Glaukos (GKOS) Stifel 2026 Virtual Ophthalmology Forum summary

Key developments and policy updates

• Recent LCD proposals for iDose surprised management due to their timing and lack of typical feedback signals from MACs, indicating limited clinical input in the process.

• The LCD process is expected to take 7–12 months, with final impacts likely felt in 2027 rather than 2026.

• Management is actively engaging with physician societies and the clinical community to advocate for evidence-based amendments during the comment period.

• There is confidence that, through education and advocacy, the final LCD will be more favorable and better reflect clinical realities.

Clinical and commercial implications

• Nearly every element of the proposed LCDs is seen as needing adjustment, especially regarding patient eligibility for iDose versus other therapies.

• Many glaucoma patients are not suitable for topical drops or SLT, highlighting the need for broader access to iDose.

• Real-world evidence shows poor compliance with drop-based therapies, particularly in underrepresented populations, increasing the importance of alternative treatments.

• The requirement for both drop and SLT failure as prerequisites for iDose is seen as clinically unfounded and overly restrictive.

Market outlook and revenue guidance

• The iDose market is still in its early growth phase, with significant headroom for expansion even if some LCD restrictions remain.

• Management does not see a need to lower 2027 revenue expectations at this stage, citing multiple growth drivers and a large eligible patient pool.

• Long-term peak sales projections remain robust, with the addressable market far exceeding current Wall Street models.