Two to three hundred million, if not more. Leadership from a company perspective, I come from the payments industry. I actually came from Wall Street for ten years, covering financial tech and services, and then I went to—I tell people I left the sell side to create value and went to work at a company and started doing mergers and acquisitions for a company called Global Payments. Many of you probably have heard of them. I ran M&A there for eight years, and then M&A at a company called InComm, which is the largest prepaid provider, for ten years. Like I said, jumped over to Paysign almost five years ago. The rest of our leadership team, you'll see, came out of the banking industry. We came out of the payments industry, so a lot of domain expertise there.
Service and delivery, we have very superior client retention. We have really good visibility into our numbers. We do everything in-house. We have our own call center, which is 24 by 7 by 365. It's bilingual, and that's a big differentiator. People don't really give a lot of credit to that, but we're signing up pharmaceutical companies who are requiring us to onshore our call center, who require us not to use AI, believe it or not. I know that's a big buzzword. Everybody likes to hear it, but the fact of the matter is that because we do this in-house, we are winning more and more business there. Just at a glance, market cap is a little over $300 million. We had annual revenue of 2024 of $58.4 million. Our trailing 12-month revenue is $74.9 million, almost $75 million. You can see the growth there.
Again, largely driven by our patient affordability business. Fully diluted EPS in 2024 was $0.07, and then trailing 12-month is $0.13. Again, we look at adjusted EBITDA 2024, $0.17, and then trailing 12-month, $0.30. From a cash perspective, I exited the third quarter with technically $7.5 million. There was some APAR that caused that number to be a lot lower than what really happened. Three days after the quarter, we pulled in another $9+ million. Our unrestricted adjusted unrestricted cash balance, it's just under $17 million. Total cash is right at $120 million. This is a stock price performance, very volatile, as most small caps, and you guys understand as investors. The large spike here reflects kind of what happened after the first quarter.
People really started to see the patient affordability business and what it could do to the numbers. The rest of this is kind of as the stock is and the market has kind of gone flattish for our company. We mentioned the revenue trailing 12-month and 2024 adjusted EBITDA trailing 12-month, $17.4 million, and total assets just over $200 million. We get paid a number of ways in our plasma business, which is an individual, mostly unbanked or underbanked individuals go in and they donate plasma. They get paid $65. That $65 then gets spent, and as they spend that money on the card, we make our money. Those are interchange. We get per transaction fees. If you go to ATM, we get an ATM fee. It is a strict usage-based card. We do not get paid from the plasma companies themselves, but they fund the cards.
We also get cardholder fees. If you do not use the card after 60, 90 days, you will get hit with an inactivity fee. There is no breakage associated with these cards. It is all a fee-down model. If you lose a card, we are going to charge you to send you a new card. We also get program management fees from the patient affordability side. I am going to get an upfront fee to set up the program, and then I am going to get $7,000, $8,000, $9,000, $10,000 a month, depending on the complexity of the program. I am going to get that every month to run that program. I am going to get paid claims fees.
Claims, if you go to the pharmacy and you give them a script and they ask you, say, "Jeff, you owe 20% and you can't afford the 20%," a lot of these pharmaceutical companies have copay programs. You've seen the commercials. Everybody's seen a Skyrizi commercial. At the end of that commercial, it says, "Ask AbbVie how we can help." They're telling you they have a copay program. If I'm going to fulfill that program or that claim for you at the pharmacy, I'm going to charge you anywhere from $2-$3. It doesn't matter if the claim's $500, $5,000. It makes no difference. It's just $2-$3. If I have to send a check to a provider, a hospital or urgent care or somebody like that, I may get upwards of $30, $40, $50 per check. We also send virtual debit cards.
This is where our payments platform comes in, where we'll send a virtual debit card as a payment to the provider who they all accept Visa MasterCard nowadays. They'll run that as a reverse interchange to help reduce their payment for their Visa MasterCard services. Effectively, they're getting paid. It's a much quicker, better solution for everybody, and I get interchange on that transaction. There are other fees, like call center fees or member number generation fees. What is that? Everybody, if you have a drug, you're going to be assigned a number, and that's kind of how the pharmaceutical companies track you. I'll get a dollar for every number. I'll get a dollar for every letter we send out. It's a service-based program, a transactional based, where we get the way we make our money.
The patient affordability business, I touched on this, but I touched on the pharmacy benefit, which is just like what I said. You walk into a pharmacy, you're going to walk out with the drug. The pharmacy is looking for that 20% copay. We're going to pay that on behalf of the pharmaceutical companies, and then they're going to reimburse us. At the end of the quarter, with that big $9.6 million difference, I had two big pharmaceutical companies. They weren't slow paying us. It's just when the invoices ended up going out and when they ended up paying us, but they paid us three days after the quarter. The medical benefit copay is the same thing, except these are mostly intravenous drugs. You're having to go to a hospital, an urgent care, a doctor's office to get those drugs administered to you.
We also have a proprietary technology, which is another reason why we're winning so much business, called Dynamic Business Rules. It is very complex, but the basic thing is that these maximizers that are out there, maximizers like a company like Sav-On or PrudentRx, these guys are out there trying to, I call it, steal money from the pharmaceutical companies because that's effectively what they do. We can identify with 98% efficacy on the first fill, which is very important, that this is a maximizer transaction, and we can stop that. That means our pharmaceutical companies do not have to pay that claim amount, yet the individual that needs that copay assistance is still getting their assistance. It is just now it is being provided by the maximizer. It is a game changer in the industry.
We saved our customers over $200 million last year in claims that they would have had to pay if they were not using our technology. This year, it will be double that easily. A very important differentiator in the marketplace. The other thing here is the pharmaceutical data and analytics. That is also a differentiator. Outside of one of our competitors, which is IQVIA, I am sure a lot of you guys have heard of them, they do not provide this data analytics. I had a call with a major pharmaceutical company this week, and we were talking through the invoicing process, and one of the requirements was that we provide the bank balance on every invoice. I said, "Why? We do not do that."
They said, "Well, how do we know what our bank balance is?" I said, "Well, you are going to log into your portal every day, and you are going to see what your bank balance is." They are like, "Really? We do not have that technology today." It is things that, as we have come into a stale industry that had zero innovation for so many years, to bring it from a payments perspective, it makes all the difference in the world. This data analytics that we provide enables the pharmaceutical companies to actually look at what their ROI on their copay programs are. Most of these copay programs are funded out of the marketing budgets for these pharmaceutical companies. It is just a different way that we have come in and been very successful in growing that market share.
By the numbers, the far left dark blue is 2022, and then you go all the way to the wonderful pea green color in 2025. The business, you've seen the growth, and you have to look at this business on a year-over-year basis. You cannot look sequentially because the claims volume is highest at the first half of the year when everybody's maximum out-of-pocket resets to zero. Everybody's familiar with your insurance plan, Cigna or UnitedHealthcare, where you may have $6,000, $7,000, $8,000 per person maximum out-of-pocket. People that are very sick and these drugs are very expensive, they usually reach that maximum out-of-pocket in the first half of the year. What you would see is claims volumes will start to fall off.
Now, because of our growth and the number of programs we're adding, we're masking that seasonal effect. Suffice to say, I've already given guidance this year that the second half of the year revenue should be pretty close to the first half of the year, which is, like I said, a little abnormal. You'll see here that our trailing 12-month revenue is $28.6 million. In 2024, it was $12.7 million. That number will be north of $30 million, in the low $30 million range for all of 2025 based on the guidance that I've given. Plasma is the other area. I talked about this, mostly unbanked and underbanked individuals. Like I said, we have about 50% market share from the number of centers that are out there in the U.S. We have about 75% of the plasma companies as customers. The market has gone through an oversupply of source plasma.
Coming out of COVID, right, there was no supply of source plasma. People were not donating during COVID. Individuals that are unbanked and underbanked, they do not donate if they are getting free money from the government. That is the biggest risk to this market. Most of them are trying to supplement their income, and they are donating every month, and you give plasma. You can give plasma two times a week up to eight times a month. There is a good revenue stream there for us as people give plasma. Anyway, there was an oversupply. The industry pendulum swung the other way, just like it does any other time, and they were collecting plasma at like double the annual rate. Normally, in a normal year, plasma collection is around 7% a year, and they were running at 14%-15%.
We've told the street that we expect this oversupply to abate, and we're already starting to see abate by the end of the first half or first quarter, sorry, of 2026. We've already started to see early indications that it's kind of returning to normal. We look forward to that improvement to occur. We had a big win in June and July. We brought 100+ centers from one of our existing customers that decided to consolidate down to one provider. At one time, they had three, then they went to two, and now they went with us for 100%. Because of that conversion, you're actually going to see the revenue from the plasma business flat year over year when we were going into the year expecting down 10%.
As we anniversary that growth in 2020 and after the second quarter of 2026, you'll start to see that business go back to around, probably my expectation is around a 5% growth per year. Good cash cow, good margins. We use that business to fund the rest of our business. Revenue by quarter, you kind of see what was occurring. Again, this is another business where you have to look on a year-over-year basis. You can't look sequentially because what happens in February? February and March, the government gives out free money, and it's called tax refunds. All these people get tax refunds. March and April are the worst months for the plasma business. It's kind of just the opposite of the patient affordability business.
On a normal year, you would expect the first quarter to be the worst quarter and then for it to ramp as you go throughout the rest of the year. It is counter what happens in the patient affordability business, which is a very nice balance. This is the slide. The piece on the right is the market share. Like I said, as we sit here at the end of the third quarter, we have about 50% market share, and that's gone up. When I came to the company almost five years ago, we had 32% market share, and at the end of 2024, it was 40%. We had an acquisition I mentioned called Gamma. We made it in March. Effectively, this was three software solutions that were all built and targeted specifically for the blood and plasma collection industry. The main application is called a donor management system.
A donor management system basically is like the ERP platform for companies, but they're for the plasma and blood donor industries. These are big ticket items, software- as- a- service, a lot of consulting fees, etc. Ours is currently in the process of getting FDA approval. We were on track to have it done by the end of the year. The government shutdown kind of pushed that back a little bit. Now we're pushed to the first part of 2026, but we've already got our indications back. I think they had five questions. This will get approval, and then we'll be in the market selling this. We're already talking to the equipment providers that are out there. We've set up a place downstairs where people can come in, customers can come in, and they can look at the plasma machines and our software and what it does.
So far, we've gotten a lot of good early indications of interest with this Donor Management System and the other applications that go along with it. This industry is predominantly controlled by one company called Haemonetics, a big company out of Canada. Most of you guys have probably heard of them, and they just haven't innovated, is the best way to say it. We think this business or this industry is ripe for opportunities. Again, with our already large install base of plasma customers, we've got a natural go-to-market strategy there to sell into those. We do other niches. Honestly, it's not really worth talking about too much, but we have other prepaid programs like a payroll card. We don't sell it. We're just the platform and the program manager behind these cards. AAA, the gift cards.
If you go to AAA and you see a gift card, excuse me, and you buy a gift card, that's our card as well. We got those spread out. That's about $2.4 million in our total sales. Everybody has one of these slides. I'm not going to spend a lot of time on it. By the way, this presentation is available here on our website, but we have products pretty much for every one of these. That being said, that $21 billion consumer incentive rebate space is where most of our business comes from. Some financial highlights. I'm not going to read every one of these, but you can see, again, focusing on the year-over-year third quarter 2025 versus third quarter 2024, we've had some really nice growth. We have good cash flow, good EBITDA, etc., and the adjusted EBITDA is what I turn your attention to.
We are covered by five sell-side analysts. They all have buy or buyer rating equivalent recommendations out there. Some of these guys, believe it or not, I used to work with back 30 years ago. I was smart enough to leave the sell side. They're good, smart individuals, price targets anywhere from $8-$10. This is a resource page. If you're interested, I highly encourage you to look at this. If you cursor over them, it'll hotlink to these resources. If you want to know anything about the plasma industry, just click on one of these three, and it'll tell you what plasma is used for and where the centers are, etc. If you want to know more about the patient affordability industry, kind of everything from the House Committee and FTC and our report down is all for the patient affordability business.
Everybody understands plasma. It's pretty easy to understand the business model, etc. People do not understand the patient affordability business. People in the pharmaceutical industry don't understand the patient affordability business. It's just very complex. I highly encourage you, if you're interested, to go look and do more research there. This is our leadership team. Like I mentioned, most of these individuals came out of either banking or payments. Mark Newcomer, the founder and CEO, owns about 18% of the company. He's the largest shareholder. Our directors, Dan Henry, many of you may or may not know Dan. Dan first started his career. He co-founded Euronet Worldwide, left there. He went to be the CEO of Netspend, which got sold to TSYS. He went and became the CEO of Green Dot Corporation, and then he left.
Dan brings a wealth of knowledge in payments, and he's tough. He's a very good independent board member who will keep you on your toes. Dennis Tripler, also independent, comes out of the healthcare banking side of the world. Jeff Newman was the GC at Euronet for many years, did a lot of their international expansion. He's been a very good resource for us as well. Bruce Mina, he's the head of our audit committee. He's the guy I communicate with most of the time. He has his own business out of New York and has been doing that for 30-plus years. With that, I will open the floor for questions. No questions. Oh, yes, sir.
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Yes. The question is, on patient affordability, are our customers the major pharmaceutical companies? The answer is yes. I used to, my background is really more on the risk side. I used to be on a board of a bank, and one of the things I understand is risk mitigation. If you're not a top 10 pharmaceutical company, I'm going to require you to put one, two, or three months' worth of money for your reimbursable expenses, which I make nothing on. It's a pass-through, but that's where I have risk. You have to put that money in, and I'm going to pay your claim for you on your behalf. If you're AstraZeneca, which I've already talked about, we have a relationship where they just let us pull money directly from them.
Our pharmaceutical customers run top 10 to guys that may have just one or two drugs that you've never heard of, and they're all over the world.
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The question is, how often, if I understand your question, how often do the generic companies impact the patient affordability business?
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To sell the primary versus generic. Most of our programs, I'm not going to say every because that's a bad word. Let's say the majority of our programs are all drugs that have not gone generic. That's why the drugs are very expensive, and that's why people—I didn't get into this—but most people can't afford a $200-a-month copay. It's just the reality of it. This is not my number. These are independent people that say, "Hey, most people can't afford a $200 emergency," right? If you look at the global population, copay holds individuals to get on a drug and stay on a drug. The other thing is that copay programs don't exist for government programs, Medicare, Medicaid, because the government has done their own negotiation with pharmaceutical companies.
This is the 170 million people that are on private insurance that are subject to copay amounts. If it's a generic drug, most of the time, the copay programs go away. That's happened. We had one plan, one program since I've been there. The drug went generic, and they pulled the copay business. There are other, believe it or not, there are retail programs out there like Viagra or some generic programs that do have copay programs. It just really depends on, like I said, it's marketing. Where are the dollars coming from? From a marketing perspective, how do they want to generate awareness with their drug? They do it through copay as well as from a financial, like I mentioned, that $200 piece. Sorry. Good questions. Yes.
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The question is, how are we adding, or where is the growth coming from with the new programs? Are they coming from existing customers? Are they coming from new customers? The answer is yes and yes. The plan, the sales strategy is land and expand. AstraZeneca, for example. Again, you're all going to get tired of me talking about them, but we started, I think, with four programs with them. Now we have over a dozen programs with them. We have other new drugs that just got FDA approval this year that we're just starting, and they have one program. That's all they will ever have is one program. Most of these biotech companies, but they need copay programs. It is really a combination of both. Our expansion has been new customers, new large pharma customers, new customers bringing more programs to us, etc.
The crazy thing in this industry is that you have to sell each program independently. Just because I have AstraZeneca and I have four programs with them does not mean I get the rest of their programs. I have to go to each brand manager and sell. Now, they do talk amongst themselves, but each drug within a big pharmaceutical industry or company is really set up with its own P&L, its own business owners, its own finance people, etc. That is why you do not have every drug company or every drug at the company. Yes. Do I have any competitors ? Competitor, yes. Do we have competitors? We have competitors. Some that you may have heard of, IQVIA. I mentioned them.
McKesson has a hub business called CoverMyMeds. We have stolen business from them. TrialCard, I think they have changed their name to Mercalis now. They are private. These are hubs. Most of our competitors are hubs. A hub is a company that helps with the drug, get through phase I, phase II, phase III FDA approval. Then they help market the drug, and they do a lot of other things. We just do the payment side. We're not getting into the hub business. It's low-margin, capital, people-intensive businesses. Yes, we have plenty of competitors. Yes.
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Yeah. A question is barriers to entry. On the plasma side, the barrier is, I mean, it's a scale game. There's a lot of economies of scale and efficiencies. It's a reason why we don't do plasma payments over in Europe because it's just not that big of a market. Signing up with the plasma companies, they're very—how do I say? They don't move around too much. We have four or five competitors in that market. On the patient affordability side, the barrier to entry there is signing up these pharmaceutical customers. I mean, pharma—and I apologize if you're in the pharmaceutical industry, but I will tell you, they don't adopt technology fast. They don't move fast. When they do move, they move in a herd mentality. This is just how that industry is. It has been like that way for decades.
They don't trust you, and they're very skeptical of changing. It is very rewarding for us, Paysign, sitting here to say, "Hey, we've won business from McKesson. We've won business from IQVIA." We keep winning more business because the brand manager at AstraZeneca, they never got fired by using McKesson. It's a top Fortune 100 company. They're not going to get fired by using IQVIA. If Paysign screws up, yeah, they're going to get fired. You got to get through that barrier. There are definitely barriers to entry. That dynamic business rules that I mentioned that nobody else has, I mean, that is one of the reasons why we really are winning business at the rate we are. I got two minutes left. Yes, sir.
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Okay. The first question was, do we break out plasma and patient affordability? We don't. We do not do segment reporting. We have visibility down to the gross margin level. After that, I mean, we use a shared services model, technology platform, etc. Suffice it to say, gross margins around the plasma business are 40-45%, depending on the volumes. On patient affordability, it's around 80%. The operating margin is obviously not nearly that high. Patient affordability has a lot more SG&A associated with it. Plasma doesn't. You get some pretty attractive operating margins. As we continue to build the business, you see that operating leverage drop to the bottom line.
The other question on GLP-1 drugs, we don't do any GLP-1 drugs today. They don't have copay programs. Most of them, those have been cash payments or individually. You have to be wealthy to have those drugs. If the government decided to introduce those, it's really the health plan. If UnitedHealthcare or Cigna decided to cover those drugs, then I could see copay programs starting to exist from there. Whether or not we win those, I don't know. We don't do any GLP-1s today. With that, I'm out of time. I appreciate your interest. Please ask me. If you have any questions, please contact me. Happy to answer. Thank you.