BrightSpring Health Services (BTSG) TD Cowen 46th Annual Health Care Conference summary

Business outlook and growth drivers

• Anticipates broad-based growth across pharmacy and provider services, with strong volumes and margin expansion driven by operational efficiencies and favorable business mix in 2025 and 2026.

• Expects EBITDA guidance of $760–790 million, with core growth of 18–23% excluding Amedisys assets, and continued focus on specialty, infusion, and home/community pharmacy script growth.

• Plans for 16–18 new LDD launches in 2026, leveraging prior years’ launches for ongoing revenue and margin growth.

• Generic drug launches, including Pomalyst and lenalidomide, will contribute to growth, with generics and LDDs both supporting EBITDA expansion.

• Investments in 2025 and 2026 are aimed at supporting future growth into 2027 and 2028.

Regulatory and industry environment

• Faces $35–40 million unmitigated IRA headwind in 2026, primarily impacting home and community pharmacy EBITDA, but has mitigated this to about $15 million through PBM negotiations.

• Majority of PBMs have agreed to some mitigation, though not yet full; ongoing advocacy with regulators and industry experts continues.

• IRA impact expected to diminish over time, with 2027 impact about half of 2026, and further reductions anticipated as some affected drugs go generic.

• Industry-wide IRA pressures may create opportunities for market share gains due to effective navigation and mitigation strategies.

Operational initiatives and strategic focus

• Enhanced focus on home infusion, with new operational leadership and dedicated teams for acute and chronic markets, aiming for improved business development and payer relevance.

• Integration of Amedisys assets expected to improve margin profile and expand geographic reach, especially in states with existing hospice but not home health presence.

• Sale of Community Living business streamlines operations and focuses services on seniors and specialty drug populations.

• Ongoing investments in operational processes and targeted growth channels to maximize volume and referral opportunities.