GRAIL (GRAL) Q4 2024 earnings summary

Executive summary

• 2024 marked a transformative year with separation from Illumina and public trading beginning in June, alongside completion of final study visits for NHS-Galleri and PATHFINDER 2.

• Sold over 137,000 Galleri tests in 2024, driving U.S. Galleri revenue up 45% year-over-year to $108.6M.

• TRICARE added Galleri as a covered benefit for eligible patients, expanding market access.

• Integration with Quest Diagnostics expanded test access to over 500,000 physicians and 7,400 locations, enabling electronic ordering nationwide.

• Major restructuring extended capital runway and improved cost efficiency.

Financial highlights

• Q4 2024 revenue was $38.3M, up 26% year-over-year; full-year revenue reached $125.6M, up 35%.

• Screening revenue for Q4 was $31.6M, up 39% year-over-year; full-year screening revenue was $108.6M, up 45%.

• Development services revenue for Q4 was $6.7M; full-year was $17M, down 6%.

• Q4 net loss was $97.1M, improving 48% year-over-year; full-year net loss was $2B, up 38%, mainly due to $1.4B impairment and $138.3M amortization.

• Q4 adjusted EBITDA was negative $84M, a 32% improvement; full-year adjusted EBITDA was negative $483.5M, an 8% improvement.

• Year-end cash position was $767M, extending runway into 2028.

Outlook and guidance

• Cash burn for 2025 expected to be no more than $320M, a projected decrease of over 40% from 2024.

• Cash runway extends into 2028, supporting major milestones including study readouts and FDA submission.

• Registrational study readouts expected in 2025 and 2026; modular PMA submission planned for H1 2026.

• No change to 2025 guidance following Quest and TRICARE developments.