Biodesix Q2 Earnings Call Highlights

Key Points

• Revenue increased 34% year over year to $26.9 million, driven by a 42% rise in diagnostic testing revenue and a 38% increase in tests processed. Primary-care testing volume surged 133%, while pulmonology volume grew 31%.
• Profitability metrics improved as gross margin reached 82%, net loss narrowed 37% to $7.3 million and adjusted EBITDA loss improved 56% to $3.2 million. Biodesix plans to expand its sales force to about 120 representatives by year-end while keeping expense growth measured.
• The company ended the quarter with $30 million in unrestricted cash and reiterated its 2026 revenue outlook of $108 million to $114 million, supported by continued volume growth, payer coverage gains and operating leverage.

Biodesix NASDAQ: BDSX reported second-quarter 2026 revenue growth of 34% year over year, supported by increased diagnostic test volumes, higher average revenue per test and continued expansion of its commercial organization.

Total revenue was $26.9 million for the quarter, while diagnostic testing revenue rose 42% to $25.4 million. Development services revenue declined to $1.5 million from $2.1 million a year earlier, which Chief Financial Officer Robin Harper Cowie attributed to the timing of project completion and revenue recognition.

Chief Executive Officer Scott Hutton said the company’s results reflected “strong growth, expanding margins, and improving operating leverage” as Biodesix works toward profitability.

Diagnostic Testing Drives Growth

Biodesix processed approximately 20,900 tests during the second quarter, an increase of 38% from the prior-year period. The company said testing growth was supported by adoption among both primary-care providers and pulmonologists. Volumes from primary care grew 133% year over year, while pulmonology volumes increased 31%.

The company has increased its focus on primary care since the second quarter of 2025, aiming to address lung nodules managed by general practitioners. Hutton said roughly half of lung nodules are managed by general practitioners.

According to Hutton, demand for Nodify testing in smaller lung nodules accelerated after publication of a validation study in March. The study, which the company described as the largest lung-nodule biomarker validation study to date, found that Nodify CDT could detect cancer in nodules as small as 4 millimeters while maintaining a low false-positive rate.

Hutton said clinicians who begin using Nodify CDT for smaller nodules have subsequently expanded use of both Nodify CDT and Nodify XL2 for patients with larger nodules. He said the pattern has appeared across customer segments, including primary care and pulmonology.

During the question-and-answer session, Cowie said primary care represented about 15% of total testing volume, consistent with the first quarter. Hutton said growth in the primary-care channel has been balanced between adding new ordering physicians and rising utilization among providers who began ordering several months earlier.

Clinical Evidence and Commercial Expansion

Biodesix also highlighted data presented in May at the American Thoracic Society annual meeting. Hutton said presentations included real-world clinical and economic data, including an independent study that found an increase in stage-one lung cancer detection after implementation of a lung-nodule program that used Nodify Lung testing to guide clinical decisions.

Two additional presentations addressed the use of Nodify Lung testing in overcoming limitations associated with PET scans for nodule evaluation, according to Hutton.

The company had an average of 104 sales representatives in the field during the quarter and plans to finish 2026 with about 120 representatives. Hutton said the company expects to maintain a hiring cadence of roughly six to eight sales professionals per quarter, prioritizing a measured approach to commercial expansion while maintaining a focus on profitability.

Most of the company’s new sales hires so far this year have been focused on primary care, though Hutton said Biodesix will continue to hire opportunistically based on market development and referral-network activity from pulmonologists.

Management also said it expects additional clinical publications and presentations during the year. Hutton pointed to the American College of Chest Physicians’ CHEST meeting, scheduled for late October and early November, as a potential venue for further posters, presentations and publications. The company also plans to provide a development partner and research-and-development update around the November AMP meeting.

Margins Improve as Loss Narrows

Gross margin reached 82% in the second quarter, improving 200 basis points from a year earlier and marking Biodesix’s fifth consecutive quarter with gross margins at or above 80%. Cowie said the improvement reflected growth in lung diagnostic testing, higher average revenue per test compared with the prior year and lower average cost per test.

The company said improvement in average revenue per test was primarily driven by additional payer coverage and revenue-cycle-management progress, continuing a trend that began in the third quarter of 2025. Cowie said the quarter-over-quarter difference in average revenue per test reflected the mix of Nodify CDT and Nodify XL2 volumes, while average revenue for each individual test improved from the first quarter.

Operating expenses excluding direct costs and expenses increased 7% year over year to $27.4 million, compared with the 34% increase in total revenue. The increase was driven by an 8% rise in sales, marketing and general administrative expenses related to commercial expansion, partly offset by a 4% reduction in research and development costs.

Net loss narrowed 37% from the prior-year period to $7.3 million. Adjusted EBITDA loss improved 56% year over year to $3.2 million.

Cowie said Biodesix expects operating expenses to remain relatively steady through the rest of the year, with moderate increases tied to planned sales-team growth. She said the company is working with partners to advance pipeline products without what she described as “massive investments.”

Liquidity and Outlook

Biodesix ended the quarter with $30 million in unrestricted cash and cash equivalents, up 17% from the first quarter. The balance included $6.5 million in net proceeds raised through the company’s at-the-market program during the quarter.

Excluding those ATM proceeds, net cash used during the quarter was $2.1 million, compared with $6.9 million in the second quarter of 2025. Cowie said management believes its existing cash, expected revenue growth and operating leverage provide sufficient liquidity to execute its growth strategy.

The company reiterated its previously raised full-year 2026 revenue outlook of $108 million to $114 million. Management said the outlook assumes continued sales-force productivity gains, stable average revenue per test from payers, volume growth in pulmonology and primary care, and ongoing evidence generation. The company also noted that development-services revenue can be seasonal and variable because of project timing and revenue recognition.

About Biodesix (NASDAQ:BDSX)

Biodesix, Inc is a commercial-stage molecular diagnostics company headquartered in Boulder, Colorado, that develops and delivers blood-based tests to improve the diagnosis and management of lung diseases, including lung cancer. The company integrates advanced proteomic and, more recently, genomic technologies to offer noninvasive testing solutions designed to guide clinical decision-making. Biodesix operates a CLIA-certified and CAP-accredited laboratory, allowing it to process patient samples at scale and maintain rigorous quality standards.

The company's flagship product, VeriStrat®, is a proteomic test that stratifies patients with non-small cell lung cancer into groups more likely to benefit from specific therapies.

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