BillionToOne (BLLN) UBS Global Healthcare Conference summary

QCT platform and clinical opportunity

• QCT reduces noise in cell-free DNA, enabling single-molecule sensitivity for single-gene prenatal conditions and harder cancer applications where signal is extremely rare.

• In simpler testing applications, QCT supports lower COGS; for difficult cancer problems, its value is framed as enabling capabilities that sequencing more cannot achieve.

• Tissue-free MRD and early detection share the challenge of identifying tiny tumor signals without knowing the tumor profile; the Clear line is positioned to support future screening.

Unity prenatal portfolio

• Single-gene NIPT is designed for general-population use without partner testing; simplified workflow and portfolio breadth help attract OB-GYNs, maternal-fetal medicine specialists and health systems.

• Fetal Antigen NIPT serves ~0.5% of patients, including high-risk alloimmunized pregnancies, and is described as a meaningful tool for maternal-fetal medicine specialists.

• Prospective, multisite, intended-use evidence and direct detection of causal variants are cited as differentiators versus approaches based on genomic correlations.

• Single-gene NIPT is designed to be accessible regardless of insurance or socioeconomic status; if PAMA takes effect Jan. 1, 2027, its Clinical Laboratory Fee Schedule is expected to rise more than 100%.

• With coverage in the long term, the fee change could add 20% to revenue and profit margins; prenatal margins are expected to be preserved or expanded.

Northstar oncology portfolio

• A head-to-head study showed Northstar Select detecting 50% more actionable therapies than incumbents; research pilots and clinician referrals are supporting adoption and accelerating test-volume growth.

• Select and Response can reinforce each other: Response may detect progression before scans and prompt another Select test, while either product can open accounts and support repeat testing.

• Clear, a tissue-free MRD test, was scheduled to launch Dec. 15, 2026; positioning emphasizes sensitivity on par with or better than some tumor-informed tests, without tissue logistics.

• Head-to-head studies across cancer types are viewed as critical to demonstrate Clear's performance; management said it is willing to conduct them.

• Tissue-of-origin add-on relevance was reported at 10%-15% for uncertain diagnoses in community oncology, versus 3% for true unknown-primary cases in literature focused on academic centers.