Prepared remarks
Good afternoon, and thank you for joining us today to discuss LifeMD's results for the second quarter ending June 30, 2026. Joining the call today are Justin Schreiber, Chairman and Chief Executive Officer, and Atul Kavthekar, Chief Financial Officer. Following management's prepared remarks, we will open the call for a question-and-answer session. Before we begin, I would like to remind everyone that during this call, the company will make a number of forward-looking statements which are subject to numerous risks and uncertainties that may cause actual results to differ materially from those projected. These risks and uncertainties are described in the company's 10-K and 10-Q filings and in other filings LifeMD may make with the SEC from time to time. Forward-looking statements made during this call are based on information available to the company as of today, August 5, 2026. The company assumes no obligation to update or revise any forward-looking statements after today's call, except as required by law. Management will also discuss certain non-GAAP financial measures that the company believes are useful in evaluating its performance. Reconciliation to the most comparable GAAP measures can be found in the press release issued earlier today. Today's call is being recorded and will be available for replay in the Investor Relations section of the company's website. Now I would like to turn the call over to LifeMD's Chairman and Chief Executive Officer, Justin Schreiber. Justin?
Thank you, Operator, and good afternoon, everyone. After the market closed today, we issued our second quarter earnings release and filed our Form 10-Q. We've also posted an updated investor presentation on our Investor Relations website. I encourage everyone to review those materials. I want to begin by addressing the quarter directly. Revenue was $47.3 million within the guidance range we provided. Adjusted EBITDA was a loss of approximately $3.5 million, reflecting elevated customer acquisition costs earlier in the quarter and a new $39 introductory offer. While elevated media costs were transient and adjusted EBITDA improved throughout the quarter, we missed our own target, and I want to be direct about why. This quarter, we restructured our customer acquisition model. We transformed our leadership team. We advanced our transition toward branded GLP-1 therapies and longer-duration members. We launched an important pharmaceutical collaboration with Halozyme. We continue to scale our pharmacy, women's health, insurance, Medicare, enterprise, and technology capabilities, and we took tangible steps to reduce our reliance on paid media as the principal engine of growth. We knew these changes would carry near-term cost. What we underestimated was the near-term pressure of those changes on profitability. And that's a miss we own. I have said before that our model is simple: quality care, quality products, and quality revenue. Our objective is not merely to grow; it is to build a healthcare and pharmacy business that generates increasing profits from a base of long-term patient relationships, one that benefits both our patients and our shareholders. That standard drove our decisions in the second quarter, and it is the lens through which I will discuss this today. Before I do that, I want to explain the strategic choice underneath these numbers because it accounts for both the near-term pressure and how we expect the business to evolve and grow from here. There's a well-worn playbook for growing a direct-to-consumer healthcare company quickly: chase the lowest price medication, maximize promotional volume, concentrate spend on a single advertising channel, and optimize for immediate cash collection. That approach can produce attractive results for a period of time. It also produces shallow patient relationships, volatile acquisition economics, regulatory exposure, and revenue that must constantly be replaced. We are deliberately not running that playbook. We are building for the patients who use LifeMD for more of their healthcare over time, not as a website they visit for a single prescription. In practice, this means employing and training high-quality affiliated providers, supporting patients between visits, integrating labs and pharmacy, expanding insurance access, and building programs that address multiple related conditions across a patient's life. When we do that well, it shows up in the numbers. Patients stay longer, engage with more of the platform, and refer friends and family. Pharmacy attachment increases and retention improves. This generates revenue that recurs instead of needing to be reacquired. That is what we mean by quality revenue. This quarter gives specific evidence that the model is working as designed. Recurring rebill revenue represented approximately 84% of total revenue. That installed base is increasingly the economic engine of LifeMD. It generates high contribution margin revenue, funds continued patient acquisition and product investment, and gives us a foundation on which to build new care and pharmacy offerings. Our gross margin also expanded to approximately 89% and gross profit was essentially flat despite lower year-over-year revenue. This is important because it demonstrates that the composition and economics of the business are improving beneath the headline numbers. We also followed through on the expense actions discussed last quarter. Advertising and marketing declined by approximately $1.8 million sequentially, and G&A declined by approximately $1.5 million. Those reductions began to show progressively during the quarter, and we expect the benefits to become more visible in the second half. So the way to read the quarter is this: the bottom line missed, but the drivers that determine future profitability—recurring revenue mix, gross margin, and operating costs—each moved in the right direction. With that context, I want to walk through the most important decisions we made this quarter and what they mean for the business from here. First, the most important strategic transition we made this quarter is how we acquire and retain patients. Paid search and digital media built this company, and they will remain valuable channels. We have deep expertise in performance marketing, and we continue to see attractive returns when we deploy capital selectively, but auction pricing in those channels is outside our control. We saw this early in the quarter, and no durable healthcare platform should have to purchase substantially all of its growth at whatever price the media market sets. So we are shifting the mix. Over time, we expect a larger share of demand to come from channels we don't have to bid for, including pharmaceutical manufacturers, employers, insurers, Medicare, national strategic partners, patient referrals, and cross-care offerings to our existing population. This shift is already underway. The XYOSTED collaboration reflects how pharmaceutical manufacturers are beginning to use LifeMD as infrastructure. We combine national patient acquisition, affiliated clinical care, benefits navigation, pharmacy fulfillment, and ongoing patient support in a single platform. Employers are looking to us to provide high-quality specialty care with transparent economics. Insurance allows patients to use benefits they already value, and each additional service we make available to an existing patient gives us an opportunity to grow without paying to reacquire that relationship from scratch. I want to be realistic about pace. Paid media will remain our largest acquisition channel in the near term, and these alternative channels build gradually. But the acquisition pressure we experienced early in the quarter reinforced the importance of moving faster in this direction. Early results support that decision. Since mid-June, acquisition costs have moderated across the business, and the unit economics in RexMD are among the strongest we have seen in a long time. In our weight management business, recent customer acquisition costs are approximately 50% lower than their peak in June of this year. We will continue to use paid media, but selectively and only where the returns justify it. Our goal is not to eliminate performance marketing; it is to surround it with multiple additional demand channels so that growth becomes more diversified, less volatile, and more valuable. Now, I'll turn to our weight management business. Weight management remains one of the largest opportunities in healthcare and one of the most important businesses inside LifeMD. The second quarter was highly competitive, particularly in the market for branded GLP-1 care. Early in the quarter, acquisition costs were elevated. We also saw major competitors reduce introductory pricing, which affected conversion and made our offering less competitive at the top of the funnel. We responded by lowering the introductory price of our branded GLP-1 program to $39. That decision reduced upfront cash collection and contributed to the EBITDA shortfall in the quarter. But it also materially improved the attractiveness of the program and changed the composition of the patients entering the program. Before the pricing change, approximately 25% of new weight management patients year-to-date were selecting multi-month packages. Following the change, approximately 85% selected multi-month packages. That matters because longer-duration patients generally provide more time to deliver meaningful clinical outcomes, demonstrate stronger retention, and create higher lifetime value. Our internal models currently indicate that the return on advertising investment from these cohorts can exceed that of the prior higher-upfront-price offering despite the lower first-month cash collection. We are also deliberately building around branded FDA-approved therapies and the clinical care surrounding them. I have been candid that the regulatory environment for compounded GLP-1 medications evolved differently than I initially expected, but I remain completely convinced that building around branded medicines, serious longitudinal care, insurance access and manufacturer relationships is the right long-term strategy. The branded market is difficult today because patients can still find lower-price, mass-compounded alternatives from hundreds of direct marketing companies. But we believe that market structure will continue to evolve and that the platforms that endure will be those that offer trusted FDA-approved medications, appropriate medical treatment, appropriate clinical oversight, affordable access, benefit support, and ongoing cardiometabolic care, not simply the lowest promotional price. That is the future LifeMD is built for. We ended the quarter with approximately 108,000 weight management patients. We have deep integrations with LillyDirect and NovoCare, a growing insurance and Medicare footprint, a national affiliated medical group, pharmacy capabilities, and the infrastructure to support patients as the therapeutic market expands into oral formulations and next-generation medicine, such as CagriSema and retatrutide. We believe the GLP-1 category remains in its early stages. The opportunity is large, and it will continue to evolve, and we are building LifeMD to participate across that broader market rather than around any single product. The philosophy behind our weight management business—longitudinal care rather than a single transaction—applies across our platform. Nowhere is that more evident than in women's health, which remains one of the programs I am most proud of and most excited about. The program encountered some pressure during the quarter, but the most recent operating trends have improved meaningfully. Over the last 30 days, new patient acquisitions have increased substantially, while customer acquisition costs have declined. Our overall women's health patient base grew 134% quarter over quarter and is expected to grow by another 300% to 400% by the end of the year. More important than the volume is the quality of the care and the patient relationships we are building. We designed the program around longitudinal, evidence-based care rather than a one-time prescription. Patients receive a comprehensive intake, appropriate laboratory testing, thoughtful diagnosis, structured clinical protocols, and ongoing management from providers trained specifically for this population. That model is producing strong engagement and retention. Last quarter, we reported that subscriber count had grown more than sevenfold from the fourth quarter base and that on-therapy retention was above 80%. Recent trends continue to reinforce our belief that this can become one of the largest and highest-quality businesses within LifeMD. Women's health is highly complementary to weight management and to the broader cardiometabolic needs of our patient population. We believe it has the potential to become as meaningful as weight management and to prove one of our core beliefs: quality care is the growth strategy. Now turning to Men's Health, which is also entering an important new phase. RexMD remains a large, recognized, and profitable brand with an engaged patient population. We continue to expand beyond sexual health into sleep, dermatology, weight management, hormone health, and personalized pharmacy products. The recent improvement in RexMD unit economics is encouraging, and the brand remains an important entry point into the broader LifeMD platform. In June, we announced an exclusive telehealth co-marketing collaboration with Halozyme's wholly owned subsidiary, Antares Pharma, for XYOSTED, the only FDA-approved, once-weekly, subcutaneous testosterone auto-injector. This collaboration is significant. It gives LifeMD the opportunity to build a national, high-quality men's hormone health program around a differentiated FDA-approved therapy supported by our affiliated medical group, pharmacy, patient support, and benefits capabilities. The initial self-pay program launched in July across 37 states at an all-in price of $249 per month with our affiliated pharmacies serving as the primary dispensing pharmacy. We also expect insurance access to become an important part of the opportunity over time. The collaboration requires startup investment during 2026 and early 2027 before the initial cohorts mature, and that investment is already contemplated in our outlook. While the precise pace of the ramp will depend on market response and the rollout of our joint commercial efforts, we believe XYOSTED can become a meaningful contributor to both our top and bottom line in 2027. Just as important, the collaboration is a blueprint. We are in discussions with other pharmaceutical manufacturers that need the same combination of care delivery, pharmacy fulfillment, benefit support, and national reach. Each successful partnership strengthens the platform and makes the next one easier to win. Before I turn to pharmacy, I want to spend a moment on the affiliated medical group because it is one of the most important and least understood parts of what we have built. Our affiliated providers continue to deliver what we believe is the best clinical care in the industry. And the group gets stronger every quarter. It is one of our clearest differentiators. Our providers are licensed across the country, which allows us to deliver care at a national scale. And they are increasingly cross-trained across our entire portfolio of men's and women's health offerings. That means a single high-quality provider relationship can support a patient across weight management, hormone health, sexual health, and more, rather than confining that patient to a single condition. We are also investing ahead of the growth we expect. We have hired 47 new providers to support the demand we anticipate across our programs in the second half of this year. A deep, multi-licensed, cross-trained medical group is not something that can be assembled quickly. It is a durable competitive advantage and it is the foundation on which our pharmacy and every one of our clinical programs is built. Our 50-state pharmacy is becoming one of the most strategically important assets in the company. It gives us greater control over the patient experience, faster product development, improved medication continuity, and the ability to capture economics that would otherwise leave the platform. Pharmacy operations carry gross margins of approximately 90%, and continued in-house fulfillment was an important contributor to the gross margin expansion we delivered this quarter. We are scaling the pharmacy across three complementary areas: branded direct-to-patient fulfillment, generic medications, and personalized compounding therapies where clinically appropriate. We are now fulfilling XYOSTED's self-pay prescriptions and anticipate other imminent branded pharmacy fulfillment relationships, which provide proven infrastructure and credibility. At the same time, we are expanding our personalized compounding capabilities. We are planning to launch more than 30 compounded products between now and year-end across hormone health, sleep, dermatology, sexual health, longevity, and other categories. Our objective is not to build a commodity mail-order pharmacy. It is to build an integrated pharmacy surrounded by a national affiliated medical group that can deliver clinically appropriate, highly personalized treatment at scale. What today is an early-stage operation, filling a handful of product lines, we expect to become by year end a full-scale pharmacy fulfilling branded, generic, and dozens of compounded therapies nationwide. We believe the pharmacy can ultimately become one of the largest growth and margin expansion engines in LifeMD. Insurance and Medicare are also becoming increasingly important to the quality of our revenue and to our long-term vision for LifeMD. Patients want to use their benefits. When they can, care becomes more affordable, customer acquisition costs can decline, and retention can improve because the relationship is less dependent on out-of-pocket costs. As we previously guided, our benefits infrastructure now reaches approximately 175 million covered lives. Insurance penetration is now approximately 10% of new patients on our primary care platform, and we are still in the early stages of bringing the full range of LifeMD specialty programs onto that infrastructure. Our Medicare initiative is also in its first stages, including the new Medicare Bridge program that helps Medicare beneficiaries access branded GLP-1 medications. We are encouraged by the early demand, but it is too soon to draw broad conclusions. The strategic significance is clear. Medicare gives us access to a large population with substantial unmet need across weight management, cardiovascular health, hormonal health, and chronic disease. We are also advancing national strategic and employer partnerships. These relationships can increase brand awareness and patient volume at attractive economics with far less dependence on media-based acquisition. They are not yet major contributors to reported results, but we believe they can become an important part of our growth mix over the coming years. Technology is the connective tissue across all of these initiatives. We are continuing to invest in the people, integrations, and infrastructure required to deliver longitudinal care across medical services, pharmacy, labs, benefits, and patient support. AI is increasingly embedded throughout that platform. We are using AI to improve intake, documentation, clinical decision support, scheduling, revenue cycle management, patient messaging, compliance, and back-office workflows. The objective is not to replace clinicians. It is to give them better information, reduce administrative burden, improve protocol consistency and increase the number of patients they can serve without compromising quality. We are also using AI to increase engineering velocity and automate operating processes across the company. These efforts are beginning to produce measurable improvements in cost per patient and cost per consult. Over time, the combination of our structured patient data, clinical infrastructure, medical group, pharmacy, and regulatory footprint should allow us to personalize care at a level that is very difficult for a point-solution competitor to replicate. We continue to expect the financial benefits of these investments to become more visible as the business scales. Ultimately, none of this happens without the right people. One of the accomplishments I am most proud of this quarter is the continued strengthening of our leadership team. Atul Kavthekar, our CFO, has brought greater financial rigor, forecasting discipline, and focus to capital allocation. Umesh Sripad, our new Chief Technology Officer, is strengthening our technology organization and optimizing the architecture required for our next phase of growth. Chris Pisano, our Chief Marketing Officer, and Tim Ragland, our GM and SVP of Growth, are sharpening our marketing efforts, evolving the commercial model, and improving execution across our business. Collectively, they are raising the standard for talent and performance at every level of the organization. Let me now connect our strategic progress to the financial framework. We are revising our full-year 2026 outlook to revenue of $205.5 million to $212.5 million and adjusted EBITDA of negative $6 million to break even. Atul will discuss the assumptions and quarterly cadence in more detail. The revised full-year outlook reflects the first-half EBITDA shortfall, the lower upfront revenue associated with our pricing and mix decisions, and the investments required to launch new strategic partnerships, including XYOSTED. Providing guidance is not an outcome we accept lightly, and we recognize that credibility is earned through execution. However, the full-year revision should not obscure an important point. Based on the current trajectory of the core business, we believe we remain largely on track to exit the fourth quarter with strong run-rate revenue and profitability. Our fourth-quarter guidance of $60 million to $64 million of revenue and $3 million to $6 million of adjusted EBITDA, excluding the Q4 launch cost related to the XYOSTED launch, implies an annualized revenue run rate of approximately $250 million and annualized adjusted EBITDA of approximately $22 million at the midpoint framework. That is modestly below the $25 million annualized adjusted EBITDA objective we discussed previously, but it still represents a business exiting the year at roughly a high single-digit to approximately 10% adjusted EBITDA margin while continuing to invest in several major growth programs. We therefore view ourselves as mostly on track toward the operating model we set out to build: a strengthening core business with a high-margin recurring revenue base, multiple new growth channels that are not yet fully reflected in the current results, declining marketing spend, tightly managed operating expenses, and the growing mix of pharmacy, insurance, strategic partnerships, and longer-duration memberships that should further improve the earnings power of the business over time. The path will not be perfectly linear. The XYOSTED collaboration, pharmacy expansion, enterprise initiatives, and new care programs require investment before they generate mature contribution margins. The work we have done to build a more durable LifeMD now needs to show up in the financial results. With that, I will turn the call over to Atul to review the quarter and our outlook in greater detail. Atul?
Thank you, Justin, and good afternoon, everyone. As a reminder, all year-over-year comparisons are on a continuing operations basis, excluding WorkSimpli, which was divested on November 4, 2025. Revenue for the second quarter was $47.3 million, within our guidance range of $47 million to $50 million, and down approximately 6% sequentially, reflecting the planned step-down in marketing investments that we described in our last call, combined with increased CPA levels through much of the quarter, and the impact of our weight management price change implemented in June, lowering the initial month care pricing from $79 to $39 to stay in line with competitors. Versus the prior-year quarter, revenue declined approximately 4% from telehealth revenue of $49 million, reflecting the continued and deliberate mix shift from compounded to branded GLP-1 therapies. Active subscribers were 356,000 at quarter end. While this number is nominally lower than the prior quarter, it reflects a deliberate shift in our weight management customer base away from the primarily month-to-month subscriber base to a higher-retention and higher-LTV multi-month subscriber. Similarly, for our Rex business, our new growth patients are being acquired at much improved unit economics. Gross margin expanded to 89%, an improvement of approximately 60 basis points sequentially, driven by lower shipping and fulfillment costs, improved provider efficiency, and the continued scaling of our in-house pharmacy. Advertising and marketing expense of $28 million, while slightly above the range indicated on our prior call, declined $1.8 million from the first quarter, and other general and administrative expenses declined approximately $1.5 million, led by lower employee expenses and other professional services expenses. All other operating expenses declined approximately $700,000 sequentially. GAAP net loss from continuing operations attributable to common stockholders was $7.9 million, or $0.16 per share. Adjusted EBITDA, a non-GAAP measure we define as income or loss attributable to common stockholders before various items as outlined in today's news release, was a loss of approximately $3.5 million. Two factors drove this: elevated customer acquisition costs on comparable spend levels and the conscious pricing decision, our $39 introductory offer that we made to improve our price competitiveness. Importantly, the monthly trajectory improved consistently through the quarter, giving us further confidence in the second-half inflection. Turning to the balance sheet, we exited the quarter with $25.1 million in cash. Second-quarter cash flow was pressured by ongoing marketing investment and the timing effects of the transition to the $39 introductory offer. As more patients choose longer-duration subscription plans, we expect stronger upfront cash collections from the rebill and, combined with lower marketing spend in the second half, we expect cash to improve through year-end. This will be partially offset by the working capital required to support increased production within our pharmacy. At quarter end, we also amended our credit agreement on favorable terms, further strengthening our financial flexibility. Turning to guidance for context, our prior guidance was set with an expectation that new patient acquisition costs would be more predictable and that a number of partnership agreements and other developments would launch earlier than what will likely be the case. And while our expectations remain that all of these developments and possibly more will come to bear, we recognize the timing is not in our sole control. As such, we are presenting our H2 guidance based on more concrete current trends and on arrangements with high visibility. Furthermore, we are providing our H2 guidance after adjusting for LifeMD's portion of the likely launch costs associated with the XYOSTED launch. With that, we are expecting Q3 revenues to be in the range of $48 million to $51 million and EBITDA in a range of negative $1 million to positive $2 million. For Q4, reflecting our expected growth, the release of numerous improvements in our technology and supply chain infrastructure, and aggressive cost management, we are expecting revenues in the range of $60 million to $64 million and EBITDA of between $3 million and $6 million. Assuming the midpoint of this Q4 range and after excluding the launch impact from XYOSTED, we are expecting a revenue run rate in Q4 of $250 million and EBITDA run rate of $22 million. Although the XYOSTED launch is in its early days, we are optimistic that it will grow to become a significant part of LifeMD's overall men's health offering. We are now testing our XYOSTED go-to-market plan, which will require an initial investment we anticipate in the $2 million to $3 million range in 2026. This is a true partnership with direct costs split between the two companies throughout the life of the program. While the ramp-up dynamics will become clearer in the coming weeks and months, we anticipate that once the patient acquisition playbook comes together, those initial patient cohorts will become accretive to LifeMD's EBITDA in mid-2027. In closing, we remain very positive in our outlook for the business, with our team solidifying, the enterprise sales pipeline growing, unit economics improving, our new product offerings continuing to build, and continuous improvements being made to our infrastructure and overall efficiency. As we continue to get clear on our pipeline, we will factor that into our overall outlook on subsequent calls. Thanks, and with that, I'll turn the call back to Justin.
Thanks, Atul. Let me close by coming back to the central point. Quarterly performance matters. The second-quarter adjusted EBITDA result was below our expectations. We understand what drove it. We've made changes and we expect better performance in the second half. The quarter also made clear that the work required to build a more durable LifeMD was greater than we initially anticipated. We are broadening the acquisition model beyond paid media. We are building longer patient relationships. We are investing in branded therapies, pharmacy, insurance, pharmaceutical partnerships, and deeper clinical programs. And we are putting in place the team and operating structure required to support those capabilities at scale. We believe that work was necessary. It gives LifeMD more ways to acquire patients, more ways to serve them, and more ways to grow without depending on a single product, advertising channel, or regulatory outcome. But the value of those investments will be determined by the results they produce. We expect to return to adjusted EBITDA profitability in the third quarter and deliver substantial sequential improvement in the fourth quarter. Our focus is on executing against that outlook while continuing to improve the quality and durability of the business. LifeMD today has a stronger recurring revenue base, higher gross margins, broader clinical capabilities, a growing pharmacy operation, and more diversified sources of demand than it did entering the year. Those are the building blocks of a much better company. We now need to prove that through consistent execution and financial performance. I want to thank our affiliated providers and employees for their continued hard work, our patients for trusting us with their care, and our shareholders for their continued support. Operator, we are ready for questions.
Questions and answers
Your first question comes from David Larsen with BTIG. Please go ahead.
Can you please talk a bit about peptides and the discussions that are going on in Washington? Assuming a bunch of these move to Category 1, what kind of appetite do you think your current membership base would have for these peptides? Would you be able to deliver on that demand? Any thoughts around the potential revenue opportunity would be very helpful.
Hi, Dave. I don't think we have a revenue number we can share today, but if you think about our current patient population—from weight loss to hormones to sexual health—we think there would be considerable demand from current patients for some of these peptides if the FDA follows through as expected and permits some of them to be made in compounding pharmacies. We also think there's a lot of demand outside of our platform as well. So there's no doubt that if some of these are permitted to be compounded by the FDA, it would be a significant market opportunity for LifeMD. We feel good about having sterile compounding capabilities. We're working on a solution to either acquire or convert our non-sterile pharmacy into a sterile pharmacy. We also have vendors that could manufacture these products once the FDA gives the green light, including other 503B pharmacies that we could fulfill through our 503A operations. We plan to take a conservative approach to the peptide space and make sure that, first and foremost, whatever we launch is safe and is prescribed properly. The preclinical data and clinical context for any product will be well described for patients.
That's very helpful, thanks. And then can you maybe talk a little bit more about the number of weight management subscribers? I think you had 108,000. Any color around what portion are on a compounded GLP-1 versus a branded GLP-1? One of your competitors said the economics around the branded GLP-1s is similar to the compounded GLP-1 economics from their perspective. Any thoughts around that? And to the extent you're able to comment, are you receiving any sort of fulfillment fee every time you send a patient to Lilly or Novo? Just the economics around the branded products would be helpful.
Sure, Dave. As it relates to Lilly and Novo, as of today, we have very positive relationships with both companies. Today, those relationships are integrations as we've described in the past, and we do not receive any economics from either company. We have said in the past that we expect these relationships to evolve, and we still feel that way. We have seen a lot of our patients who were previously on personalized compounds switch over to branded therapies; that compounding business has become much smaller. For new patients, almost 95% are going on a branded therapy; very few are getting a prescription for a personalized compound. Much of the remaining 5% is likely patients getting other medications. So the compounding business for LifeMD has become very small and shrunk faster than we initially thought. We view the compounding business as pretty insignificant to earnings moving forward and something we can guide more easily. Regarding economics for branded therapies, we have spent considerable time analyzing unit economics. We see a good-to-great unit economics model for branded GLP-1s where returns on direct-to-consumer investment can be attractive over two to three years. We believe there is significant opportunity to improve cross-care offerings and acquisition costs and that there are meaningful partnerships that could drive patients to LifeMD without the same paid acquisition costs on platforms like search and social. We're very optimistic about the branded business and also about other categories such as women's health. The company will continue to diversify over the next couple of years, and our pharmacy and the expanding portfolio of products play a big role in that.
Hey Dave, I'll add one point to that. Justin mentioned the dramatic shift from month-to-month subscribers in our weight management business into multi-month subscribers. That is a very profound change. There's a meaningful difference in the unit economics between those two models—not just in accretion and dilution from an EBITDA standpoint, but also from a cash standpoint. These multi-month subscribers tend to pay back in a very short period of time, depending on the subscription. So this is actually a very positive development from the pricing change. Rationalizing the offerings has been helpful, and that is important for investors to be aware of.
Your next question comes from the line of Sarah James with Cantor Fitzgerald.
So you framed up 2026 as a year when XYOSTED, Medicare, employer partnerships, and pharmacy scaling are all being built but not really reflected in the results, and the operating model itself is intact even with the guidance cut. If each of those channels reaches the scale that you're underwriting internally, what does the potential for 2027 EBITDA margin growth look like versus the roughly 10% you're exiting at in 2026? And which one of those four is likely to show up first as a visible impact rather than a qualitative tailwind?
Thanks for the question, Sarah. I think there will be a real visible improvement from the core business. One thing not factored into our current guidance is the introduction of a number of new products that are in the pipeline; those should shape our 2027 outlook. Regarding XYOSTED, we are optimistic, but it is just getting started and we are in early testing. We expect to be building the base of customers who will ultimately rebill, so it will take some time before that portfolio contributes materially to EBITDA. We'll be mostly in growth and investment mode in that business for a few quarters. Without giving too much away for 2027, we're pretty optimistic about the forward-looking parts of the base business and about top-line growth potential from new initiatives like XYOSTED. There may be additional programs in the works as well.
Great, and then one more. Justin, you said you really see it in the numbers when you have deeper relationships with patients across multiple health areas and possibly pharmacy. Can you talk a little bit about where you stand with that today versus where it could be in a couple of years? For example, deep customer relationships with your current book as a percentage of the total versus where it could go?
Sure. When we say deeper relationships, we mean patients using our platform for many aspects of their care. One area where we already see this is women's health, and we expect to see more in weight management in the coming months. For women's health today, many patients start with hormone therapy, and now that we launched testosterone, providers are having conversations about sexual wellness and appropriate prescriptions. We also offer weight-loss and GLP-1 support, and many patients are using multiple services. We have convenient in-home labs, and for some therapies labs are required; those go to labs like Quest and Labcorp when appropriate. We have an early cardiology offering that is relevant for women's health, as well as psychiatry, which tends to be used by patients already on another LifeMD offering. Later this year, we plan to stand up a bone health program that incorporates diet and lifestyle support and connects data collected across programs with a patient's medical data through Health Information Exchange connections, along with lab data. When combined with asynchronous and synchronous care and AI-driven longitudinal support, medication management, and clinical protocols, this creates a powerful integrated offering. Over the next couple of years, we expect to deepen relationships with patients in this way.
Your next question comes from the line of Steven Dechert with KeyBanc Capital Markets.
I wanted to ask about insurance. Last quarter you talked about the demand you were seeing from patients that wanted to use insurance. Maybe you could talk about what the usage looks like among your patient base currently versus maybe where it was three to six months ago? And what you expect that to get to over the next six months, one year, two years.
I think currently we see around 10% of new patients coming in through one of our insurance flows. That number was much smaller a quarter or two ago. We're still testing and iterating, and we continue to see more demand from patients to use their insurance to cover medications than to cover the cost of consults. Often, the actual synchronous or asynchronous care is not prohibitively expensive out-of-pocket, but pharmacy and medication costs are important drivers of patient preference to use insurance. We've seen a lot of growth in the insurance business, and we see continued growth on the cash-pay side as well. We expect insurance penetration to continue to increase as we bring more specialty programs onto payer infrastructure and as Medicare initiatives develop. We don't have an exact long-term percentage to share today, but we consider insurance an important differentiator and plan to continue investing there.
Your next question comes from the line of Yi Chen with H.C. Wainwright. Please go ahead.
This is Katie on for Yi. Building off your earlier comments about women's health, are you able to give any more color on that segment? Can you give any ending subscribers for the quarter or quarterly revenue? How much did women's health contribute to the current quarter and what are you expecting as it ramps toward the end of the year?
We're not in a position to share exact patient counts for that business today, but as a reference we have previously guided that women's health should be approaching a $5 million quarterly revenue run rate by Q4. That might be slightly aggressive, but we think the business should be between a $3 million and $5 million quarterly revenue run rate by Q4 of this year. The business has grown a lot quarter to quarter. Over the last week or two we've had several days with 50 to 100 new patients per day, which is a great rate. We feel very good about growing this business with strong unit economics. Pharmacy products for this business are scaling, providers are delivering exceptional quality care, and overall we are excited about its growth.
And that does conclude our question-and-answer session. I would now like to turn it back over to the team for closing comments.
Thanks, everybody, for joining our conference call today. We look forward to talking to you all another quarter from now. Thanks very much.
The conference call has now ended. Thank you for attending today's presentation and you may now disconnect.