OptimizeRx（OPRX）2026年度第2四半期決算説明会：売上高30%減も業績予想を維持

主要なポイント

• オプティマイズRxは2026年度第2四半期の売上高を前年同期の2,920万ドルから30%減となる2,050万ドルと発表しました。経営陣は減収の大半の原因として、一部の大口顧客の存在、粗利益率の低いマネージドサービスからの撤退、および最恵国待遇（MFN）価格設定の動きを含むマクロ経済要因を挙げています。
• 調整後EBITDAは410万ドルとなり、2025年第2四半期の580万ドルから減少しました。GAAPに基づく純損失は70万ドル（希薄化後1株当たり0.04ドルの赤字）を計上しました。
• 経営陣は、2026年度通期の売上高見通しを9,500万ドル〜1億ドル、調整後EBITDAの見通しを2,100万ドル〜2,500万ドルにそれぞれ据え置きました。
• オプティマイズRxは現在、製品およびチャネルパートナーの構成比の改善に支えられ、通期の売上総利益率が60%台後半から70%台前半の範囲に正常化すると見込んでいます。
• AIを活用した「Dynamic Audience Activation Platform」の採用は前年同期比で30%以上増加し、AI対応ソフトウェアによる売上高は25%増加しました。
• DeepIntentとの統合が運用開始され、入札フローの生成が始まりました。経営陣によると、この市場における購買の約60%がプログラマティックチャネルを通じて行われるようになっており、オプティマイズRxの獲得可能な最大市場（TAM）領域が拡大しています。

主要財務データ

オプティマイズRxは四半期末以降にさらに300万ドルの負債を返済し、未払い元本を1,670万ドルに減額しました。フィフス・サード・バンクからのタームローン金利はSOFR＋2.25%で、同社は1,000万ドルのリボルビング融資枠も利用可能です。

事業および業績の動向

売上の伸び悩む傾向は、引き続き一部の特定の大口顧客に集中しています。大手顧客1社からの売上高は前四半期に続き今四半期も発生しなかったほか、2025年に粗利益率の低いマネージドサービスをより多く利用していた顧客の影響で、前年同期比の比較に悪影響が生じました。オプティマイズRxは2023年にMedicxを買収して以来、こうしたサービスからの撤退を進めています。

経営陣は、その他の顧客層におけるエンゲージメントが改善していると述べました。中堅および新興のライフサイエンス企業は、売上高および増収率の両面で最も急速に成長している顧客層に含まれており、直近数ヶ月では別の中堅顧客が同社顧客のトップ10に入りました。

オプティマイズRxは当四半期中、プラットフォームに関する3つの取り組みを開始しました：

• DeepIntentとの統合：DeepIntentは、オプティマイズRxの認証済みEHRネットワークと直接統合された初のヘルスケア需要側プラットフォーム（DSP）となりました。この機能はすでに運用されており、初期の入札フローが開始されています。
• Natural Language Audience Builder：特許出願中のAI搭載NLABにより、製薬マーケターや代理店はDSPやメディアプランニング・プラットフォーム内で自然言語プロンプトを使用し、カスタマイズされた医療従事者オーディエンスを作成できるようになります。
• CopayCue：次世代の自己負担額有効化製品で、リアルタイムの処方意図を活用し、処方ワークフロー内で自己負担軽減情報を配信します。

同社はまた、事業の多くを継続的なサブスクリプション収入へとシフトさせています。AI対応ソフトウェア製品は前年同期比で25%成長しており、経営陣はこれにより長期的に売上高の見通しと予測可能性が向上すると考えています。

業績予想・ガイダンス

オプティマイズRxは2026年度通期の見通しを再確認しました：

経営陣は引き続き、売上高が下半期に偏重すると予想しています。第4四半期は第3四半期を大幅に上回り、通期売上高の35%から40%を占める可能性があると見込まれています。

このガイダンスには、取引が滞っていた大口顧客の下半期における完全な復調は織り込まれていません。経営陣によると、当該顧客との協議は活発に行われており、一定のプラスの寄与をもたらす可能性があるものの、潜在的な影響の定量的試算は公表されていません。

現金ベースの営業費用は現在のランレートと同水準で推移する見込みで、賞与引当金が変動要因となり得ます。また経営陣は、利益率構造の改善について2026年限りの一時的な恩恵ではなく新たなベースラインであると説明しつつ、社内計画は60%台後半の売上総利益率を中心としていると言及しました。

リスク要因と注視すべき点

• 売上高および売上高継続率は、一部の少数の大口顧客による支出削減の悪影響を受け続けており、顧客集中リスクを生じさせています。
• ヘルスケア業界のマーケティング予算は、マクロ経済環境や最恵国待遇（MFN）価格設定の動向を含む医薬品政策に関連し、引き続き慎重姿勢が見られます。
• 下半期の売上高のタイミングおよび構成には変動性が残っており、通期見通しは第4四半期への顕著な季節的偏重に依存しています。
• 同社は、FDA（米国食品医薬品局）やHHS（米国保健福祉省）による医薬品広告要件の改正可能性による利益を予測していませんが、経営陣は他のDTC（一般消費者向け）チャネルへの規制強化が医療従事者向けチャネルへの支出シフトにつながる可能性があると考えています。
• その他に議論された課題には、特許切れ、業界における潜在的なM&A（買収・合併）、政府規制、サイバーセキュリティ、競合状況、ならびにEHRおよび電子処方せんネットワーク契約への依存などが含まれます。

アナリスト質疑応答のハイライト

大口顧客の回復：経営陣は、以前取引が中断していた顧客からの完全な復調を下半期の予想に織り込んでいません。協議は再開されており、一定のプラス影響を見込んでいますが、時期や規模は不透明なままです。

プログラマティック取引の拡大：DeepIntentは電話会議の前週に運用開始され、入札フローを生み出し始めました。オプティマイズRxは他のDSPとの統合についても協議中ですが、新たなパートナーシップの発表はありませんでした。

資本配分：負債返済が引き続き最優先事項です。同社には1,000万ドルの自社株買い枠と10b5-1プランもあり、株価の下落が続いた場合には買い付けが実行される可能性があります。

顧客需要：MFN価格設定を巡る不透明感が落ち着き始める中で、上位10社および20社の製薬顧客における戦略的協議や購買シグナルが改善したと経営陣は述べています。中堅およびロングテール顧客のエンゲージメントも高まっており、より速いペースで成長しています。

長期的な収益性：経営陣は「Rule of 40」への復帰目標を維持しており、2026年は例外的な年とみなされ、2027年には成長が再開すると予想していると述べました。

財務部門リーダーシップの移行：エドワード・ステルマック最高財務・戦略責任者は2026年12月31日まで現職にとどまり、2027年からは戦略アドバイザーを務めます。2027年1月1日付でアンドリュー・ディーシルバ氏がCFOに、ヘザー・ファヴァッツァ氏が最高会計責任者に就任します。

決算説明会文字起こし全文

決算説明会の完全なトランスクリプト

経営陣による説明

Operator

Good afternoon, everyone, and thank you for joining OptimizeRx's Second Quarter Fiscal 2026 Earnings Conference Call. With us today is Chief Executive Officer, Stephen Silvestro. He is joined by Chief Financial and Strategy Officer, Edward Stelmakh; Chief Legal and Administrative Officer, Marion Odence-Ford; and Chief Business Officer, Andy D'Silva.

At the conclusion of today's call, I will provide some important cautions regarding the forward-looking statements made by management during today's call. The company will also discuss certain non-GAAP financial measures that it believes are useful in evaluating operating performance. A reconciliation of these non-GAAP measures can be found in today's earnings release as well as in the Investor Relations section on the company's website. I'd also like to remind everyone that today's call is being recorded and will be available for replay on the Investor Relations section of the company's website.

With that, I'll turn the call over to OptimizeRx's Chief Executive Officer, Stephen Silvestro. Mr. Silvestro?

Stephen Silvestro

Thank you, operator, and good afternoon, everyone. Thank you for joining us for our second quarter 2026 earnings call. We're pleased to report second quarter revenue of $20.5 million and adjusted EBITDA of $4.9 million, both of which exceeded consensus expectations. Our results reflect continued margin expansion, disciplined operational execution and the resilience of our operating model despite a health care marketing environment that remains dynamic.

While revenue declined year-over-year and contracted revenue remains below prior year levels, these declines remain limited to a small number of large customers, including the one customer we discussed last quarter that again did not generate revenue this quarter as well as customers that have made heavier use of lower-margin managed service offerings in prior-year periods, services from which we have been transitioning away since the acquisition of Medicx in 2023. Outside the business with these limited customers and across the remainder of the business, we are encouraged by improving engagement and growth.

At the same time, our continued investment in platform capabilities, including recent product launches and expanded programmatic initiatives, is strengthening customer engagement and our competitive position as we move into the 2027 planning cycle. Although the timing and mix of second half revenue remains subject to some variability, our first half performance, encouraging commercial momentum and current outlook support our decision to reiterate full year 2026 revenue guidance of $95 million to $100 million and adjusted EBITDA guidance of $21 million to $25 million. Ed will provide additional details during his prepared remarks.

Over the past several quarters, we've remained focused on executing against the initiatives within our control, improving profitability, strengthening our balance sheet, expanding our technology platform and creating new avenues for long-term growth. I believe our second quarter results demonstrate the progress we've made across each of these priorities. While portions of the pharmaceutical marketing landscape continue to experience some budget timing variability and cautious spending behavior, we are encouraged by the continued stabilization we're seeing across many of our largest customers.

More importantly, the long-term secular trends driving our business remain firmly intact. Life science organizations continue shifting toward more measurable data-driven engagement that delivers value at the point of clinical decision-making. Health care marketers increasingly expect AI-enabled planning, authenticated health care audiences, measurable outcomes and seamless programmatic execution. These are precisely the areas in which OptimizeRx has invested for years and where we believe we maintain a meaningful competitive advantage.

Our existing customers continue expanding their use of our platform across additional brands, therapeutic areas and commercial use cases. During the quarter, we saw continued adoption of our AI-enabled Dynamic Audience Activation Platform, or DAAP, which increased over 30% year-over-year, while also expanding our point-of-prescribe capabilities across both pharmaceutical and med tech customers. These solutions are powered by OptimizeRx's proprietary foundational data asset, which continues to grow as more engagement transpires across our ecosystem.

We're also continuing to make progress expanding our footprint among midsized and emerging life science companies, which we believe represent one of the largest untapped opportunities within our commercial business. As these organizations increasingly seek enterprise-grade technology solutions without enterprise scale or infrastructure investments, we believe our platform is uniquely positioned to meet the demand by bridging the technology gap for them and leveling the playing field for them to be able to compete with top-tier companies.

Just as important, we continue making progress transitioning more of our business towards recurring subscription revenue, particularly within our AI-enabled software offerings, which grew 25% year-over-year. Over time, we believe this transition will further improve revenue visibility while strengthening the durability and predictability of our financial model. Taken together, these trends reinforce our confidence that the underlying fundamentals of our business remain very strong.

Meanwhile, during the second quarter, we announced 3 significant product innovations that further strengthen our competitive position while expanding our long-term opportunities at OptimizeRx. First, we announced that DeepIntent become the first health care demand-side platform to integrate directly with our authenticated EHR network. This represents an important milestone in our strategy of making point-of-care media easier to access through the programmatic platforms health care marketers already rely on. As media buying continues shifting toward programmatic workflows, we're positioning OptimizeRx as the trusted infrastructure connecting premium point-of-care inventory with the industry's leading buying platforms. The implementation is now live.

Second, we introduced our patent-pending Natural Language Audience Builder, or NLAB. This AI-powered capability enables pharmaceutical marketers and agencies to build highly customized health care provider audiences using simple natural language prompts directly within DSPs and media planning platforms. By combining our proprietary health care intelligence with intuitive AI-driven workflows, we're making it significantly easier for marketers to build targeted audiences while further embedding OptimizeRx technology into the planning tools of our customers that they're already using today.

Finally, we launched CopayCue, our next-generation co-pay activation solution powered by real-time prescribing intent. Medication affordability remains one of the largest barriers to patient adherence, and CopayCue delivers savings information directly within the prescribing workflow at the exact moment physicians are making treatment decisions. By combining real-time intent signals with our industry-leading point-of-care and point-of-prescribe capabilities, we're helping life science organizations improve patient access while delivering stronger commercial outcomes for their brands.

Individually, each of these launches represents an important advancement for our platform. Collectively, they demonstrate something even more significant, that we have entered a new phase of innovation as a company. We are evolving beyond being solely a point-of-care marketing company into being the operating system for pharmaceutical marketers. Our technology infrastructure is connecting pharmaceutical marketers, media agencies, demand-side platforms, health care providers and patients at scale through authenticated clinical workflows.

As AI becomes increasingly integrated into commercial planning and as health care advertising continues migrating toward privacy-safe programmatic execution, we believe our combination of proprietary health care data, authenticated clinical inventory and workflow integration creates a highly differentiated platform with significant long-term growth potential. This strategic evolution not only expands our addressable market but also creates additional recurring revenue opportunities that we believe will become increasingly meaningful over time.

Before turning the call over to Ed, I'd like to share an important leadership announcement regarding our finance organization. Over nearly 5 years as Chief Financial Officer, including previously as our Chief Operations Officer and most recently as our Chief Strategy Officer, Ed Stelmakh and the Board of Directors have mutually agreed on a planned leadership transition effective December 31, 2026, that reflects both the depth of talent within our organization and our commitment to prudent financial stewardship.

Over the past 5 years, Ed has played an instrumental role in transforming our financial foundation and positioning OptimizeRx for long-term success. Under his leadership, we've significantly expanded our gross margins and operating margins, strengthened our operating discipline, successfully refinanced our debt to materially improve our cost of capital, completed the acquisition and integration of Medicx, executed the divestiture of noncore assets to sharpen our strategic focus and built a deep, highly capable finance and strategy organization that positions the company well for the future. Just as importantly, Ed has helped establish the financial discipline and operational rigor that support our long-term strategy and our commitment to sustainable shareholder value creation.

As part of our long-term succession planning process, we're pleased to announce that Andy D'Silva will succeed Ed as our Chief Financial Officer, effective January 1 of 2027. Andy has most recently served as our Chief Business Officer and has worked closely with Ed and the Board of Directors and our executive leadership team on our financial strategy, capital allocation, Investor Relations, corporate development and long-range planning. He's been deeply involved in many of the strategic initiatives that have helped transform the business over the past several years, making him well prepared to lead our finance organization as CFO.

We're also pleased to announce that Heather Favazza will be promoted to Chief Accounting Officer, effective January 1 of 2027. Heather has been an outstanding leader with our financial organization and played an instrumental role as our Corporate Controller for the last 8 years, strengthening our accounting operations, financial reporting, internal controls and overall finance infrastructure. Her promotion reflects both the strength of our accounting organization and the deep bench of leadership that we've built over the past several years.

To ensure a seamless transition, Ed will remain our Chief Financial and Strategy Officer through the end of 2026. Ed has also agreed to remain in the role of strategic adviser in 2027 to ensure ample time for thoughtful and seamless transfer of responsibilities while allowing Andy and Heather to continue working closely with him as they assume their expanded leadership roles.

Transitions like these are strongest when they're the result of thoughtful planning rather than necessity, and that's exactly what this represents. We have tremendous confidence in Andy and Heather, and we're equally grateful that Ed will continue supporting the company throughout the transition. On behalf of our Board of Directors and everyone at OptimizeRx, I want to thank Ed for his outstanding leadership and the many contributions he's made during his tenure.

With that, I'll turn the call over to Ed.

Edward Stelmakh

Thanks, Steve, and thank you for the kind words. While this is certainly a bittersweet moment, it is also one I approach with clarity, confidence and optimism for the company's future. I look forward to continuing to drive our strategic priorities through the back half of 2026 and contributing to the company's mission in an advisory role in 2027.

I want to extend my appreciation to the Board, our leadership team, all our employees and shareholders of this company for giving me this amazing opportunity for the last 5 years. It's been a true privilege to serve as your Chief Financial and Strategy Officer, and I'm excited to see what the future brings. Now let's turn to our financial results for Q2 2026.

As always, we issued our earnings release this afternoon detailing our financial results for the second quarter ended June 30, 2026. A copy of the release is available in the Investor Relations section of our website, and additional information will be included in our upcoming Form 10-Q.

Second quarter revenue was $20.5 million, a decrease of 30% from the $29.2 million we recognized during the same period in 2025. The revenue reduction was largely contained to a limited number of large customers that utilized the lower-margin managed services in 2025, an offering from which we have been transitioning away since acquiring Medicx in 2023, and one of our large customers in 2025 that has not generated revenue this quarter as well as a decrease in demand due to macroeconomic factors, including MFN pricing dynamics.

Our expenses for the quarter ended June 30, 2026, decreased $5.4 million year-over-year to $20.6 million, primarily driven by lower cost of revenue despite being impacted by $1.7 million in severance expense associated with our previously announced reduction in force. The decrease in cost of revenue was primarily attributed to a favorable product mix resulting from not having any DTC managed service revenue this quarter and a favorable channel partner mix.

We believe various margin optimization strategies we implemented over the last 18 months continue to yield meaningful benefits. As a result, we now expect gross margins to normalize into the high 60% to low 70% range for full year 2026.

Meanwhile, we had a net loss of $0.7 million or $0.04 per basic and diluted share for the 3 months ended June 30, 2026, as compared to a net income of $1.5 million or $0.08 per basic and diluted share for the same 3-month period in 2025. On a non-GAAP basis, our net income for the second quarter of 2026 was $3.1 million or $0.16 per diluted share as compared to a non-GAAP net income of $3.7 million or $0.19 per diluted share in the same year-ago period.

Our adjusted EBITDA was $4.10 million for the second quarter of 2026 compared to $5.8 million during the second quarter of 2025. Operating cash flow was $8.1 million for the first half of 2026, and we ended the quarter with a $24.1 million cash balance as compared to $23.4 million on December 31, 2025.

As we highlighted in May, our term loan with Blue Torch Capital was refinanced with Fifth Third Bank for which we fully drew down the $25 million term loan and have access to a $10 million revolver. Our current interest rate on the term loan with Fifth Third Bank is SOFR plus 2.25%. With that said, we paid $5.3 million in principal during the quarter, which was $5 million ahead of our payment schedule, leaving our outstanding debt at the end of June at $19.7 million.

Furthermore, subsequent to the quarter end, we paid off an additional $3 million in debt. At this time, we intend to deploy at least a portion of our free cash flow to pay down the principal on our loan faster as we look to continuously lower our cost of capital. With that said, we continue to believe that our healthy balance sheet will help us execute against our operational goals.

Now let's turn to our KPIs for the second quarter of 2026. Average revenue per top-20 pharmaceutical manufacturer now stands at $2.7 million. Net revenue retention rate dipped below prior-period levels to 90%. The dip was driven primarily by a small number of large accounts optimizing spend rather than a broad-based churn. Additionally, revenue per FTE came in at $750,000. While our KPIs showed decline compared to previous quarters, we have made meaningful progress on margin expansion and operating expense management, consistent with our strategy of driving profitable growth in our space.

Based on our first-half performance and the visibility we have into the remainder of the year, we are reaffirming our previously issued full year 2026 guidance. We continue to expect revenue in the range of $95 million to $100 million and adjusted EBITDA between $21 million and $25 million.

While portions of the health care marketing environment remain dynamic, our execution year-to-date, continued product innovation, expanding book of business with select clients and disciplined expense management give us confidence in our outlook for the balance of the year. As we noted previously, we continue to expect revenue to be weighted towards the second half of the year, consistent with the seasonal purchasing patterns of many of our customers with Q4 coming in significantly higher than Q3 and likely representing 35% to 40% of our full year revenues.

With that, I'll turn the call back over to Steve. Steve?

Stephen Silvestro

Thanks, Ed. Operator, let's now move to Q&A.

Operator

[Operator Instructions] Question comes from Ryan Daniels from William Blair.

質疑応答

Dustin Scaringe

This is Dustin on the call for Ryan. Maybe just first, wondering if there's an update on the larger client you've spoken about previously. I know you probably can't get into too many specifics, but wondering at a high level, what's the update there? And what are the expectations that are baked into the back half in relation to that client?

Stephen Silvestro

Dustin, thanks for the question. We, right now, don't have any expectation baked into the back half for that large client coming back, but we are starting to see some progress around it that will definitely positively impact the back half. How much, we're not really prepared to say at this point. But discussions are open, and we're actively engaging there.

We also just announced -- you may have seen the announcement of our Chief Marketing Officer. That Chief Marketing Officer is coming from that client as well. So I think is prepared to kind of help us bridge the gap there and get some things right where we had the missteps that we talked about last quarter on the commercial front.

Dustin Scaringe

Okay. Great. Understood. So you've talked about the strategic importance of DSP. Just wondering if you can talk more about the progress with DeepIntent and if you're making any inroads with other DSPs that are out there. I think you've said that also that DSP could double your business over the next 2 years. Just what does the growth curve look like for the DSP opportunity there over the next 24 months?

Stephen Silvestro

You got it. So we've got great news. We've gone live with DeepIntent as of this last week. And so that's pretty exciting for us as a business. We're now starting to see bid flow happen over the platform. I don't really think we're ready to say what the uptick looks like in terms of the next couple of weeks and months, but we do think it will be very, very meaningful. And I would also say, right now, in terms of just the broader programmatic environment, 60% of the buys out in this specific space are occurring now through these programmatic channels.

And so our comment around sort of the ability to scale the business through that ecosystem is directly tied to the number of buys that we know are happening through these DSPs. And it's not a place -- those aren't funds that we've had access to in the past. So we are expanding our near-term accessible market, and that's kind of a little bit more color around the commentary. So more to come around that. We do have other DSPs that we're speaking with, but nothing that we're ready to announce on this call. But stay tuned.

Dustin Scaringe

Okay. Got it. And then just lastly for us, there's been some discussion with the FDA and HHS about eliminating the adequate provision framework for pharma advertising. And you know that require more disclosures with the DTC ads. How are you thinking about that potential impact on the pharma marketing budgets and channel allocation? Could that lead to some shift in TV and potentially create some incremental demand for your digital and point-of-care engagements?

Stephen Silvestro

Yes. No problem, Dustin. Yes, we see those moves as favorable for our business per your last comment there. Anything that would sort of limit the ability to execute across other DTC channels where we may not be engaged at scale will automatically push funds into some of the HCP-focused marketing channels where we are connected and that are sort of our bread and butter. So we have been waiting on that with bated breath.

We're not forecasting it because it's impossible for us to predict what the FDA and HHS are or are not going to do. But we're well positioned that if they do make that decision, we will benefit. It won't just be us. Everybody in our space that's focused on HCP will disproportionately benefit also. Great question.

Operator

The next question comes from Richard Baldry from ROTH Capital Partners.

Richard Baldry

If we look at your adjusted EBITDA guidance, the implication is the second half would be somewhere between $13 million to $17 million. Can you talk about, under that backdrop, what your capital allocation strategy might start to evolve to? Do you still see pretty much an exclusive focus on reducing debt? Or do you think more of a balance between that and share buybacks at current depressed levels?

Stephen Silvestro

Yes. Ed, I'll let you take that one.

Edward Stelmakh

No problem. Yes, I think our strategy, as we said in the prepared remarks, will be, first, pay down the debt. We're down to $16.7 million of outstanding principal. And then, secondly, if the price of the stock continues to drop, we have a 10b5-1 in place to trigger buying with a $10 million approved stock buyback.

Richard Baldry

Then, in terms of the second half rebound to revenue that's implied in guidance, how much of that is visible, contracted? Or how much of that is really just assuming seasonal patterns you've seen in the past sort of repeat themselves?

Stephen Silvestro

Yes. I mean, I think, Rich, first of all, it's good to hear your voice. We, right now, are seeing, as we've shared sort of in the previous calls, still trending more towards '24 contracted revenue seasonality versus '25, just in our progress. And that's why we're reiterating the guide that we've got out there right now versus increasing the guide.

We do think the seasonality that we've experienced in previous years is pretty much what we should anticipate for the back half of this year. We're starting to already see that. But sort of the visibility that we've given is what we've put out there. That's what we've got visibility to. And anything that's incremental above and beyond that, obviously, on the next earnings call, if we have more visibility with contracted revenue, we'll be happy to provide an update around that. But no changes right now to that. We've got to sort of iron out the one major client disruption that we've got and sort of take a look at what Q3, Q4 is going to put out before we do any updates. So good -- I would say good, solid progress as we approach the back half now.

Richard Baldry

And maybe looking at, call it, top of the funnel, can you talk a little bit about non-top 20 opportunities, whether that's new logos or existing? How are they acting sort of by contrast to the top 20 who've seen obvious issues with MFN, et cetera?

Stephen Silvestro

Yes. They're growing at an accelerated rate is what I think we would tell you. The -- outside of the top 20 are some of our fastest growers, both in size and percentage growth. And so that's really encouraging. We had another mid-tier account enter sort of our top 10 list just this last couple of months. And so we're really excited to see that. We'll have more to announce around that in the future, but that the mid-tier, long-tail strategy is really proving out, and we're really excited with the progress we're seeing there. Got a gap to fill on that -- one of those top accounts that -- where the disruption was, and that's going to take a little bit of time. But with the comeback of that plus the mid-tier, we think we're entering the back half of this year and then setting ourselves up for 2027 really, really nicely.

Richard Baldry

Last for me then, back to the top 20, excluding the one challenging customer. Can you talk about just activity levels within there, whether it's discussions, pipeline, again, new opportunities? How is that activity level nonquantifiable versus what it had been sort of at the depth of MFN?

Stephen Silvestro

The activity level has definitely increased. I would say the strategic discussions are starting to flow a lot more than they were previously. Beginning of the year, particularly, I would say, late Q4 coming into Q1 and, to a degree, a little bit of Q2, and we talked about this already, there was a lot of consternation around MFN. I think, just we talked about it, everybody in our space talked about it just because people weren't sure what to expect.

I think for the most part, manufacturers are in a place where they sort of know what the new normal looks like and they're prepared for that. And so we're starting to see engagement happen across the board. Mid-tier, long tail engaging faster because they've not really been the targets of the administration, and they've been able to kind of skate by and just business as usual and accelerate, and viewed it almost as a time to kind of skip ahead and compete more effectively with the top 20. So that's been good for them.

But we're starting to see specifically people within our top 10, 20 really reengage in meaningful ways. I'm not ready to say yet that Q4 is going to be a lightning in a bottle of buy-ups like we talk about from time to time, that happens. But we're getting some really positive buying signals going into the back half of the year that look very good.

Operator

The next question comes from Eric Martinuzzi from Lake Street.

Eric Martinuzzi

Yes. Your comments on Most Favored Nation, it sounds like we've worked through the disruption. The other issues that you talked about, at least last quarter, were macro issues weighing on budgets, and that was everything from inflation to oil, geopolitical uncertainty. Is that still an overhang on spending by top 20?

Stephen Silvestro

Eric, thank you for the question. It's still a little bit of an overhang. I think there's still some consternation around macro, and pharma has been one of the largest targets of the administration, not just for MFN, but a whole myriad of reasons. So they've been a little bit conservative with budgets. But, again, per my response to Rich, we're starting to see a lot of that normalize now in the back half. And they're starting to spend more just sort of across the board to drive patient capture for the back half of the year. And I think we will benefit from that.

I do think we are -- we didn't talk about LOE at all, but we're looking at a couple of different strategic things going on in the marketplace right now, potential acquisitions, some mergers happening, a few LOE events, but they'll navigate those things. But by and large, I think the macro stuff that we discussed last quarter is starting to normalize in their approach to spend, starting.

Eric Martinuzzi

Okay. And then, Ed, certainly enjoyed working with you. I know we've got you for another 5 months. And, Andy, congratulations on the pending promotion here. I wanted to ask about the operating expense. I know you guys went through a bit of -- some cost moves in the second quarter. Is that all behind us? In other words, is this kind of a normalized operating expense that we should use for the third quarter?

Edward Stelmakh

Yes. I think the current run rate from a cash OpEx to stay kind of around this rate. The only variable there may be things like bonus accruals depending on where we commence versus budget. But generally speaking, I think we'll be in that range.

Operator

The next question comes from Constantine Davides from Citizens.

Constantine Davides

Just a question on the margin profile of the business. It looks like you've lifted that outlook. So I guess a couple of questions on that. First, is that a sustainable level of profitability? Or is it more of a 2026 profile that you're talking about? Number one.

Number two, what drove the upside in the second quarter? I think you said channel mix, but I just wanted to drill into that a little bit more. And then third point on this, just your latest thinking around how profitability changes as you layer in more -- as you tap into the DSP market over time? And I guess, more specifically, the economics of those arrangements compared to traditional engagements?

Stephen Silvestro

Sure. Happy to chime in. It's good to hear from you, Constantine. Appreciate the question. I think we're setting the new level of profitability for the business and making sure that we're communicating that clearly. It's not episodic, that really will be the new normal. You'll see -- we may outperform that a little bit from time to time, but that should be sort of the baseline expectation of the business going forward.

And going into the macro DSP ecosystem, we don't expect that the level of profitability will drop. It will sustain that same level that we're kind of guiding to and talking about now. Most of that is being driven by favorable channel mix. As I've shared on previous calls and Ed and Andy have done the same, we've been able to bring on additional channel partners that have helped us manage our gross margin, and that's been really, I think, transformational for the business. Even with the disruption in top line revenue, we've been able to continue to generate good, solid EBITDA and cash flow and pay down the debt, all the things that we've been talking about on these calls. We're feeling pretty bullish around profitability in general and our ability to continue to generate cash and pay down the debt and do the things that we'd like to do.

So [ depending ] we get the top line back in line, Constantine, like we talked about, and we all firmly believe we will, the profitability of the business will continue to follow suit. So we think -- we're excited about that. Ed, Andy, anything else you'd add to that...

Andrew D'Silva

Yes. I'll add one quick thing to that. So Constantine, when we think about our business, we're really managing the business to a high 60% gross margin. We're going to have favorable quarters like you saw last 2 quarters. But that's how we think about it internally, and that's how we're going to manage the business. So when you're looking at your models, just keep that kind of stuff in mind.

Constantine Davides

Got it. And I guess not to sort of belabor the point, but in the past, you've talked about becoming a sustainable Rule of 40 company. And Steve and I guess, Andy, Ed, all of you guys, I'm just wondering what your latest view is in terms of is that still an objective? Do you think you -- as you look out, maybe you'll prioritize growth a little bit more than you had in your prior thinking? Just any kind of comments there would be helpful.

Stephen Silvestro

I mean, look -- go ahead, Ed.

Edward Stelmakh

Yes, okay. Thanks, Steve. Yes, I would say absolutely, mainly because, I mean, this year is definitely a bit of an anomaly for us. So the profitability threshold has been set. You can see that this business can be highly profitable even in a soft year. So once growth returns, which we are confident it will certainly do in 2027, it's not going to take much to get back to Rule of 40. So my view is, absolutely, we're going to be right back at it in 2027.

Operator

Constantine, does that conclude your question?

Constantine Davides

I'm all set.

Operator

That does conclude our Q&A session. Mr. Silvestro, I'd like to hand over to you, sir.

Stephen Silvestro

Thank you, operator. As we close today's call, I'd like to leave you with 3 thoughts. First, we continue to execute our strategy while delivering disciplined financial performance. Our second quarter results demonstrate the strength of our operating model and our team's ability to balance profitability, even in years where headwinds are present, with continued investment and innovation.

Second, we believe OptimizeRx is uniquely positioned at the intersection of several powerful long-term trends that are reshaping the life sciences commercialization environment. Health care marketers are increasingly demanding AI-enabled planning, authenticated health care audiences, measurable outcomes and programmatic activation across clinical workflows. We've spent years building the infrastructure to support exactly this moment of change in the industry. We are best positioned to be the operating system for pharma marketers because of the data-driven technology that we've built.

The announcements we made this quarter from our DeepIntent partnership to the launch of NLAB, our Natural Language Audience Builder, and CopayCue, are all examples of how we're prioritizing a culture of innovation and expanding our platform to create additional opportunities for sustainable recurring growth. Importantly, these innovations don't represent isolated product launches. Together, they further strengthen the network effects within our platform while increasing the value we deliver to pharmaceutical manufacturers, agency partners, health care providers and ultimately to patients.

Third, we remain committed to disciplined execution and long-term shareholder value creation. Our priorities remain clear: continue expanding our AI-enabled platform capabilities, increase utilization of our proprietary HCP and DTC networks, accelerate adoption of our recurring software solutions, expand programmatic access through additional strategic partnerships, deliver profitable, sustainable growth while maintaining disciplined capital allocation.

We believe the investments we've made over the past several years have positioned OptimizeRx to capitalize on the continued digital transformation occurring across health care. While the market environment may continue to experience periods of variability, our long-term opportunity has never been more compelling. It's an exciting time to be a part of the OPRX story.

Before we conclude, I'd like to again recognize Ed for his tremendous leadership and contributions to OptimizeRx over the past 5 years. He's been an outstanding partner, trusted adviser and leader, helping transform our financial foundation while positioning the company for its next phase of growth. On behalf of our Board, our employees, our shareholders, Ed, thank you very much for everything that you've done for OptimizeRx.

Finally, I'd like to thank our employees for their continued dedication and execution, our customers for their partnership and trust and our shareholders for their ongoing support. We appreciate you joining us today and look forward to updating you on the continued progress of the quarter. Operator, back to you.

Operator

Thank you, Mr. Silvestro. Before we conclude today's call, I would like to provide the company's safe harbor statement that includes important cautions regarding forward-looking statements made during today's call.

Statements made by management during today's call may contain forward-looking statements within the definition of Section 27A and the Securities Act of 1933, as amended, and Section 21E of the Securities Act of 1934, as amended. These forward-looking statements should not be used to make investment decisions. The words anticipate, estimate, expect, possible and seeking, and similar expressions identify forward-looking statements. They may speak only to the date that such statements are made.

Forward-looking statements in this call include statements regarding orderly transition of finance leader responsibilities; the company's financial and growth strategy, including continued margin expansion, disciplined operational execution and resilience of its operating model; company's revenue decline being limited to a small number of large customers; company's product innovation, strengthening company engagement, competitive position and expansion of long-term opportunities; company improving its profitability, strengthening its balance sheet, expanding its technology platforms and creating new avenues for long-term growth; company maintaining meaningful competitive advantages; company's expansion into midsized and emerging life sciences companies representing one of the largest untapped opportunities; company platform being uniquely positioned to meet the demands of customers; company's ability to create a highly differentiated platform with significant long-term growth potential; company's strategy of driving profitable growth; company being well positioned to capitalize on significant opportunities and company's ability to create long-term value for its shareholders.

Forward-looking statements also include the management's expectations for the rest of the year. The company undertakes no obligation to publicly update or revise any forward-looking statements, whether because of new information, future events or otherwise. Forward-looking statements are inherently subject to risks and uncertainties, some of which cannot be predicted or quantified. Future events and actual results could differ materially from those set forth in, contemplated by or underlying these forward-looking statements.

The risks and uncertainties to which forward-looking statements are subject to include, but are not limited to, the effects of government regulation, competition, dependence on a concentrated group of customers, cybersecurity incidents that could disrupt operations, the ability to keep pace with growing and evolving technology, the ability to maintain contracts with electronic prescription platforms and electronic health records networks and other material networks -- other material risks. Apologies.

Risks and uncertainties to which forward-looking statements are subject could affect business and financial results are included in the company's annual report on Form 10-K for the year ended December 31, 2025, and in other filings the company has made and may make with the SEC in the future. These filings, when made, are available on the company's website and on the SEC's website at sec.gov.

Before we end today's conference, I would like to remind everyone that an audio recording of this conference call will be available for replay starting later this evening, running through for a year on the Investor Relations section on the company's website.

Thank you very much for joining us today. This concludes today's conference call, and you may now disconnect your