BillionToOne, Inc. Q3 FY2025 earnings call

• Completed a successful IPO in November 2025, raising $314 million in gross proceeds. - Highlights 4 pillars of differentiation: revolutionary single molecule next-gen sequencing platform, QCT technology, unique prenatal (UNITY) and oncology (Northstar Select, Northstar Response) products. - Reported 51% test growth and 117% revenue growth in Q3 2025, with 70% gross margin and emerging GAAP profitability. - Notable publications and partnerships: prenatal study in Journal of Cystic Fibrosis, UNITY HDFN publication, exclusive J&J agreement, Northstar Select head-to-head study. - Invested in EMR with Epic for Aura implementation to facilitate faster UNITY adoption in health systems.

In the third quarter of 2025, BillionToOne's prenatal revenue was $74.8 million, representing over 100% year-over-year growth. Oncology revenues were $8.7 million, a 7.6x increase year-over-year. Prenatal contributed approximately 89.6% of total revenue ($74.8M / $83.5M), while oncology contributed about 10.4% ($8.7M / $83.5M).

• Expect 2025 total revenue of $293 million to $299 million, a 92% to 96% growth Y/Y. - Q4 2025 revenue guidance: $84 million to $90 million, over 86% to 100% growth Y/Y. - Anticipate positive GAAP operating income for Q4 2025 and full year 2025.

Q: Congrats on the IPO and positive GAAP net income. Is 2026 expected to be positive?

A: Aim to continue growing profitably.

Q: On oncology reimbursement timing and 2026 investments?

A: Expect Medicare coverage for Northstar Response by end of 2026, will supplement studies.

Q: Guidance setting process and EMR impact?

A: Guidance conservative, EMR investment to accelerate adoption in large health systems.

Q: Clinical spending and oncology studies?

A: Focus on studies answering physician questions, more investment in MRD.

Q: Sales force expansion and Medicaid impact on ASP?

A: Consistent sales force growth, Medicaid incorporation of PLA code impacts ASP.

Q: MRD timeline and UNITY coverage?

A: MRD launch end of 2026, UNITY carrier screening coverage expansion, no impact from competitors.