Glaukos Corporation Wells Fargo 21st Annual Healthcare Conference

Thanks for having us, Larry.

Yeah. Well, first, let me say, it's nice to start one of these conferences and talk about corneal health first. I think it's a nice shift for us and for investors. Obviously, you referenced the second quarter results. We were pleased, obviously, with the start there, but it really was just that. You're talking about the first full quarter of commercial availability and a lot of just miscellaneous J-code cases that managed to sneak through before the end of the quarter. But to be able to produce an incremental $11 million of revenue from Epioxa was a good outcome for the second quarter, for sure. Today, now, as you make your way into the third quarter, as we've talked about coming into it, you have the J-code that went effective July 1st, and that's effectively a reset for all of those claims and the processes around those.

Any time you're dealing with what is predominantly a major medical-based claim adjudication, you're going to look at processes that, at best case, are kind of 60-ish type days to get through once it gets to the pharmacy side of the equation and seeking the approvals on that J-code. So we're now in the early days of September, and you're kind of just getting past that, and we're seeing, obviously, the claim processing start to make its way through. We're identifying where we've got now outlying situations, whether it's information that's being requested or payer logistical hitches or all the things that inevitably come up that slow you down, and we're knocking those and trying to tackle those one issue at a time.

But we're making progress, and I feel good about the building blocks that are there in place and the things that we've talked about on the second quarter call in terms of our site of care network, in terms of our payer access, if you will, and the coverage from that perspective. It's about the less fun stuff, just the blocking and tackling on a day-to-day basis, and getting these patients access to the therapy.

What's the status? Yeah. We did announce our intention to sunset Photrexa in the third quarter, and we've done just that.

That doesn't mean there's not some inventory still either in the channel or a small portion that remains to be allocated. We do continue to have the drug available for a limited access program where a physician determines that the epi-off based procedure is warranted for a handful of reasons. We want to make sure we still have a limited supply to support that, and we'll continue to do that. But otherwise, it is sunset commercially.

I think I misspoke on that.

You did. too. Sorry. I will clean that up here for the public record.

I think we have historically said 65%-70% is kind of the place, and I do not see anything that would deviate from that for right now. It is a combination of our copay assistance programs as well as the mix between Medicare and, or sorry, Medicaid and 340B hospitals. We are not really seeing anything in context from that perspective, payer requests or other things where we have to have more significant gross to net deductions. Candidly, the focus right now, we have got general payer acceptance, as we talked about. Even on the second quarter call, we were north of 120 million lives commercially that had access pathways. That has only continued to grow. It would not surprise you. A growing base of Medicaid-covered lives. We will talk more about that in the coming quarters as that metric becomes more relevant.