Harrow Q3 2026 Earnings Call Transcript

Harrow (NASDAQ:HROW) reported third-quarter financial results on Tuesday. The transcript from the company’s third-quarter earnings call has been provided below.

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Summary

Harrow achieved a record third-quarter revenue of $99.3 million, marking a 41% sequential and 39% year-over-year increase. Branded revenue significantly contributed, with VEVYE, IHEEZO, and Triessence leading sales.

The company reaffirmed its full-year revenue guidance of $350-$365 million, expecting strong Q4 performance driven by products like VEVYE, IHEEZO, and the new contributor Tyrvaya.

Harrow’s strategic initiatives included restructuring its commercial organization into four specialized teams and launching Harrow Rx to streamline product access.

Key products like VEVYE and Triessence showed substantial growth, supported by expanded sales teams and improved prescription economics.

Harrow’s adjusted EBITDA outlook was updated to over $40 million for the full year, with strategic investments and accelerated R&D impacting near-term profitability but positioning for future growth.

Full Transcript

OPERATOR

Good morning and welcome to Harrow’s third quarter 2026 earnings conference call. My name is Michelle and I will be your operator for today’s call. At this time all participants are in a listen-only mode. Later we will conduct a question-and-answer session. As a reminder, this conference is being recorded. I would now like to turn the call over to Mike Viega, Vice President of Investor Relations and Communications for Harrow. Please go ahead.

Mike Viega (Vice President of Investor Relations and Communications)

Thank you, operator. Good morning and welcome to Harrow’s third quarter 2026 earnings conference call. My name is Mike Viega, Vice President of Investor Relations and Communications. The company’s remarks may include forward-looking statements within the meaning of federal securities laws. Forward-looking statements are subject to numerous risks and uncertainties, many of which are beyond Harrow’s control, including risks and uncertainties described from time to time in its SEC filings, such as the risks and uncertainties related to the company’s ability to make commercially available its FDA-approved products and compounded formulations and technologies, and FDA approval of certain drug candidates in a timely manner or at all.

For a list and description of those risks and uncertainties, please see the Risk Factors section of the company’s most recent annual report on Form 10-K and subsequent quarterly reports on Form 10-Q filed with the Securities and Exchange Commission. Harrow’s results may differ materially from those projected. Harrow disclaims any intention or obligation to update or revise any financial projections or forward-looking statements, whether because of new information, future events or otherwise.

This conference call contains time-sensitive information and is accurate only as of today. Additionally, Harrow will refer to non-GAAP financial metrics, specifically adjusted EBITDA. A reconciliation of any non-GAAP measures with the most directly comparable GAAP measure is included in the company’s earnings release and letter to stockholders, both of which are available on the website. Joining me on today’s call are Mark L. Baum, Founder, Chairman and Chief Executive Officer; Andrew R Boll, Chief Financial Officer; Patrick Sullivan, Chief Commercial Officer; and Amir Shojaei, Chief Scientific Officer. With that, I would like to turn the call over to Mark. Mark.

Mark L Baum (Chief Executive Officer)

Thanks, Mike, and good morning, everyone. Last quarter I was clear our priority was turning the demand we were building into revenue in the third quarter. That’s exactly what happened, and it’s the clearest sign yet that the second half is playing out as we expected. Demand is growing across key products, our expanded commercial team is getting more productive every month, and we’re reaffirming our full-year revenue guidance. We’re continuing our momentum and I expect the fourth quarter to be the strongest quarter in Harrow’s history.

I also believe you will see our momentum continue into 2027. You see it in VEVYE, which delivered record revenue as our expanded sales force matures and begins to deliver improved prescription economics. You see it in Triessence, which had its strongest quarter under Harrow ownership. And you see it in IHEEZO, which heads into its historically strongest quarter with new clinical evidence from Qell. An important part of the story is how we’re organizing our commercial business to maximize the opportunities ahead. With the addition of Tyrvaya, we realigned our commercial organization into four focus teams: Ocular Surface Disease, Retina, Surgical, and Access Plus, each built around the same prescribers, care settings, and purchasing dynamics. Our largest team now serves one of the largest opportunities we have, namely Ocular Surface Disease, including dry eye, where we now own two completely differentiated products in the category.

Our new commercial structure allows our representatives to promote a broader portfolio of complementary products to the same customers, making every relationship and every sales call more productive. We’ve always benefited from commercial leverage, but this organization takes that advantage to another level. And with the launch of Harrow Rx, we’re making it even easier for those customers to access our entire portfolio through a single destination integrated into their existing workflows, primarily their EMRs. The GMELP program, which we launched over 10 years ago, has been a true labor of love and is the first program Harrow took from idea to now, in a matter of weeks, an NDA filing. When our NDA is accepted for review and we receive our PDUFA date, which will hopefully be in 2027, it will be a tremendous accomplishment for the entire Harrow family and for our stockholders alike.

I am thrilled that we will soon hopefully have the opportunity to reduce or eliminate the need for IVs and opioids in cataract surgery for millions of Americans each year. And Amir is going to cover our NDA filing a bit more shortly. In summary, today Harrow has more products, stronger commercial capabilities, and more ways to grow than at any point in our history. But we’re not done building. We’re not done building, but the emphasis has shifted from building the platform to excellence in commercial execution and delivering financial results. With that, I’ll turn it over to Andrew to walk through the financials and our outlook now. Andrew,

Andrew R Boll (Chief Financial Officer)

Good morning, everyone, and thank you for joining our call today. Third quarter revenue was a record $99.3 million, up 41% sequentially and 39% year over year. Branded revenue was $83.5 million, up about 62% year over year, and made up roughly 84% of total revenue. VEVYE generated $39.7 million, IHEEZO $25.3 million, and Triessence $10.7 million of revenue. Compounded revenue was $15.8 million. VEVYE was a clear example of demand converting to revenue. Revenues grew 35% sequentially, outpacing prescription growth as our changes to prescription economics took hold. GAAP gross margin was 75%, consistent with a year ago and an improvement from Q2 gross margins of 71%. Still, our gross margins are lower than we expected and is largely a result of lower gross margins coming from our compounding revenue and product mix.

SG&A was $53.1 million, reflecting our expanded commercial organization, and roughly flat quarter over quarter. R&D was $10.3 million, which is a little higher than we expected but the result of programs accelerating and coming in ahead of schedule, primarily reflecting GMELP NDA labeling work and clinical studies for IHEEZO and Triessence. We also recorded a one-time $5 million gain that is reflected as other income in our statement of operations.

This is related to the resolution and settlement of our litigation with OSRX dating back several years. GAAP net income was $9.8 million and adjusted EBITDA was $21.2 million versus an adjusted EBITDA loss of $1.2 million in Q2. We ended September with $75.3 million in cash and cash equivalents. Turning to our outlook, we are reaffirming full-year revenue guidance of $350 million to $365 million. That implies Q4 revenue of roughly $136 million to $151 million, or approximately 37% to 52% sequential growth. It’s a substantial step up and here’s why we believe it’s achievable. Over the past two years, Q3 to Q4 revenue growth averaged approximately 30%. This year we believe we’re entering the fourth quarter with considerably more momentum. Across our portfolio, VEVYE is benefiting from expanded insurance coverage in a large sales force and improving prescription economics.

IHEEZO is entering its historically strongest quarter while Triessence continues to gain traction in ocular inflammation supported by our expanded surgical team, and biovin sales are growing. On top of that we have a new revenue contributor with Tyrvaya, which began contributing revenue in the fourth quarter. Taken together, these drivers give us confidence in our ability to deliver a strong finish to the year. Turning to profitability, we’re updating our full-year adjusted EBITDA outlook to more than $40 million, including more than $33 million in the fourth quarter, compared with our previous guidance of $80 million to $100 million. Let me provide some context for that change. Our first half revenue shortfall and lower gross margins than we anticipated put us behind our original EBITDA expectations. At the time, we still saw a path to achieving our guidance, but it required a very strong second half including a favorable mix of higher-margin products.

We made meaningful progress in Q3, delivering $21.2 million in adjusted EBITDA and bringing our year-to-date total to $7.3 million. But to reach the low end of our previous guidance, we would still need approximately $73 million in Q4 alone, and our third quarter performance was simply not where we needed it to be. As we work through our fourth quarter forecast, several things have also changed. We’re moving forward with our GMILT NDA submission this year, which brings the FDA filing fee and preparation-related expenses into Q4. We’ve also accelerated spending across several clinical and development programs including Qell, the Phase 3 Triessence study, and YoJo, and we’re absorbing transition costs and purchase accounting impacts associated with the Tyrvaya acquisition.

Mark and I believe accelerating these initiatives is the right decision for the business, even though it affects near-term profitability. Rather than depend on unusually favorable fourth-quarter product mix to offset those additional costs, we’ve established a more conservative adjusted EBITDA outlook that reflects our current expectations. Importantly, we’re providing a floor rather than a range. Our expectation is for more than $33 million in fourth quarter adjusted EBITDA, and there is room to outperform that level depending on how the quarter develops.

We’re confident in the underlying momentum of the business and believe these investments will position us well heading into 2027. I’ll now turn things over to Pat to discuss some key commercial achievements and metrics.

Patrick Sullivan (Chief Commercial Officer)

Thanks, Andrew, and good morning. Starting with VEVYE, total prescriptions grew 17% sequentially and 83% year over year. Two factors stand out. First, we more than doubled the field team behind VEVYE this year, and newer representatives are becoming more productive in their territories. The second is economics. We focused on getting more patients onto covered therapy and it’s working. Covered prescriptions are rising with encouraging progress among Medicare patients that continued into October. That’s improving the economics of every Vevye prescription and we keep adding coverage. We recently expanded our coverage through a major national plan covering approximately 10 million lives effective January. That’s our third coverage win this year and strengthens our position heading into 2027.

Tyrvaya’s integration is also progressing well. Approximately 40 experienced sales representatives and their managers joined us from Viatris and are already calling on many familiar practices. We’re beginning to see prescription demand grow under Harrow, now shifting to Iheezo. Unit demand was 62,210, up 21% year over year. It declined about 5% from a record Q2 demand, reflecting both historically slower third quarter procedure activity and elevated practice purchases of the prior single-unit presentations late in Q2.

That said, we expect sequential demand growth and believe Q4 can set a new quarterly record. The underlying Iheezo trends are strong, our customer base continues to grow and new retina account wins along with deeper penetration of existing accounts have more than offset the units we lost when pass-through status expired in the ASC setting. As Amir will discuss next, Quell gives our retina team something we’ve never had before: prospective randomized data on Iheezo and intravitreal injections, including encouraging findings on patient comfort and tolerability for patients who return for injections month after month.

Now focusing on Bioviz. Bioviz went wide before it went deep. More practices placed initial orders than we expected, but many started small. While validating reimbursement and purchasing, early reimbursement experience has been favorable. Several accounts have reordered and demand strengthened through September and into Q4. Our focus is turning initial orders into larger, more consistent purchasing—learnings that will inform the Optiviz launch in 2027.

Let’s discuss Triesence. Unit demand reached 20,022, up 37% sequentially and 110% year over year, our strongest quarter since we relaunched the product. Ocular inflammation is a key driver and we’re especially encouraged that practices are beginning to build Triesence into their treatment protocols, which tends to make use and unit volumes more consistent and predictable over time. Our fourth quarter priorities are clear: build on Vevye’s momentum and improving economics, accelerate Iheezo’s growth in its strongest season, deepen Bioviz adoption, deliver Tyrvaya’s first quarter under Harrow and continue to grow Triesence and the rest of our portfolio. We’re entering the quarter with more ways to win than ever and our team is ready. With that, I’ll turn it over to Amir.

Amir Shojaei (Chief Scientific Officer)

Thanks, Pat. I’ll cover Quell and MKO Melt. Today we’re reporting top-line results from Quell, our phase four multi-site randomized double-masked study comparing Iheezo with routine anesthesia in 231 patients undergoing intravitreal injections. Let me start with the primary endpoint. Quell did not meet its primary endpoint of non-inferiority. The primary endpoint was successful ocular surface anesthesia, defined as a pain score of 0 meaning no pain or 1 meaning pressure only, both immediately before and immediately after the injection.

That was achieved in 55.2% of Iheezo patients compared with 59.7% receiving routine anesthesia and the upper bound of the 95% confidence interval exceeded our prespecified 12-point margin. The design context matters here. The study was designed assuming 88% of patients in each arm would achieve success. The actual observed rate overall was only about 57%. At that rate, roughly 114 patients per arm could not produce a confidence interval narrow enough to fit within a 12-point margin. In other words, the primary endpoint was inconclusive. The study did not establish that Iheezo was non-inferior, but it also did not establish that Iheezo was inferior.

For retina specialists and their patients, patient comfort, pain and safety are critically important. That is where Quell’s exploratory secondary and safety findings are encouraging. Keep in mind that routine anesthesia in this study involved proparacaine drops followed by a potent subconjunctival lidocaine injection—essentially an injection before the injection. Despite that difference in how anesthesia was administered, cumulative pain scores immediately before and after the intravitreal injection were identical at 2.0 in both groups.

Where we began to see differences was after the procedures. Patients receiving Iheezo reported lower pain in the hours following the injection, with cumulative pain scores through 24 hours of 2.9 compared with 3.7 for routine anesthesia. We also observed encouraging findings related to ocular surface health. Patients receiving Iheezo had less ocular surface staining following the procedure with a mean increase of 1.7 compared with 3.2 for routine anesthesia.

This suggests less damage to the ocular surface with Iheezo. Importantly, staining in the untreated eye remained unchanged in both groups. And finally, looking at patient-reported dryness symptoms as measured by the SPEED questionnaire, patients receiving Iheezo experienced less worsening on the day of the injection and by 24 hours their symptoms had improved from baseline. To me, this illustrates why the primary endpoint doesn’t tell the whole story. It measured whether patients met a prespecified threshold at two time points but didn’t fully capture differences in pain and ocular comfort over the hours that followed. We also observed fewer adverse events with Iheezo—27% vs 47%—with no serious adverse events in either group. I would like to extend our sincere appreciation to all the investigators and all the patients who made this study possible.

Overall, I’m encouraged by these data. Taken together, they provide valuable new clinical evidence about Iheezo in intravitreal injection procedures. And we look forward to presenting the full results at the Hawaiian Eye and Retina conference in January 2027. On MKO Melt, we completed our pre-NDA meeting with the FDA and remain on track to submit the NDA later this month or the beginning of next month, which is meaningfully earlier than we originally expected. If approved, MKO Melt could become the only on-label product for sedation during cataract surgery, giving patients effective sedation without an IV line or opioids in one of the most common surgical procedures in the U.S. With that, I’ll turn the call back to the operator for questions.

OPERATOR

Thank you. To ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again. And our first question will come from Chase Knickerbocker with Craig-Hallum. Your line’s open.

Chase Knickerbocker (Analyst)

Good morning. Thank you for taking the questions. Maybe just first on Vevye, congrats on the continued progress there. Could you just discuss in further detail some of those business changes that you made in September in light of trying to improve net realized ASP from the product? Thanks.

Mark L Baum (Chief Executive Officer)

Hey Chase, this is Mark. Thanks for the question. You know, I appreciate the question, but we’re in an intensely competitive market and I’m going to elect to not answer the question. Unfortunately, we don’t want to reveal the specific algorithm that we use in order to improve Vevye economics.

Chase Knickerbocker (Analyst)

Understood. Maybe just if you expect to see that impact kind of notably in Q4 from those business rule changes.

Mark L Baum (Chief Executive Officer)

Well, I can tell you without question that we are seeing improvement certainly in Medicare-covered prescriptions, and really I think across the board. The number of offices that are willing to submit prior authorizations for their patients in order to access Vevye is actually much higher than one would think. And critically, the number of prior authorizations that are getting approved even when there isn’t coverage is significant. So this is, I would say, over the last 60, 75 days, the first real concerted effort that our team has had in order to shift the ratio of covered to cash-pay prescriptions.

And as we said on the call, the data is extremely encouraging. The Vevye economics are certainly improving. They did in the third quarter and I think you’ll see that happen in the fourth quarter as well. Andrew, do you want to add to that?

Andrew R Boll (Chief Financial Officer)

Nothing to add, Mark.

Chase Knickerbocker (Analyst)

And then just on as far as where you think we are from a standpoint of that expanded commercial team as far as productivity for Vevye, obviously the volume growth remains impressive. And then kind of the, you know, kind of foot on the gas that the new Tyrvaya reps kind of provide to the overall franchise. And then secondly there just last from me, Mark, as you think about that coverage win in Q1, should we think about the impact there being similar to the impact we saw to Q1 from the CVS win, where we can kind of buck some seasonal trends of volumes in Q1?

Mark L Baum (Chief Executive Officer)

Sure. I’m going to take the second question because as you know, I mean, part of the reason why we had a meaningful miss in the first half of this year, and I said this in the letter to stockholders, is because of the challenges that we had from a market access perspective with that big coverage win. I don’t believe you’re going to see those same issues with this new coverage win beginning next year. In fact, you know, I don’t want to guarantee it, but I can almost promise you that we won’t see that same level of impact.

So this is a big win and you’re going to see, I think, a greater shift once again from cash-pay prescriptions to covered prescriptions. Our economics overall on a covered prescription are meaningfully higher than they are on a cash-pay prescription. So we’re very excited about, you know, not only this recent coverage win, but the other coverage wins we’ve had with even smaller plans. So we’re making real progress. We promised that we would make progress on covered prescriptions.

I think we’re meeting that promise and I think you’ll see continued progress over on coverage for Vevye in 2027. That would be a new prediction. I think you’ll see more coverage for Vevye. There seems to be some good momentum there. In terms of the productivity of the sales force, Pat, you want to jump on that?

Patrick Sullivan (Chief Commercial Officer)

Sure. Thanks, Mark, and thanks for the question. We’re very excited and bullish on our new ocular surface disease team that’s out there representing Harrow’s portfolio. I think the products that they’re representing really offer a whole suite of solutions to the ophthalmic community and really kind of align with our vision of being the preferred partner moving forward. You know, our combined team now really is early days in the process, but I would say the way we’ve designed our footprints and our engagement plans, I think early days, but very, very positive on what we’re seeing and the trends, early feedback from physicians, and ultimately the integration is going smoothly. So we’re very encouraged with Q4 on what we’re seeing early days and look forward to good results as we build upon Q3.

Chase Knickerbocker (Analyst)

Thank you guys.

Mark L Baum (Chief Executive Officer)

That’s great. I think I’m excited because if you think about where we were at the beginning of the year in terms of the number of key account managers covering VIVI versus today, it’s more than tripled. When you think about the number of reps that were covering Turvaya before Harrow acquired it, relative to today, it’s essentially doubled. And then on top of all of that, two other really important products that we’re seeing momentum with in terms of prescription volumes are Verkasia and Nadasen.

And now housed within that ocular surface disease team are those two products. And so we now have all of those reps and those are not hard-push sales. And when you have fungal infections and this is the only FDA-approved product for that condition, docs just simply need to know how to get access to Nadison. When patients have severe allergies, children have severe allergies, and doctors want to not prescribe steroids for those patients, this is really the only steroid-sparing product for Kasia, and so our reps are now letting them know about its availability.

So we have a lot more people providing that access information. And I think you’re going to see those big four products, the biggest being VIVI, really leverage this increased sales force.

OPERATOR

Thank you. And our next question is going to come from Lachlan Hanbury Brown with William Blair. Your line’s open.

Lachlan Hanbury Brown (Analyst)

Hey guys, thanks for the question. I guess first maybe just wanted to follow up on Quell and sort of elaborate on the implications for Iheso in retina. Like, are you thinking about another study or sort of where do you go from here? Do you need another study? Does this change plans to put it on the label? I guess if we could just start with your thoughts there.

Mark L Baum (Chief Executive Officer)

Yes, for us—and I’ll ask Amir to comment as well—for us, the key is medical messaging. The reason for investing in the study is, you know, not only for an amendment to the label if possible, if that made sense, but I think critically it’s medical messaging, being able to have a salesforce go out and talk about the use of our product specifically in the intravitreal injection procedure. We have not had that to date. All of the studies that were done for IHESO were done in cataract surgery.

And so now we do have a robust data set for intravitreal injections. And what we learned, I think, is that it’s pretty hard to anesthetize the eye and have a zero or one pain outcome with not only IHESO but with an injection of lidocaine. It’s not easy. And if you look at the data, I mean, you know, we were within four patients or four percentage points of being equivalent to an injection—sort of mainlining the anesthesia into the eye. So I was quite proud of the performance of the drug.

But the key for us are those secondary endpoints: being able to go out to an office and to say, look, your patients will have less pain after the injection from hours 4 to 24 hours, better ocular surface staining, and far fewer adverse events. We can now confidently, legally say that. Amir, you want to add anything to that?

Amir Shojaei (Chief Scientific Officer)

The only thing I’ll add is currently we don’t have any plans for a second study or further studies in this line. That said, we do have quite a few ongoing studies with investigator-initiated trials within the IHESO franchise.

Lachlan Hanbury Brown (Analyst)

Maybe as a second question here, I noticed some comments in the 10-Q about how the licensing of Tivia potentially breaches certain parts of the VBI licensing contract with novaleak. Just wondering, like, what the potential outcomes there could be. Like, could this ultimately require divesting Tyvaya? I realize you probably can’t say much, but can you give us any kind of clarity on what this could mean?

Mark L Baum (Chief Executive Officer)

Yeah. Well, first let me just say novaleak and Harrow has been a marriage made in heaven. We’ve been a phenomenal partner to them, they have been a phenomenal partner to us. And if you look at the growth in VIVI units and the progress that our team has made with that product, I think it’s very difficult to conclude otherwise. It’s just been a phenomenal relationship on both sides. As far as TRVIA goes, we are under confidentiality. We’re in active discussions with them and I think we believe, and I also think they believe, that the addition of all of the salespeople, the investments that we’ve made as a result of the Trvia acquisition, really do benefit sales of VIVI. And so we’re going to work through this process. And I would bet that after we’re done, we’ll probably have a stronger relationship with our partners at novaleak than we do today.

OPERATOR

Thank you. And our next question will come from Steve Seedhouse with Cantor. Your line’s open.

Steve Seedhouse (Analyst)

Great. Thanks so much for taking the question. Good morning. I wanted to dig in on bioviz a little bit. It sounds like you had a pretty defined internal model just in terms of what your expectations for that launch were going to be, and you mentioned more breadth, but maybe not as much depth early on from an order standpoint. So I was hoping you could just expand on that, maybe walk us through sort of going forward what that means. And then I’m also curious to know what you’ve learned so far, how that sort of affects your expectations for the Optuviz launch next year.

Mark L Baum (Chief Executive Officer)

Well, I’ll ask Pat to comment in a second, but what I would say is, you know, when you launch a biosimilar into a fairly competitive category, to be clear, you really don’t know what the uptake is going to be. We have very strong relationships in retina. We have an incredible retina team. So the members of the Harrow family that are on the retina side of things are just extraordinary in their productivity, the relationships that they have, and the trust that they’ve built with their customers over many, many years—and in most cases, certainly well before they even joined the Harrow family.

But you’re right, we were an inch deep and sort of a mile wide on the launch. That can be troubling on the one hand. But the reality is we had a lot of doctors, many more doctors, purchasing the product than we had actually initially modeled. So the question is, can you get pull-through after their initial purchases? And they’re not going to give you that revenue opportunity, those volumes, until they’ve gone through sort of the same buy and bill cycle that we’ve seen with Iheso and that we’ve seen with Triessense and other products that we sell in the buy and bill category.

And so after they had gone through that cycle, we did see—and are seeing today—that follow-through purchasing. And I think that’s the most important factor that I can convey on this conference call with respect to bioviz: we are getting those follow-through purchases. And I think in the fourth quarter we’re probably, you know, well ahead of our model, whereas in the third quarter we were somewhat behind. But the opportunity to sell more units to more customers can certainly allow you to make up ground quickly.

Pat, do you want to add to that?

Patrick Sullivan (Chief Commercial Officer)

Sure. Thanks, Mark. And thanks for the question. As Mark mentioned, I think, you know, the early stages of the launch in Q3, I think we garnered an awful lot of learnings. I think one of the unique things that Harrow has is the ability to show up unlike other organizations in the retina space with the biosimilars; we have the ability to leverage our other products like Iheso and Triessence. So this gives us a unique engagement approach specifically with bioviz.

I think as Mark mentioned, you know, one of the things that we do know with biosimilars being interchangeable, you know, which is a real positive. So our focus is really on displacing, you know, the originator for us with bioviz. But one of the things we do see is early in the buy and bill cycle that Mark, you know, alluded to was, you know, accounts and physicians still are going to go through that process of, although a common molecule is there, they are going to go through the process of, one, validating, you know, reimbursement and all of those different details that give them further encouragement.

We are on the other side of that at this point in time and we have very clearly segmented our business in Q4 to focus on growth and, like Mark had said, to reiterate that we are seeing early signs in Q4 with acceleration building on Q3. In terms of the market, the market opportunity for Optiviz and the iA2 mig biosimilar is, in terms of volume, meaningfully higher. The number of accounts that will use OpuViz is significantly higher than those that use Bioviz.

Steve Seedhouse (Analyst)

And just to follow up on the reimbursement and net price sort of side of things for bioviz, how has that been going relative to your expectations?

Mark L Baum (Chief Executive Officer)

Andrew, do you want to comment on that? I don’t know that we can give a lot of color on net pricing, but maybe contracting progress.

Andrew R Boll (Chief Financial Officer)

Yeah, Steve, to Mark’s point, we’re not going to comment on the net pricing of the product, just given the competitive dynamics. But in regards to coverage, I think we’ve been really pleased with the coverage that we’ve been able to get on the product. I think it’s to your earlier question about learnings going into the Optiviz launch—there’s a lot of learnings, too, as part of that going into that launch on the market access side and on the payer side that I think is going to be really advantageous for us.

But so far it’s been pretty receptive with the payers. I’ve been pleased and I think the commercial team has been pleased with the uptake on the payer side.

Steve Seedhouse (Analyst)

Thanks so much.

OPERATOR

Thank you. And our next question is going to come from Tom Schrader with U.S. Bank. Your line is open.

Tom Schrader (Analyst)

Good morning. Congratulations on all the progress. Very related questions on bioviz. Do you have a clear sense of what people testing the water want to see? Is it that you help them with reimbursement? It’s that your supply chain is easy. Do you know what they’re looking for?

Mark L Baum (Chief Executive Officer)

Well, I mean we haven’t really surveyed the accounts, but by and large, on a buy and bill product, as I said, it’s the same sort of, you know, purchasing cycle that we’ve seen with Iheso, that we’ve seen with Triessense, and really all of our buy and bill products. They buy the product, but they need to make sure that if they purchase it, they’re going to get paid for it. So it’s one thing to be successful on the buy side, but remember it’s buy and bill, and the billing piece has got to come through, and that’s a key feature that they’re investigating when they make these sort of, you know, initial purchases.

And we’re seeing that follow-through, and that’s really important, and it’s showing up in the numbers in the fourth quarter for bioviz. And we’re going to take all of those learnings into 2027 when we launch Optiviz. Keep in mind, Tom, we own the largest portfolio of buy and bill products in all of ophthalmology. I don’t think any company has the number of buy and bill products that we have. So we have within our team extraordinary experience on the buy and bill side of things.

Tom Schrader (Analyst)

And then on the Quell trial, for a mixed trial like that, is the rule that if you can get it published, then you can market the data and sort of stress the pieces you wanted? Are there any rules for what you can do for a mixed trial like that? And then a quick follow-up just on Triessence, how much of the original market, when the other people had it at peak, have you now filled?

Mark L Baum (Chief Executive Officer)

Thanks. Sure. Well, I’m going to take the second question and give the first to Amir. In terms of Triessence. Triessence is being used in an area, inflammation for ocular surgery, that we know very well within our company. It’s the basis of how we started our company. We started selling compounded triamcinolone acetonide into the cataract surgery market as a compounded medication back in 2014. So we have tremendous history. That compounded product has been used in over a million cataract surgeries by thousands of ophthalmologists in the U.S. market.

So we know the market in this space extremely well and what the size is, what the addressable market is, the opportunity. Even though, you know, we reported 20,000 units in the third quarter, it’s really a very small percentage of the overall market opportunity for that product. I’ve been talking about how confident we are in Triessence for now, I guess, a couple of years. And look, the units and the volumes for the quarters following me beginning to talk about how excited I was about relaunching Triessence were not very impressive. But what I think you’re starting to see is, you know, the overall assessment that I had a couple of years ago was on track. It was just a little bit late and you’re starting to see that pickup.

It’s not easy to grow sequentially the way the unit volumes in Triessence are growing now. We have an incredible team. The surgical team has done a wonderful job, Chad and Mike and the rest of the team. And so we’re very bullish on Triessence continuing to grow. We have not really, you know, I think our penetration is certainly, you know, in the low single digits. So we’ve got a lot of headroom with Triessence. And the key factor, before I turn it over, is the clinical outcomes. The clinical outcomes, anecdotally, on the use of Triessence, all of these new use cases that are causing this increase in volume, the clinical outcomes are extraordinary. They’re outstanding. The one-day post-ops that we hear about anecdotally, and what we’re really excited about is Amir’s got this Triessence study going and we’re going to be able to once again, just like with Iheezo and the Quell study, we’re going to go from the anecdote to the actual.

We’re going to have a data set to present that I think is going to fuel further adoption of Triessence. That was a long answer, but I do want to turn it over to Amir on Quell to comment.

Amir Shojaei (Chief Scientific Officer)

Thanks for the question. I think the way I position this is we are at the infancy of the data review right now. We have top-line results. We anticipate to have the full data. As you alluded, we will have the study published and presented at that point. The whole sort of premise behind the study would be medical messaging. We have a very strong medical team and we would be messaging this across the relevant medical conferences. This study as a whole had the rigor to be a peer-reviewed journal-published study and as such we anticipate to take it to that route with the investigators involved.

So that’s our plan.

OPERATOR

Thank you. And our next question is going to come from Daniel Clark with Leerink Partners. Your line is open.

Daniel Clark (Analyst)

Great, thank you. Good morning. Just first question, wanted to ask on the 2026 revenue guide. Just curious what scenarios you’re kind of thinking about to get to the high and low ends of the range here for sales. Thank you.

Mark L Baum (Chief Executive Officer)

Andrew, do you want to tackle that one?

Andrew R Boll (Chief Financial Officer)

Yeah, I’ll do my best, Daniel. Without providing, you know, typically we don’t provide product-level specific guidance. And so we’ve kind of talked a lot about the bridge to get there in the letter to shareholders and in the deck. But, you know, we expect to see growth quarter over quarter from VIVI. We’re going to get continued contribution from Triessence, should see sequential growth from Iheezo as well. Bio visits we’ve talked a lot about in the Q&A here.

We’re seeing continued growth there heading into Q4. And Q4 is going to be a really strong quarter for that product based on the early progress we’ve seen. And then you’ve got the contribution from Tyrvaya. And I know we didn’t provide quarterly guidance on Tyrvaya, but you can read in the MD&A, we expect that product to do over $30 million of revenue next year. That product, as a pharmacy benefit product, is going to have its best quarter in Q4.

So we get the benefit of that product’s best quarter being here at the end of 2026 and contributing to revenue where we haven’t gotten that benefit earlier in the year. And then we’re always working on things, and so we’ve got some other aspects of the business on the commercial side that we’re working on that could help us push beyond the low end of the guided range.

Daniel Clark (Analyst)

Okay, got it. Super helpful. Just to follow up on Harrow Rx, just curious, you know, are there any products or particular use cases where you think this meaningfully improves provider experience? And just how you’re thinking about the opportunity from this launch would be great. Thank you.

Mark L Baum (Chief Executive Officer)

Sure. Thank you for that, Daniel. Yeah, Harrow Rx is actually a really important platform for our company in that when I go out on the road and I talk to our sales reps who are in offices every day, meet with staff in particular at these offices who have to deal with the challenges of prescribing pharmacy benefit products. You know, they’re using one specialty pharmacy for a product by a competitor. They’re using a different specialty pharmacy for VIVI, for example.

Fortunately, Tyrvaya is actually available from Fil Rx, which is our specialty pharmacy partner. But what we have to offer our offices—and this is something I hear day in and day out when I talk to our customers—they’re always surprised at the breadth of our portfolio. They’re surprised that we have Madison, that we have Verkazia, Allevro, Flarex. I can go down the list. And so what they’re interested in is a single point of access for the entirety of our portfolio in the future.

We believe that more prescribing is going to take place through these sorts of specialty hubs. If you were to get a prescription for Allevro and send it to your local CVS, odds are they don’t have that product in stock for you to pick up in an hour or two. And so they have to order it in. And we believe, going forward, if we can provide that single access point for this very large product portfolio—now I think we have over 20 branded products—we think that’s a very attractive platform for doctors and their staff to be able to utilize, to be able to access prior authorizations and all sorts of other features that we have planned for the platform.

So it’s going to be an important part of our business. It’ll be a single point of access for the entirety of our portfolio. And I don’t believe any of the other competitors really have anything like that.

OPERATOR

Thank you. And our next question will come from Mayank Mamtani with B. Riley Securities. Your line is open.

Mayank Mamtani (Analyst)

Yes. Good morning, team. Thanks for taking our questions and appreciate the level of detail here. If I may ask, on the VIVI new patient start trends, Mark, you know, that seems strong. Are you able to comment on where these are sort of coming from? Are these switches from generic cyclosporine or other branded options, or are these new-to-prescription patients? And wonder if the mix in any way is shifting now that you know you have a fully deployed sales force and payer coverage is also expanding.

Mark L Baum (Chief Executive Officer)

Yeah, you know, the truth is we don’t know what is causing the stability and growth in our new prescription volumes. When we put these rules in place, we anticipated volumes may be coming down, that we might have to sacrifice volume in order to improve net pricing. That has simply, fortunately, not been the case. We’ve actually been able to grow new prescription starts despite these new rules, this new algorithm that actually improves net pricing and is improving net pricing for us.

So I think that’s a really positive development for the VIVI franchise. In terms of where they’re coming from, though, as I said, we don’t know. When I put VIVI in my eye—and I do—and I put the other choices in my eye, I don’t know why anyone would start anything other than VIVI. It feels great, it works fast, it has a durable treatment effect. The data is incredible and it just feels phenomenal. So like I said, I don’t know why anyone would use anything other than VIVI, but some people do.

But as I think you’re alluding to in your question, more and more people are starting with VIVI and I expect that trend to continue.

Mayank Mamtani (Analyst)

Great. And just a couple more quickly on the Iheezo step-up in 4Q to the extent possible, if you’re able to quantify year over year, you know, and also from a restocking and net price per unit reset regarding 2Q and just broadly, should we think about this in alternate-quarter buying cycles, like 2Q and 4Q being strong, or is it—as you think about next year, and I know you’re not guiding for next year today—it’s basically a 2Q to 4Q steady build with a 1Q sort of reset?

And then maybe just for Amir on the GMLT NDA filing, you know, which elements have been fast tracked, if you could comment, and any thoughts from the pre-NDA meeting you may have had on how to think about the combination product scheduling as obviously you prepare for commercial readiness. Thanks for taking the question.

Mark L Baum (Chief Executive Officer)

Mayank, thanks for the question. I’ll comment on Iheezo, and by not commenting or trying to answer your question, we really do not want to be in the business—and I think I said this in a letter to stockholders—of giving quarterly guidance on a product-specific basis. Iheezo in particular can be choppy quarter to quarter. You know, that said, the fourth quarter is always, as we said in the letter and I think talked about on this call, the strongest period for that product.

But look, second quarter’s good. The first quarter wasn’t bad. This year in particular there were some challenges with realizing revenue with Iheezo and I think we’ve talked about that many times on prior calls. But I think in 2027 you’re going to see a normalization of what to expect with Iheezo, and I can only tell you one thing: with Iheezo, 2027 is going to be a stronger year for volumes and revenue for Iheezo than 2026. Just like 2026, I think ultimately, in terms of demand, certainly was stronger than the prior year.

Amir, do you want to comment on the GMLT filing at all? I don’t know that you can say much about our pre-NDA meeting. Certainly if we’re going to actually submit to the FDA, it must have gone fairly well.

Amir Shojaei (Chief Scientific Officer)

Yeah, I think I concur with that. The meeting was productive and we are aligned with—or more importantly, we are submitting what the FDA anticipates to receive. So from that regard we are on the right foot and we will be submitting hopefully by end of this month, if not beginning of next month. That said, our anticipation is we’ll have a PDUFA goal date next year, whether it’s priority review or not. That will be part of the decision the FDA would make.

And beyond that, I think from a scheduling perspective, that would be a review during the submission as well. We are moving forward with our anticipated scheduling between the two fixed-dose combination products.

Mayank Mamtani (Analyst)

Great. Thanks so much, Ken.

OPERATOR

Thank you. And our next question will come from Thomas Flatten with Lake Street Capital. Your line’s open.

Thomas Flatten (Analyst at Lake Street Capital)

Hey, good morning. Following up on a couple questions. First for Amir, and I apologize if I missed this, but do you have a hypothesis on why you came up 30 points or so short of the 88% anesthesia goal that you had set for the study?

Mark L Baum (Chief Executive Officer)

Great question, Amir. You want to tackle that one?

Amir Shojaei (Chief Scientific Officer)

Yeah, thank you for that question. So frankly, this was the first set of sort of adequate and well-controlled study that would generate that answer to your question. So where we believe the hypothesis lies is really the relevant difference between a procedure that requires cutting the eye as opposed to a procedure that requires deep penetration into the eye. That’s where the delta is. And I think Mark alluded to this. How do you anesthetize the eye?

And when you compare the various procedures, you realize there are different numbers that you would have to sort of set your bar for. We set the bar, we extrapolated with the existing data because there was no other data available. With this data in hand, we have obviously learned the actual sort of benchmark that we should have set the study at. But that’s really the gist of it. It’s borrowed from or extrapolated from a different procedure because there were no other data available.

Mark L Baum (Chief Executive Officer)

I wanted to add to that, by the way, because it’s very interesting. When we launched Iheezo, I can’t tell you how many doctors said to us, anesthesia is not a problem. We don’t have a problem that you’re going to be able to help us solve. And I think if you look at the data from Quell, what it clearly says is patients experience pain from these injections. It seems axiomatic that if you’re going to put a needle into the sclera of someone’s eye, that it might be painful.

And I think the study certainly demonstrates that. And it also shows that whether you’re going to anesthetize the eye with an injection of lidocaine, sort of a needle before a needle, or you want to use something topical like Iheezo, you can pretty much get patients to about the same level. In fact, Amir alluded to the fact that the pain levels between the two cohorts were essentially the same at two. But what we’re excited about and what we’re now able to message lawfully through our medical team is the patient experience after the injection. It’s so important that these offices not get the calls from their patients who are experiencing pain because they may have gotten an injection of lidocaine post procedure, or that they have some ocular surface trauma or that they’ve experienced some other adverse event associated with the intravitreal injection.

And so to be able to now message that is so important for us. And I think going forward, you know, it’s a data set that will inure to the benefit of Iheezo, it will be helpful to our reps, it will justify certainly the use of Iheezo in practice for more practices. So we’re really quite pleased with the data set that we invested in. Could have been better, but it was pretty doggone good.

Patrick Sullivan (Chief Commercial Officer)

Yeah, thanks for the question. You know, on our prior earnings call, and I think through the prior communications, obviously this has been a very phased and disciplined plan that started earlier this year. If you recall, the organization made a large commitment, I think, to further expand our presence in the dry space, to really get behind Vevye, and if you recall, earlier this year. So right now what we’ve done is, to your point, we’ve taken three teams, you know, the Beatrice, Verytown and Beatrice team.

With the acquisition of Tiruvaya, we had a specialty team, as Mark mentioned, that was representing a few of our specialty products, such as, like Mark mentioned, these more rarer products for Kazi and Madison, and also brought that together in our dry team. So that is our ocular surface team. So what I would say is one of the things that we’re really excited about is we were very methodical in one, looking at a really clear approach that, one, we cover the right physicians to make sure that we have the right prioritization on products to deliver the right promotional intensity to drive the outcome that we’re looking for. So our main focus is heavily on Vevye. As you see our prescription trends, we’ve had a pretty significant growth over the prior quarter of 17%, I think 83% year over year.

We’re really excited that we’re just getting started. And we hear consistent feedback early in our new model about how we’re deploying in a very smart, sophisticated way that drives increased productivity. So in a word for us, our prioritization is Vevye and also our dry eye portfolio. But I think by leveraging the other products that we have allow us to show up in a really unique way that only Harrow can, with the breadth of our products that really, if you think about it, now we have a really premium cornerstone spot when it comes to Vevye as the leading dry eye disease product with Purvaya, FreshKote and FLAREX.

That really makes a real unique combination in our portfolio. But make no mistake, Vevye is our lead product that is getting the most emphasis and the most promotional intensity. So to answer your question, we have a very clear plan. This is just now taking shape, but this is really going to help propel us to the next level of growing not only our whole portfolio, but specifically Vevye moving forward. More prescribers, more productivity and more prescriptions.

OPERATOR

Thank you. And our next question will come from Jeffrey Cohen with Ladenburg Thalmann and Company. Your line is open.

Jeffrey Cohen (Analyst)

Hey, good morning. Thank you for taking our questions. Two from Aaron. I guess, firstly, maybe for Mark or Neil, can you talk about the Triesence Phase 3 and enrollment, how it’s going, when we may expect that to complete, and what we may see as far as press releases or filing dates?

Mark L Baum (Chief Executive Officer)

Sure. Amir, do you want to talk about that study?

Amir Shojaei (Chief Scientific Officer)

Yeah, thanks for the question. Our program for Triesence is going forward well. We are enrolling on track. We still anticipate readout next year, specifically towards the end of first quarter, beginning of second quarter. That’s our sort of current progression.

Jeffrey Cohen (Analyst)

Perfect. Okay, thanks for that. And then secondly, I guess a question for Andrew. Could you talk about R&D for the quarter and maybe give us a sense of what you’d expect on R&D, perhaps for Q4 or just generally speaking as far as levels go? I know you’ve been quite active on a number of fronts on the development side.

Andrew R Boll (Chief Financial Officer)

Yeah, thanks, Jeff. On the R&D side, you know, R&D is kind of a, I would say, almost a seasonal spend. It depends on what we have that’s active and what we can accelerate. But typically the expense, I think, as a percent of revenue should be roughly the same as where it is now. That’s where we’re going to try to pin it to. But if there’s opportunities to accelerate or investments that we think can make significant return, we’re going to—we’ll go after it.

As we’re kind of looking at Q4, you know, we’re accelerating some of these programs. We have accelerated programs. Not all of that ends up in R&D, by the way, and so some of it goes up into the SG&A line. And so, for example, with the MELT NDA filing, you know, not all of that cost that’s going to go into that filing and the PDUFA fee that’ll go with it is going to end up in R&D. There’ll be parts of it for sure, but other parts will also split up into SG&A.

Jeffrey Cohen (Analyst)

Perfect. Thanks for taking the questions.

Mark L Baum (Chief Executive Officer)

Thank you, Jeff.

OPERATOR

And I show no further questions at this time. I will now turn the call back over to Mark for closing remarks.

Mark L Baum (Chief Executive Officer)

Thank you, operator, and thanks to everyone for joining us. We’re seeing real momentum heading into what we expect to be Harrow’s strongest quarter. We look forward to reporting our full year results and hopefully see many of you at our Investor Day in New York City in March. Have a great day.

OPERATOR

This concludes today’s conference call. Thank you for participating and you may now disconnect.

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