OptimizeRx Q2 Earnings Call Highlights

Key Points

• OptimizeRx’s Q2 revenue fell 30% year over year to $20.5 million, pressured by reduced demand, lower-margin managed services and the loss of revenue from a major customer. Adjusted EBITDA was $4.9 million, but the company reaffirmed full-year revenue guidance of $95 million–$100 million and adjusted EBITDA guidance of $21 million–$25 million.
• Management said improved margins and expense discipline represent a new profitability baseline, with gross margin expected in the high-60% to low-70% range. The company generated $8.1 million in first-half operating cash flow, repaid $8 million of debt around quarter-end and may use additional free cash flow for accelerated repayment.
• OptimizeRx expects revenue to be heavily weighted toward the second half, while customer engagement shows signs of normalization and mid-sized accounts are growing. New initiatives—including DeepIntent integration, the Natural Language Audience Builder and CopayCue—aim to expand programmatic advertising and recurring software revenue.

OptimizeRx NASDAQ: OPRX reported second-quarter fiscal 2026 revenue of $20.5 million, down 30% from $29.2 million a year earlier, while adjusted EBITDA totaled $4.9 million, management said on its earnings call. The company reaffirmed its full-year revenue outlook of $95 million to $100 million and adjusted EBITDA guidance of $21 million to $25 million.

Chief Executive Officer Stephen Silvestro said the quarter’s revenue and adjusted EBITDA exceeded consensus expectations, citing margin expansion and expense discipline. However, revenue remained pressured by a limited number of large customers, including one customer discussed in the prior quarter that generated no revenue during the period.

Chief Financial and Strategic Officer Edward Stelmakh said the revenue decline also reflected reduced demand amid macroeconomic factors, including most-favored-nation pricing dynamics, as well as lower revenue from managed-service offerings that carried lower margins. OptimizeRx has been shifting away from those offerings since its 2023 acquisition of Medicx Health.

Profitability and Balance Sheet

OptimizeRx recorded a net loss of $700,000, or $0.04 per basic and diluted share, compared with net income of $1.5 million, or $0.08 per share, in the second quarter of 2025. On a non-GAAP basis, net income was $3.1 million, or $0.16 per diluted share, versus $3.7 million, or $0.19 per diluted share, a year earlier.

Second-quarter adjusted EBITDA declined from $5.8 million in the prior-year period. Expenses fell $5.4 million year over year to $20.6 million, despite $1.7 million in severance costs related to the company’s previously announced reduction in force. Stelmakh attributed lower costs of revenue to product mix, including the absence of direct-to-consumer managed-service revenue, and a favorable channel-partner mix.

The company now expects full-year gross margin to normalize in the high-60% to low-70% range. During the question-and-answer session, Silvestro said management views the updated profitability profile as a new baseline rather than a temporary condition, while Chief Business Officer Andy D’Silva said the company is managing the business toward approximately 68% gross margin.

Operating cash flow totaled $8.1 million in the first half, and cash at June 30 was $24.1 million, compared with $23.4 million at the end of 2025. The company refinanced its term loan with Fifth Third Bank, fully drawing a $25 million loan and gaining access to a $10 million revolving facility. The term loan carries an interest rate of SOFR plus 2.25%.

OptimizeRx paid $5.3 million of principal during the second quarter, including $5 million beyond its scheduled payment, leaving $19.7 million in debt at quarter-end. Subsequent to quarter-end, it paid another $3 million of debt. Stelmakh said the company intends to use at least part of free cash flow for accelerated debt repayment. He also said OptimizeRx has a Rule 10b5-1 plan in place that could trigger purchases under its board-approved $10 million stock repurchase authorization if the share price continues to decline.

Customer Trends and Second-Half Outlook

Average revenue per top 20 pharmaceutical manufacturer stood at $2.7 million, while net revenue retention was 90%. Stelmakh said the retention decline was primarily tied to a small number of major accounts optimizing spending rather than broad customer churn. Revenue per full-time employee was $750,000.

Silvestro said the company has not included a return of revenue from its disrupted large customer in its second-half assumptions. Still, he said discussions with that client have reopened and could positively affect the back half of the year, though management did not quantify the potential contribution.

The company expects revenue to remain weighted to the second half, with fourth-quarter revenue likely representing 35% to 40% of full-year revenue and coming in significantly higher than third-quarter revenue. Silvestro said contracted revenue trends remain closer to 2024 seasonality than 2025 patterns.

Management also cited growing activity among mid-sized and emerging life-science customers. Silvestro said a mid-tier account entered OptimizeRx’s top 10 customer list in recent months, and that customers outside the top 20 are among the company’s fastest-growing accounts.

While pharmaceutical manufacturers have remained cautious due to policy and macroeconomic uncertainty, Silvestro said engagement among larger customers has begun to normalize. He said the company is seeing more strategic discussions and positive buying signals heading into the second half, though he did not predict a major late-year spending surge.

Platform Launches and Programmatic Expansion

OptimizeRx announced three product and partnership developments during the quarter:

• DeepIntent became the first healthcare demand-side platform to integrate directly with OptimizeRx’s authenticated electronic health record network. The integration is live, and Silvestro said the company has begun seeing bid flow through the platform.
• The company introduced its patent-pending Natural Language Audience Builder, or NLAB, which enables pharmaceutical marketers and agencies to create healthcare-provider audiences using natural-language prompts within demand-side platforms and media-planning tools.
• OptimizeRx launched CopayCue, a copay activation solution that delivers savings information in prescribing workflows using real-time prescribing-intent signals.

Silvestro said adoption of the company’s AI-enabled Dynamic Audience Activation Platform increased more than 30% year over year, while revenue from AI-enabled software offerings increased 25%. He said the company is working to move more business toward recurring subscription revenue.

The DeepIntent connection gives OptimizeRx access to programmatic media buying workflows, an area management views as an expansion opportunity. Silvestro said about 60% of buys in the relevant market are occurring through programmatic channels and that the company is discussing potential arrangements with other demand-side platforms.

Finance Leadership Transition

OptimizeRx also announced a planned finance leadership transition. Stelmakh will remain Chief Financial and Strategic Officer through Dec. 31, 2026, before serving as a strategic adviser during 2027.

D’Silva, currently Chief Business Officer, will become chief financial officer on Jan. 1, 2027. Heather Favazza, the company’s corporate controller for the past eight years, will become chief accounting officer on the same date.

Silvestro said the succession plan reflects the company’s long-term planning process and is intended to provide a seamless transition. Stelmakh said he expects to continue advancing the company’s strategic priorities through the remainder of 2026.

About OptimizeRx (NASDAQ:OPRX)

OptimizeRx, Inc is a healthcare technology company that operates a digital health network designed to facilitate communication between pharmaceutical manufacturers, payers and healthcare providers. Through its cloud-based platform, OptimizeRx delivers targeted digital interventions—such as patient savings messages, clinical content and product information—directly into electronic health record (EHR) workflows at the point of care. By integrating with leading EHR systems, the company helps life sciences organizations optimize brand engagement, improve patient adherence and support informed prescribing decisions.

The company's core offerings include digital prescription benefit notifications, co-pay assistance alerts and real-time clinical messaging tailored to specific patient populations.

This instant news alert was generated by narrative science technology and financial data from MarketBeat in order to provide readers with the fastest reporting and unbiased coverage. Please send any questions or comments about this story to contact@marketbeat.com.

Continue following MarketBeat

Add MarketBeat as your preferred source on Google to see our latest stories in your feed.

Add As Preferred Source