MDxHealth S.A. Q4 FY2025 earnings call

Management Statement and Operational Highlights: MDX Health is driven by three core principles: focus, execution, and growth. Over the past years, it has positioned as a leader in precision diagnostics in urology. In the fourth quarter of 2025, the company began the integration of the ExoDx business, met the internal goal of transitioning all of its select MDX customers to ExoDx, and initiated the integration of its sales organization. It also collaborated with the University of Oxford on GPS-related studies and is committed to the patient and customer experience, optimizing organizational processes.

Segment Performance: In Q4 2025, total revenue was $29.5 million, up 19% year-over-year. Gross profit was $18.7 million, up 20% year-over-year, with a gross margin of 63.2% (up 0.5 percentage points). Operating loss was $5.3 million, up 14% year-over-year. Net loss was $8.9 million, up 31% year-over-year. Adjusted EBITDA was -$2.1 million. Cash and cash equivalents were $29 million as of December 31, 2025. Liquid-based test volumes increased 128% year-over-year, while tissue-based test volumes decreased 5% year-over-year.

Guidance: The management's 2026 revenue guidance is between $137 million and $140 million, expecting to achieve sustained top-line growth and operating profitability improvement. The company amended the earn out from Exact Sciences, lowering the upcoming earn out payment and deferring the full earn out amount by an additional year. It is expected that the adjusted EBITDA will reach 10% of revenue by the end of 2026.

Risks: Forward-looking statements made during the call are subject to inherent risks and uncertainties, and these risks and uncertainties are detailed in the company's filings with the Securities and Exchange Commission, specifically in the company's annual report on Form 20F.

Question and Answer: Q: Concerns about Thomas Flayton's line status; A: Noted.

Q: Tissue ASP down and related mix shift; A: Assumption of mix shift affecting ASP is correct.

Q: EBITDA lower and cash burn; A: Q4 and Q1 absorption of the ExoDx acquisition is the reason, and the company is confident in the EBITDA margin swing.

Q: 2026 revenue guidance assumptions; A: Balance between tissue and liquid growth and focus on the combined customer base.

Q: Gains from post-Q1 integration; A: Expect leverage from the mapping of the combined customer base.

Q: Operating leverage left; A: Confident in keeping OPEX fixed, gross margin is expected to range in the low 60s with attention to operating efficiency.