They specifically cover the "interventional" treatment logic in their LCD. These studies are often done on people who had sub-threshold IOP anyway. We cannot take people who already have low IOP, conduct MIGS, then say: "Look! Low IOP... it worked!!"
Drops are not "ineffective" and filtering surgery isn't "risky". These are the standard. Safe and effective, proven by science. Some people have trouble squeezing eye drops without blinking. But the current evidence base for trabeculectomy is better than MIGS.
The thesis about profitability and being fully funded is dependent on extrapolating current trends into the future.
Just to maintain revenue at the forthcoming Dec24 level, you will either need:
- Every Mixed MIGS operation that EYE currently derives revenue from to switch to iTrack-only; or...
- The price increase on iTrack-only in ASCs to offset any loss in the Mixed MIGS business, by causing a commensurate number of additional operations to be performed. (EYE will not necessarily receive +30% on their current level of ASC business; that money goes to facilities).
So we have a potential revenue cliff-edge in January, if/when the Mixed MIGS business is lost to iStent. We cannot quantify this loss, nor the alleviating effect of the price increase, because Nova won't give us any details.
I see why people are interested, but IMO this is not such a clear opportunity once you look under the hood. There's more uncertainty here than Nova wants you to believe, when they underline and bold phrases which are favourable to them, but are also misleading.
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