Steve Dechert

Steve Dechert inquired about the level of stickiness observed with patients on the Wegovy pill compared to the injectable version, and how this is factored into the 2026 guidance. He also asked for a comparison of LifeMD's weight management platform against new competitors like Lilly and Amazon.

Answer

CEO Justin Schreiber stated it is too early to determine long-term retention for the Wegovy pill, and its impact on the Q4 2026 run rate guidance is conservatively estimated. He noted strong on-therapy rates and initial retention that are better than the injectable, but long-term data is still pending. Comparing LifeMD to competitors, Justin Schreiber highlighted LifeMD's differentiators: its own 50-state provider group with full-time, highly trained specialists; a platform offering diverse specialty care including women's health, weight management, hormone therapy, and behavioral health; and the availability of synchronous care (video/audio visits) with affiliated medical group providers. He emphasized that the large market size means new entrants do not materially impact LifeMD's business.

Steve Dechert asked about the stickiness of patients on the Wegovy pill compared to the injectable version and how any higher stickiness is factored into the 2026 guidance. He also requested a comparison of LifeMD's weight management platform against new competitors like Lilly and Amazon.

Answer

Justin Schreiber, Chairman and CEO, stated it was too early to determine long-term retention for the Wegovy pill, and its impact on the Q4 2026 run rate guidance was conservatively estimated. He noted strong initial on-therapy rates for the pill, attributing it to cash-paying patients accepting the attractive $149 introductory price, with initial retention rates appearing better than injectables, though long-term data is pending. When comparing LifeMD to competitors, Schreiber highlighted LifeMD's differentiators: its own 50-state provider group with highly trained, full-time specialists, a comprehensive platform offering diverse specialty care (women's health, weight management, hormone therapy, behavioral health), and the availability of synchronous (video/audio) care with affiliated providers, unlike many competitors.

Steve Dechert of KeyBanc Capital Markets questioned the company's refund policy, the reasons for a higher refund rate in the quarter, and whether LifeMD still facilitates prescriptions for personalized (compounded) GLP-1s.

Answer

CEO Justin Schreiber described the refund policy as 'extremely liberal,' offering full refunds to patients who cannot access or afford therapy. He attributed the higher rate to the high cost of branded GLP-1s, which leads some patients without insurance to seek cheaper alternatives. He confirmed that providers can still prescribe personalized GLP-1s to third-party pharmacies when clinically appropriate.

Steve Dechert inquired about the key challenges in transitioning users from general-purpose large language models (LLMs) to Talkspace's specialized Talk AI agent, and also asked for clarification on the factors driving the high end of the 2026 revenue guidance, particularly regarding new versus existing members.

Answer

CEO Dr. Jon Cohen stated that the Talk AI agent is in beta, positioned for serious, confidential, and HIPAA-protected conversations, and it's too early to predict user migration from general LLMs. CFO Ian Harris clarified that a material portion (30-50%) of 2026 payer revenue comes from existing members, with new users driven by paid marketing, organic LLM optimization, and payer directory integrations.

Steve Dechert asked about the key challenges in transitioning users from general-purpose large language models (LLMs) to Talkspace's specialized AI agent, and what factors would drive the high end of the 2026 revenue guidance.

Answer

CEO Dr. Jon Cohen stated that the Talk AI agent is in early beta, positioned for serious, confidential conversations with security and safety, and advised to 'stay tuned' for more information post-beta. CFO Ian Harris clarified that a material portion (30-50%) of payer revenue comes from existing members, with new users driven by paid marketing, organic LLM optimization, and deeper payer directory integrations.

Steve Dechert from KeyBanc Capital Markets asked about changes in marketing spend allocation and recent trends in reimbursement rate negotiations with payers.

Answer

CFO Ian Harris noted no material changes in core marketing allocation but mentioned testing new channels for Medicare and military audiences. CEO Jon Cohen stated that payer reimbursement rates are renegotiated every few years and, having recently completed a cycle, he does not anticipate any significant negotiations within the next year.

Steve Dechert from KeyBanc Capital Markets inquired about changes in marketing spend allocation and trends in reimbursement rate negotiations with payers.

Answer

CFO Ian Harris noted no material changes in core marketing allocation but mentioned testing new channels for the Medicare and military populations. CEO Jon Cohen stated that payer rate renegotiations occur every few years and nothing significant is expected within the next year.

Steven Dechert asked about the benefits of ABCL 635 compared to existing hormonal treatments for hot flashes and whether any molecules currently in development would directly compete with ABCL 635.

Answer

Carl Hansen, AbCellera's President and CEO, clarified that ABCL 635 is positioned as an alternative to menopausal hormone therapy (MHT), addressing women with contraindications or tolerability issues. He acknowledged existing competitors like Veozah (Astellas Pharma) and elinzanetant (Bayer) on the market, expressing confidence in ABCL 635's potential for differentiation in dosing, safety, and efficacy.

Steve Dechert of KeyBanc Capital Markets asked about Absci's capacity for additional partnerships following the Almirall expansion and requested an update on the HIV collaboration with Caltech.

Answer

CFO Zach Jonasson assured that capacity is reviewed quarterly and that the company is well-positioned for new partnerships, aided by efficiencies from its AI platform. CEO Sean McClain reported no new updates on the Caltech HIV program, stating it is progressing well and is currently in Caltech's hands for their portion of the collaborative work.

Steve Dechert of KeyBanc Capital Markets asked about Absci's capacity for new partnerships following the Almirall expansion and requested an update on the Caltech HIV collaboration.

Answer

CFO & CBO Zach Jonasson stated that capacity is reviewed quarterly and is sufficient for current and new partnerships, partly due to AI-driven efficiencies. CEO Sean McClain reported no new updates on the Caltech HIV program, noting it is progressing well and is currently with Caltech for their portion of the work.

Steve Dechert of KeyBanc Capital Markets asked about the timeline for realizing cost benefits from new AI tools and requested an update on the company's new EHR selection process.

Answer

CEO David Bourdon explained that AI tools for revenue cycle and scheduling are already contributing to efficiency and quality, driving long-term operating leverage rather than immediate, large cost reductions. He noted that the AI for clinician documentation is primarily aimed at improving satisfaction. He added that a decision on a new EHR is expected in the second half of 2025.

Steve Dechert of KeyBanc Capital Markets asked for specific reasons behind the slowdown in Tier 1 software renewals and inquired about the profitability profile of the QSP business relative to Certara's other offerings.

Answer

CFO John Gallagher attributed the Tier 1 software issue to the quarterly lumpiness of bookings and expressed high confidence in second-half renewals. Regarding QSP, he noted it is currently a services business with a typical services profitability profile and mentioned the upcoming launch of Certara IQ, a software product for QSP.