Biodesix (BDSX) TD Cowen 46th Annual Health Care Conference summary

Market opportunity and growth

• Focused on transforming patient care in lung diagnostics using multi-omic approaches, with five on-market tests and Medicare coverage.

• Lung nodule management is a large, underserved market with about 6 million new nodules annually in the U.S., with current penetration in low to mid-single digits.

• Nodify portfolio is driving a shift in lung cancer diagnosis from late to early stage, supporting over 20% growth as market education and adoption increase.

• Expansion into primary care referral networks began last year, aiming to access about 50% of the market by targeting 15,000 key primary care physicians.

• Sales force grew from 65 to nearly 100 reps in 2025, maintaining ~$1 million revenue per rep, with primary care reps showing comparable productivity.

Evidence generation and clinical impact

• Real-world evidence is prioritized, with the Clarify study tracking 4,000 patients and ongoing interim publications.

• Peer-to-peer engagement and physician-led publications are accelerating adoption, shifting interest from company-driven to physician-driven demand.

• Additional studies like Altitude are underway, with data expected mid to late next year, though current evidence is considered strong.

Financial performance and outlook

• Guided to 23% revenue growth for 2026, with upside potential from increased test volume, stable ASPs, and expanding biopharma services contracts.

• Gross margins have remained around 80%, with further improvements targeted through automation and cost reductions.

• Achieved adjusted EBITDA positivity in Q4, aiming for cash flow positivity through continued operational leverage and pipeline investment.

• Recent $14.7 million capital raise and debt refinancing have strengthened and de-risked the balance sheet.