OptimizeRx (OPRX) Q4 2025 earnings summary

Executive summary

• Q4 2025 revenue reached $32.2 million, nearly flat year-over-year, while full-year revenue grew 19% to $109.4 million, with adjusted EBITDA of $12 million in Q4 and $24.3 million for the year, both exceeding expectations.

• Q4 gross profit rose 9% year-over-year to $24.1 million; full-year gross profit reached $73.6 million, up from $59.4 million.

• Q4 GAAP net income was $5.0 million versus a net loss in Q4 2024; full-year GAAP net income was $5.1 million, reversing a $20.1 million loss in 2024.

• Growth was driven by both large clients and rapid expansion among mid-tier and long-tail life science companies.

• Product mix improvements and cost optimization post-Medicx acquisition led to higher gross margins and more than doubled adjusted EBITDA and free cash flow year-over-year.

Financial highlights

• Q4 2025 revenue: $32.2 million; full year 2025 revenue: $109.4 million.

• Q4 adjusted EBITDA: $12 million; full year adjusted EBITDA: $24.3 million.

• Q4 net income: $5 million ($0.26 per diluted share); Non-GAAP net income: $9.9 million ($0.51 per share).

• Full-year non-GAAP net income was $19.9 million ($1.05/share), up from $6.2 million ($0.33/share) in 2024.

• Year-end cash and short-term investments: $23.4 million; operating cash flow for 2025: $18.7 million.

Outlook and guidance

• 2026 revenue guidance: $109 million–$114 million; adjusted EBITDA: $21 million–$25 million.

• Guidance reflects a more conservative revenue outlook due to reduced managed services and shorter contract durations.

• Gross margins expected to normalize to mid-60% range in 2026 after an unusually high Q4 2025.

• Management remains focused on sustaining Rule of 40 performance and expects continued strength into 2026.

• Revenue phasing expected to return to historical 40%-60% split between first and second half.