Thank you for joining us today to discuss the results for LifeMD's second quarter ended June 30, 2022. Joining the call today are Justin Schreiber, Chairman and Chief Executive Officer, and Marc Benathen, Chief Financial Officer of LifeMD. Following management's prepared remarks, we will open the call for a question-and-answer session. I'd like to remind everyone that today's call is being hosted via webcast, and the recording will be made available via the link in today's press release, which is available in the Investor Relations section of the company's website. Before we begin, I'd like to remind everyone that during this call, the company will make a number of forward-looking statements which are subject to numerous risks and uncertainties that may cause the company's actual results to differ materially from those projected.
These risks and uncertainties are described in the company's 10-K and 10-Q filings and within other filings that LifeMD may make with the SEC from time to time. Forward-looking statements made during this call are based on current information available to the company as of today, August 11th, 2022. The company assumes no obligation to update or revise any forward-looking statements after today's call, except as required by law. Please note that management will be discussing certain non-GAAP financial measures that the company believes are important in evaluating LifeMD's performance. Details on the relationship between these non-GAAP measures to the most comparable GAAP measures and reconciliations thereof can be found in the press release issued earlier today. I'd like to remind everyone that today's call is being recorded and will be available for replay in the investor relations section of the company's website.
Now, I'd like to turn the call over to LifeMD's CEO, Justin Schreiber. Please go ahead.
Thank you and good afternoon, everyone. Today, after the market closed, LifeMD issued a press release containing our second quarter results. Additionally, and for the first time ever, we've also made available a Q2 supplemental investor highlights presentation, which is available on the LifeMD IR site. I would encourage everyone to download and review this as it summarizes why our second quarter was really what I believe to be a pivotal period in the 2022 transformation of LifeMD. During the second quarter, LifeMD made significant progress on several important strategic initiatives to position the company for its next phase of growth. We believe that our growing profitability and expanding margins will be key to our continued transformation from a seller of prescription and OTC products into a rapidly growing and highly profitable telehealth services company.
There are a few key accomplishments I'd like to highlight for Q2. First, in the second quarter, we began nationwide direct-to-patient marketing for our virtual primary care platform, and it's been extremely successful. We're seeing some of the best acquisition costs we've ever seen, and our technology platform and clinical operations are working beautifully. We've also proven that we can cross-sell this to our indication-specific patient base, which is a very big deal. I'm more confident than ever that this platform will be a very big growth driver in the years to come. Second, we introduced several new telehealth treatment categories to complement our primary care and existing treatment offerings, which we believe have significant growth potential. Third, we drove meaningful improvements in our margin performance and profitability. Lastly, we are streamlining our overall company into a telehealth-only business through the impending divestiture of WorkSimpli.
Given our intense focus on profitability, growth of new telehealth offerings, and enhancing long-term scalability, we expect a short-term slowing of sequential growth for the next two quarters, after which we will resume a more aggressive growth trajectory at substantially higher levels of profitability. What excites me the most about our second quarter is the strong traction we're beginning to see with our virtual primary care platform. Since launching in late Q1, we now address over 200 of the most common medical conditions across all 50 states. We've built a highly differentiated and now proven technology platform that is staffed by some of the best doctors, nurse practitioners, medical assistants, and operations personnel in the country. What's even more amazing to me is the difference this platform and our affiliated physicians and the entire medical team are making in the lives of our patients every single day.
While still very early on in the growth of this platform, patient feedback about their VPC experience, their experience with our virtual primary care platform and our affiliated physician network has been tremendous. It's been better than any product this company has ever offered. During the second quarter, we saw 1,500% growth versus the prior quarter in our VPC patient count. Currently, we have over 1,200 active patients on the platform, and we are adding about another 20-30 new patients per day net of attrition. I expect this number to grow very, very quickly. Retention is strong with early attrition rates in the low single-digit %.
We continue to believe that the VPC platform is one of the most significant, if not the most significant launch the company has done to date and will be a key driver of both top and bottom-line growth going forward. We also introduced several new treatment areas during the quarter that have been well-received by our new and existing patient populations. These offerings include a proprietary topical pain management treatment called Proteron, sleep treatments, and over-the-counter dermatology treatments that complement our existing RX offering. These additions enhance our revenue mix, with 38% of new patient order volumes coming from non-erectile dysfunction treatments during the second quarter of 2022, which compares to 22% during the same period last year. We remain on track to achieve consolidated Adjusted EBITDA profitability by the fourth quarter of this year.
As an important stepping stone toward profitability, we continue to drive improved unit economics through higher gross margins and improved returns on our ad spend. As noted in our press release, we achieved record gross margins in the second quarter on both a consolidated and telehealth-only basis, while also driving an 8% improvement in the blended first-year LTV to CAC for our telehealth platform. Finally, I am proud to report that we have made solid progress in the process to streamline our overall company into a telehealth-only business through the impending divestiture of WorkSimpli. Despite challenging market conditions, we have received significant interest in WorkSimpli from a broad range of buyers. We believe we remain on track to consummate a transaction prior to year-end. With that, I will now turn the call over to our CFO, Marc Benathen, who will provide a summary of our financial results. Marc?
Thank you, Justin, and good afternoon, everyone. As Justin mentioned, the second quarter of 2022 was a pivotal quarter for the entire company as we executed upon the early phases of several key strategic initiatives. While the focus on these critical long-term areas of growth and profitability will mean our sequential growth will slow for the balance of 2022, our continued execution will position us for heightened growth in the year ahead with strong underlying profitability and be in the best interest of creating long-term value for our shareholders.
While we continue to reiterate our previous guidance on Adjusted EBITDA and consolidated profitability by the fourth quarter of 2022, we are revising our revenue guidance to be in the range of $122 million-$128 million to reflect slower growth in the back half of the year as we focus on these critical long-term strategies, followed by a return to elevated growth with consolidated profitability in 2023. Now turning to the results for the second quarter of 2022. Revenue in the second quarter totaled a record $30.5 million, up 37% as compared to the same quarter a year ago. 93% of total revenues in the second quarter were generated by recurring subscriptions.
Telehealth net revenues grew by 41% to $22.3 million, while WorkSimpli net revenues grew by 26% to $8.2 million. WorkSimpli revenues grew 27% sequentially as compared to the first quarter, following the execution of several key strategic initiatives we previously discussed. Importantly, WorkSimpli achieved EBITDA margins during the quarter of mid-teens for the first time in its history. We expect WorkSimpli's growth and rise in profitability to continue at a rapid pace. On the telehealth side of the business, we increased our active subscriber base by 53% versus prior year to end the quarter with over 168,000 active subscribers. More importantly, we continue to transition more of the patient base to longer-term subscriptions, with 71% of active patient subscribers on multi-month subscription plans as of June 30, 2022.
While this caused some impact to the timing of rebillings this quarter, as well as the next one to two quarters, multi-month subscribers drive faster payback and significantly higher unit economics, as well as stronger retention. By being able to link this data with detailed analytics on patient acquisition, marketing efficiency, retention, and product, we are driving record performance in our unit economics. This is already playing out with an 8% increase in first-year LTV to CAC in the second quarter versus the same year-ago period. Gross margins for the second quarter reached record levels at 85%, up 300 basis points versus prior year, with our telehealth-only gross margin reaching 80% for the first time. Gross profit for the quarter totaled $25.8 million, an increase of 42% from the same year-ago period.
Operating expenses for the second quarter totaled $41.5 million, an increase of $7.1 million versus the year-ago period. Our second quarter 2022 operating expenses included $7.8 million of non-cash expenses associated with stock-based compensation, the revaluation of the earn-out related to the Cleared acquisition, and depreciation and amortization expenses. Net of non-cash expenses, operating expenses decreased as a percentage of company net revenue by 200 basis points. Equally as important, we reduced our marketing expense as a percentage of revenue to 72% versus 100% of revenue in the same year-ago period and improved leverage in this key spend area by 300 basis points versus the prior quarter. Our GAAP net loss attributable to common stockholders for the second quarter totaled $13.8 million or a loss of $0.45 per share.
This compares to a net loss attributable to common stockholders of $16.8 million or $0.64 per share in the second quarter of 2021. Adjusted EPS, a non-GAAP financial measure that excludes non-cash expenses, preferred stock dividends, litigation expense, severance, and M&A expenses totaled a loss of $0.22 per share as compared to $0.46, a loss of $0.46 per share in the same year ago period. Adjusted EPS improved 12% sequentially versus the prior quarter. Adjusted EBITDA, a non-GAAP financial measure excluding the same account categories as noted in the adjusted EPS, totaled a loss of $6.9 million in the second quarter of 2022. This compares to an adjusted EBITDA loss of $12.2 million in the same year ago quarter. Now turning to the balance sheet.
Cash total is $11.7 million as of June 30, 2022. Importantly, as noted in our second quarter investor highlights presentation, through many of the efforts highlighted earlier on this call, we reduced our adjusted EBITDA loss and cash burn to under $1 million in the month of June and expect meaningful improvements in our balance of the year cash burn, including achieving consolidated adjusted EBITDA profitability by the fourth quarter. Additionally, as Justin noted, we're receiving strong demand from prospective buyers of WorkSimpli and continue to expect the consummated divestiture transaction of the business prior to year-end 2022. We believe the combination of LifeMD crossing into profitability plus estimated proceeds from this potential divestiture will capitalize LifeMD extremely well and strategically position us for the company's next leg of growth and margin expansion. This wraps up our financial results.
I'd now like to turn the call back over to Justin.
Thanks, Marc. In summary, while we expect more moderated growth for the balance of the year in our core telehealth business, I'm extremely excited about the future of LifeMD and the role that our company will play in the rapidly evolving telehealth marketplace. The key initiatives that we executed against in the second quarter include nationally launching marketing and beginning to scale our virtual primary care business, diversifying our telehealth revenue, driving meaningful margin unit economics and profitability improvements across all of our existing telehealth categories, and taking steps to streamline our company into a leading telehealth-only business through the impending WorkSimpli divestiture.
Continued execution against these critical initiatives will cement our future as a leader in telehealth with profitable operations, tremendous organic growth prospects, and a strong non-dilutive capital base post a potential WorkSimpli divestiture to support future investment as we transform from a telehealth products provider to a differentiated full suite telehealth services company. In closing, I would like to thank our entire team, especially our doctors that are treating patients every single day on our platforms, for their tireless efforts as we continue to transform the face of medicine and make amazing health care more accessible, affordable, and convenient for our patients. With that, I would like to open the call for Q&A.
Thank you. If you would like to ask a question, please signal by pressing star one on your telephone keypad. If you are using a speakerphone, please make sure your mute function is turned off to allow your signal to reach our equipment. Again, press star one to ask a question, and we'll pause for just a moment. Our first question will come from Marc Weisenberger with B. Riley Securities.
Thank you. Good afternoon. Thanks for taking the questions and appreciate all the additional detailed information. It's a lot to chew on here. Looking at the supplemental chart showing the progression of Adjusted EBITDA, can you talk about the dynamics going from April to June and then some of those puts and takes going from June into the third quarter?
Yeah. Marc, this is Marc. So the biggest thing starts with advertising. We spent a considerable amount of time in the second quarter after we completed an upgrade of our data analytics infrastructure, which gave us a lot more insight into, frankly, every campaign down to every single product subscription length and pretty much any variable that you'd wanna look at. Being able to really refine a lot of our strategies. Obviously, I can't get into, for competitive reasons, all the, you know, secrets behind that. We exceptionally refined it, and we're seeing record levels of return on ad investment.
Now, in doing so, what happened was we shifted some additional dollars towards scaling some new verticals, which is, you know, the, some of the topical pain to sleep, obviously VPC, and, you know, also driving a lot more longer term subscription length. That in turn causes a little bit of short-term impact on revenue, but really positions the company for accelerated growth and much more profitable economics with quicker payback. That was the biggest step. The second one is, you know, we're at a point now where, you know, we've said this all along, going all the way back to the middle of last year when we said we were gonna improve our EBITDA sequentially each quarter. We have the infrastructure to scale the business.
I mean, we've had that for some time now, and we're really continuing to see the benefits of the fact that we've had that. We're actually gonna see some further benefits in our capital expenditures in the coming quarter after we've gotten past that initial lift to finish building out the VPC platform and enhance it. I mean, we're really, you know, in an enhancement and growth phase at this point. But that's where really a lot of the progress is happening on the telehealth side. Obviously, WorkSimpli has hit their stride, and it's continuing to grow. We do obviously expect to divest them by the end of the year.
Both of the businesses are set up for profitability growth, with the leading reason being that, we've gotten to a point where we have very strong unit economics that are on a path to continue to get better.
Very helpful. Appreciate that. You—I think you alluded to it a little bit in the answer, but maybe if you could talk about the specific factors that are contributing to maybe some of the sequential growth that you're talking about. I guess, is that primarily related to how you are actually allocating the marketing spend and which patient cohorts you're targeting? I guess, what factors contribute to your confidence in the reacceleration of growth that you talked about?
Yeah. Yeah. You know, the first factor is length of subscription. At the end of the day, while there's obviously a benefit to us long term to get people onto six-month subscription lengths, in some cases even 12-month subscription length, it stretches out the rebuild period. There's a short-term period where you're trading people up and you're, you know, you're bringing on some of those longer-term subscriptions where you're not gonna have to rebuild every single quarter associated with those longer term subscriptions. We started to really make some of that transition in the first quarter.
We saw, you know, some impact from timing in the second quarter, and we'll continue to see for the next couple of quarters related to that. What's gonna come back to us positively is the redoing of those subscription lengths that are a little bit longer. The data that we've looked at, we are continuing to see higher rebuild rates and retention associated with those longer-term subscription lengths. It's just that we're getting to a point of building those up much more significantly this year versus, you know, what we did the beginning of this year and the very end of last year. That's on that one. Secondly, on like the product mix piece, one is VPC. I think we really hit our stride in the second quarter, and the numbers are still very small.
Obviously, we expect them to be pretty significant. You know, just to give directionally without giving, you know, exact numbers for July, I mean, the revenue in July, while the numbers are still small, was 4x the year-to-date revenue for VPC. The numbers are still very small since the subscriber base is small, but we're really starting to see a ton of traction after we made certain enhancements to that program, launched cross-sell capabilities with Overlake, and obviously improved the overall telehealth offering that we have there. Secondly, we know long term that the real success to our business and frankly any company in this industry, you cannot be predominantly driven by one category.
We continue to invest in diversifying, which means you're taking away some dollars and short-term growth from just throwing it at your leading area and leading product offering in the company, which short-term will mean a little bit slower growth. But we're seeing tremendous traction in building up some of these new categories that we highlighted on the call, which we think are gonna start to get to a very reasonable scale by the end of the year, as will VPC, which will in turn, you know, snowball and continue to make an impact in 2023, both on top and bottom line.
Got it. Very helpful. Can you talk about how we should think about, I guess, the unit economics 'cause in light of calling out how the business has kind of been shifting away from ED, how do those unit economics compare to kind of some of the other indications? As that mix continues, I guess, how do we think about that on impacting the business?
Yep.
Marc-
Just to be clear, we're not sure. Oh, yeah, Justin can take this.
Yeah, Marc, I'd love to comment on that. This is Justin. I think that what we're seeing with the early data from the VPC platform, but you know, it's a big enough sample size to draw some early conclusions from. You know, we're seeing extremely low churn, which is something I've always communicated to you and to shareholders that when you give somebody an amazing doctor, it's the stickiest service on the planet, right? So that's very encouraging. We're even seeing low churn with people that are joining on the lower price, you know, $15 a month memberships and coming in for, say, like, an initial prescription for something like Paxlovid. Like, even among those patient populations, we're seeing low churn.
Like, where churn should be. If you Google, like, where should churn be in a great SaaS business, or if you look at what that number should be, that's where we're at, right? Single digits. I think, you know, that you might see, you know, a little bit longer, you know, payback on your initial investment in acquisition. I'm really confident, you know, and we still have a lot to learn there, but I'm really confident that, you know, we'll be able to see, you know, a dollar that we spend on acquisition back in our bank account, you know, within six months, which I think is really, really good. Again, it's still a little bit too early.
We need to figure out how, you know, what percentage of the population that's on, for instance, a $15 a month subscription, you know, that we can move up to a, you know, $99 or maybe a $49 a month subscription. These are just things that, you know, we're gonna learn as we continue to build the business. We're also working on a lot of highly differentiated service offerings that we're building around chronic conditions. You know, a great example could be diabetes, right? Another example could be, you know, treating GERD. Another example, you know, could be even something like longevity, right?
We're working on a lot of these different, like, offerings where you combine a doctor and prescription medications, if appropriate, over-the-counter products, you know, and they're designed for patients in the population that have, you know, different chronic conditions or healthcare goals, right, that we can treat using the platform. You know, we think over time that these offerings will be really attractive to, you know, to patients that come in for episodic or urgent treatment to LifeMD.
Got it. Very helpful. Since you were touching on the VPC patient cohorts, what's been the mix thus far, and how has it evolved in terms of the lower tier versus the upper tier offering?
The mix has been at least 90%, I would say, $15 a month platform subscribers, you know, which are paying, you know, à la carte, you know, per consult with a doctor. Some of that, Marc, is just because that's where we put a lot of our energy initially. We have some you know really amazing initiatives that are underway right now to really kind of refine and build out the $99 a month offering.
We're really close to launching, you know, our prescription drug discount program, which is something we didn't mention on the call, but it's another great revenue stream for LifeMD, and it's gonna make low cost drugs, like, really accessible to a lot of those Americans that are on high deductible health plans or uninsured. So I'm really excited about that. We're adding, like, this month, we're taking, you know, we're gonna be launching the symptom checker that we've been working on for over a year, which I mean, is just gonna be an awesome product to offer to patients. We're adding a lot of these features, which just have taken longer than we thought to get live, but they're highly differentiating for our platform.
I think that, you know, I think they're gonna be important to, like, really growing the $99 subscriber base.
Got it. I'll just ask one more, and then I'll jump back in. If you could just talk about, I guess, the overall ad market in the second quarter, what you're seeing thus far into the third quarter, and how do you expect that to play out in the rest of the year, and then relating to your ad spend efficiency. Thank you.
I can start and maybe let Marc chime in as well. I mean, we haven't seen a lot of fluctuation in overall advertising costs. You know, it's still. We still see a you know very competitive environment online. We've seen some reduction, you know, in CPMs online, but nothing drastic. We expect, like, the third quarter to be strong. You know, obviously like in prior years, you know, come towards the end of the year and Christmas, you know, we typically slow down our ad spend, you know, more because the environment gets a lot more difficult. Marc, I don't know if you wanna add anything to that.
No, I think that that's all very accurate.
Great. Appreciate it. Thank you very much.
We will take our next question from David Larsen with BTIG.
Hi. Can you just provide a little more color around, I think like, why product revenue, I think, declined on a sequential basis, and I think, telehealth net orders declined on a sequential basis. Was that sort of an intentional strategy to focus on higher margin product sales?
Yeah. David, this is Marc. It was exactly what I outlined before for Marc. A lot of it had to do with longer subscription lengths, focused on subscribers that are higher margin. With that, we have more space now to rebilling. We started that focus earlier on in the year. We intensified that focus as we moved into the second quarter. We're gonna continue to see some impact from that for the next couple quarters as we build up a more critical mass from these longer subscription lengths, i.e., six and 12 month subs, and those begin to start rebilling next year. That was an intentional thing. Secondly, we shifted more focus to launching, not just launching, but also scaling a lot of these new indications.
Pain, you know, sleep, virtual primary care, which is also off to a great start. You know, all of those added up to what you were seeing and what we called out in the release, as well as the call today, regarding what we expect to see, relatively more modest sequential growth over the next couple of quarters, and then obviously rebounding to more aggressive growth, but much more profitable growth, going forward next year.
Okay. If you have more lives convert to a subscription model or a longer-term subscription model, I guess I'm a little unclear on why that would result in a sequential decline in revenue.
What happens is when we rebill someone, we recognize 100% of that revenue at that time. If you're on a one or three month and you get rebilled every month or every single, you know, every three months, we get, you know, effectively, we could be getting anywhere from one to three rebills next quarter from you. If you're on a six-month or a 12-month, we're not gonna get any rebills from you next quarter, but we're gonna get a lot larger or higher sum dollar rebill from you next year. There's some timing as it relates to that, which is what contributes to some of that impact.
Okay. For PDFSimpli subscribers, I think that there was a pretty good pop sequentially from Q1- Q2. Is that correct? It looks like revenue picked up.
Yeah.
Pretty significantly.
That's correct. Almost all of the WorkSimpli subscribers are monthly. I mean, they have two plans. They have month-to-month, and they have annual. Most people are month-to-month, so their revenue growth tends to pretty closely link up with their subscriber group.
Okay. Then how is the sale process progressing, and any color you can provide around potential strategic acquirers?
Yeah.
Mm-hmm.
Yeah. Here's what I'll say. It's very, very good, and we're highly optimistic about closing a transaction on or before the end of the year. I can't get into specifics because we're actively in the LOI phase. We're, you know, we've received a lot of interest. We'll leave it at that. Both ourselves and our bankers feel very good about it. Very strong demand. I just can't get into specifics 'cause we're actively in the process.
Okay. For CAC, how did that trend in the quarter, like from one Q to 2 Q and year-over-year?
Yeah. It was down slightly year-on-year on a blended basis, and it was essentially flat quarter-on-quarter, not much change.
Okay. Assuming, like, if there is a recession through 2022 and into 1H 2023, how would you expect that to impact the business, if at all?
I don't think it's gonna impact demand for our products and services. If anything, it could drive down CPMs more, so we could see some benefit on the CAC side of the business. We don't really expect it to impact the demand for the company's products and services.
Okay. Thanks very much.
Yeah, David, just to add to Marc's comments. It's Justin. You know, I think, you know, if you look at most of the conditions that we treat, I mean, there are things that need to be treated, you know, in a great economic environment or a terrible economic environment. You know, even if you did see more price sensitivity or some decreases in demand, you know, this is something we've spent a lot of time looking at. You know, we believe that that's possible. But you know, we believe that that would also likely be offset, you know, by reductions in advertising costs.
We continue to diversify the business too, which, you know, I think it's one of the most important things for me is that, you know, we continue to diversify the business, like the primary care business is the ultimate diversification. You know, I think in a more difficult economic environment, that's a big plus for LifeMD.
Okay, great. Thanks very much.
That will conclude today's question and answer session. I'll turn the conference back over to Mr. Schreiber for any additional or closing remarks.
We don't have any additional remarks. Just wanna thank everybody, all of our shareholders for their continued support. We're, you know, really optimistic about future of LifeMD, and we're gonna do some great things and, you know, continue to build a leadership position in telehealth. Have a nice evening.
That does conclude today's conference. Once again, thanks everyone for joining us. You may now disconnect.