CMS does not like using MIGS.
There is not yet any proven additional benefit (though greater longevity may eventually be proven). It's just an expensive duplication of the same benefit that can already be achieved with a stent, which is proven.
Line 1 of the LCD, Limitations of Coverage: "Minimally invasive glaucoma surgery (MIGS) is not considered a first line treatment for mild-moderate glaucoma."
They want surgeons to use drops & stents, and only if they don't work to consider a MIGS. This is the opposite of what 007 is saying.
Surgeons got annoyed in 2023 because the LCD referenced iStent by name, and that is what they all use. They've now been told they can continue using iStent, but no more doubling-up with OMNI / iTrack.
iStent outsells iTrack/OMNI by 10x... what do you think will happen when Mixed MIGS surgeons are forced to choose one?
Nova need to specify the size of their Mixed MIGS business, and stop dodging earnings calls. The silence is deafening.
On Track to Profitability, Price Target Increased (MST), page-64
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