million in Q4, with Photrexa contributing $21.4 million.

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Release Date: February 17, 2026

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

Glaukos Corp (NYSE:GKOS) reported record fourth-quarter consolidated net sales of $143.1 million, up 36% on a reported basis and 34% on a constant currency basis compared to the previous year.

The company achieved full-year 2025 consolidated net sales of $507.4 million, marking a 32% increase from 2024.

Glaukos Corp (NYSE:GKOS) reaffirmed its full-year 2026 net sales guidance range of $600 million to $620 million, indicating continued strong growth.

The launch of Epioxa, a novel treatment for keratoconus, has been well-received by the physician community, with significant interest and early positive coverage determinations.

The iDose TR product has shown strong adoption, with sales of approximately $136 million in 2025, driven by positive clinical outcomes and growing physician adoption.

Negative Points

The company anticipates new competitive product trialing headwinds in some major international markets in 2026.

The transition from Photrexa to Epioxa may cause volatility, particularly in Q2 and Q3, as the company navigates payer adoption hurdles.

The fourth quarter saw a sequential deceleration in iDose revenue due to a mix shift towards Medicare Advantage and specific rep incentive dynamics.

Initial patient access to Epioxa will be gated by site of care network deployment and payer adoption challenges, potentially delaying widespread adoption.

The company faces challenges in expanding market access for iDose TR, particularly in commercial and Medicare Advantage segments.

Q & A Highlights

Q: Can you elaborate on the early positive coverage determinations for Epioxa and any payer pushback on pricing? A: Joseph Gilliam, President and COO, explained that early positive coverage determinations have been seen with some Medicaid societies and a large blue plan. There has been no formal or informal pushback from payers on Epioxa’s pricing. The focus has been on clinical education to ensure payers understand Epioxa’s benefits compared to Photrexa.

Story Continues  

Q: What factors contributed to the sequential deceleration in iDose revenue in Q4, and what is the outlook for Q1 and 2026? A: Joseph Gilliam noted that the mix shifted towards Medicare Advantage in Q4, affecting sequential growth. Despite this, iDose grew over 10% sequentially. For Q1, continued sequential growth is expected, even with seasonal procedure volume lows. The company anticipates sequential improvement each quarter throughout 2026.

Q: Can you break down the top-line guidance for FY26, particularly regarding iDose, US stent business, and corneal health with Epioxa? A: Joseph Gilliam stated that international glaucoma is expected to grow in the high-single digits, with US glaucoma projected to grow around 30% year-over-year, driven by iDose TR. The corneal health franchise, including Epioxa, is expected to grow modestly year-over-year, with volatility anticipated in Q2 and Q3 due to the transition from Photrexa.

Q: How are you addressing the interplay between re-administration of iDose and the introduction of iDose TREX? A: Joseph Gilliam explained that the goal is to provide multiple options for patients, with re-administration of iDose TR and the future availability of iDose TREX. The choice between them will depend on clinical profiles. Re-administration is expected to become more significant in the coming years.

Q: What are your thoughts on operating expenses for 2026, especially with the Epioxa launch? A: Alex Thurman, CFO, stated that operating expenses are expected to grow in the mid-teens percentage year-over-year, aiming for cash flow breakeven. Investments will focus on iDose and Epioxa launches, with a continued commitment to R&D.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

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