BillionToOne (BLLN) Stifel 2026 Healthcare Conference 2026 summary

Oncology product differentiation

• Peer-reviewed studies show Northstar Select has 50%+ higher sensitivity than incumbents, detecting 50%+ more actionable therapies.

• Northstar Response provides quantitative tumor-burden monitoring and can detect progression significantly before scans.

• Northstar Response tracks epigenetic changes across the epigenome, which may capture tumor evolution missed by assays assessing selected variants.

• Head-to-head results showed Northstar Response was more performant than a widely used tumor-informed assay; the tissue-free approach is positioned to combine ease of use with tumor-informed-level performance.

• Northstar Select and Response can feed into each other as patients progress or need therapy selection, supporting repeat use in late-stage cancers.

Commercial execution and growth

• Oncology sales force reached ~65 reps; Q3 annualized revenue was $68 million, with average revenue per rep above $1 million, despite many reps still ramping and before Northstar Response Medicare coverage.

• Adding 5-6 reps per quarter in 2026 and potentially 7-8 per quarter in 2027 was described as the pace to sustain 100% YoY oncology test-volume growth while maintaining service quality.

• Oncology growth is not driven solely by adding reps; turnaround time and service quality remain important to clinician reliance on testing.

Prenatal market and health-system expansion

• In-network status is ~90%; broader payer access is especially important in prenatal, where out-of-network status can weigh on test volume and ASP.

• Health systems represent 60% of the prenatal market; payer contracts, Epic Aura integration and expanded panels are now in place to support long-term penetration.

• Health-system wins may add 3,000-4,000 tests per quarter each; ~3 wins in 2025 and ~1 in 2026 were cited, with further wins potentially adding upside beyond next year's baseline growth assumptions.

• Epic Aura integration was completed by Q2; health-system volumes were expected to start appearing in Q1-Q2 2027, following onboarding that can take 6-12 months or longer.

• Sales incentives are being adjusted to balance quarterly growth with health systems' longer annual sales cycles.