← All companies ← OPI Manual OPLN → ← ONC Pharmaceuticals ORMP →
OPK, OPKO Health Inc.
Revenue is led by Services (61%) and Products (26%), with 2 more lines behind.
The business
What it sells, where the money comes from, the kind of company it is.
The business in brief
read the 10-K →What this business is and what moves its needle, from its own SEC filings.
- What it is
- A pharmaceutical business, where patents grant a temporary monopoly the pipeline must keep refilling.
- Situation
- Unprofitable. No sustained operating profit across the record; an earnings multiple has nothing to rest on. What the record does show is revenue, the gross-margin trajectory, and the burn against the cash on hand. Distress / turnaround. Thin interest coverage, or operating cash burned against real debt, across the record. The balance sheet carries this situation; the debt schedule sets the clock.
- What moves the needle
- Operating margin has run around −19% through the cycle on a 34% gross margin, the operating line deeply negative — so the lever is the path to a margin at all: revenue growth against the cost curve and the cash runway, not the level of a margin that isn't there yet. Read this kind of business on the pipeline against the patent cliff, and pricing. On its own account, the filing leans hardest on pricing power & competition, set against the numbers in what the filing emphasizes, below.
- Is it a good business?
- Return on capital has rarely cleared the cost of capital (median −8%, above 15% in 0 of 9 years). Owner earnings, the cash-based check, have been thin too. This is price-taker territory, where the balance sheet and the cycle matter more than any multiple; the rest is in the 10-K.
Every line is arithmetic on the company's filings, shown in full in the sections below.
Where the money comes from
read the 10-K →Services is 61% of revenue, with Products the other meaningful line at 26%.
- Services61%$370M
- Products26%$157M
- Transfer of Intellectual Property and Other13%$80M
- Rayaldee10%$59M
From the segment footnote of the company's own 10-K. Shares are of total revenue; the profit bar shows each segment's share of segment operating profit, before unallocated corporate costs.
The record
Ten years of arithmetic, read across the cycle.
The record, 2016–2025
realized figures from each filing · older years to the left| 2016’16 | 2017’17 | 2018’18 | 2019’19 | 2020’20 | 2021’21 | 2022’22 | 2023’23 | 2024’24 | 2025’25 | TTMTTMMar 2026 | |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Income statement | |||||||||||
| $1.1B | $966M | $990M | $902M | $1.4B | $1.8B | $1.0B | $863M | $713M | $607M | $581M | RevenueRevenue |
| 50% | — | — | — | — | — | 29% | 37% | 31% | 34% | 36% | Gross marginGross mgn |
| 36% | 43% | 36% | 38% | 25% | 26% | 37% | 35% | 43% | 37% | 37% | SG&A / revenueSG&A/rev |
| 10% | 13% | 13% | 13% | 5% | 4% | 7% | 10% | 15% | 20% | 21% | R&D / revenueR&D/rev |
| ($97M) | ($276M) | ($171M) | ($274M) | $58M | $19M | ($226M) | ($157M) | ($152M) | ($117M) | ($101M) | Operating incomeOp. inc. |
| −8.6% | −28.6% | −17.3% | −30.4% | 4.0% | 1.1% | −22.5% | −18.2% | −21.3% | −19.3% | −17.4% | Operating marginOp. mgn |
| ($48M) | ($305M) | ($153M) | ($315M) | $31M | ($30M) | ($328M) | ($189M) | ($53M) | ($226M) | ($213M) | Net incomeNet inc. |
| Cash flow & returns | |||||||||||
| $32M | ($92M) | ($109M) | ($173M) | $39M | $38M | ($95M) | ($28M) | ($183M) | ($179M) | ($163M) | Operating cash flowOp. cash |
| $97M | $102M | $97M | $94M | $85M | $79M | $109M | $105M | $98M | $92M | $90M | DepreciationDeprec. |
| ($59M) | $83M | ($75M) | $35M | ($85M) | ($24M) | $106M | $44M | ($239M) | ($55M) | ($52M) | Working capital & otherWC & other |
| $19M | $47M | $28M | $13M | $34M | $32M | $25M | $16M | $25M | $12M | $11M | CapexCapex |
| 1.7% | 4.8% | 2.8% | 1.4% | 2.3% | 1.8% | 2.4% | 1.9% | 3.5% | 2.0% | 1.9% | Capex / revenueCapex/rev |
| $13M | ($139M) | ($137M) | ($185M) | $6M | $6M | ($120M) | ($44M) | ($208M) | ($191M) | ($174M) | Owner earningsOwner earn. |
| 1.2% | −14.3% | −13.8% | −20.5% | 0.4% | 0.3% | −11.9% | −5.2% | −29.2% | −31.4% | −30.0% | Owner earnings marginOE mgn |
| $13M | ($139M) | ($137M) | ($185M) | $6M | $6M | ($120M) | ($44M) | ($208M) | ($191M) | ($174M) | Free cash flowFCF |
| 1.2% | −14.3% | −13.8% | −20.5% | 0.4% | 0.3% | −11.9% | −5.2% | −29.2% | −31.4% | −30.0% | Free cash flow marginFCF mgn |
| $0 | $0 | $0 | $0 | $0 | $4M | $2M | $0 | $0 | — | $0 | AcquisitionsAcquis. |
| — | — | — | — | — | — | $0 | $0 | $90M | $47M | — | BuybacksBuybacks |
| -4% | -12% | -8% | -12% | 2% | — | -11% | -8% | -9% | -7% | -7% | ROICROIC |
| -2% | -17% | -9% | -20% | 2% | -2% | -21% | -14% | -4% | -18% | -18% | Return on equityROE |
| −2% | −17% | −9% | −20% | 2% | −2% | −21% | −14% | −4% | −18% | −18% | Retained to equityRetained/eq |
| Balance sheet | |||||||||||
| $173M | $104M | $96M | $85M | $72M | $135M | $153M | $96M | $427M | $364M | $360M | Cash & investmentsCash+inv |
| $220M | $166M | $144M | $135M | $286M | $260M | $127M | $123M | $118M | $90M | $80M | ReceivablesReceiv. |
| $47M | $49M | $42M | $53M | $132M | $87M | $74M | $66M | $57M | $66M | $64M | InventoryInvent. |
| $53M | $74M | $47M | $63M | $101M | $82M | $67M | $70M | $47M | $41M | $44M | Accounts payablePayables |
| $214M | $141M | $139M | $126M | $318M | $264M | $134M | $119M | $128M | $115M | $100M | Operating working capitalOper. WC |
| $484M | $349M | $318M | $324M | $523M | $823M | $395M | $309M | $662M | $582M | $535M | Current assetsCur. assets |
| $263M | $312M | $288M | $249M | $375M | $330M | $213M | $200M | $193M | $147M | $148M | Current liabilitiesCur. liab. |
| 1.8× | 1.1× | 1.1× | 1.3× | 1.4× | 2.5× | 1.8× | 1.5× | 3.4× | 4.0× | 3.6× | Current ratioCurr. ratio |
| $705M | $717M | $700M | $712M | $710M | $719M | $596M | $598M | $529M | $484M | $482M | GoodwillGoodwill |
| $2.8B | $2.6B | $2.5B | $2.3B | $2.5B | $2.4B | $2.2B | $2.0B | $2.2B | $1.9B | $1.9B | Total assetsAssets |
| $44M | $104M | $105M | $211M | $251M | $205M | $210M | $214M | $440M | $346M | $247M | Total debtDebt |
| ($130M) | $192K | $9M | $126M | $179M | $71M | $57M | $118M | $14M | ($18M) | ($113M) | Net debt / (cash)Net debt |
| — | — | — | — | — | 1.0× | -18.8× | -11.6× | -3.2× | — | — | Interest coverageInt. cov. |
| $2.0B | $1.8B | $1.8B | $1.6B | $1.7B | $1.7B | $1.6B | $1.4B | $1.4B | $1.3B | $1.2B | Shareholders’ equityEquity |
| 3.8% | 2.9% | 2.2% | 1.5% | 0.6% | 0.8% | 1.8% | 1.3% | 1.5% | 1.8% | 1.9% | Stock comp / revenueSBC/rev |
| Per share | |||||||||||
| 556M | 559M | 563M | 595M | 641M | 648M | 719M | 752M | 694M | 751M | 759M | Shares out (diluted)Shares |
| $2.01 | $1.73 | $1.76 | $1.51 | $2.24 | $2.74 | $1.40 | $1.15 | $1.03 | $0.81 | $0.77 | Revenue / shareRev/sh |
| $-0.09 | $-0.55 | $-0.27 | $-0.53 | $0.05 | $-0.05 | $-0.46 | $-0.25 | $-0.08 | $-0.30 | $-0.28 | EPS (diluted)EPS |
| $0.02 | $-0.25 | $-0.24 | $-0.31 | $0.01 | $0.01 | $-0.17 | $-0.06 | $-0.30 | $-0.25 | $-0.23 | Owner earnings / shareOE/sh |
| $0.02 | $-0.25 | $-0.24 | $-0.31 | $0.01 | $0.01 | $-0.17 | $-0.06 | $-0.30 | $-0.25 | $-0.23 | Free cash flow / shareFCF/sh |
| $0.03 | $0.08 | $0.05 | $0.02 | $0.05 | $0.05 | $0.03 | $0.02 | $0.04 | $0.02 | $0.01 | Cap. spending / shareCapex/sh |
| $3.68 | $3.30 | $3.18 | $2.71 | $2.61 | $2.60 | $2.17 | $1.85 | $1.97 | $1.69 | $1.59 | Book value / shareBVPS |
| 9-yr | 5-yr | |
|---|---|---|
| Revenue / share | −9.6%/yr | −18.5%/yr |
| Capital spending / share | −7.6%/yr | −20.8%/yr |
| Book value / share | −8.3%/yr | −8.3%/yr |
The year, in the company's words
the filing →Verbatim from the 10-K's management discussion. Each sentence is shown only because its subject, direction, and stated figures check out against the filed numbers on this page. The words are the company's; the arithmetic is the record's.
- Revenue-14.9%
“Revenue from services for the year ended December 31, 2025 decreased by approximately $110.4 million, or 23.0%, compared to the year ended December 31, 2024. The decrease was driven by total reductions of $119.8 million, composed of $109.6 million reflecting the sale of BioReference's lab and oncology operations, and $10.2 million from lower clinical test volume in continuing operations, which were partially offset by a $9.4 million increase from higher clinical test reimbursement rates.”
✓ figure matches the filed record
The record, charted
FY2016–2025Each measure over its full record; the current point and the worst year marked.
Owner earnings vs. net income
Owner earningsNet incomeThe accountant's number, and the cash an owner can take; the gap is the tell.
Where the cash went
ReinvestBuybacksDividendsAcquisitionsRetainedEach year's operating cash, by what management did with it: the mix, and how it drifts.
Net income is the accountant's number; owner earnings is the cash an owner could take out. The walk between them, off the cash-flow statement, and whether the gap is widening or holding.
In fiscal 2025 the business turned a $226M loss into ($191M) of owner earnings: more cash than the profit line showed, after the non-cash charges and the capital it put back in.
| FY2025 | FY2024 | FY2023 | FY2022 | FY2021 | |
|---|---|---|---|---|---|
| Reported net income | ($226M) | ($53M) | ($189M) | ($328M) | ($30M) |
| Depreciation & amortizationnon-cash charge added back | +$92M | +$98M | +$105M | +$109M | +$79M |
| Stock-based compensationreal costnon-cash, but a real cost | +$11M | +$11M | +$11M | +$19M | +$14M |
| Working capital & othertiming of cash in and out, other non-cash items | −$55M | −$239M | +$44M | +$106M | −$24M |
| Cash from operations | ($179M) | ($183M) | ($28M) | ($95M) | $38M |
| Capital expenditurecash put back in to keep running and to grow | −$12M | −$25M | −$16M | −$25M | −$32M |
| Owner earnings | ($191M) | ($208M) | ($44M) | ($120M) | $6M |
| Owner-earnings marginowner earnings ÷ revenue | -31% | -29% | -5% | -12% | 0% |
Owner earnings is the cash an owner could pull out without starving the business: operating cash less the capital it must spend to hold its position . The cash-flow statement also adds stock comp back as non-cash, but it is a real cost paid in shares; counted as the expense it is (less $11M), owner earnings is nearer ($202M).
Maintenance capex is estimated as depreciation where a growing business invests above it; free cash flow is the figure the scorecard's free-cash margin reads.
Quality & stewardship
Returns, the balance sheet, capital allocation, and pay.
Owner’s Scorecard
Will it survive?
- No meaningful interest burdenLittle or no interest expense reported
What this means
Little or no interest expense reported, the business isn't leaning on lenders to operate.
- Net cashCash $364M + ST investments $12M − debt $346M
What this means
Cash and short-term investments exceed every dollar of debt by $30M, on net the company owes nothing, and can act from strength when others can't. It also holds $12M in longer-dated marketable securities; counting those, it sits at net cash of $42M. Net debt is the leverage figure that matters: the cash is already set against the debt. Strategic or illiquid investments aren't counted here.
- Long (60+ days)DSO 54 + DIO 60 − DPO 37 days
What this means
Days cash is tied up between paying suppliers and collecting from customers. Lower is better; a long cycle means growth itself eats cash.
Is it a good business?
- Below average through the cycle9-yr median, range -12%–2%; -7% latest = NOPAT ($93M) ÷ invested capital $1.2BIndustry peers: median -49%
What this means
The rate the business earns on the money tied up in it, Buffett's north star, because over time a stock tracks the ROIC beneath it. Above ~15% sustained hints at a moat; a return below the cost of capital (~8%) erodes value as a business grows rather than building it — the test Buffett weighs most. The headline is the median of the last 9 years (it ran -7% most recently), so one peak or trough year doesn't set the verdict. Asset-light businesses (R&D expensed, little capital) read artificially high, pair this with Owner Earnings.
- Consumes cash through the cycle10-yr median margin, range -31%–1%; latest ($191M) = operating cash ($179M) − maintenance capex $12MIndustry peers: median -44%
What this means
What an owner could take out without starving the business: operating cash less the maintenance capital it must spend to hold its position — Buffett's owner earnings. That's -31% of revenue this year, a -14% median across 10 years. Treating stock comp as the real expense it is (less $11M of SBC) leaves ($202M).
- Are earnings backed by cash? ($179M)Loss, and burning cashNet income ($226M) · cash from operations ($179M)
What this means
The company reported a net loss, so a conversion ratio isn't meaningful. What matters then is whether operations still threw off cash, here, they did not.
How is the cash used?
- No surplus to allocate
What this means
The business didn't generate positive Owner Earnings this year, so any distributions came from the balance sheet or borrowing, not from operations.
- Investing or harvesting? 0.13×HarvestingCapex $12M ÷ depreciation $92M
What this means
Descriptive, not a grade. Above ~1× means investing faster than assets wear out (growth, or, sustained for years, today's earnings carrying less depreciation than tomorrow's will). Below means spending less than it's wearing out (efficiency, or a melting asset base). The ratio won't tell you which; the filings will.
Graham’s defensive tests · 2 of 5 met
Graham’s numerical criteria for the defensive investor (The Intelligent Investor, ch. 14), run on the filings. A floor of safety, not a buy signal; many fine modern businesses fail his strictest liquidity rules by design.
- Adequate size MissRevenue ≥ $2B · $607M
What this means
Big enough to weather a storm. Graham's 1972 floor was ~$100M of sales (≈ $700M today); we use a $2B revenue line as a conservative modern stand-in.
- Strong liquidity PassCurrent ratio ≥ 2× · 3.97×
What this means
Current assets at least twice current liabilities, near-term bills covered without touching the business. Strict by design: many cash-rich modern firms run leaner and miss it, holding their cushion in longer-dated securities.
- Conservative debt PassDebt ≤ working capital · $346M vs $435M WC
What this means
Graham's rule that borrowings not exceed net current assets. Capital-heavy and buyback-heavy firms routinely fail it, read it next to interest coverage, not alone.
- Earnings stability MissA profit every year (10-yr record) · 9 loss years
What this means
Graham wanted earnings in each of the past ten years, the stability a defensive owner leans on.
- Dividend record MissUninterrupted dividends · none paid
What this means
An unbroken dividend was Graham's mark of durability. He wanted twenty years; the filings show about ten, and a single suspension breaks the streak. Non-payers, many fine modern compounders, fall outside his defensive net by design.
- Earnings growth —Earnings +33% over the record · —
What this means
Earnings were negative early in the record, a growth rate isn't meaningful.
- Moderate price —P/E ≤ 15 and P/E × P/B ≤ 22.5 · decided by the price
What this means
Graham's valuation gate, the wall he kept between a sound business and a sound investment. Three-year average earnings are $-0.21/share (latest year $-0.30), the averaged base the calculator's gate runs on, and book value is $1.68/share. Enter a price in “What the price implies” just below for the P/E, P/B, and whether it clears. But this is the rule Buffett outgrew: there's no hard P/E law, and a wonderful business can deserve a far richer multiple if the thesis holds, treat it as the bargain-hunter's floor, not a verdict on the price.
Durability & moat, 2016–2025
Whether the record’s returns held, and what the capital reinvested earned.
- Profitable years 1 of 10
What this means
Lost money in 9 year(s), look at what happened there before trusting the average.
- Return on capital ≥ 15% 0 of 10 yrs
What this means
A moat shows up as a high return on invested capital that holds year after year, not one good vintage.
- Operating margin −18% → −20% (3-yr avg ends)
What this means
Through the cycle the operating margin held roughly steady — about −18% early, −20% lately, median −19%.
- Reinvestment, incremental ROIC returns capital
What this means
The capital base barely grew: this business returns cash through dividends and buybacks rather than reinvesting. Judge it on the cash returned, not on compounding.
- Worst year 2019 · −30.4% op. margin
What this means
Operations went underwater in 2019, understand why before trusting the good years.
- Share count +3.4%/yr
What this means
The share count is rising, dilution works against you on a per-share basis.
Does AI threaten the moat?
Low contestabilityThe moat is physical, regulated or balance-sheet-funded, the kind AI cuts costs within but does not contest.
The filing raises AI among its risks, but in other terms (security, regulation, energy or the like), not as a competitor to its product.
AI is unlikely to contest a moat that is physical, regulated or balance-sheet-funded; here it reads more as a cost tool than a threat.
Read from the filing's own risk factors, paired with the industry's structure under its SIC code; the durability is read above, the price below.
All figures as filed; the source filing is linked above.
Current Position
as of the latest quarter, Mar 31, 2026Can the business pay what it owes this year, off the freshest balance sheet: the quality of the assets, the debt actually coming due, and what a low ratio means here.
- Cash & short-term investments$347M
- Receivables$80M
- Inventory$64M
- Other current assets$44M
- Debt due within a year$2M
- Accounts payable$44M
- Other current liabilities$103M
From the company's latest filing.
Acquisitions & goodwill
from the balance sheet & the 10-year cash-flow recordGoodwill grows only when a company acquires and falls only when it concedes it overpaid. The size of that bet, the cash put into buying rather than building, and how much has already been written off.
$38M written down across 2 years (2018, 2019): goodwill the company has already conceded it overpaid for, charged against earnings. A write-down costs no cash (the cash went out when the deal was signed), but it is management marking its own past judgment to market.
Goodwill, acquired intangibles and equity from the latest balance sheet; acquisition spend and write-downs summed across the 10-year record, from the company's own filings.
Management, ownership & pay
read the proxy →From the proxy: how much of the business the people running it own, and how they are paid, beside what the business earned for its owners in the same years.
| Fiscal year | Chief executive | Pay, as filed | “Actually paid” | Owner earnings |
|---|---|---|---|---|
| 2021 | Dr. Phillip Frost | $2.1M | $2.4M | $6M |
| 2022 | Dr. Phillip Frost | $972k | −$1.2M | ($120M) |
| 2023 | Dr. Phillip Frost | $2.3M | $2.2M | ($44M) |
| 2024 | Dr. Phillip Frost | $2.2M | $2.0M | ($208M) |
| 2025 | Dr. Phillip Frost | $1.9M | $1.3M | ($191M) |
Both pay figures are the company’s own, from the pay-versus-performance table its proxy statement files. “As filed” is the Summary Compensation Table total: salary, bonus, and equity awards at their value on the day of grant. “Actually paid” is the SEC’s prescribed recalculation, which re-marks those equity awards to what they became as they vested; it can swing far above or below the filed figure in either direction, and negative years occur. Owner earnings are the whole business's, from the record above, for the same fiscal years.
- Insider ownership44.7%
The stake all directors and executive officers hold together, per the 2026 proxy: skin in the game, the first thing Munger reads.
- Stock-based compensation$11M
The slice of the business handed to employees in shares this year, 2% of revenue. Buffett's oldest accounting fight: this is compensation, compensation is an expense, real whether or not the headline earnings admit it. One trap: the cash-flow statement adds SBC back, so the operating cash, and the owner earnings drawn from it, are flattered by exactly this amount; counted as the cost it is, what an owner keeps is lower.
Inverting the record
Invert: instead of why OPKO Health Inc. is a good business, the question is what would make owning it a mistake, and whether those marks are in the record. Disconfirming tests across 2016–2025.
2 of the 4 tests turned up something to look into; the other 2 came back clean.
- Look hereIs it less profitable than it was?−21.9% vs −9.0%
The business ran at a loss early in the record (an owner-earnings margin of −9.0%) and the loss has widened to −21.9% across the last three years, with the latest year at −31.4%. Ask the filing where the widening sits — price, cost, or spending growing faster than revenue — and what would narrow it.
- Look hereDid debt outgrow the business?$44M → $247M
Debt rose from $44M to $247M while owner earnings went from about ($87M) to ($148M): the borrowing grew and the earnings that would carry it are not there now. Debt raised for buybacks or deals rather than growth is the kind that bites in a downturn.
- Did receivables and inventory outpace sales?
- Are "one-time" charges a yearly habit?
Each test is read from the filings and is noisy alone; a flag can mark a cyclical trough or a year of heavy investment as easily as a problem. The filing says which.
Peers, Pharmaceuticals
The same industry, side by side on owner economics. Each figure is a through-cycle median, so a peak or trough year can’t distort it; the group median at the foot is the line to read each against.
| Company | Revenue | Gross margin | Op. margin | ROIC | Owner earn. margin |
|---|---|---|---|---|---|
| PCRXPacira BioSciences | $726M | 73% | 3.7% | 2% | 16% |
| KNSAKiniksa Pharmaceuticals International, PLC | $678M | 88% | -9.3% | -6% | 5% |
| RAREUltragenyx | $673M | 100% | -154.9% | -92% | -113% |
| AXSMAxsome Therapeutics Inc. | $638M | 99% | -79.2% | — | -44% |
| TGTXTG Therapeutics Inc. | $616M | 88% | -29896.1% | -572% | -23443% |
| OPKOPKO Health Inc. | $607M | 34% | -18.8% | -8% | -13% |
| INSMInsmed Incorporated | $606M | 77% | -202.3% | -138% | -182% |
| CPRXCatalyst Pharmaceuticals Inc. | $589M | 86% | 35.9% | 48% | 37% |
| Group median | — | 87% | -49.0% | -8% | -28% |
The price
What a price has to assume.
What the price implies
reverse-DCFOPKO Health Inc. is profitable, but owner earnings are negative this year because capital spending currently outruns operating cash, a build-out, so the owner-earnings reverse-DCF has no positive base to grow. We read the price from both ends instead: type a price to see the steady-state profitability it demands, then set the mature margin you would believe and weigh the two against each other. Nothing leaves your browser unless you enter it in your notebook.
Revenue, delivered−19%/yr’20→’25
Enter a price to run it.
A dated snapshot of the price you typed, the assumptions you set, and what the page showed for them. A snapshot is never edited after it is saved. Your notebook is yours alone — the commitment states what is stored and what we will never do.
Two reads of one future. From your price: the owner earnings the company must reach, valued at a mature multiple and discounted back at your rate, expressed as the margin it implies on revenue grown at your rate. From your belief: the mature margin you would credit, set on the dial above. When the margin the price demands runs above the one you would believe, you are paying for a future taken on faith. For a deep cyclical at a trough, normalized through-cycle earnings are the better lens; this mode is for the genuinely unprofitable, and for the profitable business whose capital spending currently outruns its cash.
Manual order: ← OPI its page in the Manual OPLN →
Industry order: ← ONC the Pharmaceuticals chapter ORMP →