Financial Data and Key Metrics Changes - For Q4 2024, the company reported revenue of $339 million, a 20% increase year-on-year, and adjusted EBITDA of $26 million, representing a 30% increase compared to the same quarter last year [2][3] - For the full year 2024, total revenue reached $1.228 billion, up 17% from the previous year, with adjusted EBITDA of $91 million, reflecting a 19% year-over-year increase [2] Business Line Data and Key Metrics Changes - The resident count at the end of Q4 2024 was approximately 186,000, marking a 14% increase from the same quarter last year [2][3] - The growth in revenue was driven by organic growth, acquisitions (Heartland and Freedom), and seasonal factors related to vaccine clinics [3] Market Data and Key Metrics Changes - The company experienced strong organic growth in the high single digits, combined with M&A activity leading to low double-digit growth expectations for 2025 [6] - The flu season's extended duration did not materially impact the company's vaccine administration, as nearly all residents are inoculated regardless of season severity [8] Company Strategy and Development Direction - The company is focused on leveraging its M&A pipeline, which remains robust, and is comfortable with the ongoing process related to the IRA [7][12] - The management is optimistic about the integration of clinical intervention services and data analytics to enhance customer offerings [22] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in navigating the challenges posed by the IRA and indicated that it has not significantly hindered M&A opportunities [12] - The company anticipates steady drug mix and reimbursement trends as it looks towards 2025 [21] Other Important Information - The company ended Q4 2024 with $4.7 million in cash [3] - Management highlighted the positive influence of vaccine-related revenue on Q4 EBITDA growth [18] Q&A Session Summary Question: Impact of IRA on M&A opportunities - Management stated that the M&A pipeline remains robust and the IRA has not significantly affected it, possibly even providing slight benefits [12] Question: Changes in contracting with PBM partners - Management refrained from discussing specific negotiations but acknowledged that various factors are under consideration [14] Question: Year-over-year improvement in vaccine administration - Management noted that the benefits from flu and COVID vaccines were primarily realized in Q4, with limited tailwind expected for 2025 [16] Question: Observed drug mix trends and pricing perspective for 2025 - Management indicated that there are no substantial changes expected in drug mix or reimbursement as they look to 2025 [21] Question: Progress on clinical intervention initiatives - Management expressed pride in the progress made by the data analytics and clinical teams in delivering value-added services [22]

Company Operations and Market Presence - As of December 31, 2024, the company operates 51 pharmacies serving approximately 186,000 residents across 7,000 LTCFs in 38 states[16] - The company holds an approximate 12.6% market share nationally in the LTCF pharmacy sector, making it the largest provider for ALF/MC as of December 31, 2024[72] - U.S. institutional pharmacy market revenues for 2024 are estimated to be approximately $24.8 billion, indicating a significant market opportunity for the company[72] - The U.S. ALF industry is projected to have a CAGR of over 5% from 2023 to 2030, with approximately 800,000 residents in ALFs by 2024, of which the company serves about 126,000[87] - The company has doubled the number of residents served at large, multi-location accounts from approximately 15,000 in 2018 to approximately 39,000 as of December 31, 2024[93] - The resident adoption rate of the company's services at ALFs reached 88% as of December 31, 2024[94] - The company has a robust M&A function, focusing on acquiring pharmacies that are customer-focused and located in attractive markets[99] Financial Performance - Revenues for the year ended December 31, 2024, were $1,228,409,000, an increase from $1,046,193,000 in 2023, representing a growth of approximately 17.4%[400] - Gross profit for 2024 was $244,371,000, compared to $208,310,000 in 2023, indicating a gross margin improvement[400] - The company reported a net loss of $71,033,000 for 2024, compared to a net income of $37,720,000 in 2023, reflecting a significant decline in profitability[400] - Cash and cash equivalents increased from $752,000 in 2023 to $4,660,000 in 2024, showing a substantial improvement in liquidity[398] - Accounts receivable rose from $77,262,000 in 2023 to $97,153,000 in 2024, indicating growth in sales but also potential collection challenges[398] - Total assets increased from $271,165,000 in 2023 to $320,810,000 in 2024, reflecting overall growth in the company's financial position[398] - The company’s total liabilities decreased from $211,306,000 in 2023 to $170,834,000 in 2024, suggesting improved financial health[398] - Selling, general, and administrative expenses surged to $307,291,000 in 2024 from $167,364,000 in 2023, indicating increased operational costs[400] Services and Technology - The company has invested more than $20 million in advanced pharmacy automation technologies over the past 10 years, deploying over 100 automated dispensing machines across its network[37] - The company provides compliance packaging services, organizing medications into individual or multi-unit doses according to specific "Med Passes," improving control and reducing errors in drug administration[39] - The pharmacy workflow software enhances drug dispensing management, increasing labor productivity and improving overall resident safety[40] - The company utilizes proprietary data analytics systems to ensure accurate medication dispensing and adherence to drug regimens[18] - The Guardian Compass platform provides real-time operational dashboards and metrics to improve labor productivity and sales forecasting for local pharmacies[54] - The GuardianShield suite includes 10 specialized programs aimed at improving accuracy, efficiency, and safety for LTCFs, with eight currently active and two in development[56] - The Falls Risk Management Program and Disease State Management services are being developed to optimize resident health and lower healthcare costs[68] - The company’s Clinical Intervention Program aims to improve resident outcomes through detailed prescription processing and analytics reporting[64] Regulatory Compliance and Challenges - The company is subject to the Comprehensive Drug Abuse Prevention and Control Act, requiring registration with the DEA and compliance with controlled substances regulations[127] - The company receives reimbursements from Medicare and Medicaid, which are subject to various administrative rulings and interpretations that may affect financial outcomes[150] - The company must comply with federal and state laws governing financial arrangements between healthcare providers, including the Anti-Kickback Statute[132] - The company is subject to inquiries and audits by federal and state agencies, which could result in sanctions affecting financial condition[139] - The company believes its operations are in substantial compliance with applicable federal and state laws, but future interpretations may pose risks[140] - The company must monitor interactions with patients to avoid violations of the Civil Monetary Penalty Law[138] - Environmental regulations require proper disposal of unused medications, which the company has historically managed without material difficulties[149] Workforce and Employee Benefits - As of December 31, 2024, the company employed approximately 3,400 persons, including over 500 pharmacists and over 80 nurses[182] - The company offers a competitive mix of compensation and insurance benefits, along with customizable health insurance packages to attract and retain talent[183] Market Trends and Demographics - The aging U.S. population is projected to grow to 82 million people aged 65 and older by 2050, representing a greater than 47% increase from 2022, which will drive demand for pharmacy services[78] - More than half of the 800,000 U.S. residents in ALFs in 2024 are above 85 years old, necessitating greater emphasis on healthcare delivery and complex drug regimen coordination[79] - The number of Medicare Part D beneficiaries has increased from 22 million in 2006 to 53 million in 2024, expanding the pharmaceutical drug coverage for residents[84] Legislative Changes - In July 2024, CMS issued the Fiscal Year 2025 Skilled Nursing Facility Prospective Payment System Final Rule, projected to increase Part A payments to SNFs[156] - The 21st Century Cures Act implemented Average Sales Price pricing for Part B DME infusion drugs starting January 2017, with the Medicare home infusion therapy benefit becoming permanently effective on January 1, 2021[160] - In August 2022, the Inflation Reduction Act introduced significant drug pricing reforms for Medicare Part B and Part D, including price negotiation authority and caps on beneficiary cost sharing[166] - By 2025, all Part D plans will be required to offer enrollees the option to pay out-of-pocket prescription drug costs in capped monthly installment payments[169] - The final rule published in May 2024 requires certain minimum nurse staffing requirements for long-term care facilities[179]

Revenue Expectations - Revenue for Q4 2024 is expected to be approximately $338.6 million, an increase of approximately 20.5% year-over-year, driven by organic growth and acquisitions [7]. - Full year 2024 revenue is expected to be approximately $1.228 billion, an increase of approximately 17.4% year-over-year [7]. - Initial guidance for full year 2025 revenue is projected to be between $1.330 billion and $1.350 billion [14]. Resident Count - Resident count is expected to be approximately 186,000 at the end of Q4 2024, an increase of approximately 14.1% year-over-year [7]. Net Income and Loss - Net income for Q4 2024 is expected to be between $10.1 million and $11.1 million, a decrease of $3.5 million to $4.5 million year-over-year [7]. - Full year 2024 net loss is expected to be between ($71.8) million and ($72.8) million, a decrease of $109.5 million to $110.5 million year-over-year [7]. Adjusted EBITDA - Adjusted EBITDA for Q4 2024 is expected to be approximately $25.9 million, an increase of approximately 30.3% year-over-year [7]. - Adjusted EBITDA for the full year 2024 is expected to be approximately $90.8 million, an increase of approximately 19.2% year-over-year [8]. - Initial guidance for full year 2025 Adjusted EBITDA is projected to be between $97.0 million and $101.0 million [14]. Financial Results Announcement - The company plans to announce complete Q4 and full year 2024 financial results on March 26, 2025 [10].

Financial Performance - Revenues for the three months ended September 30, 2023, were $262,741 thousand, compared to $314,393 thousand for the same period in 2024, representing a decrease of approximately 16.4%[11] - Gross profit for the three months ended September 30, 2023, was $52,192 thousand, while for the same period in 2024, it increased to $60,878 thousand, reflecting a growth of about 16.2%[11] - Operating loss for the three months ended September 30, 2023, was $(6,330) thousand, compared to an operating loss of $(104,613) thousand for the same period in 2024, indicating an improvement in operational efficiency[11] - Net loss attributable to Guardian Pharmacy Services, Inc. for the three months ended September 30, 2023, was $(6,995) thousand, compared to a net loss of $(121,990) thousand for the same period in 2024, showing a significant reduction in losses[11] - For the nine months ended September 30, 2024, the company reported a net loss of $82,874, compared to a net income of $23,161 for the same period in 2023[15] - Net income (loss) for the three months ended September 30, 2024 was $(121.99) million, a significant decline compared to the previous year[100] Expenses - Selling, general, and administrative expenses for the three months ended September 30, 2023, were $58,522 thousand, while for the same period in 2024, they rose to $165,491 thousand, indicating an increase of approximately 182.5%[11] - Interest expense for the three months ended September 30, 2023, was $716 thousand, compared to $1,026 thousand for the same period in 2024, reflecting a decrease of about 30.2%[11] - Total other expenses for the three months ended September 30, 2023, were $665 thousand, while for the same period in 2024, they increased to $1,028 thousand, representing a rise of approximately 54.5%[11] - The company experienced a significant increase in share-based compensation expense, rising to $128,029 for the nine months ended September 30, 2024, compared to $16,632 for the same period in 2023[15] - Selling, general, and administrative expenses for the three months ended September 30, 2024 increased by $107.0 million or 182.8%, primarily due to share-based compensation related to the Corporate Reorganization and IPO[105] - Share-based compensation expense for the three months ended September 30, 2024 was $122.4 million, significantly higher than $20.7 million in the same period in 2023[105] Cash Flow and Equity - Cash and cash equivalents at the end of the period increased to $37,221 from $621 at the beginning of the period, indicating a net change in cash of $36,469[15] - The company reported net cash provided by operating activities of $35,623 for the nine months ended September 30, 2024, down from $56,265 for the same period in 2023[15] - The balance of members' equity as of September 30, 2023, was $26,191, a decrease from $44,013 as of June 30, 2023[13] - As of June 30, 2024, total equity decreased to $57,213, down from $59,859 as of December 31, 2023, reflecting a net income of $15,848 and distributions of $20,921 during the period[12] Acquisitions and IPO - The Company completed its IPO on September 27, 2024, issuing 9,200,000 shares at a public offering price of $14.00 per share, resulting in net proceeds of $119,784 after deducting underwriting discounts of $9,016[23] - Total consideration for acquisitions during the nine months ended September 30, 2024, was $15,882, which included cash of $12,460 and contingent earnout payments of up to $2,700[35] - The cash payment related to the merger consideration during the corporate reorganization was $55.2 million, funded by IPO proceeds[84] - The Company incurred $13,047 in offering costs related to the IPO, which were recorded to additional paid-in capital[23] Market and Competitive Position - The company continues to face risks related to market competition, regulatory changes, and supply chain disruptions, which could impact future performance[7] - The company has a strong competitive position as a provider of pharmacy services to ALFs and BHFs, which are seen as the highest growth sector of the LTCF market[81] - The company’s core growth strategy focuses on increasing the number of residents served through a combination of organic and acquired growth[82] Operational Metrics - The number of residents served increased from 161,000 in September 2023 to 180,000 in September 2024, contributing to revenue growth[100] - Prescriptions dispensed rose from 5.6 million in the three months ended September 30, 2023 to 6.4 million in the same period in 2024, reflecting operational growth[100] - Revenue associated with the acquisitions for the three months ended September 30, 2024, is $16,563,000, and for the nine months, it is $32,434,000[42] Debt and Financing - The company entered into a new term loan of $15,000,000, extending the maturity date to April 23, 2027, with quarterly installments of $1,375,000 until maturity[45] - As of September 30, 2024, total notes payable increased from $22,969,000 on December 31, 2023, to $34,099,000[46] - Future principal payment obligations for long-term debt total $34,250,000, with significant payments due in 2027[47] - The company was in compliance with all debt covenants as of September 30, 2024[47] Taxation and Accounting - The Company recorded an incremental net deferred tax asset/(liability) of $5,973 through additional paid-in capital as a result of the Corporate Reorganization[22] - The effective tax rate for the period after the Corporate Reorganization was -0.1%, primarily due to the non-deductible share-based compensation charge[74] - The Company adopted new accounting standards on January 1, 2023, with no material impact on its Consolidated Financial Statements[31] - The Company is currently evaluating the impact of adopting new accounting standards related to segment reporting and income tax disclosures, expected to be effective in 2024 and 2025[32][33]

Exhibit 99.1 Guardian Pharmacy Services, Inc. Reports Third Quarter 2024 Financial Results ATLANTA—(BUSINESS WIRE)— Guardian Pharmacy Services, Inc. ("Guardian") (NYSE: GRDN), one of the nation's largest long-term care (LTC) pharmacy services companies, today announced financial results for the third quarter ended September 30, 2024. Third Quarter 2024 Highlights Three Months Ended September 30, 2024 • Revenue of $314.4 million, an increase of 20% year-over-year, driven by organic growth of the business and ...