BillionToOne (BLLN) 44th Annual J.P. Morgan Healthcare Conference summary

Technology and product innovation

• Developed a patented single-molecule next-generation sequencing (smNGS) platform with QCT technology, enabling 10x improvement in sensitivity and precision for molecular diagnostics and category-defining products in prenatal and oncology.

• UNITY test enables direct fetal risk assessment from maternal blood, detecting about three times as many affected pregnancies as traditional methods and simplifying prenatal screening.

• Northstar platform offers ultrasensitive liquid biopsy for therapy selection and response monitoring, detecting 51–109% more actionable variants than competitors.

• Proprietary machine learning and bioinformatics integration drive quantitative accuracy, process efficiency, and improved patient outcomes in both prenatal and oncology applications.

• MRD and early cancer detection products are in development, leveraging the same core technology for high sensitivity.

Financial performance and growth

• Achieved rapid revenue growth from $0 to $334 million annualized run rate in five years, with 117% year-over-year revenue growth from Q3 2024 to Q3 2025 and triple-digit growth in both prenatal and oncology segments.

• Maintains 70% gross margins, with ongoing reductions in cost of goods sold (COGS) per test and further improvements expected as lab capacity utilization and ASPs increase.

• Covered lives reached approximately 235 million, with average sales price rising to $501 and further increases expected through expanded contracting.

• Projected revenues for 2025 are $293–$299 million, with 2026 guidance raised to $415–$430 million.

• Expects to remain GAAP profitable, with gross margins in the high 60%–70% range, and plans to invest further in SG&A and R&D.

Commercial strategy and market position

• Second largest prenatal lab in the U.S., with strong provider advocacy and 51% year-over-year test volume growth driven by geographic expansion and in-network coverage.

• Salesforce is less than 20% the size of competitors but highly productive, adding 100+ new clinics per quarter and achieving over 100% net test retention in most cohorts.

• Commercial growth levers include expanding sales team, increasing in-network status, and leveraging Epic Aura integration for health system penetration.

• Oncology business expected to grow faster than prenatal, with new product launches targeting $20B therapy selection and $30B MRD markets.

• Head-to-head clinical data and superior technology drive provider adoption in both prenatal and oncology segments.