Biodesix (BDSX) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $25.6 million, up 42% year-over-year, driven by strong growth in both diagnostic testing and development services.

• Diagnostic testing revenue grew 37% to $22.3 million, with test volumes up 29% to 17,800 and higher average revenue per test due to expanded payer coverage and improved revenue cycle management.

• Development services revenue nearly doubled, increasing 99% to $3.3 million, reflecting successful execution on contracts and new agreements.

• Gross margin expanded to 84% GAAP (82% excluding a one-time $0.4 million tax recovery), up 300 basis points year-over-year.

• Net loss improved by 30% to $7.8 million compared to Q1 2025.

Financial highlights

• Operating expenses (excluding direct costs) increased 18% year-over-year to $27.6 million, mainly due to higher sales, marketing, and administrative investments.

• Adjusted EBITDA loss was $4.1 million, a 35% improvement from Q1 2025.

• Cash and cash equivalents stood at $25.6 million, up 35% from December 31, 2025, aided by $16.8 million in net proceeds from at-the-market offerings.

• Share-based compensation expense was $1.1 million, up 15% year-over-year.

• Interest expense increased 17% to $2.0 million, reflecting additional debt drawn in 2025.

Outlook and guidance

• Full-year 2026 revenue guidance raised to $108–$114 million, representing 25% growth at the midpoint over 2025.

• Continued progress expected toward sustained adjusted EBITDA profitability, driven by sales productivity, clinical evidence, and pipeline growth.

• Growth guidance weighted toward test volume increases, with modest ASP improvement expected.

• Gross margin expected to be maintained at approximately 80%.

• Ongoing investments in research and development and sales force expansion are anticipated to support future growth.