Harrow Health Earnings Call Highlights Growth Amid Headwinds

Harrow Health ((HROW)) has held its Q1 earnings call. Read on for the main highlights of the call.

Harrow Health’s latest earnings call struck an overall optimistic tone despite some near‑term bumps. Management highlighted robust prescription growth, market share gains and an expanding commercial footprint, while acknowledging discrete gross‑to‑net and seasonal headwinds that weighed on Q1 results. Executives stressed that demand trends remain strong and that corrective actions are already in place.

Reaffirmed guidance and stronger second half

Harrow reaffirmed its full‑year 2026 revenue outlook of $350M to $365M, signaling confidence in its growth trajectory. The company guided Q2 revenue to a range of $71M to $81M and emphasized that the second half of 2026 should outpace the first as new catalysts and pricing actions take effect.

Q1 revenue snapshot and product mix

For Q1, consolidated revenue came in at $44.2M, reflecting a transition quarter for several franchises. VEVYE contributed about $20.9M, IHEEZO $1.9M, specialty and TRIESENCE $7.8M, and the Access+ unit delivered $13.5M as inventory and operational issues were worked through.

VEVYE prescriptions surge and share gains

Dry eye therapy VEVYE continued to be the growth engine, posting record prescription momentum and share gains. New prescriptions rose roughly 25% sequentially, total prescriptions increased about 11% and the prescriber base expanded 12%, with VEVYE exiting March at roughly 14% branded share and surpassing XIIDRA on monthly total prescriptions.

VEVYE on track for nine‑figure revenue

Management reiterated that VEVYE remains on pace to exceed $100M of revenue in 2026, underpinned by both volume and pricing. Following recent changes to business rules that limit co‑pay exposure, Harrow expects VEVYE net pricing to improve by around 30%, supporting more profitable growth as coverage and utilization deepen.

IHEEZO poised for pricing and packaging lift

IHEEZO, used for ocular anesthesia, showed 18% year‑over‑year unit demand growth and a 21% increase in new ordering accounts during the quarter. The company expects a 20–25% lift in net pricing and a meaningful demand step‑up in the second half once multiunit packaging and new retina‑specific clinical data roll out.

Retina data and H2 inflection for IHEEZO

Key IHEEZO catalysts are slated for later this year, including data presentations at the ASRS meeting in July and QUELL top‑line results in Q4. Management believes these clinical milestones, coupled with packaging changes, can reposition IHEEZO for stronger adoption and revenue recovery starting in Q3 and accelerating into H2 2026.

TRIESENCE volumes accelerate sharply

Steroid injection TRIESENCE posted standout growth, with unit volume up 136% year‑over‑year in Q1 and roughly 250% over the past six quarters. Notably, 44% of Q1 volume came from ocular surgery accounts, and new account growth reached about 28% sequentially, underscoring deepening penetration across surgical settings.

Sales force buildout to drive conversion

Harrow has significantly expanded its commercial footprint, hiring roughly 90 to 100 sales professionals across its portfolio. The company doubled the VEVYE sales team, tripled TRIESENCE coverage and added retina and specialty reps, expecting this broader reach to convert existing demand trends into stronger revenue in the back half of the year.

Access+ returns to growth mode

The Access+ cash‑pay business, which offers lower‑priced ophthalmic products, has largely recovered from prior inventory constraints. Harrow rebuilt safety stocks, normalized operations and is expanding the Access+ sales team, positioning the unit to re‑enter growth mode with offerings exemplified by products priced in the sub‑$60 range.

New launches and J‑code expansion opportunities

Several commercial catalysts are lining up, including the BYOOVIZ launch and distributor stocking around mid‑year and a Q3 trade launch for BYQLOVI following sampling. A permanent J‑code for IOPIDINE 1% becomes effective July 1, opening access to an addressable market of more than 1.5M laser procedures and leveraging the same in‑office call point as IHEEZO.

Pipeline progress with G‑MELT

On the development front, Harrow advanced G‑MELT, an IV, opioid‑free procedural sedation candidate acquired recently. Pharmacokinetic and toxicology work has begun or been completed as planned, with manufacturing scale‑up underway and a regulatory path that targets a pre‑submission meeting and a potential filing in early 2027.

VEVYE gross‑to‑net hit and corrective actions

Q1 results were pressured by an approximately $8M VEVYE gross‑to‑net adjustment driven by a higher mix of high‑deductible patients and heavier co‑pay buydowns at a major pharmacy benefit manager. In response, Harrow implemented mid‑April business‑rule caps designed to limit buydowns and protect net pricing without materially dampening volume.

Reporting lag complicated visibility

Management noted that claims reporting lag masked the gross‑to‑net issue until data from February and March fully rolled in. As a result, the magnitude of the problem only became clear in mid‑April, prompting reactive instead of proactive adjustments, but executives now expect more predictable economics going forward.

Q1 loss and seasonal softness

Harrow reported a negative adjusted EBITDA of $12.7M for Q1, in line with expectations for the weakest quarter of the year. Seasonality, limited recognized revenue from IHEEZO due to channel inventory absorption and softer compounding activity following inventory constraints all contributed to the temporary earnings pressure.

IHEEZO channel and ASC transition

IHEEZO’s near‑term revenue will remain muted as existing channel inventories are worked down and usage patterns shift. Ambulatory surgery center utilization has fallen to about 18% from roughly 30%, and management expects ASC usage could effectively be replaced by increased in‑office adoption over time as practices adjust.

Uncertain near‑term impact from new brands

While BYQLOVI and BYOOVIZ are progressing toward broader commercialization, Harrow chose not to quantify their revenue contributions for 2026. Investors should view these brands as incremental upside rather than built‑in drivers of the current year’s guidance until adoption trends and payer dynamics are better understood.

Forward guidance and long‑term ambition

Looking ahead, Harrow reaffirmed its 2026 revenue guidance of $350M to $365M and projected Q2 revenue between $71M and $81M, with sequential improvement expected from Q2 onward. Longer term, management pointed to catalysts like VEVYE pricing normalization, IHEEZO’s H2 ramp, new product launches and G‑MELT’s progress in support of an aspirational goal of reaching $250M in quarterly revenue by the end of 2027.

Harrow’s call painted a picture of a company in investment mode, trading near‑term profitability for scale and share in key ophthalmic niches. Strong demand for VEVYE and TRIESENCE, improving infrastructure at Access+ and a packed catalyst calendar set the stage for a stronger second half, though investors will be watching closely to confirm that pricing fixes and channel shifts translate into cleaner, higher‑quality revenue growth.