Guardian Pharmacy lifts outlook as earnings grow despite IRA-related sales dip

Guardian Pharmacy Services reported on 5 November that sales in the third quarter of 2026 were $371.1 million, down 2%. The company put the decline down to price reductions under the Inflation Reduction Act (IRA). The result gives an early read on how Medicare price negotiation is reaching the dispensing end of the supply chain.

Earnings moved in the opposite direction. Net income was $19.1 million, and adjusted EBITDA grew 24%. The summary of the results describes net income as having doubled, but the prior-year figure was not in the material available to CompePharma, so that comparison could not be checked.

Management also raised its forecasts for the full year, covering both revenue and adjusted EBITDA. The new ranges were not available, so it is not possible to say how far the outlook has moved or what it implies for the final quarter.

Guardian also pointed to growth activity: several pharmacy acquisitions and the opening of new greenfield locations. The names, prices and locations of these deals and sites were not disclosed in the material reviewed.

By way of context, the IRA lets the US government negotiate prices for certain high-spend Medicare drugs, and its effects are increasingly showing up in the results of companies along the pharmaceutical supply chain.