OptimizeRx Q3 2026 Earnings Results & Report

OptimizeRx EPS Results

• Actual EPS: $0.20
• Consensus EPS: $0.1620
• Beat/Miss: Beat by +$0.0380
• One Year Ago EPS: N/A
• EPS Beat Rate: 7 of last 8 quarters

OptimizeRx Revenue Results

• Actual Revenue: $21.62 million
• Expected Revenue: $21.19 million
• Beat/Miss: Beat by +$427.00 thousand
• YoY Revenue Growth: N/A

OptimizeRx (NASDAQ:OPRX) is a healthcare technology company that connects life sciences companies with healthcare professionals and patients through digital communications. Its platform uses channels such as electronic health records and other clinical workflows to deliver relevant information at the point of care.

The company’s services support programs for medication access and affordability, patient education and engagement, and communication between healthcare providers and life sciences organizations. OptimizeRx also provides tools intended to help life sciences companies reach clinicians and patients through digital channels.

Founded in 2006, OptimizeRx is based in Rochester, Michigan, and serves customers across the U.S. healthcare ecosystem.

OptimizeRx Q3 2026 Earnings Call Transcript

Key Takeaways

• Negative Sentiment: OptimizeRx cut its 2026 revenue outlook to $87 million–$93 million, citing customer spending delays and limited visibility into fourth-quarter “buy-ups.” Contracted revenue was about 20% below the comparable prior-year level, increasing the execution risk of meeting the revised range; adjusted EBITDA guidance was maintained at $21 million–$25 million.
• Positive Sentiment: Profitability remained strong despite lower sales: third-quarter revenue fell 17% year over year to $21.6 million, while adjusted EBITDA rose to $6.3 million and margin expanded to about 29% from 20%. Management attributed the improvement to favorable mix, cost reductions, and margin optimization.
• Positive Sentiment: Management cited improving early indicators for 2027, including contracted revenue running about 20% ahead of the comparable point in the prior-year RFP cycle, expanding opportunities in key accounts, and renewed spending from a previously significant customer. Executives said it is too early to provide 2027 guidance, and the returning customer’s spending remains below historical levels.
• Neutral Sentiment: Net revenue retention declined to 83%, which management attributed mainly to spending pullbacks at a small number of large accounts rather than broad-based churn. The company is expanding programmatic distribution through DeepIntent, The Trade Desk, and PulsePoint, but said these initiatives are still in the early stages of commercialization.

Presentation

[Operator]

Good afternoon, everyone, and thank you for joining OptimizeRx third quarter fiscal 2026 earnings conference call. With us today is Chief Executive Officer Silvestro. He is joined by Chief Financial and Strategy Officer Ed Stelmakh, Chief Legal and Administrative Officer Marion Odence-Ford, Chief Business Officer Andy D'Silva, and Corporate Controller Heather Favazza. At the conclusion of today's call, I will provide some important questions regarding the forward-looking statements made by management during today's call. The company will also discuss certain non-GAAP financial measures that it believes are useful in evaluating operating performance. A reconciliation of these non-GAAP measures can be found in today's earnings release, as well as in the investor relations section of the company's website. I would also like to remind everybody that today's call is being recorded and will be available for replay on the investor relations section of the company's website.

[Operator]

With that, I would like to turn the call over to OptimizeRx Chief Executive Officer Stephen Silvestro. Mr. Silvestro?

[Stephen Silvestro, CEO at OptimizeRx]

Thank you, operator, and good afternoon, everyone. Thank you for joining our third quarter 2026 earnings call. We are pleased to report third quarter revenue of $21.6 million and adjusted EBITDA of $6.3 million, both of which exceeded consensus expectations. While revenue came in modestly ahead of expectations, our adjusted EBITDA performance was again particularly strong, reflecting our continued gross margin strength and the benefits of our disciplined approach to cost management. Importantly, our bottom line performance reflects the structural improvements we have made to our operating model, including the cost reduction initiative completed during the first half of the year. These actions have allowed us to operate more efficiently while continuing to invest in the technologies, products, and commercial capabilities we believe will drive long-term growth. Although the broader pharmaceutical marketing environment remains dynamic, we believe our third quarter performance demonstrates the underlying profitability and operating leverage of our business.

[Stephen Silvestro, CEO at OptimizeRx]

At the same time, we recognize that our top line performance has not yet reflected the full potential of investments we have made in our platform. Contracted revenue for 2026 continues to track approximately 20% below the comparable prior year. As a result, we have a larger amount of revenue to secure and recognize during the fourth quarter to achieve our previously issued guidance. Given this backdrop, we are updating the full year 2026 revenue guidance to a range of $87 million-$93 million, while maintaining our adjusted EBITDA guidance of $21 million-$25 million. This revision reflects expected timing of our customer spending decisions and the increased amount of business that would need to convert and be recognized before year-end to achieve our previous revenue expectations. We remain encouraged by the sustainable progress we are making across our business, including a very encouraging start to 2027.

[Stephen Silvestro, CEO at OptimizeRx]

We are seeing expanded opportunities within key accounts, indications of pent-up demand as customers ramp up the 2027 RFP season, and growing commercial opportunities associated with our programmatic distribution capabilities. We are also pleased to report that one of our previously displaced top five clients has returned and begun to reinvest in new solutions with OptimizeRx. As you may recall, this customer represented a meaningful portion of our revenue in 2025, but had not generated revenue during the first three quarters of 2026. We are now pleased to report that we have begun generating revenue from this customer during the fourth quarter. While spending has not yet returned to historical levels, we view this as a positive development and an encouraging indication of renewed customer engagement and interest and contribution to growth next year in 2027. In addition, we are encouraged by the progress we have made by strengthening our commercial organization.

[Stephen Silvestro, CEO at OptimizeRx]

During the third quarter, Sarah Bast joined OptimizeRx as Chief Marketing Officer, bringing more than two decades of pharmaceutical marketing experience, including significant leadership roles in point-of-care media and agency partnerships. Her appointment represents an important investment in executing our go-to-market strategy as we seek to deepen relationships with pharmaceutical manufacturers, strengthen our position with leading healthcare marketing agencies, and accelerate adoption of our expanding product portfolio. Importantly, we believe our revised outlook reflects the near-term timing and conversion of customer spending rather than a change in our long-term market opportunity. Our focus remains on converting these opportunities into revenue while maintaining the financial discipline and operational efficiency that have driven our strong profitability and performance. Ed will provide additional details on our financial performance and outlook shortly.

[Stephen Silvestro, CEO at OptimizeRx]

Turning to the broader market, pharmaceutical manufacturers continue navigating an environment characterized by evolving spending priorities, budget scrutiny, and a heightened focus on measurable returns on marketing investment. While these dynamics have contributed to delays in certain customer decisions and the timing of campaign execution, we continue to hear encouraging feedback regarding the underlying demand for our solutions. It is important to state here that OptimizeRx is uniquely positioned as the only tech company in this space with a proven AI-enabled operating system that is rapidly scaling information across a proprietary network of EHR systems. Those interactions are underpinned by OptimizeRx's growing proprietary data, which enables our technology to find patients in need of therapy and the doctors who treat them.

[Stephen Silvestro, CEO at OptimizeRx]

In our conversations with our pharma and agency customers, we are seeing continued interest in solutions that improve targeting precision, deliver measurable outcomes, and reach healthcare providers and patients at the moments when engagement is most relevant. Our focus remains on translating that interest into signed agreements, active campaigns, and recognized revenue. We believe there is pent-up demand within our customer base as pharmaceutical manufacturers evaluate how and when to deploy their remaining marketing budgets. Although the timing of that spending remains difficult to predict, the underlying customer needs align closely with the capabilities we have been building across our platform. We believe the combination of stronger commercial leadership and broader distribution capabilities through our programmatic initiatives will improve our ability to capture demand as we look for customer spending to normalize in 2027.

[Stephen Silvestro, CEO at OptimizeRx]

Rather than relying solely on historical patient characteristics or static audience definitions, our technology is designed to anticipate future treatment eligibility and help pharmaceutical manufacturers engage the appropriate audiences during critical windows in the patient journey. We believe this approach represents an important advancement in how life science organizations identify and engage potential treatment candidates. We believe these proprietary and patented capabilities will become increasingly valuable as pharmaceutical manufacturers seek more sophisticated, measurable, and AI-enabled approaches to commercial engagement. We continue to make meaningful progress advancing our programmatic strategy with what we believe represents one of the most significant long-term growth opportunities for OptimizeRx. Since opening our proprietary EHR network to programmatic buying earlier this year, we have established relationships with three leading demand-side platforms: DeepIntent, The Trade Desk, and most recently, PulsePoint.

[Stephen Silvestro, CEO at OptimizeRx]

Together, these integrations are expanding access to our authenticated point-of-care inventory through the platforms pharmaceutical manufacturers and agencies already use to plan and execute their campaigns. in September, we announced an integration with The Trade Desk through its OpenPath solution, providing advertisers with access to over 800,000 verified healthcare professionals across more than 400 EHR and e-prescribing systems through OptimizeRx's point-of-care network. More recently, we announced a partnership with PulsePoint, further expanding our programmatic distribution footprint. Through this integration, OptimizeRx will contribute approximately 250,000 incremental NPIs to PulsePoint's network. We expect our inventory to become available to PulsePoint advertisers throughout November. Importantly, these partnerships represent more than just additional distribution channels. They are an important step toward integrating point-of-care advertising into the broader omnichannel strategies of pharmaceutical marketers. Historically, EHR advertising has largely been purchased through direct relationships or specialized channels, often separately from the other digital investments.

[Stephen Silvestro, CEO at OptimizeRx]

Our programmatic strategy is designed to eliminate those barriers, making it easier for customers to incorporate authenticated clinical inventory into their existing media plans. By expanding access through multiple leading DSPs, we are creating new opportunities to reach advertisers, increase utilization of our proprietary network, and capture a greater share of pharmaceutical marketing budgets. While these initiatives remain in the early stages of commercialization, we believe they represent an important evolution in our business model. Rather than relying exclusively on traditional direct sales, we are building a more scalable distribution infrastructure that allows demand to flow into our network through multiple channels. We believe this strategy, combined with our differentiated AI-enabled audience intelligence and authenticated clinical inventory, positions OptimizeRx to benefit from the continued shift toward programmatic healthcare advertising and creates additional opportunities for sustainable long-term revenue growth. We also continued expanding our AI-enabled product portfolio.

[Stephen Silvestro, CEO at OptimizeRx]

in September, we announced an enhancement to our Natural Language Audience Builder, or NLAB, extending its capabilities beyond healthcare provider audiences to include privacy-safe direct-to-consumer audiences. By incorporating our micro-neighborhood targeting capabilities, NLAB now allows pharmaceutical marketers and agencies to develop coordinated HCP and consumer audiences through a unified natural language workflow. This represents an important advancement in our strategy to simplify omnichannel healthcare marketing. Rather than developing HCP and DTC campaigns through disconnected planning processes, marketers can use a common approach to identify and activate relevant audiences across both channels. We believe this improves planning efficiency, strengthens audience coordination, and creates opportunities for more effective and efficient engagement through the patient treatment journey. Together with DAAP, our programmatic integrations, and our recently introduced CopayCue solution, these capabilities are expanding the ways pharmaceutical manufacturers can engage healthcare professionals and patients through our platform.

[Stephen Silvestro, CEO at OptimizeRx]

Collectively, these initiatives reflect our evolution from a traditional point-of-care marketing business toward a broader technology-enabled platform, supporting audience intelligence, media planning, programmatic activation, and clinical workflow engagement. Over time, we believe this evolution can create additional recurring revenue opportunities, improve customer retention, and strengthen the scalability of our financial model. As we look ahead, I believe OptimizeRx is differentiated by three fundamental competitive advantages. First, we've built a proven and increasingly scalable AI-enabled platform. AI has been foundational to our technology strategy for years, and solutions such as DAAP and NLAB demonstrate our ability to translate that investment into differentiated commercial capabilities. Importantly, we believe our platform can support additional customers and use cases without a proportional increase in our cost structure. Second, our proprietary data and solutions provide meaningful differentiation in an increasingly AI-driven world.

[Stephen Silvestro, CEO at OptimizeRx]

While general-purpose AI can automate many marketing functions, we believe our combination of proprietary healthcare data, predictive intelligence, and authenticated clinical workflow access is difficult to replicate or disintermediate. Third, we've established a proprietary network with substantial reach and meaningful barriers to entry. Our integrations across more than 450 EHR and e-prescribe systems provide access to over 1.1 million verified healthcare professionals. These relationships and technical integrations have taken years to develop and form a durable competitive advantage. Together, these fundamental competitive advantages position OptimizeRx to benefit from the continued evolution of healthcare marketing toward AI-enabled planning, programmatic activation, and measurable engagement. As we move toward the end of 2026 and begin preparing for 2027, our priorities remain clear. First, we're focused on improving top-line execution and converting the commercial opportunities currently within our pipeline.

[Stephen Silvestro, CEO at OptimizeRx]

Second, we will continue expanding adoption of our AI-enabled data-driven technologies, including DAAP and NLAB, while building on our proprietary data asset and growing portfolio of intellectual property. Third, we'll focus on increasing utilization of our proprietary network through programmatic distribution and additional strategic partnerships. Finally, we remain committed to maintaining the financial discipline and operating efficiency that have supported our strong profitability performance. We believe the combination of these priorities positions OptimizeRx to emerge from the current period of spending uncertainty with a stronger operating model, broader technology capabilities, and additional avenues for sustainable growth. Before turning the call over to Ed, I'd also like to touch on our previously announced finance leadership transition. Today is Ed's last earnings call with OptimizeRx, although he will continue serving as Chief Financial and Strategy Officer through the end of 2026.

[Stephen Silvestro, CEO at OptimizeRx]

Effective January 1, 2027, Andy D'Silva will assume the role of Chief Financial Officer, and Heather Favazza will become Chief Accounting Officer. This transition remains on track, and we appreciate Ed's continued leadership and support as we prepare for the next chapter of the company's growth. I'd also like to personally thank Ed for his incredible leadership during his tenure here at OptimizeRx. With that, let's turn the time over to Ed.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Thanks, Steve, and good afternoon, everyone. As always, we issued our earnings release this afternoon detailing our financial results for the third quarter ended September 30, 2026. A copy of the release is available in the investor relations section of our website, and additional information will be included in our upcoming Form 10-Q. Third quarter revenue was $21.6 million, a decrease of 17% from the $26.1 million recognized during the same period in 2025. The year-over-year decline was primarily attributable to reduced spending among a limited number of large customers, including customers that utilized our lower-margin managed services offering in the prior period, as well as continued budget pressures and spending delays associated with a broader market condition, such as MFN pricing uncertainty. Our expenses for the quarter ended September 30, 2026, decreased $5.1 million year-over-year to $18.9 million.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

This was driven by lower cost of revenue and compensation-related expenses, despite being impacted by $0.7 million in severance costs associated with our previously announced reduction in force. The decrease in cost of revenue was largely attributable to a favorable products and channel mix, including a significant reduction in DTC managed service revenue this quarter. Our ongoing margin optimization initiatives implemented over the last 18 months continue to yield meaningful benefits, resulting in expected gross margin in the low 70% range for the full year 2026. Net income for the third quarter of 2026 was $1.2 million, or $0.06 per basic and diluted share, compared to a net income of $0.8 million, or $0.04 per basic and diluted share in the third quarter of 2025.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

On a non-GAAP basis, our net income for the third quarter of 2026 was $3.8 million, or $0.20 per diluted share, as compared to $3.1 million, or $0.16 per diluted share in the same year-ago period. Our adjusted EBITDA was $6.3 million for the third quarter of 2026, compared to $5.1 million during the third quarter of 2025. Even though revenue declined 17% in third quarter of 2026, our adjusted EBITDA margin was approximately 29% for the quarter, up from approximately 20% in the third quarter of 2025, an improvement of more than 900 basis points. We believe this demonstrates that our margin optimization and cost management initiatives are working and that our business model can generate higher profitability as revenue grows.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Operating cash flow was $12.9 million for the first three quarters of 2026, and we ended the quarter with $22.3 million cash balance, as compared to $23.4 million on December 31, 2025. As we highlighted last quarter, our long-term loan with Blue Torch Capital was refinanced with Fifth Third Bank, through which we fully drew down the $25 million term loan and have access to a $10 million revolver. Our current interest rate on the term loan with Fifth Third Bank is SOFR plus 2.25%. With that said, we paid $6.3 million in principal during the third quarter, which was $6 million ahead of our payment schedule, leaving our outstanding debt at the end of September at $13.4 million. Furthermore, subsequent to the quarter end, we paid off an additional $3 million in debt and now have a debt balance of $10.4 million.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

We intend to continue paying down our outstanding loan principal ahead of schedule, in combination with executing on our share repurchase program. Our bottom line performance continues to be strong and in line with our strategy of driving sustainable, profitable growth. Now, let's turn to our KPIs for the third quarter of 2026. Average revenue per top 20 pharmaceutical manufacturer now stands at $2.5 million. Net revenue retention rate dipped below prior period levels to 83%. The dip was driven primarily by a small number of large accounts optimizing spend rather than broad-based churn. Additionally, revenue per FTE came in at $706,000. While our KPIs showed decline compared to previous quarters, we have made meaningful progress on margin expansion and operating expense management, consistent with our strategy of driving profitable growth.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Based on our performance through the first nine months of 2026 and our current outlook for the remainder of the year, we are updating our guidance for 2026 and are looking for revenue to come in between the range of $87 million and $93 million, and are maintaining our adjusted EBITDA of $21 million-$25 million. As Steve mentioned, contracted revenue continues to track approximately 20% below the comparable prior year level, resulting in a larger amount of revenue remaining to secure and recognize during the fourth quarter than we had previously anticipated. While this increases the execution risk associated with achieving our revenue outlook, we remain encouraged by several developments, including renewed spending from a previously significant customer, expanding opportunities with key accounts, indications of pent-up demand, and the continued rollout of our new products and programmatic capabilities.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

We believe these factors, combined with the seasonal spending patterns historically associated with the fourth quarter, provide a path to achieving our full-year objectives. However, the timing and conversion of these opportunities will be particularly important as we close out the year. From a profitability perspective, our strong gross margins and the benefits of our cost reduction initiatives provide additional support for our adjusted EBITDA outlook. Before handing it over to Steve, I wanted to once again thank everyone for your support and trust over the last five years. As previously mentioned, I look forward to staying engaged with OptimizeRx leadership team in my role as a strategic advisor. Once again, I want to congratulate both Andy and Heather on their well-deserved promotions. With that, I will turn the call back over to Steve. Steve?

[Stephen Silvestro, CEO at OptimizeRx]

Thanks, Ed. Operator, now let's move to Q&A.

[Operator]

Thank you. If you would like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you would like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. Our first question is from Ryan Daniels with William Blair. Please proceed.

[Dustin Scaringe, Analyst at William Blair]

Hey, everyone. This is Dustin on for Ryan. Thanks for taking our questions. Great to see the wins with the programmatic partnerships. Now that you have DeepIntent, The Trade Desk, and PulsePoint, I am not sure if you have kind of sized up roughly what percentage of the programmatic space you have won with these three DSPs together, but maybe we can get some idea of how much runway there is left. I know it is early innings, but I imagine that there is a lot of runway, but what percent are these three together? Thank you.

[Stephen Silvestro, CEO at OptimizeRx]

Hey, Dustin. Thanks for the question. Good to hear your voice. These three are really the three big ones in the space that we have gone after deliberately with some intentionality. We believe they represent probably 60%-70% of the volume in this space, so we are connected in the right spots. In terms of generating revenue from the partners, still, as you pointed out, still very, very early days. It will take a little while to build the swell on that. These integrations have already demonstrated some really, I think, encouraging results in these early days for us in terms of volume and bidding and acquisition. We are feeling very good going into the 2027 RFP season, as indicated in our prepared remarks, and as is indicated in our contracted revenue, we are running close to 20% ahead right now in RFP season.

[Stephen Silvestro, CEO at OptimizeRx]

Looking strong on that. A lot of that is due to some of the RFP stuff that is going through those programmatic desks. We will be able to size it more as we get up, ramped, running, and start to see more flow. These are the three big ones that we were targeting.

[Dustin Scaringe, Analyst at William Blair]

Gotcha. Good to hear on that. Then maybe you can talk about some of your shift toward mid and long tail life science customers. Where are you with that, and how is that progressing?

[Stephen Silvestro, CEO at OptimizeRx]

Yeah, happy to address that. We are seeing exceptionally good play in the mid-tier and in the long tail. We've got some dedicated sales resources now focused on that. We had one of those mid-tier clients join our sort of top 10 client pool in the last two quarters, which is really encouraging to see. We've had really significant play in the long tail as well, buying one and two solutions, kind of testing things out. But those early indications give us a lot of I think they give us a lot of faith in what we're going to see from them in 2027.

[Stephen Silvestro, CEO at OptimizeRx]

I think we've articulated this before on the call, but part of the struggle that these mid-tier and long tail clients have is they don't have the massive budgets to come in and spend on sales force resources and all the Cadillac benefits that the top 10 or 15 pharmaceutical manufacturers and agencies do. So, what our solutions do is level the playing field for those mid-tier and long tail clients, and that's why we're seeing sort of outsized investment starting to come in from those portions of our client pool.

[Dustin Scaringe, Analyst at William Blair]

Okay. Thanks for that. Just last one for us. NRR, probably not where you want it right now, down to 83%. Just wondering, should we assume that this is kind of the trough quarter and we should be up from here, or how should we think about that going forward? Thanks.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah, I will give you a little bit of insight, then I will have Ed and Andy chime in as well. I think that a lot of the NRR and just generally the KPIs are really focused on the disruption in that one client and some of the pullback. I think when we normalize that for 2027, you are going to see a pretty big turn in what those KPIs look like. Part of the reason why we are talking about what we are seeing already in 2027 is just to help level set so that people do not panic in terms of the revenue model. Things are actually looking really, really good. But as we have committed as a leadership team previously, we have been very effective at our guide. We wanted to make sure that we were being transparent in our fourth quarter.

[Stephen Silvestro, CEO at OptimizeRx]

With the lack of visibility in buy-ups, we just did not think it would be fair to everybody to just sort of roll the dice and try to hit it out of the park on buy-ups with the expectation that we may not get there, just without the visibility in Q4. We are just over-communicating and making sure that we are being clear, but we feel really great about 2027, and that is really where the game is. Ed, anything else you would add to that? Andy?

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Yeah, I think for NRR, I think, yeah, it probably is the trough. As you know, these are last 12 months oriented figures, so they are kind of doing the job they were designed to do, which is to give you a sense for where the business stands based on the trend currently established. And depending on where Q4 shakes out, I am expecting that number to start to improve as we go into 2027.

[Stephen Silvestro, CEO at OptimizeRx]

Thanks, Ed.

[Dustin Scaringe, Analyst at William Blair]

All right.

[Stephen Silvestro, CEO at OptimizeRx]

That helped, Dustin?

[Dustin Scaringe, Analyst at William Blair]

Thank you very much.

[Stephen Silvestro, CEO at OptimizeRx]

Yes? You good?

[Dustin Scaringe, Analyst at William Blair]

Yeah.

[Stephen Silvestro, CEO at OptimizeRx]

You got it, man.

[Dustin Scaringe, Analyst at William Blair]

Yeah, it's all good. Thank you.

[Stephen Silvestro, CEO at OptimizeRx]

Yep.

[Operator]

Our next question is from Richard Baldry with Roth Capital Partners. Please proceed.

[Richard Baldry, Analyst at Roth Capital Partners]

Thanks. Wondering if you are willing to put any floor into the 2027 growth now that you are this far into RFP season. Do you think you can get cleanly back to double digit, low-mid double digit? Is there a way to think about what you are seeing so far and with that, your client coming back that had been a headwind for the year?

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. Hey, Rich. Good to hear your voice. Looking forward to seeing you next week. We are not ready to put a floor out there. We have not guided to 2027 yet, but we are right now, as I shared, we are about 20% ahead on the contracted revenue coming into 2027, and that is a really good indication of sort of what we think 2027 will look like. Again, it is still early days, right. But the 2027 projection is looking a little bit more like growth rates from 2025 than it is from 2026. And that is what we anticipated. We knew when the client came back, given the size of that client, that we would start to see spend levels that were more aligned and appropriate with what we were experiencing in 2025. So, too early to give guidance yet. RFP season is feeling very strong.

[Stephen Silvestro, CEO at OptimizeRx]

Sales team is doing a great job, and the mojo on the team and just the general sentiment and culture within the business, I would say, is the best it has been in a very long time.

[Richard Baldry, Analyst at Roth Capital Partners]

If you back out sort of the headwinds from the top 20, because the blended growth is not as negative as the top 20, could you talk sort of about your non-top 20 health there. Is it growing well year-over-year. What are new logo wins looking like, maybe in non-pharma, like biotech or med devices. Or how are you feeling outside of that category as an indication of sort of underlying strength for your demand for what you are offering.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. The growth in the top 20 and long tail is really, I would say, is very encouraging. And we are seeing a smattering of not just pharma biotech, but we are, to your point, seeing some med tech come in, some other types of businesses that are utilizing the network and the tools that we have got to compete with some of the larger manufacturers. As I shared, we did have one of those mid-tier clients reach kind of top 10, maybe even like top five status within the business this year and going into next year. So, we are feeling very encouraged around that. And seeing the expanded use cases for the platform and the technology, the way that they are using it, is also, I think, expanding the TAM of the business. So, it is really good.

[Stephen Silvestro, CEO at OptimizeRx]

I can't really share a broken out growth rate, but it's well into double digits, I would say, from where it was last year. Andy, Ed, feel free to chime in if you want to add anything else, but very encouraging.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Yeah. I think you nailed it, Steve. I think the long tail has a lot of opportunities there. We have some very skilled team members in the sales team that are highly focused on growing that, and we think that the budgets there are open for a first win.

[Richard Baldry, Analyst at Roth Capital Partners]

Switching on the cost side, are the cost efficiency gains pretty much behind you, or are there other areas you can maybe use AI technologies to keep pushing that a little bit? A tangential to that, with the EBITDA defended as well as it is, why the focus on paying debt down so fast versus maybe doing aggressive buybacks to reward your patient investors?

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. Andy, why don't you take the EBITDA question, and Ed, why don't you take the paying down the debt question? Okay.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Yeah. We are constantly looking to be able to optimize our OpEx and just overall structure. You saw over the last 12 months, we implemented a pretty significant cost-cutting strategy that is paying dividends to our bottom line right now. And we will continue to look at that kind of stuff as we go into 2027. Obviously, we are not going to commit to anything right now. But with AI continuing to advance and the automation initiatives that we have within the company, there is a lot of opportunities that we see.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. And then on the buyback. Ed, you want to talk about the. Yeah, go ahead.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Yeah. So, great question, Rich. So we are actually, as we said before, are looking to change that mix a little bit and actually start to push a little bit harder on the actual stock buyback. I would say stay tuned in Q4, and I think you will see more activity there from us on the equity buyback.

[Richard Baldry, Analyst at Roth Capital Partners]

Got it. Thanks for the question.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah, you got it. No problem, Rich. Thank you for the good questions.

[Operator]

Our next question is from Josh Nichols with B. Riley Securities. Please proceed.

[Josh Nichols, Analyst at B. Riley Securities]

Hey, thanks for taking my question. Great to see another quarter of strong margin, paying off the debt. I think it was already touched on, look, 2027 contracted revenue looks like that is trending well. I just want to dive a little bit more into Q4. I know you mentioned the contracted revenue is tracking like 20% below or so, lower levels. Just looking at the implied guide for Q4, it is kind of down 13% year-over-year. Is that delta really kind of a good way to think about the potential risk for the midpoint overall? Or how much of the Q4 revenue, based on the guidance, is already contracted today?

[Stephen Silvestro, CEO at OptimizeRx]

Andy, why don't you take that one?

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Hey, Josh. Nice to hear your voice. Right now, for the full year, to hit the midpoint of our guidance range, we are a little over 90% in contracted revenue. In the last couple years prior to this, we were closer to the mid-90% range. There is a little to go get this year. But with that being said, obviously, there was a lot of disruption this year with that large customer, with MFN, and things like managed services. Typically, in situations like that, you will see a little bit more activity in the back part of the quarter, back part of the fourth quarter. Based on the conversations we are hearing from our sales team and our sales-focused executives, there seems to be enough pent-up demand to help bridge that gap.

[Josh Nichols, Analyst at B. Riley Securities]

Yeah, thanks for the color there, Andy. I know previously you have talked about, given the company's large fixed cost structure, about 30% type EBITDA margin being achievable. I had to notice that despite revenue being down, you did 29% EBITDA margin this quarter. With the bookings looking pretty solid so far for 2027, do you think that that is like a target that you are going to potentially look to revisit, or there is potential upside if the company gets back to healthy double-digit growth?

[Stephen Silvestro, CEO at OptimizeRx]

Yeah, I will take that one.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Yeah.

[Stephen Silvestro, CEO at OptimizeRx]

No, go ahead, Andy. You take it. Go ahead.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Yeah, Ed and Steve have been saying for the last few quarters, our operating model truly is scalable as the business continues to grow top line. Our objective has always been to get to a 30%+ gross margin as the revenue continues to grow. We haven't finalized our guidance or anything like that for 2027, so we're not going to commit to a 30% margin for next year. You can obviously see there's a path to do that and then not be distant future.

[Josh Nichols, Analyst at B. Riley Securities]

Sounds good. Appreciate it. Thanks.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

Thank you.

[Stephen Silvestro, CEO at OptimizeRx]

Thanks for the questions.

[Operator]

As a reminder, it is star one on your telephone keypad if you would like to ask a question. Our next question is from Eric Martinuzzi with Lake Street Capital Markets. Please proceed.

[Eric Martinuzzi, Analyst at Lake Street Capital Markets]

Yeah, just wanted to better understand the Q4 reset here. Is the tracking 20% below, is that a number that has gotten larger at this snapshot, or was that similar to where we were exiting Q1, Q2?

[Stephen Silvestro, CEO at OptimizeRx]

Hey, Eric. Thanks for the call. It's largely the same as where we were. We've not seen an improvement in the contracted revenue year-over-year. We thought we would see a little bit more buy-up activity, and we just haven't seen the buy-up activity that we hoped we would see coming into the fourth quarter. As we've been very consistently messaging and communicating all throughout the year, we knew that Q4 was going to be dependent on the return of some buy-ups, and we hoped that we would get our large disrupted client back to spending and back engaged in the fourth quarter. I think we are delighted that the client is back and they're spending. The levels are still small because they're starting to invest off of non-budgeted dollars, right?

[Stephen Silvestro, CEO at OptimizeRx]

They're coming back in off of non-budgeted dollars, but they are spending and I think in a pretty meaningful way. But the visibility into buy-ups is the main reason for the adjustment on the guidance. We just don't know yet. There is a possibility that we could see some of that come in, but we just don't have visibility. And I think we as a management team feel strongly we want to just continue to be clear on the communication and try to manage the expectations and maintain our solid credibility, which we've worked hard to build up. So, that's really what it is. No major disruptions to contracted revenue. We just haven't seen the buy-up growth yet that we are anticipating, so.

[Eric Martinuzzi, Analyst at Lake Street Capital Markets]

It seems like a strange behavior, though. I would think pharma would want to attract customers. You're not that big of a budget spend for them. To hear that the RFP momentum is up 20%, but yet the 2027 is up 20%, but the 2026 is down 20%. Help me square those.

[Stephen Silvestro, CEO at OptimizeRx]

Well, contracted revenue has in it a year-over-year, it's got a year-over-year tracking across time, right? If you take out the $10 million plus of that one disrupted client and factor that in, that's a good portion of the 20% decline of contracted revenue, right, year to date. It doesn't take a whole lot to get to the 20%. Then if you contemplate what the RFP season and the output of that could look like coming into 2027, that's where you start to see recovery happening. That is in fact what we're seeing. Ed, you can chime in and answer anything else there that you would add, but I think that it's very linear mathematically, Eric, in terms of what we're seeing.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Yeah, I agree. I think, look, I mean, being 20% below with now three quarters into the year is a little different than being 20% ahead with just a few weeks of next year's RFP season behind us. As Steve said, we're still early innings, but really positive signs that we're coming back strong into 2027. However, this year it's kind of starting to get a little bit baked, which is the reason why we're dialing down our revenue expectation in line with what we're seeing in our backlog. Now, could there be a surprise on the upside in Q4? You never know. But the odds of that, the next six weeks are definitely getting a little bit lower than we would like. Hence the reason why we're dialing it down.

[Eric Martinuzzi, Analyst at Lake Street Capital Markets]

Steve, with the change in the Congress shifting from Republican to Democrat, I know historically sometimes big pharma becomes a punching bag for that type of party shift. Just curious to know if your clients are anticipating that at all as they look out to next year.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. We have gotten a couple questions around that, or really, I would say not questions, more comments from clients around that. I think they are just uncertain, Eric. They are uncertain. I think they have just come through a, what they thought was going to be sort of a frothy period for them with the current administration being largely Republican-controlled, and that wasn't, as we all know. They got whacked with the piñata stick via MFN and 5,000 other things. So, what they thought would be a windfall for them, I think, with this current administration and Congress and the House, was certainly not. They all recalibrated around that. So, they don't really know what to expect around this. It's really an interesting topic. There were a few good articles out.

[Stephen Silvestro, CEO at OptimizeRx]

I can talk to you about them later, but there was one in Endpoints, another one in the Wall Street Journal, and I'll be happy to share them along, from some of the executives kind of sharing and sharing thinking. But we'll see where that goes.

[Eric Martinuzzi, Analyst at Lake Street Capital Markets]

Got it. Thanks for taking my questions.

[Stephen Silvestro, CEO at OptimizeRx]

Absolutely.

[Operator]

Our next question is from David Grossman with Stifel. Please proceed.

[David Grossman, Analyst at Stifel]

Thank you. Steve, you mentioned in your prepared remarks that there are some indications of pent-up demand that were encouraging. Can you perhaps give us a little more detail about what you are seeing and why you are encouraged?

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. Thanks, David. Good to hear your voice. Hoping to see you soon. What we have seen is that people have warehoused dollars throughout the year and have waited to see Q1 through Q4 where they were going to place bets and whether or not they were going to get whacked with this administrative piñata stick and have to course correct. We are seeing pockets of spend increase, particularly in the mid-tier long tail, as I have already shared. We believe that that pent-up demand still exists with several of the major brands that we deal with. We will start to see some of the buy-up activity, we believe, in the next six weeks. The challenge on recognizing the revenue is we have got to contract it, deliver it, measure it, and so forth in a period of time, which is what Ed was articulating.

[Stephen Silvestro, CEO at OptimizeRx]

To be able to get all of that accomplished inside of six weeks at a broader level, we just want to make sure we are communicating clearly around it. As Ed said, the pent-up demand is there, and it could materialize, but we do not have visibility to it, and so we do not want to overpromise in that regard. But it is there. Most of the time, as you know, David, from our conversations, these are use it or lose it dollars. So, they are going to have to do something with the dollars that they had warehoused for the first three quarters. We will see how they deploy them. Interestingly enough—

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

I was going to add—

[Stephen Silvestro, CEO at OptimizeRx]

Yeah, go ahead, Ed. Add to this one.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Yeah, I was going to add to Steve's comments. I think, quantitatively speaking, the fact that we're up 20% year-over-year on contracted revenue, same time period. It's kind of a good early indicator of some demand that was really visible in 2026.

[Stephen Silvestro, CEO at OptimizeRx]

Yeah. There's one other thing I would say to you, David, and I'll give you the next question, but if you look at some of the other guys that have reported or companies that have reported that have a different revenue model that might be subscriptive in nature, they're reporting quarters that are up for Q3, Q4 outlook, and that's mostly because they're looking more in a forward-looking way in their subscription-based models. That's an indication it's a bellwether of where the industry is trending, I believe. We can talk more about it on the call after if you want, but

[David Grossman, Analyst at Stifel]

Right. Okay. No, thank you for that. Then just back to your comment about the one large client that has pulled back this year. Is it fair to say, just based on the number you just provided us, that that's about 10 points of NRR year to date? Is that the way to look at that, or for the year it'll be about 10 points of NRR?

[Stephen Silvestro, CEO at OptimizeRx]

Ed, you can verify that, or Andy, sure.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Andy, go ahead. I can do the math that fast.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

That is about right. They were 10% customers last year, and this year, the first nine months of the year, they did not do any revenue, so that is about right.

[David Grossman, Analyst at Stifel]

Right. Okay. If I think about that, let us just say you are going to get a bit of a. The headwind goes away because you comp out, right? Because you say they are going to start growing a little bit at least in their spending in the fourth quarter. Is there any reason to think that NRR would not be 100% or better for next year?

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

No, I mean, if you got-

[Andy D'Silva, Chief Business Officer at OptimizeRx]

I mean, we haven't given guidance yet.

[Ed Stelmakh, Chief Financial and Strategy Officer at OptimizeRx]

Yeah.

[Andy D'Silva, Chief Business Officer at OptimizeRx]

I wouldn't say we can really give you I mean, that would be bridging that gap pretty significantly on giving guidance. Obviously, if our business grows a meaningful portion next year, our NRR would grow, be over 100%. Historically speaking, roughly 5%-15% of our business comes from new logos every year. I mean, if you kind of think about that and apply a growth rate that you believe is reasonable for next year, you can kind of back of envelope get to what you would think NRR would be.

[David Grossman, Analyst at Stifel]

Yeah, I guess what I'm getting at is, do we have any other known divots coming that would impact 2027?

[Stephen Silvestro, CEO at OptimizeRx]

No, not in 2027. We have got some 2028, like LOE that we will have, which we are planning for and have already planned around. You and I talked about that at our last conference, so just normal course of business stuff, but no major divots that we see at this point.

[David Grossman, Analyst at Stifel]

Got it. All right, guys. Good luck. Thank you.

[Stephen Silvestro, CEO at OptimizeRx]

Thanks, David.

[Operator]

This will conclude our question and answer session. I would like to turn the floor back over to Steve Silvestro for closing comments.

[Stephen Silvestro, CEO at OptimizeRx]

Thank you, operator, and thank you to everyone for joining our call today. It was really a. Excuse me. Pardon me. Sorry about that. As we conclude our call today, there are really three things that I want us to be focused on. First, our third quarter results demonstrate the progress we have made in strengthening the financial foundation of OptimizeRx, and I think we have talked about that, and questions reflect that. While revenue growth remains below our expectations for the fourth quarter, our ability to deliver significant adjusted EBITDA performance reflects the benefits of our margin optimization efforts, our disciplined cost management, and the operating efficiencies we have implemented throughout the year. These improvements position us to generate stronger operating leverage as revenue growth returns, which I think is great news for all of us. Second, we believe our technology platform and proprietary data are highly differentiated.

[Stephen Silvestro, CEO at OptimizeRx]

Our continued investments in our patent-protected DAAP technology, our expanded NLAB capabilities, our strategic partnerships with programmatic DSPs such as DeepIntent, The Trade Desk, and PulsePoint, and our continued product innovation are creating new ways for pharmaceutical manufacturers to engage healthcare providers and patients. Together, these advancements strengthen our competitive position and expand our long-term growth opportunities. Third and lastly, we remain focused on translating these investments into improved commercial execution. While we have yet to recognize revenue from the investments we have made in 2026, we are very encouraged by the demand signals from customers. We are also encouraged by the improvements made in our commercial organization, bringing renewed strength and firepower to OptimizeRx's culture and the opportunities associated with our expanding product portfolio. These changes are showing up in our year-to-date contracted revenue growth for 2027 and are an encouraging indicator of what lies ahead.

[Stephen Silvestro, CEO at OptimizeRx]

We believe the progress we have made in 2026 has established a stronger foundation for the future of OptimizeRx, and we remain committed to delivering sustainable growth, improving profitability, and creating long-term value for our shareholders. Finally, I would like to thank our employees for their dedication and execution, our customers and our partners for their continued trust, and our shareholders for their ongoing support. In particular, I would also like to thank Ed for his guidance, his direction, his stewardship during his tenure at OptimizeRx, as he continues to transition finance leadership to Andy and Heather, and to help ensure that we are prepared for the next chapter of the company's growth. We appreciate you joining us today and look forward to updating you on the progress of the next quarter.

[Operator]

Thank you, Mr. Silvestro. Before we conclude today's call, I would like to provide the company's safe harbor statement that includes important cautions regarding forward-looking statements made during today's call. Statements made by management during today's call may contain forward-looking statements within the definition of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. These forward-looking statements should not be used to make investment decisions. The words anticipate, believe, estimate, expect, intend, may, plan, possible, seeking, will, and similar expressions identify forward-looking statements. They may speak only to the date that such statements are made.

[Operator]

Forward-looking statements in this call include statements regarding the company's full year 2026 revenue and adjusted EBITDA guidance, the company's ability to secure, convert, and recognize revenue during the fourth quarter, the timing and normalization of customer spending, including expected pent-up demand and the 2027 RFP season, renewed spending from a previously significant customer, expected gross margin for the full year 2026, the benefits of the company's cost reduction and margin optimization initiatives and resulting operating leverage, the company's commercial organization and go-to-market strategy, the company's programmatic strategy and partnerships, including the expected availability of its inventory to PulsePoint advertisers, the commercialization and adoption of the company's products and AI-enabled capabilities, including DAAP, NLAB, and CopayCue, the company's competitive advantages and position, the company's ability to create recurring revenue opportunities and achieve sustainable long-term growth, the company's intention to repay its outstanding debt ahead of schedule and potential share repurchases, the orderly transition of finance leader responsibilities, and the company's ability to create long-term value for its shareholders.

[Operator]

Forward-looking statements also include management's expectations for the rest of the year and for 2027. The company undertakes no obligation to publicly update or revise any forward-looking statements, whether because of new information, future events, or otherwise. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified. Future events and actual results could differ materially from those set forth in, contemplated by, or underlying these forward-looking statements.

[Operator]

The risks and uncertainties to which forward-looking statements are subject to include, but are not limited to, the timing and amount of customer spending and the company's ability to convert contracted and pipeline opportunities into recognized revenue, the effects of government regulation and drug pricing policy, competition, dependence on a concentrated group of customers, the success of new products and programmatic partnerships, cybersecurity incidents that could disrupt operations, the ability to keep pace with growing and evolving technology, the ability to maintain contracts with the electronic prescription platforms and electronic health records network, risks related to the company's indebtedness, and other material risks.

[Operator]

Risks and uncertainties to which forward-looking statements are subject could affect business and financial results are included in the company's annual report on Form 10-K for the year ended December 31, 2025, and subsequent quarterly reports on Form 10-Q, and in other filings the company has made and may make with the SEC in the future. These filings, when made, are available on the company's website and on the SEC website at sec.gov. Before we end today's conference, I would like to remind everyone that an audio recording of this conference call will be available for replay starting later this evening, running through for a year on the investor section of the company's website. Thank you for joining us today. This concludes today's conference call. You may now disconnect your lines.

Participants

Executives

• Stephen Silvestro, CEO
• Ed Stelmakh, Chief Financial and Strategy Officer
• Andy D'Silva, Chief Business Officer

Analysts

• Dustin Scaringe, Analyst at William Blair
• Richard Baldry, Analyst at Roth Capital Partners
• Josh Nichols, Analyst at B. Riley Securities
• Eric Martinuzzi, Analyst at Lake Street Capital Markets
• David Grossman, Analyst at Stifel