Paysign, Inc.

Q1 2026 revenue was $28 million, up 50.8% year over year, with net income of $5.4 million, or $0.09 per diluted share, versus $2.6 million, or $0.05 per diluted share, in Q1 2025. Adjusted EBITDA was $10.6 million, or $0.17 per diluted share, up 113.4% from $5 million, and gross margin expanded to 65% from 62.9%. For the quarter, Pharma revenue increased 81.9% to $15.7 million and Plasma revenue increased 24.9% to $11.7 million. Full-year 2026 guidance was maintained at revenue of $106.5 million to $110.5 million, gross margin of 60% to 62%, net income of $13 million to $16 million, and adjusted EBITDA of $30 million to $33 million; management said it is increasingly confident in the upper end of those ranges. For Q2, the company expects to exit with 147 to 150 active patient affordability programs and 555 to 560 plasma centers.

Mark Newcomer described Q1 as the strongest start to a year in company history and said the quarter validated Paysign’s strategy of building purpose-built platforms with operating discipline. He emphasized the scale and durability of the patient affordability business, noting strong program growth, a robust pipeline, and continued momentum coming out of Assembia. He also said the plasma SaaS effort and broader international opportunities remain longer-term growth avenues, though the FDA discussion is still ongoing.

Jeffery Baker said the quarter showed meaningful operating leverage: cost of revenues rose 42.2% and operating expenses rose 25.5%, both below the 50.8% revenue growth rate. He pointed to gross margin of 65%, operating margin of 23.8%, adjusted EBITDA margin of 37.8%, and unrestricted cash of $20.5 million with no bank debt. He also noted restricted cash of $159 million, mainly from customer program deposits and funds on card, and said the only remaining cash obligation is about $6 million related to Gamma, to be paid annually on the next 3 March anniversary dates. Baker said there were no share repurchases in the quarter and that cash is being held for possible acquisitions or redistribution to shareholders until a better use is found.

Analysts focused on program growth, plasma center closures, margin sustainability, the SaaS/app initiative, and cash deployment. Management said the pharma pipeline is roughly 50/50 between new clients and growth within existing clients, that it expects to exceed the 55 net program adds achieved in 2025, and that the system has enough capacity to handle more growth. On plasma, management said the 19-center closure should not hurt revenue because affected cardholders should transition to nearby centers, and that plasma revenue should still grow sequentially and through the rest of the year. On the SaaS/app, Mark Newcomer said discussions with the FDA are ongoing and that there is currently no revenue from it.