Guardian Pharmacy Services (NYSE:GRDN) raised its full-year revenue and adjusted EBITDA guidance after third-quarter profit rose on higher prescription volumes, improved reimbursement and purchasing initiatives, even as drug price reductions weighed on reported revenue.
The long-term care pharmacy operator reported revenue of $371 million for the quarter ended September 30, 2026, down 1.7% from $377 million a year earlier. Chief Financial Officer Will Mudd said revenue would have increased by a high-single-digit percentage without the impact of Inflation Reduction Act-related drug price reductions that took effect earlier in the year.
Net income rose to $19 million from $9.6 million, while adjusted EBITDA increased 24% to $33.9 million. Guardian ended the quarter serving approximately 218,000 residents, a high-single-digit increase from a year earlier, and prescription volume rose 10%.
Higher Outlook Follows Margin Gains
Guardian now expects 2026 revenue of $1.44 billion to $1.46 billion, up from its previous range of $1.43 billion to $1.45 billion. It raised its adjusted EBITDA forecast to $136 million to $138 million from $129 million to $131 million.
Mudd said the revised outlook reflects the stronger-than-expected third quarter, market expansion initiatives and expectations that improved reimbursement and other operating trends will continue into the fourth quarter. The guidance excludes acquisitions beyond those already completed.
Third-quarter gross profit rose 14% to $85.2 million, and gross margin reached 23%, up sequentially. Mudd attributed the performance in part to improved reimbursement, purchasing initiatives, plan optimization and the launch of the company’s vaccine programs. Adjusted EBITDA margin was 9.1%.
During the question-and-answer session, President and CEO Fred Burke said Guardian had benefited from outsized gains this year from initiatives under way for multiple years. Mudd cautioned that the company did not expect gains of the same magnitude in future quarters.
Acquisitions and startup pharmacies completed since 2024 collectively contributed positive adjusted EBITDA but reduced the quarter’s adjusted EBITDA margin by 44 basis points, Mudd said. Chief Operating Officer David Morris said that effect could fluctuate as Guardian invests in additional locations.
Expansion Includes Nautilus Asset Deal
Guardian’s startup pharmacy in Lexington, Kentucky, is operational, and the company plans new locations in Houston and Huntsville, Alabama. Each would be Guardian’s second pharmacy in its respective state, Morris said.
The company closed its acquisition of Wellness Concepts in Grottoes, Virginia, in July and completed an asset acquisition from Nautilus late in the quarter. Nautilus had served assisted living communities in 14 states through a centralized mail-order model. Guardian transitioned those residents to 18 existing pharmacies in their markets, Morris said.
Morris described Nautilus as an asset-light transaction that uses existing capacity and requires limited incremental investment. He said it would be accretive after onboarding costs are absorbed.
Guardian also added a small pharmacy in Sioux City, Iowa, in October and acquired Van’s Institutional Pharmacy, which serves communities in western Tennessee and Kentucky. The Van’s deal brought Guardian’s pharmacy count in Tennessee to five, Morris said.
Reimbursement and Growth Strategy
Burke said Guardian is working with payer partners on a reimbursement model that puts greater emphasis on generic drugs and better compensates the company for its services. Generics account for more than 90% of prescription volume and generate the vast majority of gross profit, he said.
Guardian has approximately 14% share of its primary assisted living market, according to management. Burke said the company can grow by winning facilities and entering new markets, even if industry occupancy eventually reaches capacity. He cited NIC MAP data showing assisted living occupancy reached 89% in the third quarter.
Burke said Guardian typically begins serving a facility after being named its preferred pharmacy, then works to increase resident adoption toward its corporate average of 90%. He estimated that roughly 100 independent long-term care pharmacies fit Guardian’s acquisition target profile.
Guardian ended the quarter with approximately $120 million in cash and no debt. Mudd also said the final tranche of about 13.5 million Class B shares converted to Class A shares on September 27. Founders, executives and certain employees entered lock-up agreements covering approximately 30 million shares through September 14, 2027, subject to limited exceptions.
About Guardian Pharmacy Services (NYSE:GRDN)
Guardian Pharmacy Services, Inc is a provider of pharmacy services focused primarily on residents of long-term care and other institutional healthcare settings. Through its network of pharmacies, the company supplies prescription medications and related pharmacy support to assisted living communities, skilled nursing facilities, behavioral health organizations, and other care providers.
The company’s services include medication dispensing and packaging, prescription delivery, medication management, clinical pharmacy support, and technology-enabled tools designed to help caregivers and healthcare professionals manage residents’ medication regimens.
