Executive Director Sean Slattery, good morning to you both.
Morning, George.
Morning, George.
The format for today is that Rick and Sean will walk you through the results released this morning. This should take around 25 minutes and will be followed by a 15-minute question-and-answer session. The aim is to finish this webinar by 11:15 A.M. this morning. Again, if you'd like to ask a question, please click on the Q&A tab in the ribbon below and type the question into the box, and we'll endeavor to get through as many questions as we can in the time that we've got allotted. That completes the housekeeping for today, and I'd now like to hand it over to Rick and Sean to get us started.
Okay, thanks, George, and good morning to everyone. I want to thank you for joining us today for our first quarter FY 2026 update. Just to give you an idea of what we're going to go through over the next 20 minutes or so, I'm going to start out providing a very quick summary of our first quarter results, followed by a more comprehensive view of the U.S. business activity. Then I'll walk through some of the current market trends that are affecting the business and why we think that we're well positioned as we look into the future and how we're going to take advantage of some of these trends and actually address a number of the challenges we see in the market. I'll also provide you a quick update on our strategic options review process and what to expect from this point on.
We will finish up with a discussion around current priorities and the direction for the business year ahead. If we'll go to the next slide, just real fast for those of you that might be new or we've not really gone through a current view of what MedAdvisor Limited is all about, particularly after the changes with the Australian divestiture. We are very focused on pharmacy-led patient engagement, bridging the gap between pharmaceutical companies and pharmacies to deliver personal medication journeys and experiences for patients in the United States. Our AI-driven platform actually removes barriers to care by simplifying the medication management process for individuals and helps to reduce pharmacy burden. We offer a plug-and-play solution that enables pharmacies to run impactful programs with ease and driving measurable results.
Over the past 30 years, the organization has built a number of very, very strong and deep relationships across both pharma and pharmacy organizations. Many of these relationships have been in place and ongoing for 15 - 20 years. We have a good foundation. We'll talk about this a little bit more in the presentation, but a good foundation to build for our future growth. If we'll go to slide five. As highlighted here, the U.S. business has continued to experience significant headwinds through the first quarter of the new financial year. With that said, the sale of the Australia and New Zealand business has put the company in a solid position to withstand the current headwinds, and we'll talk more about that later. Cash at the end of the period was around AUD 13 million, and all debt has been discharged.
The AUD 8 million holdback from the Jonas transaction will be due in the next month, and we will have an even better capital position at that point in time. Focusing on the decline in revenue for a moment, I'll go into some details in certain areas. The decline in revenue was really driven by a number of different factors, but there is significant policy pressure from the new administration on both pharma as well as pharmacies, but primarily in the pharma sector. Ongoing financial strain across the pharmacy sector has been a significant challenge, and we are starting to see new competition both on the pharmacy side as well as pharma side in our core business.
Notably, over 40% of the revenue decline, which I will talk more about in just a minute, was directly related to regulatory delays, which had a substantial impact on our vaccine program revenues in the quarter. Gross margins were softer due to two main factors: increased platform costs and a shift in our product mix. In the quarter, traditional programs accounted for around 74% of our revenue, which is up significantly from 50% in the prior corresponding period. If we go to the next slide, we'll dive in a little deeper into some of what's going on and what's impacting the revenue results. While Q1 presented challenges across all categories, as I just mentioned a minute ago, particularly in vaccines, we are now seeing early signs of stabilization and potential recovery in some key areas.
Looking at each category in a little more detail, we can look at general medications first. The largest contributor to revenue was this was the largest revenue contributor in the quarter. However, we saw a 33% decline year-over-year, primarily driven by reduced volume in heart, diabetes, and COPD brands. Notably, the heart category affected the majority of the decline, but we do anticipate there'll be some positive movement in the second quarter, particularly going into the third quarter as these brand positions stabilize. These are more mature brands in the cardiac category. On the positive side, with the intense competition on GLP-1s, these are manufacturer competition across organizations such as Novo Nordisk and Lilly, particularly in the diabetes and the obesity category. We expect revenue to improve in this category in Q2 and even more so as we look into the second half of the financial year.
Vaccine program revenue was hit particularly hard, being down 90% compared to the same time last year, largely due to lower than expected RSV and COVID volumes as we entered into the flu season. This is a very similar issue to what we saw in a similar timeframe last year. RSV vaccines in particular were down about 70% from 2023 to 2024, and another 50% as you go from 2024 to 2025. This is a significant impact in the volumes that actually were not expected by the pharmaceutical manufacturers, which really affected their planning in the quarter. This is exacerbated by a number of vaccine regulatory delays that carried on into the August timeframe that affected planning on both pharmacy and pharma for both COVID and RSV vaccines, as well as pneumococcal vaccines. A significant hit.
At the same time, we did see some shifting in the shingles category, more so than was expected. The brand in that category is revisiting their overall strategy. We do expect to see some level of growth in this quarter, and we're looking to execute a new strategy as we go into the second half of the financial year. Looking to Q2, we expect a pickup in vaccine program revenue across COVID, pneumonia, and shingles categories, though market uncertainty may continue to weigh in on performance. As we continue to look at the impact from the changes that the new administration is making in the vaccine regulatory space, we'll have more visibility to the direction there. Relative to specialty medications, specialty medication revenue was down 18% due to funding pressures in some of the more mature brands in this category.
We did see some reasonable growth in the dermatological and HIV categories. We're currently running programs with five different brands in this space, but we have a pipeline of over 30 brands as we look into the future. We do expect that the revenue contribution from specialty medication categories is going to improve as we go into the second half. Significant opportunity there. As we go into slide seven, as I mentioned previously, we're seeing a number of key trends that are significantly reshaping the U.S., both pharmacy and pharmaceutical landscape. I want to revisit some of these trends and the implications to our business, as well as possible opportunities that we believe that they do represent. If we look first at the pharma category, pressure from the U.S. government on medication pricing reform is putting pressure on pharma to significantly lower prices and create new direct-to-patient models.
There have been direct-to-patient models in place previously, but we are now starting to see more of these models, particularly with the TrumpRx.com platform that's been announced. In addition to Lilly Direct and Pfizer Direct, we're seeing AstraZeneca Direct, etc. Pharmacies are also looking at these shifts to understand how they can play a role in helping to dispense or fill these medications for patients at the revised pricing that we'll start to see through some of these direct-to-patient models. In addition to traditional medication awareness channels such as TV, there's significant pressure there as well. We have seen spending in the top 10 drug brands fall 20% from June to July, and we expect to start to see some budget movement from TV into the digital and other performance-based communications types of platforms and programs as we go into the new year.
This could represent some opportunity for us as we start to see not only the pricing pressures, but start to see the move away from TV. If we look at the pharmacy sector, major chains like CVS and Walgreens are closing store locations due to financial pressure. The number of pharmacy locations in the United States is down about 15% from about five years ago. However, the grocers and mass retailers are expanding their pharmacy share. They're taking advantage of the front-of-store traffic coming in and creating an experience that involves a pharmacy and other pharmacy-related services. We are seeing some solid momentum there, while in other parts of the market, we're seeing some challenges.
The good news in some of this is that, according to some of the recent surveys, patients still do see the pharmacist as a trusted resource to help manage their care, particularly their medications, but even more and more broader care. They do expect a face-to-face type of interaction. At the same time, they do have an expectation in access to a variety of services through digital means, whether that's through apps to help refill medications, or to help schedule different services into the pharmacy. Patients are expecting to have the right balance between face-to-face kinds of opportunities with pharmacists and digital interaction with the pharmacy. This is being viewed as more of a hybrid care delivery model, which is really starting to take form across pharmacy and other parts of the healthcare ecosystem.
The financial pressures, increased competition from online pharmacies, new pharma direct offerings, and even AI innovation are pushing every pharmacy group to review their digital and AI strategy, which we think plays to our advantage. At the same time, it can create some level of complexity and delays in movement in certain kinds of programs that are a focus for us. The good news is pharmacy is still a key player relative to dispensing and filling medications, providing a variety of services, including vaccines, to patients. As we look into the competitive environment, one key point is the pharma shift to direct-to-consumer has resulted in a consolidation of multiple budgets that we've seen in different parts of the organization that are a little more isolated in the past. These budgets are now coming under the consumer umbrella.
It is opening up the door for new competition across a variety of new customer touchpoints outside of the pharmacy, but other areas where a pharmaceutical manufacturer might get information or touch a patient, such as through a doctor relationship. Those budgets are all housed in the same place at this point, and we're having to go after the budgets through direct and indirect competitors. As pharmacies start to assess their digital strategies, as I just mentioned a minute ago, new digital and AI platforms are coming into play to support this new hybrid model. We're starting to have conversations with the pharmacies about how our particular programs fit into their broader strategies to engage their customers across a variety of services within the pharmacy.
With patients increasingly trusting pharmacists and demanding hybrid care platforms that connect pharma, pharmacy, and the patient in a seamless loop, these are definitely gaining ground. This is exactly where we're investing. We're building the connective infrastructure for future value-based engagement. Relative to the government influence, I've touched on a couple of points already, but one key point just to reemphasize is that the government policy uncertainty and the disruptions that have been created, particularly over the last 60 - 90 days in the vaccine market, are significantly impacting both pharma and pharmacy stakeholders. We are seeing some challenges, as we've experienced in this quarter, and particularly as we go into the next quarter into the new year, that are creating uncertainty in where to focus strategy, tactics, budgets, etc., to help drive vaccine administration in an appropriate fashion in this new world.
While macro headwinds are definitely real, they're reshaping a market around what we think is going to fit the direction that we're heading. It's going to align with the foundation we're building and the direction that we're going. It's getting through these headwinds that is going to be the challenge, and we'll talk about that in the next few slides. If we go to slide eight, we are continuing to build a solid foundation, as I mentioned on the front end, that is positioned as well in the future. First, our network scale is definitely unmatched in the United States. Over 170 million people fill in excess of 2.3 billion prescriptions and over 25,000 pharmacies that are in our network. This reach gives us a really powerful platform to deliver value to our pharma as well as our pharmacy clients. Second, our programs deliver an exceptional return on investment.
These are programs, again, we've been running over a 30-year timeframe where we're seeing significant ROI across categories: 14 to 1 in the specialty categories, 7 to 1 in general medications, and 3 to 1 ROI opportunities across vaccine awareness programs. These programs typically provide somewhere in a 2 - 7 times higher ROI than what you would find in a typical direct-to-consumer DTC kind of media benchmark. This is TV. The results of the programs are definitely there and have been proven over time. As I mentioned on the front end, we have longstanding relationships across pharma and pharmacy. Many of these relationships have extended 10, 15, 20 years in some cases.
Finally, on the right-hand side, we believe that if you look at this network and you look at the capability that is there, the number of prescriptions, the patient reach, etc., the addressable market opportunity for our business is well over AUD 500 million annually. We're just getting to 10% of that volume. With the right focus and the right investments, etc., we do believe that the opportunity is there, and we, as I'll talk about in a minute, have the ability to weather the storm and get on the back end and deliver significant value to our customers and to our shareholders. If we go to the next slide, just real fast, we are focused on the U.S. now as a result of the divestiture of the Australia and New Zealand business.
We received a number of non-binding offers in the quarter, I'm sorry, through the process on the United States business. None of these really materialized to the point that it made sense to bring those to shareholders for consideration. The board is resolved to prioritize the transformation of the U.S. business. That's where our focus is now: modernizing our systems, strengthening our commercial performance, positioning the business for sustainable growth, and I'll expand on that here in a minute. I will say that the board does retain the option to revisit the future trade sale if market conditions, when market conditions turn more favorable, and we can have conversations and look at the right valuation for the business. From a capital perspective, we're now in a much stronger position. At September 30, we have around AUD 13 million in the bank, as I mentioned earlier.
Just to reinforce, a further AUD 8 million is expected to come in in the holdback payment next month. Over the three-year timeframe, we see an estimated earnout of around AUD 7.4 million. As indicated at the time of the sale, the net proceeds will be held and are currently held in a separate account while the board continues to look at the capital management options. With that, now let's take a look at the business transformation and the rest of FY 2026. As we've discussed in many of these sessions, we are at the end of the development of our new platform. We'll be launching our Next Generation Patient Engagement Platform at the end of this quarter, and we will be starting to migrate and transition both programs and pharmacies as we move into the new year. We're very excited about getting the new platform in place.
It will help us to ensure that we can maintain the current cost base and improve in certain areas and help enable innovation at scale. This is going to be a cornerstone for us from a perspective of delivering more personalized, efficient, and scalable services to our clients as we move into the latter part of the financial year. To strengthen our commercial capabilities, we've also brought in a couple of new senior-level executives with deep experience in both agency and direct-to-consumer channels. As our pipeline converges and continues to improve, we'll expand the sales team further to capitalize on emerging opportunities, but we're going to monitor the sales process. We're going to monitor the pipeline, and we'll drive expansion from there. The new individuals on the team bring expertise that's really important as we see the shift in pharma focus to the direct-to-consumer as a whole.
The way that you sell into these parts of the organizations is somewhat different than the traditional sales process that the legacy sales team has been involved in. We're very excited to have those individuals on the sales team. Operationally, we're continuing to redesign key business processes. This includes enhancements to the presale support program execution, customer retention. Each of these are aimed at improving efficiency and delivering better outcomes to our clients. This is going to be enabled, and many of these processes will be automated through the new platform that will be delivered. This is a significant focus to ensure that we can deliver quality programs at scale to our customers. We're also building out or rebuilding our digital reach within the pharmacy network.
As I mentioned earlier, the pharmacies have gone through a significant amount of change, and through that process, we've had a number of shifts in our pharmacy network. While our overall reach remains the same, the digital reach has changed over time, and we are very focused on making sure that that is rebuilt to the place where it's been in the past. We are also very focused in the future. We're having selective conversations with AI organizations that bring varying levels of improved workflow, in this case, particularly in the pharmacy, and conversational kinds of capabilities and new opportunities for patient engagement in the pharmacy. We will be very focused in developing those relationships and bringing those capabilities into the network so we can further improve our value proposition even further than what we're doing in the digital space. Finally, our cost optimization efforts continue to be a priority.
These initiatives continue into the end of FY 2026, even into FY 2027. We will see cost reduction or OPEX reduction of around 15% at a minimum in FY 2026 over FY 2025, and we'll continue to focus on opportunities to improve that and ensure that we remain as a resilient business moving forward. As we look ahead to FY 2026, the health program pipeline is valued at around AUD 100 million unweighted, which we now need to execute on. The focus is on conversion and delivery on that pipeline as we move through this quarter, going into the second half of the year. A key point is that market uncertainty remains a key theme in the business in the United States, at least for our sector of this business, and particularly as we go through into the second quarter.
We anticipate that vaccine-related revenue will continue to trend below prior years, reflecting ongoing regulatory and demand challenges. However, we do expect general medication programs to restart and our number of general medication programs to restart in Q2 and ramp up further into Q3, which will help stabilize our revenue base. A bright spot, as I mentioned earlier, is in our outlook for our specialty medications. We forecast solid growth in this segment, and we expect that this segment is going to contribute a higher percentage of revenue as we move into the latter part of FY 2026. On the margin front, we do expect continued pressure due to product mix continuing as we continue to lean more heavily into the traditional solutions for a period of time.
This is partially due to the expansion on digital in the network, as well as managing the scale and the transaction flow as we transition programs and pharmacies to the new platform. We do expect platform and operating costs to trend lower towards the end of the financial year, but in particular going into FY 2027. Overall, while challenges do persist, we're executing with discipline and positioning the business for long-term growth and resilience. That concludes my remarks for now. I appreciate your time again, and turn it back to George, and we can start the Q&A.
Great. Thank you, Rick. Just as a reminder, if you'd like to ask a question, just click on the Q&A box in the ribbon below and type a question into that box. I've got a few questions here, so let's get started. Question one, what gives you confidence in your vaccine forecast, given you had similar views of recovery same time last year?
I'm sorry, say that again, George. What gives you?
What gives you confidence in your vaccine forecast, given that you had similar views of recovery same time last year?
I think just to be clear, last year at this point in time, we had just experienced the significant downturn in the RSV vaccines, and the results were definitely unexpected. We did see some recovery going into the second half of the financial year, as we expected, particularly in pneumonia. Pneumonia did pick up, as did shingles. The RSV and COVID categories did start to fall off as expected. What has happened in this case, and I just want to be clear on the expectations too, in this case, we have seen a significant impact again on RSV vaccines, which I was talking with a pharmaceutical executive today, and there was an expectation it was going to pick up. It is down 50% over last year. COVID vaccines are still being administered, but they're off from last year as well.
We do know we do have contracts with shingles, pneumonia, and COVID going into this quarter, and we do see, we expect to see some volume, but we're not going to see the volume we saw last year. As I said earlier, the vaccine revenue is going to be affected by what I just described. In addition, it's being affected by the delay in regulations and the modification in regulations and guidelines coming from the government for vaccines. At this point, there's a significant amount of uncertainty. If I suggested that there is going to be a significant turn in relation to vaccines, that was not intended. We're still concerned about vaccines. It's still an important part of the business. It's an important part of the manufacturer's business, as well as pharmacies.
However, there are a number of challenges and a number of headwinds in the market, and we're working to navigate through those challenges with the pharmacies as we speak. In fact, like I said, I was talking to them today.
Great. Thanks, Rick. Just following on from that, there's a question here around specialty medication revenues that were expected to improve in FY 2026, as you called out in FY 2025 results. However, specialty medication revenue declined by 18% in the quarter. From here, should we expect it to get worse before it gets better?
In the specialty medication category, I would expect, based upon the pipeline that we have and the performance of the programs, that we'll see solid growth in specialty medications. The decline year-over-year is related to two mature brands that have completely changed, shifted their strategy relative to adherence versus awareness. We do awareness programs around specialty medications to help create awareness of alternative medications for individuals on certain generic medications. If it's an adherence-type program, which this one mature brand has shifted to, those particular types of prescriptions are filled in specialty pharmacies. Specialty pharmacies are not a part of our network. It's really a shift in strategy. At this point, the brands we're working with, the 30+ brands I mentioned earlier, those brands actually are focused on helping to drive awareness as TV spend starts to get some level of pressure on it.
I'll leave it at that.
Thanks, Rick. One for Sean. There's probably a few questions here on cash flow, and some are asking what is it expected for the month, others for the quarter, and others for the year. I'm not sure how you'd like to answer this one, Sean.
Our cash flow, it is a bit lumpy. Some of that's due to seasonality. Some of that is in terms of agreements that we've got with our primary suppliers, one being our technology partner. We've got some lumpy milestones in there. It will continue to be a bit lumpy over the continuation of FY 2026. We will burn some cash across the balance of FY 2026, but the board is continually, and executive management is continually looking at our cost base. We've cut a lot of discretionary spend. The majority of that, we've got a minimal marketing budget that we're working with. We've cut all other discretionary spend, and we continue to monitor and action our cash flow on literally a weekly basis.
Great. Thanks, Sean. Question around pipeline. It says at the last update, the pipeline was AUD 125 million. Did you not win AUD 25 million of business, or is this converted?
Relative to the pipeline, it's slightly over AUD 100 million, but some of the pipeline, as time goes by, is converted, both contracts in the current quarter as well as future quarters. Some of that has been refined as we brought in a new sales team, and we go back and we're trying to clean up the pipeline and ensure these are true opportunities. There's been some cleanup. On that point, we have two individuals that have left the sales team recently and two new ones that just joined. Those new ones are, like I said, going in and reviewing and validating the pipeline to ensure we've got the right level of outlook. There was some level of that AUD 125 million or the AUD 25 million that was converted, and some of it was removed.
Great. Thanks. Question around Thrive. Does Thrive close the loop between the patient, the pharmacy, and the physician?
The question is, does Thrive close the loop?
Yeah.
No. Now, Thrive, it's an interesting question, but now Thrive actually is our data-driven process to message a patient in different ways at different points in time. Meaning you can message a patient via a direct mail to their home. You can message a patient when they're picking up their prescription through a text message, through an email, etc. Thrive is we actually take the medication information from the pharmacies, and we look at data over time, and we use that data to help profile that individual as being adherent or not being adherent to their medication. To the best we can tell, determine the types of communications channels that are most likely more effective for that individual to help them manage their medication. The whole intent of Thrive is personalized communications at the right point in time to the right channel, and again, typically through the pharmacy.
That doesn't connect the communication from the doctor through the pharmacy. That's not from that connected care perspective. At least that's the element. It's an interesting question.
Thank you. A couple of questions here around the strategic options that are in yourself. I'll try and sort of meld them into one. It says, your priorities are very focused towards accelerating the business. Where does it leave the strategic options process? Is it on hold? When do you expect to return cash to shareholders?
I think I actually missed a key point when I was making a comment there. We actually have brought the strategic options review process to a close, and we are refocusing our efforts on the transformation of the United States business and focused on getting it to a point to where the value is there for the shareholders or potentially other options if it makes sense. The strategic options review process is finalized, if you will. With that said, we are open to any and will consider any incoming inquiries that there might be, but we're not actively looking at options for the United States business at this point in time. There was a last point on that question.
what extent or when do you expect to return cash to shareholders?
As Sean mentioned, they continue to look at cash and capital management, etc. That's an ongoing process on the part of the board. Nothing's decided at this point.
I was just going to interject there and say that whilst it forms part of our cash balance, we have that quarantined in a separate account, and that's part of our capital management discussion subject to the strategic review that we're leading. We haven't reached an answer yet. It's certainly quarantined and earmarked for return to shareholders when we go through what happens with the strategic review, and then the most tax-effective way to return that to shareholders, be it dividend, return of capital, whatever it might be.
Thanks, Sean. Next question. Painful to see the massive decline in the share price. What are the top three items that management feel will help the turnaround?
The top three items that we believe will help with the turnaround?
Yeah.
Primary focus is on the strengthening of the pharmacy network. We have the pharmacy network. We have the pharmacy relationships. In order to drive increased contract value and speed of conversion, etc., the pharmacy network has got to continue to get the right focus and expansion into digital. Related to that, the platform completion is on track. It has to be finalized. We have to move all programs, all pharmacies to that platform in order to ensure that we are delivering our programs on part of pharma and pharmacy in a quality fashion and at scale. The two are somewhat related, but I would say there's a whole effort in relation to the pharmacy network completion of the platform. You have the platform, you have the pharmacy network.
In order to continue to drive differentiation both with the pharmacy partners as well as with pharma, is the infusion of AI capabilities. I know everybody talks about AI, but I will tell you, I was at the National Association of Chain Drug Stores conference a few weeks ago in San Diego, and the Chairman of the National Association of Chain Drug Stores, Chief Pharmacy Officer of Walgreens, one of the largest pharmacy groups in the U.S., Chief Pharmacy Officer of Walmart, the largest retailer globally, and a number of other pharmacy executives, their total focus was on digital enablement of the pharmacy and how you're going to leverage AI to really transform relationships, drive customer loyalty, but drive down workload on the part of the pharmacist. They're all investing in that category and being relevant in driving capability in that space as quickly as we can.
Given capital requirements, we're looking to do that through strategic partnerships. That's got to be a third leg of the stool, if you will.
Look, I know it's gone past 11:15 A.M., so we might just end it there. There are still a few questions. We'll endeavor to get back to those people that ask questions through email. Rick, I might just hand it back to you for any closing remarks you'd like to make.
Okay. Sure, sure. Thanks, George. And thanks for everyone that joined us today. I very much appreciate it. These last several quarters have been an extreme challenge. We are definitely working through a significant amount of change in our business, and we are positioning ourselves to continue to weather the storm. We feel confident, based on the comments I just made, that we've got the team, we have the platform, we have the foundation through our pharmacy network. With the right focus and a little bit of time, we're very confident that we're going to get there, and we're going to deliver value for our customers and for our shareholders. I appreciate you spending some time with us today and listening to my ranting a little bit. I hope everybody has a wonderful day, and thanks again for your support in these very, very challenging times. Thanks, George.
Great. Thanks, Rick, and thanks, Sean. I'll add my thanks to everyone for joining us today. That wraps up our proceedings, and I invite you all to now disconnect. Have a nice day.