Option Care Health (OPCH) Q4 2025 earnings summary

Executive summary

• Served over 315,000 unique patients in 2025, completing 2.5 million infusion events across all 50 states, with a focus on high-quality, cost-effective care and clinical innovation.

• Net revenue for Q4 2025 rose 8.8% year-over-year to $1,465.4 million; full year revenue up 13.0% to $5,649.5 million.

• Expanded payer partnerships, adding five new regional and two nontraditional payer programs, and deepened relationships with health systems and specialty prescribers.

• Continued investment in technology, AI, and automation, with 40% of claims now processed without human intervention, driving efficiency and scalability.

• Opened new infusion suites and pharmacies, expanded the formulary, and grew advanced practitioner clinic locations, supporting higher acuity therapies and patient choice.

Financial highlights

• Net revenue for 2025 was $5.6 billion, up 13% year-over-year, with acute revenue growing in the mid-teens and chronic therapies in the low double digits.

• Gross profit dollars increased 7.4% to $1,087.9 million; SG&A as a percent of sales declined 50 basis points to 12.1%.

• Adjusted EBITDA reached $471.3 million, up 6.2% year-over-year, with an 8.3% EBITDA margin.

• Adjusted diluted EPS was $1.72, up 8.9%; operating cash flow was $258.4 million for 2025.

• Absorbed a 160 basis point revenue headwind from Stelara biosimilar adoption in the chronic portfolio.

Outlook and guidance

• 2026 revenue guidance is $5.8–6.0 billion, reflecting 4% growth at the midpoint and a 400 basis point headwind from Stelara IRA and biosimilar conversion.

• Adjusted EBITDA guidance for 2026 is $480–505 million, with a $25–35 million gross profit headwind from Stelara biosimilars expected to be evenly distributed through the year.

• Adjusted diluted EPS expected at $1.82–1.92; operating cash flow guidance set at over $340 million, a 30%+ increase year-over-year.

• Net interest expense forecasted at $50–55 million; tax rate at 26–28%; share count of 159 million for Q1.