We've got breaking news on drug pricing out of the CMS. Bertha Kums has got the details. Bertha, >> that's right, Melissa.The Centers for Medicare and Medicaid out with their inflation reduction act negotiated prices. These are the companies in the uh drugs that will be at these prices starting in 2027 in Medicare Part D. One of the biggest uh categories is diabetes of course, Goi, Rebelsis.In that uh cohort, the negotiated price is $274. at 71% below uh the list price but of course we know the MFN price is ...

Financial Data and Key Metrics Changes - Revenue grew 20% to $377.4 million, with adjusted EBITDA rising 19% to $27.3 million, yielding adjusted EPS of $0.25 [5][14][15] - Total resident count increased by 13% to 203,766, driven by both organic growth and acquisitions [5][14] - Adjusted EBITDA margins held steady at 7.2%, reflecting the dilutive impact from recent acquisitions and greenfield startups [5][15] Business Line Data and Key Metrics Changes - The pharmacy segment experienced strong performance, with significant contributions from new acquisitions in Washington and Oregon [14][15] - Gross profit increased to $74.7 million, with a margin of 19.8% [15] - The company noted that its four- to five-year locations are performing at or above the consolidated adjusted EBITDA margin, while newer locations are progressing steadily [15] Market Data and Key Metrics Changes - Guardian holds a national market share of 13% in serving assisted living facilities, with 37 pharmacies having over 20% market share and 12 pharmacies exceeding 40% [8][9] - The company serves nearly 204,000 residents, primarily in-house, and expects to benefit from demographic trends as the aging population grows [9][10] Company Strategy and Development Direction - The company aims to drive organic growth through new customer facility wins, higher resident adoption, and greenfield expansions, while also pursuing targeted acquisitions [10][11] - Guardian is focused on enhancing profitability by integrating new pharmacies and leveraging technology and operational efficiencies [10][11] - The company is navigating policy changes proactively and advocating for legislative solutions to address industry challenges [6][10] Management's Comments on Operating Environment and Future Outlook - Management expressed confidence in offsetting anticipated EBITDA headwinds despite expected flat revenue growth in 2026 [6][10] - The company highlighted the importance of local leadership and scale in executing its growth strategy [7][10] - Management noted that the acquisition pipeline remains active, with a disciplined approach to selecting operators and markets [18] Other Important Information - The company filed an S-3 shelf registration for up to 6 million shares to provide financial flexibility [12] - Cash position improved to $36 million, with strong cash generation and no debt outstanding [17] Q&A Session Summary Question: Comparison of vaccine program contribution this year to last year - Management noted steady performance in the vaccine program, with a stronger start in September compared to last year [22][23] Question: Resident count and acquisition impact - Management confirmed that recent acquisitions are included in the Q3 resident count, with expectations for steady growth in Q4 [24][25] Question: Status of negotiations with PBMs regarding IRA issues - Management indicated that discussions are ongoing and they are growing more confident in offsetting headwinds [26][27] Question: Margin impact from acquisitions - Management highlighted that recent acquisitions are dilutive to margins but are expected to improve over time as they mature [33][41] Question: Changes in Medicare Part D plans and resident switching - Management stated it is early in the process to assess the impact of changes in Part D plans, with ongoing efforts to optimize plans for residents [46][48] Question: Changes in drug consumption patterns - Management observed a steady growth in acuity among residents, leading to increased utilization of certain brand medications [50]

Core Insights - Medicare open enrollment for 2026 will introduce higher costs for beneficiaries of Part D prescription drug plans, including increased premiums and out-of-pocket deductibles [1][4] - A significant change is the annual out-of-pocket drug cost cap of $2,100 for covered medications, as mandated by the 2022 Inflation Reduction Act [5] - Beneficiaries must be vigilant as some plans may stop covering certain drugs, and pharmacies may not offer the lowest costs for all medications [1][6] Enrollment Details - The open enrollment period for Medicare this year runs from October 15 to December 7, allowing beneficiaries to modify their coverage [3] - During this period, beneficiaries can switch between Original Medicare and Medicare Advantage, change Medicare Advantage plans, and adjust their Part D prescription drug plans [3] Beneficiary Statistics - Out of 68.8 million total Medicare beneficiaries, 54.8 million are enrolled in Medicare Part D plans operated by private insurers, indicating a large segment affected by the upcoming changes [4] - In 2025, 85% of standalone Part D plans had deductibles, with the maximum annual deductible for 2026 set to increase to $615 from $590 [7]

Core Viewpoint - Pfizer's stock has declined 10.7% year-to-date, underperforming its industry, sector, and the S&P 500, and is trading below its 50-day and 200-day moving averages [1][2][9] Group 1: Sales and Revenue Trends - Sales of Pfizer's COVID-19 products, Comirnaty and Paxlovid, are projected to drop to approximately $11 billion in 2024 from $56.7 billion in 2022, with similar revenues expected in 2025 [7] - Despite declining COVID revenues, non-COVID operational revenues improved in 2024, driven by key products like Vyndaqel, Padcev, and Eliquis, as well as newly acquired products [10][24] - Oncology revenues grew 7% on an operational basis in Q1 2025, supported by drugs such as Xtandi, Lorbrena, and Padcev [13] Group 2: Challenges and Headwinds - Pfizer faces challenges from declining sales of COVID-19 products, headwinds from U.S. Medicare Part D redesign in 2025, and significant impacts from patent expirations expected between 2026-2030 [3][15][16] - The company anticipates an unfavorable impact of approximately $1 billion from the Medicare Part D redesign, particularly affecting higher-priced drugs [16] - The stock has been under pressure due to uncertainties around tariffs and the macroeconomic environment, despite pharmaceuticals being exempted from initial tariffs [4][5] Group 3: Strategic Developments - Pfizer's acquisition of Seagen has strengthened its position in oncology, with ongoing advancements in its oncology clinical pipeline [12][14] - The company is focusing on cost cuts and internal restructuring, aiming for savings of $7.7 billion by the end of 2027 [25] - Pfizer's valuation appears attractive, trading at a price/earnings ratio of 7.60, significantly lower than the industry average of 15.12 [19] Group 4: Future Outlook - The Zacks Consensus Estimate for 2025 earnings has increased from $2.98 to $3.06 per share, indicating positive earnings momentum [22] - Pfizer's diversified portfolio, particularly in oncology, is expected to support top-line growth in 2025 and beyond [11][24] - The company offers a dividend yield of around 7.4%, appealing to income investors [25][26]

Core Points - Medicare open enrollment occurs from October 15 to December 7, allowing over 66 million Americans to make changes to their coverage for the upcoming year [1][2] - This period is crucial as it is the only time beneficiaries can alter their coverage unless they qualify for a special enrollment period [2][18] Enrollment Details - During the open enrollment, beneficiaries should review materials regarding eligibility and plan changes, typically titled "Evidence of Coverage" (EOC) or "Annual Notice of Change" (ANOC) [3] - Beneficiaries can switch between traditional Medicare and Medicare Advantage plans, enroll in a Medicare Part D plan, or change their existing Part D plan [7] Medicare Plan Types - Traditional Medicare covers hospital stays (Part A) and doctor visits (Part B), with most beneficiaries not paying premiums for Part A but incurring costs for Part B and other services [4][5] - Medicare Advantage plans, offered by private insurers, bundle various Medicare parts and often include additional benefits like dental and vision coverage, but may limit provider choices [6] Future Changes - Starting in 2026, out-of-pocket costs for prescriptions under Medicare's drug plan will be capped at $2,100, with the maximum Part D deductible increasing from $590 to $615 [9] Coverage Components - Medicare consists of several parts: Part A covers inpatient care, Part B covers medically necessary services, Part C is Medicare Advantage, and Part D covers prescription drugs [10][11][12][13][14] - Standard Medicare does not cover certain services such as routine eye exams, dental care, and cosmetic surgery [15] Special Enrollment and Initial Enrollment - Special enrollment periods may apply for beneficiaries who experience specific life changes, such as moving or losing employer-sponsored coverage [18] - New Medicare enrollees have an initial enrollment period that spans three months before and after their 65th birthday [19] Government Shutdown Impact - Medicare open enrollment for 2026 will proceed as scheduled despite a federal government shutdown, with benefits and coverage remaining unaffected [20][21]