管理層發言
Good afternoon. Thank you for joining us today to discuss LifeMD's results for the fourth quarter and full year ended December 31, 2025. Joining the call today are Justin Schreiber, Chairman and Chief Executive Officer; and Marc Benathen, 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 within other filings that LifeMD may make with the SEC from time to time. Forward-looking statements made during this call are based on current information available to the company as of today, March 9, 2026. The company assumes no obligation to update or revise any forward-looking statements after today's call, except as required by law. Also, please note that management will be discussing certain non-GAAP financial measures that the company believes are important in evaluating LifeMD's performance. Details on the relationship between these non-GAAP measures and the most comparable GAAP measures and reconciliations thereof can be found in the press release issued earlier today. Finally, I would like to remind everyone that today's call is being recorded and will be available for replay in the Investor Relations section of the company's website. Now I'd like to turn the call over to LifeMD's CEO, Justin Schreiber. Please go ahead.
Thank you, and good afternoon, everyone. After the market closed, we issued a news release announcing our fourth quarter and full year financial results and posted an updated corporate presentation on our website at ir.lifemd.com. LifeMD delivered a very strong fourth quarter and full year with solid performance across all of our business lines. We entered 2026 with over 322,000 active subscribers, nearly $37 million in cash and no debt, giving us the strongest balance sheet and liquidity position in the company's history. Across our platform, we now onboard approximately 1,200 new patients per day, and we received more than 120,000 unique daily visitors to our websites, a clear reflection of the strength of our brands and the growing demand for our services. Our weight management business alone is seeing record patient acquisition volumes in the first quarter with new sign-ups approaching 700 per day, while customer acquisition costs have declined sequentially, a combination we are very excited about. Weight management remains a significant long-term growth opportunity for us. More than 100 million Americans are clinically eligible for GLP-1 therapy, yet only a fraction have been prescribed treatment. Subsequent to year-end, we successfully launched oral Wegovy through our collaboration with Novo Nordisk, significantly expanding access for patients who prefer an oral option. We are one of the few virtual care providers fully integrated with both Novo Nordisk and Eli Lilly affiliated pharmacies, and we are optimistic these collaborations will continue to evolve and deepen. Beyond our current partnerships, we see significant pipeline opportunities with other large pharmaceutical companies and strategic partners. And we believe LifeMD's infrastructure and patient base make us a highly attractive partner in this space. Our second biggest area of focus after weight management is women's health. We have invested more resources into the launch of this offering than anything we've launched in the history of our company. We started by acquiring Optimal Human Health, a virtual concierge women's health company founded by Dr. Doug Lucas. Dr. Lucas is a former orthopedic surgeon and bone health specialist, who has built a significant social media presence with over 160,000 followers and more than 10 million views across platforms, establishing himself as a recognized authority in women's hormonal and bone health. We also partnered with Dr. Tara Scott, known as the Hormone Guru. Dr. Scott is an internationally recognized physician who is board-certified in OB/GYN, functional medicine and integrative medicine with 26 years of private practice experience and two decades of work in the menopause space. We have more advisers of this caliber joining our Women's Health Advisory Board in the weeks and months to come. As we've shared on prior calls, we are committed to building the highest quality virtual women's health care offering in the country focused on menopause, perimenopause, hormonal health and bone health. The market need is clear. Nearly 50% of U.S. counties lack an OB/GYN and 1.3 million women enter menopause each year, creating massive unmet demand for expert hormonal health care. While still early, we are seeing unit economics move in the right direction and expect women's health to be a meaningful contributor to growth in 2026 and a major driver in the long term. Upcoming catalysts include the launch of insurance and Medicare support for our women's health offerings, pharmacy bundles that combine GLP-1, hormone and other therapies and strategic media and influencer programs in the pipeline for later this year. Turning to men's health. Our RexMD brand, now with approximately 215,000 active patients, returned to growth in the second half of 2025 and continues to perform strongly on a profitable basis. We are focused on expanding RexMD's clinical offering beyond its core sexual health programs into other personalized generic and compounded medication categories. In the last week, we launched the RexMD integration with NovoCare and now offer injectable and oral Wegovy directly to RexMD patients. We are launching five new men's health care offerings and treatments from our pharmacy in the first half of 2026 in areas including insomnia, erectile dysfunction, dermatology and topical pain relief. Further, we are closely following FDA guidance on peptide therapies and are prepared to launch those that are permitted to be compounded and are supported by strong clinical data. A key enabler across all these verticals is our affiliate pharmacy, which is now licensed in all 50 states and processing approximately 20,000 prescriptions per month. With our recently licensed 503-A compounding operation, we have the ability to produce personalized compounded medications at scale, supporting our efforts across men's health, women's health and other specialty verticals. We view our pharmacy infrastructure as another growth driver for the company with the potential to meaningfully expand margins and deepen patient engagement across the platform. In March, we beta launched a 30-state virtual cardiology offering. This program allows new and existing LifeMD patients to book a cash pay or insurance covered visit with board-certified cardiologists from the comfort of their home. Our affiliated cardiologists can treat a range of conditions in a virtual environment, prescribe and manage medications and provide diet and lifestyle care plans. Importantly, the diagnostics and care delivered to this program are driven by an AI-supported intake process that pulls in the patient's medical history from a health information exchange and synchronizes it with biomarker data from labs and information provided during patient intake. The result is a significantly more efficient experience for the cardiologist, an enhanced experience for the patient and most importantly, improved clinical outcomes. I am excited to see this program scale, and I believe it will serve as a blueprint for how we triage, diagnose and treat patients across our entire platform in the years to come. Let me now review our infrastructure priorities for 2026. We are focused on three areas that we believe will meaningfully accelerate growth and operating leverage across the business. First and most importantly is artificial intelligence. We have built a dedicated world-class AI and engineering team inside LifeMD that is focused exclusively on deploying advanced agentic AI capabilities across care delivery, diagnostics and patient operations, supported by strong governance controls. This is not something that we are outsourcing or experimenting with on the side. It's central to our strategy and is embedded throughout our platform today. In the first half of this year, we plan to launch our AI clinical decision support tool. As I mentioned with our cardiology offering, this tool connects directly to a patient's medical record, pulls in data from health information exchanges and integrates biomarker data from labs to support diagnosis and personalized treatment recommendations of our affiliated providers. We expect our AI clinical decision support tool to drive new patient acquisition, improve the efficiency of message-based and synchronous consults and enable even more patients to access the industry-leading care provided by our affiliated clinicians. One area where we see particularly high demand is personalized prescribing, especially with compounded medications. Our AI tools will be able to analyze a patient's clinical profile, lab results and treatment history to help providers design highly individualized compound formulations tailored to each patient's specific needs. When you combine that capability with our 503-A compounding pharmacy, you get something that is very difficult to replicate: AI-driven personalized medicine manufactured and fulfilled in-house at scale. We believe this intersection of AI and pharmacy is a major differentiator and will drive both better patient outcomes and improved unit economics across the platform. We believe LifeMD will be a leader, if not the leader, in delivering urgent and specialty health care using AI. The combination of our proprietary technology, our 50-state affiliated medical group, our pharmacy infrastructure and the structured clinical data we have accumulated from over 1.3 million patient consults gives us what we believe is one of the most compelling AI-enabled care platforms in virtual health. Beyond the clinical side, we are embedding AI and automation deeper into our operational workflows, enabling us to handle significantly more volume without proportional increases in overhead. We see a clear path to substantially improving our G&A efficiency throughout 2026 and we expect these investments to be a meaningful contributor to margin expansion as the year progresses. Our second infrastructure priority is benefits. Today, our platform covers over 110 million lives through commercial and government payer contracts. By the end of the second quarter, we expect that number to grow to over 220 million lives through an expanded partnership with a leading third-party benefits partner. This is a critical competitive advantage. When patients are able to use their insurance on our platform, we've seen customer acquisition costs decline by as much as 30% plus we expect meaningful improvements in retention in this population. As we layer insurance enablement across weight management, women's health and primary care, we believe this infrastructure will be a significant long-term differentiator for LifeMD. The third infrastructure priority is our technology platform. We are investing in building a true platform experience for our patients, one that is architected to incorporate emerging AI capabilities and insurance benefits infrastructure in a way that feels invisible to the patient. This means rethinking how our platform is built at a foundational level, modernizing our underlying systems, creating flexible integration layers and designing patient-facing workflows that can seamlessly absorb these technologies without adding complexity. Today, AI tools and benefits verification exist largely as point solutions that sit outside of the core patient journey. Our goal is to enhance the platform so these capabilities are native to the experience, woven into how patients access care, communicate with their providers and manage their treatment. Getting the architecture right is what makes a seamless patient experience possible at scale, and it is what will allow us to move quickly as both AI and the insurance landscape continue to evolve. We made meaningful progress on this in 2025, and it remains a top priority in 2026. In summary, LifeMD entered 2026 from a position of strength with record demand in weight management, a diversifying specialty care platform, a scalable pharmacy operation, deepening pharmaceutical collaborations and the financial flexibility to invest aggressively in growth. We are confident in our growth trajectory and excited about the road ahead. With that, I'll now turn the call over to our CFO, Marc Benathen, to provide more detail on our fourth quarter and full year financial results and outlook.
Thank you, Justin, and good afternoon, everyone. Our fourth quarter results were very strong and ahead of our previous guidance, driven by outperformance in all areas of the company. During the quarter, we added over 13,000 net new subscribers to our patient subscriber count. This was the largest net gain of any quarter in 2025 and is reflective of the strong business momentum as a result of LifeMD making significant inroads with the penetration of branded therapy within our weight management subscriber base and a consistent multi-quarter return to sequential growth in our men's health business. To date, in the first quarter, we have seen this momentum continue and even accelerate in the first quarter of 2026 with GLP-1 patient new sign-ups at record levels and over 80% of new patient sign-ups going on branded therapy. We are leveraging our pristine balance sheet to invest in accelerating the acquisition and onboarding of patients to best position us for long-term growth and significant momentum in the back half of 2026. Now turning to the fourth quarter numbers. Revenue grew 4% versus the year ago period to $46.9 million. Telehealth subscriber growth remains strong with the number of active subscribers increasing 16% year-over-year to nearly 323,000 at quarter end. Gross margin for the fourth quarter was 87.1%, an expansion of 570 basis points versus the prior year due to revenue mix and increasing operational efficiency as we scale. Gross profit was $40.8 million, an increase of 11% from the year ago period. Our GAAP net income attributable to common stockholders for the fourth quarter of 2025 was $19 million or $0.41 per share. This figure includes the one-time benefit from the sale of WorkSimpli last November. Excluding this one-time gain, our GAAP net loss from continuing operations was $1.9 million or $0.04 per share. This compares with a GAAP net loss from continuing operations for the fourth quarter of 2024 of $6.8 million or a loss of $0.16 per share. Adjusted EBITDA is a non-GAAP measure we define as income or loss attributable to common shareholders before various items as outlined in today's news release. Adjusted EBITDA totaled $4.8 million for the fourth quarter of 2025, up from $1.1 million in the year ago period. Now turning to the full year numbers. Revenue grew 25% versus the year ago period to $194.1 million. Gross margin for 2025 was 85.7%, a slight decrease of 50 basis points versus the prior year due to mix. Gross profit was $166.3 million, an increase of 25% versus 2024. Our GAAP net income attributable to common stockholders for 2025 was $11.2 million or $0.25 per share. This figure includes the one-time benefit from the sale of WorkSimpli. Excluding this one-time gain, our GAAP net loss from continuing operations was $13.3 million or $0.30 per share. This compares with a GAAP net loss from continuing operations for the full year 2024 of $26.3 million or a loss of $0.64 per share. Adjusted EBITDA totaled $15.3 million for the full year 2025 as compared with $3.7 million in the year ago period. We exited the fourth quarter and full year 2025 with $36.8 million in cash and no debt. Turning to financial guidance. We expect first quarter 2026 revenue in the range of $48 million to $49 million with adjusted EBITDA loss in the range of $4 million to $5 million. This expected loss is purely being driven by record volumes of approximately 700 new patient sign-ups a day in our GLP-1 weight loss business amidst significant demand for our branded and oral therapy business. We see this discretionary investment as a major driver for potential growth in the coming quarters. At the same time, we have achieved this record demand with a 4% sequential decline in CACs within this business line. Our very strong balance sheet allows us to easily finance this investment. LifeMD plans to return to adjusted EBITDA profitability in the second quarter following this investment. For the full year 2026, we expect revenue of between $220 million and $230 million and adjusted EBITDA between $12 million and $17 million. By the fourth quarter of 2026, we expect our annualized run rate for revenue to exceed $250 million and for adjusted EBITDA our annualized run rate to exceed $25 million.
Thanks, everybody. I think now we'll open up to questions.
分析師問答
We will now open the call for questions. We will take our first question from David Larsen with BTIG.
Congratulations on the good quarter and the good year. Can you talk a little bit about the demand you're seeing for the Wegovy pill and the brand products? How does that compare to, say, third and fourth quarter of 2025 heading into first quarter of 2026?
Dave, this is Justin Schreiber. I'll take that one. The demand, as we mentioned on the call, has been very strong since this product launched in early January. If you were to compare it, as we said, we nearly doubled new patient acquisition in the weight loss business. A lot of that was driven by the Wegovy pill. We also saw really encouraging unit economics, which is why we decided to spend more on new patient acquisition in this area.
Okay. And then when you say patient or unit economics, can you expand a little bit on that? What is the revenue model for the Wegovy pill? Is it being priced at like $150 a month, which I think is the cash pay price that Novo charges? Any additional color, like gross margins on that product, would be very helpful.
Yes, David, this is Marc. It will depend upon dosage. But typically, it's at a $249 a month price all in as a bundle and can move up from there. The gross margins are healthy. We're in approximately $100 an order or so in margin, which is pretty healthy. We treat it from an accounting and financial statement standpoint similar to how we've treated other bundled relationships and recognize the net amount into the P&L, which is driven by the margin since essentially the product today is a pass-through. The margin we make is on the additional services we provide to our patients. So it's very similar economics to what we've seen on branded injectables, which are strong economics that have multifold returns on a three-year basis.
Okay. That's great. And then any more color on the investments you're going to be making in Q1 of 2026 that's going to create that sort of EBITDA margin phenomenon?
Yes. The big increase is going to be in the sales and marketing line. In 2025, we were typically around the $20 million to $22 million mark in sales and marketing within the telehealth business. We're going to be in the $30 million to low $30s range in the first quarter, but that's also with CAC reducing sequentially about 4% to 5% and volumes doubling. It's impressive that we're able to drive much more volume with reduced CAC. Because of the volume, it's going to drive incremental dollars. Those dollars will pay back to us in the coming quarters, particularly in the back half of 2026. Given the demand out there and where LifeMD is positioned in the market, our insurance capabilities, we collectively believe it makes sense for us to capitalize on this opportunity.
Okay. And just one last quick one before I hop back in the queue. The ramp in revenue, I think you mentioned maybe $63 million in revenue in the fourth quarter. It's a pretty good ramp from Q1. What will be the drivers of that increase as we progress through the year, please?
Predominantly subscriber count growth. It's mostly going to take place in the GLP-1 weight business, the growth in the women's health business, which is at its infancy, and the Rx business, which is back to sequential growth and will continue to be a consistent grower as we move through each of the quarters. Those three areas will drive the subscriber count growth as we move throughout the year.
We'll move now to Sarah James with Cantor Fitzgerald.
Congrats on a great quarter and exciting outlook. There's a lot of growth levers here to unpack. I want to stick on the topic of the run rate revenue and earnings. Can you help frame when you're getting to that $25 million annualized EBITDA by exiting 2026? How much of that growth is coming from women's health versus weight management versus cross-care pharmacy? What are the main drivers in 2026?
Sarah, when we launch a new offering like women's health, while we do breakeven on the unit economics typically around the six- to seven-month mark, it is not going to be EBITDA positive on a consolidated basis in the first year. It will add revenue, likely around $10 million on a full year basis with a higher run rate by the fourth quarter, but it's not EBITDA positive in that first year. The EBITDA accretion this year will come from our more mature men's health and weight management businesses continuing to scale subscriber count against highly leverageable fixed costs. We are making a discretionary marketing investment now, particularly in weight management and to a lesser degree in scaling complementary offerings in men's health. Women's health will be in a great position at the end of the year, probably slightly accretive on a run rate basis and then significantly accretive in 2027.
That's helpful. To get a better basis on women's health: when you think about the early performance versus your entrance into weight management or RexMD, how is women's health comparing on metrics like CAC, conversion to care plans and early retention? What does the ramp look like versus other markets you've entered?
Sarah, we've seen higher intent for these offerings from a CPC basis than anything we've ever launched, which is very encouraging on the marketing side. We've struggled a bit on conversion rate and have put an enormous amount of energy into improving that. We've invested in our brand, assets and advisers and invested more than we've ever invested in a launch in company history for the women's health program. We're starting to see the benefits: we've cut the CPA approximately in half over the last 30 days, and there's still room for improvement. There's enormous demand and an incredible service offering, including compounded hormone therapies priced better than almost everybody else, especially considering the quality of our offering. Early on-therapy and retention rates are north of 80%, which is really strong. Our plan was to build something with an incredible value proposition, price it properly and have excellent retention. It's early, but the initial numbers are very good and everyone internally is excited.
We'll take our next question from Steven Dechert with KeyBanc.
Congrats on a solid quarter. Just wondering the level of stickiness you're seeing with people on the Wegovy pill versus the injectable? If that is a higher stickiness level, how much is that factored into your 2026 guidance?
It's a bit early to fully understand long-term retention. We have taken a conservative stance on that. We've seen really strong on-therapy rates, likely because people coming to LifeMD know they want the Wegovy pill, qualify for therapy and are okay paying cash. The interim price for that drug is $149, so it's an attractive price point. On-therapy rates and initial retention rates are certainly better than the injectable, but long-term retention remains to be determined.
Okay. And then on your weight management platform compared to competitors: Lilly announced a weight management offering and Amazon launched a direct-to-consumer offering. How does your platform compare to some of these competitors out in the market?
We put out an updated investor presentation that details our differentiators. Compared to Amazon, we operate our own 50-state provider group staffed mostly with full-time providers who are highly trained in their specialty areas. That differentiates us from companies that use third-party providers. We are a platform for care offering different types of specialty services: women's health, weight management, hormone therapy, behavioral health and psychiatry. Patients can access synchronous care—video or audio—with a highly trained provider who is part of LifeMD's affiliated medical group, not a 1099 provider from a third-party staffing business. Those capabilities, our pharmacy integration, and the breadth of specialty care are unique differentiators. The market is large and diverse and while competitors will likely capture some demand, we're seeing strong demand for LifeMD services and our pharmacy products, and we don't see these competitive announcements materially impacting our business.
We'll take our next question from Ryan Meyers with Lake Street Capital Markets.
First question: thinking about the patient acquisition channels you are investing in during Q1, are you going after different marketing channels? Is the marketing strategy any different here or similar to what you've done in the past?
It's mostly similar to what we've done in the past. We do have some new media partnerships that have performed very well and delivered thousands of new patients. We also onboarded several smaller employers in the last 30 days as part of a pilot; feedback has been incredible. We are working on some significant partnerships with very large companies that could be transformational if they close, and we could see progress on those in the next 60 to 90 days. We have an active pipeline of opportunities that would drive patient acquisition.
Got it. That's helpful. Second question: with benefits infrastructure on track to cover over 220 million lives by the end of Q2, when you think about potential lifetime value of a covered patient versus a cash pay patient, is there a big difference?
That's a great question. I don't have a precise answer because the insurance business is still new for us. I believe retention will be stronger for patients using commercial insurance or Medicare on the LifeMD platform, who pay a copay and have a lower membership fee than cash-pay patients. So I expect better LTVs and retention for insured patients, but we need to prove that out. We were surprised by the strong demand when we turned on insurance in a few states and saw an immediate impact on CPA, though it was a lower-priced offering and there were billing kinks to work out. We don't yet have a clear long-term picture, but we have enough data to know there is a viable long-term business model. We expect the business to shift more toward commercial and government insurance patients over the coming quarters and anticipate reporting more detail on this in future updates to investors.
We'll move now to H.C. Wainwright. Yi Chen is on the line.
This is Eduardo on for Yi. Could you reiterate the total number of subscribers and detail the number of them that came on specifically for the Wegovy pill? Are you seeing any migration from patients who were on injectables to the pill, or is it primarily new customers signing up for the oral drug?
We have 322,000 overall subscribers. As indicated in the updated presentation posted to the Investor Relations website today, approximately 80,000 plus are weight management subscribers. We haven't released the exact count for the oral Wegovy pill, but we are seeing very strong demand for that product since it only started selling in January. We haven't reported our Q1 subscriber count yet, so we aren't releasing that specific figure at this time, but the pill is clearly driving a lot of new patient demand for us.
Got it. That's helpful. Regarding the pharmacy, now that you're licensed in all 50 states, what percentage of RexMD and LifeMD fulfillment is currently handled in-house? What's the incremental margin lift with in-house fulfillment?
We are approaching the 70% mark with in-house fulfillment. The margin lift is still being finalized, but we're seeing roughly 150 to 200 basis points of margin improvement from internal fulfillment. The long-term benefit is flexibility—particularly for personalized and 503-A compounded products, which we can now produce out of our pharmacy for lifestyle conditions and specialty verticals.
Understood. Would you be willing to detail additional drugs you're considering compounding and bringing into your offering that you think would be key growth drivers for the pharmacy?
We have a strong internal roadmap, but we're not at liberty to detail that at this time.
At this time, there are no further questions in queue. I will now turn the meeting back to Justin Schreiber for closing remarks.
Thank you, everyone, for your questions and for your interest in LifeMD. We look forward to speaking with you once again when we report our first quarter results. Have a great evening.
Thank you. This brings us to the end of today's meeting. We appreciate your time and participation. You may now disconnect.