biote Q1 Earnings Call Highlights

Key Points

• biote said a voluntary recall of certain bioidentical hormone pellets in January created a temporary supply disruption that cut Q1 revenue by an estimated $1.7 million, added about $1.5 million of incremental costs, distracted the salesforce and reduced procedure volumes.
• Revenue fell 8.3% year-over-year to $44.9 million (procedure revenue down 13.2% to $31.3M) while dietary supplement sales grew 19.1% to $11.0M; gross margin slipped to 68.9% and adjusted EBITDA declined to $8.7M with net income of $2.7M ($0.06 EPS).
• Management expects supply to normalize as Asteria adds shifts and third-party partners fill orders, has expanded the salesforce and trained 200+ practitioners, and has maintained 2026 guidance of revenue above $190M and adjusted EBITDA greater than $38M while anticipating procedure revenue to return to growth in H2.

biote NASDAQ: BTMD executives said a voluntary recall of certain bioidentical hormone pellet inventory created a temporary but meaningful headwind in the company’s first quarter of 2026, impacting procedure revenue, margins, and salesforce productivity while management works to restore supply continuity through its Asteria Health manufacturing operation and third-party partners.

Recall-driven disruption weighed on Q1 performance

Chief Executive Officer Bret Christensen said the company voluntarily withdrew certain bioidentical hormone pellet inventory from the market in January “out of an abundance of caution.” He said the temporary supply disruption reduced first-quarter revenue by an estimated $1.7 million and led to about $1.5 million of incremental costs.

Christensen added that the recall became “a significant distraction” for the salesforce because representatives were “forced to service accounts versus focusing on growth.” While the company expects the impacts to continue into the second quarter, Christensen said management views the issue as temporary and not reflective of long-term demand trends.

Revenue declined as procedures fell; supplements grew

Chief Financial Officer Bob Peterson reported revenue decreased 8.3% year over year to $44.9 million. Procedure revenue declined 13.2% to $31.3 million, including the $1.7 million recall-related impact tied to hormone pellets shipped by Asteria Health.

Peterson attributed the decline in procedure revenue primarily to lower procedure volume in existing clinics—“which includes the impact of hormone pellet supply constraints related to the recall”—as well as slower productivity from new clinics because sales representatives were focused on supporting recall-impacted clinics.

Dietary supplement revenue increased 19.1% to $11.0 million, which Peterson said was “primarily driven by the continued growth of our e-commerce channel.” He said the company continues to forecast dietary supplement revenue growth at a mid-to-high single-digit rate for full-year 2026.

Margins and expenses reflected recall costs and mix shift

Gross profit margin fell to 68.9% from 74.3%, which Peterson said was primarily due to $1.1 million of incremental costs related to the recall. He also noted a product mix shift: Asteria Health produced about 30% of shipped pellets in the first quarter, down from more than 50% in the fourth quarter of 2025.

Peterson said the company expects second-quarter product mix to continue to include an elevated level of third-party supply, which is expected to pressure gross margin. “Our goal remains to meet customer needs through the vertical integration of Asteria Health,” he said.

Selling, general, and administrative expenses rose 4.1% to $27.8 million, driven by higher legal expense and $0.4 million of SG&A costs tied to the recall.

Earnings, cash flow, and balance sheet update

Net income was $2.7 million, with diluted earnings per share attributed to Biote shareholders of $0.06, compared with net income of $15.8 million and diluted EPS of $0.37 in the prior-year quarter. Peterson said first-quarter 2026 net income included a $2.1 million gain from changes in the fair value of earn-out liabilities, versus a $10.7 million gain in the first quarter of 2025.

Adjusted EBITDA decreased to $8.7 million, with an adjusted EBITDA margin of 19.4%, which Peterson attributed to “lower sales, reduced gross profit, and higher operating expenses.” Cash flow from operations was $3.9 million. As of March 31, 2026, the company had $5.3 million in cash and cash equivalents after fully repaying the remaining amount due under its share repurchase liabilities in January 2026.

Practitioner training, salesforce expansion, and outlook

Christensen said Biote has made progress over the past 12 months in advancing strategic priorities, including strengthening its commercial organization, expanding the sales team, and focusing on maximizing value from “existing top-tier clinics.” He reiterated the company’s goal of expanding sales personnel from over 90 at the end of 2025 to about 120 in 2026, and said the effort is “substantially complete” after hiring more than 25 new sales personnel in the first quarter.

He also said the company trained more than 200 new practitioners in the quarter, a 16.5% increase from the first quarter of 2025, with training sessions running “near full capacity.” Christensen described newly trained practitioners as a leading indicator of future procedures and dietary supplement sales, while noting that after training it typically takes about six months for new practitioners to contribute meaningfully to financial performance.

In the question-and-answer session, Christensen said clinic attrition has “stabilized and been stable now for several quarters,” though he added it remains “a little bit higher than we’d like.” He said the supply constraints in the quarter made it difficult to assess improvement, but pointed to “some positive signs in daily volumes prior to the recall.” He told another analyst that he had not seen meaningful clinic attrition tied to the recall, though he said it was too early to assess whether there had been any patient attrition or modality switching.

On the supply situation, Christensen said the recall covered product “compounded and manufactured prior to October of 2025,” and the process of returning and replacing product strained Asteria. He said Biote has worked to scale production, including adding a second shift, and has leaned on third-party pharmacy partners to help fulfill orders. Peterson added that the company has also slowed some shipments from Asteria intentionally to build safety stock, and said the second shift recently began, which he suggested would help address constraints in areas such as “filing and packaging.” Management said it remains in an allocation environment, but described conditions as improved versus earlier in the recall period and said normalization is expected in the coming weeks.

Peterson said the company maintained its 2026 guidance, forecasting revenue above $190 million and adjusted EBITDA greater than $38 million. Procedure revenue is still expected to return to growth in the second half of 2026, though Peterson said the company now expects first-half procedure revenue growth to be “moderately lower than previously forecast” due to the recall and related supply constraints.

Christensen said management’s confidence in a second-half return to growth is supported by several factors, including improving daily volume trends prior to the recall, potential pent-up demand following supply shortages, the expanded salesforce, and continued practitioner training volume.

About biote NASDAQ: BTMD

biote Corp. operates in practice-building business within the hormone optimization space. It trains physicians and nurse practitioners in hormone optimization using bioidentical hormone replacement pellet therapy in men and women experiencing hormonal imbalance. The company offers Biote Method, a comprehensive end-to-end practice building platform that provides Biote-certified practitioners with the components developed for practitioners in the hormone optimization space comprising Biote Method education, training, and certification services; practice management software that allows Biote-certified practitioners to order, track, and manage hormone optimization product inventory and other administrative requirements; inventory management software to monitor pellet inventory; and information regarding available hormone replacement therapy products, as well as digital and point-of-care marketing support.

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