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BIODESIX INC (BDSX)·Q2 2025 Earnings Summary

Executive Summary

  • Q2 2025 delivered a revenue beat and strong gross margin expansion: revenue of $20.0M (+12% YoY) vs S&P Global consensus $18.47M, with gross margin at 80% (+150 bps YoY). Adjusted EBITDA loss widened to $(7.2)M; management reiterated Adjusted EBITDA positivity in Q4 2025 . Revenue Consensus Mean: $18.47M*; Adjusted EBITDA Consensus Mean: $(4.75)M*.
  • Segment mix: Lung Diagnostic Testing $17.9M (+8% YoY) on ~15,100 tests; Development Services $2.1M (+53% YoY) with dollars under contract at an all-time high of $12.5M (+54% YoY), supporting H2 cadence .
  • Guidance maintained: FY2025 total revenue $80–$85M; gross margin expected to remain in the upper 70s for the rest of the year; sales force ramp targets 83–87 reps in Q3 and 93–97 in Q4, underpinning volume-driven growth .
  • Strategic catalysts: expanding primary care penetration (PCP orders ≈9% in June vs ~4% pre-pilot), improved digital ordering (+63% YoY), ALTITUDE enrollment completion, and Thermo Fisher companion diagnostic collaboration recognition post FDA approval .
  • Stock reaction drivers: revenue beat and durable margin narrative vs a larger-than-expected EBITDA shortfall; confirmation of Q4 EBITDA positivity and H2 Development Services uptick likely key to estimate revisions and sentiment . Q2 2025 EPS actual $(0.08) vs Primary EPS Consensus Mean $(1.37)*.

What Went Well and What Went Wrong

What Went Well

  • Primary care channel expansion accelerated adoption: PCP ordering increased >100% vs pre-2024 pilot; PCP share reached ~9% in June, improving conversion via on-site blood draws and digital ordering (+63% YoY). Quote: “Completing the blood collection on-site… results in 30% more tests delivered… Customer retention… who utilize digital ordering is 40% higher” .
  • Development Services momentum: revenue +53% YoY to $2.1M; dollars under contract reached $12.5M (+54% YoY), with typical Q4 uptick expected; recognition as Thermo Fisher validation collaborator following FDA CDx approval strengthens external credibility .
  • Margin quality: gross margin at 80% (+150 bps YoY) despite supply cost increases, driven by workflow optimization and mix; management expects margins to remain in the upper 70s through year-end .

What Went Wrong

  • Profitability: Adjusted EBITDA loss widened to $(7.2)M (+29% YoY) and Net loss increased to $(11.5)M (+6% YoY), reflecting higher SG&A with sales force ramp; EBITDA missed S&P Global consensus (est. $(4.75)M*) .
  • Operating expense intensity: OpEx (ex-direct) rose to $25.7M (+15% YoY), primarily sales and marketing investment to support territory build-out; near-term deleverage until rep productivity matures .
  • External headwinds: management cited supply cost increases and macro uncertainty; broader payer/quality framework tailwinds delayed as HEDIS lung measures were put on hold for 2025, tempering potential near-term volume uplift .

Financial Results

Consolidated and Segment Performance

MetricQ4 2024Q1 2025Q2 2025
Total Revenue ($USD Millions)$20.429 $17.958 $20.018
Lung/Diagnostic Tests Revenue ($USD Millions)$17.205 $16.316 $17.898
Development Services Revenue ($USD Millions)$3.224 $1.642 $2.120
Gross Profit ($USD Millions)$16.1; 79% $14.3; 79.4% $16.0; 80%
Operating Expenses excl. Direct ($USD Millions)$22.7 $23.4 $25.7
Net Loss ($USD Millions)$(8.251) $(11.101) $(11.468)
Diluted EPS ($)$(0.06) $(0.08) $(0.08)
Adjusted EBITDA ($USD Millions)$(3.935) $(6.196) $(7.213)
Cash & Equivalents ($USD Millions)$26.245 $17.603 $20.728

Estimates vs Actuals (Q2 2025)

MetricConsensusActualSurprise
Revenue ($USD Millions)18.467*20.018 +$1.551M; +8.4% – bold beat
Primary EPS ($)(1.367)*(0.08) +$1.287 – bold beat
EBITDA ($USD Millions)(4.750)*(8.257)*−$3.507M – miss vs EBITDA consensus

Values marked with * were retrieved from S&P Global.

Segment Breakdown and KPIs

MetricQ2 2024Q1 2025Q2 2025
Diagnostic Tests Revenue ($USD Millions)$16.539 $16.316 $17.898
Development Services Revenue ($USD Millions)$1.386 $1.642 $2.120
Tests Delivered (Lung Diagnostics)——~15,100
Avg Sales Reps in Field——74
Dollars Under Contract (Services) ($USD Millions)——$12.5
Digital Ordering YoY——+63%
PCP Ordering Share~4% pre-pilot—~9% in June

Note: Tests delivered and PCP share are operational KPIs disclosed on the call.

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total Revenue ($USD Millions)FY2025$92–$95M (Mar 3, 2025) $80–$85M (May 13, 2025) → maintained (Aug 7, 2025) Lowered (Mar→May); Maintained (May→Aug)
Gross Margin %FY2025 (H2 narrative)Not specifiedUpper 70s expected rest of year New disclosure
Adjusted EBITDAQ4 2025Positive in Q4 expected (May 13) Reiterated positive in Q4 Maintained
Sales Force SizeQ3/Q4 2025Ramp program in progressQ3: 83–87; Q4: 93–97 reps Increased ramp targets clarified

Earnings Call Themes & Trends

TopicPrevious Mentions (Q4 2024)Previous Mentions (Q1 2025)Current Period (Q2 2025)Trend
AI/Technology & Multi-omicsNot highlightedMulti-modal genomics/proteomics/radiomics + AI strategy Re-emphasized multimodal + AI approach in diagnostics Consistent strategic pillar
Digital Ordering/EMRNot highlightedEarly EMR integrationsDigital ordering +63% YoY; retention +40% with digital; improves completeness Strengthening adoption
Supply Cost/MacroNot discussedNot discussedSupply cost increases, macro uncertainty acknowledged; GM resilience Manageable headwinds
Tariffs/Macro Risk DisclosureBroad risk language—Forward-looking statements note enhanced U.S. tariffs risk Ongoing risk awareness
Product Performance (Nodify/VeriStrat)Strong growth16th straight quarter >15% growth in Lung Diagnostics 15,100 tests; PCP share ~9% in June; >100% PCP order increase Expanding into PCP
R&D Execution (ALTITUDE/CLARIFY)CLARIFY announced (Q3 2024) CLARIFY accruing; ALTITUDE ongoingALTITUDE enrollment completed; CLARIFY >1,100 patients; interim data H2 Milestones achieved
Regulatory/Partnerships——Thermo Fisher CDx FDA approval; Biodesix recognized as key collaborator Positive validation
Regional TrendsHurricane Helene disrupted late Q3’24 —Not notedNormalized volumes
Development ServicesQ4 ’24 strongQ1 ’25 +61% YoY Q2 ’25 +53% YoY; $12.5M under contract; Q4 uptick expected Building pipeline

Management Commentary

  • CEO strategic message: “We leverage a multimodal approach that includes genomics, proteomics, and radiomics combined with AI… In Q2, we grew revenue by 12% YoY, improving our gross margins by 150 bps to 80%” .
  • Channel strategy: “Ordering the test in the primary care setting and collecting the sample on-site helps… 30% more tests delivered… Customer retention… who utilize digital ordering is 40% higher… digital ordering increased by 63% over last year” .
  • Services business: “In early July, Thermo Fisher announced their new NGS assay received FDA approval… recognized Biodesix as a key collaborator… We exited the quarter with $12.5M under contract, an all-time high” .
  • CFO profitability trajectory: “We are maintaining our guidance of $80–$85M… expect to achieve adjusted EBITDA positivity in the fourth quarter… gross margins to remain in the upper 70s” .

Q&A Highlights

  • Bridge to Q4 EBITDA positive: Primarily revenue leverage from sales rep ramp to ~95 reps by Q4; no major cost-cutting planned beyond ongoing efficiency initiatives .
  • Revenue drivers: Volume-driven growth with stable ASPs; Development Services typically strongest in Q4 due to biopharma budget cadence .
  • PCP vs pulmonology: PCP orders >100% vs pre-pilot; pulmonology growth may shift to referral networks, broadening funnel upstream while maintaining overall organizational growth .
  • HEDIS measures: HEDIS placed on hold for 2025; disappointment noted, but does not impact 2025–2026 forecast; tests applicable to both screening and incidentally found nodules .
  • Capital needs and rep productivity: Management targets EBITDA and cash flow positivity; pilot experience suggests PCP reps can sustain ~$1M annualized productivity with upside in select territories .

Estimates Context

  • Q2 2025 vs consensus: Revenue beat ($20.018M vs $18.467M*), EPS beat ($(0.08) vs $(1.367)) and EBITDA below consensus (actual $(8.257)M vs $(4.75)M*), reflecting near-term deleverage from sales ramp despite stronger gross margins . Values with * retrieved from S&P Global.
  • FY2025 consensus: Revenue Consensus Mean $84.517M* aligns with guidance $80–$85M; Target Price Consensus Mean $32.5*; Consensus Recommendation was unavailable*. Values with * retrieved from S&P Global.
  • Implications: Consensus may raise near-term revenue estimates modestly on run-rate strength and Services backlog, but EBITDA/adj. EBITDA paths hinge on H2 rep productivity realization and Q4 Services cadence. Values with * retrieved from S&P Global.

Key Takeaways for Investors

  • Revenue quality improved: mix benefits and workflow efficiency supported an 80% gross margin; volume-led growth should continue with sales force expansion .
  • Bold revenue/EPS beat vs S&P Global, but EBITDA miss underscores the cost of commercial expansion; watch Q3/Q4 operating leverage inflection . Consensus values retrieved from S&P Global*.
  • PCP channel penetration and digital ordering materially enhance test conversion and retention; these are structural drivers of volume and margin sustainability .
  • Development Services pipeline is robust ($12.5M under contract) with typical Q4 uptick; partnership validation (Thermo Fisher) adds external proof points .
  • Guidance credibility: maintained $80–$85M with explicit rep ramp milestones and margin expectation (upper 70s); Q4 adjusted EBITDA positivity remains the pivotal proof point .
  • Risk checks: macro/supply costs, tariff exposure disclosures, and delayed HEDIS measures temper near-term tailwinds; payer/regulatory progress remains a medium-term catalyst .
  • Trading setup: Momentum into H2 on Services and rep ramp; near-term stock reaction likely driven by confidence in the Q4 EBITDA positive milestone and sequential volume/margin trajectory.

Values marked with * were retrieved from S&P Global.