Guardian Pharmacy Services - Earnings Call - Q1 2025

Executive Summary

• Q1 2025 delivered solid top-line growth: revenue rose 20% YoY to $329.3M, with resident count up 15% to ~189,000; Adjusted EBITDA was $23.4M (7.1% margin) despite ~$0.5M of accelerated Heartland integration costs and ~$1.0M public-company cost in the quarter.
• Results vs consensus: revenue beat ($329.3M vs $321.2M*), while S&P “Primary EPS” was a slight miss ($0.207* vs $0.22*) as integration costs were pulled forward into Q1. Values marked with * are from S&P Global.
• Guidance: 2025 revenue guidance reaffirmed at $1.33–$1.35B with management indicating the outcome should land toward the upper end; Adjusted EBITDA guidance maintained at $97–$101M and includes ~$4M of full-year public-company costs.
• Setup/catalysts: (1) Q2 expected roughly flat with Q1; (2) vaccine clinic seasonality should again lift Q4; (3) active M&A pipeline and new Wichita acquisition on 4/1/25 (post-quarter) support expansion; (4) management sees limited tariff impact; IRA implications remain under active discussion with payors.

What Went Well and What Went Wrong

• What Went Well

  • Double-digit YoY growth in revenue (+20%), resident count (+15%), and Adjusted EBITDA (+16%) amid ongoing acquisition integration.
  • Management reiterated full-year guidance and signaled revenue should trend toward the top of the range given the strong start to the year.
  • Strategic progress: closed a Wichita, KS pharmacy on 4/1/25 (52 total), continued integration of Heartland and Freedom, and highlighted a robust acquisition pipeline near-term.

• What Went Wrong

  • Profitability modestly pressured by an accelerated Heartland IT platform transition, pulling ~$0.5M of costs into Q1; public-company costs (~$1M in Q1; ~$4M FY) also weighed on margins.
  • Q2 outlook called “consistent” with Q1 implies limited sequential momentum before seasonality benefits recur in Q4 (vaccine clinics).
  • External/regulatory overhangs: uncertainty around any executive action and longer-dated IRA impacts; management remains engaged but visibility still developing.

Transcript

Operator (participant)

Good day, everyone, and welcome to the Guardian Pharmacy Services first quarter 2025 earnings call. At this time, all participants are in a listen-only mode. Later, you'll have the opportunity to ask a question during the question-and-answer session. If at any time during this call you require immediate assistance, please press star zero for the operator.

Today's speakers will be Fred Burke, President and CEO of Guardian Pharmacy Services, and David Morris, EVP and CFO of Guardian Pharmacy Services. Before we begin, I'd like to remind everyone that the statements included in this conference call and in the press release issued today may constitute forward-looking statements within the meaning of the Private Securities Litigation Reform Act. These statements include, but are not limited to, comments regarding our plans, objectives, business outlook, and our financial results for 2025 and beyond.

Actual results could differ materially from those expressed or implied in forward-looking statements because of a number of risk factors and uncertainties, which are discussed in the company's quarterly report on Form 10-Q and earnings release issued today. Guardian Pharmacy Services undertakes no obligation to update any forward-looking statements.

Additionally, on this afternoon's call, the company will reference certain non-GAAP financial measures such as EBITDA and Adjusted EBITDA included in our earnings release, as well as on our website, our reconciliations of these non-GAAP financial measures to the GAAP measures reported in our financial statements. This afternoon's call is being recorded, and a replay of this call will be available later today. I'm now pleased to introduce the President and CEO of Guardian Pharmacy Services, Fred Burke.

Fred Burke (President and CEO)

Welcome to Guardian Pharmacy Services' first quarter 2025 earnings call. On today's call, I'll share financial highlights, discuss our recent pharmacy expansions, and provide an update on some of the industry trends we're closely monitoring. However, before moving into our agenda, I would like to take the opportunity to introduce Ashley Stockton, our new Senior Director of Investor Relations, who joins us with close to 30 years' experience in the equity markets. Most recently, she was head of institutional equity sales in the Southeast for JP.Morgan. Welcome, Ashley.

Now, moving on with our agenda, starting with the first quarter highlights, I'm pleased to report a strong start to the year, which includes revenue of $329 million, an increase of 20% year-on-year, a resident count at the end of the quarter of approximately 189,000, a 15% increase from the first quarter last year, and Adjusted EBITDA of $23.4 million, representing an increase of 16% compared to last year.

Excluding Pubco costs, this represents growth of 20%. As for guidance, given our strong first quarter, we think we will end up in the upper half of our revenue range and remain confident in our Adjusted EBITDA range. I want to emphasize how pleased I am with our strong double-digit growth in the first quarter and the meaningful progress we've made on integrating multiple acquisitions and advancing our strategic initiatives.

The underlying trends in our core business remain strong, and our acquisition pipeline is highly active, with several near-term opportunities on the horizon. We remain deeply committed to growing our business in a way that drives sustainable long-term value for shareholders. David will share more detail about our financial results and our outlook for the remainder of the year.

Today, we are pleased to announce that we closed an acquisition of a small pharmacy in Wichita, Kansas, on April 1, bringing our total number of pharmacies to 52. This new pharmacy will work with our Kansas City location, allowing better service and further penetration of the Kansas market. Furthermore, we are continuing to integrate the two 2024 acquisitions, Freedom and Heartland.

David will elaborate on this, but as a reminder, we have developed a tried-and-tested integration playbook that takes acquired pharmacies from breakeven, which most of them are when we acquire them, to operating at our company margin profile over the course of three to four years. Additionally, we continue to bring a number of our greenfield startups fully operational. Continuous expansions strengthen our regional presence in a given market and are typically driven by our existing local pharmacy operators.

As an example, Columbus, Ohio, launched by Cincinnati. The Cincinnati pharmacy has experienced significant growth since acquisition in 2020, and their new Columbus pharmacy will improve service to the communities we already serve in this area and continue their growth. You will remember, we also have the following contiguous startups coming up to scale: Oklahoma City, Omaha, and Naples.

The impact of tariffs is top of mind for many in our industry right now. At Guardian, we feel comfortable we will avoid major impact, and I'd like to share why. First, our pricing structure for branded drugs should insulate us. As a reminder, 70% of our revenue comes from Part D, and we are paid on a spread based on the average wholesale price, or AWP, of the drug.

On the branded drug side, if manufacturers pass on tariffs in the form of a price increase, Guardian is protected because the AWP will increase commensurately, and our reimbursement algorithm is calculated off that AWP. On generic drugs, it's a more complicated picture impacted by where the APIs are sourced and/or where the final product is manufactured, as well as how many generic manufacturers produce the drug.

That said, the generic marketplace is highly competitive such that manufacturers will have a hard time raising prices on multi-source products. If they do, most of these products are very low in cost, so we should see a relatively low impact. Finally, I'd like to provide a brief update on the important topic of a potential impact stemming from the Inflation Reduction Act on our performance in 2026 and beyond. We are continuing to have constructive conversations with key policymakers and our PBM partners.

There are no significant developments to report since our last earnings call a little over a month ago. Hence, we continue to remain confident in our ability to navigate the potential margin impact related to the IRA and hope to have more visibility over the next several months. Now, I'll turn the call over to David to review the quarter in greater detail. David?

David Morris (EVP and CFO)

Good afternoon, and thank you all for joining the call today. I'll share a review of our first quarter performance and then provide some additional color on our expectations for the balance of 2025. I'll then close our comments today with some details on our integration playbook and what to expect from our new pharmacy expansions. For the first quarter of 2025, revenue increased 20% to $329.3 million, driven by organic growth and the acquisitions of Heartland and Freedom Pharmacies, the former which will anniversary this quarter.

Resident count grew 15% to 189,000. Gross profit of $64.4 million increased 17%, and Adjusted EBITDA grew to $23.4 million compared to $20.3 million a year ago, representing growth of 16% and an EBITDA margin of 7.1%. Excluding Pubco, Adjusted EBITDA growth is 20% year-over-year.

One important thing to note as it relates to our EBITDA is that we decided to begin the transition of Heartland's IT operating infrastructure over to our primary platform beginning in the first quarter. As with all acquisitions, we closely monitored the integration efforts and made the decision that expediting the operating system conversion was the right thing to do for the long-term success of the business.

This will accelerate the local team's access to proprietary tools only available on our primary operating system. We began the operating system conversions in the two Idaho locations and plan to complete both in the first half of 2025. The remaining two locations in Denver and Salt Lake City are on track to be completed in the latter half of this year.

The accelerated operating system conversions will add several benefits, allowing for full access to Guardian Data Analytics Platform, the operating workflow enhancement and efficiencies, as well as will allow us to improve the customer experience. We continue to be on track with our three- to four-year integration process, which includes continuing to strengthen the teams, implementing Guardian's purchasing platform, and relocating and expanding the two pharmacies in the high-growth markets of Denver and Salt Lake City throughout the remainder of 2025.

Expediting the operating system transition also accelerated cost, putting pressure on Q1 profitability. However, we believe it was important for the overall pharmacy integration. Further, this is a good reminder that these acquisitions and our de novo startups are diluted to operating profits the first two to three years as they transition to the Guardian systems, infrastructure, and our overall business model.

In fact, 10 of our 52 pharmacies currently are roughly 20% of our network at tenure of about one year or less. These newer pharmacies represent embedded earnings power as they are still ramping up to the Guardian's margins profile. Turning to the balance sheet, we ended the first quarter with $14 million in cash, and we remain in a strong financial position with zero debt and plenty of dry powder on our existing revolver.

As Fred mentioned, we believe that revenue will come in at the higher end of our $1.33 billion-$1.35 billion range as a result of the upside in the first quarter. For Adjusted EBITDA, we are reiterating our EBITDA range of $97 million-$101 million. At this early point in the fiscal year, we want to remain conservative in our forecast given the quarter-to-quarter variability associated with integration-related expenses.

Historically, our quarterly cadence of revenue and Adjusted EBITDA has been evenly distributed across the quarters, but we want to remind you of the new seasonality factor we experienced in 2024 as you think about the full year of 2025. As referenced in our March 26 earnings call, changes in the profitability profile of our COVID and flu vaccine clinics created a notable seasonality increase in Q4 of 2024, which we expect will be repeated this year.

As we think about the second quarter of 2025, we expect it to be consistent with Q1 of 2025 in terms of revenue and Adjusted EBITDA. Driving the assumption for revenue is the upside in resident count we experienced in Q1, which was a result of pulling forward residents that we expected to onboard in Q2.

In terms of Adjusted EBITDA, accelerating the timing of Heartland's IT conversion will likely result in it being a flat quarter-to-quarter. Finally, as I mentioned on our fourth quarter call, I want to remind you today that 2025 will include a full year of Pubco cost of around $4 million compared to just one quarter and approximately $1 million of those related expenses in 2024.

To close out my comments today, I'll share some details about our integration playbook that we've honed through the years of executing our pharmacy acquisition strategy. We typically execute two small acquisitions of new locations each year. We take a very thoughtful and strategic approach when considering acquisitions and aim only for targets that meet our rigorous criteria, including strong collaborative operators, rich territory for national counts, and the ability to continue to grow and improve the business.

I'll remind you again that these acquisitions are not baked into our initial annual guidance that we provided. Utilizing our playbook, it typically takes three to four years to complete the integration and have the pharmacies achieving our overall operating metrics. Recall that many of these independent pharmacies do not have the scale or efficiencies that we're able to achieve and are also struggling to break even at the time of acquisition.

In our first year, we focus on launching a collaborative integration process, onboarding such things as payroll, benefits, accounting, licensing, credentialing, and vendor management. In addition, in year one, we're transitioning to Guardian's reimbursement model. We're strengthening and training the local leadership teams, including supervisory skill development, and we begin implementing Guardian's IT structure.

Turning to year two, we focus on solidifying the foundation, including the continuing development of the local leadership team and positioning the business for continued growth. From an operational standpoint, we bring them onto the Guardian purchasing model and margin management tools. We ramp up the sales and marketing effort, providing access to our national accounts. We are focused on efficiency initiatives that include automation and reconfiguring and/or moving the pharmacy.

We will continue to work to improve the revenue cycle and margin management. As we move into years three and four, that is when we really start seeing the improvements in profitability and begin achieving leverage. Once we are fully integrated, typically in year three or four, that is when we see the growth and profitability start to mirror Guardian's overall profitability profile.

We currently have seven sites that are somewhere along this path and look forward to continuing to add to the pipeline as we execute our acquisition strategy. I'll close today by echoing Fred's remarks that we're pleased with our strong start to 2025. This year, we will remain focused on leveraging the core operations, expanding our operating reach, and continuing to invest in our teams.

I also want to thank the entire Guardian team for their continued effort and dedication to making this an incredible place to work every day and ensuring we're able to provide the highest level of service to all of our customers. I look forward to keeping you updated as we continue to progress through the year. Operator, let's open the call to questions.

Operator (participant)

Thank you. Ladies and gentlemen, we'll now begin the question and answer session. Should you have a question, please press the star followed by the number one on your touch-tone phone. You will hear a prompt that your hand has been raised. Should you wish to decline from the polling process, please press the star followed by the number two. If you are using a speakerphone, please lift the handset before pressing any keys. One moment, please, for your first question. Your first question is from John Ransom from RGF. Please go ahead.

John Ransom (Analyst)

Hey, good evening, everybody. David, could you maybe size the Heartland drag in the first quarter and for the full year versus what you contemplated initially? I guess it's specifically the integration costs that run through the P&L.

David Morris (EVP and CFO)

Hey, John. How are you?

John Ransom (Analyst)

I'm well.

David Morris (EVP and CFO)

Good, good. Just a couple of things on the comments around the Heartland integration. The first being that the cost associated with that is in our guidance and in our numbers. With us making the decision to expedite the conversion to the operating system, it did pull a little bit of cost from Q2, Q3 into Q1. It's plus or minus, I would say, $500,000.

John Ransom (Analyst)

Okay, perfect. Fred, this is a—I get to ask you an unfair question, but just the Trump executive order, there are a lot of opinions about that. I do not know if you had a chance to study that, and did you have any initial thoughts about how that would or would not complicate further negotiations with your payer partners?

Fred Burke (President and CEO)

What an interesting thing to happen today. I have been trying to think about it, and it's unknown at this point, John. It's so unclear what effect it would have. It's frustrating in some measures because, as I reported earlier, we're really very positive in the discussions we're having with our payors to resolve the IRA issue.

Now this comes along. We'll just have to monitor it very closely and see where we go from here. It strikes me that this executive order to gain some traction, I believe our payor partners will be similarly interested in resolving that. Based on my own personal knowledge and understanding of the MMA, this strikes me as very difficult given the non-interference clause. I suspect that that will play out over the coming months in the judiciary, and potentially the Congress would have to make some changes to allow this. That's all I can say at this point. Wish I knew more. Let's stay close and assess it as we get more information.

John Ransom (Analyst)

The last one for me, so just sort of a mechanics question. The PBM, they have to set their Part D pricing annually. That's at the network. The next available opportunity would be, I assume, when you renegotiate 2026. Of course, that's the IRA as well. I assume you'd get an opportunity. That would be the first opportunity. There's no force majeure clause in your contracts that would reset this year. It's a negotiation opportunity for 2026. Do we have that right?

Fred Burke (President and CEO)

I would think so. I think you're right. I don't envision this taking effect in the immediate term anyway.

John Ransom (Analyst)

Right, right. Okay. Nobody's told me I've been right all day, Fred, so that just made my day. I'm just going to leave on top and let you get back in the queue.

Fred Burke (President and CEO)

Great. Good talking to you.

John Ransom (Analyst)

Thank you. Yes, sir.

Operator (participant)

Your next question is from David McDonald from Truist Securities. Please go ahead.

Grayson McAlister (Analyst)

Hey, guys. This is actually Grayson McAlister on for Dave. I guess just one kind of follow-up for you. Obviously, resident count was really strong in the quarter. I was hoping that you could break that out, kind of, I guess, between a same store metric and the contribution from Heartland and Freedom would be helpful.

Fred Burke (President and CEO)

Our resident growth year on year organically met the guidance that we've discussed, which is high single-digit organic. The balance would be from the acquisitions that you named.

Grayson McAlister (Analyst)

Got it. Okay. That's helpful. I just wanted to see how the pipeline is shaping up and see if any of the uncertainty that we're seeing around tariffs, kind of around the economic environment, is having any impact on opportunities that you guys are seeing come through. Thanks.

David Morris (EVP and CFO)

From a pipeline standpoint, Fred mentioned that it's robust and as strong as it's ever been. There's pressure out there on some of these smaller businesses in addition to the tariffs and IRA things that we discussed. I would say it's consistent to even more robust is what we're seeing.

Fred Burke (President and CEO)

I mentioned that we have several active projects underway.

Grayson McAlister (Analyst)

Awesome. That's all I've got for you. Thanks, guys.

David Morris (EVP and CFO)

Thank you.

Operator (participant)

Ladies and gentlemen, as a reminder, should you have any questions, please press the star key followed by the number one. We'll pause a moment for further questions. There are no further questions at this time. Please proceed with closing remarks.

Fred Burke (President and CEO)

Just let me take a minute and thank everyone from our teams to our investors for your support and trust in us. We look forward to continuing to move out through the year and achieve the guidance that we've set forward. Thanks for joining the call, and I look forward to seeing you soon. Thanks.

Operator (participant)

Ladies and gentlemen, this concludes your conference call for today. We thank you for participating and ask that you do please disconnect your lines. Thank you.