Doximity - Earnings Call - Q4 2025

Executive Summary

• Q4 2025 delivered double-digit growth and strong profitability: revenue $138.3M (+17% YoY), non-GAAP diluted EPS $0.38, adjusted EBITDA $69.7M (50.4% margin), and free cash flow $97.0M; all exceeded prior guidance and Street estimates, with subscription revenue at $131.9M (+17% YoY).
• Full-year FY2025 revenue reached $570.4M (+20% YoY) and adjusted EBITDA $313.8M (55% margin), both above the company’s earlier outlook; GAAP diluted EPS was $1.11 and non-GAAP diluted EPS $1.42.
• FY2026 outlook guides to revenue of $619–$631M (~10% growth) and adjusted EBITDA $333–$345M (~54% margin), reflecting tougher comps from earlier program launches and prudence amid policy uncertainty; Q1 FY2026 guidance calls for revenue $139–$140M and adjusted EBITDA $71–$72M.
• Key catalysts: accelerating adoption of workflow modules (point-of-care, formulary), expanding client portal usage (strong upsell enablement and ROI proof), and rapidly growing AI tools; NRR remained robust (119%; top 20 at 123%) with 116 customers >$500k TTM.

What Went Well and What Went Wrong

What Went Well

• Strong beat vs guidance and Street: Q4 revenue and non-GAAP EPS exceeded guidance and consensus; adjusted EBITDA margin reached 50.4% and free cash flow grew 56% YoY to $97.0M.
• Workflow and AI momentum: over 620k unique active prescribers on workflow tools; AI tool usage up more than 5x YoY; newsfeed engagement up >30% YoY; management highlighted AI-driven efficiency and client interest in AI optimization.
• Portal traction and share gains: portal clients grew faster; integrated programs increased deal sizes and January launches; top 20 NRR at 123% and total NRR at 119% TTM, evidencing durable expansion among large accounts.

“Physicians love our specialty-specific AI tools… Our AI tools grew the fastest, again, last quarter, up more than 5x year-on-year” — CEO Jeff Tangney.

What Went Wrong

• Slower growth guide for FY2026: revenue growth ~10% reflects tougher YoY comparisons (benefit from earlier launches in FY2025) and cautious upsell assumptions amid policy uncertainty.
• Health systems still tentative: marginal improvement noted, but guidance assumes no material acceleration given near-term sensitivity to macro/policy changes.
• Upsell variability risk: management emphasized that upsells are more variable and prudence is baked into guidance, particularly in early-year periods.

Transcript

Operator (participant)

Good day, everyone, and welcome to the Doximity Q4 2025 earnings call. At this time, I will hand the call over to Perry Gold, Head of IR. Please go ahead, sir.

Perry Gold (VP of Investor Relations and Revenue Operations)

Thank you, Operator. Hello and welcome to Doximity's Fiscal 2025 Fourth Quarter earnings call. With me on the call today are Jeff Tangney, Co-founder and CEO of Doximity; Dr. Nate Gross, Co-founder and CSO; and Anna Bryson, CFO. A complete disclosure of our results can be found in a press release issued earlier today, as well as in our related Form 8K, along with a copy of our prepared remarks, all available on our website at investors.doximity.com. As a reminder, today's call is being recorded, and a replay will be available on our website. As part of our comments today, we will be making forward-looking statements. These statements are based on management's current views, expectations, and assumptions, and are subject to various risks and uncertainties. Actual results may differ materially, and we disclaim any obligation to update any forward-looking statements or outlook.

Please refer to the risk factors in our annual report on Form 10K, any subsequent Form 10Qs, and our other reports and filings with the SEC that may be filed from time to time, including our upcoming filing on Form 10K. Our forward-looking statements are based on assumptions that we believe to be reasonable as of today's date, May 15th, 2025. Of note, it is Doximity's policy to neither reiterate nor adjust the financial guidance provided on today's call unless it is also done through a public disclosure, such as a press release, or through the filing of a Form 8K. Today, we will discuss certain non-GAAP metrics that we believe aid in the understanding of our financial results. A historical reconciliation to comparable GAAP metrics can be found in today's earnings release.

Finally, during the call, we may offer incremental metrics to provide greater insights into the dynamics of our business. These details may be one-time in nature, and we may or may not provide updates on those metrics in the future. I would now like to turn the call over to our CEO and Co-founder, Jeff Tangney. Jeff?

Jeff Tangney (Co-Founder and CEO)

Thanks, Perry, and thank you, everyone, for joining our Fourth Quarter earnings call. We have three topics today: our financials, network growth, and client summit recap. First, our top line. We delivered $138 million in revenue for the Fourth Quarter of our Fiscal 2025, 4% above the high end of our guidance range. For our full Fiscal Year ended March 31st, we had $570 million in revenue and grew 20% year on year. Of note, our top 20 clients, who know and measure us best, once again grew the fastest at 23% in Fiscal 2025. Our bottom line was also strong in Q4, with an adjusted EBITDA margin of 50%, or $70 million, which was 10% above the high end of our guidance. Our free cash flow was stronger still at $97 million, up 56% year on year.

For the full Fiscal Year, our adjusted EBITDA grew 36% to $314 million. Our adjusted EBITDA margin was 55% for the year, up from 48% the prior year. We generated free cash flow of $267 million, an increase of 50% year on year. Okay, turning now to our network growth and engagement. Our unique active users on a Quarterly, monthly, weekly, and daily basis all hit fresh highs in Q4. This growth was again led by our newsfeed, which is both our most used and most monetized product. Our unique newsfeed users hit record highs last Quarter, while our articles read or tapped were up more than 30% year on year. Our workflow tools also hit fresh highs in Q4, with over 620,000 unique active prescribers. As a reminder, our workflow tools include our telehealth, fax, scheduling, and AI tools.

Our AI tools grew the fastest again last Quarter, up more than 5X year on year. In short, as the practice of medicine grows both more mobile and more AI-powered, we're proud to be leading the way. Okay, turning now to our recent physician and pharma client summits. In March, we hosted our 13th annual Physician Tech Summit in San Francisco. It was great to roll up our sleeves for two days alongside 150 of our nation's most tech-savvy doctors. For the third year in a row, our Doximity GPT products took center stage. Physicians love our specialty-specific AI tools and HIPAA-secure environment, and we're learning a lot from their real-world use. One popular new feature is our ability to upload and securely analyze documents.

Per a recent JAMIA study, a fifth of patients nowadays have medical records that are lengthier than Moby Dick, so for a specialist treating a new patient, it can literally take hours of reading to fully come up to speed. With Doximity GPT, they can just upload the patient's file, and our AI can chart the patient's lab values over time, summarize key clinical findings, or search for complex diagnostic clues. It is a long-overdue cure for what physicians affectionately call "note bloat." In a short couple of years, we have seen AI tools like this truly change the mood in medicine, from AI leery to AI cheery. For the first time in over a decade, there is genuine hope that physician burnout and information overload can actually be eased with technology. We are incredibly proud and motivated to help, crafting AI tools that just work for busy clinicians.

This is our mission and our roots as a team. Following our Physician Summit last month, I have personally shifted my focus from our client portal to our clinical AI products. Speaking of our client portal, the rollout's going very well. The majority of our pharma clients now have access, and they love tracking their day-to-day results and ROI. These daily portal insights are also fueling client interest in how our new AI-powered integrated offerings can help them automate their programs. This AI orchestration was a key theme at our annual pharma client summit in New York last week, where we were joined by over 40 marketing leaders from the world's largest pharmaceutical companies. Their top request was to use our AI to optimize their programs at a more strategic level.

By giving us more latitude to select the right content at the right time for each doctor, we've been able to improve our clients' results along with our own revenue and predictability. I would like to end by thanking my Doximity teammates, who continue to work incredibly hard to care for those who care for us. As AI-assisted medicine becomes a reality, our future has never been brighter or more exciting, and I'm proud to be on this journey with you. With that, I would like to hand it over to our CFO, Anna Bryson, to discuss our financials and guidance. Anna?

Anna Bryson (CFO)

Thanks, Jeff, and thanks to everyone on the call today. Fourth Quarter revenue grew to $138.3 million, up 17% year over year, exceeding the high end of our guidance range. Full year revenue grew to $570.4 million, up 20% year over year. As a reminder, Fiscal 2025 revenue benefited from our strategic shift to more multi-module integrated offerings. This not only drove larger deal sizes, but also enabled a greater share of annual programs to launch in January. Transitioning to these more efficient launch timelines contributed to a few points of revenue growth upside in Fiscal 2025. Similar to prior Quarters, our existing customers continue to lead our growth. We finished the Quarter with a net revenue retention rate of 119% on a trailing 12-month basis. For our top 20 customers, net revenue retention was higher at 123%, so our biggest, most sophisticated customers remain our fastest growing.

We ended the Quarter with 116 customers contributing at least $500,000 each in subscription-based revenue on a trailing 12-month basis. This is a roughly 17% increase from the 99 customers that we had in this cohort a year ago, and these customers accounted for 84% of our total revenue. Turning to our profitability, non-GAAP gross margin in the Fourth Quarter was 91%, flat versus the prior year period. For the full Fiscal Year, non-GAAP gross margin was 92% versus 91% last year. Adjusted EBITDA for the Fourth Quarter was $69.7 million, and adjusted EBITDA margin was 50%, compared to $56.4 million and a 48% margin in the prior year period. For the full Fiscal Year, adjusted EBITDA was $313.8 million, and adjusted EBITDA margin was 55%, compared to $230.5 million and a 48% margin last year.

We are proud to continue to run a very profitable business with 36% year-over-year growth in our bottom line. Now turning to our balance sheet, cash flow, and an update on our share repurchase program. We generated free cash flow in the Fourth Quarter of $97 million, compared to $62.3 million in the prior year period, an increase of 56% year-over-year. For the full Fiscal Year, we generated free cash flow of $266.7 million, compared to $178.3 million last year, an increase of 50% year-over-year. We ended the year with $916 million of cash, cash equivalents, and marketable securities. During the Fourth Quarter, we repurchased $26.8 million worth of shares. For the full Fiscal Year, we repurchased $116.2 million worth of shares at an average price of $33.73. As of March 31, we had $424 million remaining in our existing repurchase program. Now moving on to our outlook.

For the First Fiscal Quarter of 2026, we expect revenue in the range of $139-$140 million, representing 10% growth at the midpoint. We expect adjusted EBITDA in the range of $71-$72 million, representing a 51% adjusted EBITDA margin. For the full Fiscal Year, we expect revenue in the range of $619 million-$631 million, representing 10% growth at the midpoint. We expect adjusted EBITDA in the range of $333 million-$345 million, representing a 54% adjusted EBITDA margin. Now I'll provide more color on our outlook. As mentioned above, Fiscal 2025 was a strong year of strategic progress for us. Our new multi-module integrated offerings allowed many of our customers to get their annual programs live in January.

While we expect these earlier launches to be the norm going forward, Fiscal 2025 received the benefit of being the transition year, leading to a few points of revenue growth upside. This dynamic creates a tougher year-over-year comparison for Fiscal 2026, which is reflected in our expected revenue growth rate. Long term, we believe these more efficient January launches are a meaningful step forward for our customers and our business. These earlier launches allow our customers to maintain an uninterrupted presence on our platform, which helps drive ROI. As customers realize higher returns, we expect this will translate into even greater investment on Doximity over time. As far as visibility, as of today, we have just under 70% of our initial subscription-based revenue guidance under contract. We expect the pharma HCP digital market to grow at roughly 5%-7% again this year.

While we have not yet seen any impact to our business from recent macro uncertainty, we believe it's prudent to assume the market growth rate could be on the lower end of this range, which is reflected in our guidance. That said, we believe our pharma business will maintain its strong competitive position and grow at roughly twice the market rate, remaining our fastest-growing business in Fiscal 2026. Between client portal insights, integrated program traction, and record physician engagement, we believe we are set up for another year of meaningful share gains. Finally, we are excited to increase our investments in AI this year. These investments will help us build better tools for our members, develop smarter solutions for our clients, and drive greater efficiency across our entire business over the long term. We believe we are in the early innings of realizing AI's full potential at Doximity, and we couldn't be more excited for the future. With that, I will turn it over to the operator for questions.

Operator (participant)

Thank you. If you would like to ask a question, please press star one on your telephone keypad. Once again, that is star one for questions today. We will take our first question from Brian Peterson, Raymond James.

Brian Peterson (Managing Director and Senior Equity Research Analyst)

Thanks for taking the question and congrats on the strong 20% growth this year. Jeff, I just wanted to start out on the macro. I know you guys mentioned that you haven't seen any impact as of yet, but how are your customer conversations in terms of their willingness to spend this year? As they're thinking about this volatility that we're seeing from this administration, any perspective on where their heads are?

Jeff Tangney (Co-Founder and CEO)

Great, Brian. Yeah, thanks. This is Jeff. Yeah, as we said in our prepared remarks, we have not seen any signs of a market slowdown yet, but given the material policy uncertainty, we are assuming that there will be. That said, just having gotten together last week with 40 of our biggest clients, which was the best turnout we've ever had at our pharma advisory board, I have to say there's a lot of excitement about AI there as well. I'd say they are also AI cheery, just like doctors are. As we said in last Quarter's call, the clients that buy our AI optimization were growing at double the rate of the other clients on average. We are excited about their AI cheeriness as well. It's interesting. The way that they're starting to do their work is actually starting to change.

It used to be that for their med-legal review, they would come in with one version of an article and just do that in a Word document and redline it and approve it once. Now they're coming in with spreadsheets full of different options, variations. That's exciting because that allows us to build this library that the AI can then go choose and see what's performing best and optimize their results in real time, which we're seeing meaningful gains from doing. Again, our AI cheery clients are feeling good about leveraging this. The other new thing that they liked at our pharma advisory board last week was our portal just continues to evolve and get smarter and teach them more. One new feature we've added this Quarter is the ability to see what percent of their targets are what they call no-see physicians.

That is, doctors that no longer see reps, which is roughly half of all U.S. doctors. Actually, some say three out of every five. That allows them to go, as they look at their ROI and their analyses, and they claim more credit as marketers relative to salespeople because they're able to look at these doctors that they know the reps aren't getting in to see. I'd say the overall mood was cautiously optimistic among our pharma clients, but you're right. There is this big cloud of, I think, policy uncertainty that I think we're all assuming will continue to be there this year.

Brian Peterson (Managing Director and Senior Equity Research Analyst)

Thanks, Jeff. Anna, maybe one for you. You called out some AI investments in Fiscal Year 2026. How should we be thinking about the payback period on some of these investments, understanding it's early days? I do get the question a lot from investors on kind of the broader monetization of AI. Is there anything that you can add there? Thanks, guys.

Anna Bryson (CFO)

Yeah, thanks for the question, Brian. As we've mentioned before, we're still in the early stages of learning how AI could make our business more efficient over time. We're also still in the early stages of investments here. When we think about longer-term margins and how AI could impact our margins long-term, we also have to take into account other considerations such as what further efficiencies we might see from our client portal or what further efficiencies integrated programs might bring to our business. It's too soon to know exactly what that more medium to long-term margins could look like for us. We feel really good, once again, about guiding to two years in a row of 50%+ adjusted EBITDA margins. As we've talked about before, especially with the margin expansion we saw this year, we're already seeing our AI investments pay off. We're still going to continue to make more, but we have been able to scale our business without sufficient additional headcount over the last year, which I think has been a big proof point that AI is already working for us as a business.

Brian Peterson (Managing Director and Senior Equity Research Analyst)

Thanks, Anna.

Operator (participant)

Our next question comes from Michael Cherny, Leerink Partners.

Michael Cherny (Senior Managing Director and Senior Research Analyst)

Good afternoon. Again, congratulations on ending the year strong. Maybe if I can just kind of follow up on Brian's question a bit, I'm just going to keep it at one here. Relative to the macro dynamic, I think it's certainly prudent that you're taking the stance here of uncertainty. We're seeing it across the board. That being said, certainly over the course of the most recent Quarter, there was uncertainty, maybe not the actual news around tariffs, most favorite nation, but at least this specter of the potential for some type of drug pricing constraints going as far back as the inauguration. Even along those lines, you still did an NRR of 119% over the course of the Quarter, stronger with your larger customers.

Maybe if we dovetail all these together, is there anything we can look back in the time that you've been a company over the last few years, maybe during COVID, or anything along those lines where there's been that level of trepidation where you've seen some real-time pausing so we can compare how to factor in what clearly might be a macro-oriented short-term pause against what has obviously been a strong trend, even when you take away the change in timing? I know that was a convoluted question, but appreciate any more macro color you have. Thanks.

Anna Bryson (CFO)

Yeah, thanks for the question, Michael. We've certainly gone through tons of evolutions as a business over the last several years with changes. We had COVID that was a huge tailwind for our business. You know, we experienced some upsell downside post-COVID when there was return to office and a macro downturn. I think one of the biggest things for us as we're looking ahead to next year is one of our biggest learnings over the past, I'd say, three to five years, as we've seen things change, is our upsells can be more variable.

When we think about the next three to five months, while as Jeff mentioned and as I've mentioned, we have not yet seen any slowdown in our business, and we continue to have a ton of excitement for our products from our clients, we also know that these dollars are a little more variable. That's one of the biggest parts of our guidance that we're baking in to be a little bit more prudent, which is why we're talking about the client's budget growth being more on that 5% range as opposed to the 7% range. The biggest factor here as we look ahead over the next 12 months will be what our clients' budgets look like. As you mentioned, we've been in policy uncertainty for six months now, and we haven't seen the slowdown. Of course, we're hopeful that we won't. But once again, as we're guiding out the next 12 months, we think it's the right thing to do to be prudent that we could see a slowdown.

Operator (participant)

The next question comes from Elizabeth Anderson, Evercore ISI.

Elizabeth Anderson (Senior Managing Director and Research Analyst)

Hi guys. Congrats on the Quarter. Thanks so much for the question. I was wondering if you could talk to me a little bit more about some of your other business assumptions for the Quarter, sort of like more on the physician recruitment side and maybe point of care formulary. Obviously, you've had strength across a number of those products recently. I just want to sort of understand how you're balancing those out and thinking about those in terms of FY2026. Thanks.

Anna Bryson (CFO)

Hey, Elizabeth. Thanks for the question. Yeah, a couple of things there. As we've talked about before, our pharma business has led our growth over the past year. A big part of that growth was our formulary and our point of care products. We're really excited to continue to see the traction there this next year, especially within our integrated offerings and selling those modules on a package basis and optimizing those programs for our clients. We still believe, as we said in our prepared remarks, that pharma will remain our fastest-growing business. As far as the other businesses you were asking about, recruiting and health systems, we have definitely seen marginal improvement in our health system business over the last six to nine months. Our subscription enterprise offering is actually doing particularly well there. We also do appreciate, once again, that health systems are typically more near-term impacted by policy changes and macro uncertainty. So our guidance doesn't necessarily assume we're going to see any continued momentum there.

Elizabeth Anderson (Senior Managing Director and Research Analyst)

Got it. That's super helpful. If we think about sort of the share gain commentary you guys offered on the prepared remarks, could you unpack that a little bit more? Are you seeing it sort of just in terms of the offering? Are you seeing dollars shift? I'd just be curious to sort of hear what you're hearing from customers in that regard.

Anna Bryson (CFO)

Yeah, sorry about that, Elizabeth. I had a mute button issue there. Yeah, we are definitely continuing to see very strong share gains. I think there's a couple of things. The first thing I'll point to is we just mentioned we did see an inflection point last year in our workflow modules. Our clients are really starting to now think about these modules as core modules, a truly diversified channel, and it's helped us capture a larger share of our overall client budgets. That has helped us grow at faster than 2x the market rate last year. The second point I'll make is our client portal. The insights from our client portal have helped our customers make buying decisions based on real-time ROI and recommendations that we've been able to help with. That has also certainly helped us take share. I'd say those are the two pieces over the last year that we're excited, once again, to see ahead over the next three to five years as well. But those were the two pieces that were really responsible for the large share gains we took this past year.

Elizabeth Anderson (Senior Managing Director and Research Analyst)

Super helpful. Thank you.

Operator (participant)

The next question today is Scott Berg, Needham.

Ryan MacDonald (Senior Analyst)

Hi, this is Ryan McDonald on for Scott Berg. Congrats on a great Quarter. Jeff, you mentioned obviously having the pharma client summit a couple of weeks ago. Curious if the No Handouts for Drug Advertisements Act was brought up at all in conversations, particularly because it seems like if this kind of goes through here, you'd have these tax deductions for direct-to-consumer marketing that would go away. I wonder if this actually has the potential to be a positive for your business, as you might see some greater shift in mix of spend towards the HCP channel and benefiting Doximity. We'd just love to hear your comments on maybe what clients are saying about that potential tailwind there.

Jeff Tangney (Co-Founder and CEO)

Hey, Ryan. Yeah, good question. I think there has been a lot of interesting discussion recently around the role of DTC by the administration, how much has increased, how much has decreased. There has kind of been bipartisan increase in things like price transparency, which we think can be good for the world. There has also been a focus on extra middlemen in the chain that can hurt our partners and our physicians' patients, which we certainly are glad is getting looked at. We do not really have anything in this space or anything that we are actively hearing from our clients to report on at this time. I will say our clients usually have a completely separate team for DTC. Those sorts of crossovers, when they do occur, are often more gradual than acute, just like the shift to digital.

That said, we do actively invest in products like our formulary module that is focused around transparency for physicians and, of course, downstream to patients, which many of them are increasingly seeking availability and accessibility data when they're considering therapies. Modules like that that I think are responsive to trends in both administration-driven priorities, but also physician and patient-driven priorities are things that we plan to continue to invest in.

Ryan MacDonald (Senior Analyst)

Thanks for the color there. Anna, maybe as a follow-up for you, you mentioned last Quarter on the call that the success of the integrated programs really pulled forward some spend in program launches earlier in the year. Just curious now that we're sort of five months into the year, are you seeing any notable changes in seasonality or how we should be thinking about seasonality of the business as we progress through the remainder of the calendar year here, please? Thanks.

Anna Bryson (CFO)

Yeah, thanks for the question. We're super excited by the integrated programs. In case you can't tell, I think it's one of the better things we've come out with for our clients over the last several years. We did launch a ton of those programs in January, as you mentioned, and that did contribute to a few points of revenue growth upside in Fiscal 2025. What we're so excited for about these integrated programs is that they should theoretically, over the long term, create a more predictable and consistent revenue curve for us year to year. I think as of right now, we're still in that transition phase, and we'll likely see a revenue curve that looks pretty similar to this past year. As we look ahead over the next three years or so, as we get more clients into these integrated programs that have January starts and December completions, it's only better for our revenue predictability, our visibility, as well as what the revenue curve will look like in the shape of the year. I think this is a huge step forward for us to get to that more consistent curve.

Ryan MacDonald (Senior Analyst)

Thanks. Congrats again.

Operator (participant)

We'll go next to Jared Haase, William Blair.

Jared Haase (Equity Research Associate)

Hey, good afternoon, and thanks for taking the questions. Maybe I'll ask another one kind of around the market share gain commentary. I guess with respect to the outlook for the 5-7% market growth, sort of still intact here, I'm curious if you're seeing anything incremental in terms of how budgets are being allocated across digital channels. Thinking programmatic, obviously network platforms like Doximity, other channels that might be at the point of care like the EHRs. Are you seeing any incremental changes in terms of how budgets are being sort of the mix of those budgets across those different channels?

Jeff Tangney (Co-Founder and CEO)

Yeah, thanks, Jared. This is Jeff. Yeah, so again, we've seen no signs of the market growth rate slowing down yet. Again, we are looking at the uncertainty from a policy perspective and assuming it'll go to the bottom end of our range, which is 5%. Talking about some of the other channels that are out there, I'd say I think they're not gaining share, at least not at the pace that we are. It really just comes back again to ROI, right? Does it really reach the right person, and does it really get that person thinking? Again, I think it's been a flight to quality that we've seen among our clients. They're leaning more into what they call endemic because that's what they're seeing work.

I will share a couple of our largest clients told us a year ago that they were really going to try out and experiment more in the programmatic space and in other spaces. Just catching up with them this last week, they told me that those experiments that they ran, well, they did not work, or at least they did not work to the level of return that they have seen with the programs that they are doing with us. Again, I think we are gaining more share there against a host of competing options.

Jared Haase (Equity Research Associate)

Got it. That's nice to hear. Jeff, maybe another one for you. You talked a little bit about kind of the nice traction with the newsfeed in the Quarter. Just wanted to get an update on sort of the status of kind of the ad load across that newsfeed. How much more room do you see for incremental advertising content within that application? I guess relative to some of the newer products that you've launched and had some success with recently, how important do you think the newsfeed will be to the growth story over the next few years?

Jeff Tangney (Co-Founder and CEO)

Yeah, thanks, Jared. First, I'll just say our clients and I, we're over the moon that we saw a 30% increase, more than 30% year on year, in our articles tapped in our newsfeed. I think we have really become the newsfeed of medicine, the place that doctors come to stay up to date on the latest news. With a decade now of first-party data on what their clinical interests are, I think we're just in a strong position to continue to deliver them the news that they need. I will point that there are others that I assume we are taking share from there. Our clients are telling us about that. You can look online and see that MedX or MedTwitter is not flourishing, right? There's just less of that there.

I think we're seeing some migration, I think, from other platforms to our platform, which again, has been to our net benefit. To your question about ad load, our ad load really hasn't increased. I would say what's happened is it's now spread across more channels. This is really where our workflow channel, let me give stats on each Quarter, has really been important. That whole point of care formulary motion for us has allowed us to grow in basically a whole new vector without having to affect our newsfeed channel.

Jared Haase (Equity Research Associate)

That's great. Thank you.

Operator (participant)

Moving to Allen Lutz with Bank of America.

Allen Lutz (Director and Senior Equity Research Analyst)

Good afternoon, and thanks for taking the questions. I want to follow up on the comments around workflow tools, point of care, formulary. Growth there has been really robust. Jeff, you mentioned that some of your customers experienced they tried to go out and work with programmatic. Maybe that did not work. As you think about these new products that you are launching in the market, is it that your customers are they tried programmatic, and now they are actually leaning into your newer products, or are they just going back to the newsfeed? Trying to get a sense of maybe where some of that incremental spend that maybe went away as they were testing programmatic, where has that come back to in the Doximity platform?

Jeff Tangney (Co-Founder and CEO)

Yeah, thanks for the question. This is Jeff. I'll take that. Yeah, I mean, we're really proud of our point of care and our formulary growth. As we announced last Quarter in our Q3, we had over 100% year-on-year growth in those workflow channels, which has certainly been great for us. To your question about how they're allocating across these other channels, I'll give some credit to our portal as well here, which has helped them see on an ongoing basis, not just on a once-a-year lookback, but on a more frequent basis to see the true return on investment that they're seeing from our platform and the data and the results, and just keeping us, frankly, more top of mind. I said when we started working on the portal a year and a half ago that clients recognized when we talked to them, we have the best product.

We have the best reach. We have the best level of engagement and interest, but we were not the easiest to buy from, right? It took a lot of effort for them to set up two Zoom calls with us and to get a quote and do all that. I think our portal has really reduced that friction quite a lot so that, again, now, any time of day or night, they can log in and see how their programs are doing, and they can also think about how they can grow them.

Allen Lutz (Director and Senior Equity Research Analyst)

Thanks, Jeff. Then one for Anna. I have a question on the guidance framework. If we take a step back and look at the initial guidance that you provided last year, I think it contemplated 7-9% revenue growth. I think the comparable last year was a relatively easy comparable. This year, you're guiding sort of this 8-11%. It is higher growth from the initial guide. Even though there is a tougher comparable, there is more macro uncertainty this year versus last year, arguably. I guess, how do we square those things where I guess there are tougher comps this year, less certainty? How do you think about the framework for guidance this year compared to last year? Thanks.

Anna Bryson (CFO)

Yeah, thanks for the question, Alan. I think there's a couple of things I'll hit on here. First and foremost, last year was really the first year we started to see our new products take off, our workflow products, and we started to see what our client portal could do for us. We feel like we are in a much better position than we had been in years prior from a product offering perspective and from a share gain perspective. Last year, I think we hadn't yet seen our clients' budgets stabilize yet. We really weren't sure what our clients' budgets were going to look like. We had seen quite a bit of deceleration post-COVID. It's been really great for us to see over the past 12 months not only have our clients' budgets stabilized, but marginally improved.

You can see that in our 20% year-on-year growth that we just reported for this last year. Once again, I think we feel better about our competitive position than we ever have. We feel as though we are in a place that even if the market growth rate is on the lower end of the range, as we're forecasting here it could be, we feel as though we have good visibility into these numbers and hitting our guidance for the year.

Allen Lutz (Director and Senior Equity Research Analyst)

Great. Thank you very much.

Operator (participant)

Up next is Scott Schoenhaus, KeyBanc.

Scott Schoenhaus (Managing Director and Equity Research Analyst)

Hey, team. Thanks for taking my question. Anna, this question's for you. I think this period a year ago, you had just over 70% of subscription revenue for the year locked in. You just made in the comments, you're just under 70%. I understand the dynamics of some of the pull forward in January for the annual contracts. Any more color on the dynamics this year versus last year? My follow-up question is, that remaining 30%, could you provide color on how much of that is mid-year upsells versus renewals given the strong mid-year upsells that you saw last year? Thanks.

Anna Bryson (CFO)

Thanks for the question, Scott. Yeah, as you mentioned, last year, when we gave our initial subscription revenue guidance, we had just over 70% of that under contract. Throughout the year, we saw stronger upsells. We had stronger annual upfront sales, and we had more January launches, which contributed to a revenue raise of roughly $58 million or about 11% since the start of the year. If we did a look back to the percent of our final Fiscal 2025 revenue that we had under contract to start the year, it would be closer to 60%. This number can naturally fluctuate throughout the year depending on sales and launches. This is why we feel as though just under 70%, which, to be clear, means within a percent or two of 70%, is a really prudent starting point for our business for Fiscal 2026.

I think that also probably helps answer the second part of your question about what we're assuming for upsells. I think, once again, given the environment we're in and knowing upsells may be more variable, our guidance is more heavily weighted and dependent on renewals.

Scott Schoenhaus (Managing Director and Equity Research Analyst)

Perfect. Thank you so much, Anna.

Operator (participant)

And Anne Samuel from JPMorgan has the next question.

Anne Samuel (Executive Director and Equity Research Analyst)

Hi. Thanks so much for the question. I was hoping maybe we could dig in a little bit more on point of care solutions and was wondering if you could kind of speak to how we should be thinking about the composition of growth for that. Is it more clients joining and pricing versus increasing the number of sponsored calls? I know at your analyst day, you spoke to 1 in 100 calls being sponsored, but curious where we stand on that now and where we can go from here.

Anna Bryson (CFO)

Yeah. I think the great thing about point of care and the way we've kind of reframed our pitch around it too with our clients is that our clients are thinking about it as a truly diversified channel. It is a unique channel from our newsfeed where our clients are almost thinking about it as if it's buying from another company even. That's how diversified the channel is. It is an area where, as Jeff had mentioned, we have a lot of white space, a lot of unmonetized white space. It is an area our clients have certainly been leaning into. That just helps our platform increase reach and frequency for our clients. We are really excited about that. I think we think big picture over the next three to five years, our newsfeed was our first act, our workflow tools are our second act, and we think one day maybe AI will be our third act.

Anne Samuel (Executive Director and Equity Research Analyst)

Great. Thank you.

Operator (participant)

The next question is Richard Close from Cantor Fitzgerald.

Richard Close (Managing Director and Senior Equity Research Analyst)

Yeah. First, congratulations on a strong year. Maybe diving a little bit deeper into the upsells in the portal. I guess I'm curious, are clients buying on the portal now? If so, how is that going? How do you think about maybe more certainty or visibility into the in-year buy-ups from buying on the portal? Just curious there.

Jeff Tangney (Co-Founder and CEO)

Yeah. This is Jeff. I'll take that. Yes, we do present recommendations in our portal, and that does allow our clients to see the pricing. We do, to be clear, still have a separate contract paper flow that does not happen directly in the portal yet, but we're working on that. It does allow clients to go and see the other things they can be doing and make that upsell motion, I think, a lot more friction-free and seamless for our clients and our own internal teams as well. We're excited about where that can take us. In terms of our upsell sort of frequency, I'd say the key thing I'd point to there or visibility, the key thing I'd point to there is these integrated programs are just much, much more visible for us as a company. Because again, we're effectively putting all of our channels together.

They're buying the whole bag, if you will. We are allowed to go, and again, optimize the right content at the right time for the right doctor. That, I think, will be a meaningful improvement, as Anna has said, to our revenue visibility in future years. This is the first year we are going through it, so I think we are being cautious about how it will improve our visibility and these upsell cycles. I will say it is a hard win for us contractually in terms of terms with our clients. I think a sign, again, of how much they give us a seat at their strategy table and view us as this long-term partner, not as a Quarterly buy.

Richard Close (Managing Director and Senior Equity Research Analyst)

Okay. That's helpful. Thank you.

Operator (participant)

The next question is from Jessica Tassan, Piper Sandler.

Jessica Tassan (Vice President and Senior Research Analyst)

Hi, guys. Thank you so much for taking the questions and congrats on the year. I was hoping maybe, Anna, you could help us understand the revenue cadence over the course of the year, just appreciating the high level of visibility. Kind of what explains the implied sequential step-up from F1Q to F2Q given the early launches in January? It would just be helpful to hear how we should be thinking about F1Q, 2Q, to 3Q. Thanks.

Anna Bryson (CFO)

Yeah. Thanks for the question, Jeff. The nature of our customer's buying cycle is such that, as you know, they deploy about 65-70% of their budgets upfront, and then they upsell throughout the year. One of the things we are super excited about this year is getting our programs live in January. Getting our clients to have that uninterrupted presence on channel. Throughout the year, though, as they're upselling on top of those programs, that leads to natural step-ups throughout the year. We believe going forward, we'll continue to see a Q3 that is going to be our highest Quarter because our customers are adding onto their programs. Even with these integrated programs, we believe we'll continue to see that step-up. The other thing I'll say with the integrated programs that we're excited by, and we'll see how it goes.

It's still obviously very, very new for us. But when our clients are making their upsell decisions, especially now that we have our client portal that helps track real-time ROI, having that longer time on channel starting in January as opposed to starting in April and having, say, six months to track your program performance and see how well it's performing on Doximity, we actually think these January launches could help our upsell cycle. So once again, we're not baking that into our guidance because it's still too early, and it's really the first year we're running these programs. But we think they could prove to be actually very beneficial for us as we get into the upsell season.

Jessica Tassan (Vice President and Senior Research Analyst)

That's really helpful. Thank you. My quick follow-up would be just as you think about the workflow tools, I think you all have talked about that opportunity as being commensurate in size to the newsfeed. I'm curious if we should think about kind of the two tools, so point of care and formulary, as being the sum of workflow, meaning that those two products can basically double the TAM from newsfeed and that potentially monetizing AI or DocsGPT would be then an additional opportunity from there, or should we think about that as part of the workflow as well? Thanks again.

Anna Bryson (CFO)

Yeah. Thanks for the question, Jeff. It's the former. As I mentioned before, newsfeed was our first act. It's still our largest revenue driver. Workflow has now become our second act. It's been a huge growth driver for us over the past year or so. As we look ahead, and we're not going to give a specific timeframe on this, as we look ahead, we believe that AI could be our third act. Those are three truly distinct channels that will be truly distinct products for our clients.

Operator (participant)

The next question today comes from Steven Valliquette, Mizuho Securities.

Stephen Valiquette (Managing Director)

Great. Good afternoon. Thanks for taking the question. I also have a question just around the guidance. When thinking about the implied growth rates for revenue and EBITDA in the Fiscal first Quarter, they're essentially right at the midpoint of the full year growth rates within the FY26 guidance for revenue and EBITDA. I guess a couple of things just to try to confirm. One, as far as the macro environment risk, you said you're not seeing any impact yet, but just confirm yes or no. Is there anything baked into the Fiscal 1Q guidance for any macro risk? How should we think about the impact just from a modeling perspective? Maybe just assume more impact in the back half of the Fiscal Year versus first half? I know there's no perfect answer to it, but just want to get your high-level thoughts around that. Thanks.

Anna Bryson (CFO)

Yeah. I'll answer the last part of the question first. I think once we get back to the integrated programs, I think we'll see a little bit more stability in our revenue growth cadence throughout the year. As far as Q1 specifically, the first point I'll make is about the comparison period. As you might remember, last Q1 saw an uplift from a lot of spring program launches. This year, back to the integrated programs, we're seeing more stability, which once again, we believe is best for the predictability of our revenue curve long-term. As far as your question about if we have any macro assumptions baked into Q1, we are being cautious in our upsell assumptions for this Quarter. Given that general macro uncertainty, upsells typically start around this time period. That is baked into our Q1 guidance.

Stephen Valiquette (Managing Director)

Got it. Okay. Thanks.

Operator (participant)

Jeff Garro from Stephens has the next question.

Jeff Garro (Managing Director and Equity Research Analyst)

Yeah. Good afternoon. Thanks for taking the question. To put maybe a different lens on FY26 revenue drivers, could you help us think through NRR expectations versus anticipated contributions from new customers?

Anna Bryson (CFO)

Yeah. Absolutely. I'm happy to take that question. I think first and foremost, we do continue to believe that our larger customers will lead our growth. That said, we do have some exciting traction amongst SMB and amongst newer customers over the past six to nine months, especially with our Agency Partner Program. That's actually helped us bring in many new six-figure clients. We do think that SMB could be a nice growth factor for us, especially over the long term. As a reminder, if we think big picture, we only work with just over 10% of brands that have less than $100 million in US sales. We're really excited about bringing our insights and partnership to more of them over time. I do think we'll see some SMB traction this year. That said, the nature of our business is such that the largest clients will continue to lead our growth.

Jeff Garro (Managing Director and Equity Research Analyst)

Excellent. I appreciate that. Quick follow-up to try to put a little bit of a macro spin on it. Could you help us with any comments on expectations for new drug approvals over the next 12 months and whether the velocity of approvals and new treatments entering the market has any impact on your revenue outlook for FY26? Thanks again.

Perry Gold (VP of Investor Relations and Revenue Operations)

Hi, Jeff. Yeah. Great questions. Of course, as you know, it is still early, and there has been material policy uncertainty here with the administration, particularly around that topic. We are taking a more cautious and a longer approach to the market there. I will say, though, if you look at the science, it is an exciting era for humanity and the future of medicine. I mean, there are new therapies getting ready that are anticipated for the next few years, ranging from rare disease, metabolic disruptors, oncology, neurology, cardiology, advanced therapeutic techniques in the cell and gene therapy space, and of course, a continuation of what is now a blockbuster battle out there.

While there is uncertainty downstream of new priorities that can be seen as tough on pharma, there's also other statements that can be seen as streamlined processes for getting new therapies approved and out the door, or equalization such as what we're seeing in the repeal of potentially the small molecule penalty in the IRA. We'll be monitoring just like everyone else is. I think if you looked at the U.S. Pharma ETF, which some look to as kind of a bellwether for the industry, it's down less than 3% year to date. The day that the most recent executive order was announced around potential most favored nation policies, I mean, pharma stocks in general were up. I'll end by noting that we're a relatively well-insulated platform. At the moment, I'm not sure our products are particularly uniquely exposed in a positive or negative way compared to the rest of the industry, with one exception, and that's our leading ROI, which can make us really a preferred anchor strategy even when budgets get tight. Efficiency-driven environments can favor proven high ROI digital.

Jeff Garro (Managing Director and Equity Research Analyst)

Great. Thanks again.

Operator (participant)

The next question is from David Roman Goldman Sachs.

David Roman (Managing Director and Senior Equity Research Analyst)

Thank you. Good afternoon, everybody. I wanted just to come back and try to put some of the pieces together on the multi-module products. Because I think when I reflect back to the last call, it was very early in the adoption curve of those products. And as I kind of look at where we are today and at least try to reflect your comments on what's implied in the guidance, it sounds like either you've marched through that very quickly or we're reaching potentially a peak earlier than expected. How should we think about the just evolution of the commentary on those products from where we were at the time of the last call to where we are today?

Jeff Tangney (Co-Founder and CEO)

Yeah. Thanks, David. This is Jeff. I'll just say our multi-module products are doing really well. I mean, as we said on last Quarter's call, we expect our point of care and formulary modules to be a nine-figure business for us this year. To the prior questions about how big are these additional channels, the answer is very large. The great news is now that we're getting more and more ROI reports back from clients who've tried these new modules, their ROIs are great. We're able to show that to them more frequently with our portal. That's gone really well. The way this works inside big pharma is that it does take a year or two to sort of prove yourself as a high ROI vehicle. Once you do, more folks lean in.

I can tell you, again, point of care and formulary are our newer modules. They still have yet to be adopted by more than low double-digit % of our client base, of our brands. We still see a lot of room there to grow. Again, just expanding the proven ROI story we have with our proven land and expand approach, more brands inside the same clients. In terms of multi-modules, I think that really is these integrated programs that we're so excited about. It does allow us to optimize for our clients. The results that they're seeing so far have been just really strong. From our point of view, it has put us in a stronger position to negotiate contracts that are larger, longer in length, and are very predictable in terms of their launch date.

The launch dates that we have in these integrated contracts are not dependent on the client, which is great, right? We're not stuck in that medical-legal review cycle of January, February of years past. Again, that's, I think, a long-term big win for the business.

David Roman (Managing Director and Senior Equity Research Analyst)

Very helpful. Maybe just a follow-up on just the engagement side. Can you maybe help us? You've talked a lot about the e-newsletter as a key opportunity. Can you maybe help us think through the mix of engagement on the platform between e-newsletter, physicians logging in, searching content proactively, use of the workflow tool, etc., and maybe how that's just kind of evolved over time?

Jeff Tangney (Co-Founder and CEO)

Yeah. So we do not have an e-newsletter product. So just so I am clear on that front, we do have a newsfeed product. As we mentioned last Quarter, we had over one million unique prescribers using our newsfeed last Quarter on this call. This Quarter, we announced we hit a new record. We are obviously above that million user mark. Again, this Quarter, we also announced that we had 30% growth in the number of articles tapped in that newsfeed year on year, which again speaks to its continued use, adoption, and growth. Yeah, no, we feel really good about how we are the newsfeed of medicine, delivering the news that doctors need to know, want to know, on a very frequent basis. We also feel good about our new channels, as I have already described.They are sold to a minority of our clients to date. Again, we see them being just as large as our newsfeed business.

Operator (participant)

The next question today comes from Jailendra Singh from Truist.

Jailendra Singh (Managing Director and Equity Research Analyst)

Thank you. Thanks for taking my questions. First, a quick follow-up on the client portal and your comment that Daily Portal Insights are driving client interest in AI-powered offerings for them. Are you able to monetize these AI-powered offerings? Around what percentage of your pharma clients who are on the portal are using these AI-powered offerings at this point? Kind of related to that, as you think about all these new solutions for pharma and usage you are seeing on the provider side, what is your updated view on 10:1 ROI you have talked about for pharma clients in the past?

Jeff Tangney (Co-Founder and CEO)

Sure. This is Jeff. I'll take first crack at this, and I think Anna may add a few things. We have not given out a percentage of which percent of our clients have purchased our AI optimization package. Suffice it to say, it is still a minority. Of course, we want them to buy it because it's a big upsell for us. It's a larger program. I think we had said on last Quarter's call that those programs were—I forget exactly how much larger.

Anna Bryson (CFO)

We said on last Quarter's call that the brands buying those programs grew more than twice as fast as those that bought our module standalone.

Jeff Tangney (Co-Founder and CEO)

Yeah. I think that's the answer to the AI growth we're seeing there is quite strong. Again, from our point of view, it's better for the doctor, right? Instead of seeing a piece of content that was slated for a particular time slot or whatever, they're able to see what best fits, I think, their learning journey on the product. Again, the clients who purchased this so far have been really pleased.

Jailendra Singh (Managing Director and Equity Research Analyst)

Any update on the ROI part of the question?

Jeff Tangney (Co-Founder and CEO)

Oh, yeah. The short answer there is the portal has allowed us to do many more studies more frequently. We're pleased to be able to make this more turnkey for our clients. There still is some overhead. There's a test and a control, and they call it an ANCOVA analysis that's done. We've done many more of those studies than we have in the past. That's great because, again, normally our clients used to only do that once a year in September. Now we're able to come back and each Quarter show them a new test and control study, or they're able to log into the portal and see it. That's not only showing them the value they're getting from us, but it's also helping them optimize their programs. Again, we're optimizing it for them every day as well as we, again, use our tools to optimize their results.

Jailendra Singh (Managing Director and Equity Research Analyst)

Okay. A follow-up. I understand you have not seen any impact on business yet from a macro point of view. Can you talk about any proactive steps you can take or maybe you're taking to make sure pharma clients see Doximity as a partner to optimize their spending versus an additional cost to make sure that they don't end up going to those lower quality platforms again?

Jeff Tangney (Co-Founder and CEO)

Sure. Yeah. I mean, we spend a lot of time investing in that. We have a great team on this. We have made some investments to our team. We've hired in some executives from YouTube and Facebook and places that I think are upping our knowledge of how to think about video modules and pull that together. I would just let this some good insights for our clients. I mean, the key thing you hit on yourself, Jailendra, which is showing them their ROI on a more frequent basis and letting them go and see their program results literally on a daily basis with daily refreshes has increased our level of partnership and trust and transparency in a way that's just been very positive for our strategic relationships with our clients.

Operator (participant)

Our next question today comes from Craig Hettenbach from Morgan Stanley.

Craig Hettenbach (Managing Director and Equity Research Analyst)

Thanks. Jeff, just going back to your comment of low double-digit penetration for kind of point of care, is there anything you're doing from a sales perspective to kind of continue to push the momentum in that product and kind of how you see that evolving this year and beyond?

Jeff Tangney (Co-Founder and CEO)

Yeah. Great question, Craig. This is where I'll give a shout-out to Lisa Greenbaum, our Chief Commercial Officer. She's really just done a terrific job of making sure our whole team understands how this product works at a detailed level. She's, I think, really instituted a lot of rigor in our sales training. And she calls it being credentialed internally on the ability to talk about point of care. I think that's really helped us as an organization do a better job of the N+1 product.

I think this is an important matrix scalability for us as an organization as we add these new channels that we have the rigor internally to make sure our full team is up to speed on handling all the questions and helping our clients optimize their programs and ROI with each of our channels. In addition, of course, we have internal marketing managers who are tasked with owning the numbers for each of these modules and products. They are getting stronger and stronger in the organization as we help our sales teams, again, be an N+1 product sales team as opposed to just a two or three product sales team.

Craig Hettenbach (Managing Director and Equity Research Analyst)

Got it. Just as a follow-up, cash approaching $1 billion. You talked on the call about kind of investing in technology and AI.Any thoughts there in terms of kind of how you're looking to put cash to work in organic and inorganic potential investments?

Nate Gross (Co-Founder and CSO)

Sure. Hey, this is Nate. So we have really good active exposure to opportunities in the market right now. I will say things are starting to look a little more interesting from an evaluation perspective than prior Quarters. We're actively studying the market. We're getting approached by really everything from software to AI transforming what was historically a service and now is an AI-enabled service, as you might expect, due to our user distribution and our partner distribution. We'll be optimistic. Again, our culture here, going back 15 years now, is super disciplined and is value-sensitive and R&D team-forward as ever.

We're really lucky to be able to make decisions with this high-quality bar, focus on true platform fit, not, say, forced into inorganic revenue growth or something like that. We have a phenomenal and quite large, the largest R&D team serving medicine, group of engineers and product designers who can often build this sort of tech in-house. We're constantly thoughtful about our use of cash when we're building our flywheel. We won't hesitate to make a move when we need to. It will always be towards being truly thoughtful about expanding our market opportunities and serving doctors.

Operator (participant)

Ladies and gentlemen, that is all the time we have for questions today. This does conclude our conference. We would like to thank you all for your participation. You may now disconnect.