Sight Sciences, Inc. Q3 FY2024 earnings call

• Strategic Initiatives: Developed OMNI and TearCare technologies for glaucoma and dry eye. OMNI has been used in over 200,000 glaucoma procedures, and TearCare in over 60,000 dry eye procedures.
• Medicare Coverage: Final local coverage determinations (LCDs) confirm continued Medicare coverage for cataract surgery procedures with MIGS procedures, but there's an impact on combination MIGS procedures (approx. 10% of billed procedures affected).
• Commercial Organization: Made organizational changes to enhance execution, including reengaging accounts and optimizing sales force performance.
• Dry Eye Market Access: Advancing work on reimbursement, with a three-pronged strategy including developing best-in-class tech, strong clinical outcomes, and effective market access. The budget impact analysis for TearCare is expected soon.
• Leadership Hires: Added Dr. M.K. Raheja as EVP of Research and Development and Brenton Taylor as EVP of Operations to advance strategic plans.

Surgical Glaucoma: Total revenue was $18.6 million in the third quarter of 2024, representing a 1% increase compared to the third quarter of 2023 and a sequential decline of 8% compared to the second quarter of 2024. This segment contributed significantly to overall revenue. Dry Eye: Dry eye revenue was $1.5 million in the third quarter of 2024, down 4% compared to the third quarter of 2023 but ahead of expectations. The revenue contribution from dry eye was a smaller portion compared to surgical glaucoma.

• Revenue Outlook: Maintains full-year 2024 revenue guidance of $81 million to $83 million. Expects double-digit surgical glaucoma revenue growth in Q4 2024 but faces headwinds from LCDs. Dry eye revenue expected <$0.5 million in Q4 2024, with growth anticipated in 2025 via market access wins.
• Operating Expenses: Revises adjusted operating expenses guidance for full-year 2024 to $104 million to $106 million from prior range of $107 million to $109 million.

• LCD Impact: Limitations on combination MIGS procedures pose a short-term headwind to surgical glaucoma growth.
• Medicare Device-Intensive Status: OMNI did not receive device-intensive status in the final 2025 Medicare payment rule, with ongoing evaluation of CMS' determination.
• Reimbursement Dependence: Dry eye's growth relies on securing favorable reimbursement and market access, which is uncertain.

Q: Asked about sequential decline in dry eye sales and confidence in surgical glaucoma sequential step-up despite LCD headwinds.

A: Alison Bauerlein noted seasonality and targeted plans; Matt Link emphasized clarity from LCD finalization and OMNI's efficacy.

Q: Inquired about device-intensive calculation and omni's qualification.

A: Matt Link explained the claim data process and that omni is believed to qualify but awaits public claim data details.

Q: Asked about MIGS volumes, impact of LCD restrictions, and 2025 guidance.

A: Alison Bauerlein stated no 2025 guidance yet, and Matt Link discussed omni's comprehensive procedure as a unique value proposition.

Q: Questioned free cash flow, investment balance, and dry eye performance ahead of price increase.

A: Alison Bauerlein discussed cash burn reduction and working capital improvement; Paul Badawi emphasized omni's comprehensive nature. Alison Bauerlein also noted dry eye performance was driven by stocking ahead of price increase.

Q: Inquired about dry eye claims, expansion, and standalone opportunity in glaucoma.

A: Alison Bauerlein and Matt Link discussed early claim stages and payer conversations; Paul Badawi and Matt Link talked about standalone glaucoma opportunity and real-world data development.

Q: Asked about SION, glaucoma pipeline, and TearCare payer win impact.

A: Alison Bauerlein noted SION is a complementary product; Paul Badawi discussed glaucoma pipeline progress. Ali Bauerlein discussed TearCare's pre-existing infrastructure and quick ramp potential post-payer wins.

Q: Questioned surgical glaucoma 2025 growth target confidence.

A: Ali Bauerlein stated 2025 plans are still being vetted and specifics will be provided later.