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BI

BIODESIX INC (BDSX)·Q4 2024 Earnings Summary

Executive Summary

  • Q4 2024 revenue was $20.4M (+39% YoY) with gross margin at 79%, net loss improved to $8.3M, and Adjusted EBITDA loss narrowed to $3.9M . Full-year 2024 revenue reached $71.3M (+45% YoY) with 78% gross margin .
  • FY2025 guidance: total revenue $92–$95M, management targets Adjusted EBITDA profitability in H2 2025 and expects gross margins to remain in the mid-to-upper 70s .
  • Operating momentum driven by 34% YoY growth in Lung Diagnostic Testing revenue (Q4 $17.2M) on higher test volumes (approx. 14,600 in Q4; 54,300 for FY) and strong reimbursement; Diagnostic Development Services (Biopharma Services) accelerated to $3.2M (+72% YoY) with $12.2M under contract entering 2025 .
  • Street consensus via S&P Global for Q4 2024 revenue/EPS was unavailable at the time of analysis; comparison to estimates is not provided. Values would have been retrieved from S&P Global.

What Went Well and What Went Wrong

What Went Well

  • Strong top-line growth and margin resilience: Q4 revenue $20.4M (+39% YoY) and gross margin 79%; FY revenue $71.3M (+45% YoY) and gross margin 78% .
  • Lung Diagnostics adoption and volumes: Q4 Lung Diagnostics revenue $17.2M (+34% YoY) on ~14,600 tests; FY Lung Diagnostics $64.7M (+43% YoY) on ~54,300 tests, reflecting expanded coverage and commercial execution .
  • Positive momentum in Biopharma Services and contracted backlog: Q4 Diagnostic Development Services revenue $3.2M (+72% YoY), with $12.2M under contract heading into 2025, supporting future revenue visibility .
  • Management tone: “We exceeded our revenue targets… improving our Gross Margins to 78%… We are well‑positioned for continued growth and expect 2025 will be a transformative year” — CEO Scott Hutton .

What Went Wrong

  • Sequential cash draw: Cash and cash equivalents decreased to $26.2M at year-end from $31.4M in Q3 and $42.2M in Q2, reflecting spend cadence and year-end impacts; Perceptive Advisors Tranche C availability was extended post-quarter to increase flexibility .
  • Operating expense growth: Q4 OpEx (excl. direct costs) rose 25% YoY to $22.7M, driven by sales and marketing investments and higher depreciation tied to new facilities; FY OpEx $90.2M (+17% YoY) .
  • Q3 disruption: Test volumes at the end of Q3 were impacted by Hurricane Helene, highlighting exposure to episodic macro disruptions .

Financial Results

MetricQ2 2024Q3 2024Q4 2024
Total Revenues ($USD Millions)$17.9 $18.2 $20.4
Gross Margin (%)78.4% 77.0% 79.0%
Net Loss ($USD Millions)$10.8 $10.3 $8.3
GAAP Diluted EPS ($USD)$(0.08) $(0.07) $(0.06)
Adjusted EBITDA ($USD Millions)$(5.6) $(5.6) $(3.9)
Cash and Cash Equivalents ($USD Millions)$42.2 $31.4 $26.2

Segment breakdown:

Segment Revenue ($USD Millions)Q2 2024Q3 2024Q4 2024
Lung Diagnostic Testing$16.5 $17.2 $17.2
Diagnostic Development/Biopharma Services$1.4 $1.0 $3.2

KPIs:

KPIQ2 2024Q3 2024Q4 2024
Lung Diagnostic Test Volumes (Tests)13,900 13,900 ~14,600
Gross Profit ($USD Millions)$14.0 $14.0 $16.1
Operating Expenses excl. Direct Costs ($USD Millions)$22.3 $22.6 $22.7

Key drivers:

  • Gross margin uplift tied to workflow optimization and scale in Lung Diagnostics; Q4 gross margin 78.7% (call) vs. 77.0% in Q3 .
  • Revenue mix: Biopharma Services strengthened in Q4 post timing-related softness in Q3 .

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total Revenue ($USD Millions)FY 2025N/A$92–$95 Initiated
Gross Margin (%)FY 2025N/AMid–upper 70s Initiated
Adjusted EBITDAFY 2025H2 2025 profitability (reiterated from prior) H2 2025 profitability Maintained
Sales Force Size (Teammates; Territories)FY 202571 teammates; 48 territories at Q4’24 baseline Add ~6 per quarter; ~95 teammates; 50 territories by YE 2025 Raised

Clarifications:

  • Revenue growth expected primarily from volume; models assume conservative ASP with slight uptick from coverage expansion .
  • Cash flow: expect elevated Q1 burn with sequential improvement, aiming for cash flow breakeven shortly after Adjusted EBITDA breakeven; Tranche C availability extended, ATM in place (unused) .

Earnings Call Themes & Trends

TopicPrevious Mentions (Q2 2024, Q3 2024)Current Period (Q4 2024)Trend
Primary Care Referral StrategyNot highlighted in Q2; Q3 focused on CLARIFY launch and CHEST data Pilot showed success accessing primary care; plan to add ~6 sales teammates per quarter, ending ~95 to support PCP-referral model Increasing focus, scaled execution
Gross MarginQ2 78.4% ; Q3 77.0% Q4 78.7–79%, maintain mid-to-upper 70s in FY25 Stable high-70s, slight improvement
Clinical Studies (CLARIFY, ALTITUDE)Q2 ATS data; Q3 announced CLARIFY CLARIFY enrollment >600 to-date; ALTITUDE under DSMB with potential 2025 data release Building evidence cadence
Reimbursement/CoverageStrong reimbursement supporting growth Continued expansion of coverage noted in FY narrative Improving coverage supports ASP/volume
Biopharma ServicesQ2 +228% YoY revenue; Q3 timing-related dip Q4 $3.2M (+72% YoY); $12.2M backlog entering 2025 Strengthening backlog and delivery
Macro/Supply DisruptionsQ3 impact from Hurricane Helene No Q4 specific macro disruptions citedNormalized
AI/Multi-omicsNot explicit in Q2/Q3 press; multi-omics emphasized AI and machine learning core to discovery/development and services; intent to lead across proteomic/genomic/radiomic Elevated strategic emphasis
Guidelines/Policy (CHEST/HEDIS)CHEST meeting data in Q3 CHEST guideline update prioritized for 2025; HEDIS lung screening measures watched; potential to expand addressable market Potential 2025 catalysts

Management Commentary

  • CEO framing: “We exceeded our revenue targets… strengthened clinical and commercial capabilities… expect 2025 will be a transformative year” .
  • Strategy and sales expansion: “Pilot was a success… adding ~6 sales teammates per quarter… ~95 teammates supporting 50 territories” .
  • Evidence generation: “CLARIFY accrued >600; ALTITUDE DSMB meets in Q2; potential to release data before year-end if endpoints met” .
  • Financial trajectory: “Achieve adjusted EBITDA profitability in the second half of the year… maintain gross margins mid–upper 70s” .
  • CFO detail: “Q4 revenue $20.4M (+39% YoY)… Lung Diagnostic testing ~14,600 tests… backlog $12.2M… we believe we can fund the business to profitability with available cash” .

Q&A Highlights

  • Guidance mix and drivers: Biopharma Services ~8–9% of FY25 revenue; majority of growth from volume with conservative ASP assumptions; EBITDA path via revenue growth and tight expense control .
  • Primary care pilot specifics: PCPs are accessible and efficient call points with in-office phlebotomy; pilot reduced friction and improved referral alignment to pulmonologists .
  • Pipeline/MRD: Prioritized minimal residual disease with MSK; potential unique pairing of pre-resection risk-of-recurrence and post-resection MRD surveillance using multi-omic approaches .
  • CHEST guidelines/impact: First prospective controlled trial (ALTITUDE) in lung nodule management; CHEST leadership indicated 2025 updates, potentially aiding payer/physician adoption .
  • Gross margin upside: Target to maintain upper-70s; incremental improvements possible via operational optimization and volume .
  • Cash burn cadence: Higher in Q1 due to bonuses/payroll resets; decreasing across 2025 with path to cash flow breakeven after EBITDA breakeven; Tranche C and ATM provide optionality .

Estimates Context

  • S&P Global consensus estimates for Q4 2024 revenue and EPS were unavailable at the time of analysis due to data access limitations; therefore, we cannot present a comparison to Street estimates. Values would have been retrieved from S&P Global.

Key Takeaways for Investors

  • Revenue trajectory accelerating: Q2→Q3→Q4 sequential revenue growth ($17.9M → $18.2M → $20.4M) with YOY momentum and margin resilience; sets up for FY2025 $92–$95M guidance .
  • Path to profitability: Management reiterates Adjusted EBITDA profitability in H2 2025; cash flexibility enhanced via term loan amendment and ATM (unused) .
  • Commercial leverage: PCP-referral model validated; planned sales force expansion likely to unlock additional addressable volumes in mature territories .
  • Evidence catalysts: CLARIFY and ALTITUDE data readouts (potentially in 2025) and possible CHEST guideline updates are key stock catalysts that could accelerate adoption and payer support .
  • Mix improvement: Q4 Biopharma Services rebound and $12.2M contracted backlog support multi-line revenue durability; watch quarterly timing effects .
  • Risk checks: Cash decline quarter-to-quarter, rising OpEx for sales/marketing and depreciation; monitor liquidity pacing and cost discipline as hiring accelerates .
  • Trading setup: Near-term narrative sensitive to clinical/guideline milestones and confirmation of EBITDA breakeven timing; sustained high-70s gross margin and sequential revenue growth are supportive for multiple expansion if execution continues .

Management/press release and SEC references:

  • Q4/FY 2024 press release and 8-K: financials, guidance, margins, cash .
  • Q4 2024 earnings call transcript: commercial strategy, KPIs, margins, guidance details .
  • Prior quarters (Q3/Q2) press releases: trend analysis and context .