electroCore (NASDAQ:ECOR) reported second-quarter 2026 revenue of $9.5 million, up approximately 28% from $7.4 million a year earlier, as growth in Veterans Affairs prescription sales and direct-to-consumer Truvaga sales lifted results. The company raised its full-year revenue outlook to growth of more than 30% over 2025 and said it is targeting positive adjusted EBITDA in the third quarter of 2027.
GAAP net loss narrowed 17% year over year to $3.1 million, or $0.33 per share, from $3.7 million, or $0.44 per share, in the prior-year quarter. Adjusted EBITDA loss improved to $1.8 million from $2.4 million, a 26% improvement. Interim President and CFO Joshua Lev said the company’s performance reflected continued operating leverage despite investments in its commercial organization.
VA Sales and Quell Growth
The VA remained electroCore’s largest source of growth. Prescription gammaCore revenue increased about 11% year over year, and roughly 16,400 VA patients have received the device, representing an estimated 2.7% penetration of the addressable VA headache market, according to Lev.
The company also reported $1.3 million in quarterly sales for its Quell product line, up approximately 700% from the prior-year period and about 30% sequentially. Quell Fibromyalgia, a prescription therapy sold through the VA, accounted for $3.8 million of the roughly $4 million in cumulative Quell revenue since electroCore acquired NeuroMetrix in May 2025.
Lev said Quell has become a “bright spot” in the company’s portfolio and cited fibromyalgia prevalence among service members as a potential market opportunity. The company is focusing on increasing Quell adoption among VA facilities that have already purchased other electroCore products.
Direct-to-consumer Truvaga revenue rose approximately 27% year over year to $1.3 million. However, competition in health and wellness advertising increased customer-acquisition costs. Lev said the number of competitors bidding on Truvaga-branded search terms rose to eight in the first half of 2026 from five a year earlier, while direct cost per click increased roughly 30%. The company reduced media spending 2% during the quarter, and Truvaga’s media efficiency ratio declined to 1.91.
Commercial Reorganization and Federal Expansion
Chief Operating Officer Mike Fox said electroCore doubled its number of sales regions, expanded its regional sales director organization from three to six leaders, and recruited, contracted and trained 17 new 1099 sales representatives. Those representatives cover 29 VA medical centers, or about 20% of the national VA medical center network, Fox said.
The company aims to diversify prescription revenue across more facilities. Its top 15 accounts generated 54% of second-quarter VA revenue. Fox noted that staffing issues at a Phoenix VA prosthetics department delayed fulfillment of about 30 orders, shifting roughly $145,000 of prescribed revenue from the second quarter into July.
electroCore also revised sales incentives to emphasize sustained account-level growth and is targeting a 30% increase in refill rates in every region by the end of 2026. Fox said the company expects variable incentive compensation to decline to about 27% of prescription revenue by the end of 2027, from approximately 35%, while overall sales and marketing expense is targeted at about 54% by that time.
Beyond the VA, the company contracted a representative to expand Kaiser business outside California and hired an employee focused on Department of Defense and federal workers’ compensation channels. electroCore is also pursuing opportunities for TAC-STIM with first responders, including a planned SWAT training academy study in November and evaluations with state police departments.
The company said Lovell Government Services will become its sole federal supply schedule contract holder for electroCore products across VA and Department of Defense markets. Fox said the arrangement is intended to simplify procurement, while Lev said the change is expected to eliminate about 3% of general and administrative expenses and transaction fees associated with direct federal sales. The transition is expected to be completed by the end of August.
Margins, Cash and Product Development
Gross profit increased to $8.2 million from $6.5 million a year earlier, while gross margin declined to 86.5% from 87.3%, primarily due to a higher inventory reserve. Research and development expense rose to $800,000 from $500,000, reflecting increased studies and grants, stock-based compensation, and initial work on enhancements to the Truvaga mobile application.
Selling, general and administrative expense was $10.1 million, compared with $9.4 million a year earlier. Sales and marketing expense increased $1.4 million, including about $900,000 in variable expenses supporting higher sales. Total cash, cash equivalents and marketable securities were approximately $10 million as of June 30, compared with $11.6 million at the end of 2025.
Lev said the company believes its existing capital resources can support its plan to reach positive adjusted EBITDA in the third quarter of 2027 without a dilutive capital raise, provided it achieves the anticipated operating leverage.
On the regulatory front, electroCore said the FDA issued a preliminary Form 483 after a May inspection related to NeuroMetrix, citing four observations and two discussion points regarding the handling and documentation of patient complaints. The company said it responded with corrective actions. Those actions will delay a potential direct-to-consumer rebrand and relaunch of Quell 2.0.
The company is also preparing a potential FDA submission by year-end for chemotherapy-induced peripheral neuropathy using Quell. Lev said a study acquired with NeuroMetrix had already been completed and that the current work centers on organizing the data for submission. electroCore is additionally conducting VA real-world research involving gammaCore and possible effects on post-traumatic stress disorder, while outlining a next-generation clinical device intended to incorporate biometrics and vagus nerve stimulation.
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.
