Guardian Pharmacy Services (GRDN) Oppenheimer 36th Annual Healthcare MedTech & Services Conference summary

Business performance and recent results

• Exited Q4 with strong momentum, driven by successful vaccine clinics and optimized labor and purchasing strategies.

• Two acquisitions in the Pacific Northwest contributed positively, leveraging synergies in national accounts, purchasing, and revenue cycle management.

• Continued benefits from plan optimization and a slight increase in patient acuity supported year-end results.

• Raised guidance early in the year, primarily due to robust vaccine clinic performance, with similar trends expected in Q4 2026.

Guidance, risks, and upside factors

• Guidance is based on forecastable elements, with upside potential from increased patient acuity and better-than-expected M&A or startup performance.

• IRA headwinds are being managed, with the impact expected to decrease significantly in 2027 and 2028.

• EBITDA impact from IRA is expected to be mitigated, with business metrics returning to normal over time.

Regulatory and legislative environment

• Industry faces challenges from IRA, especially for single-unit operators, prompting support for legislative efforts.

• Strong bipartisan support exists for the Preserving Patient Access to Long-Term Care Pharmacies Act, with ongoing advocacy through trade groups.

• Drug pricing regulation remains a focus, with efforts to align reimbursement algorithms and avoid unintended negative impacts.