MDxHealth (MDXH) Q1 2026 earnings summary

Executive summary

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

• Strategic decision to discontinue the Resolve UTI business and close the Plano, Texas lab due to reimbursement uncertainty and a $10.4 million Medicare recoupment claim.

• Refocus on core prostate cancer diagnostics (Confirm, GPS, ExoDx), with sales force fully aligned and SelectMDx customers transitioned to ExoDx.

• Initiated AI-driven initiatives and partnerships to enhance operational efficiency and clinical value, including collaborations for AI-enhanced offerings and integration into clinical trials.

• Updated 2026 revenue guidance for core cancer business (excluding Resolve) to $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% year-over-year.

• 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 product mix.

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

• Pro forma operating loss was $7.9 million (vs. $4.7 million prior year); net loss was $9.4 million (vs. $9.3 million prior year); adjusted EBITDA was $(4.3) million, a 226% increase in loss year-over-year.

• Cash and equivalents at quarter-end 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) is $110–115 million, targeting 20–26% year-over-year growth.

• Expect sequential acceleration in tissue-based test volumes as integration and sales focus improve, and focus on expanding market share in prostate and other urologic cancers leveraging AI and digital innovation.