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 2025 was $5,649.5 million, up 13% year-over-year, with Q4 revenue at $1,465.4 million, and a continued focus on sustainable growth and industry leadership.

• 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 clinics, including the acquisition of Intramed Plus, and expanded advanced practitioner capabilities to over 25 centers.

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 for 2025 was $1,087.9 million, up from $1,012.9 million in 2024.

• 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% year-over-year; operating cash flow was $258.4 million.

• $307 million of stock repurchased in 2025, including $95 million in Q4.

Outlook and guidance

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

• Adjusted EBITDA guidance for 2026 is $480–505 million, including a $25–35 million gross profit headwind from Stelara biosimilars.

• Adjusted diluted EPS expected at $1.82–1.92; operating cash flow guidance set at $340 million or more, a 30%+ increase over 2025.

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

• Management reaffirmed guidance, citing confidence in execution and no material changes in market trends or biosimilar impacts.