Guardian Pharmacy Services, Inc. (GRDN) Q2 2026 Earnings Call Transcript

Hello, everyone. Thank you for joining us, and welcome to Guardian Pharmacy's Second Quarter 2026 Earnings Call. Operator provided instructions on how to ask questions. I will now hand the call over to Ashley Stockton, Investor Relations. Please go ahead.

Good afternoon. Thank you for participating in today's conference call. This is Ashley Stockton, Vice President, Investor Relations for Guardian Pharmacy Services. I'm joined on today's call by Fred Burke, President and Chief Executive Officer; David Morris, Chief Operating Officer; and Will Mudd, Chief Financial Officer. After the close today, Guardian posted its financial results for the quarter ended June 30, 2026. A copy of the press release is available on the company's Investor Relations website. Please note that today's discussion will include certain forward-looking statements that reflect our current assumptions and expectations, including those related to our future financial performance and industry and market conditions. Such forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties that could cause actual results to differ materially from our expectations. We encourage you to review the information in today's press release and quarterly report on Form 10-Q as well as the specific risk factors and uncertainties discussed in our annual report on Form 10-K. We do not undertake any duty to update any forward-looking statements, which speak only as of the date they are made. On today's call, we also will use certain non-GAAP financial measures when discussing the company's financial performance and condition. You can find additional information on these non-GAAP measures and reconciliations to their most directly comparable GAAP financial measures in today's press release, which again is available on our Investor Relations website. And now I will turn it over to Fred for high-level commentary.

Thank you, Ashley, and good afternoon, everyone. We appreciate you joining us today to review Guardian's second quarter results. But before David and Will review the second quarter in detail, I would like to begin with some perspective on our performance through the first half of 2026 and our outlook for the remainder of the year. Guardian continues to execute well, supported by solid fundamentals across our local markets and meaningful progress against our strategic priorities, including continued geographic expansion. Through the first half of 2026, reported revenue grew 2%. Absent the IRA pricing reductions, revenue would have increased low double digits, a clearer indication of the underlying growth of the business. Importantly, we have successfully mitigated the profitability impact of the changing reimbursement environment under the IRA through disciplined execution across the business, enabling us to generate adjusted EBITDA growth of 23% during the first half of 2026 compared with the first half of 2025. Based on our year-to-date performance and current expectations for the balance of the year, we are raising our full year 2026 outlook. We now expect revenue of $1.43 billion to $1.45 billion and adjusted EBITDA of $129 million to $131 million. As we move through the remainder of the year, our priorities remain consistent, delivering outstanding service to the residents and communities we support, expanding our platform in attractive markets, investing in the clinical and operational capabilities that strengthen our value proposition and maintaining the financial discipline that has long been a hallmark of our model. Supporting those priorities requires an organizational structure and leadership team capable of managing the scale of the business today while positioning for growth ahead. At the broader corporate level, in June, we took an important step in the evolution of our company with the appointment of David Morris as Chief Operating Officer. David assumed this role after serving as Guardian's Chief Financial Officer since inception. He has played a central role in building this company and has helped shape our strategy, financial discipline and operating model. He knows our business, our pharmacy leaders and our local markets extremely well. Moving into the broader COO role gives David the opportunity to apply his experience more directly to our operations and sales organizations. The new field operations leadership team we put in place earlier this year to help advance operational excellence now reports to David. He will discuss this new structure in greater detail. With David moving into the COO role, we are pleased to have appointed Will Mudd as Chief Financial Officer. Will joined Guardian in 2012 and has worked closely with David for more than a decade. During that time, he has taken on increasing responsibility across the organization and has played an important role in building and scaling the financial infrastructure that supported Guardian's growth and our transition to becoming a public company. His appointment is a natural progression and reflects our confidence in his ability to lead the finance organization through Guardian's next phase of growth. These transitions demonstrate the depth of talent we have developed within Guardian, the strength of our succession planning process and our commitment to creating opportunities for leaders to grow within the organization. Alongside these changes, Kendall Forbes, a co-founder and long-term business partner who played an important role in Guardian's development, has retired. We are grateful for his many contributions to Guardian over the years and wish him all the best in his next chapter. Lastly, I want to briefly address the upcoming conversion of the final tranche of our Class B common stock into Class A common stock, which will occur in late September and represents approximately 13.5 million shares. Following that conversion, we expect between 35 million to 37 million shares of Class A common stock will be held collectively by employees, members of management and directors, including shares they hold today. Nearly all those shares are subject to a closed window trading restriction until the next open trading window following our third quarter earnings release, which is currently expected in early to mid-November. The management and directors who hold the substantial majority of shares remain committed to taking a measured and prudent approach to liquidity over time to ensure a structured and orderly process with minimal market disruption. With that, I will turn the call over to David, who will provide additional perspective on our operations.

Thanks, Fred. I'm pleased to report that we delivered another solid quarter. Will plans to review our financial results in greater detail, but I would like to provide some operating context and discuss the progress we are making to strengthen Guardian's infrastructure as we scale. Our clinical capabilities remain an important part of our value proposition and support our ability to drive top line growth. Through the first half of the year, our clinicians have served over 300,000 residents. Across this population, our pharmacy teams have completed more than 50,000 clinical interventions affecting over 45,000 residents. As an example, we identified approximately 4,000 allergy risks and 5,000 instances of potentially duplicate drug therapies. These interventions help reduce medication-related risk for our facility partners and, more importantly, help prevent adverse health outcomes across the resident population. We're also advancing several new clinical initiatives and are highly encouraged by the progress we are seeing. One example is our falls risk program, which we are expanding to additional facilities for further evaluation. Early data has shown meaningful improvement in outcomes, and we are encouraged by the opportunity to assess the program across a broader resident population and data set. Turning to profitability: we continue to translate strong top line performance into bottom line growth. As we scale, we are benefiting from increased purchasing leverage, improved labor productivity and greater efficiency across our support infrastructure. While we expect these benefits to continue, we also recognize the importance of investing in the leadership, systems and infrastructure necessary to support our future growth and we'll do so as necessary. The strength of our operating performance is also supporting solid cash generation. Beyond our capital expenditure needs, we continue to view M&A and greenfield start-ups as a highly attractive use of capital and an important driver of incremental growth. Consistent with that strategy, subsequent to quarter end, we announced the acquisition of Wellness Concepts, a long-term care pharmacy based in the Shenandoah Valley of Virginia. This pharmacy adds a service-oriented team with a strong reputation for quality in the communities it serves. While it was smaller in size, it was very much in line with the type of pharmacy we look to add to our platform. Additionally, we launched a new greenfield pharmacy in Lexington, Kentucky, marking our first location in that state. Lexington is the fourth greenfield pharmacy developed by the team that joined Guardian through our Middle Tennessee acquisition in 2009. The launch is a collaborative effort between our Tennessee and Cincinnati pharmacies and demonstrates how acquired talent and local market expertise can come together to support continued growth. This effort is being led by David Brown, one of our newly appointed Senior Vice President, Regional leaders. That brings me to one of our most important organizational initiatives in recent years, the implementation of our new regional leadership structure. To enhance our organization, we have appointed 8 regional Senior Vice Presidents from within the company to provide leadership across our national footprint. These are some of our strongest and most experienced operators who have a proven track record. They understand our pharmacy teams, our customers and the markets in which we operate. The objective is to bring greater consistency, accountability and support to our local pharmacies while preserving the entrepreneurial culture and local decision-making that have always distinguished Guardian. Our regional leaders will help pharmacies share best practices, develop and mentor local management teams and identify opportunities to operate more efficiently and effectively. They will also play a central role in strengthening two-way communication between our pharmacies and support organization. This includes translating company-wide priorities into action at the local level while ensuring that the experience and perspective of our local operators help inform broader strategic decisions. While the COO role is new for me, I have worked closely with our pharmacies and these regional leaders since Guardian's earliest days. I look forward to deepening those relationships and working alongside them to strengthen execution throughout the organization. I'll now turn it over to Will for a review of the quarter.

Thank you, David, and good afternoon, everyone. I'm pleased to be speaking with you today in my first earnings call as Chief Financial Officer. I've had the privilege of working closely with David, Fred and the finance organization for many years, and I'm excited to continue supporting the company's growth with the same financial discipline and operational focus that have helped define Guardian's success. I'll now walk through our second quarter results in more detail and provide additional context around our outlook for the remainder of this year. Residents served at quarter end were over 210,000, up high single digit year-over-year, reflecting continued growth across our facility base, increased adoption rates and continued contributions from M&A. Script volumes also increased high single digits year-over-year. Reported revenue for the quarter was $351.2 million, up 2% year-over-year. Absent IRA-related pricing reductions, revenue would have been up low double digits year-over-year in the quarter. Revenue growth benefited from organic growth, M&A, higher resident acuity and our continued plan optimization efforts. We also saw favorable product and payer mix, both of which we expect to remain supportive through the end of the year. These factors benefited gross profit, which increased to $80 million in the quarter, up 18% year-over-year with a gross margin of 22.8%. We delivered this improvement despite continued pressure from higher fuel costs. SG&A was $56.5 million and represented 16.9% of revenues in the quarter, in line with our expectation. As we highlighted last quarter, we reached a settlement in a payer dispute that resulted in an $8.5 million cash payment, which was recognized as other income in the second quarter. Because the settlement payment is not reflective of our ongoing operating performance, it has been excluded from adjusted EBITDA. Importantly, the resolution also helped establish a stronger, mutually beneficial relationship with the payer, which was our objective from the onset. Stock-based compensation was $2.9 million in the quarter and should remain near this level on a quarterly basis for the balance of the year. Adjusted EBITDA was $29.7 million, representing 19% year-over-year growth and an adjusted EBITDA margin of 8.4%. We achieved this margin while continuing to absorb dilution from the acquisitions and greenfield startups completed in 2024 and 2025. These locations remain below our corporate margin and reduced consolidated margin by approximately 60 basis points during the quarter compared with 80 basis points in the first quarter, demonstrating continued progress in bringing the group closer to our consolidated margin. The effective tax rate for the quarter was 26%, in line with our expectations. Net income is $22.1 million, inclusive of the previously mentioned $8.5 million settlement compared to $8.8 million in the year-ago quarter. Turning to the balance sheet: we ended the quarter with cash of close to $90 million, up from approximately $65 million in the prior quarter. Importantly, cash conversion returned to a more normalized level following a one-time working capital reset associated with the implementation of the IRA in the first quarter. As Fred noted, based on our first half performance and current expectations for the remainder of the year, we are raising our full year 2026 guidance. We now expect revenue in the range of $1.43 billion to $1.45 billion, up from $1.4 billion to $1.42 billion. Our adjusted EBITDA range goes to $129 million to $131 million, up from $123 million to $127 million. As we have historically stated, our outlook does not include any contribution from future acquisitions. However, we will continue to actively pursue business development opportunities consistent with our approach in prior years. With the larger acquisitions completed in the prior year now fully lapped, second half forecasted revenue growth will be driven primarily by organic performance with a modest contribution from the two smaller acquisitions thus far in 2026. As such, absent the IRA pricing reductions, we expect underlying revenue growth to remain in the high single digits. Reported revenue, however, in the second half of the year is expected to decline year-over-year by a low single-digit percentage, reflecting the continued impact of the IRA-related pricing reductions. We expect our adjusted EBITDA margin to remain relatively stable in the third quarter, followed by a typical seasonal increase in the fourth quarter associated with vaccine activity. With that, I'll turn it back over to Fred for closing comments.

Thank you, Will. Again, we are very pleased with our performance through the first half of 2026 and with the continued execution across the organization, particularly in managing the impact of the IRA-related pricing environment. We will continue to focus on driving profitable growth across our existing markets, expanding through greenfield development and pursuing disciplined M&A. We have a strong and experienced leadership team in place to execute against these priorities with continuity, accountability and operating focus as we continue to scale the business. Combined with our strong balance sheet and meaningful financial flexibility, these capabilities position Guardian to build on the momentum we have established. As always, I want to thank our teams throughout Guardian. Their commitment to our residents, our facility partners and one another is what makes Guardian such a special organization. Operator, we'll now open the line for questions.

Operator provided instructions on how to ask questions. Your first question comes from the line of Brian Tanquilut with Jefferies.

Congrats on the first strong quarter. Before I forget, David, Will, congrats also on the promotion. Fred, when I think about the M&A and the greenfields that were announced in the press release here, can you discuss how you're thinking about the ramp process or ramp phase and how long that will take for those specific assets to get to company averages? And can you share your thoughts or some visibility into the pipeline for both greenfields and M&A for the rest of the year and into next year?

Thank you very much, Brian. I appreciate you joining and in answer to your question: we have a very robust pipeline, as David mentioned, both for greenfields and for new M&A activity. We've always said that it takes us roughly four years to bring these new locations up to the corporate average profitability — some quicker, some may be a little longer depending on what has to be done. So in terms of these two particular assets, I would forecast that it will be about normal.

Your next question comes from the line of Raj Kumar with Stephens.

David, Will, congrats on the new roles. I wanted to follow up on the IRA impact. You called out it's now around 40% relative to the 2026 impact for the IRA; last quarter you had called out 50%, so there's a 10-point improvement. What's driving that differential and what underlying operational improvements or PBM/payer contracting improvements have taken place since then to drive that conviction?

Raj, the revenue impact is yet to be definitively analyzed because we don't yet have the specific drug list. So we're just estimating at this point based on the relative volume of the 2027 tranche relative to the 2026 tranche. So somewhere in that range is what it will be, but we'll know here pretty soon.

Okay. Got it. And then thinking more specifically to you, David, on some of the initiatives you called out: as you think about mobilizing them and making them illustrative for payers and PBM partners, what are the milestones and ways you foresee playing into longer-term outcomes for these clinical capabilities?

Raj, that's something that we've discussed over the past few years. It's been ongoing, and we set out probably five years ago with a very intensive education process with all of our payers to make sure they understood the value that we bring to the equation for these frail residents and for the ultimate health plans themselves. More near term, we've talked about our falls risk program, and it continues to make great progress. Our sample size is relatively small, but we've seen meaningful reductions in the fall-related risk metrics. We'll be providing more detail as we continue to roll out this plan and we have more representative data to talk about.

Your next question comes from the line of Parker Snure with Raymond James.

I wanted to ask about the regional leadership structure changes. Will this create any changes in how you operate day-to-day? What capabilities or strengths do you think this will add to the overall enterprise?

There will be gradual changes. As we discussed in the opening comments, these are leaders that have been with us probably 15-plus years on average. They've run very strong businesses and grown regions prior to the reorganization. They will be able to provide more guidance, assistance and insight to some of our local presidents — some that have been with us for a while, some that are new through our M&A activity. I think we will heavily strengthen the organization as we prepare it for continued growth. We expect it to be a very positive impact. It's early on, but we are already starting to see some impact.

Okay. Great. If I can just get one follow-up: you have about $90 million of cash on the balance sheet, no debt, strong free cash flow, relatively low CapEx. Outside of M&A, how are you thinking about potential capital deployment, maybe potential shareholder returns, or do you want to remain flexible?

It's a very positive problem to manage. Yes, our main focus is to deploy cash on acquisitions and greenfield start-ups because it leverages our business well. Also, at this point, we want to maintain dry powder until we know for certain what happens with the Omnicare assets in case there's any opportunity there. Of course, as we move through the year, we'll reassess and are exploring all options.

Your next question comes from the line of Allen Lutz with Bank of America.

Fred, I want to follow up on your comment about keeping dry powder available in case of Omnicare-related opportunities. What are the range of outcomes for you that we should be thinking about related to that process as we think about the remainder of the year? And can you remind us, is any impact from Omnicare or its fallout reflected in the 2026 guidance?

Good question. I wish I could answer it definitively, but I cannot. The deal has not closed, at least not that we're aware of. Until it does, I don't know that we can really engage in any further conversations. There may or may not be interest on their part, but we're prudently standing by in case they may seek to divest some of their assets. Certainly, we view it as an organic growth opportunity. At the moment, since we're in somewhat of a standstill mode, we have not incorporated any of that into our guidance.

Your next question comes from the line of Grayson McAlister with Truist.

This is Grayson on for Dave. I wanted to extend my congratulations to Will and David as well. I wanted to go back to the Lexington greenfield. It fits nicely between your Tennessee and Cincinnati pharmacies. I imagine you're already serving some clients in the state. Could you talk a bit about the thought process behind that greenfield and any benefit you get in the state from serving some of the same clients or leveraging capabilities through some of your legacy pharmacies?

Grayson, great question. If you look at the map, you'll see we're not previously in Kentucky. This marks our first location there, but we have locations in proximity. We're currently serving business in Kentucky from some of our other facilities. This is a perfect example of a contiguous expansion with an existing team. This is the type of opportunity we seek when there's enough business in an area to launch a bricks-and-mortar site. There will be assistance from existing Guardian pharmacies, whether Columbus, Ohio or other surrounding pharmacies, to help launch this business and support it as it comes up to scale.

There are no further questions at this time. This concludes today's call. Thank you for attending. You may now disconnect.