OptimizeRx Reiterates 2026 Outlook After Steeper Revenue Drop

The Tip Desk · October 19, 2026 · 3 min read

Second-quarter revenue fell 30% to $20.5 million as the healthcare technology company kept full-year revenue guidance at $95 million to $100 million.

OptimizeRx Corp. (OPRX) saw second-quarter revenue fall 30% to $20.5 million from $29.2 million a year earlier, a much steeper year-over-year decline than the 10% drop to $19.8 million in the first quarter. The healthcare technology company said the contraction was concentrated among a small number of customers and that it was encouraged by increased investment across other portions of its customer base.

Chief Executive Stephen L. Silvestro said second-quarter revenue and adjusted EBITDA both exceeded consensus expectations, reflecting continued margin expansion, disciplined execution, and resilience in the operating model. Adjusted EBITDA was $4.9 million. Non-GAAP net income was $3.1 million, or $0.16 a diluted share.

GAAP results swung to a net loss of $(0.7) million, or $(0.04) a share, from net income of $1.5 million, or $0.08 a share, a year earlier. Cost of revenues fell to $4.8 million from $10.6 million. Sales and marketing, general and administrative, and research and development expenses were $5.5 million, $3.7 million, and $3.3 million. Income from operations was a loss of $88,000.

For the 12 months ended June 30, 2026, net revenue retention was 90%, down from 121% a year earlier. Average revenue per top 20 pharmaceutical manufacturers was $2.66 million, and those customers accounted for 54% of total revenue.

The company reiterated fiscal 2026 revenue guidance of $95 million to $100 million and adjusted EBITDA guidance of $21 million to $25 million, after updating 2026 revenue guidance to that same range in the first-quarter release. Silvestro said that despite some variability in second-half timing and mix, first-half performance and commercial momentum give the company confidence to reiterate the outlook.

In the first-quarter release, Silvestro had cited short- to intermediate-term disruption from most-favored-nations pricing dynamics and other macroeconomic factors leading to more measured customer spending, and said the company did not view those pressures as enduring obstacles. He said the long-term shift toward digital, data-driven engagement across life sciences remains intact.

The company completed a $35 million traditional banking facility, including a $25 million term loan and a $10 million undrawn revolver, and repaid $8.3 million of principal since inception. It paid down $5.3 million of term-loan principal during the quarter, including $5.0 million ahead of schedule, and an additional $3.0 million after quarter-end. Cash and cash equivalents were $24.1 million as of June 30, 2026. Accounts receivable were $24.8 million. Long-term debt, net, was $17.8 million.

OptimizeRx said DeepIntent became the first healthcare demand-side platform to integrate its authenticated electronic health record network, that it launched a patent-pending Natural Language Audience Builder, and that it introduced CopayCue, a next-generation copay activation solution. Silvestro said those innovations strengthen the company’s position in AI-enabled audience intelligence, programmatic point-of-care activation, and clinical workflow engagement.

The board appointed Andy D’Silva as next chief financial officer and Heather Favazza as chief accounting officer, effective January 1, 2027. Ed Stelmakh will continue as Chief Financial & Strategy Officer through December 31, 2026, then serve as a strategic advisor through the end of 2027. The company said its financial and growth strategy remains unchanged.