Good afternoon, and thank you for joining us today to discuss the Results for LifeMD's Third Quarter, ended September 30, 2023. 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. 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 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 have 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, November 8, 2023. The company assumes no obligation to update or revise any forward-looking statements after today's call, except as required by law. Also, 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. Finally, 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 CEO, Justin Schreiber. Please go ahead.
Thank you, and good afternoon, everyone. After the market close, we issued a press release announcing our third quarter results and posted an updated corporate presentation on our website at ir.lifemd.com. LifeMD had a tremendous third quarter with record revenue and profitability. Our core telehealth operations produced extremely strong results in both our lifestyle healthcare businesses, led by Rex MD, our men's health brand, and our rapidly growing virtual primary care business, led by growth in our GLP-1 weight management offering. Our Rex MD business grew 12% versus the year-ago period, with a net margin of 38% in the third quarter. The performance of our GLP-1 weight management business has been nothing short of exceptional, with revenue quadrupling over the prior quarter's results, far surpassing our projections.
Looking ahead to Q4 and beyond, LifeMD is positioned to not just sustain, but continue to build upon the tremendous success we've experienced throughout the year across our telehealth businesses and with WorkSimpli. I believe LifeMD is uniquely positioned for 2024 to be a record-setting year. To deliver excellent value for our shareholders, we remain laser-focused on the following four major strategic initiatives. First, our largest initiative in the year ahead is continued focus on accelerating the growth of our weight management program. Since launching in Q2 of this year, our weight management program has already attracted over 16,000 patient subscribers, representing more than $24 million of annual recurring revenue. Even as we scale our daily acquisition volume, this offering's economics remain tremendous, with our day one return on ad spend consistently exceeding 1x.
Moreover, we anticipate several tailwinds to further accelerate the growth of this business into 2024, including: continued growth in brand recognition of our weight management offering. 2, LifeMD beginning to accept commercial and government insurance programs, which I will speak about in a moment. 3, better availability of medications and likely expansion of insurance coverage in 2024 for GLP-1 medications. 4, expanded therapeutic options within the GLP-1 drug class, including generic liraglutide and FDA approval, which happened today, of Mounjaro for weight loss in adults with obesity. And 5, new growth channels from partnerships that are already in the works. Second, we remain focused on making substantial progress in the growth of our B2B enterprise program.
As we announced during the third quarter, we executed an agreement with Ascend Therapeutics, a leader in the hormonal and women's health markets, which allows Ascend to leverage LifeMD's cutting-edge telehealth platform, data capabilities, and healthcare marketing expertise to support its products. This not only generates ongoing fees for LifeMD, but also places the all-important patient-provider relationship within our affiliated medical group. LifeMD also executed a joint sales and marketing agreement with IQVIA, leveraging our leading telehealth infrastructure in partnership with IQVIA's comprehensive commercialization solutions. With a robust B2B pipeline, we expect to execute additional opportunities in the near future. Third, we have made and will continue to make significant progress in enrolling our affiliated medical group in commercial insurance plans. We expect to bill our first consult in Q4, and we'll be rolling out coverage nationwide throughout 2024.
As commercial insurance becomes more embedded within our offerings, we expect it to significantly lower the out-of-pocket cost of our services to our patients and to be a big driver of overall patient satisfaction and retention. Additionally, we have already begun building an industry-leading compliance infrastructure for Medicare participation and anticipate being prepared to launch and scale this as soon as it makes sense for our patients and our business. We believe that participation in commercial and government insurance programs will fuel another leg of significant growth for LifeMD. And our fourth key initiative is continued focus on our lifestyle healthcare business, led by Rex MD, where we continue to drive double-digit growth with net margins exceeding 30%. Our men's sexual health business continues to be highly profitable and shows no signs of slowing.
In 2024, we see further opportunities to expand this rate of growth and profitability through the introduction of new complementary product, products, including ones geared toward hormone replacement therapy, weight management, and cardiovascular health. Lastly, WorkSimpli continues to deliver exceptional results on both the top and bottom lines. This self-managed business is a meaningful contributor to LifeMD's overall profitability and cash flow. Moreover, WorkSimpli has successfully diversified from a PDF solutions business to a diversified workplace services business, including HR solutions, digital signing, proprietary forms, AI technology, and plans to enter additional adjacent markets in 2024. WorkSimpli now operates in 20 languages globally and has increased its once negligible small business customer penetration to approximately 15% of the total subscriber base today. We expect WorkSimpli to generate at least 20% annual growth in 2024, with Adjusted EBITDA margins of approximately 30%.
In short, we're in a really exciting spot, and with that, I'll 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. LifeMD had record third quarter performance on both the top and bottom line, with consolidated net revenues growing to $38.6 million and consolidated Adjusted EBITDA growing to $2.8 million. Additionally, we ended the quarter with over $15 million in cash and our second consecutive quarter of positive operating cash flow. We are in a well-capitalized position to continue to execute upon our aggressive growth and profitability plans. Now turning to the results for the third quarter of 2023. As I mentioned, revenue in the third quarter totaled $38.6 million, an increase of 23% compared with the same year-ago period and up 7% versus the second quarter. Total telehealth revenues grew 14% versus the year-ago period and 9% sequentially.
Net revenues from our weight management business more than quadrupled versus the prior quarter. Subscriber growth remained very strong, with the number of telehealth active subscribers increasing 22% to approximately 207,000, and WorkSimpli active subscribers increasing 14% to over 170,000, both versus a year-ago period. Consolidated gross margin for the third quarter was a record 88%, up 300 basis points versus the prior year period. Gross profit for the quarter totaled $33.8 million, an increase of 27% from the year-ago period. Operating expenses for the third quarter totaled $38.4 million, an increase of $4.6 million versus the year-ago period, reflecting our discretionary increases in selling, marketing, clinical, and patient care expenses to support the rapid growth of our weight management offering.
Net of these investments, operating expenses were flat year-over-year. Operating expenses in the third quarter included $5.2 million of non-cash expenses associated with stock-based comp, non-cash interest, depreciation, and amortization expenses. Our GAAP net loss attributable to common stockholders for the third quarter totaled $6.9 million, or a loss of $0.20 per share. This compares to a GAAP net loss attributable to common stockholders of $8.1 million, or a loss of $0.26 per share in the third quarter of 2022. Adjusted EPS is a non-GAAP financial measure that excludes non-cash expenses, dividends, stocks, and insurance acceptance readiness, litigation expense, non-controlling interests, M&A expenses, financing transaction costs, and foreign currency translation.
Reflecting those adjustments, Adjusted Diluted EPS for the third quarter of 2023 was $0.08 per share, compared with a loss of $0.03 per share in the same year-ago period. Adjusted EBITDA, a non-GAAP financial measure that excludes the same items I noted for Adjusted EPS, totaled $2.8 million in the third quarter of 2023. This compares with an Adjusted EBITDA loss of $806,000 in the same year-ago quarter. Cash and cash equivalents totaled $15.3 million as of September 30, 2023. We believe the strength of our balance sheet and profitability of our current operations will more than adequately allow us to fund the growth in our business.
For 2023, we expect to achieve the midpoint of our previously disclosed revenue range, more specifically, revenue between $148 million and $149 million, and Adjusted EBITDA between $10 million and $11 million, including the estimated impact of approximately $4 million of deferred revenue related to weight management, resulting from the GAAP-required amortization of fully paid subscription amounts over their initial time period. This wraps up our financial results. I'd now like to turn the call back over to Justin.
Thanks, Marc. As we conclude today's call, I want to take a moment to reflect on our journey and the path ahead. Over the past few years, I have constantly stressed our commitment to building a best-in-class telehealth technology platform. I believe our third quarter achievements validate our continued efforts. At the heart of our success is our telehealth platform, guided by an exceptional 50-state affiliated medical group and purpose-built technology that powers Rex MD and our rapidly growing virtual primary care business. Our GLP-1 weight management offering, in particular, has exceeded all of our forecasts, and we're just getting started. Looking ahead, we are in a position of strength. With the ongoing success of our businesses, WorkSimpli, and our planned B2B partnerships, we expect to deliver even more impressive results.
As we prepare to finish this quarter and enter 2024, I am confident in our ability to not only maintain our momentum, but to accelerate it. With that, I would like to open the call for Q&A.
Thank you. At this time, we'll be conducting a question-and-answer session. If you'd like to ask a question, please press star one on your telephone keypad. A confirmation tone will indicate your line is in the question queue. You may press star two if you'd like to remove your question from the queue. For participants using speaker equipment, it may be necessary to pick up your handset before pressing the star keys. One moment, please, while we poll for questions. Our first question comes from Sarah James with Cantor Fitzgerald. Please proceed with your question. Sarah, are you there? Are you muted? Your line is live with the speakers. Sarah James, are you muted? Okay, I'm going to David, are you there?
Yep, I can hear you now. If you were calling for me, I didn't hear you, but yes, I'm here. Congratulations on a great quarter, great revenue and EBITDA. Did I hear you correctly in saying that you're at a $20 million annual sort of trend for your weight management program with.
Yes.
16,000 lives?
Yes. We're currently at about 16,000+ lives at about $129 a month is the pricing. So that's where you get to the $24-ish million that we quoted.
Okay. And then what are your expectations for that life count heading into next year? And like, what portion do you expect to retain? Do most people stay on the program or not? Thanks.
Yeah, this is Marc. So we're seeing thus far, and again, it's very early on, we're not giving full guidance for the number of lives next year. We anticipate giving 2024 guidance in January of 2024 after the plan for next year has been fully approved by the board. The expectation, though, is that we're going to see very significant growth next year, and again, we will follow up with more full guidance within the next couple of months. As far as retention, there is a little bit of the initial falloff, which we've talked about before, in the range of around 25%-30% within the first 30 days, entirely due to insurance coverage and the cost of copay. After that, we're seeing really strong retention.
We're seeing 80%-90%, very high numbers of people, staying on the program after. Again, the data is very early on, but, we are very optimistic, about weight management. And as I think folks may recall from earlier calls, we built the original model with extremely pessimistic, retention in place. So if retention continues to play out the way, that we've seen early on, we expect there could be some considerable upside in the coming years.
Okay, and then can you maybe talk about pricing for the various products? When do you think some of these will come off patent? Will you, will you benefit - will your margins benefit from that, if and when that happens? Just any thoughts there?
Sure, David. I mean, we're charging right now. This is Justin. We charge right now around $100 a month with discounting, for you know, for patients to use our platform, access our affiliated providers, you know, and receive everything that comes with being a patient of LifeMD. I do think that it's nice to have, you know, another, the first GLP-1 coming off a patent that's happening in December. So we expect to have a supply agreement in place by Q1 with the generic manufacturer of liraglutide. You know, I think that will help to reduce that third of patients that we end up refunding right away because of, you know, access and cost issues.
You know, I'm also very optimistic, and I know this is controversial, but I'm optimistic that, you know, throughout next year, prices, you know, that there's, there continues to be downward pressure on prices, within the kind of GLP-1 category. You know, even today we saw the approval. We saw Eli Lilly's approval of Mounjaro for weight management. And there's, you know, there's some thinking right now that. Well, what we saw was that they expect to price that around $1,000 a month and with a 50% discount coupon. So, you know, we're optimistic that over time, prices are going to come down the drugs. LifeMD is also, you know, going through the process of contracting with major insurance plans across the country.
You know, we think that being a network is going to enable us to, you know, also for patients with private insurance or eventually Medicare, when Medicare covers these medications and this treatment, we think that will enable us to, you know, to lower that monthly or quarterly price of our services. So longer term, yes, we think that the price will come down. And as you know, as we've mentioned before, we're also working with some very, very large, some of the biggest diet companies throughout the U.S., and we expect some of those partnerships to also help us on the coverage side and, you know, getting more patients approved and covered by their insurance companies for these medications. So that ultimately results in people spending less, you know, on the complete offering.
Right. So are. Do you have a partnership in place with, like, a Medifast or a Nutrisystem right now? And then could you introduce those products to your members? And then if your members wanted to transition from the GLP-1s over to a more sort of, we'll call it, traditional sort of weight management program, would they be able to do that? And just what are your thoughts on CGMs? Do you have a program in place to use them with health coaching? Thanks very much.
Sure. So with regards to Medifast and Nutrisystem, these are two companies we've talked about, you know, previously that we did pilot programs with. We're also working on, we've done pilot programs with other companies that we haven't that weren't public. And as of right now, you know, we haven't announced any partnerships with any of these companies, although we've said publicly that, you know, we expect to, you know, announce a transformational partnership with one of these kind of very prominent nationwide health and wellness or diet companies. I'm excited about, you know, I think it's essential that LifeMD offers, you know, a food plan, a diet plan, you know, along with, you know, access to GLP-1 medications.
I think it's also important that we offer coaching and nutritional advice, which is something else that we're working on, which, you know, is interesting in the pilot that we did with Medifast. Medifast, you know, also has, you know, an amazing coaching network throughout the United States. So that's something that we're potentially excited about down the road. I think the other thing that we're really looking at is technology solutions. So I think that, you know, there are a lot of different technology solutions that we can in-license that would bolt on to our existing technology platform, you know, that would help patients kind of track their eating, hold them accountable, you know, to eating properly, you know, and maximizing their metabolic health. So I'm very excited about that as well.
You know, also on the CGM front, you know, we're in the early stages of talking to some of the leading manufacturers of CGM devices, and I think that's something that over time, we'll also incorporate into our offering.
Okay, fantastic. I'll hop back in the queue. I don't want to take up all the time here. Thanks, great quarter. Congrats.
Thank you.
Thank you.
Our next question comes from Sarah James with Cantor Fitzgerald. Please proceed with your question.
Hi, guys, and apologies for earlier. So I wanted to get a little bit of an understanding of where your clinical recruitment pipeline is right now, how you're thinking about pacing, bringing on the staff, and then just from, like, a ROI perspective, how do you think about allocating that staff's time between weight management and primary care?
Thanks, Sarah. This is Justin. That's a good question. We've spoken a lot about how proud we are of the reputation that our affiliated medical group has built in the industry. We have an enormous amount of interest, you know, when it comes to working for LifeMD. I think I've said before, we have 400-500, you know, resumes that have come in over the last couple of months, you know, as we've scaled the medical group as a result of the growth of our GLP-1 weight management offering. I'm not concerned at all. We have-- We're in the process of onboarding, you know, another three-five providers over the next couple of weeks. You know, that's going very well. I think that you're gonna.
Yeah, I think we're gonna have to onboard probably at least 10-20 providers over the next six months, and I'm not concerned at all about our ability to do that. And I'll also mention we're extremely picky with the providers that we allow to interact with and treat LifeMD patients. So when I say we're gonna be able to recruit providers, it always means we're gonna be able to recruit the best providers out there.
Got it. And then in my conversations with the payers, there seems to be some movement going on in the regulatory front, in certain democratic states like California and New York, around GLP-1 coverage, that could be positive for acquiring coverage. I'm wondering if you're seeing any of that flow through in your business, in volumes in California and New York, or if it's too early?
I think it's too early. I mean, our patients are still having, you know, there's still issues with coverage, these medications. There's still supply issues, you know, around supply issues. Patients are oftentimes struggling to find them in neighborhood pharmacies. So I, I'm not familiar with those kind of legislative initiatives, but we're of course all for that at LifeMD. I mean, one of the interesting things is we see firsthand, all day, every day, how many people's lives are being positively impacted by these medications. You know, I understand it's all about long-term outcomes, but, you know, based on what we've been seeing over the last 12 months, I find it highly unlikely that we're not going to see pronounced, long, very positive long-term outcomes from, you know, these therapies.
Great. And last question, if I could. Can you give us any update on the cross-selling efforts that you guys have going on between the legacy businesses like Shapiro and Rex and your primary care? Any update there?
I don't have any specific numbers that we're prepared to share today. I can tell you that the weight management offering is the number one service that is cross-sold to, you know, Rex MD patients in their member portal. So that's been really successful, and this is something that in 2024, we expect to dramatically accelerate, but I don't have any like specific numbers that I'm prepared to share today, Sarah.
Okay. Thank you.
Our next question comes from Yi Chen with H.C. Wainwright. Please proceed with your question.
Thank you for taking my questions. The weight management revenue more than quadrupled versus the second quarter. Do you think that's primarily because some of your competitors do not offer this product or because there is something, some unique combination of offerings that's available at LifeMD?
There are a number of, I mean, there are a lot of other companies, telehealth providers, offering this product. So no, I don't think that's the reason for our success. I think that demand, there's very, very high demand across the country for these drugs because of their efficacy. And I think that, you know, LifeMD already has a very strong brand out there that people recognize, and I think we're doing a great job at bringing patients in, helping them access amazing care. We're seeing more and more patients that are coming to us because they heard about LifeMD from a friend or family member that's on a medication. So I think it's an extremely competitive environment out there, but I think we're doing a great job at doing what we do best.
Do you believe the weight management revenue has the potential to sequentially grow twice, three times, or four times every quarter going forward?
Yes. Marc. The weight management revenue has the potential to grow extremely substantially every single quarter going forward for the foreseeable future. Is it going to quadruple every single quarter? No. I mean, as the numbers get bigger, obviously you would end up with a completely insane number. However, I do expect in the next quarter to see in weight management more than 100% sequential growth, so the revenue more than doubling quarter on quarter. And I do expect to see very heightened growth next year versus this year. This will all be factored into the guidance that we provide for 2024, in the beginning of 2024, but we don't see any signs of it slowing down. As a matter of fact, the business continues to accelerate.
Thank you. Last question is, do you intend to keep WorkSimpli throughout 2024?
Yes. Marc. We're evaluating all options for WorkSimpli. We haven't made any final determinations. If we did exit the business next year, and at some point we will exit the business, we expect it to be a substantial exit, returning a significant amount of cash back to the company and obviously generating a lot of value for our shareholders. Something that we're exploring, but no final determinations have been made yet, but we do expect it to be substantially beneficial to shareholders.
Got it. Thank you.
Our next question is from Neil Chatterji with B. Riley. Please proceed with your question.
Hi, this is Brandon Carney on for Neil. Congratulations on a great quarter, and thanks for taking our questions. Just to start, maybe, with the Zepbound approval today, maybe I could ask for some color on how the addition of new GLP-1 options, accelerate the potential growth of, the weight loss business.
Sure. This is Justin. I'll answer that. Look, I think that the more options that our affiliated providers have to help patients achieve their weight loss objectives, you know, the better and more comprehensive the offering is going to be. So all of these approvals help us. You know, the other drugs in this class that are also working their way through the FDA are going to help us. You know, liraglutide is going to be an option for some patients as well. So this stuff certainly is very helpful. I think what's more helpful though, is going to end up being like these drugs coming off the shortage list, you know, them being available for patients, accessible to patients, and then, you know, them being covered ultimately by insurance plans. Affordability is.
Great, thanks.
The number one thing.
Right. Right. And then I guess just going back to the retention question, so you mentioned, like, the 25%-30% drop-off in the first 30 days. I'm just wondering if there's any mitigation strategies going into pushing down that number, or if you think that things like what you're just talking about will just naturally push down that number?
We're doing everything we can. The reality is most of these patients are coming in, you know, and signing up for this program because they've heard about a GLP-1, because they have a friend or family member, or they heard about it in the news or read an article on it, and that's what they want. And if they find out that their insurance is not gonna cover it, it's gonna cost them $1,000 a month, or there's a number of those patients as well that are just not, they don't qualify for the drug. So, you know, we adhere kind of very strongly to the label that's on these medications.
So patients that are between 27-30 BMI, that don't have at least one comorbidity, a LifeMD affiliated provider will not prescribe them the medications. Obviously, patients that are under 27 BMI, we will not prescribe the medications to them. So that 30% number, it's not only patients that are not able to afford the medication or don't have coverage for the medication. There's also some patients in there that are Medicare age. So to be, you know, out of an abundance of caution and, you know, just to be very careful, like, LifeMD doesn't prescribe or treat patients that are of Medicare age until we turn on formally our Medicare program. So, you know, those, there are a lot of people that sign up, even though our technology won't let them sign up.
A lot of people will change their date of birth in order to sign up for the program, and we obviously find that out when we check their ID, and they see a provider, and then those people are refunded. So it's a mix. That 30% number, there's a mix of. There are numerous reasons why those people are, you know, refunded. And we will. I think that number can come down a little bit, but we're what we're more focused on is actually just doing everything we can to offer incredible care, you know, to the two-thirds of patients that end up on a therapy. And then we're also really focused on what happens after these patients, you know, reach their goal weight.
Like, how do we, you know, how do we keep, you know, at least a third of those patients even, you know, on the LifeMD platform, interacting with one of our affiliated providers, using our technology, all the other things we offer? You know, how do we, you know, how do we keep those, a third of those patients for years? And that's actually what we're most focused on right now as a team.
Great. Then that's really helpful. Thanks. And, maybe just one last one. You know, on the commercial insurance launch, are you still expecting programs in 10 states by the end of the year? And, how does the outlook look, for further expansion next year?
We're a little bit behind schedule. We thought we would have the majority of these plans in place and active by, you know, by this month. I think that we will have major plans. We will be contracted with major plans in all 10 states by the end of the year. I think it's probably gonna take us; it's probably gonna end up being Q1 until we have the broad coverage across those initial 10 states. And I think we've learned a lot from this process. So as we expand the program throughout the rest of the country, I think we can do it, you know, a lot, a lot, a lot, a lot quicker than it's taken us to get these plans in place in the first 10 states.
Got it. Yeah. Thanks for taking our questions, and congratulations again on a really great quarter.
Yeah, you're welcome. It's our pleasure.
We have reached the end of the question and answer session. I'd now like to turn the call back over to Justin Schreiber for closing comments.
Thank you for your questions and for your interest in LifeMD. We look forward to speaking with you once again when we report our year-end financial results in March 2024. Have a good evening.
This concludes today's conference. You may disconnect your lines at this time, and we thank you for your participation.