GKOS · Glaukos Corporation

The thesis

Glaukos has become a two-launch growth company. In the third quarter of 2026, the iDose TR drug-eluting glaucoma implant and the Epioxa keratoconus therapy pushed net sales up 58% to $211.0 million, and management raised 2026 guidance to $775–785 million. Two things settle the case: whether Medicare's contractors finalize a restrictive coverage rule for iDose TR, and whether Epioxa keeps growing past its first full quarter of reimbursement.

The company reported on 28 October 2026. It also gave preliminary 2027 net sales guidance of $1 billion, and management said on the call that this figure already includes downside scenarios for a restrictive iDose coverage rule. The narrative is accelerating. The report is two days old, and at least eight brokers raised price targets on 29 October 2026, per Benzinga.

The shares are crowded after the move. They closed at $242.48 on 29 October 2026, a 52-week high, with a 14-day relative strength index (RSI) of 92.9 and a three-month gain of 41.9% on adjusted daily closes. Those numbers describe the price, not the business. The company's view is that the next leg of the business case runs through reimbursement and the pace of the Epioxa rollout.

Bullish and bearish views on Glaukos Corporation

The bull case on Glaukos Corporation (GKOS), in brief: Guidance raised by $90 million at the midpoint. The bear case: Medicare coverage for iDose TR is unresolved.

Bull case

• Guidance raised by $90 million at the midpoint. The 28 October 2026 release lifted 2026 net sales guidance to $775–785 million, up from $680–700 million. That range had itself been raised on 29 July 2026 from $620–635 million.
• iDose TR is now a large product line. iDose TR sold about $76 million in the third quarter, per the 28 October 2026 earnings call. Management now expects full-year iDose revenue in the low $280 millions, against a prior $275–280 million.
• Epioxa ramped fast once reimbursement began. Epioxa sold about $53 million in its first full quarter after its J-code (J2789, the Medicare billing code) took effect on 1 July 2026. Corneal Health revenue rose 154% to $59.0 million. On the call, management cited coverage of about 90% of commercial lives and more than 80% of Medicaid lives.
• Margins and the balance sheet strengthened. Non-GAAP gross margin was 87.7% in the third quarter, up nearly 400 basis points year on year. Cash and investments rose to $339.8 million, from $289.3 million at the end of the second quarter, and the company reports no debt (28 October 2026 release).
• New clinical data supports iDose TR. A randomized Phase 4 trial of iDose TR plus cataract surgery against cataract surgery alone met its primary endpoint, per the 28 October 2026 call. It showed an 11.1 mmHg mean eye-pressure reduction and a 3.6 mmHg incremental effect at three months.

Bear case

• Medicare coverage for iDose TR is unresolved. Medicare administrative contractors drafted proposed local coverage determinations (LCDs) for iDose TR in May 2026. They have one year from the draft to finalize or drop them, and management gave no update on 28 October 2026. In the third quarter, iDose growth came partly from fee-for-service Medicare patients in one contractor's jurisdiction, per the call.
• Profit is thin on a GAAP basis. Third-quarter GAAP net income was $2.0 million, or $0.03 per diluted share, against non-GAAP earnings of $0.47. The quarter carried $14.1 million of expense tied to a resolution agreement with the Regents of the University of California and $5.9 million of other litigation costs (28 October 2026 release).
• The price has run past several targets. The 29 October 2026 close of $242.48 is above the raised targets from Wells Fargo ($226), Stifel ($225), BTIG ($234) and Piper Sandler ($240), per Benzinga. It sits only modestly below Citigroup ($247), HC Wainwright ($248), Needham ($251) and Truist ($255).
• Epioxa is early in its rollout. Management described the buy-and-bill channel, in which sites purchase the drug and then bill payers, as early on 28 October 2026. It said prior-authorization delays are typical of early rare-disease launches. One full reimbursed quarter is too short a history to show a steady growth rate.

Price setup

The shares closed at $242.48 on 29 October 2026, their 52-week high, on adjusted daily closes. On the morning after the report, the shares traded at $210.01 in pre-market dealing, up 15.75%, and later rose as much as 30.8% to $237.26 during the regular session, per Benzinga. Benzinga put the market value at $10.7 billion at that price.

The 14-day RSI of 92.9 is far above the 70 level usually read as overbought, and the 41.9% three-month gain leaves the price well above its recent averages. The gap area matters most. A close back below the $210.01 pre-market level would mean the shares had given back most of the reaction to the report. The analyst targets raised on 29 October 2026 range from $225 to $255, so the stock already trades inside the range of Street targets.

Catalysts, next 30 days

• On or before 9 November 2026: The third-quarter Form 10-Q, which management said it expects to file by that date. It gives the full detail behind the litigation charges and the revenue lines.
• ~31 December 2026 (est.): Phase 2 results for the axitinib tyrosine kinase inhibitor retina program, and Phase 2 top-line results for the iLution Demodex blepharitis program. Management guided both to year-end on 28 October 2026.
• ~2027-02 (est.): The fourth-quarter 2026 report, which tests the $775–785 million guide and Epioxa's second full reimbursed quarter.

Elapsed catalysts

• Any date before ~2027-05 (est.): Medicare contractors finalize or withdraw the iDose TR LCDs. A final rule carries a 45-day period before it takes effect, per the 28 October 2026 call. No date has been announced. (passed 3d ago)

What would change the view

A final Medicare LCD that sharply restricts iDose TR coverage in the fee-for-service jurisdictions driving its growth would break the case. So would an Epioxa quarter that fails to grow sequentially from about $53 million. Either would undercut the $1 billion 2027 outlook, which management built partly on both products. A cut to the 2026 sales guide at the fourth-quarter report would end the thesis outright.

On price, a daily close below $205 would put the shares under the $210.01 level where they traded before the regular session on 29 October 2026. At that point the market would have rejected most of the post-report repricing, whatever the fundamentals show.

What it trades with

Glaukos's drivers are specific to the company: Medicare reimbursement for iDose TR, and payer and site rollout for Epioxa. Its link to medtech peers such as DexCom (DXCM) and Natera (NTRA) is loose. The closer influences are ophthalmology reimbursement policy and the surgical market for minimally invasive glaucoma surgery (MIGS), which management cited as a factor in its 2027 guide. As a high-growth, high-valuation healthcare name, the shares are likely to move with broader growth-stock sentiment and interest rates during sell-offs. That linkage would weaken if the stock held its post-report level through a broad growth-stock decline.