Doximity’s fourth quarter results for 2025 were met with a sharp negative market reaction, as management cited a combination of delayed pharmaceutical industry budgets and a notable increase in AI-related infrastructure spending as primary factors behind underwhelming outcomes. CEO Jeffrey Tangney pointed to record engagement across the platform, particularly in workflow and AI tools, but acknowledged that “client uncertainty” stemming from late-signed government pricing agreements caused several top pharma customers to delay or reduce upfront spending. Management also highlighted that the majority of revenue growth came from existing customers, with a 10% increase in high-value accounts, but also noted that elevated investments in AI pressured margins.
While we enjoy listening to the management's commentary, our favorite part of earnings calls are the analyst questions. Those are unscripted and can often highlight topics that management teams would rather avoid or topics where the answer is complicated. Here is what has caught our attention.
Our Top 5 Analyst Questions From Doximity’s Q4 Earnings Call
Brian Tanquilut (Raymond James) asked how much government pricing agreements affected pharma client spending. VP Perry Gold explained that late-signed MFN agreements were a major driver of delayed budgets and reduced upfront bookings, but expects funds to be released later in the year.
Allen Lutz (Bank of America) questioned the timing of AI monetization. Gold reiterated that AI product revenue is not expected until later in the year, with initial quarters focused on user growth and investment in infrastructure, and that a 50% adjusted EBITDA margin is a floor, not a target.
Michael Cherny (Leerink Partners) asked about competitive differentiation in the AI landscape. CEO Jeffrey Tangney pointed to the platform’s physician trust, integration with hospital systems, and the PeerCheck program as key factors distinguishing Doximity from other AI providers.
Glenn Santangelo (Barclays) requested clarification on the expected revenue growth trajectory for 2026. Gold stated that management expects to “exit the year as a double-digit grower,” driven by deferred pharma spending and new AI initiatives.
Ryan MacDonald (Needham & Company) inquired whether regulatory scrutiny of direct-to-consumer (DTC) pharmaceutical marketing could shift more budget to physician-focused channels. Gold replied that no impact had yet been observed but acknowledged it as a potential future tailwind if FDA enforcement increases.
In the coming quarters, watch (1) the timing and magnitude of pharma budget releases and upsell activity, (2) the commercial launch and adoption rates of Doximity’s AI products among both hospitals and pharma clients, and (3) the impact of ongoing policy changes on healthcare marketing budgets. The pace of margin recovery and progress in integrating AI tools across health systems will also be key markers of execution.
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