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DATE

March 5, 2026, at 4:30 p.m. ET

CALL PARTICIPANTS

  • Chief Executive Officer — Stephen L. Silvestro
  • Chief Financial and Strategy Officer — Edward Stelmakh
  • Chief Commercial Officer — Andrew Jacob D'Silva

TAKEAWAYS

  • Revenue -- $32.2 million for the quarter and $109.4 million for the full year, reflecting solid performance across both legacy and new client segments.
  • Adjusted EBITDA -- $12 million for the quarter and $24.3 million for the year, more than doubling year over year.
  • Net Income -- $5 million ($0.26 per diluted share) on a GAAP basis for the year, compared to a net loss of $100,000 in the prior period.
  • Non-GAAP Net Income -- $9.9 million ($0.51 per diluted share) for the year, up from $5.5 million ($0.30 per diluted share) in the prior year.
  • Gross Margin -- 74.8% for the quarter, up from 68.1% in the comparable quarter last year, attributed to favorable solution and channel partner mix; management does not expect this margin level to continue in 2026.
  • Operating Expenses -- Decreased by $2.9 million year over year, primarily due to lower cash OpEx from post-acquisition cost reductions.
  • Operating Cash Flow -- $18.7 million for the year, compared to $4.9 million previously.
  • Cash & Short-term Investments -- $23.4 million at year-end after paying down $8 million of debt in 2025, including $6 million prepayment.
  • Debt Balance -- $26.3 million as of year-end, with intentions to accelerate paydown using free cash flow.
  • Guidance for 2026 -- Revenue expected between $109 million and $114 million; adjusted EBITDA anticipated between $21 million and $25 million.
  • Free Cash Flow -- Nearly $19 million generated from operations in 2025.
  • Share Repurchase Authorization -- $10 million buyback program approved, to be funded by available cash and executed via open market or private transactions.
  • Revenue per FTE -- $839,000, up from $701,000 in the previous year.
  • Net Revenue Retention -- 116% for the year.
  • Average Revenue per Top 20 Pharma Manufacturer -- $2.8 million for the year, slightly down from $3 million, due to reduced buy-ups and lower data-related revenue.
  • Managed Service Revenues -- $9 million contribution in 2025; management expects minimal managed services revenue in 2026.
  • DAP (Dynamic Audience Activation Platform) Subscription Revenue -- Subscription run-rate approached 10% at year-end, with management targeting further growth as DAP adoption increases.
  • Mid-tier & Long Tail Client Growth -- Accelerated uptake in these segments, described by management as “exceeding our expectations.”
  • Gross Margin 2026 Outlook -- Guidance lowered to “mid-60% range,” as management views the Q4 margin level as unrepeatable due to a one-time channel mix.

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RISKS

  • CEO Silvestro said, "we are seeing softness in our year-to-date contracted revenue numbers as compared to last year," citing market shifts away from managed services and increased client conservatism.
  • Stelmakh noted a slower start to the year than management had hoped for, with revenue phasing expected to follow a 40%/60% split between first and second half, indicating a back-end loaded year.
  • Management expects minimal managed services revenue in 2026, removing a prior $9 million revenue contributor and potentially impacting overall topline momentum.

SUMMARY

OptimizeRx Corp. (OPRX +1.48%) reported double-digit full-year revenue growth, record gross margin in the quarter, and substantial year-over-year expansion in adjusted EBITDA and operating cash flow. Management highlighted a strategic pivot to increase subscription-based DAP revenues and further penetrate mid-tier and long-tail life sciences clients, presenting ongoing growth potential. However, a market-wide pause tied to most-favored nation pricing negotiations and a structural contraction in managed services is materially weighing on contracted revenue visibility for the near term.

  • Clients are adopting shorter contracting cycles, transitioning from traditional six-to-twelve-month deals to quarter or half-year terms amid economic conservatism.
  • Channel partner and specialty messaging mix produced an unusually high Q4 gross margin, but this is not expected to persist, as reflected in management's mid-60% margin guidance.
  • Management approved a $10 million share buyback, demonstrating confidence in long-term value despite near-term revenue uncertainty.
  • Company leadership stated that artificial intelligence is driving efficiencies within client organizations and may eventually channel higher spend into OptimizeRx Corporation services, with CEO Silvestro stating, "AI may serve as a tailwind."
  • The shift to more consistent subscription revenue from DAP is expected to enhance revenue predictability as a cornerstone of management's ongoing commercialization strategy.

INDUSTRY GLOSSARY

  • DAP (Dynamic Audience Activation Platform): A proprietary, AI-enabled OptimizeRx Corporation platform facilitating targeted and timely outreach to healthcare providers, enhancing engagement and marketing ROI for life sciences clients.
  • Managed Services: Customized solution engagements involving significant human support and tailored project work, as opposed to recurring software or platform subscriptions, often resulting in episodic revenue recognition.
  • Point of Care: The clinical setting and associated platforms where healthcare providers interact directly with patients, targeted for marketing messages and product awareness campaigns in pharma commercialization strategies.

Full Conference Call Transcript

Stephen L. Silvestro: Thank you, Operator. Good afternoon to everyone joining us for today's fourth quarter and fiscal year 2025 earnings call. We delivered a strong fourth quarter, exceeding both consensus estimates and our internal expectations. Revenue for the fourth quarter was $32,200,000 and adjusted EBITDA was $12,000,000. For the full year, revenue totaled $109,400,000 with adjusted EBITDA of $24,300,000. Our full year 2025 results clearly demonstrate the strength of our operating model and the significant opportunity within our market. We delivered solid top-line performance across both our largest and most established clients, and a growing cohort of newer customers, particularly in the mid-tier and long tail life science companies.

We view this segment as highly attractive, providing a meaningful runway to expand our customer base and deepen our relationships over time. At the same time, improvements in our product mix and channel partner strategy contributed to higher gross margins in 2025. When combined with cost optimization initiatives following the Medix acquisition, and the benefits of our largely fixed cost, highly scalable operating model, we more than doubled both adjusted EBITDA and free cash flow year over year. While we are pleased with our fourth quarter results, we are seeing softness in our year-to-date contracted revenue numbers as compared to last year.

This is mostly driven by a previously communicated market shift away from managed services, which contributed a material portion of our contracted revenue in 2025. In addition, we believe some of our clients are adopting a more cautious spending tone in the early stages of 2026 as they adjust their portfolios to most favored nation pricing. We feel confident that the latter is a temporary phenomenon that will start to normalize in the course of the coming few months. Given this backdrop, we are updating our 2026 guidance and are taking a more conservative view on revenue while continuing to stay focused on profitability.

For 2026, we expect revenue in the range of $109,000,000 to $114,000,000 and adjusted EBITDA between $21,000,000 and $25,000,000. I also want to be clear, management and our Board believe there is still significant opportunity for value creation, particularly when examining the demand and operating leverage we saw in 2025. Indeed, 2025 demonstrated the strength of our profitable growth model. We achieved Rule of 40 performance, delivered adjusted EBITDA margins above 20% for the year, and generated nearly $19,000,000 in free cash flow from operations. Reflecting our confidence in the long-term value of the business, our Board has authorized a $10,000,000 share repurchase program.

We intend to finance the repurchase using our available cash and cash equivalents in open market or privately negotiated transactions. I would also like to address some of the speculation and questions we receive regarding artificial intelligence. Our business has experienced minimal disruption from AI, and we do not expect to be disrupted in the future. We are not a commoditized software solution, but a strategic partner to life science companies supported by a proprietary and highly valuable communications network that connects pharmaceutical manufacturers with healthcare professionals and patients at critical moments of care. In fact, AI may serve as a tailwind. We are hearing from customers that historically up to 50% of marketing budgets were allocated to content creation.

As AI drives efficiencies within our client base, that allocation of spend is likely to be redeployed to both expand reach and improve execution of marketing efforts—areas where OptimizeRx Corporation is particularly well positioned. We believe we are strongly positioned for long-term outperformance on both the top and bottom line. We address key pain points for our customers, including enhancing brand visibility, reducing script abandonment, improving interoperability between disparate point of care platforms, and supporting the transition to more complex and specialty medications.

A strong example of our impact comes from one of our largest customers, a top 10 pharmaceutical manufacturer that engaged OptimizeRx Corporation to support specific oncology initiatives through our point of care and point of prescribe-based marketing solutions. While early programs were focused on targeted use cases, the results demonstrated measurable impact in reaching prescribers within a clinical workflow and influencing engagement at key decision points. As performance validated the DAP model, the manufacturer expanded their investment with OptimizeRx Corporation in 2025 to support multiple oncology brands across various indications. This expansion across brand and tumor types drove meaningful year-over-year revenue growth, evolving from initial pilot programs into a scaled multi-brand oncology engagement strategy.

When we talk about enterprise engagements, this is the momentum we are looking for. We are also seeing strong momentum in the med tech sector. One flagship client first partnered with us post-COVID to expand prescriber reach through our legacy point of care marketing solutions. Consistent script lift in 2024 prompted the client to adopt DAP, our AI-enabled Dynamic Audience Activation Platform, which facilitated precise, timely outreach to prescribers, including many previously untapped new prescribers, exactly when it mattered most in a patient journey. This continues to be a major differentiator for the company and for our clients. By activating and leveraging these high-value HCPs identified through DAP, the client rapidly scaled deployment to additional brands and channels.

This multi-brand, multi-channel scaling is delivering substantial impact in a highly competitive and rapidly growing landscape. The success of this program resulted in the customer drastically increasing its investment in OptimizeRx Corporation’s solutions from pilot dollars in 2022 to several million dollars in 2025. This pattern—starting with targeted POC engagement, progressing to DAP adoption and then accelerating across the portfolio—highlights the repeatable path to accelerated growth and stronger ROI that we see across dozens of similar pharma and medtech companies. OptimizeRx Corporation is uniquely positioned to drive sustainable long-term growth and shareholder value. The keyword here is sustainable.

With one of the nation’s largest point of care networks and the only true point of prescribe network, we enable pharmaceutical manufacturers to engage healthcare providers directly at the moments that matter most—when actual decisions are being considered and made. Building on this foundation, we have developed a purpose-built omnichannel platform that integrates advanced patient-finding capabilities such as DAP and micro-neighborhood targeting. These tools are redefining how pharmaceutical companies, physicians, and patients connect, improving patient outcomes and transforming engagement across the healthcare ecosystem. Our reach across both point of care and direct-to-consumer channels provides a durable competitive advantage.

We believe OptimizeRx Corporation is the only company with the scale, technology, and data integration required to seamlessly engage providers and patients across all channels. This positions us as a comprehensive commercialization partner, supporting customers throughout the full product lifecycle—deepening relationships and expanding long-term value capture. As we have discussed on prior calls, a key focus moving forward is to further demonstrate our reach, scalability, and value as a trusted strategic partner. Our ability to consistently expand relationships with our largest customers underscores the value we deliver and the impact we have on script lift and the commercialization process.

I am confident that continued focus on execution, notwithstanding some of the near-term headwinds seen in our space, combined with our differentiated platform and strong customer outcomes, will translate into meaningful long-term shareholder value. We believe our momentum positions us to capture additional market share and expand our role within the pharma industry’s multibillion-dollar digital ecosystem. Our customers remain deeply integrated across our HCP and DTC offerings, and our objective is to support them seamlessly across the full patient care journey. I will now turn the call over to our CFSO, Edward Stelmakh, who will walk us through the financials. Ed?

Edward Stelmakh: Thanks, Steve, and good afternoon, everyone. A press release was issued with the financial results for our fourth quarter and fiscal year ended 12/31/2025. A copy is available for viewing and may be downloaded from the Investor section of our website, and additional information can be obtained through our forthcoming Form 10-K. Fourth quarter revenue came in at $32,200,000, and this was largely in line with our previously communicated expectations as we continue to convert more of our DAP agreements into subscription revenue that is spread more evenly over the course of the year. In addition, buy-ups came in at a more moderate level than in 2024.

Gross margin increased from 68.1% in the quarter ended 12/31/2024 to 74.8% in the quarter ended 12/31/2025. Year-over-year gross margin expansion is tied to a favorable solution and channel partner mix. While the fourth quarter was a record gross margin quarter, we do not anticipate gross margins to be at this level in 2026 and continue to believe we will be in the mid-60% range, as the fourth quarter saw an unusually high amount of specialty messaging in higher-margin channels, which was a favorable but uncommon mix for us.

Our operating expenses for the quarter ended December 31, 2025, decreased by $2,900,000 year over year, largely due to lower cash OpEx as we saw benefits from the post-acquisition cost reduction measures implemented in 2024. Meanwhile, our net income came in at $5,000,000 or $0.26 on a fully diluted basis for 2025, compared to a net loss of $100,000 during 2024. On a non-GAAP basis, our net income for 2025 was $9,900,000 or $0.51 per diluted share outstanding, as compared to a non-GAAP net income of $5,500,000 or $0.30 per diluted share outstanding in the same year-ago period. Our adjusted EBITDA came in at $12,000,000 for 2025, compared to $8,800,000 during 2024.

We ended the year with cash and short-term investments totaling $23,400,000 as of 12/31/2025, as compared to $13,400,000 on 12/31/2024. We were able to increase our cash balance throughout the year despite paying off $8,000,000 of principal during 2025, including $6,000,000 ahead of our prepayment schedule. Our operating cash flow was $18,700,000 for 2025, versus $4,900,000 in 2024. As a result, our current debt balance stands at $26,300,000. We continue to believe we are well funded to execute against our strategic and operational goals and will look to utilize free cash flow to pay down debt at an accelerated rate and opportunistically look to repurchase shares.

Now I would like to turn to our KPIs for the twelve months ended December 31, 2025. Average revenue per top 20 pharmaceutical manufacturer was $2,800,000, which declined slightly from $3,000,000 in 2024 and was directly tied to lower buy-ups and data-related revenue that I highlighted earlier. Meanwhile, net revenue retention rate remained strong at 116% and revenue per FTE came in at $839,000, topping the $701,000 posted during the twelve months ended 12/31/2024. Finally, I would like to provide additional color around our guidance, which now calls for 2026 revenue to come in between $109,000,000 and $114,000,000 and adjusted EBITDA between $21,000,000 and $25,000,000.

As you may recall, our first half 2025 revenue was positively impacted by managed service revenues, which contributed approximately $9,000,000 in 2025. Since we do not expect a similar revenue mix in 2026, our revenue phasing is likely to fall in line with historical 40% to 60% attribution between first and second half of the year. I will now turn the call back over to Steve.

Stephen L. Silvestro: Thanks, Ed. Operator, we will now open for questions.

Operator: We will now begin the question and answer session. To ask a question, you may press star then 1 on your telephone keypad. If you are using a speakerphone, please pick up your handset before pressing the keys. To withdraw your question, please press star then 2. We will pause momentarily to assemble our roster. The first question comes from Ryan Daniels with William Blair. Please go ahead.

Ryan Daniels: Curious in your commentary on some of the end market weakness, a few points there. One, are you really just seeing the conservatism with the 17 companies that are MFN negotiations or is it broader across the entire client base? That is number one.

Stephen L. Silvestro: Alright. Thanks, Ryan. Good to hear from you. We are seeing a broader pause across all of the clients. They are trying to just digest what it is going to mean for them. So the contracting duration has started to shorten a little from maybe six to twelve months down to quarter pulses or even half-year pulses as they are contemplating how they are going to deploy spend. I think that will normalize over time, or we think it is going to normalize over time as they get through it. And outside of those that are negotiating, I think it is really just over-conservatism for the first quarter. That is our stance, and that is what we are hearing.

People are just being cautious.

Ryan Daniels: Okay. And are you seeing any nuances between DTC and HCP marketing? Are you seeing pressure on both of those from your partners?

Stephen L. Silvestro: Yeah. It is about the same across the board. They are not being viewed differently at this point by any of the manufacturers. Everybody has got the same view of both DTC and HCP spend as a whole.

Ryan Daniels: Okay. That is helpful. And then maybe one for Ed. You mentioned during the quarter, gross margins were obviously great and drove a lot of upside to the bottom line. I think you said there were some specialty messaging and higher-margin channels. Can you go into a little bit more detail on what that was or what drove that? And then why you do not think that could be sustainable? Is it something that you do not want to model, but maybe in a given quarter, you might be able to do that again and drive margins through those specialty messages?

Edward Stelmakh: Hey, Ryan. Thanks for the question. So I guess two parts here. First of all, what happened in Q4 2025. We did have a very favorable mix of channel partners that we utilized to drive our messages. And as you know, we can pick and choose which channel partners we can drive messages to, but we are clearly going to be running those messages through channel partners where we can reach the best audience under DAP. So that is what happened there in terms of our ability to drive higher margins for that quarter.

As far as 2026 is concerned, we are guiding to a mid-60% gross margin range mainly due to the fact that we do not feel comfortable taking the high end of the equation and running it through the year. We can do it periodically, but I do not see us doing this on a regular basis throughout the year.

Ryan Daniels: Okay. I appreciate that. And then maybe last question. I will go back to Steve. You mentioned you are not seeing any disruption from AI, but would love to hear your purview on how it is actually helping your operations. I know you have used AI in some of your real-time analytics and product deployment in the past. So just curious what AI has meant to you maybe over the last quarter or two and what you are investing in as we look forward over the next few years to enhance your offering or your ROI for clients. Thanks.

Stephen L. Silvestro: Yeah. No problem, Ryan. Happy to talk to you. And it is actually an extension of what Ed just mentioned, which is everyone is pretty hyped up on the Agentic AI deployment across the board. As you know, we have been doing this now for years. So it is not anything new for OptimizeRx Corporation. But what it does is create efficiency and speed within organizations. You still need human input to get things to actually move.

But what it will enable us to do is get clients to stop spending money on things like content creation or other stuff where they were very people heavy, and start to deploy AI in a way that enables them to spend more money on commercial—and that is where we are particularly strong. And so we are excited about the AI piece. We do not see it as disruptive to us at all. We see us as an enabler of people adopting more AI.

And then just to piggyback on Ed's comment around channel partner selection and deployment of messages that impacts the profile, I think that is a great example of what AI could do for OptimizeRx Corporation as more people adopt the agentic and other components of AI that are getting out there. It allows us to be more efficient with channel partner distribution, message distribution, and physician identification. And so we are welcoming it. I think it is not broad enough yet, Ryan, where we are willing to reset the profile of the business from a margin perspective, but we were able to flash that publicly and show what the potential is within this business as we continue to grow it.

So for me, I am very excited about it. I am trying not to overhype it, but it is a positive for us. Appreciate you calling it out.

Ryan Daniels: Okay. Thanks for all the color, guys. Appreciate it.

Edward Stelmakh: Yeah. Thanks, Ryan.

Operator: The next question is from Eric Martinuzzi with Lake Street. Please go ahead.

Eric Martinuzzi: Yes. Historically, you have been able to give some color on the percent of revenue that is under contract. I would guess, given the duration color that you gave, Steve, that maybe that number is not in, you know, what I would say, a 30% number is what you have talked about in the past. Can you give us any color on percent under contract?

Stephen L. Silvestro: Yeah. We can give a little bit of color. Right now, if we take out the managed service component, Eric, that we talked about, which is predominantly first-half contracted, we are running roughly 15% to 20% off of where we normally would be. And that is mostly due to the timing of the contract and the duration of the contract. You take out the managed service component, it is mostly contract duration—meaning shorter term contracts—we would have seen same time last year or years previous. And we think that is—we are not panicking about that.

We think that is going to adjust over time and we think as we get to the midyear, we will start to see that the contracted revenue numbers will take care of themselves and normalize themselves. But, Ed, feel free to chime in if you want. I know you and Andy are also tracking it very closely.

Edward Stelmakh: Yeah. I think you got it right, Steve. We are 15% to 20% behind last year's numbers. We typically do not disclose the exact percentage of revenue that is already under contract, but we will give you a gauge for whether we are running ahead or behind. Just to give you a little more color, as Steve said, there was an impact of managed services playing a pretty material role last year in the first half around the same time. That is missing from the equation this year to a large extent. And shorter duration contracts are also hitting us a little bit out of the gates.

But we are reading the market, and we are very positive and very optimistic about pharma once they get through the first quarter or two of this year, normalizing their spending within the year and coming back strong in the back half of the year.

Eric Martinuzzi: And following up on the managed services comment, I think you said there was—was it $9,000,000 in the first half or was it $9,000,000 for 2025?

Edward Stelmakh: It was $9,000,000 of revenue in 2025.

Eric Martinuzzi: And does the guide for 2026 include any amount for managed services?

Edward Stelmakh: Very little. As we said last year, managed services is a very episodic solution for us. It comes and goes, so we are not counting on much of it coming in this year.

Eric Martinuzzi: Got it. Thanks for taking my questions.

Edward Stelmakh: You got it. Thanks.

Operator: The next question is from Constantine Davides with Citizens. Please go ahead.

Constantine Davides: Great. Steve, you highlighted in your prepared remarks performance for mid-tier and smaller manufacturers. Just wondering what exactly you are doing to attack that portion of the market and what has been driving that success?

Stephen L. Silvestro: Hey, Constantine. Good to hear from you. Really, what it is, is we have an ability to supplement a lot of what those mid-tier and long tail clients do not have infrastructurally within their own businesses. So if you think about what OptimizeRx Corporation is evolving into as a commercialization partner for a lot of these assets—taking new assets to market, launching them, trying to drive sales—we can fill a lot of the empty space where they may not have big budgets for big marketing teams, Cadillac budgets for agencies, hundreds of sales reps out on the street. And we are able to fill that gap very seamlessly in a cost-efficient, effective way.

And the growth in the mid-tier and the long tail has, I would say, exceeded our expectations. The uptick there is faster than we were even initially anticipating. It is a really, really good sign. And, you know, coming back to one of the questions that Ryan had around the people that are negotiating on the MFN front, all of those are the top 10 manufacturers. It is the Lillys of the world and the Pfizers and everybody else that people are familiar with—household names. But the volume of specialty pharmaceuticals is actually still coming out of the mid-tier and the long tail, the biotech sector. And so it is a particularly interesting opportunity for our business.

So we are honing in on it. Appreciate it. It is a great question.

Constantine Davides: Great. And then just in terms of capital deployment, I saw you guys announced a share repurchase plan. And just trying to think about how—or understand how—you are thinking about paying down debt versus deploying it towards buybacks, what we should be expecting there.

Stephen L. Silvestro: Sure. Ed, I will let you handle that one.

Edward Stelmakh: Alright. Thanks, Steve. Hey, Constantine. We are going to look at every opportunity as it comes to us. As you know, historically, we have paid down debt with all of our excess cash flow. And the plan is to continue to do that as much as possible this year as well. But also, we will gauge it against the opportunity to come in and buy back our stock at the right price point. So I guess the easy answer to your question is it depends. But in most cases, you can expect us to spend that money on paying down the debt.

Constantine Davides: Got it. And then maybe one last one for you, Ed. What have you contemplated in guidance in terms of approximate NRR for the year?

Edward Stelmakh: NRR—consistently, we are shooting for anything above 100% as a good marker. We have not really unpacked our guidance based on specific NRR numbers, but I think if you look at where we are guiding now, there is probably some room for slight excess above 100%.

Constantine Davides: Got it. Thank you.

Stephen L. Silvestro: Thanks, Constantine.

Operator: Again, if you have a question, please press star then 1. The next question is from Jeffrey Robert Garro with Stephens. Please go ahead.

Jeffrey Robert Garro: Good afternoon and thanks for taking the questions. I want to ask a few more follow-ups on the end market dynamics—really focused around customer behavior. Curious if any comments you can give on what January and February bookings look like versus December when those pharma companies were still in the middle of negotiating those most favored nation pricing agreements. And then as we think about lower spend early here in 2026, is that likely to result in increased catch-up spend in the back half of the year? Or is there a possibility that piece of the budget is just unlikely to be recaptured this year?

Any particular feedback or anecdotes you are hearing from your customers to support what the likely back half behavior is?

Stephen L. Silvestro: Hey, Jeff. Good to hear from you. The dynamics right now that we are seeing out in the marketplace—which is pretty consistent with everybody in our peer group that I think you are following or are aware of—is exactly what we said. Everyone is a little bit distracted with the MFN negotiations even if they are not directly in those negotiations. They are in a wait-and-see mode. We do think that is disruptive in the first half of the year. That is why we have adjusted the guide to accommodate for that. We do think the business will be back to its 40/60 traditional performance in terms of revenue flow.

And so that would tell you that the back half will probably be a little bit stronger than the first half. In terms of how January, February, etc., are looking, we have already shared a contracted revenue number and told you that we did $9,000,000 in the first half. So you would have to pull that out because we know it is not repeatable, and then we told you where we were year to date. So that should give you the info that you are looking for. We feel pretty confident in the way that we are going to get to the first half, and we feel more confident in the back half.

And the conversations we are currently having with clients, the client satisfaction that we are hearing back from our Chief Commercial Officer, has us feeling bullish on the back half of the year. But again, we have dropped the guide a little bit on the top line just to adjust for some of the things that we have already mentioned. And we have reiterated and raised the guide on EBITDA. So that should be, I think, a pretty good signal on how we feel about the year. Happy to answer more questions around the dynamics, but I think that probably addresses it right now.

Jeffrey Robert Garro: Alright. All super helpful. And maybe to probe a little bit more on visibility and the business shifts to drive more consistent results. Maybe you could update us on converting some of your DAP arrangements to subscription. I think at one point in 2025, it was greater than 5% of annual revenue, I would assume, for 2025, and a later update, you talked about a line of sight into moving that to 10%. So any color you could give on where that subscription mix ended exiting 2025, and how you see that progressing in 2026 would be helpful.

Stephen L. Silvestro: Andy, why do I not have you talk to the conversion factor if you would like? I do not know that we are going to disclose a number yet, Jeff, but Andy can talk to you about the trend we are seeing, and we feel really good about it.

Andrew Jacob D'Silva: Yeah. So we got pretty close to 10% as it relates to exiting the year on that run rate. Obviously, not for the full year. We were between 5% and 10% for the full year.

Stephen L. Silvestro: As you think about it in 2026 and going forward, if we continue to increase DAP as a percent of our overall business, I believe you would start to see a continued increase in the subscription side of the business. And DAP is a key focus area for our growth.

Jeffrey Robert Garro: Great. Thanks for taking the questions.

Stephen L. Silvestro: Thanks, Jeff.

Operator: The next question is from David Michael Grossman with Stifel. Please go ahead.

David Michael Grossman: Good afternoon, guys. Thanks for taking my question. So just to level set on maybe the macro assumptions underlying the revised guide for 2026. Are you thinking that we have stabilized at a level and should be flat to up from these levels? Are you contemplating incremental degradation? Maybe you could just give us some incremental insight into how you are thinking about that and how that was embedded in the revised guidance?

Stephen L. Silvestro: Sure. Ed, do you want to take that one?

Edward Stelmakh: Yeah. I can take it. Definitely a slower start to the year than we had hoped for. Our current thinking is that as the year goes forward, these things will start to improve—hoping Q2, Q3 is when we really see that come to fruition. Those are the signals we are getting back from the market. They are taking a bit of a pause, trying to digest what MFN means to their individual portfolios. They are signing up for shorter-duration contracts out of the gates, but eventually they will open up their wallets and continue to market like the kind of industry they have been for many, many years.

David Michael Grossman: Is your sense that it will be more of a fourth quarter—a back-end loaded year—than we typically have in the fourth quarter? Or do you expect it will be similar?

Edward Stelmakh: It is hard to predict, but I would look at it in a similar way we had a few years ago—a slowdown in FDA approvals. Pharma watches certain factors like that very closely. So anytime there is any kind of disruption, or change in course, they will usually hit the pause button or pump the brakes a bit, but then come back strong in the back half of the year.

David Michael Grossman: And on the net revenue retention, how much is the decline in the fourth quarter related to managed services? Or was managed services in the fourth quarter similar to what you saw in the fourth quarter last year? Just trying to get a sense because it looks like NRR dipped a little bit in the fourth quarter. And just wondering if that is really tied to the managed service dynamic or if there are other things at play there like the reduced spending.

Edward Stelmakh: It is partially that. It is also the buy-ups and the conversion to a subscription model that happened in 2025. It just moved out to where revenues are recognized. So those two factors contribute to the drop.

David Michael Grossman: Got it. And I guess, Steve, just on your AI commentary, when you are talking to these large pharmaceutical companies, what are they sharing with you in terms of their own internal deployment and where they want you to fill in terms of how they are deploying AI on the marketing side of the house?

Stephen L. Silvestro: Sure. Happy to comment on it, and then I know we are looking to see you here next week so we can chat some more on it. The large part of what they are trying to do right now is look at it for, basically, internally—the way that they are structuring clinical trials, making that more efficient; large language models; working to train on those large language models; looking to use data that they have got from places like IQVIA or Surescripts or any of the other providers that they have amassed over the years and start to deploy some of that in a more direct way, and create some efficiencies around that.

Those are the big things that they are looking to do, and I already shared the content creation comment, David, which is a huge one. The amount of content, as everybody knows on the call, that pharma creates is enormous. And if they can leverage some of these tools that are coming out to basically eliminate the manual labor associated with building all of that content and the approval process that has constrained that content from getting deployed in a timely manner, that is going to be an unbelievable unlock for the industry. The biggest frustration for pharmaceutical marketers is going through the medical, legal, and regulatory process.

One of the areas that they are really looking at is trying to use AI to eliminate the need to go through that entire process the way that it is currently constituted. You could think about medical simulations. You could think about legal—obviously, legal is a huge place that could be disrupted with this—and then on the regulatory front, same thing. Those are all places where large language models and AI can absolutely disrupt or replace what is going on in those spaces. And so if pharma is successful in the deployment of what is being called by McKinsey and others, Agentic AI, they will be able to speed their time to get things to market.

So drugs—getting through approval and getting launched and getting deployed—will be significantly faster than it currently is. That will give them way more marketing opportunities and more marketing budget to focus on execution, which is what they really want to spend money on. And that is where we sit. We sit on the execution side.

David Michael Grossman: Okay. Thank you very much.

Operator: The next question is a follow-up from Constantine Davides with Citizens. Please go ahead.

Constantine Davides: Thanks for letting me ask one more. Steve, at the end of 2026, you guys announced a few new partnerships and transitioned—looks like transitioned—a couple to exclusivity arrangements. So wondering if you can talk about your ongoing efforts there. I think, for exception, that world was pretty well canvassed, but just how much more room to run is there in both the EHR world, but also the stand-alone prescribing arena?

Stephen L. Silvestro: Thanks for the question, Constantine. It is a great one. It is important for everyone to know EHR and e-prescribe are two different animals, and every EHR has an e-prescribe module that is bolted into it. In some cases, the EHR owns the e-prescribe and it is native. In other cases, they have integrated an e-prescribe into it. So those are two different points of connectivity that we have. What we are really focused on is expanding not just our EHR footprint, but what we call our point of prescribe footprint as well.

The reason for that is we want to make sure that we are actively engaging in the digital conversation with the prescriber when they are contemplating the diagnosis and prescription therapy selection and subsequently transmitting that to whatever pharmacy it is going to go to after the real-time benefit check and so on and so forth. So it is less about platforms that we do not have. It is more about further integration into those platforms and making sure that we are consistently embedded in every part of the workflow that we can be.

Now, just on your question around the exclusivity, we were able to peel back a few channel partners from competitors who had signed agreements with these specific channel partners and either failed to pay the channel partner, failed to perform, or did not deliver on what they said they were going to deliver. Those channel partners proactively approached OptimizeRx Corporation through our channel lead, who does a phenomenal job with relationships, and wanted to become part of the network. To me, that is a huge positive signal that we are doing good by our partners and striving to be the best partner that we can for them, and that is why we have more people coming.

I am excited to share more about that. I am not going to share names on this call, Constantine, but at some point, you are going to see press releases with the names and joint statements from me and those additional channel partners coming in the not too distant future.

Constantine Davides: Thanks for the additional color, sir.

Stephen L. Silvestro: You got it. Did that answer the question? I just want to make sure I got it.

Constantine Davides: Absolutely.

Stephen L. Silvestro: Okay. Thanks.

Operator: This concludes our question and answer session. I would like to turn the conference back over to Stephen L. Silvestro for any closing remarks.

Stephen L. Silvestro: Thank you, Operator. Thank you all for joining us today. I would like to end by congratulating and thanking the entire OptimizeRx Corporation team for a tremendous 2025. We deeply appreciate their dedication and hard work as we navigate an increasingly complex and rapidly evolving digital pharma marketing landscape. Our industry is undergoing significant transformation; our products and services are uniquely positioned to redefine how pharmaceutical brands, patients, and prescribers connect. Our mission-driven culture continues to fuel innovation and execution, enabling us to attract and retain strong partnerships while reinforcing our role as a trusted and long-term technology partner.

While we remain in the early stages of what is still a relatively nascent industry, we are confident that our proven business model, solutions, and technology platform are directly addressing the evolving needs of our customers. Our synchronized HCP and DTC marketing capabilities powered by real-time brand eligibility signals, combined with expanded functionality such as micro-neighborhood targeting, allow us to deliver hyper-local, privacy-safe audiences across both patients and prescribers. These differentiated capabilities continue to expand our competitive moat and strengthen our market leadership. For the remainder of the year, our priorities are clear. We are intensely focused on increasing customer utilization of DAP and building greater revenue predictability by transitioning more customers to a subscription-based model.

Establishing a consistent recurring revenue component is a critical step as we advance toward becoming a sustained Rule of 40 company. We believe these initiatives will be transformative and central to driving long-term shareholder value for OptimizeRx Corporation. Thank you again for your time today. I look forward to speaking with you on our next earnings call and connecting with many of you at the upcoming industry conferences. Operator, please proceed with OptimizeRx Corporation's safe harbor statement.

Operator: Thank you, sir. Before we conclude today's call, I would like to provide the company's safe harbor statement that includes important cautions regarding forward-looking statements made during today's call. Statements made by management during today's call may contain forward-looking statements within the definition of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. These forward-looking statements should not be used to make investment decisions. The words “anticipate,” “estimate,” “expect,” “possible,” and “seeking,” and similar expressions identify forward-looking statements. They speak only as of the date that such statements were made.

Forward-looking statements in this call include statements regarding our plans to drive sustainable long-term growth; plans for shareholder value creation; converting more customers to our recurring model; becoming a sustained Rule of 40 company; strength of our operating model; experiencing minimal disruption from AI; unlocking new opportunities for profitable revenue growth; plans to make our revenue streams more predictable; plans to drive substantial operating leverage; estimated 2026 revenue and adjusted EBITDA ranges; long-term outperformance on both the top and bottom lines; continued strong momentum in the med tech sector; ability to improve patient outcomes and to transform engagement across the healthcare ecosystem; ability to consistently expand relationships with our largest customers; estimation of total addressable market size; ability to capture additional market share and expand our role within the pharma digital ecosystem; market penetration; revenue growth; gross margin; operating expenses; profitability; cash flow; technology; investments; growth opportunities; acquisitions; and upcoming announcements.

Forward-looking statements also include management's expectations for the rest of the year. The company undertakes no obligation to publicly update or revise any forward-looking statements whether because of new information, future events, or otherwise. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified. Future events and actual results could differ materially from those set forth in, contemplated by, or underlying these forward-looking statements.

The risks and uncertainties to which forward-looking statements are subject include, but are not limited to, the effects of government regulation; competition; dependence on a concentrated group of customers; cybersecurity incidents that could disrupt operations; the ability to keep pace with growing and evolving technology; the ability to maintain contracts with electronic prescription platforms and electronic health records networks; and other material risks. Risks and uncertainties to which forward-looking statements are subject that could affect business and financial results are included in the company's Annual Report on Form 10-K for the year ended 12/31/2023 and in other filings the company has made and may make with the SEC in the future.

These filings, when made, are available on the company's website and on the SEC website at sec.gov. Before we end today's conference, I would like to remind everyone that an audio recording of this conference call will be available for replay starting later this evening and running for a year on the Investors section of the company's website. Thank you for joining us today. This concludes today's conference call. You may now disconnect your lines.