BDSX

• Commercial Strategy & Diagnostic Growth

  • Primary care test volume grew 133% year-over-year, while pulmonology test volume grew 31% year-over-year. Growth is driven by both new physician customers and increased utilization from existing accounts, with primary care currently contributing ~15% of total testing volume, consistent with the prior quarter.
  • The March 2026 publication of the largest ever lung nodule biomarker validation study confirmed Notify CDT can accurately detect cancer in nodules as small as 4mm with a low false positive rate, driving a significant increase in orders for smaller nodules during the quarter.
  • Clinical adoption of Notify CDT for smaller nodules consistently leads to increased subsequent utilization of both Notify CDT and Notify XL2 for larger nodules across all customer segments, expanding overall account penetration.
  • New real-world clinical and economic data presented at the May 2026 ATS Annual Meeting further validated the clinical and economic value of Biodesix's lung nodule risk stratification testing, reinforcing the franchise's role in addressing unmet clinical needs.

• Financial & Operational Performance

  • Gross margin reached 82%, a 200 basis point year-over-year improvement, marking the fifth consecutive quarter with gross margins at or above 80%. Margin improvement came from higher diagnostic testing volume, improved average revenue per test, and lower average cost per test.
  • Total operating expenses (excluding direct costs) grew only 7% year-over-year against 34% total revenue growth, demonstrating strong operating leverage. Sales, marketing, and G&A expenses increased 8% to support planned commercial team expansion, while R&D costs decreased 4% year-over-year.
  • Net loss for the quarter was $7.3 million, a 37% improvement year-over-year. Adjusted EBITDA loss was $3.2 million, a 56% improvement from Q2 2025.
  • The company ended the quarter with $30 million in unrestricted cash and cash equivalents, a 17% increase from Q1 2026, including $6.5 million in net at-the-market offering proceeds. Excluding ATM proceeds, net cash used in operations was $2.1 million, a 70% improvement from Q2 2025.

• Commercial Team Updates

  • Q2 2026 averaged 104 field sales representatives, with salesforce productivity improving across all tenures: newer reps are meeting expected productivity targets, while tenured reps continue to grow their contribution. The company plans to end 2026 with ~120 total field sales reps, maintaining a steady hiring cadence of 6-8 new hires per quarter.
  • To date in 2026, the majority of new sales hires have been focused on the primary care segment, with hiring done opportunistically to match growing demand.

• Full-year 2026 total revenue guidance is maintained at $108 million to $114 million, which was previously raised from the company's prior outlook.
  • Gross margins are expected to remain around 80% or slightly above 80% for the full year, with no major incremental increases expected from current levels.
  • Operating expenses are expected to remain relatively steady through the second half of 2026, with only moderate step-ups to accommodate the expanding commercial sales team.
  • Management expects continued operating leverage as the expanded sales team gains tenure and productivity improves, with continued progress toward sustained adjusted EBITDA profitability.
  • The company confirms it has sufficient liquidity to execute its full 2026 growth strategy.

BioDesix recorded total Q2 2026 revenue of $26.9 million, representing 34% year-over-year growth. The Diagnostic Testing segment generated $25.4 million in revenue, a 42% year-over-year increase, accounting for 94.4% of total company revenue. Total test volumes for this segment reached approximately 20,900 units, growing 38% year-over-year, with average revenue per test improving due to expanded payer coverage and better revenue cycle management. The Development Services segment recorded $1.5 million in revenue, down from $2.1 million in the year-ago quarter, accounting for 5.6% of total revenue. The year-over-year decline reflects timing differences in project completion and revenue recognition, though the segment currently holds $8.5 million in contracted business with sustained strong demand.

• Development Services revenue is subject to quarterly lumpiness and seasonality based on project execution and revenue recognition timing, which can create variability in quarterly top-line results.
  • Market adoption of Biodesix's blood-based lung nodule testing depends on updates to clinical practice guidelines, which have not been revised by CHEST in over 12 years and the timing of any favorable update remains uncertain.
  • While the company has seen strong traction in primary care expansion, accelerating sales force growth too quickly could compromise operating leverage and delay progress toward profitability, which management actively mitigates with a disciplined hiring approach.
  • Forward-looking results are subject to general risks and uncertainties detailed in the company's SEC filings, which could cause actual performance to differ materially from management projections.

Q: Given the strong traction from the small nodule publication and cross-utilization of tests for larger nodules, will this trend remain a meaningful driver of test volume growth in the near and medium term? / A: Management confirmed that this will remain a meaningful growth driver. Post-publication, the trend has established a new higher growth trajectory, with strong adoption from both new and existing customers centered on demand for early lung cancer detection in smaller nodules.

Q: Given signs of recovery in biopharma and biotech, has this translated into increased new deal flow and contracted revenue for your Development Services segment? / A: Management noted that the company had a strong ASCO 2026 conference, with continued high levels of interest from biopharma partners. The pipeline of potential deals remains robust, and the company will provide updates as new agreements are finalized.

Q: What is the dynamic behind your slower-than-expected Q2 sales headcount addition, and how are new hires split between pulmonology and primary care? / A: Lower-than-modeled headcount in Q2 is purely due to hiring and training timing, as reps are only counted once they are active in the field. Hiring is done opportunistically, with the majority of 2026 new hires to date focused on primary care, aligned with growth in referrals from pulmonology practices.

Q: Given the strong response to your spring publication and primary care growth, would you consider accelerating sales force expansion away from your current disciplined growth strategy? / A: Management will maintain its current disciplined approach focused on reaching profitability. The company will continue with its planned cadence of 6-8 new hires per quarter, ending 2026 at ~120 sales reps, and only adds headcount where there is clear line of sight to an immediate return on investment.

Q: Why does your full-year guidance imply lower second half year-over-year growth than the first half, and what would drive results above the guidance range? / A: The lower implied growth reflects much stronger year-over-year comparables in the second half of 2025, which included ~$1 million in one-time back pay collections. To exceed guidance, the company needs sustained sales rep productivity gains, stable average selling prices from payers, continued volume growth across segments, and potential timing of Development Services revenue recognition.