Paysign Q4 2025 Earnings Call - Patient affordability scales, driving a clear margin inflection

Kevin, Moderator/Investor Relations, Paysign: As a reminder, this conference call is being recorded. The comments on today’s call regarding Paysign’s financial results will be on a GAAP basis, unless otherwise noted. Paysign’s earnings release was disseminated to the SEC earlier today and can be found on the investor relations section of our website, paysign.com, which includes reconciliations of non-GAAP measures to GAAP-reported amounts. Additionally, as set forth in more detail in our earnings release, I’d like to remind everyone that today’s call will include forward-looking statements regarding Paysign’s future performance. Actual performance could differ materially from these forward-looking statements. Information about the factors that could affect future performance is summarized at the end of Paysign’s earnings release and in our recent SEC filings. Lastly, a replay of this call will be available until June 24th, 2026.

Please see Paysign’s fourth quarter and full year 2025 earnings call announcement for details on how to access the replay. It’s now my pleasure to turn the call over to Mr. Mark Newcomer, President and CEO. Please go ahead.

Mark Newcomer, President and Chief Executive Officer, Paysign: Thank you, Kevin. Good afternoon, everyone, and thank you for joining us today for Paysign’s year-end 2025 earnings call. I’m Mark Newcomer, President and Chief Executive Officer. Joining me today is Jeff Baker, our Chief Financial Officer. Also on the call are Matt Turner, our President of Patient Affordability, and Matt Lanford, our Chief Payments Officer, both of whom will be available for Q&A following our prepared remarks. Earlier today, we announced our fourth quarter and full year financial results for 2025, which demonstrated continued strength and exceptional growth across all key metrics. For the full year, revenue increased 40.5% to $82 million. Net income increased 98% to $7.6 million, and adjusted EBITDA increased 107% to $19.9 million.

Importantly, operating margins increased 723 basis points, providing clear evidence that we’ve reached a key inflection point where future revenue growth should drive increasing operating leverage and profitability. We continue to deliver strong growth in our patient affordability business. Annual revenue grew 168% year-over-year, reaching $33.9 million compared to $12.7 million in 2024. Claims processed increased by approximately 79%. For those newer to our story, our patient affordability platform helps pharmaceutical companies ensure patients can access high-cost medications by administering co-pay assistance programs. In 2025, our platform helped deliver nearly $1 billion in financial assistance to patients, supporting access to high-cost therapies for more than 840,000 individuals.

At the same time, we help manufacturers better control how those dollars are spent, which is one of the key value propositions we provide. A key differentiator of our platform is our dynamic business rules technology, which helps pharmaceutical manufacturers avoid unnecessary costs associated with co-pay maximizer programs. In 2025 alone, the solution saved our clients over $325 million, and this year we have already saved our clients almost $150 million. That level of savings represents a meaningful economic benefit for our customers and highlights the value of our platform. We added 55 programs during the year, bringing total active programs to 131 across more than 70 patient affordability clients. A mix of transition programs and new launches contributed to both immediate and long-term revenue growth.

Our programs span both retail and specialty pharmacy, as well as in-office administered and infused products. Oncology and other cancer treatment products remain a significant portion of our program base, and biologics represent approximately 50% of claim volume across the platform. We continue to see strong expansion within our existing client relationships. For example, following the onboarding of one of the nation’s largest pharmaceutical manufacturers in 2024, those programs scaled successfully throughout 2025, and we added four additional programs from that same manufacturer during the year. This type of expansion within large pharmaceutical clients highlights both the scalability of our platform and the durability of demand. Paysign now has active programs with six of the top 10 U.S. pharmaceutical manufacturers ranked by revenue. Next month, we attend the Asembia Specialty Pharmacy Summit here in Las Vegas.

As in prior years, we are seeing strong interest from potential clients evaluating our solutions, and we enter the conference with a robust pipeline. Over the past several months, we’ve had conversations with shareholders, analysts, and prospective investors to help them better understand the patient affordability business and the broader industry landscape in which we operate. Increasingly, those discussions have touched on legislative, regulatory, and policy-related topics. I thought it would be helpful to ask Matt Turner, our President of Patient Affordability, to provide some additional context.

Matt Turner, President of Patient Affordability, Paysign: Thank you, Mark. Before addressing some of the questions we’ve been hearing from investors and analysts about potential headwinds to our business, I want to briefly give an overview of how our patient affordability business fits within the broader healthcare ecosystem. Our platform is focused on helping pharmaceutical manufacturers support patient access to high-cost branded therapies, primarily within the commercially insured patient population. These are typically branded medications where out-of-pocket cost can be significant and where co-pay assistance programs are essential to ensuring patients can begin and stay on therapy. At the same time, our platform helps manufacturers better manage how those assistance dollars are deployed, particularly in an environment where payer dynamics can introduce inefficiencies into the system. That combination of improving access while also driving economic value is what underpins the demand for our solutions. With that context, I’ll address a few areas we’ve been asked about.

First, on the expansion of the direct-to-consumer, also known as DTC, and cash pay models. These programs have existed in various forms for over a decade and are not new. They were built primarily for products with little or no commercial insurance coverage. That is a very different segment from where we operate today. For the types of high-cost branded therapies on our platform, where list prices can be tens of thousands of dollars, which represents approximately 90% of the drugs in our platform, cash pay and discount alternatives are simply not a viable solution for most patients. Commercial insurance, combined with manufacturer copay assistance, remains the most effective model for patients. As a result, we view DTC expansion as a complementary solution in certain cases, but not a meaningful substitute for our core business. Second, regarding pharmacy discount programs such as GoodRx, TrumpRx, Cost Plus, or similar offerings.

These products have existed for more than 20 years and serve an important role in reducing cost for lower-priced generic medications or for those patients without insurance. They are not designed for, nor do they compete with, branded specialty medications where commercial insurance and copay programs are the standard of care. Our business is squarely focused on that branded drug segment and the more than 850 specialty drugs, so these programs are simply not relevant to what we do. Third, and perhaps most important, given the current policy environment on legislative and regulatory considerations, most of the activity around copay accumulator and maximizer programs have taken place at the state level. Despite ongoing discussions in congressional committees, there has been no meaningful federal action to date, nor do we expect any in the foreseeable future. The key reason is simply structural.

A large portion of commercially insured Americans are covered under employer-sponsored health plans governed by ERISA, which limits the impact of state-level regulations. We do not see that as changing. As a result, these programs continue to operate despite changes in state laws. Importantly, demand for our dynamic business rule solutions, which helps manufacturers navigate maximizer programs, continues to grow. As Mark said, this year, we have already saved our clients almost $150 million that would otherwise have been absorbed by those programs. Stepping back, we continue to monitor the competitive and regulatory landscape closely. Based on what we see today, we do not view these dynamics as a material threat to our business. If anything, they continue to reinforce the need for solutions like ours, which is reflected in the continued growth of our business and pipeline.

Our differentiated dynamic business rules capability is a driving tangible ROI for our pharma customers while we enhance affordability for hundreds of thousands of consumers. Back to you, Mark.

Mark Newcomer, President and Chief Executive Officer, Paysign: Thank you, Matt. Turning to our plasma donor compensation business. In 2025, plasma compensation contributed $45.6 million in revenue, representing a 4% increase over 2024’s $43.9 million. We believe the business will continue to exhibit revenue growth, driven primarily by center filling excess capacity rather than new center openings. That said, we do expect a modest number of new center openings in 2026, maintaining our market share of just under 50%. We exited 2025 with 595 centers, an increase of 115 centers over the previous year, and we continue to engage the remaining plasma collection companies who are currently not our customers. We believe our expanded suite of donor management and engagement tools we acquired last year creates additional opportunities to grow our footprint in this space.

As we await FDA 510(K) review of our donor management system, also known as a BECS or Blood Establishment Computer System, we are actively working to integrate the BECS with a number of plasmapheresis devices and strengthen our relationship with those manufacturers to make installations and transitions to our solution as seamless as possible. This integration is included in our latest filing with the FDA. Our broader suite of solutions continue to receive positive feedback from blood and plasma collection organizations across the United States, Europe, and Asia, and we are highly encouraged by the long-term growth potential of this business. 2025 marked a meaningful step forward as our patient affordability business scaled and became a central driver of growth and profitability, while our plasma business continued to provide a stable foundation.

We believe we are still in the early stages of our patient affordability opportunity and enter 2026 with strong momentum in which to build upon. With that, I’ll turn it over to Jeff for additional details on our quarterly and full year-end financial results.

Jeff Baker, Chief Financial Officer, Paysign: Thank you, Mark. Good afternoon, everyone. As Mark highlighted, the fourth quarter and full year results reflect both strong growth in our patient affordability business and the early benefits of operating leverage across the platform. For 2025, total revenues increased 40.5% to $82 million. Pharma industry revenue increased 167.8% to $33.9 million, driven by the addition of 55 net patient affordability programs launched during the past 12 months, and a corresponding increase in monthly management fees, setup fees, claim processing fees, and other billable services such as dynamic business rules and customer service contact center support. Processed claims increased over 79%. This growth reflects continued expansion of our platform and increasing demand for solutions that improve patient access while helping manufacturers better manage their co-pay assistance spend.

Plasma revenue increased 4% to $45.6 million, primarily due to the addition of 115 net plasma centers added during the past 12 months, offset by a decline in average plasma donations per center as plasma inventory levels were elevated throughout much of 2025. This led to a reduction in our average monthly revenue per center as compared to the same period in the prior year. We exited the year with 595 centers versus 480 centers at the end of 2024. Other revenue increased by $671,000 or 36.2%, primarily due to the growth in usage in the number of cardholders of our payroll, retail, and corporate incentive programs. More importantly, we are beginning to see the benefits of operating leverage across the business.

Total operating expenses were $41.4 million, an increase of 32.6%, well below the revenue growth we experienced, which coupled with our improved gross profit margin to 59.4% versus 55.1%, drove our operating margins to 9% versus 1.7% the prior year. We have reached an important inflection point where our fixed costs can support meaningful scalability without commensurate increased expenses, so we expect further improvements in these metrics throughout 2026. This is consistent with what Mark described earlier. As patient affordability becomes a larger part of our business, we expect to see continued improvement in margins and operating leverage. Here are a few other important details to point out for the fourth quarter and full year results.

For the fourth quarter, our earnings before taxes increased to $2.5 million versus $1.2 million the same period last year. Fourth quarter net income was impacted by a higher effective tax rate of 45.4%, which reduced earnings per share by $0.02 per fully diluted share versus the prior period. The fourth quarter Adjusted EBITDA, which is a non-GAAP measure that adds back stock-based compensation to EBITDA, was $5.4 million or $0.09 per diluted share, versus $2.9 million or $0.05 per diluted share for the same period last year. The fully diluted share count for the quarters used in calculating the per share amounts was 61.6 million and 55.5 million, respectively. We exited the year with $21.1 million in cash, almost double from the prior year.

This excludes any impact to pass-through receivables and payables we periodically have related to our pharma patient affordability business. We also continue to have zero bank debt, funding operations and our Gamma acquisition through operating cash flow. Turning to our outlook for 2026, we expect revenue of $106.5 million-$110.5 million, representing 30%-35% year-over-year growth, with plasma and pharma contributing equally and other revenue contributing $2.5 million. Considering the seasonality in both our main healthcare businesses, we expect plasma revenue to be the lowest in the first quarter, with tax refunds going out and ramp up throughout the remainder of the year. While we expect pharma revenues to be the highest in the first quarter and decline throughout the remainder of the year as patient affordability claims ramp down.

This outlook reflects continued momentum in our patient affordability business, which we expect to remain the primary driver of growth. Gross profit margins are expected to be between 60%-62%, reflecting increased revenue contribution from our pharma patient affordability business. Operating expenses are expected to increase 20% over 2025 as we continue to make investments in people and technology. Of this amount, depreciation and amortization expense is expected to be between $9.5 million-$10 million, while stock-based compensation is expected to be approximately $5.5 million. Given our large, unrestricted, and restricted cash balances and the current interest rate environment, we expect to generate interest income of approximately $3.1 million. Our full year tax rate is estimated to be between 22.5%-25%.

Net income is estimated to nearly double over 2025, reaching a range of $13 million-$16 million or $0.21-$0.26 per diluted share. Adjusted EBITDA to be in the range of $30 million-$33 million or $0.49-$0.53 per diluted share. The number of fully diluted shares for the year is estimated to be 62.3 million. For the first quarter of 2026, we expect revenue of $27 million-$27.5 million, representing 45.2%-47.8% growth over first quarter 2025, and expect to have 137 active patient affordability programs and 589 plasma centers exiting the quarter.

Margins are expected to expand across the income statement versus the same period last year, equating to an operating margin between 20%-22%, net margin between 17%-19%, and Adjusted EBITDA margin between 34.5%-36.5%. Fully diluted earnings per share is estimated to be $0.07-$0.08, while Adjusted EBITDA per share is estimated to be $0.15-$0.16. Overall, our outlook reflects continued strong growth, driven primarily by our patient affordability business, along with further margin expansion as we scale. With that, I would like to turn the call back over to Kevin for questions and answers.

Kevin, Moderator/Investor Relations, Paysign: Thank you. We’ll now be conducting a question and answer session. If you’d like to be placed in the question queue, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. One moment please while we poll for questions. Our first question is coming from Jacob Stephan from Lake Street Capital Markets. Your line is now live.

Jacob Stephan, Analyst, Lake Street Capital Markets: Hey, guys, appreciate you taking the questions. Congrats on a really nice quarter here. You know, I appreciated all the color on the pharma industry. One thing I kind of wanted to touch on a little bit, so we’re kind of hearing some, you know, pharma services providers, and you know, that the drug manufacturers have actually been kind of less active recently with regards to new initiatives. I’m wondering if you’re seeing any difference in behavior with your pharma manufacturers over the last few months here.

Matt Turner, President of Patient Affordability, Paysign: No, I mean, this is Matt Turner. I would argue that it’s just the opposite. You know, if you were at J.P. Morgan and listening to the conversations there, nobody’s slowing down anything. You know, we were sitting there listening to David Ricks, the CEO of Lilly, and he was talking about the billions of dollars they’re pumping into AI, and you know, the fact they’re doing a deal every nine days. You know, almost all the presentations there really pointed to not a slowdown by any means. Everybody’s pipelines are really strong right now. You know, almost every manufacturer has some form of a weight loss or GLP-1 type product in line. You know, FDA calendar for PDUFAs this year looks really good.

You know, I mean, I don’t really see a slowdown. I would say that the push for innovation is growing overall, and I think that’s obviously what we’ve been trying to provide, you know, for the last seven years as we built out this vertical, really is the innovation side of things. No, I don’t see a slowdown from our perspective at all, especially not in the patient affordability business.

Jacob Stephan, Analyst, Lake Street Capital Markets: Okay. Maybe, I mean, you did kind of touch on the GLP-1 opportunity. I’m wondering, you know, what that looks like for you guys. Do you have any current GLP-1s on the platform? You know, how are you thinking about attacking that market going forward?

Matt Turner, President of Patient Affordability, Paysign: Yeah. That’s we don’t have any of the two larger GLP-1s that are for weight loss, nor do we have the diabetes products. Those are largely retail plays, and we’re certainly making a push. We’ve been making a push in that area. You know, those drugs have been in market now for a little bit. If you look at those products as well, they’re very much a DTC product than they are a traditional copay type product. It’s not to say the copay offers aren’t out there, they are, but it represents a very small subset of that actual volume is going through copay. There’s not a ton of upside on a GLP-1 product used for weight loss.

There would be, if you’re looking at the diabetes sides. You know, we have one client that has a GLP-1 product. I think we’re in an excellent position to win that business, as we do have a very good portion of their retail as well as almost all of their specialty products. I think we’re in a very good spot to pick up a GLP-1 in the next 12-18 months. You know, I think that’s as much as I can really say there. I don’t, you know, we don’t have any commitment saying that it’s ours or anything, and plus, we don’t know what the volume is gonna look like there.

Yeah, we’re certainly trying to make inroads to get access to more of those programs.

Jacob Stephan, Analyst, Lake Street Capital Markets: Got it. Maybe just last one for me. Jeff, you made an interesting comment about fixed costs, you know, potentially kind of plateauing, minimal additions kind of needed. I’m wondering, you know, from just looking at the math, you know, that looks like around a $22 million-$23 million quarterly kind of cost basis. I’m wondering if you could kind of give me some more color on that.

Jeff Baker, Chief Financial Officer, Paysign: Yeah. The comment really, when we talk about, you know, fixed costs, is like the base cost of what our business has been in 2025. We looked at our OpEx of $41 million. The incremental cost that we have to add going forward as the business grows is certainly a lot less than what it has been historically. If you look at 2024, we were pushing, you know, SG&A growth was pretty much tracking with revenue growth. 2025, really strong improvements there. In 2026, we think there’s even more operating leverage to lend out of that business. When you look at it, you know, we’re gonna do a good job trying to control our costs. We’re only looking for SG&A to grow 20%.

When you peel the onion back, you know, keep in mind. You know, some of that growth is related to the acquisition we did in March. It wasn’t even in for a full year in 2025. So you have a full year of amortization in 2026. And then you have some stock comp increase about $1.5 million year-over-year. So take those two however you wanna look at that and adjust it out or whatever. But our, you know, our controllable SG&A is really looking very leverageable.

Jacob Stephan, Analyst, Lake Street Capital Markets: Got it. I appreciate all the color. Great quarter, guys.

Jeff Baker, Chief Financial Officer, Paysign: Yeah, thanks.

Kevin, Moderator/Investor Relations, Paysign: Our next question today is coming from Gary Prestopino from Barrington Research. Your line is now live.

Gary Prestopino, Analyst, Barrington Research: Hi, good afternoon, all. Hey, I couldn’t write down fast enough. Did you say you were gonna exit Q1 with about 137 pharma programs?

Jeff Baker, Chief Financial Officer, Paysign: Yes, that’s correct.

Gary Prestopino, Analyst, Barrington Research: What did you say for the plasma? Was it $589?

Jeff Baker, Chief Financial Officer, Paysign: 589. Yeah, we had in the first quarter we had 5 centers get sold to a competitor. They left us, and then 1 center closed. There are 6. Those are the 6 centers.

Gary Prestopino, Analyst, Barrington Research: Okay. Okay, that’s fine. Just getting back to when you were talking about like the GLP-1s versus your, you know, high-cost branded pharmaceuticals, is there any difference in the revenue per claim process there if you’re doing, you know, basically kind of, lack of a better word, it’s not really a specialty drug, like a, say, a cancer and oncology drug?

Jeff Baker, Chief Financial Officer, Paysign: Yeah. I mean, each claim type, right, is gonna have different potential transactional fees that will attach to it. If you look at the specialty, you know, and I would say that overall, you know, if you just look at a base, say, pharmacy claim or medical claim, it doesn’t really matter if it’s specialty or pharmacy. We’re gonna make on that claim processing fee about the same. When you look at the bolt-ons that can happen in the specialty space, they compound pretty quickly. You know, a dynamic business rule claim is worth far more to us than just the singular co-pay claim.

While the volume around retail products like GLP-1s or, you know, any of the cardiovascular drugs, you know, if you go back historically and look at like Crestor, Lipitor, Plavix, modern-day Brilinta, sure, there’s a lot of volume there, but your chance to make, you know, to kinda add on the additional functionality, that can generate larger revenue is just not there on the retail side, which is one of the reasons we highly target the specialty space, because we can make far more money on 1,000 DBR claims than we can on, say, 20,000 retail claims. Profit potential, you know, and even bottom line margin is far superior in the specialty space.

That being said, we are working to bring on more retail brands so that we have a very weighted and comprehensive portfolio of products.

Gary Prestopino, Analyst, Barrington Research: Okay. Thank you.

Kevin, Moderator/Investor Relations, Paysign: Thank you. Our next question is coming from Jon Hickman from Ladenburg Thalmann. Your line is now live. Our next question is coming from Peter Heckmann from D.A. Davidson. Your line is now live.

Peter Heckmann, Analyst, D.A. Davidson: Hey, good afternoon, everyone. I had a follow-up, Jeff, on, in terms of thinking about the guidance for 2026. You talk about equal contribution from plasma and pharma. I assume you’re talking about it from a dollar revenue perspective. If so, that still represents a pretty significant acceleration on the plasma side. I didn’t hear in your prepared comments, you know, why that might be. If you could provide a little bit of additional color in terms of whether that’s an increase in revenue per center or anticipation of a big addition of net centers for the year.

Jeff Baker, Chief Financial Officer, Paysign: Yeah. Sorry.

Kevin, Moderator/Investor Relations, Paysign: No, go ahead.

Jeff Baker, Chief Financial Officer, Paysign: The revenue comment was the comment on the whole business was revenue both from the plasma and the patient affordability or pharma side. One of the main drivers in the plasma, if you recall, we had 132 centers in June and July. So we’re gonna have those uncomped until that time, so midyear. So you’re gonna see the growth of plasma with those numbers for the first half of the year be much stronger than the second half of the year, obviously. My expectations haven’t changed with plasma is that in a normalized year it’s about a 5% grower, you know, and it’s a very good cash cow, and we manage the business accordingly.

Let me give a little more color on the plasma revenue growth. The increase in collection efficiencies associated with the latest hardware upgrades effectively gives the average plasma center approximately 10% greater capacity. A good way to look at that would be for every 10 centers, a collector can now get 11 centers worth of capacity, which is reducing the demand for new center openings. That just, you know, it gives them the ability to collect more.

Peter Heckmann, Analyst, D.A. Davidson: I see. That’s helpful. Okay. Just going back to the new BECS system, any feedback so far from the FDA or any thoughts in terms of the

Matt Turner, President of Patient Affordability, Paysign: Potential timeline there for the year for their completion of the review.

Jeff Baker, Chief Financial Officer, Paysign: Yeah, I mean, it’s currently under review. We expect to hear back from them within the next 60 days. That’s kind of about as much as I’ll go into at this point, but so far, everything’s very positive. We’ve gone into our substantive review with them.

Matt Turner, President of Patient Affordability, Paysign: Okay, that’s good to hear. Thank you.

Jeff Baker, Chief Financial Officer, Paysign: Yep. Welcome.

Kevin, Moderator/Investor Relations, Paysign: Thank you. Our next question is coming from Jon Hickman from Ladenburg Thalmann. Your line is now live.

Jon Hickman, Analyst, Ladenburg Thalmann: Hi. Could you give us some sense of where you are on the pharma side with your kind of part of the market? What’s the TAM here and where like are you in the second inning, third inning of growth here or can you elaborate?

Matt Turner, President of Patient Affordability, Paysign: We always hesitate to give the TAM because it’s very difficult for us to give a TAM for something that you can’t, you know, there’s no way to exactly tell. The dollars are wrapped up in marketing amounts and everything else, and nobody discloses exactly how much money they’re paying these vendors. We estimate the TAM is somewhere between, you know, $500 million-$850 million at any given time. You know, we think with some of the offerings that we have, specifically with dynamic business rules, that we are pushing that TAM higher, as we’re able to generate revenue from some of these unique offerings that we’re bringing to the table.

Also, as you know, as we continue to build this out and add more features, add more products, we think the TAM can expand, you know, even further, you know, upwards to a billion. Asking about if we’re, you know, kind of what inning we’re in. I think we’re in the first inning. There’s still a lot of growth potential here. We don’t see anything slowing down when it comes to, you know, to new program acquisition. If you look at the growth that we’re doing year-over-year, and not just from a dollar perspective, right? Just from a, you know, also throwing in the number of programs that we’re adding in. You know, last year it was one every 6-point-something days, we were putting a new program up.

You know, hopefully this year we have similar metrics as far as the number of programs that we’re pulling in. Yeah, we’re nowhere near the middle of this at all. We’re very much in the beginning and I think we’ll continue to see very strong growth out of this vertical for many years to come.

Jon Hickman, Analyst, Ladenburg Thalmann: To follow up. So are you inviting competition here? Like, are people starting to pay attention to what you’re doing?

Matt Turner, President of Patient Affordability, Paysign: I mean, that. Yeah.

Jeff Baker, Chief Financial Officer, Paysign: There’s always really been competition.

Matt Turner, President of Patient Affordability, Paysign: Yeah.

Jeff Baker, Chief Financial Officer, Paysign: Right?

Matt Turner, President of Patient Affordability, Paysign: Yeah.

Jeff Baker, Chief Financial Officer, Paysign: I mean, we’ve come into the market and really gone up against the competition. By bringing new functionality, new features to the market, that’s part of the reason why we’re winning the business.

Matt Turner, President of Patient Affordability, Paysign: Yeah, this was a very stale business that had become almost commoditized. It was, you know, treated like just picking something off of the shelf. That made it very easy for some manufacturers and, you know, of course, they enjoyed that when things like maximizers and accumulators weren’t an actual threat to, you know, to their bottom line. As that has emerged as a bigger threat, the need for innovation was there. Unfortunately, kind of the legacy, you know, dinosaurs in the industry just never reacted. You know, yeah, there’s some new players popping up, you know. That happens every time there’s an industry that’s ripe for disruption. I would say the good thing for us is we were ahead of that, and we also helped to cause a lot of the disruption.

If you look at how we have sold into this industry, you know, we’ve really shaken a lot of things up and forced manufacturers to rethink how co-pay programs should function as a whole, how they should pay for them. The open book pricing that we brought to the table, where we’re not making shady money, that we can’t tell people how we’re getting paid, like, that really was a disruptor to this marketplace.

If you kinda look at our, you know, the catapult that we had for growth, you go back to, I think it was 2023 when we, in June, July, when we put out a webinar around pricing transparency and a lot of things in that area, that was really part of the lift off for us, because we did show the industry there’s a better way to do this. You can still make money, you can still have everything that you need, just we can do it in a way to where we’re not robbing you blind behind your back, which is what a lot of other competitors were doing.

Jeff Baker, Chief Financial Officer, Paysign: Another thing, Jon, you know, when we look at our competitive advantage, certainly that’s one very important one. Another one is, we take it for granted as a payments company, but our competitors don’t have the same, let’s say, insight into, for their pharma customers’ programs like we do. I mean, we give our customers a web portal. They come in, they can see bank balances, they can see transaction data. They see a lot of information that we’re able to provide them, so they could figure out if their program is successful or not. We take that for granted as, you know, it’s kind of table stakes as a payments company, but our other competitors don’t have that because they’re not payments companies.

The last thing is the dynamic business rules. I can’t stress enough the fact that with 97% efficacy on first fill, that’s completely agnostic to the consumer that is getting their drug. That we’re able to identify whether that transaction is related to a maximizer program or not. That’s huge. It’s unheard of, and nobody else in the market has that technology.

Jon Hickman, Analyst, Ladenburg Thalmann: Okay, one more question. Matt, what are you most worried about here on this side of the business?

Matt Turner, President of Patient Affordability, Paysign: That’s a tough one. I don’t, you know, I don’t know that right now we really have a lot of worries. It’s pretty positive on our side. If you look at what we’ve built out, I would say going back three years, it was a lot around personnel and how would we scale this inside with people. It was about finding talent at that point that we could bring in and that could help the organization grow. We spent the last few years really doing that. We invested a lot of time and energy in bringing the right people, in creating a pathway for people that were really good to be able to grow inside the organization.

You know, now that we have that in place, as you look at over the 55 programs that we brought in last year, we didn’t have a growth issue when it came to dealing with people. We had already actually built the systems around that. We were able to just drag people in, drop them into the right place. We have established training curriculums now. It’s become a much easier lift for us. I would say I don’t really have any fears at the moment. It’s all positive for us right now. You know, we look forward to the continued growth that we have. We’re looking forward to expanding on the partnerships that we currently have.

Jon Hickman, Analyst, Ladenburg Thalmann: Okay, thank you very much. Nice results.

Matt Turner, President of Patient Affordability, Paysign: Thank you.

Jeff Baker, Chief Financial Officer, Paysign: Thank you.

Kevin, Moderator/Investor Relations, Paysign: Thank you. Our next question is coming from Gary Prestopino, Barrington Research. Your line is now live.

Gary Prestopino, Analyst, Barrington Research: Yeah, I just have a follow-up. Mark, did you give any indication of your pipeline on the patient affordability side? I mean, at times you have said that you feel pretty confident you’re gonna exit the year at X amount of programs. Could you maybe just comment on that?

Matt Turner, President of Patient Affordability, Paysign: This is Matt. I don’t know that we’ve ever given that guidance this early in the year.

Jeff Baker, Chief Financial Officer, Paysign: No.

Matt Turner, President of Patient Affordability, Paysign: You know, I’ll also kinda point back to our selling cycle, which is, you know, for most of our opportunities, you know, in the 90-day area. You know, we know what the pipeline looks like right now for a number of opportunities. I think we would probably comment on that as we got a little more

Jeff Baker, Chief Financial Officer, Paysign: Correct.

Matt Turner, President of Patient Affordability, Paysign: A little further down the year, you know, after the Asembia conference, things like that. That’s really where we kinda start to narrow down what we think the pipeline will look like between now and the end of the year. Plus, it gives us a chance to do a better evaluation of the FDA PDUFA calendar and what opportunities out of that we believe are, you know, are truly winnable for us. Yeah, I don’t think we can give a number of programs this early in the year, but hopefully we can do that, you know, in the next quarter if everything lines up right.

Gary Prestopino, Analyst, Barrington Research: All right. You know, you guys are doing really well and, you know, obviously the stock market’s been a you know, miniature disaster the last couple of months here. Doesn’t look like, obviously, the fundamentals of the business are reflected in the stock price. I’m just wondering, as you go around and talk to investors, is it that they don’t understand what’s going on with your company? Is there, say, a fear that artificial intelligence is going to usurp maybe your ability with your dynamic business rules? You know, is it? What can you pinpoint as to what is some of the hesitation among investors to grasp the story?

Jeff Baker, Chief Financial Officer, Paysign: Yeah, Gary. When we talk to investors, you know, everybody obviously understands the plasma business is kinda like retail, same store sales type stuff.

Gary Prestopino, Analyst, Barrington Research: Right.

Jeff Baker, Chief Financial Officer, Paysign: I think the biggest, you know, the market’s been in a show-me state, sort of speak, with the operating leverage from the Patient Affordability business. Now, there’s a lot of noise out there always with direct to consumer. If you remember back when Donald Trump was gonna solve all the pricing issues, he had his own TrumpRx, and he had his direct to consumer initiative. Quite frankly, I mean, they announced that I think there were 30 drugs or something, whatever. We had 2 of them on there. The pricing on the direct to consumer side for those cash paying customers was cheaper if you had insurance than if you paid directly to the consumer.

Keep in mind, there’s roughly 160 million people out there on private insurance. That’s what these co-pay programs are for. It’s not for the cash paying customer. I think people don’t necessarily understand co-pay. I know for a fact they don’t understand co-pay. We’re gonna work really hard in 2026 to tighten that message, to make sure people understand that there is a co-pay. The co-pay really exists. There’s a market for co-pay. We have a better mousetrap that nobody else has, and it’s showing up in the numbers. Now this year in 2025, you definitely saw the operating leverage possible.

I mean, our operating margin goes from 1.7% to 9%, and that’s not insignificant. Then, you know, based on the guidance that I’ve given, you know, we expect that to go up substantially in 2026 and beyond. You know, I can’t control the stock price or the investor community or whatever, but I think the numbers speak for themselves, and eventually the market is efficient over the long term.

Matt Turner, President of Patient Affordability, Paysign: One thing I’ll add, too, if you look at the other competitors that we have in the marketplace, if you go and look at, you know, Syncora, you look at McKesson, they both own, you know, copay offerings, right? It’s such a small part of their balance sheet that it never gets brought up in an earnings call. We’re really the first public company that’s out here talking about this to our analysts who are trying to absorb this information because, you know, for us, it’s not a rounding error. For McKesson, for Syncora, this represents a de minimis part of their overall portfolio. I think it’s also given the street a chance to catch up to see this as a new offering in the market.

Hopefully, you know, they’ll get behind this and, you know, we’ll have more people understand it. I think the private equity market understands as well. There’s a number of private equity funds that have purchased assets like this privately. If you were to go look at the private markets, there’s a lot of M&A activity happening in this space, not just the copay space, but patient services as a whole. It’s constantly changing. So, you know, we had a chance to go down to the Cantor HCIT conference and meet with a bunch of people and just listen to what they had to say. It’s, you know, there’s a lot of activity in this space. It’s just not in the public market.

I think that’s part of the headwind for us too, is explaining that, and having people understand that there’s a bigger amount of money at play here than what it just seems like on our side.

Gary Prestopino, Analyst, Barrington Research: What about from the standpoint of, you know, your competitive advantages, those dynamic business rules. Is there a feeling out there, and I guess this is the stupid AI question, could AI somehow usurp what you’re doing in the market?

Matt Turner, President of Patient Affordability, Paysign: I mean, I joke with clients when we talk on the phone that, you know, AI can do anything that you can dream up. I just don’t know when it’s gonna be able to do it. You know, I mean, AI, we don’t view AI as a threat. We’re working internally to build out, you know, our own AI-based systems to help us make our algorithms stronger, so that we spot maximizers and accumulators easier. You know, I think the other part of that to say is that just because they change what they’re doing one time, doesn’t mean that we won’t be right there changing it to find it.

Not to go into a ton of detail, but once I have one patient and I know that patient’s, you know, impacted by a maximizer, it doesn’t matter what the plan does, I can back into that patient because I know they were a maximizer patient yesterday. They’re probably a maximizer patient today. We don’t think that’s really a threat to our business model. You know, we see AI on our side as actually a positive, and we’re gonna be implementing more of that on the patient affordability side to help us have a stronger, more robust product across our vertical.

Gary Prestopino, Analyst, Barrington Research: Okay, thank you.

Kevin, Moderator/Investor Relations, Paysign: Thank you. We’ve reached the end of our question and answer session. I’d like to turn the floor back over for any further closing comments.

Mark Newcomer, President and Chief Executive Officer, Paysign: Thank you, Kevin. In closing, we delivered strong results in 2025. We remain confident in our long-term strategy. Wanna thank you all for joining us today, and we look forward to speaking with you again in Q1.

Kevin, Moderator/Investor Relations, Paysign: Thank you. That’s a wrap on today’s teleconference webcast. You may disconnect your line at this time and have a wonderful day. We thank you for your participation today.