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BIODESIX INC (BDSX)·Q1 2025 Earnings Summary

Executive Summary

  • Q1 2025 revenue was $18.0M (+21% YoY) with gross margin of 79.4%; Diagnostic Testing rose 18% to $16.3M and Development Services rose 61% to $1.7M .
  • Revenue missed S&P Global Street consensus of $19.5M*; Adjusted EBITDA loss was $6.2M vs Street estimate of ~$4.5M*, and GAAP net loss improved 18% YoY to $11.1M .
  • FY2025 revenue guidance was cut to $80–$85M (from $92–$95M in March), while management reiterated expectation to reach Adjusted EBITDA positivity in Q4 2025 .
  • Commercial reconfiguration to a territory-based model and delayed primary care sales hiring were key drivers; pro forma cash increased to $27.6M after drawing $10M Tranche C and warrants were repriced to $0.4191 .
  • Likely stock reaction catalysts: guidance reduction, sequential revenue down vs Q4, and execution on PCP expansion needed to restore growth; balancing positives in margin strength and capital runway .

What Went Well and What Went Wrong

What Went Well

  • Revenue +21% YoY with strong mix: Diagnostic Testing +18% and Development Services +61%; gross margin expanded to 79.4% (from 78.6% YoY) on workflow optimization and services expansion .
  • Management reaffirmed path to Adjusted EBITDA positivity in Q4 2025; CFO expects gross margins to remain in the upper 70s for the rest of the year .
  • Strategic progress in commercial and product pipeline: CEO highlighted “continued progress toward our three key goals… growing top line revenue, improving operational efficiencies… and advancing our pipeline” and noted 16th straight quarter of >15% Lung Diagnostics growth .

What Went Wrong

  • FY2025 revenue guidance reduced to $80–$85M due to being “approximately one quarter behind” in the commercial plan from PCP sales hiring delays; sequential revenue declined from $20.4M in Q4 2024 to $18.0M in Q1 2025 .
  • Adjusted EBITDA loss of $6.2M (vs Street est. ~$4.5M*) and fewer reps in the field (65 vs 71 in Q4), with hiring ramp shifted later in the year .
  • Operating expenses rose 3% YoY (excl. direct costs), driven by +$0.9M R&D; stock comp declined YoY but remains a non-GAAP add-back .

Financial Results

Core P&L vs Prior Year and Prior Quarter

MetricQ1 2024Q4 2024Q1 2025
Revenue ($USD Millions)$14.818 $20.429 $17.958
Gross Profit ($USD Millions)$11.632 (78.6% GM) $16.100 (79% GM) $14.300 (79.4% GM)
Operating Expenses ($USD Millions, total incl. direct)$25.839 $27.078 $27.094
Net Loss ($USD Millions)$(13.614) $(8.251) $(11.101)
Diluted EPS ($USD)$(0.14) $(0.06) $(0.08)
Adjusted EBITDA ($USD Millions)$(6.961) $(3.935) $(6.196)

Actual vs Street Consensus (Q1 2025)

MetricActualConsensusSurprise
Revenue ($USD Millions)$17.958 $19.500*Miss: $(1.542)
Primary EPS ($USD)$(0.08) $(1.40)*Beat (vs more negative estimate)
EBITDA ($USD Millions)$(6.196) $(4.467)*Miss: $(1.729)

Values marked with * retrieved from S&P Global.

Segment Breakdown

Segment Revenue ($USD Millions)Q1 2024Q4 2024Q1 2025
Diagnostic Tests$13.796 $17.205 $16.316
Development Services$1.022 $3.224 $1.642
Total Revenue$14.818 $20.429 $17.958

KPIs

KPIQ1 2024Q4 2024Q1 2025
Lung Diagnostic Test Volumes (approx.)~11,900 ~14,600 ~13,800
Gross Margin %78.6% ~78.7% 79.4%
Sales Reps in Field (avg.)—71 65
Dev. Services Under Contract (not yet recognized) ($USD Millions)—$12.2 $10.9
Cash & Equivalents ($USD Millions)—$26.2 $17.6; Pro forma $27.6 after $10M draw

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total RevenueFY2025$92–$95M (Mar-2025) $80–$85M (May-2025) Lowered
Gross Margin %FY2025Mid-to-upper 70s (Q4 call) Upper 70s expected (Q1 call) Maintained
Adjusted EBITDAFY2025Positivity in H2 2025 (Q4 call) Positivity in Q4 2025 (Q1 call) Refined timing
Sales Team SizeYE 2025~95 reps, +6 per quarter (Q4 call) ~95 reps; accelerate to +10 per quarter starting Q2 (Q1 call) Accelerated hiring cadence
LiquidityNear-term$26.2M cash at 12/31/24; Tranche C availability extended Pro forma cash $27.6M after $10M Tranche C draw; warrants repriced to $0.4191 Strengthened cash; warrant terms modified

Earnings Call Themes & Trends

TopicPrevious Mentions (Q3 2024, Q4 2024)Current Period (Q1 2025)Trend
Sales force strategy & productivityBuilding lung-focused team; ~$1M revenue/rep; 48→50 territories; +6–8 reps/qtr Reconfigured to territory “pod” model; 65 reps in Q1; plan 70–75 in Q2, ~85 in Q3, ~95 in Q4; PCP-focused hiring delayed ~1 quarter Execution delay but scaling up
Primary care expansionPilot success; opportunity via referral networks Target ~15,000 PCPs handling ~80% of nodules; logistics easier (on-site phlebotomy); similar ramp to pulmonology expectations Expanding upstream
Digital ordering & EMREarly EMR integrations; strong ASP trend Digital ordering +58% YoY; retention +40% higher with digital; selective EMR expansions in 2025 Adoption improving
AI/radiomicsMulti-omic approach; AI importance acknowledged Radiomics pilot complete; hired Head of Radiomics; integrating imaging + blood biomarkers Building capability
Macro/weather impactsHurricane Helene impacted Q3 volumes Q1 impacted by seasonality, abnormal weather/fire and respiratory illness Transitory headwinds
Gross margins & cost disciplineGM ~78%; cost control GM 79.4%; expect upper 70s through year; SG&A down 1% YoY despite more reps Resilient margins
Dev. Services pipeline$11.1–$12.2M under contract $10.9M under contract; ~10% of revenue expected mix Stable demand
Regulatory/guidelinesCHEST guideline updates anticipated in 2025 Reiterated expectation; ALTITUDE progress; CLARIFY interim data H2’25 Potential 2025 catalyst

Management Commentary

  • CEO: “Year-over-year, we grew revenue by 21%… Lung Diagnostics revenue grew 18%, which is the 16th straight quarter of greater than 15% growth… we are revising our revenue guidance to $80–85 million for the year… we are reiterating our expectation to achieve Adjusted EBITDA positivity in the fourth quarter” .
  • CFO: “Gross margin percentage in the first quarter 2025 was 79.4%… Operating expense… was $23.4 million… Net loss… improved 18% year-over-year… we drew down $10 million tranche C loan… revising revenue guidance to $80–$85 million… expect to achieve adjusted EBITDA positivity in the fourth quarter” .
  • Strategic shift: “We… reconfigure our sales team into a territory-based sales structure… we estimate that we are approximately one quarter behind in our commercial plan… reconfiguring is now complete, and we have restarted the commercial expansion” .
  • AI/radiomics: “We are pleased to welcome Dr. Michael Kammer as our Head of Radiomics… uniquely positioned to combine AI and radiomics with biological insights” .

Q&A Highlights

  • Sales hiring delays and confidence in revised guide: Management refined the PCP hiring profile and expects 70–75 reps in Q2, ~85 in Q3, ~95 in Q4; confident in revised revenue and EBITDA timeline .
  • Capital needs: With $10M tranche C draw, pro forma cash $27.6M; management believes funding is sufficient to reach breakeven while expanding commercial and advancing pipeline .
  • Dev. Services mix: Management expects Development Services to be roughly ~10% of total revenue; ~$10.9M under contract at Q1 end .
  • Product portfolio: VeriStrat data at ASCO shows treatment selection utility; NGS is crowded but strategic; Nodify remains primary focus to drive profitability .
  • Operational levers: Cost discipline and hiring cadence balance top-line ramp with goal of Q4 Adjusted EBITDA positivity .

Estimates Context

  • Revenue: Actual $17.958M vs Street $19.500M* → Miss of $(1.542)M .
  • Adjusted EBITDA: Actual $(6.196)M vs Street $(4.467)M* → Miss of $(1.729)M .
  • EPS: GAAP diluted EPS $(0.08) vs Street Primary EPS $(1.40)* (Street figure reflects S&P Global “Primary EPS” methodology; not directly comparable to GAAP diluted EPS reported) .
    Values retrieved from S&P Global.

Where estimates may need to adjust:

  • FY2025 revenue models should reflect the $80–$85M guide and one-quarter delay in PCP sales ramp .
  • Q2–Q4 revenue cadence should incorporate hiring schedule (70–75 reps in Q2; ~85 Q3; ~95 Q4) and stable gross margin in upper 70s .

Key Takeaways for Investors

  • Guidance reset is the key negative; focus on execution of PCP expansion and territory “pod” reconfiguration to re-accelerate Diagnostic Testing revenue in 2H 2025 .
  • Margin profile remains strong (~79% GM); cost discipline continues, supporting Q4 2025 Adjusted EBITDA positivity despite a delayed hiring ramp .
  • Liquidity fortified via $10M tranche C draw (pro forma cash $27.6M); warrants repriced to $0.4191—monitor dilution mechanics and covenant flexibility .
  • Pipeline and data momentum (VeriStrat ASCO data; CLARIFY interim data in H2 2025; ALTITUDE progress; radiomics hire) can bolster payer and clinical adoption narratives over 6–12 months .
  • Near-term trading setup: watch Q2 hiring throughput and sequential revenue stabilization; any incremental payer coverage, EMR integrations (+58% digital ordering; +40% retention) are upside levers .
  • Medium-term: CHEST guideline updates in 2025 could be a structural catalyst for Nodify adoption; Dev. Services revenue (~10%) provides diversification but remains secondary to lung diagnostics .

Appendix: Additional Relevant Press Releases (Q2/Q1 window)

  • ISPOR/ATS Nodify Lung health economics and real-world adoption data (May 15, 2025) .
  • ASCO VeriStrat chemo-immunotherapy survival stratification in NSCLC (May 22, 2025) .
  • Q1 2025 earnings release scheduling (April 29, 2025) .