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GH

Guardant Health, Inc. (GH)·Q1 2025 Earnings Summary

Executive Summary

  • Q1 2025 delivered 21% revenue growth to $203.5M, with normalized EPS loss of $0.49; revenue and EPS both beat S&P Global consensus, aided by oncology volume strength, improved reimbursement, and ~$5M out-of-period upside in oncology revenue . Consensus Revenue $190.0M*, Consensus EPS -$0.590*; Actual Revenue $203.5M, EPS (normalized) -$0.49; Beat by ~$13.5M and $0.10*, respectively. Values retrieved from S&P Global.
  • Management raised full-year revenue guidance to $880–$890M (from $850–$860M), lifted oncology growth outlook to ~18%, and increased screening revenue/volume guidance given Shield’s ADLT pricing uplift .
  • Strategic and operational catalysts: Shield ADLT status (Medicare pricing to $1,495), Shield and Reveal both gross-margin positive, Guardant360 Tissue multiomic launch, and new Pfizer collaboration leveraging Infinity smart liquid biopsy platform .
  • Key margin drivers: Guardant360 ASP improved to $3,000–$3,100; Reveal and Shield COGS reductions drove gross margin expansion to 63% GAAP (65% non-GAAP) .

What Went Well and What Went Wrong

What Went Well

  • Oncology revenue up 20% to $150.6M with ~59,000 tests (+25% YoY), supported by Guardant360 ASP improvement ($3,000–$3,100) and reimbursement gains; “we are also very pleased to achieve positive gross margins for both Reveal and Shield” .
  • Shield momentum: ~$5.7M revenue on ~9,000 tests; ADLT designation increased Medicare price to $1,495 effective April 1, enabling higher ASP and reinvestment in commercial buildout .
  • Product innovation: launch of Guardant360 Tissue (multiomic DNA/RNA/AI PD‑L1/methylation, 40% fewer slides) and Pfizer collaboration to use Infinity platform for therapy development and ctDNA monitoring .
    Quote: “Guardant360 Tissue… first-of-its-kind multiomic CGP product… complements our industry-leading Guardant360 liquid products” – Helmy Eltoukhy .

What Went Wrong

  • GAAP net loss remained elevated at $(95.2)M; free cash flow burn was $(67.1)M in Q1 (timing of annual bonus payout), and non-GAAP operating expenses increased to $199.6M on Shield commercial investments .
  • Licensing & Other revenue fell to $1.9M from $5.2M YoY, partially offsetting segment growth .
  • Screening scale remains back-half weighted; Shield volume ramp depends on salesforce productivity and broader guideline inclusion; management raised OpEx guidance to $830–$840M to accelerate commercial buildout .

Financial Results

MetricQ3 2024Q4 2024Q1 2025
Revenue ($USD Millions)$191.5 $201.8 $203.5
GAAP Net Loss per Share ($)$(0.88) $(0.90) $(0.77)
Non-GAAP Net Loss per Share ($)$(0.45) $(0.62) $(0.49)
Gross Margin % (GAAP)61% 62% 63%
Gross Margin % (Non-GAAP)63% 63% 65%
Segment Revenue ($USD Millions)Q1 2024Q1 2025
Oncology$125.7 $150.6
Biopharma & Data$37.6 $45.4
Screening$0.0 $5.7
Licensing & Other$5.2 $1.9
Total Revenue$168.5 $203.5
KPIsQ3 2024Q4 2024Q1 2025
Oncology Clinical Tests (units)53,100 57,300 ~59,000
Biopharma Tests (units)10,500 11,050 n/a
Shield Tests (units)n/a~6,400 ~9,000
Guardant360 ASP ($)>$3,000 ~$3,000 $3,000–$3,100
Reveal ASP ($)n/a~$400–$500 >$600
Shield ASP ($)n/a~$600 ~$600 in Q1; ~$800 expected Q2–Q4
Reveal Cost per Test ($)n/an/a< $500
Shield Cost per Test ($)n/a~$600 ~ $500
Estimates vs. Actual (Q1 2025)Consensus*ActualNotes
Revenue ($USD Millions)190.0*203.5 Beat by ~$13.5M (+7.1%)*
EPS (Normalized, $)-0.590*-0.49 Beat by ~$0.10*

*Values retrieved from S&P Global.

Guidance Changes

MetricPeriodPrevious GuidanceCurrent GuidanceChange
Total RevenueFY 2025$850–$860M $880–$890M Raised
Oncology Revenue GrowthFY 2025~15% ~18% Raised
Screening RevenueFY 2025$25–$30M; 45k–50k tests $40–$45M; 52k–58k tests Raised
Biopharma & Data GrowthFY 2025Low double-digit Low double-digit Maintained
Non-GAAP Gross MarginFY 202562–63% 62–63% Maintained
Non-GAAP OpExFY 2025$815–$825M $830–$840M Raised (reinvest screening GM)
Free Cash Flow BurnFY 2025$(225)–$(235)M $(225)–$(235)M Maintained
Ex-screening FCF breakevenQ4 2025Breakeven in Q4 2025 Breakeven in Q4 2025 Maintained

Earnings Call Themes & Trends

TopicQ3 2024 (Prev)Q4 2024 (Prev)Q1 2025 (Current)Trend
Smart Liquid Biopsy & Infinity appsLaunched G360 LDT; ASP reached $3,000; apps pipeline for therapy selection Reinforced platform traction; feature roadmap; clinical volume acceleration expected Highlighted Infinity apps: tumor burden, subtyping, HRD, IO prediction; synergistic liquid+tissue upgrades Strengthening
Shield commercializationMedicare price $920; early launch momentum; adherence >90% First full quarter: ~$4.1M revenue; gross margin breakeven; focused Medicare beneficiaries ~$5.7M revenue; ADLT to $1,495; volume ramp, VA coverage, ACP guideline mentions Scaling with pricing tailwind
MRD RevealManaging volumes ahead of reimbursement; COGS reduction underway Medicare coverage in CRC surveillance; ASP tailwind; further COGS cuts Gross margin positive; ASP >$600; pipeline in breast/IO monitoring; 7-day TAT emphasis Inflecting
Tariffs/macroNot highlightedBalance sheet optimized via convert exchange; breakeven path reiterated Minimal tariff impact expected; inputs not sourced directly from China Neutral/minimal risk
Tissue CGPMedicare Tissue price to $3,500 from Jan 1 Tissue upgrade traction expected Launch of Guardant360 Tissue multiomic, 40% fewer slides required Positive upgrade
Regulatory/guidelinesCMS colonoscopy cost-sharing removed after blood test Monitoring NCCN MRD updates; ADLT process underway Shield ADLT granted; ACS Clinical Practice Update notes blood test role; VA coverage below Medicare age Favorable momentum

Management Commentary

  • “We started the year with very strong momentum… and are very pleased to achieve positive gross margins for both Reveal and Shield in the first quarter due to significant reductions in testing costs.” – Helmy Eltoukhy .
  • “We meaningfully raised our full year screening revenue guidance given our increased expectations for both salesforce productivity and ASP now that Shield has received ADLT status.” – AmirAli Talasaz .
  • CFO: “Both Reveal and Shield became gross margin positive in the first quarter… Shield cost per test was approximately $500… we expect ASP to be around $800 (Q2–Q4) due to ADLT status.” – Michael Bell .
  • “Guardant360 Tissue… the first of its kind broad multiomic tissue CGP test… can provide results with 40% less tissue required than most of our key competitors.” – Helmy Eltoukhy .

Q&A Highlights

  • Oncology acceleration drivers: EMR integrations, product upgrades, Tissue launch; G360 ASP sustained at $3,000–$3,100; out-of-period upside ~$5M in Q1 (vs $8M prior year) .
  • Shield ASP dynamics: Q1 ~ $600, move to ~$800 for Q2–Q4 with ADLT; payer mix (Medicare FFS, MA, early commercial) conservatively reflected .
  • Screening volume ramp: back-half loaded given rep productivity curve; ACS guideline inclusion and Abu Dhabi program are potential upside; guidance assumes only a fraction of Abu Dhabi .
  • Reveal adoption: surveillance coverage and reduced TAT (<7 days) expected to drive acceleration; ASP guided to ~ $600; ADLT application planned .

Estimates Context

  • Q1 2025: Revenue beat consensus by ~$13.5M (+7.1%); normalized EPS beat by ~$0.10 (consensus -$0.590 vs actual -$0.49). Values retrieved from S&P Global. Actuals from press release .
  • FY 2025: Street revenue consensus $968.4M*, above updated guidance $880–$890M; potential for estimate revisions depending on Shield ASP realization, oncology volume trajectory, and biopharma pipeline conversion. Values retrieved from S&P Global.

Key Takeaways for Investors

  • Top-line momentum sustained with improving mix: oncology ASP gains and Shield/Reveal gross margin positivity support margin trajectory; non-GAAP gross margin guided at 62–63% for FY 2025 .
  • Bold guidance raise anchored by Shield ADLT and stronger oncology volumes; watch for ACS guideline inclusion and MA/commercial payer adoption to further lift Shield ASP/volumes .
  • Near-term trading catalysts: data presentations (Shield multi-cancer), VA coverage below Medicare age, Tissue multiomic launch, Pfizer collaboration—each expands TAM and validates platform .
  • Cash discipline maintained: FCF burn held at $(225)–$(235)M; ex-screening business targeted for breakeven in Q4 2025; balance sheet fortified via convertible exchange in February .
  • Risk checks: Licensing & Other revenue softness; Shield ramp dependence on salesforce productivity/guidelines; OpEx raised to accelerate screening buildout—monitor quarterly unit economics and salesforce ROI .
  • Thesis evolution: Platform differentiation (multiomics + methylation + AI) across liquid and tissue is driving share gains and ASP tailwinds, while MRD transitions to profitable growth—arguably improving medium-term operating leverage .