Revenue Guidance

FY 2025

$92 million to $95 million "

$80 million to $85 million "

lowered

Adjusted EBITDA

FY 2025

adjusted EBITDA profitability in the second half of 2025 " "

adjusted EBITDA positivity in Q4 2025 " " "

lowered

Sales Team Expansion

FY 2025

add approximately 6 sales teammates per quarter, ending 2025 with 95 teammates "

hire 10 sales reps per quarter starting in Q2 2025, ending FY 2025 with approximately 95 sales reps " " "

raised

Gross Margins

FY 2025

gross margins expected to remain in the mid to upper 70s " "

gross margins expected to remain in the upper 70% range "

raised

Capital Needs

FY 2025

no prior guidance

additional $10 million tranche C loan drawn "

no prior guidance

Sales Force Expansion

Previous calls in Q4 2024, Q3 2024, and Q2 2024 consistently discussed building the sales team with plans to add 6–8 reps per quarter, territory segmentation, and reconfiguration (e.g., maintaining pulmonology focus while piloting additional roles). " " " " " " "

In Q1 2025 the discussion remained robust with details about shifting focus from pulmonology to primary care, reconfiguring roles (including associate “hunter/farmer” roles) and addressing execution challenges in hiring and turnover. " " " "

Consistent focus on expanding and reconfiguring the sales force. In Q1 2025, there is an added emphasis on integrating primary care expertise, indicating an evolution in strategy while execution challenges remain a constant operational priority.

Primary Care Integration

Q4 2024 mentioned a pilot program and targeted expansion into primary care (with positive pilot insights) while Q3 and Q2 did not include detailed discussion on primary care integration. " "

Q1 2025 provides extensive details about recruiting primary care sales reps, tailoring onboarding/training for primary care, and a territory reconfiguration that supports the “pod‐based” structure incorporating both pulmonology and primary care reps. " " " "

Emergent and more detailed focus in Q1 2025 compared to earlier periods – whereas Q4 had initial pilot insights, the current period shows a robust integration strategy with dedicated roles and expanded territory models.

Pipeline Development & Commercialization Risks

In Q4 2024, the MRD test and ALTITUDE study were discussed—with emphasis on a multiomic MRD program in collaboration with Memorial Sloan Kettering and a pivotal ALTITUDE trial. Q2 2024 focused on ALTITUDE study design and enrollment challenges, while Q3 2024 did not mention pipeline topics. " " " "

Q1 2025 highlighted the development of a combination MRD test (integrating genomic and proteomic platforms) targeting biopharma, and provided updated timelines for both MRD (research use by end-2025, commercial launch planned 2026–2027) and the ALTITUDE study. " " " "

Increased emphasis in Q1 2025 with more detailed commercialization timelines and risks. Earlier discussions were either limited to pilot studies or general updates; now there is a clearer focus on integrating multiomic approaches and aligning reimbursement strategies before full launch.

Clinical Data, Studies & Guideline Updates

Across Q2, Q3, and Q4, the company consistently discussed studies (e.g., CLARIFY, ALTITUDE, ClariPhy) and guideline updates, with presentations at key conferences and references to long-outdated guidelines that expected revisions (e.g., CHEST). " " " " " "

Q1 2025 continued this focus with discussions on clinical data supporting lung diagnostics (including Nodify XL2 and CDT), details on ongoing Clarify and ALTITUDE studies, and the integration of new operational processes (such as digital ordering and mobile phlebotomy) to improve guideline adherence. " "

Stable focus with incremental improvements. While all periods emphasize the importance of robust clinical data and guideline influence, Q1 2025 adds further operational integration to bolster test utilization and refine clinical outcomes.

Cost Management, EBITDA & Profitability

Prior periods (Q2, Q3, Q4) consistently emphasized disciplined cost management, targeted improvements in adjusted EBITDA and gross margins, and strategies to achieve breakeven through controlled SG&A and operating expense management. " " " " "

In Q1 2025, cost management remains a priority with further commentary on controlled SG&A, modest increases in operating expenses despite hiring, improved adjusted EBITDA figures, and a clear target of adjusted EBITDA positivity by Q4 2025, supported by a new $10M tranche to strengthen liquidity. " " " "

Consistent focus on financial discipline. The narrative remains continuity‐oriented as the company balances growth (via sales expansion) with cost control, and the Q1 2025 discussion reinforces a commitment to disciplined expense management while leveraging new funding to support the profitability path.

Revenue Guidance, Order Backlog & Lung Diagnostic Dependence

In Q2, Q3, and Q4 discussions, revenue guidance was upbeat (with Q4 forecasting $92–95M and Q2/Q3 providing detailed backlog numbers and high lung diagnostic volume contributing roughly 90%+ of revenue). " " " " " " " " "

Q1 2025 revised the revenue guidance to $80–85M due to execution delays but continued to highlight strong order backlog growth (e.g., $10.9M backlog) and a heavy reliance on lung diagnostics (approximately 90% of revenue). " "

Slightly adjusted outlook in Q1 2025 with more conservative revenue guidance reflecting short‐term delays, yet the overall emphasis on volume and lung diagnostic dependence remains strong. The robust backlog growth indicates continued market momentum despite cautious near-term expectations.

Cash Burn, Liquidity & Operating Expense Concerns

Q2, Q3, and Q4 consistently discussed liquidity improvements from recent public offerings and controlled operating expenses, while noting some cash burn challenges and the utilization of noncash expenses and ATM facilities to maintain operational flexibility. " " " " "

Q1 2025 reported a lower cash balance compared to Q4 but offset by a new $10M loan, detailed ongoing operating expenses (with modest SG&A increases and higher R&D investment), and an improved adjusted EBITDA loss, reinforcing a disciplined spending approach as they move toward breakeven. " "

Ongoing focus on liquidity and cost control. Despite seasonal pressures (with Q1 showing lower cash reserves), the infusion of additional loan funding and maintained control on expenses illustrate a continuity of the disciplined, profitability-first approach, even as the company navigates short-term operational challenges.

Reimbursement Coverage & Payer Contracts

In Q2, Q3, and Q4, Biodesix detailed expansion of payer coverage with new contracts from multiple private payers and improved ASPs; these efforts were linked to clinical data presentations and an overarching strategy to support lung diagnostic test adoption. " " " " "

Q1 2025 provided no discussion of new reimbursement or payer contract developments, omitting details on policy wins that were a focus in previous periods.

Not mentioned in Q1 2025. This represents a shift in the discussion, with prior periods actively discussing reimbursement wins while the current period does not address new contracts—possibly indicating a temporary deprioritization or completion of a prior cycle in payer negotiations.

Impact of External Disruptions

Q3 2024 highlighted the impact of hurricanes (especially in the Southeast) on test volumes and operational disruptions, with detailed regional examples and recovery expectations. " " " Q2 and Q4 did not mention such disruptions.

Q1 2025 noted that external operational disruptions (including seasonality, weather events, and other factors like fire events and respiratory illness season) contributed to a sequential decline in test volumes compared to Q4 2024. " "

Inconsistent attention. While Q3 2024 detailed hurricanes specifically, Q1 2025 broadened the scope to include multiple external factors affecting volumes. The disruptions continue to be mentioned as a challenge, though the focus has shifted from localized hurricanes to a wider range of operational factors.

Declining Focus on Nodify Test Adoption

Previous earnings calls (Q2, Q3, Q4) did not indicate a decline in focus on Nodify adoption – rather, they highlighted robust test volume growth, increasing market penetration, and expanding clinical studies to support adoption. " " " " "

In Q1 2025, management explicitly reaffirmed that Nodify remains the top priority despite past concerns; they clarified that no new commercial focus will be shifted to other products to avoid distracting from Nodify’s growth and reimbursement strategy. "

Reaffirmation of focus. While earlier periods did not mention any decline, Q1 2025 directly addresses any potential concerns by clearly stating that Nodify remains central to their strategy. This proactive clarification underscores its importance for achieving profitability while ensuring that attention is not diverted to other emerging products.