Glaukos surges 45% since May-end as iDose TR sales fuel rally

Glaukos Corp. shares have rallied 45.7% since late May, driven by investor confidence in its glaucoma therapy iDose TR and a broadening product pipeline.

Glaukos reported first-quarter revenue of $54 million from iDose TR, beating analyst expectations and triggering a sharp rally on April 29. The stock pared gains in May after Medicare Administrative Contractors proposed restricting iDose TR coverage to patients who have failed both selective laser trabeculoplasty and two topical medications, while also limiting concurrent use with minimally invasive glaucoma surgery and capping re-administration to once every two years.

"We remain confident in receiving exclusions or modifications to the proposed restrictions in the final LCD draft," Glaukos management said during investor conferences in late May and early June, according to a company presentation. The company is positioning iDose TR as a first-line treatment for ocular hypertension and reaffirmed its 2026 and 2027 guidance.

The rally has outpaced the broader medical instruments industry's 4% gain and the S&P 500 Index's 0.9% decline over the same period. Several analysts expect the proposed LCD restrictions to have minimal impact on iDose TR sales, citing a sizable pool of patients who have undergone SLT over the past decade and remain eligible for the therapy.

Epioxa Emerges as Second Growth Engine

Beyond iDose TR, Glaukos is building momentum with Epioxa, its treatment for keratoconus. The company has built a treatment network covering roughly 65% of the U.S. population, with plans to expand to approximately 95%. Reimbursement pathways now cover more than 100 million commercial lives, and four of the five largest U.S. payers have included Epioxa in their coverage. A permanent J-code takes effect in July 2026, which management expects to resolve temporary claims-processing delays.

Pipeline Spans 13 Programs Across Ophthalmology

Glaukos is advancing one of the broadest innovation pipelines in ophthalmology, with 13 publicly disclosed programs spanning glaucoma, corneal disorders, retinal diseases and ocular surface therapies. Beyond iDose TR and Epioxa, the company is developing iDose TREX, iStent infinite for earlier-stage glaucoma, PRESERFLO MicroShunt, and iLution for Demodex blepharitis. Management plans to initiate studies on next-generation iLink technologies and a keratoconus screening device later this year.

The company faces near-term headwinds, including reimbursement complexity for Epioxa until the J-code is fully operational, slowing international glaucoma growth from competitive product launches, and elevated operating expenses from investments in commercial infrastructure and direct-to-consumer campaigns. The Zacks Consensus Estimate projects a 2026 loss of 57 cents per share, improving 36.7% year over year, followed by 2027 earnings of 47 cents per share. Revenue is expected to grow 23.7% to $627.6 million in 2026 and another 26.6% to $794.3 million in 2027.

The sustained rally signals that investors are betting on iDose TR's commercial potential despite regulatory uncertainty. Glaukos' next catalyst will be the final LCD determination from Medicare Administrative Contractors, which will clarify the therapy's addressable patient population.

This article is for informational purposes only and does not constitute investment advice.