Harrow (HROW) is a founder-led pharmaceutical specializing in ophthalmic drugs (both front and back of eye), established in 2011. They have three main products currently (the following is from their website):
IHEEZO™, an ocular surface anesthetic;
VEVYE®, a water-free formulation for the treatment of the signs and symptoms of dry eye disease; and
TRIESENCE®, a triamcinolone acetonide injection used primarily for treating uveitis and for enhancing visualization during vitrectomy.
IHEEZO, acquired in 2021 and FDA approved in 2022, was awarded permanent J-code (J-2403) and Transitional Pass-Through reimbursement status in 2023 and officially launched in May of 2023 at the American Society of Cataract and Refractive Surgery (ASCRS) meeting. Today, IHEEZO is a key component of Harrow’s portfolio, focused on in-office procedures done by retinal specialists, delivering a non-opioid anesthetic solution to eyecare providers.
VEVYE, acquired in 2023 and launched in January 2024, bolsters Harrow’s presence in the vast and rapidly expanding dry eye disease market. VEVYE positions Harrow as a key player in a high-demand therapeutic area, diversifying its portfolio and extending its presence beyond surgical and acute care products.
TRIESENCE was acquired as part of a transaction in early 2023 for five FDA-approved ophthalmic products. Following its acquisition, Harrow began preparations to ensure the re-launch of TRIESENCE, which had been on the FDA’s Shortage List for over 5 years and out of stock for nearly 2 years at purchase. After working with trusted manufacturing partners to revitalize the manufacturing and supply chain processes, Harrow officially relaunched TRIESENCE in late 2024. A combination of IHEEZO and TRIESENCE strengthens Harrow’s relationships with retina specialists and further diversifies its portfolio of branded pharmaceutical products.
The largest segment is Vevye for DED (dry eye disease). This market is very large, and difficult to break into for a number of reasons. Drugs are principally accessed through the major pharmacy chains (called pbm – pharmacy benefits managers), doctors tend to be resistant to change, insurance plans favor tier 1 drugs on formularies, and patients may give up trying to find a treatment that works (the currently available tier 1 drugs are not very good). To work around this Harrow created VAFA (vevye access for all), which heavily subsidized the cost of the drug to patients (though still profitable to Harrow), and in a sort of guerrilla marketing way bypassed the pbms (which are gatekeepers to the tier 1 drugs). Vevye gained significant market share, about 10%, with very minimal sales effort – reinforcing its claims of superiority, as it showed consumers voting with their wallets – and as of January 2026 it replaced Xiidra as the tier 1 drug at CVS, which is the largest of the top 3 PBMs (it is about 25% of the market). This is a very significant achievement, as it BOTH reduces the cost to the patient to 0$ (often), while simultaneously increasing the revenue Harrow receives for each prescription. A true win-win. Moreover, those new prescriptions tend to be very sticky. To gain tier 1 status at CVS is generally viewed as the first step in eventually gaining tier 1 at all the PBMs, though of course that is not guaranteed. Vevye ended 2025 with about 11% market share, and while up to date prescription information is difficult to obtain, it has reported sharply increasing new prescriptions in 2026. Q3 YoY growth is 225%, and YTD is 332%. These will clearly fall, as it is a new entry, but given its new Tier 1 status it has shown new acceleration.
Iheezo Q2 YoY growth was 63%, while Q3 was 49%.
A further market is what are called biosimilars, which are essentially identical drugs to patented drugs. The important drugs that Harrow competes with are Lucentis and Eylea. At the moment the only biosimilars on the market here are Pavblu by Amgen, which was introduced in late 2024. The overall market is about $8B, and Pavblu is on a run rate of 125M per quarter. There will be other competitors to Pavblu so Harrow immediate large slice, but it is a considerable opportunity. Harrow’s biosimilar will now launch in January 2027.
The other large (possibly ‘very’ large) opportunity is MELT-300, which is a sublingual non-opiod sedation for cataract surgery. It has completed the phase 3 clinical trials showing superior results, and is expected to launch in 2H 2028.
Revenue history is:
| FY | Total Rev | % Growth |
|---|---|---|
| Dec 2020 | 48.9 | 4.5 |
| Dec 2021 | 72.5 | 48.3 |
| Dec 2022 | 88.6 | 22.2 |
| Dec 2023 | 130.2 | 47 |
| Dec 2024 | 199.6 | 53.3 |
| Dec 2025 | 280 | 40.3 |
While the growth rate for this year (to be reported at the end of March) is slowing, there is solid basis for expecting 2026 and beyond to strongly reverse this trend.