Business Context and Reporting Period
Company: Glaukos Corporation (GKOS)
Filing Type: Form 10-Q (Quarterly Report)
Reporting Period: Three months ended March 31, 2026
Business Overview: Glaukos is an ophthalmic pharmaceutical and medical technology company focused on developing dropless platform therapies for glaucoma, corneal disorders, and retinal diseases. Key products include the iStent family, iDose TR (glaucoma), and Epioxa (keratoconus).
Key Financial Metrics
| Metric (in thousands, except per share) | Q1 2026 | Q1 2025 |
|---|---|---|
| Net Sales | $150,571 | $106,664 |
| Gross Profit | $117,232 | $82,348 |
| Gross Margin | 78% | 77% |
| Operating Expenses | $137,088 | $103,026 |
| Loss from Operations | $(19,856) | $(20,678) |
| Net Loss | $(19,783) | $(18,146) |
| Net Loss Per Share (Basic & Diluted) | $(0.34) | $(0.32) |
| Cash, Cash Equivalents & Short-term Investments | $276,685 | $278,760 |
| Working Capital | $396,338 | $373,709 |
Note: Cash, cash equivalents, and short-term investments are derived from the Balance Sheet ($104,249 + $172,436). Working capital is calculated as Total Current Assets ($485,753) less Total Current Liabilities ($89,415).
Material Changes vs. Prior Period
- Revenue Growth: Net sales increased 41% year-over-year to $150.6 million, driven primarily by a 58% increase in U.S. glaucoma sales (led by iDose TR) and a 23% increase in international glaucoma sales.
- Expense Increases: Operating expenses rose 33% to $137.1 million. Selling, General, and Administrative (SG&A) expenses increased 32% due to higher compensation and stock-based compensation ($5.2 million increase). Research and Development (R&D) expenses increased 36% to $44.1 million, reflecting continued clinical studies and product development.
- Profitability: While the operating loss narrowed slightly from $20.7 million to $19.9 million, the net loss increased by 9% to $19.8 million due to a decrease in non-operating income (primarily foreign currency fluctuations).
- Cash Flow: Net cash used in operating activities improved to $12.5 million from $18.5 million in the prior year. Net cash provided by financing activities increased significantly to $15.8 million, largely due to proceeds from stock option exercises ($19.3 million).
Guidance, Outlook, and Risks
Recent Developments & Outlook:
- Epioxa Launch: The company commenced a controlled commercial launch of Epioxa (keratoconus treatment) in Q1 2026. A permanent HCPCS J-code (J2789) was assigned by CMS, effective July 1, 2026.
- iDose TR Expansion: FDA approved a supplemental NDA for the re-administration of iDose TR in January 2026. Reimbursement for iDose TR has become more consistent across Medicare Administrative Contractors (MACs).
- Strategic Option: In February 2026, Glaukos entered an Option Agreement to potentially license technology or acquire a biopharmaceutical company, with upfront payments up to $17.5 million contingent on milestones.
- Capital Expenditures: The company anticipates higher capital expenditures in 2026, including a planned $80+ million investment in a new R&D and manufacturing facility in Huntsville, Alabama, with construction expected to begin in 2026.
Risks and Contingencies:
- Reimbursement Uncertainty: Ongoing risks related to Medicare physician fee payment rate reductions and MAC coverage determinations for MIGS procedures.
- Transition Risks: Potential disruption in U.S. Corneal Health sales as the company transitions from Photrexa to Epioxa.
- Macroeconomic Factors: Exposure to tariffs, supply chain disruptions, and foreign exchange rate fluctuations (notably the Euro).
- Profitability: The company has an accumulated deficit of $952.9 million and cannot assure sustained profitability.
Investor Verification Checklist
- iDose TR Reimbursement Status: Verify the finalization of professional fee payment rates across all seven MACs and the impact on adoption rates.
- Epioxa Commercialization: Monitor the transition from Photrexa to Epioxa and the effectiveness of the new J-code (J2789) on reimbursement and sales volume.
- Option Agreement Milestones: Track the progress of the February 2026 Option Agreement to determine if the $17.5 million upfront payment or acquisition will be triggered.
- Capital Expenditure Execution: Confirm the timeline and funding for the new Huntsville, Alabama facility and its impact on future cash burn.
- Stock-Based Compensation: Review the sustainability of SG&A growth, specifically the $19.1 million in stock-based compensation recognized in Q1 2026.