Guardian Pharmacy Services - Earnings Call - Q3 2025

Executive Summary

• Strong Q3 performance with double-digit growth: revenue $377.4M (+20% YoY), adjusted EBITDA $27.3M (+18% YoY), adjusted EPS $0.25; guidance raised for FY25 revenue to $1.43–$1.45B and adjusted EBITDA to $104–$106M.
• Results beat Wall Street consensus on revenue and EPS, while GAAP EBITDA was below consensus due to acquisition/greenfield dilution and PubCo costs; revenue $377.4M vs $354.1M*, EPS $0.25 vs $0.235*, EBITDA $22.3M vs $25.5M* (consensus uses GAAP EBITDA, not adjusted).
• Management flagged vaccine clinic seasonality (some pull-forward into Q3; Q4 still “steady”) and continued cohort maturation; tax rate guided lower in Q4 (high-20s) and mid-20s in 2026.
• Strategic expansion continues (Oregon acquisition, Pacific Northwest footprint, robust pipeline) with strong cash generation ($36.5M cash, no debt) and an effective S-3 shelf plus extended lock-ups (93% locked until June 30, 2026), reducing near-term overhang.

What Went Well and What Went Wrong

What Went Well

• Growth and guidance: Revenue +20% YoY to $377.4M; adjusted EBITDA +18% YoY to $27.3M; adjusted EPS $0.25; FY25 revenue and adjusted EBITDA guidance raised.
• Strategic footprint expansion: Acquisition of Managed Healthcare Pharmacy (Oregon), deepening Pacific Northwest presence; integration tracking as expected and national customer onboarding underway.
• CEO tone and positioning: “This quarter again demonstrates the power of our model—combining local clinical and business expertise with the scale and resources of our national platform” (Fred Burke).

What Went Wrong

• Margin dilution and EBITDA consensus miss: GAAP EBITDA below consensus as greenfields/acquisitions remain dilutive; PubCo costs (~$1.3M in Q3) weigh on margins; adjusted EBITDA margin held at 7.2% but below “ex-new-cohort” potential (~8%).
• Elevated tax expense: Q3 provision of $7.0M; reported tax rate 42% driven by non-recurring items tied to the prior corporate reorg/IPO; Q4 to normalize to high-20s.
• Continued policy headwinds: Ongoing Inflation Reduction Act (IRA)/PBM negotiations; management confident but specifics constrained by NDAs; 2026 expected to be flattish on reported revenue as mitigation offsets EBITDA headwinds.

Transcript

Operator (participant)

Good day, everyone, and welcome to Guardian Pharmacy Services' third quarter earnings call. At this time, all participants are on a listen-only mode. Later, you will have the opportunity to ask questions during the question-and-answer session. I will now hand the call over to Ashley Stockton.

Ashley Stockton (Senior Director of Investor Relations)

Good afternoon. Thank you for participating in today's conference call. This is Ashley Stockton, Senior Director of Investor Relations for Guardian Pharmacy Services. I'm joined on today's call by Fred Burke, President and Chief Executive Officer, and David Morris, Chief Financial Officer. After the close today, Guardian posted its financial results for the quarter ended September 30th, 2025. A copy of the press release is available on the company's Investor Relations website. Please note that today's discussion will include certain forward-looking statements that reflect our current assumptions and expectations, including those related to our future financial performance and industry and market conditions. Such forward-looking statements are not guarantees of future performance and are subject to risks and uncertainties that could cause actual results to differ materially from our expectations.

We encourage you to review the information in today's press release, as well as in our quarterly report on Form 10-Q to be filed with the SEC, including the specific risk factors and uncertainties discussed in our SEC filings. We do not undertake any duty to update any forward-looking statements, which speak only as of the date they are made. On today's call, we will also use certain non-GAAP financial measures when discussing the company's financial performance and condition. You can find additional information on these non-GAAP measures and reconciliations to their most directly comparable GAAP financial measures in today's press release, which again is available on our Investor Relations website. I will turn it over to Fred for commentary on the quarter.

Fred Burke (President and CEO)

Thank you, Ashley, and good afternoon, everyone. Thank you for joining us as we review another strong quarter for Guardian. Before diving into the details, I want to take a brief moment to reflect on how far we've come. This quarter marks an important milestone, our first full year as a publicly traded company. A little over a year ago, we stood on the floor of the New York Stock Exchange to ring the bell, not as the culmination of a journey, but as the beginning of a new chapter in the 20-plus year life of our company. When we went public, we made a commitment to continue to execute with discipline, grow with purpose, and carry forward the entrepreneurial spirit that has always defined Guardian, all while earning the trust of our new shareholders along the way.

I believe that thus far we've delivered on that promise, and I'm very proud of what our team has achieved. As I look ahead, I'm even more energized by the opportunities in front of us to continue building a company that provides exceptional service to our communities and the residents they serve, creates value for our partners, and delivers sustainable long-term growth for our shareholders. With that foundation in mind, let's turn to our third quarter performance, which marked another period of strong double-digit growth across revenue, resident count, and adjusted EBITDA, which yielded adjusted EPS of $0.25. Revenue grew 20% to $377 million, atop 13% resident growth driven both organically and through acquisitions. Adjusted EBITDA grew 19% to $27 million, with margins holding steady at 7.2%, including the continued dilutive impact from recent greenfields and acquired pharmacies.

Given the strength of the quarter, we are raising full-year revenue and adjusted EBITDA guidance, which David will go over in detail later in the call. Now, turning to the policy environment, the unintended consequences of the Inflation Reduction Act remain an issue for our industry as a whole. Consistent with our longstanding approach, we're working closely with our peers and trade group to advocate for legislative and policy solutions that address these impacts and support the long-term stability of our sector. At the same time, we've continued to take proactive steps with our payors. Those initiatives are taking shape, and combined with other strategic actions across the business, we are growing ever more confident in our ability to offset the anticipated EBITDA headwind, even as reported revenue growth is expected to remain relatively flat in 2026.

Our philosophy on addressing policy issues remains simple: control what we can and navigate thoughtfully around what we cannot. It is becoming increasingly clear how important the right people and scale are to executing successfully through these challenges. That same mindset, disciplined, proactive, and grounded in leadership, extends across our organization. To that end, our pharmacy entrepreneurs fuel our growth with ingenuity and commitment to the clients we serve, and the specialized teams supporting them strengthen our platform every day, from purchasing to PBM contracting to data analytics, to name a few. Most of our pharmacy leaders have been with Guardian for more than a decade, some going on two. Prior to joining, they were highly skilled clinicians who built successful independent pharmacies from the ground up, entrepreneurs in their own right.

They recognized the opportunity to combine their local expertise and community relationships with the strength of Guardian's national platform and scale, unlocking new levels of performance and profitability within their pharmacies. Many have since built on that success, launching greenfield locations in adjacent markets. Guardian has continued to invest in these professionals, helping them deepen their business acumen. Today, they are exceptional operators who embody a rare combination of clinical expertise, entrepreneurial drive, and business-minded execution. That blend is central to our model and underscores why selecting the right local leadership teams is so critical and why we remain highly selective and targeted in our acquisitions. Collectively, our operators have helped propel us to be the clear leader in serving assisted living facilities. While our national market share is 13%, we have a much stronger presence in the markets where we operate.

In fact, 37 of our pharmacies have 20%+ market share, with 12 pharmacies operating at over 40%. Additionally, we now serve nearly 204,000 residents, the vast majority in-house. Looking ahead, we expect to benefit from powerful demographic tailwinds as the aging population grows, while continuing to gain share through new facility partnerships, higher resident adoption, and greenfield expansion with the help of our existing operators. At the same time, at the corporate level, we'll continue to pursue targeted acquisitions, such as the recent additions in Oregon and Washington, which put us on the map in the Pacific Northwest and answered demand from our national customer partners. Integration with both pharmacies is tracking as expected, with both teams already onboarding facilities operated by our national customer partners. Over time, we expect this geographic area to become an important growth contributor.

On the heels of these acquisitions, our pipeline continues to be very attractive and active. Furthermore, as the assisted living facility market continues to consolidate, we believe Guardian's scale, sophistication, and partnership-driven model positions us as the provider of choice. Looking back, we've accomplished a lot in the last year. We've expanded our pharmacy footprint, delivered consistent financial performance, strengthened our balance sheet, and deepened relationships with a broader investor base. Internally, we've enhanced our infrastructure and continued to navigate policy-related headwinds. Together, these accomplishments give us confidence as we enter our second year as a public company, stronger and better positioned for the opportunities ahead. Our priorities remain clear: drive organic growth through new customer facility wins, higher adoption, and greenfield expansions. Expand our network through disciplined acquisitions aligned with our culture and vision.

Enhance profitability by integrating new pharmacies, implementing our technology advantages, and leveraging procurement, reimbursement, and logistics efficiencies. Lastly, navigate policy changes thoughtfully with confidence and discipline, advocating for fair outcomes while managing risks proactively. These are the same levers that have propelled Guardian's growth for over two decades, but today, enhanced by greater scale, visibility, and financial flexibility. On that note, happy birthday, Guardian. We're still early in our journey as a public company, but our foundation is strong, our strategy is clear, and our momentum is real. With that, I'll turn the call over to David Morris, our CFO, who will take you through the quarter's financial results and outlook in more detail.

David Morris (CFO)

Thank you, Fred, and good afternoon. Before I begin with the review of our 3Q results, I wanted to quickly mention the recent shelf S-3 filing and lockup agreement we announced in mid-October.

Having been a public company for a year now, we recently became eligible to file an S-3 registration statement. As such, we filed an S-3 shelf registration for up to an aggregate 6 million shares, which has since become effective, to provide flexibility to efficiently access the public markets if and when needed and subject to market conditions. In conjunction with that filing, we also announced that we worked with our pre-IPO shareholders to lock up approximately 93% of the shares until June 30 of 2026. There are no immediate or specific plans to offer securities pursuant to the shelf registration. We view the shelf as a tool for financial flexibility rather than a near-term catalyst, and we will continue to take a disciplined long-term approach to capital markets activity. Turning to the financial results, I'm pleased to announce another strong quarter for Guardian with adjusted EPS of $0.25.

Revenue grew 20% to $377.4 million, reflecting mid-double-digit organic revenue growth. Total resident count ended the quarter at 203,766, up 13% versus a year ago. Upside in revenue this quarter came from several areas. First, a higher percentage of new residents joined early in the period, providing a full quarter benefit. Second, plan optimization efforts continued to perform well, improving coverage for residents while reducing co-pays. Third, vaccine activity was strong as many communities launched their clinics earlier in the season. Finally, acquisitions contributed meaningfully with a full quarter of revenue from Washington and two months of contribution from Oregon. This pharmacy is a great strategic fit for Guardian, bringing on board an experienced leadership team with a strong reputation for service excellence. Alongside our operations in Washington, this expansion gives us a solid foothold in a new growth region, the Pacific Northwest.

Gross profit increased to $74.7 million, posting a 19.8% margin. Adjusted SG&A was 13.7% as a percentage of revenue. Adjusted EBITDA rose 19% to $27.3 million, which included PubCo cost of $1.3 million that we did not have in the prior year. Adjusted EBITDA margins held steady with the second quarter at 7.2% and was down roughly 10 basis points year over year, reflecting the dilutive impact of recent acquisitions and greenfield startups, along with PubCo costs that were not included in last year's results. Underlying core margins continue to expand as we see stronger profitability from pharmacies that are now maturing within our network. Our four- to five-year locations are performing at or above our consolidated adjusted EBITDA margin, and our two- to three-year locations are tracking steadily toward that same level. As I have mentioned before, our most recent acquisitions, those made in the last two years, are still dilutive.

Without them, margins would be closer to 8%. Given the upside in the quarter, acquisitions year to date, and the overall momentum of the business, we're raising our 2025 guidance. Revenue is now expected to be in the range of $1.43 billion-$1.45 billion, up from our prior range of $1.39 billion-$1.41 billion. We're also raising our adjusted EBITDA guidance to $104 million-$106 million, up from the previous $100 million-$102 million range. The midpoint of this range represents solid 16% growth year over year. A couple of reminders for Q4. Starting with SG&A, we expect it to trend slightly lower as a percentage of sales in the fourth quarter, consistent with the seasonal revenue lift we typically see from vaccine activity this time of year. Stock-based compensation is expected to decline meaningfully in Q4 to approximately $1.1 million as we sunset the pre-IPO equity program-related expense.

Finally, reported income tax expense was elevated at 42% this quarter, which is higher than the previous quarter, primarily due to non-recurring income tax expense associated with the corporate reorganization and related to the IPO from 2024. We expect the fourth quarter tax rate to be in the high 20s and step down to the mid-20s in 2026. Turning to the balance sheet, we ended the quarter with $36 million in cash, an increase of $18 million even after funding our Oregon acquisition. This performance highlights the strength of our cash generation, with the cash conversion continuing to track above 60%. We remain in a very strong financial position, with no debt outstanding under our credit facility and ample liquidity to fund ongoing strategic growth, including M&A with internally generated cash flow.

Our acquisition pipeline remains very active, and we continue to take a disciplined approach, prioritizing the right local operator and markets that enhance our regional density and national scale. In closing, on our first anniversary as a public company, I want to echo Fred's thanks to all of our employees and shareholders. We're proud of the momentum we've built, and we are confident in our ability to continue executing on our strategic growth plan. Guardian was built pharmacy by pharmacy, relationship by relationship, and that's exactly how we'll continue to grow, anchored in local leadership, powered by our national scale, and with an unwavering commitment to service.

Ashley Stockton (Senior Director of Investor Relations)

Operator will now open the line for questions.

Operator (participant)

Ladies and gentlemen, we will now begin the question and answer session. If you'd like to ask a question, please press star followed by the number one on your touch-tone phone. You will hear a prompt that your hand has been raised. If you would like to withdraw your question, please press star then the number two. If you are using a speakerphone, please make sure to lift your handset before pressing any keys. One moment while we prepare that Q&A roster. Your first question comes from the line of John Ransom from Raymond James. Please go ahead.

John Ransom (Managing Director)

Hey, good evening. Just a question about the fourth quarter. How would you compare the contribution of the vaccine program this year to last year? I think this is what, the third year you've done it, and I'm sure you learn a little something every year. The backdrop is interesting because there's a little less vaccine uptake among the greater world, especially COVID. I'm just curious kind of what you're seeing with your population, how the uptake looks, and just how the program overall compares to what you did last year, which is also very successful.

Fred Burke (President and CEO)

Hey, John, Fred here. Did I hear you say third quarter or fourth quarter?

John Ransom (Managing Director)

Fourth quarter. In your applied guidance, what's going on with your vaccine program this year compared to last year?

Fred Burke (President and CEO)

It's steady as we go. You did mention an interesting anomaly that we wondered about, which is the CDC guidance potentially could have caused fewer people to be vaccinated, particularly COVID. We are not seeing that. It's steady as we go. However, I will comment that we started the clinic season with a stronger September this year than last. So some of the total perhaps has been pulled forward into Q3.

John Ransom (Managing Director)

Okay. As we think about resident count, it looks like you're only missing one month of acquisition. This resident count is a pretty good placeholder for 4Q with a little bit of one month of that one acquisition.

Fred Burke (President and CEO)

That's correct. Generally, we measure residents served as of the end of the quarter. The acquisitions that were completed recently are included in the Q3 number. Recognize that we do see fluctuations quarter to quarter, particularly in Q4, as some loved ones are reluctant to move their mother or father into assisted living in certainly the November, December period. I would expect to see steady as we go in Q4 on resident count.

John Ransom (Managing Director)

Just last for me, I know you hit head-on the IRA issue and the conversations with the PBMs. Using the baseball analogy, how close are you to wrapping up these negotiations and kind of putting a bow on this issue?

Fred Burke (President and CEO)

John, as you know, these are very sensitive discussions, literally covered by NDAs. I do not want to comment on specifics with respect to the PBM negotiations other than to reiterate what I said before, which is they're taking shape, and we're growing ever more confident in our ability to offset the headwind.

John Ransom (Managing Director)

Fred, we've talked about this before, but is there any more? It's always interesting to me, like some industries, the payers are more willing to give providers some bogeys that result in upside to their—and as we know, you're paid a dispensing fee and you're paid a spread. Is there any more indication that they might be, especially with all the issues going on with Part D and more Part D plans embedded in MA and sensitivity around Part D losses? Is there any more chopping of wood? That's a bad expression. Is there any more kind of fulsome discussion around, "Hey, look, guys, why don't we throw in an upside kicker for X or Y?" Or is it still just kind of mechanically the same in terms of just dispensing fee and spread?

Fred Burke (President and CEO)

At Guardian, as having mentioned before, we are very willing to think about value-based models because we are very comfortable in the value that we are providing to their insured lives. It is evolving. There is not a major shift, but each is interested in exploring this idea, as are we. We are working our way toward that, but it is an evolution.

John Ransom (Managing Director)

The normal glacial pace of healthcare is still going to affect here. We'll think about it next year.

Fred Burke (President and CEO)

All right. All right. One Georgia boy to another, we'll keep chopping that wood.

John Ransom (Managing Director)

All right. Thank you. Thank you, guys.

Operator (participant)

Your next question comes from the line of David MacDonald from Truist. Please go ahead.

David MacDonald (Analyst)

Yeah, good afternoon, everyone. Just a couple additional ones. One, can you guys spend just a quick minute on some of the areas where, from a margin standpoint, if I just look at the amount of acquisition activity that you've had and just kind of the impact in terms of margins as those come on, any couple of key areas that you would flag in terms of where you've done better to continue to maintain those flattish margins despite the meaningful M&A activity?

David Morris (CFO)

Hey, David. It's David. How are you doing?

David MacDonald (Analyst)

Hey, David.

David Morris (CFO)

Hey, we've talked about the various cohorts, and I mentioned in the comments our four or five-year cohorts are performing well ahead of our overall margins, and the two or three-year cohorts are coming along as well. We have a substantial investment we've made in the last 18 months-24 months in 11 locations, probably greater than 10% of our overall revenue that are a drag on our overall EBITDA margin. It takes, on average, four years to get these businesses up to performing where they need to be, and some are performing quicker and better, and some take longer. I think it's pretty much steady as she goes, and we're pleased with all the various businesses and where they are in the various cohorts. It's pretty much steady as she goes.

David MacDonald (Analyst)

Okay. And then just one other quick follow-up. In that same vein, when you think about the pipeline, it sounds like there's still a fair number of opportunities sitting in front of you. How do you think about pacing, I guess, on two fronts? One, just the margin impact as they come on, but also, number two, just are there any kind of operational bottlenecks internally in terms of how many of these things you want to take on at the same time?

David Morris (CFO)

Yeah, I think we've talked about in the last 24 months, things have been accelerated, specifically with the large Heartland acquisition at four locations. I'm not sure we can set expectations to continue at that level. The pipeline's robust, and as I said, very active. We see 2026, 2027 of us continuing our similar type approach. We have many contiguous startups that we're looking at as well as an active pipeline. No real bottlenecks that would impact us being able to continue to execute much as we have this past year.

David MacDonald (Analyst)

Okay. Thank you very much.

Operator (participant)

Your next question comes from the line of Raj Kumar from Stephens. Please go ahead.

Raj Kumar (Equity Research Analyst of Healthcare Services)

Hi, good afternoon. Maybe just kind of touching on the implied 4Q here. It seems like the dilutive impact to margins is slightly accelerating. Maybe just kind of want to get your thoughts on if that's just conservatism or kind of anything to call out on that front.

David Morris (CFO)

Hey, Raj, David. I think our adjusted EBITDA margins were forecast to remain relatively steady, and the biggest impact there would be the investment that we've made over the last 12 months-8 months depressing overall margins. I think the Q4 would tick up slightly because of the seasonality with the vaccine clinics.

Raj Kumar (Equity Research Analyst of Healthcare Services)

Got it. Maybe just as a follow-up, appreciate the commentary on the mature pharmacy kind of margin. Maybe just kind of thinking about what the ceiling or the kind of theoretical ceiling is there from a margin perspective, and kind of also thinking about one of your mature pharmacies, what kind of the available expansion capacities to those pharmacies as we think about that helping out in this overall high single-digit organic revenue growth framework that you've kind of laid out long-term.

David Morris (CFO)

We've talked about the impact that our investment in the contiguous startups and acquisitions has on overall margin. It's ±80 basis points. Where can the business be, say, in 24, 36 months, or even longer? We hope to continue to optimize these acquisitions. That's going to enhance our overall margin. We're going to leverage the platform that we've built, not only in each pharmacy where we're not to full market share, but also leverage our support infrastructure. 8% higher, we're going to be working on that every day, every quarter, but hopefully we'll see things continue to improve.

Raj Kumar (Equity Research Analyst of Healthcare Services)

Got it. Thank you.

Operator (participant)

Ladies and gentlemen, as a reminder, if you would like to ask a question, please press star followed by the number one. If you are using a speakerphone, please make sure to lift your handset before pressing any keys. Your next question is a follow-up from John Ransom from Raymond James. Please go ahead.

John Ransom (Managing Director)

Hey there. Just going back to the fun topic of Medicare Part D, as you no doubt know, there's a lot of turmoil in the market. There's fewer standalone Part D plans. There's more MAPD plans. I just wonder, how does Guardian look at that? In your plan optimizer tool, are you seeing more switching within your residents? Is it creating more kind of churning behind the scenes, or is it not something that's risen to the level of something that you've noticed?

Fred Burke (President and CEO)

I'll start on that one, John. It's very early in the process because the details were late in coming this year. So the big effort is underway as we speak, and we'll know more as we move through the next few weeks.

John Ransom (Managing Director)

Okay. Thank you. And I'm sorry, do you have a general preference for standalone versus MAPD, or do you care?

Fred Burke (President and CEO)

We're relatively agnostic. We want to help the resident find the best plan for their particular situation and their drug regimen.

John Ransom (Managing Director)

Okay. And have y'all noticed anything kind of different? I was just looking at some numbers that suggest some small moves. But has there been any change to point out in terms of the mix of brand versus generics or the mix within brand? And I know you're not real leveraged expensive biosimilars, but is there anything to call out in the average drug consumption this year versus last year? And is that bigger than a breadbox for you?

Fred Burke (President and CEO)

We've mentioned in previous communications that we see increasing levels of acuity, which manifests itself with greater utilization of some of these brands. That has continued. I would call it just steadily a steady growth in acuity. Obviously, that is also greatly impacted by resident mix, this being a market where our residents are turning over. It can fluctuate quarter to quarter, year to year, depending on that. In general, these residents that we serve have a high acuity level.

John Ransom (Managing Director)

And the fact that the whole Part D deductible and out-of-pocket max has changed, are you noticing that in a shift of the plans being more in the hook in the fourth quarter? Are you seeing any kind of change versus last year when that wasn't the case?

Fred Burke (President and CEO)

We have not, and I'm surprised at that. Perhaps it may take more than one year.

John Ransom (Managing Director)

Okay. All right. Thank you.

Operator (participant)

Thank you very much. There are no further questions at this time. This concludes today's conference call. Thank you very much for your participation. You may now disconnect.