electroCore (NASDAQ:ECOR) executives highlighted record fourth-quarter revenue growth, expanding adoption within the U.S. Department of Veterans Affairs (VA) system, and accelerating sales of its Truvaga wellness product during the company’s fourth-quarter and full-year 2025 earnings call. Management also announced a CEO retirement and outlined leadership changes set to take effect April 1, 2026.
CEO retirement and leadership transition
Chief Executive Officer Dan Goldberger said he will retire effective April 1, 2026, following discussions with the board about the company’s next phase of growth. Goldberger said that since joining in late 2019, his focus was strengthening the company’s financial position and establishing a focused commercial strategy, citing momentum in the VA channel, portfolio expansion, and improved financial footing.
Clinical and product portfolio updates
Errico emphasized the clinical foundation supporting electroCore’s non-invasive vagus nerve stimulation (nVNS) platform. He said the company’s flagship gammaCore device is supported by more than 20 peer-reviewed publications and multiple randomized controlled trials, including ACT-one, ACT-two, PRESTO, and PREMIUM, which he said demonstrated statistically significant reductions in migraine and cluster headache frequency, intensity, and duration. Errico noted gammaCore is FDA-cleared for both acute and preventative treatments in adults and adolescents.
He also pointed to U.K. audit data indicating that a “meaningful portion” of cluster headache patients achieved clinically significant response rates with measurable cost savings compared to standard care. Beyond headaches, Errico discussed exploratory studies across indications such as Sjögren’s syndrome, gastroparesis, traumatic brain injury, and inflammatory conditions related to COVID-19, citing encouraging signals across fatigue, quality-of-life measures, and anti-inflammatory biomarkers. He added that ongoing trials in PTSD, long COVID, substance abuse disorder, musculoskeletal pain, and concussions—including research supported by partnerships such as NFL and NFLPA-funded work—align with the company’s indication expansion strategy.
Errico said the Quell device also has growing peer-reviewed support, including randomized controlled trials demonstrating efficacy across multiple pain-related conditions, including fibromyalgia.
On the consumer side, Errico said Truvaga continues to gain traction as a wellness product focused on stress reduction, sleep quality, and emotional well-being. He cited recognition from lifestyle publications and social and digital engagement, naming Women’s Health and Men’s Health as sources of website traffic, and noting mentions and promotions by Miranda Kerr and affiliates including TrueMed, Ben Greenfield, and Luke Storey. He added that Truvaga is available through online retail outlets such as Best Buy and RehabMart and said independent in-home studies indicate high levels of user-reported calmness and sleep improvement after consistent use.
Fourth-quarter and full-year 2025 financial results
Lev said electroCore delivered “another year of strong top-line revenue growth,” extending its growth trend and exceeding both revenue and EPS analyst consensus estimates, according to management. He described the VA hospital system as the company’s largest customer and said it continues to grow with expanded adoption of electroCore’s non-invasive pain therapeutics. He also said Truvaga sales grew strongly, driven by the company’s e-commerce store and an expanding affiliate network.
- Q4 2025 revenue: $9.2 million, a record and up 31% year-over-year.
- Full-year 2025 revenue: $32.0 million, up 27% versus 2024.
- Prescription device revenue (full-year): $26.0 million, up 23% year-over-year, driven by gammaCore and Quell within the VA system.
- Quell Fibromyalgia revenue: $1.5 million in 2025 following the May 2025 acquisition of Quell assets.
- Q4 general wellness revenue: $1.4 million, up 31% year-over-year.
- Full-year general wellness revenue: $5.5 million, up 97% compared with 2024, primarily driven by Truvaga.
- Full-year Truvaga sales: $5.4 million, up 93% from 2024.
Lev said Truvaga revenue was flat sequentially, but noted the third quarter included a one-time $500,000 order tied to a third-party clinical trial. Excluding that order, he said Truvaga revenue grew approximately 40% sequentially. He reported return on advertising spend (ROAS) of approximately 2.10 in the period, up from 1.80 in the third quarter, attributing the increase primarily to seasonal holiday sales. Lev said return rates increased slightly but remained roughly 12%–15%.
On profitability and expenses, Lev reported full-year 2025 gross profit of $27.8 million and gross margin of 87%, up from 85% in 2024. Research and development expense was $2.7 million, up about $375,000, which he attributed primarily to development work on gammaCore Emerald and the next-generation mobile application. Selling, general and administrative expense rose to $38.2 million from $31.2 million, including a $4.3 million increase in sales and marketing driven primarily by higher personnel expenses. General and administrative expense increased $2.7 million, which Lev attributed to higher legal fees, an IT and systems investment, and increased transaction fees.
Net loss for 2025 was $14.0 million, or $1.65 per share, compared with a net loss of $11.9 million, or $1.59 per share, in 2024. Adjusted EBITDA net loss was $8.7 million, compared with $9.0 million in the prior year. Cash equivalents and marketable securities were approximately $11.6 million at Dec. 31, 2025, compared with about $12.2 million a year earlier.
VA adoption metrics and commercial strategy
Lev said that as of Dec. 31, 2025, 200 VA facilities purchased gammaCore products, up from 170 a year earlier, and approximately 13,400 VA patients received a gammaCore device. Based on the company’s analysis, management estimated this represents roughly 2% penetration of the addressable VA headache market. Lev added that electroCore expanded its VA sales presence in 2025 by adding internal team members and contracted representatives.
During Q&A, Goldberger said the company believes growth in the VA channel is driven by increasing “boots on the ground” through employees and a 1099 network. He characterized the 1099 approach as a variable expense that can scale without adding headcount. Goldberger also said Fox’s federal-channel experience could help accelerate growth within the VA and potentially other federal systems.
2026 outlook: growth target, product plans, and reimbursement efforts
Lev said the company expects the majority of 2026 revenue to continue coming from the VA and stated management believes full-year 2026 revenue has the potential to grow at approximately 30%. However, he said the company is not issuing detailed guidance at this time due to the leadership transition and will revisit formal guidance when appropriate.
Management discussed plans to expand the nVNS platform and introduce additional wellness offerings, including Quell Relief for lower extremity pain. In Q&A, Goldberger described Quell Relief as an over-the-counter product and said the company plans a first-half 2026 launch using a “soft launch” approach to gauge traction and refine media spend. He added that any revenue from Quell Relief would be incremental to the company’s stated ~30% year-over-year growth expectation.
Goldberger also discussed reimbursement efforts, calling Kaiser a key opportunity. He said electroCore is now on contract with Kaiser in addition to being on formulary, which he said makes it easier for prescribers to prescribe the product. He said the company plans to develop key opinion leaders and advocates within the Kaiser system during 2026, describing Kaiser as a potential “beachhead” for broader managed-care adoption, with additional insurers potentially following in later years.
On international markets, Goldberger said NHS England remains the primary driver of revenue outside the U.S., while noting administrative bottlenecks related to prescribing rules. He added the company has distributors in places such as Belgium where it has some reimbursement, and said electroCore is working with third-party distributors to develop infrastructure that supports coverage pathways or cash-pay options.
About electroCore (NASDAQ:ECOR)
electroCore, Inc is a commercial-stage bioelectronic medicine company headquartered in Rockaway, New Jersey. The company specializes in the development and commercialization of non-invasive vagus nerve stimulation (nVNS) therapies designed to address a variety of neurological and inflammatory conditions. Established in 2006, electroCore has focused its efforts on translating neuromodulation science into a compact, patient-administered treatment device.
The company’s lead product, gammaCore®, is a handheld, battery-powered device that delivers nVNS through the skin to the cervical branch of the vagus nerve.
