LifeMD Q1 Earnings Call Highlights

Key Points

• Q1 results: LifeMD reported revenue of $50.2 million, beating guidance, and added a record >42,000 net telehealth subscribers to finish with over 365,000, while front‑loaded marketing drove a GAAP net loss of $9.6 million and an adjusted EBITDA loss of about $4.5 million.
• Strategic shift and growth drivers: The company is pivoting weight‑management toward branded GLP‑1s (just under 100,000 weight‑management patients and ~120% sequential sign‑up growth), scaling an in‑house pharmacy and expanding insurance access (from ~112 million to ~230 million covered lives) with a Medicare GLP‑1 Bridge launching July 1.
• Guidance and balance sheet: Management reaffirmed full‑year 2026 guidance of $220–$230 million revenue and $12–$17 million adjusted EBITDA, expects annualized run‑rate above $250 million revenue and >$25 million adjusted EBITDA by Q4, and ended Q1 with $34.5 million cash, no debt, and a $30 million undrawn revolver.

LifeMD NASDAQ: LFMD reported first-quarter 2026 results that management said marked a strong start to the year, highlighted by revenue that topped guidance and record subscriber growth as the company continued shifting its weight management business toward branded GLP-1 therapies and expanded insurance-supported offerings.

First-quarter results and subscriber growth

Chairman and CEO Justin Schreiber said the company delivered “revenue of $50.2 million ahead of guidance” and added “more than 42,000 net telehealth subscribers, the largest quarterly net addition in our history.” LifeMD ended the quarter with “over 365,000 subscribers,” according to Schreiber and CFO Atul Kavthekar.

Kavthekar said nearly all revenue was derived from recurring subscriptions and noted that year-over-year comparisons were presented on a continuing operations basis, excluding WorkSimpli, which was divested in November 2025. Revenue was essentially flat versus the prior-year period of $50.9 million, he said.

Profitability was pressured by marketing investment. Kavthekar reported a GAAP net loss from continuing operations attributable to common stockholders of $9.6 million, or $0.20 per diluted share, compared with a $2.4 million loss, or $0.06 per diluted share, in the year-ago period. Adjusted EBITDA was a loss of approximately $4.5 million, in line with the company’s previously issued guidance range of a $4 million to $5 million loss.

Margins, marketing investment, and balance sheet

Gross margin expanded about 420 basis points to 88%, which Kavthekar attributed primarily to “improvements in lower shipping and fulfillment costs, including the continued scaling of our in-house pharmacy fulfillment.” Gross profit was $44.2 million, up 3% year over year despite flat revenue, he said.

Selling and marketing expenses rose to $29.8 million, up 34% year over year, reflecting what Kavthekar described as “the strategic front-loaded patient acquisition investment.” He said the first quarter was “the peak of our marketing investment for the year,” and that marketing spend “has begun normalizing,” with expectations for sales and marketing to step down in the second quarter and remain at more typical levels in the back half.

On the balance sheet, Kavthekar said LifeMD ended the quarter with $34.5 million in cash, no debt, and a $30 million undrawn revolving credit facility established at the start of the year.

Operational priorities: weight management, women’s health, Rex MD, AI, and pharmacy

Schreiber framed the company’s strategy as “quality care, quality products, quality revenue,” arguing that higher-quality care and products drive longer patient relationships and “more durable, higher quality, and ultimately more profitable” revenue over time. He emphasized that LifeMD is building a broader virtual care platform that includes a “50-state affiliated medical group,” an integrated pharmacy, lab capabilities, expanding insurance coverage, pharmaceutical collaborations, and specialty care programs, while “layering AI across that infrastructure.”

Weight management. Schreiber called weight management the company’s largest opportunity, citing momentum following the introduction of oral GLP-1 therapies. He said customer acquisition costs improved 4% to 5% sequentially in Q1 even as volumes “effectively doubled” from roughly 300–400 new patients per day to 600–1,000 patients per day. LifeMD ended the quarter with “just under 100,000 weight management patients,” he said, and noted sequential sign-ups increased approximately 120% from the fourth quarter.

Women’s health. Schreiber said the company’s women’s health program is designed around longitudinal care, including intake, labs, protocols, and ongoing management by trained providers. He said subscriber count grew “more than 7x from the Q4 base,” customer acquisition costs remained attractive, and on-therapy retention was “tracking north of 80%.” Schreiber added that LifeMD plans to introduce “seven new compounded pharmacy products focused on hormone and bone health” in coming months.

Rex MD and men’s health. Schreiber said Rex MD has approximately 215,000 active patients, with growth across erectile dysfunction, sleep, and hair loss, with sleep “currently the fastest growing category.” He said personalized ED medications combining sildenafil and tadalafil grew more than 40% versus Q4, and that as more fulfillment shifts in-house, the company expects continued margin expansion.

AI and operating leverage. Schreiber said LifeMD is deploying AI “aggressively but thoughtfully,” describing AI as foundational across software development, care delivery, and back-office workflows, including intake, documentation, patient support, revenue cycle, and compliance. He said the company expects the margin impact to become “more visible in the second half of 2026,” and emphasized AI is intended to increase provider capacity without adding headcount.

Pharmacy scale and insurance expansion. Schreiber said LifeMD operates a 22,500-square-foot pharmacy facility licensed in all 50 states with commercial and 503A compounding capabilities, currently processing about 20,000 prescriptions per month. On insurance, he said LifeMD ended the quarter with approximately 112 million covered lives and expects to reach about 230 million by the end of the month. Schreiber highlighted a “Medicare GLP-1 Bridge launching July 1” as a key access initiative.

Guidance reaffirmed; second-quarter outlook reflects mix shift

Management reaffirmed full-year 2026 guidance of $220 million to $230 million in revenue and $12 million to $17 million in adjusted EBITDA. Both Schreiber and Kavthekar also reiterated expectations for annualized run-rate revenue above $250 million and annualized run-rate adjusted EBITDA above $25 million by the fourth quarter of 2026.

For the second quarter, LifeMD guided revenue of $47 million to $50 million and adjusted EBITDA ranging from a loss of $2 million to a profit of $1 million. Kavthekar said the company expects to continue transitioning to branded GLP-1s, while efficiencies and cost savings progress.

On the year-over-year revenue dynamics, Kavthekar said the first quarter of 2025 included heavy use of compounded GLP-1s, and that the company has continued migrating toward branded drugs. “We don’t make as much,” he said, but described branded-drug patients as having “meaningfully better retention,” calling it “the right direction for the business.”

Analyst Q&A: pharma collaborations, insurance economics, Medicare Bridge, and compounding exposure

Asked about relationships with Novo and Lilly, Schreiber said LifeMD views them as “very long-term collaborations,” but said he could not provide additional detail due to NDAs. He said discussions have been “really, really productive” around compliant ways to help patients access therapies, and he expressed optimism that “in the near term… the next quarter or two,” at least one or both relationships could evolve to help “overall unit economics.”

On the elevated Q1 marketing spend, Kavthekar said the company used many of the same channels as before, including Google Ads and social media. He described the quarter as an opportunity to acquire customers at “really attractive” CPAs and said LifeMD also expanded its “database” of prospective targets for future marketing.

Regarding insurance-supported programs, Schreiber said the company is seeing “a considerable improvement in retention rates” among insurance patients, “a significant reduction in customer acquisition costs by as much as… 50%,” and “at least a 10-point improvement in retention” over the first three to six months, though he noted cohorts are newer. Kavthekar added he was surprised that 75% to 80% of patients coming through the site indicate interest in insurance.

On the CMS Bridge program being extended through 2027, Schreiber said LifeMD is “very excited” and is working through details with outside counsel. He said the company has not built it into its model yet, but if it works as expected, it could be “a really, really big opportunity” in the second half of the year.

In response to a question about the FDA’s proposal related to excluding semaglutide from a bulk list, Schreiber said the changes would have “zero impact on the business,” adding, “we don’t compound these medications,” though he acknowledged some patients remain on personalized compounds sourced from third-party pharmacies.

About LifeMD NASDAQ: LFMD

LifeMD NASDAQ: LFMD is a U.S.-based telehealth company that delivers on-demand, membership-based virtual healthcare services. Through its digital platform and mobile applications, LifeMD connects patients with board-certified healthcare providers for diagnosis, treatment and ongoing management of a range of acute and chronic conditions. The company’s core offering centers on personalized care plans supported by prescription fulfillment, lab testing and prescription delivery services.

LifeMD’s service portfolio spans several specialty areas, including men’s health, hormonal therapy, weight management and primary care.

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