Guardant Health (GH) Q4 2024 earnings summary

Executive summary

• Achieved record 31% year-over-year revenue growth in 2024 to $739 million, with Q4 revenue up 30% to $202 million, driven by strong clinical oncology and biopharma test volumes, major product upgrades, and international expansion.

• Major upgrades to Guardant360 and the launch of Smart Liquid Biopsy accelerated test volumes and reinforced market leadership.

• Shield became the first FDA-approved and Medicare-covered blood test for CRC screening, opening a large new market and generating $4.1 million in Q4 revenue.

• Reveal received Medicare coverage for CRC surveillance, with significant cost reductions making it gross margin positive.

• Completed a $600 million convertible debt exchange, extending maturity to 2031, and executed a $45 million share repurchase.

Financial highlights

• Full-year 2024 revenue reached $739 million, up 31%; Q4 revenue was $202 million, up 30% year-over-year.

• Precision oncology revenue grew 34% to $688 million; clinical test volume up 20% to 206,700; biopharma revenue rose 31% to $145 million with test volume up 35%.

• Non-GAAP gross margin was 62% for the year (63% in Q4); excluding screening, gross margin was 64%.

• Adjusted EBITDA loss improved to $258 million from $344 million in 2023; free cash flow burn reduced to $275 million.

• Net loss for 2024 was $436.4 million ($3.56/share), improved from $479.4 million ($4.28/share) in 2023.

Outlook and guidance

• 2025 revenue expected at $850–$860 million, representing 15–16% growth (19–20% excluding 2024's $22 million non-recurring upside).

• Oncology revenue projected to grow ~15% (20% excluding non-recurring items); clinical volume growth expected at ~25%.

• Biopharma and data revenue forecasted for low double-digit growth; Shield screening revenue guided at $25–$30 million from 45,000–50,000 tests.

• Non-GAAP gross margin expected at 62–63%; operating expenses to rise 8–9% mainly due to screening investments.

• Free cash flow burn for 2025 guided at $225–$235 million, with core business breakeven in Q4 2025.