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Glaukos (GKOS)
NYSE:GKOS
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Glaukos
(NYSE:GKOS)
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Rating:60Neutral
Price Target:
$126.00
▲(4.23% Upside)
Action:ReiteratedDate:02/24/26
The score is held back primarily by weak financial performance (margin compression, widening losses, and negative cash flow). Offsetting this, the technical setup is constructive (clear uptrend with positive momentum) and the latest earnings call was supportive with reaffirmed >20% growth guidance and strong iDose TR/Epioxa progress, though execution and reimbursement/coding timing risks remain.
Positive Factors
Revenue Growth
Robust multi-year revenue scaling with record FY2025 and strong Q4 growth reflects clear product-market fit and accelerating commercial traction. Sustained top-line expansion improves the company's ability to invest in sales, R&D and infrastructure, supporting durable market share gains and potential future operating leverage.
iDose TR repeat-dosing label
Regulatory approval for repeat administration materially enlarges the addressable patient pool and enables recurring procedural revenue from the same patients over time. This label differentiates iDose TR from single-use competitors, strengthens clinical value proposition, and supports sustained revenue per patient and long-term adoption.
Epioxa commercial launch
Epioxa adds a non-surgical corneal therapy that diversifies revenue beyond surgical glaucoma implants. Early site deployments covering ~50% of the U.S. population and initial payer engagement create structural access and the potential to build a durable corneal franchise, reducing single-product dependency over the medium term.
Negative Factors
Negative cash generation
Continued negative operating and free cash flow indicates the business still relies on existing cash or financing to fund operations and launches. Persistent cash burn constrains optionality, raises financing risk if execution slips, and increases pressure to hit commercial milestones to avoid dilutive capital raises over the next several quarters.
Margin erosion & losses
Material gross-margin compression and widening net losses point to deteriorating profitability despite revenue growth. Sustained margin recovery is required to generate self-funding cash flow; without it, elevated R&D and launch spend will prolong negative returns and impair the company’s ability to achieve its stated cash-flow breakeven targets.
Reimbursement and coding risk
Real-world uptake depends on coding and payer coverage; temporary miscellaneous J-code and prior-authorization friction can materially slow adoption and delay revenue recognition. Reimbursement setbacks or slower payer acceptance would increase selling costs and elongate payback periods for launch investments, impacting medium-term profitability.
Glaukos (GKOS) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$6.92B
Dividend YieldN/A
Average Volume (3M)879.88K
Price to Earnings (P/E)―
Beta (1Y)1.03
Revenue Growth30.38%
EPS Growth47.64%
CountryUS
Employees995
SectorHealthcare
Sector Strength45
IndustryMedical - Devices
Share Statistics
EPS (TTM)-0.28
Shares Outstanding58,078,810
10 Day Avg. Volume811,850
30 Day Avg. Volume879,882
Financial Highlights & Ratios
PEG Ratio-1.87
Price to Book (P/B)9.84
Price to Sales (P/S)12.73
P/FCF Ratio-119.57
Enterprise Value/Market Cap1.01
Enterprise Value/Revenue13.78
Enterprise Value/Gross Profit17.30
Enterprise Value/Ebitda-47.81
Forecast
1Y Price Target
$133.45Price Target Upside10.39% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering14
EPS Forecast (FY)-0.53
Revenue Forecast (FY)$613.73M
Glaukos Business Overview & Revenue Model
Company DescriptionGlaukos Corporation, an ophthalmic medical technology and pharmaceutical company, focuses on the development of novel therapies for the treatment of glaucoma, corneal disorders, and retinal diseases. It offers iStent, iStent inject, iStent inject W micro-bypass stents that enhance aqueous humor outflow inserted in cataract surgery to treat mild-to-moderate open-angle glaucoma. The company's product pipeline includes iStent Infinite, a three stents product that is designed for use as a standalone procedure in patients with refractory glaucoma; and iDose TR, a targeted injectable implant based on its micro-scale device-platform that is designed to deliver therapeutic levels of medication. The company markets its products through direct sales organization, as well as through distributors in the United States and internationally. Glaukos Corporation was incorporated in 1998 and is headquartered in San Clemente, California.
How the Company Makes MoneyGlaukos generates revenue primarily through the sale of its medical devices and surgical products for the treatment of glaucoma. The company's key revenue streams include direct sales of its iStent and iStent inject devices, which are used in minimally invasive surgical procedures. Additionally, Glaukos may receive revenue from partnerships and collaborations with healthcare providers and institutions that utilize its products in clinical settings. The company benefits from a growing patient population with glaucoma and increased adoption of MIGS procedures, which contributes to its earnings. Strategic partnerships with ophthalmic practices and health systems also play a significant role in expanding its market presence and driving sales.
Glaukos Earnings Call Summary
Earnings Call Date:Feb 17, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:May 06, 2026
Earnings Call Sentiment Positive
The call reported multiple substantial positive developments: record Q4 and FY2025 revenue, strong iDose TR adoption and revenue (~$136M in 2025), FDA approval and active commercial launch progress for Epioxa, tangible early payer engagement and site deployments, and continued pipeline momentum across several programs. Challenges and near-term headwinds were acknowledged — including Q4 iDose sequential dynamics, expected transition volatility from Photrexa to Epioxa (temporary misc J-code impacts and prior-authorization delays), international competitive trialing, and higher OpEx to support launches. Overall, the positives (record results, robust product momentum, successful approval and launch activities, and clear guidance) materially outweigh the manageable and largely execution/timing-related lowlights.Q4-2025 Updates
Positive Updates
Record Quarterly and Annual Revenue
Q4 2025 consolidated net sales of $143.1M (record) — up 36% reported / 34% constant currency vs. year-ago quarter. Full-year 2025 consolidated net sales of $507.4M (record) — up 32% vs. 2024.
Reaffirmed 2026 Guidance with Strong Growth Expectation
Company reaffirmed FY2026 net sales guidance of $600M–$620M, which implies >20% year-over-year growth at the midpoint and ~+$100M growth versus 2025 at the midpoint.
iDose TR Momentum and U.S. Glaucoma Growth
U.S. glaucoma Q4 net sales $86.4M — up 53% YoY, driven by iDose TR, which generated ~ $45M in Q4 and approximately $136M in 2025. Management expects U.S. glaucoma growth embedded in guidance to be ~30% YoY in 2026 driven entirely by iDose TR.
Epioxa FDA Approval and Commercial Launch Progress
FDA approval of Epioxa (topical corneal cross-linking without epithelial removal) announced in Q4; initial commercial launch activities underway with drug availability expected later in the current quarter. Positioned as first FDA‑approved topical, incision-free therapy for keratoconus.
Early Epioxa Market Access and Site Network Progress
Epioxa site-of-care network early deployment: O2n systems already deployed in locations covering nearly 50% of the U.S. population with a pipeline of systems expected to expand reach closer to 90%. Initial payer outreach engaged payers representing ~50% of commercially covered lives, including 4 of the top 5 commercial payers.
Encouraging Early Coverage and Coding Path
Several early positive coverage determinations reported (commercial and Medicaid). Permanent J-code submitted and expected effective July 2026; interim availability under a new technology miscellaneous J-code until then.
International and Corneal Franchise Growth
International glaucoma Q4 net sales $32.8M — up 18% reported / 13% constant currency YoY. Corneal health Q4 net sales $24.0M — up 12% YoY (Photrexa $21.4M). Management expects corneal health to grow modestly YoY in 2026 with volatility during the Photrexa→Epioxa transition.
Robust R&D and Clinical Pipeline Progress
Continued investment in R&D (> $1B invested since inception). Milestones: iStent infinite PMA enrollment completed; PRESERFLO 510(k) pivotal advancing; iDose TREX Phase IIb/III enrollment underway (Phase IIa showed IOP reductions of 8.6–10.8 mmHg through 3 months); iDose TRIO Phase IIIb commenced; iLink KC screening tool planned this year; ILution Phase II started; retinal GLK-401 FIH enrollment completed.
Capital Discipline with Operating-Leverage Target
CFO guidance to balance investments and revenues with goal of cash-flow breakeven/positive in 2026. OpEx expected to grow in the mid-teens YoY (management noted operating-leverage expectations despite increased spend for launches).
Negative Updates
Q4 iDose Sequential Deceleration and Mix Dynamics
Management noted a sequential deceleration signal in iDose in Q4 (although still positive sequential growth "north of 10%"), attributed to mix shift toward Medicare Advantage and rep incentive timing (pull into Q3 / pullout into Q4).
Epioxa Adoption Headwinds Early — Coding and Payer Friction
Initial patient access to Epioxa will be gated by site-of-care deployment and payer adoption. Use of a temporary miscellaneous J-code until permanent J-code (expected July 2026) likely to produce measured adoption and elongated approval/prior-authorization timelines in the near term.
Transition Volatility from Photrexa to Epioxa
Management expects a modest YoY cornea growth in Q1, a potential material dip in Q2 during the Photrexa → Epioxa transition (patients entering approvals but not yet treated), a flattish Q3 as J-code comes online, and a stronger exit in Q4 — indicating pronounced timing/seasonality risk in 2026 results.
Competitive and Trialing Headwinds Internationally
Company anticipates new competitive product trialing headwinds in some major international markets through 2026, expected to partially offset iStent infinite contributions and lead to high-single-digit international growth guidance for the year (vs. higher growth in select quarters).
Re-administration and Cannibalization Uncertainty
FDA labeling now allows unlimited re-administration of iDose TR in patients with healthy corneas — management says re-administration is expected but was not a material factor in 2026 guidance; uncertainty remains about potential cannibalization between TR and future TREX (duration/pricing trade-offs).
Operating Expense Increase and Launch Investment
OpEx expected to grow mid‑teens YoY (management cited operating expenses around the mid‑hundreds, which will increase investment in Epioxa launch and commercialization), creating near-term margin pressure despite planned operating leverage.
Regulatory/Coverage Risks Remain (MAC LCD Possibility)
While management views an LCD from MACs as premature and not probable today, they acknowledged it remains possible and is a risk to access for iDose TR if adverse coverage decisions were to occur.
Company Guidance
Glaukos reaffirmed FY2026 net sales guidance of $600–$620 million (midpoint implying >20% YoY growth), after record FY2025 consolidated net sales of $507.4 million (+32% vs. 2024) and Q4’25 net sales of $143.1 million (+36% reported, +34% constant currency). Management expects U.S. glaucoma to grow ~30% in 2026 driven entirely by iDose TR (iDose TR sales ≈ $45M in Q4 and ≈ $136M in 2025) with sequential quarterly growth for iDose throughout 2026; international glaucoma is expected to be high single‑digit growth (Q4’25 international sales $32.8M, +18% reported / +13% cc); corneal health is expected to grow modestly (Q4’25 corneal sales $24.0M, Photrexa $21.4M) but with a Q2 transition dip, flatter Q3 as the permanent J‑code is established (permanent J‑code expected July 2026) and a stronger exit in Q4. Management also guided to mid‑teens % YoY operating expense growth as it balances launch investments with cash‑flow goals, noted Epioxa equipment deployments already cover nearly 50% of the U.S. population (pipeline to approach ~90%), reported payer engagement representing ~50% of commercially covered lives (including 4 of the top 5), announced a $0 co‑pay program for eligible patients, and highlighted FDA approval of unlimited re‑administration labeling for iDose TR — all cited as drivers and risks reflected in the guidance.Glaukos Financial Statement Overview
Summary
Strong multi-year revenue scaling and lower leverage support the story, but the core fundamentals are still weak: sharp 2025 gross-margin compression, widening net losses, negative ROE, and continued negative operating/free cash flow.Income Statement
Revenue has scaled meaningfully over time, rising from $225.0M (2020) to $507.4M (2025), including strong 2025 growth (+8.0%). However, profitability remains a clear drag: 2025 gross margin fell to ~55.7% (down from mid‑70%s in 2021–2024), while operating and net results are still deeply negative (2025 net margin ~-37.0%). Losses also widened versus 2024 (net loss $187.7M vs. $146.4M), signaling the business is still not demonstrating operating leverage.34
Negative
Balance Sheet
Leverage looks manageable with debt to equity improving sharply to ~0.21 in 2025 (from ~0.83 in 2023), which supports financial flexibility. Total equity remains sizable ($656.2M in 2025). The key weakness is continued negative returns for shareholders (2025 return on equity ~-28.6%), and equity has declined from 2024 ($766.9M) as losses persist.62
Positive
Cash Flow
Cash generation remains challenged: operating cash flow was negative in 2025 (-$46.3M) and free cash flow was also negative (-$54.0M). That said, cash burn improved versus 2024 (free cash flow -$67.6M), and free cash flow showed a large positive growth rate in 2025 (reflecting a smaller outflow). The main concern is that the company is still funding operations with cash outflows rather than internally generated cash.38
Negative
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 507.44M | 383.48M | 314.71M | 282.86M | 294.01M |
| Gross Profit | 282.76M | 289.45M | 239.14M | 213.88M | 227.38M |
| EBITDA | -150.31M | -95.64M | -82.12M | -48.76M | -1.47M |
| Net Income | -187.69M | -146.37M | -134.66M | -99.19M | -49.59M |
Balance Sheet | |||||
| Total Assets | 893.49M | 974.76M | 940.41M | 1.07B | 1.13B |
| Cash, Cash Equivalents and Short-Term Investments | 278.76M | 318.92M | 295.43M | 352.69M | 414.05M |
| Total Debt | 139.64M | 105.87M | 383.74M | 382.91M | 383.38M |
| Total Liabilities | 237.33M | 207.82M | 478.65M | 544.16M | 541.68M |
| Stockholders Equity | 656.15M | 766.93M | 461.77M | 530.00M | 587.15M |
Cash Flow | |||||
| Free Cash Flow | -54.01M | -67.62M | -78.01M | -63.35M | -23.08M |
| Operating Cash Flow | -46.34M | -61.32M | -57.76M | -33.08M | 24.71M |
| Investing Cash Flow | -77.61M | 47.83M | 14.10M | 44.78M | -58.23M |
| Financing Cash Flow | 11.89M | 91.54M | 15.04M | 6.25M | 39.26M |
Glaukos Technical Analysis
Positive
120.89
Price Trends
115.48
Positive
103.20
Positive
98.27
Positive
Market Momentum
1.09
Negative
56.77
Neutral
89.01
Negative
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For GKOS, the sentiment is Positive. The current price of 120.89 is above the 20-day moving average (MA) of 115.79, above the 50-day MA of 115.48, and above the 200-day MA of 98.27, indicating a bullish trend. The MACD of 1.09 indicates Negative momentum. The RSI at 56.77 is Neutral, neither overbought nor oversold. The STOCH value of 89.01 is Negative, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Positive sentiment for GKOS.
Glaukos Risk Analysis
Glaukos disclosed 25 risk factors in its most recent earnings report. Glaukos reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Glaukos Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
75 Outperform | $1.86B | 27.37 | 18.31% | ― | 29.47% | 23.24% | |
68 Neutral | $3.77B | -15.72 | -17.63% | ― | 8.97% | -1024.86% | |
64 Neutral | $3.00B | 30.15 | 6.11% | ― | 7.81% | -26.32% | |
60 Neutral | $6.92B | -36.96 | -26.38% | ― | 30.38% | 47.64% | |
54 Neutral | $4.43B | -96.32 | -36.57% | ― | 25.45% | 66.62% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
45 Neutral | $1.84B | -8.47 | -97.88% | ― | 17.87% | -57.03% |
* Healthcare Sector Average
GKOS
Glaukos
120.89
2.56
2.16%
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Glaukos Corporate Events
Business Operations and StrategyFinancial Disclosures
Glaukos Reports Record Q4 Sales, Reaffirms 2026 Outlook
Positive
Feb 17, 2026
On February 17, 2026, Glaukos reported record fourth-quarter 2025 net sales of $143.1 million, up 36% year over year, driven by a 42% surge in glaucoma revenue and 53% growth in U.S. glaucoma sales, while full-year 2025 revenue climbed 32% to $507.4 million. Despite higher sales and improved non-GAAP margins, the company posted a GAAP net loss of $133.7 million for the quarter and $187.7 million for the year, heavily impacted by a $112.9 million non-cash impairment tied to the Photrexa-to-Epioxa transition.
Non-GAAP metrics showed operational progress, with the quarterly non-GAAP operating loss narrowing to $16.4 million from $18.3 million a year earlier and full-year non-GAAP operating loss improving to $57.4 million from $93.3 million, supported by robust gross margins and continued R&D investment. Glaukos ended 2025 with $282.6 million in cash and no debt, and reaffirmed its 2026 net sales outlook of $600 million to $620 million, underscoring management’s confidence that new platforms such as iDose TR and Epioxa will drive sustained growth and reinforce its competitive position in ophthalmic therapies.
The most recent analyst rating on (GKOS) stock is a Buy with a $160.00 price target. To see the full list of analyst forecasts on Glaukos stock, see the GKOS Stock Forecast page.
Business Operations and StrategyFinancial Disclosures
Glaukos Reports Strong Preliminary Q4 and 2025 Sales Growth
Positive
Jan 13, 2026
On January 13, 2026, Glaukos announced preliminary, unaudited results showing fourth-quarter 2025 net sales of about $143 million, up 36% year-on-year, driven by $86 million in U.S. glaucoma sales including $45 million from iDose TR, $33 million in international glaucoma sales and $24 million in corneal health revenue. For full-year 2025, net sales are expected to reach approximately $507 million, a 32% increase over 2024, with $299 million in U.S. glaucoma sales (including $136 million from iDose TR), $122 million in international glaucoma sales and $86 million in corneal health sales; the company ended the year with roughly $283 million in cash and no debt, reaffirmed its 2026 revenue guidance of $600 million to $620 million, and plans to report final fourth-quarter and full-year 2025 results on February 17, 2026, underscoring strong execution and momentum in its core glaucoma and corneal health franchises.
The most recent analyst rating on (GKOS) stock is a Buy with a $138.00 price target. To see the full list of analyst forecasts on Glaukos stock, see the GKOS Stock Forecast page.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.