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Sight Sciences secures Medicare coverage for glaucoma procedures

EditorNatashya Angelica
Published 03/10/2024, 15:22
SGHT
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Sight Sciences , Inc. (NASDAQ:SGHT), a medical device company specializing in the development of ophthalmic devices, has announced that Medicare Administrative Contractors (MACs) have published final local coverage determinations (LCDs) for Micro-Invasive Glaucoma Surgery (MIGS) procedures. The determinations will maintain Medicare coverage for specific glaucoma procedures in the states governed by these MACs, with an anticipated effective date of November 17, 2024.

The final LCDs, released today, follow the proposed determinations published in May 2024 and confirm coverage for phacoemulsification and intraocular lens placement procedures when performed with a single MIGS procedure. These procedures include canaloplasty in combination with trabeculotomy ab interno, associated with the company's OMNI® Surgical System, and goniotomy, linked to their SION® Surgical Instrument technology.

However, the LCDs also outline coverage limitations or non-coverage policies for MIGS procedures as first-line treatments for mild-to-moderate glaucoma. Moreover, they do not cover surgical MIGS procedures, such as canaloplasty or goniotomy, when performed concurrently with an aqueous shunt procedure in the same eye, nor phacoemulsification with a combination of MIGS procedures.

Sight Sciences has expressed intentions to continue its engagement with each MAC, the Centers for Medicare and Medicaid Services (CMS), and clinical societies to support procedures performed with OMNI and SION technologies.

The company's communication included forward-looking statements subject to risks and uncertainties, emphasizing that actual outcomes could differ materially from those projected. These statements are based on management's expectations and assumptions at the time they are made. Sight Sciences trades on the Nasdaq Global Select Market under the ticker SGHT. The information in this article is based on a press release statement.

In other recent news, Sight Sciences, Inc. has reported an 11% sequential increase in total revenue for Q2 2024, reaching $21.4 million. This growth was reflected in the Surgical Glaucoma segment, with revenues hitting $20.2 million.

Despite a 46% year-over-year decrease in Dry Eye revenue, the company maintains a positive outlook for its TearCare procedure for meibomian gland dysfunction. Sight Sciences has plans to raise TearCare prices to $1,200 per set, with expectations of favorable insurance coverage decisions in 2025.

In a significant development, Sight Sciences has gained Medicare coverage for specific Micro-Invasive Glaucoma Surgery (MIGS) procedures related to its products. This coverage, confirmed by Noridian Healthcare Solutions, includes procedures performed in conjunction with a single MIGS operation, such as canaloplasty combined with trabeculotomy ab interno, related to the company's OMNI® Surgical System, and goniotomy, tied to the SION® Surgical Instrument technology.

However, the coverage introduces limitations for MIGS procedures as first-line treatments for mild-to-moderate glaucoma and for certain combinations of surgical procedures performed simultaneously in the same eye.

These are the recent developments in Sight Sciences, as the company continues to engage with Medicare Administrative Contractors and clinical societies to support procedures performed with OMNI and SION technologies.

InvestingPro Insights

Sight Sciences' recent announcement regarding Medicare coverage for its MIGS procedures comes at a critical time for the company. According to InvestingPro data, SGHT has a market capitalization of $306.37 million, reflecting its position in the medical device sector. The company's revenue for the last twelve months as of Q2 2023 stands at $79.39 million, with a high gross profit margin of 85.8%, indicating strong pricing power for its specialized ophthalmic devices.

However, investors should note that Sight Sciences is currently not profitable, with an operating income of -$51.9 million over the same period. This aligns with an InvestingPro Tip suggesting that analysts do not anticipate the company to be profitable this year. Despite this, SGHT has shown remarkable stock performance, with a one-year price total return of 73.11%, potentially reflecting market optimism about its future prospects and the impact of developments like the recent Medicare coverage determinations.

Another InvestingPro Tip highlights that SGHT holds more cash than debt on its balance sheet, which could provide financial flexibility as the company navigates the evolving healthcare reimbursement landscape. This strong liquidity position may be crucial as Sight Sciences continues to engage with MACs and CMS to support its OMNI and SION technologies.

For investors seeking a more comprehensive analysis, InvestingPro offers additional tips and insights on Sight Sciences. There are 7 more InvestingPro Tips available for SGHT, which could provide valuable context for understanding the company's financial health and market position in light of the recent Medicare coverage news.

This article was generated with the support of AI and reviewed by an editor. For more information see our T&C.

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