Good morning, everyone, and thank you for joining OptimizeRx's fourth quarter and full year fiscal 2024 earnings conference call. With us today is Chief Executive Officer Steve Silvestro. He is joined by Chief Financial Officer Ed Stelmakh, Chief Legal Officer Marion Odence-Ford, and Senior Vice President of Corporate Finance, Andrew D'Silva. At the conclusion of today's call, I will provide some important cautions regarding the forward-looking statements made by management during today's call. The company will also be discussing certain non-GAAP financial measures which it believes are useful in evaluating the company's operating results. A reconciliation of such non-GAAP financial measures is included in the earnings release the company issued this morning, as well as in the investor relations section of the company's website.
I would like to remind everyone that today's call is being recorded and will be made available for replay as an audio recording of this conference call, and will also be provided on the investor relations section of the company's website. Now, I would like to turn the call over to OptimizeRx CEO Steve Silvestro. Sir, please go ahead.
Thank you, Operator, and good morning, everyone. Thank you for joining today's fourth quarter and fiscal 2024 earnings call. As many of you know, this is my third day as OptimizeRx's new CEO. I'm honored to have the opportunity to lead the next phase of OptimizeRx's growth and transformation. Now more than ever, we will be laser-focused on operational excellence while ensuring we delight our customers and forge stronger relationships with valued business partners. Over the past few months, we've completed an extensive strategic review of the company's business process, operations, and growth plans, and we believe we're on the right path forward.
We're working towards continuing the company's growth, focusing very closely on customer centricity and delight, continuing to expand our unique value proposition with pharma, converting customers to our recurring revenue model while driving to become a Rule of 40 company and unlocking new opportunities for profitable revenue growth. Importantly, I'm looking forward to meeting more of our investors throughout the year and hearing our investors' thoughts and perspectives on our shared objective: shareholder value creation. While we believe we are executing the right strategies, we're always open to hearing our investors' thoughts on alternative strategies that further our shared goals. As for our 2024 financials, I'm happy to say that we beat our guidance and Street expectations with revenue and adjusted EBITDA coming in at USD 92.1 million and USD 11.7 million, respectively.
I believe OptimizeRx is uniquely positioned to drive value creation and build long-term sustainable shareholder growth by leveraging one of the largest EHR and e-prescription networks in the country to help pharma manufacturers reach healthcare providers at the point of care. Building on that, we are combining that unparalleled network with a unique purpose-built omnichannel technology platform that is transforming how pharmaceutical companies, physicians, and patients engage, ultimately improving care outcomes for patients. These elements give us a distinct competitive edge. With an unrivaled point of care reach, we believe we are the only company in the industry that can effectively connect both doctors and patients at scale. This has allowed us to develop the broadest suite of solutions in the industry, enabling us to meet the diverse needs of our customers across the full spectrum of their product lifecycle.
Coupled with our highly experienced team and a long-standing track record of delivering for top-tier pharma clients, we firmly believe we are in a leadership position in the industry that will take others years to match. As our business continues to evolve, our offerings are scaling as we continue to tackle some of pharma's toughest commercial challenges, including brand visibility, as many clinicians and providers have reduced in-person meetings and are spending more time in front of computers. Script abandonment, as approximately 50% of patients never fill their scripts at the pharmacy. Interoperability, as providers' inability to access relevant patient information in one place to make more informed decisions at the point of care.
Finally, the shift to more complex and expensive specialty medications, where more complex diagnosis criteria are required to identify brand-eligible patients, as expensive specialty medications now account for roughly half of total drug expenditures in the U.S. On average, we're driving strong brand engagement with measurable success. When launching a six-month program with a brand, we consistently achieve an ROI well over 10 to 1 on HCP marketing spend. Additionally, we see a 25% average script lift in our six-month programs. These capabilities enable us to capture a greater share of wallet from established customers. In 2024, our top five customers averaged over USD 9 million in revenue, and we're on track to elevate at least one more customer to this level in 2025. A great example of our impact comes from one of our largest customers, a top five pharma manufacturer.
After a successful 2023 supporting multiple brands, including a launch brand, 2024 began with strong bookings across the portfolio. Independent program analysis for this manufacturer demonstrated a material impact on prescription lift, leading supported brands to increase their share of voice across the OptimizeRx network. To drive further results, some brand teams focused on boosting incremental new prescriptions in addition to refills before year-end. To support this objective, we identified key areas where additional investment could expand program scale, physician reach, improving patient conversion for each program. As I move forward in my new role as OptimizeRx CEO, I'm working with our executive team to implement a robust multi-year plan to grow the business and increase shareholder value. While many aspects of the business will be the same, everything will be going through the lens of getting us to a Rule of 40 company over the next several years.
In moving towards this financial goal, we expect to drive substantial operating leverage and build a more predictable business, including by establishing a consistent recurring revenue component to our business as we aim to convert our DAAP customers to a subscription-based model from the data component of our offerings. We believe this will improve margins and visibility over time while substantially enhancing the overall predictability of our revenue streams. In turn, this will also enhance our ability to scale the business and plan for substantial growth that we and our investors are seeking. With a USD 10 billion TAM and a large under-penetrated market and tailwinds driven by increased pharma advertising spend on digital channels, OptimizeRx today is well-positioned to execute on our revamped strategic plan.