MDxHealth (MDXH) Q4 2024 earnings summary

Executive summary

• Achieved 28% revenue growth in Q4 and full year 2024, with Q4 revenue at $24.7M and full-year revenue at $90.0M, driven by increased test adoption and operational discipline.

• Test volume growth was 26% in Q4, with tissue-based tests up 50% and liquid-based tests up 10% year-over-year.

• Adjusted EBITDA loss improved by 68% in Q4 and 24% for the full year, with net loss decreasing 36% in Q4 and 12% for the year.

• No expansion of the commercial sales organization, highlighting increased sales rep productivity.

• Ended 2024 with $46.8M in cash and cash equivalents, supporting business plan execution and obligations.

Financial highlights

• Q4 2024 revenue rose to $24.7M, up 28% from $19.4M in Q4 2023, all organic growth; full-year revenue was $90.0M, up 28% year-over-year.

• Q4 gross profit was $15.5M, up 22% year-over-year; full-year gross profit was $55.1M, up 26% year-over-year.

• Q4 gross margin was 62.7%, down from 65.3% due to test mix and payment timing; full-year gross margin was 61.2%, down 1.4pp year-over-year.

• Q4 operating loss declined 27% to $4.6M; net loss decreased 36% to $6.8M; full-year net loss was $38.1M, improved 12% year-over-year.

• Adjusted EBITDA for Q4 was negative $1.4M, a 68% improvement year-over-year; full-year adjusted EBITDA was negative $14.7M, a 24% improvement.

Outlook and guidance

• 2025 revenue guidance confirmed at $108–$110M, targeting at least 20% growth.

• Expect to cross adjusted EBITDA profitability in the first half of 2025.

• Guidance does not rely on significant Germline test contributions, though some impact is expected in the second half.

• Gross margins expected to remain in the mid-60% range for the next few quarters.