electroCore Q3 Earnings Call Highlights

Key Points

• Revenue reached a third-quarter record of $9.7 million, up 12% year over year, but electroCore lowered its 2026 outlook to $39 million–$42 million as sales-organization changes took longer than expected. Management expects the delayed acceleration in 2027 and preliminarily forecast 30%–40% growth.
• The net loss narrowed to $1.3 million from $3.4 million, while gross margin improved to 88.5% and adjusted EBITDA loss fell to $700,000. Cash and marketable securities declined to $7.5 million; the company is exploring term-loan refinancing and targets positive adjusted EBITDA by the end of 2027 without new dilutive equity financing, contingent on execution.
• VA sales were a key growth driver: new patient orders rose 21% year over year, and management is targeting a refill rate above 70% versus 42% through September. The company submitted an FDA application for Quell to treat chemotherapy-induced neuropathy, while its anticipated over-the-counter Quell launch remains delayed.

electroCore NASDAQ: ECOR reported record third-quarter sales and a narrower loss, but revised its 2026 revenue outlook as changes to its sales organization took longer than expected to reach the full field.

The medical device company reported revenue of $9.7 million for the quarter ended Sept. 30, up 12% from $8.7 million a year earlier. Management now expects 2026 revenue of $39 million to $42 million, replacing its prior guidance for more than 30% year-over-year growth.

Co-Chief Executive Officer and Chief Financial Officer Joshua Lev said the company expects the sales acceleration it had anticipated in the second half of 2026 to materialize in 2027. electroCore offered preliminary 2027 revenue growth guidance of 30% to 40%.

Loss narrows as margins improve

Third-quarter net loss fell to $1.3 million, or $0.13 per share, from $3.4 million, or $0.40 per share, a year earlier. The latest quarter included approximately $400,000 in other income related to the settlement of indemnification claims and a $100,000 income tax benefit.

The company reported an operating loss of $1.6 million and an adjusted EBITDA loss of $700,000, compared with an adjusted EBITDA loss of $2 million a year earlier. Adjusted EBITDA is a non-GAAP measure.

Gross margin rose to 88.5% from 86% a year earlier, primarily because of a favorable product mix. Total operating expenses declined to $10.1 million from $10.4 million.

Lev said the company believes it can reach its first quarter of positive adjusted EBITDA by the end of 2027 without a new dilutive equity financing, provided it achieves its growth and operating efficiency plans. Asked about the timing, Lev said revenue expected in 2026 had shifted into 2027. An analyst noted that the company had previously pointed to the third quarter of 2027.

Cash, equivalents and marketable securities totaled approximately $7.5 million at Sept. 30, down from approximately $10 million at June 30. Lev said inventory purchases to support anticipated prescription-product growth accounted for a significant portion of the quarter’s cash use. The company is also evaluating options to refinance its term loan, including extending principal repayment dates, but has not entered into an agreement.

VA sales changes and refill targets

Revenue growth was driven primarily by sales of Quell Fibromyalgia and prescription gammaCore products to the Department of Veterans Affairs, Lev said. electroCore acquired the Quell products from NeuroMetrix in May 2025.

Co-CEO and Chief Operating Officer Mike Fox said the company added sales leadership and is using smaller territories to increase accountability. Representatives added since June generated an average of approximately $210,000 per month in VA revenue during the third quarter from their territories, up from approximately $160,000 per month before they arrived, he said.

Fox said VA new patient orders across all products rose 21% year over year in the third quarter. The company’s national refill rate was 42% for the year through September, and management aims to raise it above 70% through measures including a patient training pilot.

Quell Fibromyalgia had its strongest month on record in October, Fox said, and more than 1,000 VA patients had been prescribed Quell during 2026. He said more than 70% of VA accounts were not prescribing the product at that point.

Lovell Government Services handled approximately 91% of electroCore’s VA orders in September, up from roughly 57% in June. Fox said Lovell is now the primary channel for prescription product sales to the VA and Department of Defense.

Quell submission and consumer strategy

On Oct. 27, electroCore submitted a 510(k) premarket notification seeking Food and Drug Administration clearance for Quell to treat chemotherapy-induced peripheral neuropathy, or CIPN. The device received breakthrough device designation for the indication in 2022.

Lev said any CIPN-specific revenue would be incremental to the company’s 2027 forecast. In a best-case scenario, he said, the company expects to hear from the FDA in the second half of the first quarter of 2027. He said there are no current plans for additional trials to support the application.

Lev also said an anticipated over-the-counter Quell launch has been delayed following FDA Form 483 observations related to the earlier NeuroMetrix over-the-counter product. The timing of a launch remains undetermined, he said.

In its direct-to-consumer business, electroCore reduced spending on Truvaga advertising as competition increased. Lev said third-quarter Truvaga revenue declined from a year earlier, although return on advertising spending improved 8%. He expects Truvaga revenue to grow for the full year, but much more slowly than its triple-digit growth in 2025, as the company prioritizes profitability.

About electroCore (NASDAQ:ECOR)

electroCore, Inc NASDAQ: ECOR is a commercial-stage medical device company focused on bioelectronic medicine and non-invasive vagus nerve stimulation (nVNS). Its technology is designed to stimulate the vagus nerve through the neck without requiring surgery or implanted components.

The company's primary prescription product is gammaCore, a handheld nVNS device used for the acute treatment of pain associated with migraine and episodic cluster headaches in adults. electroCore also markets consumer-oriented products, including Truvaga, a handheld vagus nerve stimulation device positioned for general wellness applications.

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