By Melane Sampson
electroCore (NASDAQ: ECOR) has built a commercial-stage bioelectric medicine and wellness platform around non-invasive neuromodulation, with applications spanning prescription therapeutics, military human performance, and direct-to-consumer wellness. The company’s non-invasive vagus nerve stimulation (nVNS) uses electrical signals delivered through the skin of the neck to stimulate the vagus nerve without surgery or an implanted device.
“The vagus nerve plays a critical role in balancing the body’s autonomic nervous system. It regulates the “fight-or-flight” and “rest-and-digest” responses to modulate vital functions like digestion, heart rate, immunity, and stress,” Joshua Lev, interim president and chief financial officer of electroCore, says in an interview with BioTuesdays.
Mr. Lev explains that the vagus nerve is the longest cranial nerve in the body, extending from the brain through the neck and thorax into the abdomen, with branches extending to numerous organs, including the heart, lungs, and gastrointestinal tract. It serves as an important communication pathway between the brain and the body.
“One of the essential functions of the vagus nerve is to balance the nervous system,” he says. “It regulates the sympathetic nervous system, associated with the body’s fight-or-flight response, and the parasympathetic nervous system, associated with rest and digest response.”
In 2010, electroCore developed a non-invasive method of delivering vagus nerve stimulation, using proprietary electrical signals delivered through the skin to stimulate the vagus nerve.
Mr. Lev explains that until then, vagus nerve stimulation was invasive, requiring surgery to implant a stimulator device around the nerve. “Our technology has shifted the paradigm by enabling patients to administer their own doses of therapy in the comfort of their home for a range of indications.”
Today, electroCore commercializes multiple products based on its bioelectric technology. The company’s flagship prescription product, gammaCore Emerald, is an FDA-cleared nVNS device used for the acute and preventive treatment of certain primary headache disorders, including migraine and cluster headache. The device is marketed primarily through the U.S. Department of Veterans Affairs (VA), which Mr. Lev says is electroCore’s largest customer.
He emphasizes that approximately 600,000 headache patients are within the VA system, while electroCore estimates that its penetration of the addressable market remains in the low single digits. “We believe there is a significant amount of opportunity still available to us within the VA system.”
The company’s commercial opportunity is expanding beyond headache management. Physicians are increasingly prescribing gammaCore for off-label uses like PTSD, while clinical trials evaluate nVNS across a broad spectrum of other conditions.
electroCore’s technology is currently featured in more than 30 investigator-initiated studies. These trials explore potential applications for PTSD, stroke, gastrointestinal disorders, and mild traumatic brain injury—including concussion. “Because these studies are investigator-initiated, the company doesn’t bear the full cost of conducting them, although that means we have less control over their timing and outcomes,” Mr. Lev notes.
“This is one of the main catalysts for investors moving forward,” he adds. “We are so much more than a single-product company.”
Mr. Lev points out that the company expanded its bioelectric platform in 2025 by acquiring NeuroMetrix and its proprietary Quell technology. The integration introduces Quell Fibromyalgia, the first and only FDA-authorized, prescription-only wearable neurostimulation device designed to reduce symptoms in adult fibromyalgia patients with high pain sensitivity.
“We have been able to leverage our existing VA commercial infrastructure to introduce Quell into the federal healthcare system,” he says. “Quarterly Quell revenue has grown substantially since the acquisition, without requiring the company to build a separate commercial infrastructure.”
Beyond fibromyalgia, electroCore is targeting a significant market expansion for Quell to treat chemotherapy-induced peripheral neuropathy (CIPN). Management anticipates leveraging existing clinical trial data to anchor a future regulatory filing.
While the prescription portfolio provides the company’s principal revenue base, Mr. Lev says electroCore is also developing a consumer wellness business through Truvaga, its non-prescription nVNS platform.
“Truvaga is marketed through our website directly to consumers for stress reduction, relaxation and sleep. Unlike gammaCore, which is a prescription medical device, Truvaga is positioned as a general wellness product.”
The company offers Truvaga Plus, a rechargeable device with unlimited use and an accompanying app, and Truvaga 350, a cord-free disposable version designed to deliver 350 two-minute sessions.
Mr. Lev highlights that Truvaga generated approximately $5 million in revenue in 2025, compared with approximately $2.5 million in 2024. Although the business has been growing rapidly, he says the company is deliberately balancing growth with profitability because the consumer business carries lower operating margins than its prescription business.
“We’d rather grow 30% to 50% and invest in the areas where we have high growth so we go ahead and actually get closer and closer to adjusted EBITDA positive for our investors.”
electroCore has another wellness-oriented application in TAC-STIM, a ruggedized version of its nVNS technology developed with the U.S. Air Force Research Laboratory for military human-performance applications. “This version is designed to withstand battlefield conditions, including being dropped from heights and driven over by machinery,” Mr. Lev clarifies.
TAC-STIM is being used by military and special operations personnel in settings involving high-cognitive-demand and high-stress. Research involving military personnel has explored whether neuromodulation can support sleep, mood, cognitive performance, and learning.
The company anticipates that these diverse clinical targets will validate bioelectronic stimulation as a non-pharmaceutical means of modulating the vital physiological pathways underlying pain, stress, sleep and cognitive function.
“The commercial opportunity is expanding alongside our technology platform,” Mr. Lev says. electroCore is currently selling into the VA and has begun pursuing additional federal and commercial channels, including Kaiser Permanente, a non-profit healthcare organization.
He adds that the VA represents approximately 9.5 million covered lives, while Kaiser Permanente has approximately 12.5 million. The company has begun efforts to establish adoption within Kaiser as a potential pathway toward broader commercial insurance coverage.
“Financially, electroCore is entering this expansion phase from a position of accelerating revenue growth,” Mr. Lev indicates.
The company generated approximately $32 million in revenue in 2025, representing 27% growth from 2024. In the first quarter of 2026, revenue reached $9.6 million, up approximately 43% year over year, which Mr. Lev says was driven primarily by prescription gammaCore sales, Quell and Truvaga. “We subsequently increased our full-year 2026 revenue-growth outlook to more than 30%, while emphasizing improving operating leverage.”
He adds that, for investors, the objective is not simply to grow revenue, but to do so increasingly efficiently.
As such, the company is reorganizing its commercial operation, including expanding its network of commission-based sales representatives with established relationships across the VA and broader federal marketplace.
“We expect this strategy to increase market penetration while reducing sales and marketing expense as a percentage of revenue,” Mr. Lev says. “The longer-term objective is to reach adjusted EBITDA positivity by the third quarter of 2027.”
At the same time, electroCore is investing in the next generation of its technology. Current devices are handheld, but Mr. Lev explains that the company is developing wearable platforms incorporating biosensors and closed-loop capabilities. He says such systems could eventually monitor physiological responses and dynamically adjust stimulation.
“For electroCore, the opportunity extends beyond any single device or indication. We are a platform technology company, not a single-product or single-technology company,” Mr. Lev contends.
The company’s robust intellectual property portfolio comprises more than 200 issued patents and pending applications. This extensive coverage protects its core nVNS and peripheral nerve stimulation platforms, hardware and specialized therapeutic processes.
As electroCore expands beyond its established headache franchise, Mr. Lev notes that the strategy centers on translating its core neuromodulation platform into new therapeutic indications, scaling its commercial footprint, and driving meaningful operating leverage.
He emphasizes that electroCore’s commercialized product portfolio establishes a steady financial foundation, while an expanding clinical pipeline and robust investigator-led research program pave clear avenues for future growth.
“Bioelectronic stimulation is an alternative as well as a complementary approach to invasive procedures and pharmaceuticals,” Mr. Lev concludes. “We are offering this approach where conventional treatment may be insufficient, poorly tolerated, or difficult to sustain, and we are focused on translating the potential of this platform into broader clinical adoption, diversified revenue, and sustainable profitability.”
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