Custom Health Holdings Inc (TSX:CHLT) just landed Buy-rated coverage from Stifel, with analysts setting a C$12 price target and pointing to upside as high as C$18 a share.
The pitch: a pill-dispensing platform that's quietly solving one of healthcare's most expensive headaches.
That headache is medication non-adherence, which costs the US healthcare system an eye-watering $0.5 trillion a year. Only about half of prescriptions get taken as directed, and the fallout, hospitalizations, ER visits, disease progression, adds up fast.
Custom Health's answer is a full-stack system: a device called Spencer that dispenses and monitors pills at home, an AI-powered platform called AdhereNet, and a network of automated pharmacies behind it. Stifel says the result is a 98% adherence rate, far above the industry norm.
Insurers have taken notice. Custom Health already has more than 100,000 patients contracted through deals with major US health plans, including Humana (NYSE:HUM), Elevance and BlueCross BlueShield, plus pain management specialists Commonwealth and BKC. Stifel expects the company to nearly triple its active patient count next year, from about 6,000 to 17,000, helped along by its recent acquisition of InnovativeRx, with revenue more than doubling.
One area where Custom Health has a particularly good story to tell: opioids. The platform helps physicians safely wean patients off opioid prescriptions, which lines up with the NOPAIN Act, a law that kicked in this past January and sweetens Medicare reimbursement for opioid-reduction efforts. Better adherence also tends to boost Medicare Star ratings, translating into higher rebates and bonus payments for health plans.
The typical Custom Health patient is in their 50s or 60s and juggling more than 10 chronic medications, exactly the population set to grow as the US and Canada keep aging.
Stifel thinks the InnovativeRx deal could unlock 4x revenue growth over the next two to three years as Custom Health works through 30,000 of the 100,000 patients already under contract, with more acquisitions still on the table.
The margin story is arguably the most compelling part: the Spencer device alone represents close to a $200 million recurring revenue opportunity at gross margins north of 60%. Layered on top of traditional pharmacy dispensing margins around 20%, Stifel sees a path to EBITDA margins in the high teens, well above what most pharmacy peers manage.
Stifel's initiation wasn't the only news out of Custom Health this month. The company has since signed a binding letter of intent to acquire Wisconsin-based Evergreen Pharmacy LLC, a deal expected to add more than US$78 million in annual revenue.
The price tag is modest relative to that boost: US$3.5 million total, including at least US$1 million in prescription drug inventory and US$450,000 in net working capital, cash on closing, with US$175,000 held back for six months as an indemnity cushion.
Evergreen is licensed to operate in Wisconsin, Illinois and Michigan, with room to expand into Minnesota, and specializes in managing complex therapies across behavioral health, dermatology, gastroenterology, infectious disease, rheumatology and neurology. It brought in about US$78.8 million in revenue and US$0.6 million in normalized EBITDA for the 12 months ended December 31, 2025, and posted positive net income in both fiscal 2025 and the first quarter of 2026.
For Custom Health, the deal fits neatly with the growth story Stifel laid out: more patients on complex drug regimens, a bigger Midwest footprint, and another building block toward that four-times revenue potential.