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LifeMD, Inc. (LFMD)·Q2 2025 Earnings Summary
Executive Summary
- Q2 2025 revenue rose 23% year over year to $62.2M, gross margin was 88%, and adjusted EBITDA was $7.1M; GAAP diluted EPS was -$0.06, improving from -$0.19 in Q2 2024 .
- Versus consensus, LifeMD missed on revenue and EPS: Revenue $62.2M vs ~$66.3M consensus* and EPS -$0.06 vs ~-$0.01 consensus*, largely due to temporary performance challenges at RexMD and higher weight-management refund rates .
- FY 2025 guidance was lowered: Total revenue to $250–$255M (from $268–$275M), adjusted EBITDA to $27–$29M (from $31–$33M); telehealth revenue and telehealth adjusted EBITDA also reduced, citing RexMD CAC pressure and downstream subscription effects .
- Stock reaction: following the Aug 5 release and guidance cut, shares fell $5.31 (44.85%) to close at $6.53 on Aug 6, 2025, highlighting investor sensitivity to guidance and RexMD execution .
What Went Well and What Went Wrong
- What Went Well
- Telehealth revenue up 30% YoY to $48.6M with telehealth adjusted EBITDA up 560% to $3.4M; CFO: “Telehealth revenue grew 30% year-over-year and telehealth adjusted EBITDA increased 560%” .
- Operating execution: >$8M operating cash flow, cash $36.2M at quarter-end, and all senior debt repaid shortly after quarter-end, strengthening the balance sheet .
- Strategic expansion: nationwide behavioral health launch, acquisition to accelerate women’s health, and scaling LifeMD+ membership; CEO called Q2 “extremely productive” with “transformational expansion” into underserved areas .
- What Went Wrong
- RexMD headwinds: elevated customer acquisition costs (CAC) in ED drove lower new subscriber volume and downstream revenue; guidance cut attributed “mostly” to RexMD performance .
- Weight management refunds: higher-than-anticipated refund rates for patients lacking insurance coverage or unable to afford branded GLP‑1 therapies pressured results near term .
- Gross margin compression: 88% vs 90% prior-year due to revenue mix and higher allocation of physician costs to COGS driven by utilization .
Financial Results
Segment revenue breakdown:
Key KPIs:
Actual vs S&P Global consensus (Q2 2025):
Values retrieved from S&P Global.*
Guidance Changes
Earnings Call Themes & Trends
Management Commentary
- CEO: “The second quarter of 2025 was an extremely productive quarter… Our platform is undergoing a transformational expansion… I believe we are exceptionally well positioned to transform the lives of millions of Americans in the years ahead.” .
- CFO: “Telehealth revenue grew 30% year-over-year and telehealth adjusted EBITDA increased 560%… We exited the quarter with $36.2 million in cash and have now fully paid off all senior debt… Due to some temporary challenges facing our Rex MD business—which are now largely resolved—we are revising our full-year 2025 guidance…” .
- CEO on strategy: scaling LifeMD+ and expanding behavioral/women’s health; premium membership driving retention and margin expansion .
- CFO on refunds/CAC: weight management ahead of plan but higher refund rates; RexMD CAC spikes (15–25% sequential in parts of Q2) drove volume pullback, downstream subscription impact; performance improvements already underway .
Q&A Highlights
- Insurance coverage: contracted with 100+ plans across 40 states, ~80M covered lives; unit economics for insured patients encouraging; broader scaling expected in 2026 .
- RexMD dynamics: CAC pressures up 15–25% at times; actions taken returned CAC/acquisitions/day to near historical levels; FY guide embeds prudence without assuming full rebound .
- LifeMD+ marketing: measured scaling; plan includes spend increase in back half but not “very significant”; focus on balanced profitability growth .
- Behavioral health: nationwide launch live; onboarding daily; expect scaling in 30–60 days and accretive in 2026 .
- Medicare: reworking medical group structure; expansion to 49 states targeted by year end; scaling expected in 2H 2025 .
- Refund policy: liberal refunds when therapy not accessed or unaffordable; competitive pressure from low-cost compounded GLP‑1s contributes to higher refunds .
Estimates Context
- Q2 2025 actual vs consensus: Revenue $62.2M vs ~$66.3M*, EPS -$0.06 vs ~-$0.01*; both misses driven by RexMD acquisition inefficiencies and weight-management refunds .
- Q3 2025 setup: Company guides revenue $61–$63M and adjusted EBITDA $6–$7M vs S&P Global revenue consensus ~$62.13M* and EPS consensus ~-$0.045*; guidance aligns with cautious recovery trajectory .
- FY 2025 implication: Lowered guidance ($250–$255M revenue, $27–$29M adjusted EBITDA) suggests consensus revisions down across revenue, EBITDA, and EPS near term .
Values retrieved from S&P Global.*
Key Takeaways for Investors
- The quarter showed durable telehealth growth and cash generation, but headline misses vs estimates and a notable guidance cut were driven by RexMD CAC spikes and weight-management refund rates; watch CAC normalization and refund mitigation to gauge momentum into Q3/Q4 .
- Balance sheet strengthened with full senior debt repayment and $36.2M cash; supports continued investment in behavioral, women’s health, and LifeMD+ initiatives .
- Strategic diversification (behavioral, women’s health, LifeMD+) and AI-enabled operations position the model for margin expansion in 2026+, but near-term execution in RexMD and payer coverage expansion are critical .
- Insurance pathway: >100 plans/40 states with ~80M lives; broader scaling likely in 2026; expect cohort LTV improvement with insured patients, potentially easing refund pressure .
- Guidance prudence: Q3 guide and FY reset embed conservative assumptions around RexMD rebound; upside hinges on faster CAC normalization and weight-management coverage/pricing tailwinds .
- Legal overhang: ongoing litigation costs appear in non-GAAP reconciliations; monitor developments though core operations remain the primary driver .
- Trading lens: stock’s sharp drop post print reflects sensitivity to growth visibility; near-term catalysts include evidence of RexMD recovery, payer coverage wins, behavioral/women’s health scaling, and LifeMD+ attach/retention metrics .