OPKO HEALTH INC (OPK)

Sector: Health Care

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2026 Annual Meeting Analysis

OPKO HEALTH INC · Meeting: June 18, 2026

Policy v1.2medium confidenceView Filing ↗
For informational purposes only. This AI-generated analysis applies a published voting policy to publicly available proxy filings. It does not constitute investment advice, proxy voting advice, or a solicitation of any kind. AI analysis may be incomplete or inaccurate — always review the actual filing and make your own independent decision.

Directors FOR

1

Directors AGAINST

10

Say on Pay

AGAINST

Auditor

FOR

Director Elections

Election of Directors

1 FOR/10 AGAINST

Against Analysis

✗ AGAINST
Phillip Frost, M.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC (Nasdaq Composite) +103.8%, a gap of -122.9pp, far exceeding the 30pp threshold for negative absolute TSR; director since 2007; no 5-year mitigant (5-year return -72.5% vs ^IXIC, gap vastly exceeds threshold)

Dr. Frost has served as CEO and Chairman since 2007 and OPKO's stock has lost about 19% over the past three years while the Nasdaq Composite (^IXIC) gained roughly 104%, a gap of nearly 123 percentage points — far above the 30-point threshold our policy sets for directors at companies with negative returns; the 5-year record is even worse (-72.5% vs the ^IXIC), so there is no long-term track record to offset the recent underperformance.

✗ AGAINST
Jane H. Hsiao, Ph.D., MBATSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since 2007; no 5-year mitigant

Dr. Hsiao has served as a director since 2007, giving her full tenure overlap with the severe underperformance period; with OPKO's stock down about 19% over three years while the Nasdaq Composite (^IXIC) rose over 103%, the gap far exceeds our policy trigger, and the five-year picture (-72.5% for OPK) provides no mitigating context.

✗ AGAINST
Elias A. Zerhouni, M.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since May 2022 (over 24 months ago); no 5-year mitigant applicable for full tenure

Dr. Zerhouni joined the board in May 2022, which is more than 24 months before the 2026 annual meeting, so the new-director exemption does not apply; his tenure fully overlaps with the three-year underperformance period during which OPKO fell roughly 19% while the Nasdaq Composite (^IXIC) gained over 103%, a gap that well exceeds our policy threshold.

✗ AGAINST
Steven D. RubinTSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since 2007; no 5-year mitigant

Mr. Rubin has served as a director since 2007, with full overlap with the underperformance period; OPKO's stock declined roughly 19% over three years while the Nasdaq Composite (^IXIC) gained over 103%, a gap of nearly 123 percentage points, and the five-year return of -72.5% confirms sustained, not transient, underperformance.

✗ AGAINST
Gary J. Nabel, M.D., Ph.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since May 2022 (over 24 months ago); no 5-year mitigant applicable for full tenure

Dr. Nabel joined the board in May 2022, more than 24 months ago, so the new-director exemption does not apply; his full tenure overlaps with the three-year period during which OPKO's stock lost about 19% while the Nasdaq Composite (^IXIC) rose over 103%, a gap far above our policy trigger.

✗ AGAINST
Prem A. Lachman, M.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since March 2021 (over 24 months ago); no 5-year mitigant

Dr. Lachman joined the board in March 2021, which is more than 24 months before this meeting, so the new-director exemption does not apply; OPKO's stock has lost roughly 19% over three years versus a gain of over 103% for the Nasdaq Composite (^IXIC), and the five-year return of -72.5% shows the underperformance is not a short-term blip.

✗ AGAINST
Roger J. Medel, M.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since December 2020 (over 24 months ago); no 5-year mitigant

Dr. Medel joined the board in December 2020, well over 24 months ago; his tenure fully overlaps with the severe underperformance period during which OPKO fell about 19% while the Nasdaq Composite (^IXIC) gained over 103%, and the five-year return of -72.5% confirms this is a sustained pattern.

✗ AGAINST
John A. PaganelliTSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since 2003; no 5-year mitigant

Mr. Paganelli has been a director since 2003 and has full tenure overlap with the underperformance period; OPKO stock dropped roughly 19% over three years while the Nasdaq Composite (^IXIC) gained over 103%, a gap nearly four times our policy trigger, and the five-year return of -72.5% provides no offsetting long-term record.

✗ AGAINST
Richard C. Pfenniger, Jr.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since 2008; no 5-year mitigant

Mr. Pfenniger has served on the board since 2008, giving him full overlap with the underperformance period; OPKO's stock declined roughly 19% over three years while the Nasdaq Composite (^IXIC) rose over 103%, and the five-year return of -72.5% leaves no basis for a mitigating 5-year check.

✗ AGAINST
Alice Lin-Tsing Yu, M.D., Ph.D.TSR underperformance: OPK 3-year return -19.1% vs ^IXIC +103.8%, gap -122.9pp exceeds 30pp threshold; director since 2009; no 5-year mitigant

Dr. Yu has served as a director since 2009, with complete overlap with the underperformance period; OPKO's stock lost roughly 19% over three years while the Nasdaq Composite (^IXIC) gained over 103%, and the five-year return of -72.5% confirms this is not a transient trough.

For Analysis

✓ FOR
Subbarao V. Uppaluri, Ph.D.

Dr. Uppaluri was appointed to the board on March 18, 2026, which is less than 24 months before this meeting, so our policy's new-director exemption applies and the TSR underperformance trigger does not fire for him.

Ten of eleven director nominees receive an AGAINST vote because OPKO's stock has declined roughly 19% over the past three years while the Nasdaq Composite (^IXIC — Nasdaq Composite) gained over 103%, a gap of nearly 123 percentage points that far exceeds our policy's 30-point trigger for companies with negative absolute three-year returns; the five-year return of -72.5% vs the ^IXIC confirms sustained underperformance with no mitigating long-term track record. The sole exception is Dr. Uppaluri, who was appointed in March 2026 and is exempt under the new-director rule.

Say on Pay

✗ AGAINST

CEO

Phillip Frost, M.D.

Total Comp

N/A

Prior Support

98%%

Variable pay above benchmark context: CEO received $480,000 discretionary cash bonus plus $400,000 in stock option awards with no disclosed objective performance conditions; OPK 3-year TSR -19.1% vs ^IXIC +103.8%, a gap of -122.9pp; incentive plan lacks clear measurable performance criteria — bonuses described as purely discretionary

The CEO's total compensation of $1,854,000 includes $880,000 in variable pay (a discretionary cash bonus plus stock option awards), but the proxy explicitly states there are no set performance formulas or criteria for either bonuses or option grants — meaning this variable pay is effectively fixed pay in disguise, which our policy treats as a direct trigger for a NO vote. Separately, the pay-for-performance alignment check fails badly: OPKO's stock lost roughly 19% over three years while the Nasdaq Composite (^IXIC) gained over 103% — a gap of nearly 123 percentage points — yet executives continued to receive above-baseline discretionary bonuses and option grants each year with no reduction or performance linkage. The prior year's 98% shareholder approval does not override these structural concerns, because the pay structure (fully discretionary incentives with no objective metrics) has not changed in a way that addresses the fundamental misalignment between executive pay and shareholder experience.

Auditor Ratification

✓ FOR

Auditor

Ernst & Young LLP

Tenure

N/A

Audit Fees

N/A

Non-Audit Fees

N/A

The proxy filing does not include an auditor fee table with specific audit and non-audit fee amounts, and auditor tenure is not disclosed; under our policy, when fee data and tenure cannot be confirmed from the filing, we do not assume a negative trigger and default to FOR; Ernst & Young is a Big 4 firm appropriate for a company of OPKO's size and complexity.

Overall Assessment

OPKO Health's 2026 annual meeting ballot is dominated by a severe, sustained stock-price underperformance problem: the company's shares have lost roughly 19% over three years and 72.5% over five years while the Nasdaq Composite (^IXIC) gained over 103% and 100% respectively, triggering AGAINST votes on ten of eleven director nominees and a AGAINST vote on Say on Pay due to fully discretionary incentive plans with no objective performance conditions. The auditor ratification receives a FOR in the absence of disclosed fee data that would trigger a negative, and only the newly appointed Dr. Uppaluri escapes the TSR trigger under the new-director exemption.

Filing date: April 30, 2026·Policy v1.2·medium confidence

Compensation Peer Group

1 companies disclosed in 2026 proxy filing

^IXIC__INDEX_BENCHMARK__:Nasdaq Composite Index