MDxHealth (MDXH) Q1 2026 earnings summary

Executive summary

• Revenue grew from $11 million in 2019 to $108 million in 2025, with Q1 2026 revenue up 13% year-over-year to $27.4 million, driven by aggressive growth, ExoDx integration, and focus on precision diagnostics for urology.

• Strategic decision made to discontinue the Resolve UTI offering and cease operations at the Plano, Texas laboratory due to reimbursement uncertainty.

• Focus is now entirely on core prostate cancer diagnostics, leveraging AI initiatives, sales force integration, and digital innovation.

• Initiated AI-driven strategic initiatives, including partnerships for AI-enhanced diagnostics and integration into clinical trials.

• Updated 2026 revenue guidance for core cancer business (excluding Resolve) is $110–$115 million, representing 20–26% year-over-year growth.

Financial highlights

• Q1 2026 as-reported revenue was $27.4 million, up 13% year-over-year; pro forma revenue for core prostate cancer operations (excluding Resolve) was $23.9 million, up 11%.

• Gross profit increased 7% to $16.6 million; pro forma gross profit was $15 million with a gross margin of 62.9%, down from 68% in Q1 2025 due to test mix.

• Operating expenses rose 19% to $23.9 million, mainly from ExoDx acquisition-related costs.

• Pro forma operating loss was $7.9 million, compared to $4.7 million prior year, mainly due to ExoDx acquisition.

• Net loss decreased 4% to $8.9 million; pro forma net loss was $9.4 million, nearly flat year-over-year.

• Cash and equivalents at March 31, 2026, were $43.2 million; after a $15 million earn-out payment, pro forma cash would be $28.2 million.

Outlook and guidance

• 2026 revenue guidance for core cancer business (excluding Resolve) set at $110–115 million, targeting 20–26% year-over-year growth.

• Expectation of sequential acceleration in tissue volume through Q2–Q4 as integration and sales focus improve.

• Focus on expanding market share in prostate and other urologic cancers, leveraging AI and digital innovation.