BillionToOne (BLLN) Q1 2026 earnings summary

Executive summary

• Achieved 84% year-over-year revenue growth in Q1 2026, reaching $108.4 million, with strong performance in both prenatal and oncology segments and an annualized run-rate of $434 million.

• Net income reached $18.0 million, reversing a net loss of $4.0 million in Q1 2025.

• Delivered approximately 188,000 tests, up 44% year-over-year, with continued expansion in both prenatal and oncology diagnostics.

• Launched UNITY Confirm, a first-of-its-kind non-invasive prenatal confirmation assay, and expanded payor contracts to 300 million contracted lives.

• Expanded laboratory capacity and launched new products, including Northstar PGx/CH.

Financial highlights

• Q1 2026 revenue was $108.4 million, up from $59.0 million in Q1 2025 (84% growth).

• Prenatal revenue grew 72% year-over-year to $97.7 million; oncology revenue increased nearly 400% to $10.7 million.

• Gross profit was $79.1 million, with gross margin expanding to 73% from 64% a year ago.

• Operating income reached $17.8 million, reversing a $2.3 million loss in Q1 2025.

• Adjusted EBITDA was $26.0 million, up from $1.8 million in Q1 2025.

Outlook and guidance

• Raised 2026 revenue guidance to $450–$465 million, up from previous $430–$445 million, reflecting 48–52% growth over 2025.

• Guidance increase driven by Q1 strength and expected ASP lift from new payer contracts; volume assumptions unchanged except for Q1 outperformance.

• Expects to maintain profitability near current levels despite ongoing investments in sales, R&D, and clinical evidence.

• Current liquidity is expected to fund operations for at least the next 12 months.