Paysign (NASDAQ:PAYS) reported fourth-quarter and full-year 2025 results that management said showed “continued strength and exceptional growth” across key metrics, driven primarily by rapid expansion in its patient affordability platform and improving operating leverage.
Full-year 2025 results and margin improvement
For full-year 2025, the company said revenue increased 40.5% to $82.0 million. Net income rose 98% to $7.6 million, while adjusted EBITDA increased 107% to $19.9 million. CEO Mark Newcomer highlighted a 723-basis-point improvement in operating margins, saying the company has reached an “inflection point” where additional revenue growth should translate into higher operating leverage and profitability.
Patient affordability platform expands programs and claim volume
Paysign’s patient affordability business was the largest source of growth in 2025. Management said annual revenue in the segment increased 168% year-over-year to $33.9 million from $12.7 million, while processed claims increased by approximately 79%.
The company said its platform supports pharmaceutical manufacturers’ co-pay assistance programs for high-cost branded medications, primarily for commercially insured patients. Newcomer said that in 2025 the platform helped deliver nearly $1 billion in financial assistance to more than 840,000 individuals.
A key point of differentiation, executives said, is Paysign’s dynamic business rules technology, which aims to reduce costs tied to co-pay maximizer programs. Newcomer said the solution saved clients more than $325 million in 2025 and had already saved clients nearly $150 million “this year” (as discussed on the call).
Paysign added 55 programs during 2025, ending the year with 131 active programs across more than 70 patient affordability clients. Newcomer noted that oncology and other cancer treatments remain a significant portion of the program base and that biologics represent about 50% of claim volume. The company also described expansion within existing relationships, including adding four additional programs during 2025 from a large pharmaceutical manufacturer onboarded in 2024. Paysign said it now has active programs with six of the top 10 U.S. pharmaceutical manufacturers ranked by revenue.
In Q&A, President of Patient Affordability Matt Turner said he has not observed a slowdown in manufacturer activity, arguing instead that “the push for innovation is growing.” Turner also discussed GLP-1 drugs, stating Paysign does not currently have the two larger GLP-1 weight-loss products or the diabetes products on its platform. He described the weight-loss GLP-1 market as more direct-to-consumer (DTC) oriented, with a smaller subset of volume flowing through co-pay programs, while suggesting there could be more opportunity on the diabetes side. Turner said Paysign has one client with a GLP-1 product and believes it is “in a very good spot to pick up a GLP-1 in the next 12–18 months,” while emphasizing there is no commitment in place and volume is uncertain.
Turner also addressed investor questions about potential headwinds, including:
- DTC and cash-pay models: Turner said these models have existed for over a decade and are generally aimed at products with limited insurance coverage, which he differentiated from Paysign’s focus on high-cost branded therapies. For drugs with list prices in the tens of thousands of dollars—Turner said this represents about 90% of the drugs on Paysign’s platform—he said cash-pay and discount alternatives are “simply not a viable solution for most patients.”
- Pharmacy discount programs: Turner said offerings such as GoodRx and similar programs are designed primarily for lower-priced generics or uninsured patients and are “not relevant” to branded specialty medications where commercial insurance and co-pay programs are standard.
- Legislative and regulatory environment: Turner said most activity around co-pay accumulator and maximizer programs has occurred at the state level, with no “meaningful federal action” to date and none expected in the foreseeable future. He cited ERISA’s role in limiting state-level impact for many employer-sponsored plans and said demand for Paysign’s dynamic business rules solutions continues to grow.
Plasma donor compensation business remains a stable base
Paysign’s plasma donor compensation business contributed $45.6 million in revenue for 2025, up 4% from $43.9 million in 2024. Baker said the increase was primarily tied to adding 115 net plasma centers over the past 12 months, partially offset by a decline in average plasma donations per center as inventory levels were elevated throughout much of 2025. The company ended 2025 with 595 centers, up from 480 a year earlier.
Newcomer said the company expects plasma revenue growth to be driven primarily by existing centers filling excess capacity rather than new openings, though it anticipates a modest number of new center openings in 2026 while maintaining market share “just under 50%.” He also said Paysign continues to engage plasma collection companies that are not yet customers and sees opportunity in an expanded suite of donor management and engagement tools acquired last year.
Regarding the company’s donor management system (BECS), Newcomer said Paysign is awaiting FDA 510(k) review and is working to integrate the system with plasmapheresis devices to make installations and transitions more seamless. In Q&A, management said it expects to hear back from the FDA within the next 60 days and that the review process has been positive so far.
When asked about 2026 plasma guidance implying faster growth, Baker pointed to the timing of 2025 center additions—highlighting that 132 centers were added in June and July—creating a stronger year-over-year comparison in the first half of 2026. He said his normalized expectation for the plasma business remains “about a 5% grower.” Management also cited improved collection efficiencies from hardware upgrades that it said effectively add around 10% capacity per center, reducing the need for new center openings.
Balance sheet and 2026 outlook
Baker said Paysign ended 2025 with $21.1 million in cash, nearly double the prior year, excluding periodic pass-through receivables and payables tied to the patient affordability business. He also said the company has zero bank debt and funded operations and its Gamma acquisition through operating cash flow.
For 2026, Paysign guided to revenue of $106.5 million to $110.5 million, representing 30% to 35% year-over-year growth, with plasma and pharma expected to contribute equally and other revenue expected to contribute $2.5 million. Baker said gross margin is expected to be 60% to 62% and operating expenses are expected to increase 20% as the company invests in people and technology. The company expects depreciation and amortization expense of $9.5 million to $10.0 million and stock-based compensation of about $5.5 million, along with approximately $3.1 million of interest income. The full-year tax rate is estimated at 22.5% to 25%.
Paysign forecast net income of $13 million to $16 million, or $0.21 to $0.26 per diluted share, and adjusted EBITDA of $30 million to $33 million, or $0.49 to $0.53 per diluted share, based on an estimated 62.3 million fully diluted shares.
For the first quarter of 2026, the company guided to revenue of $27.0 million to $27.5 million, up 45.2% to 47.8% year-over-year, and said it expects to exit the quarter with 137 active patient affordability programs and 589 plasma centers. Baker also projected operating margin of 20% to 22%, net margin of 17% to 19%, and adjusted EBITDA margin of 34.5% to 36.5% for the quarter, with fully diluted EPS of $0.07 to $0.08 and adjusted EBITDA per share of $0.15 to $0.16.
In closing remarks, Newcomer said 2025 marked a “meaningful step forward” as patient affordability scaled and became a central driver of growth and profitability, while plasma continued to provide a stable foundation. He said the company enters 2026 with strong momentum.
About Paysign (NASDAQ:PAYS)
Paysign, Inc (NASDAQ:PAYS) is a U.S.-based financial technology company specializing in prepaid payment solutions. Through its cloud-based platform, the company enables corporations, government agencies and payroll providers to issue and manage stored-value cards, digital wallets and disbursement programs. Paysign’s offerings span gift and incentive cards, payroll and earned-wage access cards, government benefit distribution, tax refund solutions and health savings account disbursements.
The company’s flagship Paysign Experience Platform provides configurable card programs with real-time transaction reporting, fraud monitoring and regulatory compliance tools.
