$205M Adjusted EBITDA. $110M in Debt Paid Down. And the Stock Dropped 24%
The Turnaround Worked. The Growth Pivot Is the Harder Bet.
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Two weeks ago, we published a deep-dive on a turnaround healthcare company trading at roughly 6x forward earnings with 38% EBITDA margins and a $266 million profit swing.
The thesis was simple: the market was still pricing the crisis. The business had moved on.
Then Q4 earnings dropped. And the stock sold off.
Revenue missed. NARCAN got hit by a government shutdown. GAAP net income came in below guidance. And 2026 guidance showed adjusted EBITDA declining roughly 30% from 2025 levels.
The market saw those numbers and panicked. The stock is down about 24% from our initial coverage.
But here’s the thing about messy earnings prints - sometimes the headline obscures the actual story.
Full-year adjusted EBITDA came in at $205 million - above the high end of guidance. Adjusted net income hit $87 million - also above guidance. Gross margins expanded 900 basis points to 54%. The company paid down $110 million in debt. Operating cash flow grew 53%. And net leverage fell from 3.3x to 1.9x.
That doesn’t sound like a business falling apart. But it doesn’t sound like a clean win either.
The stock is now trading at roughly 5x trailing adjusted earnings and 2x adjusted EBITDA. Cheaper than when I first wrote about it. The question is whether it’s cheaper for the right reasons or the wrong ones.
Here’s what happened, what the 2026 guidance actually means, and where the thesis stands today...