This article first appeared on GuruFocus .
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Total Revenue:$26.9 million, a 34% increase year-over-year.
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Diagnostic Testing Revenue:$25.4 million, up 42% year-over-year.
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Test Volumes:Approximately 20,900, a 38% increase year-over-year.
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Development Services Revenue:$1.5 million, compared to $2.1 million in the prior year period.
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Gross Margin:82%, a 200 basis point improvement over Q2 2025.
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Operating Expenses (excluding direct costs):$27.4 million, a 7% increase year-over-year.
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Net Loss:$7.3 million, a 37% improvement compared to the prior year period.
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Adjusted EBITDA:Loss of $3.2 million, a 56% improvement over Q2 2025.
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Cash and Cash Equivalents:$30 million at quarter-end, a 17% increase compared to Q1.
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Net Cash Used (excluding ATM proceeds):$2.1 million, versus $6.9 million in Q2 2025.
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Full-Year Revenue Outlook:Maintained at $108 million to $114 million.
Release Date: August 05, 2026
For the complete transcript of the earnings call, please refer to the full earnings call transcript .
Positive Points
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Biodesix Inc ( NASDAQ:BDSX ) delivered strong Q2 2026 results with total revenue of $26.9 million, a 34% increase year-over-year, driven by 42% growth in diagnostic testing revenue.
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Test volumes grew 38% year-over-year, with notable adoption from primary care (up 133%) and pulmonology (up 31%), indicating broad market penetration.
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Gross margin improved to 82%, marking the fifth consecutive quarter at or above 80%, driven by higher average revenue per test and lower cost per test.
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The company achieved significant operational leverage, with operating expenses (excluding direct costs) growing only 7% despite 34% revenue growth, and net loss improving by 37% year-over-year.
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Clinical evidence, including the publication of the largest lung nodule biomarker validation study, is driving increased adoption of Notify CDT in smaller nodules and expanding utilization across the broader lung nodule continuum.
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Cash position strengthened to $30 million, a 17% increase from Q1, with net cash used in operations improving by 70% year-over-year, supporting the company's path to profitability.
Negative Points
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Development services revenue declined to $1.5 million from $2.1 million in the prior year period, reflecting timing of project completion and revenue recognition, which can be lumpy.
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The company's full-year revenue guidance of $108 million to $114 million implies a slowdown in second-half growth to 16-22% year-over-year, due to tougher comps and a $1 million back-pay collection in the prior year.
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Sales force expansion is progressing slower than expected, with the company ending Q2 with 104 reps versus a planned 120 by year-end, potentially limiting near-term growth capacity.
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Gross margin improvements are expected to moderate, as management noted it is 'hard to drive it too much higher' above 80%, limiting further margin expansion potential.
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The company remains unprofitable, with an adjusted EBITDA loss of $3.2 million in Q2, and relies on continued operational discipline to achieve sustained profitability.
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The lack of updated ACCP guidelines for blood-based biomarkers remains a headwind, as the company awaits potential guideline updates that could significantly expand market adoption.
Q & A Highlights
Q: Can you elaborate on the drivers behind the strong test volume growth, particularly the impact of the recent publication supporting Nodify CDT testing in small nodules, and whether this can remain a meaningful growth driver in the near to medium term? A: Scott Hutton (CEO): Yes, we believe the post-publication trend represents a new trajectory for growth. The interest in smaller nodules stems from the critical importance of early detection and diagnosis. We've seen great traction from both new and existing customers in adopting both Nodify CDT and Nodify XL2, and we expect this to be a sustained driver.
Q: Given the strong first-half revenue growth of 38%, the full-year guidance implies a slowdown in the second half. What has to go right to land above the implied range? A: Scott Hutton (CEO) and Robin Cowie (CFO): Our outlook is based on continued commercial team growth, improved sales rep productivity, and anticipated volume growth across pulmonology and primary care. We expect ASP stability from payers. The implied slowdown is largely due to a strong step-up in second-half 2025 comps, including approximately $1 million from back pay collections. Excluding that, the year-over-year growth looks closer to the first half.
Q: How are you balancing the accelerated commercial investment and pipeline development against the objective of sustaining profitability, and what level of expense growth is embedded in the second half? A: Robin Cowie (CFO): We are pleased with the leverage we're gaining. Our number one priority is growing top-line revenue, and our number two priority is getting to profitability. We anticipate steady operating expenses from current levels with moderate step-ups due to the commercial team expansion. We are working cost-effectively with partners to advance pipeline products without massive investments.
Q: Can you walk us through the sales team dynamics, including the hiring cadence and the split between pulmonology and primary care-focused reps? A: Scott Hutton (CEO): We are approximately two reps short of what you may have modeled, which is just a timing issue. We hire opportunistically based on progress in pulmonology and subsequent introductions to primary care physicians. To date this year, the majority of new hires have been primary care-focused. We plan to end the year with approximately 120 sales representatives.
Q: What should we expect regarding future publications and news from the development pipeline? A: Scott Hutton (CEO): We have a number of papers submitted and will share news as they are accepted. We typically target the CHEST meeting in late October/early November for presentations. We are excited about our clinical efforts, including data from the Clarify study that has been submitted. We also plan to provide an R&D and development partner update around the AMP meeting in November.
Q: Does the strong response to the spring publication and PCP efforts change your opinion on growing at a responsible pace versus accelerating investment? A: Scott Hutton (CEO): We continually assess opportunities to expand the sales force more rapidly, but we remain very cost-conscious and mindful of our path to profitability. We want to ensure a clear line of sight to an immediate return on investment. We will maintain a six-to-eight hiring cadence per quarter and end the year around 120 sales professionals.
Q: Any updated thoughts on activity around guidelines from the American College of Chest Physicians (ACCP)? A: Scott Hutton (CEO): The ACCP has not updated relevant guidelines in over 12 years, with no reference to blood-based biomarkers. We have built a strong data package and will continue to publish and present. CHEST acknowledged they were behind and moved their target to updating guidelines in 2026. We will be eager to see updates at the CHEST meeting in Phoenix this October.
Q: How is the PCP growth breaking out between new providers and existing providers ordering more tests, and are the educational seminars continuing? A: Scott Hutton (CEO): We see strong momentum in growth from new ordering physicians in primary care, while those who began ordering a few months ago continue to increase and improve. It's a balanced approach. We are hosting peer-to-peer educational events to build the market, and we see physicians leave with a better understanding of how NodifyLung can positively impact early detection.
Q: How much of the growth acceleration can be attributed to expanded PCP targeting versus rising productivity across the broader sales force, and was there any catch-up from Q1 weather disruption? A: Scott Hutton (CEO) and Robin Cowie (CFO): We did not see a significant or material weather impact in Q1, and the timing was mid-quarter, allowing for catch-up within the quarter. The growth is driven by a combination of PCP expansion and improving productivity across the entire sales organization, with newer reps advancing along expected productivity curves.
Q: With operating expenses increasing just 7%, can you elaborate on the cost improvements and whether the benefits have been largely realized? A: Robin Cowie (CFO): We are constantly working on operational improvements to increase efficiency. With gross margins already above 80%, it's hard to drive them much higher, but we are continuously working to strengthen our best-in-class margins. We don't expect huge increases, which is why we reiterate margin guidance around 80% or just above.
For the complete transcript of the earnings call, please refer to the full earnings call transcript .
