My name is Ryan Daniels. I'm the Healthcare Services and IT Analyst that covers OptimizeRx. Very happy to introduce Steve Silvestro, who's to my far right. He's the company's CEO, and Andy D'Silva is the company's Head of Investor Relations. A couple quick housekeeping items. Number one, after the session, we will go up to Burnham B on the second floor for the Q&A breakout session. Number two, required to inform everyone that our disclosures are available on our website at williamblair.com. Steve will go through the OptimizeRx story, so I won't go into a lot of detail, but very excited to have them here today.
Great organization serving the pharmaceutical manufacturing industry, a very unique value proposition in that it's really the only entity that's fully integrated at the point of care into the EHRs when doctors are kind of working with patients and have that sense of urgency. They can deliver messages not only to individuals through direct-to-consumer marketing, but also to those providers. A very synergistic business model, very high ROI, we think a great long-term opportunity here. With that, I'm going to turn it over to Steve, who will go through the presentation, and Steve and Andy again will be upstairs in Burnham B, where we'll do the Q&A session. Steve, I'll turn it over to you.
Thanks, Ryan. Appreciate it. Can you guys hear me okay on the sounds coming out okay? All right, great. Good to be with everybody this morning. We'll get into it. I don't think we need to read the forward-looking statements comment in here. This is our business at a glance, just corporate profile, sort of where we're at. Currently trading at $5.38, 18.8 million shares outstanding. Market cap just a little bit north of $100. We've got $20 million on the balance sheet right now. Debt is virtually neutral. Had a good refi this last couple months ago, and were able to cut the debt expense in half in terms of interest, and so that was really good.
Company's been in business now for quite a bit of time, although I would say we've had a bit of a restart in the last three years, kind of a relaunch of our business. Business really started out as a means of communication with physicians looking to find financial savings for patients that they were treating. The founders of the business were two ex-pharmaceutical sales reps that were calling on major accounts. Their job was really to find a way to digitize some of the work that they were doing, and a lot of that was circulated around copay financial savings. Initially, they stood up a website, took their copay assets, digitized them, put them on the website, and then tried to get physicians to use that. Soon after that, they were approached by one of the major manufacturers in pharma.
It was Eli Lilly. They were also approached by Allscripts, which was an EHR. They were running a pilot to try to determine whether or not there was an ability to run those inside of the EHR systems that were spinning up with the funding from the Affordable Care Act. That pilot was massively successful. That began sort of the quest of integration into EHRs. As you heard Ryan say, we're now integrated into the largest network. We have built the largest network at the point of care. Point of care meaning that sort of sacred time when a physician is engaging with a patient, making a diagnosis decision, a clinical decision, and subsequent therapeutic administration. Company's got 130 employees. We're predominantly U.S.-based. We do have a development site in Croatia.
We have tech and engineers that are based out of there and a little bit of legal based out of there. Then we have some contracting that happens on the engineering front out of India, as most do. Business is really focused on tackling some of the major problems within the healthcare industry. These are things that you'd be familiar with seeing all the time if you're following the space or following our business. Those are really brand visibility, so making sure that brands are able to communicate the value proposition that their specific asset has, both to patients and to providers. Providers are increasingly having less and less time to engage with patients and understand their specific needs in terms of therapy regimen, so getting that information to physicians when they're contemplating therapy selection is really critical. Shift to specialty medications.
Most of the prescriptions that are being prescribed outside of the DTC environment are now specialty medications, so things like oncology or immunology. Even most of the cardiology drugs now fall into that specialty category, even the GLP-1s that we've been hearing so much about on the news. Affordability is a huge issue, continues to be a huge issue. We don't have to do a poll in here, but if I was to ask you what you're paying for your current prescriptions, you probably couldn't tell me what they cost. You could tell me what the copay is, but you certainly couldn't tell me what the ex-manufacturer price is, what the insurance company's paying, what the cash pay price is. If you can't do that, I guarantee you my 82-year-old Italian immigrant mother cannot do it.
We have a real unique ability to make sure that affordability is front and center for patients and for physicians. What that enables the physician to do is to make the right clinical decision for the patient without the cost sort of prohibiting that. You'll hear terms like prior authorization and real-time benefit check. We're dealing with some of that as well. We're tackling the issue of script abandonment, and this is a really big issue. Most of the challenges in the U.S. actually don't come from the first prescription being written. It comes from subsequent prescriptions being abandoned. 70% of scripts that are written in the U.S. are not filled the first time that they're transmitted to the pharmacy. That is a very big problem and a really sort of mind-blowing statistic, which means that follow-up's required.
You'll see some of the pharmacies like Walgreens and CVS have got apps where they're trying to pull people in and make sure that they come to pick up their scripts. They're trying to find a way to remind the doctor, "Hey, the script hasn't been fulfilled. Call your patient again." We sort of sit as an intermediary in some of those areas as well with pharmacy alerts. Interoperability and scalability. This is really a huge problem within our space. When the Obama administration funded the EHRs to spin up with the Affordable Care Act, the goal was to create interoperability in the healthcare system. Meaning that all of these EHRs, electronic healthcare record systems, could plug into each other. That would evitate the need for walking around with CD-ROMs from doctor- to- doctor or bringing files and so forth, or waiting for a file to be emailed across.
That interoperability didn't happen. What happened was everyone sort of grabbed those funds, built their own little fiefdom, and then very quickly put a moat around it so that they could control the data, control the patients. The problem is that didn't benefit the patients. It benefited the 387 independent EHR family offices that are sitting out there right now. There are a couple of big players in the EHR space that you'd be familiar with. Most of them are academic-focused, like the Epics or the Cerners, meaning institutionals, big hospital systems. The outpatient setting is largely massively fragmented, continues to be.
We sit as an intermediary of connectivity through that entire ecosystem of outpatient EHRs, meaning we are connecting and creating interoperability so that when a physician needs to get information about a specific patient. We can provide that and facilitate it at the point of care when the patient is with the physician. That's a huge piece that we work on. Really daily EHR use can be all-consuming. There is not a physician that I've ever met, and I've met quite a few physicians, that is enamored with their EHR experience. They all hate their EHR. It is a terrible experience. Largely because they're forced to walk through a certain number of steps that really doesn't align with the way that they learned how to practice medicine in medical school.
We're seeing more and more intervention at the point of care and different ways of trying to force physicians to treat in a specific way. Most of that is coming from pressure from insurance companies and payers trying to control cost. The response is from doctors, "We hate the EHR. How can you make it better for us?" We're continually looking at deploying tools inside of our network that will benefit the experience of the physician, and support them in treating their patients. Our mission really is to sit at that intersection of pharmaceutical manufacturers trying to get their drugs sold and their products deployed, patients that are in desperate need of those medications, and also the physicians that are trying to treat those patients with the most effective medication they can for that specific disease.
The unfortunate reality in our current country is that most of the patients that need these medications don't have a pathway to get them. Part of our mission is to ensure that patients get the correct medication that they need, and that they have a successful outcome, and that the outcomes are good for everybody overall. What we see definitively is when the patient does get the right medication and they're compliant with it, the outcomes actually reduce the overall cost burden for everybody that's involved in that transaction, even though the incentives are initially misaligned. This is our leadership team. We've got a great leadership team. Andy's here, our Chief Business Officer with me, a nd you may know him from B. Riley, was an Analyst for many, many years covering this space. And has just been a wonderful partner financially and in our Investor Relations.
Also operationally, Andy's helped bring a lot of great discipline to us in the last couple of years, and you can see that reflected in our financials. Our financial profile is very, very strong, and I credit Andy with getting us there. Our CFO, Ed Stelmakh, industry veteran, was the former CFO of Otsuka North America , so really understands how pharmaceuticals think about making investments, how they're thinking about partnering with different people, and Ed's been wonderful to have on the leadership team these last five years. Marion is our Chief Legal Counsel. Marion is a longtime industry veteran, spent a number of years at Decision Resources Group as we scaled that together from really its inception to 200+ million and exited it.
Brendan is our Chief Operating Officer, and Brendan did a stint at State Street, so he can speak banker, but he did a lot of time at OptimizeRx and was the Head of Operations there and just did a wonderful job. A small group, but a great group and all focused on growth. This theme is really something that we are laser-focused on as a business, is just connectivity, and you'll sort of see this throughout the presentation. I know we'll move to Q&A after this in a different room, and you can fire any questions you've got at us. This business really sits at the intersection of communication of all of these different stakeholders in our space. Because we're a tech platform, we enable that communication to happen seamlessly over API rails, which is something that's really unique to our business.
Other people that have sort of come in the space tangentially or trying to get into the space are doing it in different ways with maybe surveys or emails or websites and different things. For us, the communication happens real time, meaning bi-directional over the API rails in sub-second increments. The tech that we have is an ETL-based software technology. It's AI-driven, we're able to use our AI that we built, patented four years ago, to fill in any gaps in data that might help the transmission be better of information, and we'll talk about that at a patient level. This is really where we sit. We connect to two million HCPs across the U.S. It's basically everybody that's in the outpatient setting we can reach at this point. 240 million patients. It's a very broad reach. We're connected to over 300 independent EHRs.
We do that in different ways, directly through API or sometimes we're connected through e-prescribing modules. E-prescribe is a piece of software that every EHR is required to have that was federally mandated with the whole opioid crisis. Legislation pushed that. Now all prescriptions that are written in the U.S. are required to be transmitted through an e-prescribing module, and we have connectivity to 80%, 90% of what the e-prescribing volume is. We have over 400 brands that are active in our platform at any given time, and that continues to grow. We reach the top 20 pharma, although I would say we have nascent footprint in each of those. We talk about we have the top 20. In these pharmaceutical manufacturers, every brand is managed as an independent P&L, which basically means an independent business.
While we may be in a Merck, for example, or a J&J. J&J may be promoting 25 different brands, we may have two or three, and be scaling to the others. Our job as a commercial organization is to go in and expand once we've landed in those organizations. The team has done a very good job over the last couple of years of really doing that. Last year was a great year for the business, 20%+ growth. You guys know the financials. This year, we had a little bit of disruption with one of our top clients, but we're back on track here, I think, for the back half. I think we'll see some great things back half and then going into 2027, certainly will be amazing.
The last thing that I would say is really an important piece for you all to know is that in this space, return on investment is something that our clients are continually looking at. They want to understand where they're getting the most bang for their buck, so to speak, and they want to know if they invest $100 with OptimizeRx versus $100 with an agency or another tactic that they see in their marketing mix, what's the return going to look like over time? Consistently, we've delivered the highest return on investment independently verified in our space. That's what's helped us scale from $4 million or $5 million in revenue to where we are today, just a little bit north of $100 million.
That will continue to be really important, especially going into the future, where spend is going to be managed on sort of a real-time basis as we talk about DSPs. What does our technology do? Our technology, really, we call it DAAP, our Dynamic Audience Activation Platform. It is an AI-driven technology that has the ability to train on large language models and data sets. We have access to all of the longitudinal patient-level information in the United States. That's everyone's health history for five years. All the claims that are made around patients for insurance companies, prescriptions that are written, any labs that were ordered, imaging that was done, and so on and so forth. The technology sits on that, trains on it, and finds patterns at an individual patient level of what's going on in that patient's history.
When a potential diagnosis is identified, we can activate messaging to the physician, and at the same time, we can start to message through our DTC, direct-to-consumer channels, to the patient. The idea is we're bringing those people together for a conversation, and when the physician is with the patient, we're communicating real-time digitally at the point- of- care. This is something that's very unique to OptimizeRx. No one else has this capability in our space yet, and we've patented it. Patent's a couple of years old, although we're extending the patents now as we go. Pretty exciting stuff. Something that would be close to this, although it doesn't have the connectivity, would be an OpenEvidence like business where they have a chatbot that's AI-enabled, and physicians are starting to use that at really rapid levels.
They got a $12.9 billion private valuation a few weeks ago, which was pretty exciting to see because it aligns a lot with the value proposition of what we have going here, although different means. Once we find those patients, as I said, we can execute across all these areas on the right-hand side of the screen. Some of these are DTC channels like digital and audio, direct mail, CTV, ATV, which is a huge space, digital display, social, digital POC, and field force. You could think of that connectivity. If you're familiar with the space, you know these are the areas you want to be communicating in. In addition to that, we've just made a couple of announcements around demand-side platforms and partnerships that we've launched. You may have seen the DeepIntent partnership. There will be several others.
DeepIntent doesn't happen to be public, although they did take a huge investment from Vitruvian a couple quarters ago, $750 million. The DSPs represent about 80% of the flow of cash and purchase for these types of solutions. OptimizeRx traditionally hasn't dealt with DSPs. Most of our relationships have been direct with manufacturers and the agencies that are working with the manufacturer partners. We view this as a huge opportunity for us to unlock more demand for our business. We think in the next 24 months, we'll probably double the size of where we currently are just based on adding the DSPs. We've got really good early indication on that. First one goes live with DeepIntent in the next couple of weeks. We're pretty excited about that. Fingers crossed everything goes well. All the tech implementation has been done.
You'll see several other announcements on DSPs here coming up in the next weeks. What that allows us to do is to navigate this new ecosystem of data onboarders. Folks that you'd be familiar with would be LiveRamp in the financial world. Trade Desk would be considered DSPs. They're bid-based systems, which means that for us, we load the connectivity into that. We don't really have to engage our commercial team in it because the acquisition of inventory, so to speak, or communication, is automated. Once it's automated, people can get in, and it just starts to scale. That's the early indication that we've seen. Pretty excited about that. In terms of driving brand through the AI-driven platform, this slide, we put in a couple case studies. I don't know, Andy, if you want to talk to a couple.
Are you mic'd?
I'm not mic'd.
Okay. We can mic you. Yep. You're good. Go ahead.
Yeah. We put in two case studies here. Happy to review them. Basic gist is when you utilize DAAP in our platform, you see a substantial increase in things like script lift and ROI, and that's basically name of the game when it deals with pharmaceutical companies and physicians. We're typically running well over five to one, 10 to one ROIs, and that's well above any industry norm. If you look at these kind of trends, it really bodes well as there continues to be more digital adoption within the space. You want to click forward, Steve?
Yeah.
Similar situation here. Again, just another case study across a different indication set. Basically, again, you're seeing substantial script lift, substantial improvement in overall outcomes when you're leveraging our platform. Basically, that's the trend that we're trying to amplify as we continue to grow as a company.
One of the things that you all may not know, because you're not involved in the analytics of this as deeply as, thank you, Andy, as we are, is pharmaceutical manufacturers measure successive campaigns on script lift, meaning that they're looking for number of prescriptions to be written versus not written. It's a test and control methodology. Consistently, as Andy said, for us in point- of- care, we always are percolating to the top of that script lift, meaning because we have direct connectivity and direct influence with the physician at the point- of- care, the ability to drive that script is outsized compared to something that would be informative or tangential outside of the point- of- care space.
At best, the physician may remember an ad that they see, but if they're sitting in front of a patient and they're looking at the patient's health record and they're making a clinical decision and your information is there, they're much more likely to consume it and act on it, which is what we continue to see. Our script lift results continue to be very, very high. The market for digital spend in pharma continues to be enormous. It's a $10 billion digital TAM, of which the point- of- care is $1.5 billion-$2 billion. That's really where it is. We are not even scratching the surface of where this could really go. We are excited about the DSP component just because we think it accelerates our growth arc, and we'll start to see that here in the next couple of quarters.
Instead of the yeoman's work we've been doing direct with the manufacturers, getting MSAs in place and getting those deals up and running, this will give us a quick skip ahead. You can see that it continues to grow over time. Right now just a little bit more data around DAAP, and we can answer questions when we get into it. 350 brands supported, 45% coverage in the top 200 brands, 10% solution penetration rate. That's still low. Current opportunity with existing brands represents by itself $2 billion-$3 billion. I think this is a really important number for people in this room to understand. While we are penetrated into the top 20, like I said, we have just barely started to penetrate.
If we did nothing, if we brought not a single additional client into this company, and we were successful at just upselling inside the manufacturers where we were, that's $2 billion- $3 billion worth of opportunity for the company. You'll start to see more commercial investment coming from our office into the business. 10% of brands right now are utilizing DAAP, significant ACV, and the highest lift. Even within our own business, we're now getting adoption of our dynamic audiences versus before we would've just been selling the messaging. All the years that Ryan's covered the business was predominantly focused on messaging at the point- of- care. Now you're starting to see what is really a recurring model happen, where people are subscribing to the DAAP model.
It started out as 0%, then went to 5%, now 10% recurring, and we'll continue to grow that over time. We will never be a fully recurring revenue model because we do have dynamic transactional revenue, and anyone in this space will have that. That's the nature of what the space looks like. The fast-growing DAAP component is getting us in the right place where we want to be. We're excited about DAAP. You want to talk about the KPIs?
Yeah. We put out KPIs just based on key metrics that we're following in the company. A lot of them are tied to the larger swath of where pharma dollars are spent, which is the top 20. Like Steve said, we have a decent footprint in there. On top of that, it makes up over 50% of our current revenue base. Over recent years, we've seen actually substantial growth in the long tail of customers, which is why you're seeing growth in the company, but the overall percent of the top 20 kind of shrinking year-over-year. The real driver for that is, one, there's just a lot more companies outside the top 20 than are in the top 20. We're making a pretty significant push there, even in things like MedTech, which is obviously outside of the pharmaceutical space.
Perhaps most importantly, those companies don't have a full suite of internal solutions. The ability for us to drive really profitable ROI for them is a big driver for why they're adopting us at a pretty fast clip. Outside of that, we have honestly one of the best in-industry revenue per FTEs. We're at over $800,000 right now. I think if you look at companies like Microsoft and much more scaled companies, they're around that level too, so it's quite impressive. Go to the next slide, Steve. I'll touch on these financials too. Obviously, last quarter was reported. We did almost $20 million in revenue, over $3 million in adjusted EBITDA. Last year, we did almost $25 million in adjusted EBITDA on just under $110 million in revenue. Our business has been growing at a pretty fast clip since we started generating revenue.
This upcoming year, we have guidance out there that's slightly down year-over-year. That's largely due to some macro factors like most favored nation pricing, which created some disruption with pharma, as well as what Steve mentioned earlier, just some disruption with one of our larger clients, which we're getting back on track with right now. Regardless of that, you can take a look at our adjusted EBITDA. It's still expected to be in the $21 million-$25 million range. We did a lot of operational efficiencies, trimmed fat from acquisitions and things like that give us a ton of operating leverage and scalability. Even on down years, I think our valuation is highly protected, particularly at the level it's at right now. I'll turn it back over to Steve.
Thanks, Andy. Key takeaways from the presentation really are these. We've got a highly scalable technology platform, increasing level of recurring revenue in the business. It's a very stable revenue model. We've demonstrated that now over a number of years. We're at a point of significant investment in the business, meaning we're investing commercially and starting to grow in ways that we wouldn't have been able to in the past. It's a proven health tech platform. Physicians love it, which is rare, but our feedback that we get is very, very positive, and our utilization rates continue to grow and improve over time. It's a sustainable competitive advantage.
No one is able to come in and do at scale what we are doing, and I think people would very much like to be able to do that, but there's too much of a moat around the space that the decisions on territory around the EHR were made 10 years ago, and if you weren't there 10 years ago, it's sort of too late to get in there now with the moats. People can do onesie, twosie things, but nothing that's going to be at scale enough for pharma to say, "This is a platform I want to go all in on." Large and expanding market opportunity. Point- of- care continues to be and will continue to be the hot space for manufacturers and now DSPs and agencies to really understand.
With less and less time that physicians have, the more critical it is for that information to be timely and delivered in the appropriate way with the appropriate patient in place. We feel like we are positioned very well to have outsized growth. Excited to have you guys here and looking forward to going over to answer any questions that you got as we migrate to the next room, Ryan.
Great. Thank you, guys. We'll be in room B upstairs for the Q&A session. Please join me in thanking the team, and hopefully we'll see some of you come through.
Okay. Thanks, guys