Quick Thoughts On Harrow Inc
VEVYE and IHEEZO Today, Biosimilars and MELT-300 Tomorrow, and My Valuation for 2027.
I have published two articles on Harrow so far. Harrow remains my favorite investment in today’s market. Although one might think this is just a pharma company making drugs, there is some nuance. It is a pharma company that sells already established drugs; effectively, it is a drug distributor. In this article, I will discuss some recent developments in their business and why I remain bullish on this company.
VEVYE As Near-term Catalyst
First, Harrow is experiencing rapid growth led by VEVYE, which has become the leading Dry Eye Disease (DED) drug and achieved over 10% U.S. market share in Q3 2025, largely driven by the Vevye Access For All (VAFA) program and an efficient, small salesforce. VEVYE has effectively doubled its market share in just two quarters, rising from 5.20% in Q1 2025 to 7.80% in Q2 2025, and then reaching 10.50% in Q3 2025. Moreover, VEVYE is currently ahead of MIEBO in four markets.
Second, the strong performance of VEVYE, driven by best-in-class clinical performance and strong demand, contributed to 22% quarter-over-quarter revenue growth in Q3 2025. The sustained growth is evident in adoption, as the company saw a 36% quarter-over-quarter increase in prescribing physicians by the end of September 2025.
Third, VEVYE’s market share is exploding. Starting January 2026, it will be a tier 1 drug with the largest Pharmacy Benefit Manager (PBM), which should drive further growth. VEVYE gained over 5 percentage points of market share in the span of two quarters without any help from PBM access. So, it could reach as much as 20% market share by the end of 2026. We will see more clarity in their Q4 2025 earnings call.
Fourth, VEVYE’s market share is a huge catalyst for 2026 and will drive a major revenue acceleration. Q3 2025 revenue from VEVYE was $22.6M. Assuming no ASP change and a doubling of market share by 2026, I expect revenue from VEVYE in Q4 2026 to be over $44M. This implies over $175M in ARR from VEVYE exiting 2026.
IHEEZO’s Growth is Accelerating
IHEEZO is currently a fast-growing branded ocular anesthetic for Harrow, with Q3 2025 revenue of about $21.9M, up roughly 20% sequentially and about 70% year over year. Unit demand for IHEEZO in Q3 2025 was up 47% from the prior year and 3% sequentially, supported by high reorder rates in the mid‑80% range and expanding account penetration, including coverage across all major retina GPOs. IHEEZO has Orange Book patents extending into the late 2030s and currently advantaged reimbursement via a permanent J‑code and temporary pass-through status through April 2026 for Ambulatory Surgical Centers (ASCs).
Future growth should be driven by continued penetration of the large U.S. market for ocular surface anesthesia, which spans tens of millions of procedures annually, alongside further expansion within retina accounts where Harrow’s “retina pivot” is accelerating adoption. Management is guiding to strong Q4 seasonality and record 2025 revenue and is positioning IHEEZO as a strategic entry point into practices ahead of the planned launches of anti‑VEGF biosimilars BYOOVIZ and OPUVIZ in 2026–2027, creating procedural and commercial synergies.
IHEEZO’s explosive growth is unlikely to sustain indefinitely. The expiration of IHEEZO’s transitional pass-through status in April 2026 represents a critical “reimbursement cliff” event. However, specific statutory provisions for non-opioid drugs will likely soften the landing, though potentially with reduced margins. Regardless, there will likely be some pressure on IHEEZO’s ASP. While unit sales growth may remain near the Q3 2025 level of roughly 45%, I think revenue will grow more slowly at around 40%. So, I assume $32M in Q4 2026 revenue and about $128M in ARR for IHEEZO.
TRIESENCE
TRIESENCE’s unit demand grew 67% sequentially in Q3 2025, positioning it for potential future growth following its expansion into the ocular inflammation market in October 2025. Since its relaunch in October 2024, TRIESENCE has demonstrated roughly fourfold growth. In Q3 2025, 53% of all accounts ordering TRIESENCE were new customers, signaling expanding reach and strong physician response to the product’s clinical performance and favorable reimbursement profile. Management has expressed high conviction in TRIESENCE’s long-term value, explicitly categorizing it as a “nine-figure revenue product” (i.e., exceeding $100 million annually). I think reaching 30% of that in the first full year, 2026, is not unreasonable, implying a Q4 2026 annual run rate close to $30M.
Biosimilars
Harrow expects to launch BYOOVIZ (ranibizumab-nuna), a biosimilar to Lucentis, in the mid‑2026 timeframe. The company expects to launch OPUVIZ (aflibercept-yszy), a biosimilar to Eylea, in mid‑2027 or the second half of 2027. Although biosimilars are a competitive space, management has stated that they are not attempting to replicate extraordinary market share capture (referencing Pavblu), but are instead targeting a stable market share of approximately 3% to 4%. They also noted that even a modest market share within this segment would be substantial, with revenue per percentage point estimated north of $80M. So, the internal target for biosimilars is $240M to $320M (midpoint of $280M). Assuming in the first year Harrow captures 30% of the $280M revenue target, the Q4 2026 annual run rate would be north of $80M.
MELT-300: Non-Opioid, Non-IV Sedation
Harrow officially closed the acquisition of Melt Pharmaceuticals, which brings MELT-300 into Harrow’s pipeline as a potentially transformative asset. The drug is designed to provide sedation and analgesia without the need for an IV or opioids. Currently, more than 9 out of 10 U.S. cataract surgery patients are administered IV fentanyl; MELT-300 aims to reduce or eliminate this opioid exposure. The NDA is expected to be submitted in the first half of 2027, with potential FDA approval in the first half of 2028 and a possible commercial launch in the second half of 2028.
While initially targeted at the roughly 5 million annual U.S. cataract surgeries, the drug has potential applications in over 100 million short-duration procedures, including dentistry, dermatology, and managing claustrophobia during MRI scans. This is a huge asset, as anyone can see. To facilitate access to these broader markets, Harrow recently hired Frank Mullery, who previously led Mylan’s injectables business in North America.
Valuation and My Thought
