BrightSpring Health Services (BTSG) Wells Fargo 21st Annual Healthcare Conference summary

Key business drivers and growth acceleration

• EBITDA growth accelerated from 6%-8% (2022–2024) to nearly 40% in 2025 and over 40% in early 2026, driven by specialty pharmacy LDD wins, generic conversions, and operational efficiencies.

• Specialty pharmacy growth is supported by LDD wins, ramping of prior LDDs, generic conversions, and fee-for-service business.

• Infusion segment sees volume growth in acute and chronic therapies, leveraging high-quality services and targeted disease strategies.

• Home and community pharmacy growth is multifaceted, with focus on profitable volume, operational efficiencies, and AI-driven automation.

• Exiting uneconomic customers and script changes have improved profitability.

Financial performance and profitability trends

• Gross profit per prescription in Q2 was lower than Q1 due to seasonality, but underlying gross profit grew when excluding inventory price appreciation.

• Focus remains on sustainable long-term EBITDA and gross profit dollar growth, not just per-script metrics.

• Continued investment in growth initiatives, including sales force and technology, with a mix of permanent and temporary expenses.

• Operating expenses have increased to support future growth, with ROI as a key consideration.

LDDs, generics, and market dynamics

• Exclusive and ultranarrow LDD arrangements are becoming the norm for oncology and rare drugs, with high service quality and patient satisfaction as differentiators.

• LDD ramp-up typically takes 2–3 years, with growth visible from drugs launched as far back as 2021.

• Generic conversions are managed proactively, with rapid patient conversion and ongoing volume growth supported by a large sales force.

• Generic price declines occur over 5–10 years, but are offset by new LDD launches, fee-for-service growth, and increased patient volumes.

• 2027 generic conversions are expected later in the year, with more impact in 2028.