NASDAQ:BDSX Biodesix Q2 2025 Earnings Report $0.40 +0.01 (+3.00%) As of 03:19 PM Eastern This is a fair market value price provided by Polygon.io. Learn more. ProfileEarnings HistoryForecast Biodesix EPS ResultsActual EPS-$0.08Consensus EPS -$0.07Beat/MissMissed by -$0.01One Year Ago EPSN/ABiodesix Revenue ResultsActual Revenue$20.02 millionExpected Revenue$18.47 millionBeat/MissBeat by +$1.55 millionYoY Revenue GrowthN/ABiodesix Announcement DetailsQuarterQ2 2025Date8/7/2025TimeAfter Market ClosesConference Call DateThursday, August 7, 2025Conference Call Time4:30PM ETConference Call ResourcesConference Call AudioConference Call TranscriptPress Release (8-K)Quarterly Report (10-Q)Earnings HistoryCompany ProfilePowered by Biodesix Q2 2025 Earnings Call TranscriptProvided by QuartrAugust 7, 2025 ShareLink copied to clipboard.Key Takeaways Positive Sentiment: 12% revenue growth year-over-year to $20 million in Q2 and gross margin expansion to 80%, with management targeting positive adjusted EBITDA in Q4. Positive Sentiment: Territory-based sales strategy now covers 49 regions, adding primary care reps that have doubled PCP test orders to ~9% and boosted on-site blood draw compliance by 30%. Positive Sentiment: Development services revenue surged 53% year-over-year to $2.1 million, exiting the quarter with a $12.5 million contract backlog (up 54%) and a key Thermo Fisher NGS partnership. Positive Sentiment: ALTITUDE prospective trial reached full enrollment and CLARIFY real-world study has accrued over 1,100 of 4,000 patients, with interim data due in H2 2025. Negative Sentiment: The planned HEDIS quality measure for lung nodule management was put on hold over technical and clinical readiness concerns, delaying potential payer-driven adoption. AI Generated. May Contain Errors.Conference Call Audio Live Call not available Earnings Conference CallBiodesix Q2 202500:00 / 00:00Speed:1x1.25x1.5x2xThere are 9 speakers on the call. Operator00:00:00Good day and thank you for standing by. Welcome to the Biodesix Q2 twenty twenty five Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during the session, you will need to press 11 on your telephone. Operator00:00:21You will then hear an automated message advising your hand is raised. To withdraw your question, please press 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Chris Brinsey. Please go ahead. Speaker 100:00:39Thank you, operator, and good afternoon, everyone. Today, Biodesix released results from the 2025. Leading the call today will be Scott Hutton, Chief Executive Officer. He is joined by Robin HarperCowie, Chief Financial Officer. An audio recording of today's call and the press release announcement with the quarterly results can be found in the Investor Relations section of the company's website at biodesix.com. Speaker 100:01:08As today's call includes forward looking statements, we encourage you to review the statements contained in today's press release and the risks and uncertainties described in our SEC filings, which identify certain factors that may cause the company's actual events, performance and results to differ materially from those contained in the forward looking statements made on today's webcast. In addition, we will discuss non GAAP financial measures on this call. Descriptions of these non GAAP financial measures and reconciliations of GAAP to non GAAP financial measures are included in today's press release. I would now like to turn the call over to Scott Hutton, Chief Executive Officer. Scott? Speaker 200:01:50Thank you, Chris, and thank you all for joining us today. At Biodesics, our mission is to transform patient care and improve outcomes through personalized diagnostics that are timely, accessible, and address immediate clinical needs. We leverage a multimodal approach that includes genomics, proteomics, and radiomics combined with AI to discover, develop, and commercialize innovative diagnostic tests for physicians, biopharmaceutical, life sciences, and diagnostic companies to help improve patient care. In 2025, we are focused on three main goals, growing our top line revenue, improving operational effectiveness and efficiencies that will result in a positive adjusted EBITDA in the fourth quarter, and advancing our pipeline for future growth and expansion. In the second quarter, we made progress on all three by growing revenue by 12% year over year, improving our already strong gross margins by 150 basis points to 80% and presenting clinical data on multiple pipeline products. Speaker 200:03:01Starting with the clinical offering in lung diagnostics, our major focus is on lung nodule management, where nodules are either found incidentally when the patient has an image taken for another purpose or during low dose CT screening for lung cancer. In our recent earnings calls, we've provided detailed information about our plan to expand our commercial sales efforts to better address gaps in care for patients with lung nodules. Throughout last year, a growing number of ordering pulmonologists provided important feedback stating that ordering the Notify XL2 and Notify CDT test within their referral network would help optimize nodule management. If the tests are ordered earlier, those patients who are at higher risk of lung cancer should be referred on to the interventional pulmonologist. While lower risk patients may remain with the primary care physicians for monitoring. Speaker 200:03:56This feedback was instrumental in the formation and implementation of our territory based sales strategy to engage both pulmonologists and their referral network, including primary care. In the first quarter, we implemented this change and reconfigured our sales team to 49 territories. Each territory is anchored by a pulmonology sales rep with a mix of primary care sales reps and associate sales reps providing support in driving adoption in pulmonology and through their referral network. The specific combination of the sales roles in each territory is tailored to the local clinical need. We believe this approach allows us to directly address the nearly fifty percent of patients with lung nodules currently being managed by primary care physicians outside of pulmonology. Speaker 200:04:50In the second quarter, we completed training of our first full class of primary care sales reps who entered the field in late June. While the first full class has only been in the field for a few weeks, the response from primary care physicians has been encouraging, with physicians recognizing the clinical need and the benefits of improved lung nodule risk assessment with notified testing. Prior to the initiation of our primary care pilot conducted in the 2024, approximately four percent of notified tests were ordered from primary care. And as a result of our targeted efforts, that number has increased to approximately nine percent in June. We're also working on ways to make it easier for clinicians to order and implement our test in their practices. Speaker 200:05:36In fact, one added benefit to our updated sales strategy is the availability of on-site blood draw capabilities within the primary care setting. This has historically been a challenge in pulmonology where we frequently need to leverage our extensive mobile phlebotomy network to collect blood samples for testing. Once a patient leaves the physician's office, we face the all too common challenge of patient compliance to ensure the blood draw is completed. Completing the blood collection on-site before a patient leaves the facility results in 30% more tests delivered than if the patient leaves and needs to schedule a blood draw at another time. Ordering the test in the primary care setting and collecting the sample on-site helps to address this challenge. Speaker 200:06:23In addition, electronic ordering streamlines the process and ease of use for the physicians in their office. Customer retention in those offices who utilize digital ordering is 40% higher than those who do not. Since Notify launch, we've expanded our digital test ordering capabilities through our Biodesix physician portal and a number of early EMR integrations. Through these efforts, our digital ordering has increased by 63% over last year. In the second quarter, we had an average of 74 sales reps in the field who delivered 15,100 total lung diagnostic tests and just under $1,000,000 in annualized revenue per sales rep. Speaker 200:07:08Looking forward, we expect to have an average of 83 to 87 reps in the field in the third quarter and 93 to 97 reps in the fourth quarter, allowing us to drive patient access to cutting edge diagnostic test regardless of where they're being managed. In addition to our commercial efforts, we continue to build the book of clinical evidence supporting the use of our notified test. In the second quarter, health economic and outcomes research data supporting our tests were presented at ISPOR twenty twenty five. And an independent study from a clinical user of the test was presented at ATS twenty twenty five. We are also continuing to make progress with our CLARIFY study, which is a retrospective chart review evaluating the use of notified testing in real world clinical practice. Speaker 200:07:58This trial is expecting to enroll approximately 4,000 patients. Since launch of the study in late October twenty twenty four, we've already accrued over 1,100 patients and anticipate releasing interim data from the study in the second half of this year. Finally, we're pleased to provide an update on our prospective randomized clinical study, ALTITUDE. The data and safety monitoring board met and determined that the study has enrolled a sufficient number of patients to reach statistical power and recommended that patient enrollment close. Patient enrollment closed in late July, and now the investigators continue the mandated one year patient follow-up to track outcomes. Speaker 200:08:42As the company is blinded to the data while the study is ongoing, we do not have any additional information on potential results, but are pleased to see that the sufficient number of patients have been enrolled as we move to the next phase of follow-up. We will provide additional information on the study as it becomes available. Moving to our pipeline. We had multiple presentations on our products and development. Our current pipeline consists of our combination proteomic and genomic MRD tests, expanded indications for Veristrat into several new tumor types with immunotherapy selection, and digital diagnostics. Speaker 200:09:20Multiple presentations on our MRD test were presented in April and May, including at AACR twenty twenty five. Our unique MRD test combines the proteomic information from our risk of recurrence test that can give insights into a patient's immune status, along with tumor informed genomics that leverages the high sensitivity of droplet digital PCR for disease monitoring. At ASCO, new data was presented from the prospective registry study Incyte demonstrating the potential of the Verastrat test in helping to guide first line immunotherapy treatment strategies in patients with non small cell lung cancer and PD L1 of greater than fifty percent. At ASMS, we shared data on the use of the Verastrat test in identifying hormone treatment responses in men with metastatic castration resistant cancer. Finally, we will also share more data on the prognostic significance of Veristrat in multiple MSI high solid tumors in patients eligible for treatment with Keytruda. Speaker 200:10:25These data will be presented by our collaborators at the upcoming ESMO meeting in the fall. Shifting to development services, we continue to see strong interest in our development services offering that leverages our multi omic approach and R and D expertise to help deliver insights that our biopharma, life science tools and diagnostic partners use to personalize patient care and help improve disease detection and treatment decisions across various disease types. In the second quarter, we delivered $2,100,000 in revenue, growing 53% year over year. The funnel has also continued to grow and we exited the quarter with $12,500,000 under contract, representing a 54% increase over last year at this time and an all time high. In early July, Thermo Fisher announced their new NGS assay received FDA approval as a companion diagnostic. Speaker 200:11:23The announcement recognized Biodesics as a key collaborator in the validation of the test. This partnership and approval are key examples of the strength of the Biodesics development services offering, including the test discovery and development, clinical trial testing, and regulatory support for companion diagnostics. We look forward to providing further updates on additional progress with Thermo Fisher and this initiative. Overall, we are very encouraged by the continued strong year over year growth in this business and believe there is significant potential for upside. With that, let me turn it over to Robin to review our financial performance for the quarter. Speaker 200:12:03Robin? Speaker 300:12:05Thanks, Scott, and good afternoon, everyone. Second quarter total revenue was $20,000,000 a 12% increase over the prior year. Lung diagnostic testing revenue in the 2025 was $17,900,000 from approximately 15,100 tests as compared to $16,500,000 from approximately 13,900 tests for the 2024, representing 9% growth in test volumes and representing 8% growth in revenue. Development services revenue was $2,100,000 in the quarter, representing 53% year over year growth. We ended the second quarter with $12,500,000 under contract, and as Scott previously mentioned, this represents an all time high. Speaker 300:12:52Our gross margin percentage in the second quarter twenty twenty five was 80%, up 150 basis points from 78.4% in the 2024. Despite increases in supply costs and existing macroeconomic uncertainty, we expect gross margins to remain in the upper 70s through the rest of the year. Overall operating expense, excluding direct costs and expenses, was $25,700,000 in the second quarter, which was a 15% increase over the 2024. Total SG and A was $22,400,000 versus $19,700,000 a 14% increase, driven primarily by the addition of 13 more active sales representatives, or 21% growth in the number of reps in the field, and the planned expansion Scott has talked about in detail. As Scott noted before, we are continuing to scale the sales team and expect 83 to 87 active sales reps in the field in the third quarter and 93 to 97 in the field in the fourth quarter. Speaker 300:13:54R and D expense was $3,300,000 versus $2,600,000 or a $700,000 increase due to the investment in clinical studies to help advance adoption of our lung diagnostic tests and advancement of our pipeline. Net loss for the second quarter twenty twenty five was $11,500,000 an increase of 6% year over year. Adjusted EBITDA, which excludes non cash and other one time items, was a loss of $7,200,000 which was an increase of 29% year over year. We ended the quarter with $20,700,000 in unrestricted cash and cash equivalents. Cash in the second quarter included the drawdown on the $10,000,000 tranche C loan from Perceptive Advisors. Speaker 300:14:37Cash used from operations in the second quarter was $6,600,000 a 23% improvement over the $8,600,000 in the 2025. We are maintaining our guidance of 80,000,000 to $85,000,000 of revenue for the year. Because of our strong gross margins and the planned and actual expansion of the sales team and the rep productivity achieved to date, we expect to achieve adjusted EBITDA positivity in the fourth quarter. Now I'll turn it back to Scott for some closing thoughts before the Q and A. Scott? Speaker 200:15:10Thank you, Robin. To summarize our achievements, we grew the size of the sales team to an average of 74 sales representatives in the field during the quarter, an increase of 13 reps, up 21%. We increased primary care ordering of lung diagnostic tests over 100% during the quarter versus levels seen prior to the pilot program in 2024. We achieved an all time high in development services business dollars under contract of $12,500,000 up 54%. We announced new clinical and economic data supporting notified lung test at the ISPOR twenty twenty five annual meeting and the ATS twenty twenty five international conference. Speaker 200:15:55We reached patient enrollment requirements in July 2025 for ALPITUDE, with patient follow-up expected to continue for approximately one more year. We presented data on three pipeline initiatives, including the combination genomic and proteomic MRD test at the AACR Annual Meeting, the use of Veristrat in first line immunotherapy treatment selection at the ASCO Annual Meeting, and Verastrat in hormone resistant cancer at ASMS. And we were honored to be recognized as a top workplace for the second consecutive year, a strong reflection of our exceptional team and thriving culture. Before moving on to questions, I want to restate that we have the best lung focused team in diagnostics and continue to make significant progress in building a market in an area that has not historically used diagnostics in the way that other medical or oncology specialties have. With first mover advantage in lung nodule management and an ever increasing body of robust clinical and health economic data, we are generating the momentum to drive greater clinical and payer adoption as we move through 2025 and beyond. Speaker 200:17:07With all that's happening, it's a very exciting time here at Biodesics. We look forward to sharing more with you in the coming quarters. Let's now move to questions. Operator, let's start the Q and A session. Operator00:17:19Thank you. And our first question comes from Andrew Brackmann of William Blair. Your line is open. Speaker 400:17:43Great. Hi, Scott. Hi, Robin. Good afternoon. Thanks for taking the question. Speaker 400:17:47Scott, you gave a lot of commentary on the primary care opportunity and what you're seeing so far. Can you maybe just unpack that a little bit more for us? Perhaps why are you more confident now that this is the right strategy versus maybe the pilot? And I guess related to that, anything with respect to trends that you're seeing now that may be different than the pilot? Thanks. Speaker 200:18:07Yeah. Thank you, Andrew. Great questions. I don't know that there's really anything different. It's just as we gain more experience, it's continuing to reaffirm what we learned during the pilot. Speaker 200:18:18So, if confidence is going up, it's just because we have broader or deeper experiences. And they remain consistent. So, we knew all along that nearly fifty percent of patients are stuck in primary care. That's a big problem. I think what we're finding now is with the support of our pulmonology partners, we're tapping into that. Speaker 200:18:40And so, we think that this is going to expand that market opportunity and maybe more importantly our access to that. We'll continue to provide updates on the progress we see. As we stated, we just had our first class exit. They're in the field. We're continuing to invest and we're always recruiting and expanding the sales force as we disclosed. Speaker 200:19:03So, we'll continue to provide additional progress reports and feedback. But pulmonologists more and more are supporting the strategy. More and more of our existing and ordering pulmonologists want to reach out to their primary care physicians because they see the value. So, it really is why you do pilots like we did. It gives us a lot of insights. Speaker 200:19:24It increases the confidence that we're making the right decisions. And now we're just back out demonstrating that it was the right decision, and we're going to continue to highlight those successes. Speaker 400:19:35That's great color. Thanks for all that. And then with respect to the commentary on electronic ordering, is there anything maybe you can share with respect to the utilization uptick you've seen in those accounts that have begun ordering electronically? And related to that, how do you think about this as a potential way to maybe even open up new customer doors? Thanks. Speaker 200:19:56Yeah, great question, Andrew. I think it may surprise most, but the majority of healthcare practices and hospitals still prefer to utilize facts as the means by which they order or communicate with diagnostic companies and others. And so for us, that is not high-tech, it's not fast, it's not the most accurate means by which we can communicate. And so whether it's full EMR integration or something like our Biodesix physician portal, there are faster means by which we can communicate. And so for us, it's really been around utilization of our portal and EMR integration, kind of the combination of the two. Speaker 200:20:38When individuals use our portal, compliance with the test order improves significantly. And so a way to think about that is when they go to fill out the order request form, utilizing a portal, you can't progress until you've filled in all of the sections of the form. If you submit a fax, there could be spots that are left empty, so that would require one of our customer care representatives to get on the phone, call a practice, and ask for that information. Just in hearing that explanation and example, you can see that that's going to provide a delay. Knowing that lung cancer is the deadliest of all cancers and time matters, we really are focused on being not only as effective as possible, but really how efficient can we be. Speaker 200:21:25So when somebody utilizes a digital ordering platform, whether it's EMR or portal, because of that, we see less tests cancel, right? We see less tests that are submitted without all of the appropriate clinical factors. They're just going to enable that that patient not only stays in the system, but they get the results they need. Is that helpful? Speaker 400:21:48Very helpful. I'll leave it at two. Thanks, everyone. Speaker 200:21:51Thank you, Andrew. Operator00:21:53Thank you. And our next question comes from Bill Bonello of Craig Hallum. Your line is open. Speaker 500:22:02Hey, guys. What a nice turn from last quarter. Couple of questions. Robin, can you help us sort of bridge to EBITDA positive in Q4? I mean, really that's substantial move from this quarter. Speaker 500:22:23And so just trying to understand how much of it is just leverage of revenue growth. Is there cost cutting involved? How do we think about that? Speaker 300:22:34Yeah, absolutely. Hi, Bill. So, it is primarily driven by revenue growth. So, last quarter we talked about the cadence of hiring and how last quarter we were not where we wanted to be, and that we needed to shift to adding the 10 reps per quarter, which we saw this quarter and are well on track for third and fourth quarter. That really catches us up to our original plan of getting to about 95 reps in the field in the fourth quarter. Speaker 300:23:08So, between that and the normal sort of uptick we typically see in our services revenue in the fourth quarter, that's the biggest driver of bridging from where we were in the second quarter to where we expect to be in the fourth. Speaker 500:23:22Okay, that's helpful. So, not necessarily any specific initiatives around operating expenses or anything like that, just leverage? Speaker 300:23:34Yeah. No, we have run very lean for a very long time, and we continue to do so. We've made a lot of operating improvements, and you saw an uptick in our gross margin again this quarter, for which we're very proud, and we're continuing to focus on those. So, the focus on operating expense remains cost containment, running lean, being efficient, and trying to find more operational efficiencies, not just in COGS, but also throughout the rest of the business. But our plan does not include any major cost cutting measures in the third or fourth quarter. Speaker 500:24:16Sure. Okay, that's helpful. And when we think about the acceleration, the revenue growth that's going to happen that's implied in your guidance in the back half of the year. Should we think of that as primarily volume driven and because you're adding the additional reps or is there anything on the ASP side? Speaker 300:24:41Exactly. It's rep driven and volume driven. We've seen nice stability in our ASPs. We're not forecasting in any major changes in ASP at this time. So, yes, it's rep and volume driven. Speaker 500:24:59Okay. And then one last question, if I could, which is, again, when you're thinking about that ramp, how are you thinking about the Development Services? Is Q2 sort of steady from there? Was it outlier high? Does it grow from there? Speaker 500:25:19How are you thinking about that? Speaker 300:25:22Well, we typically see a nice uptick in the fourth quarter, just because of the cadence of how pharmaceutical companies work and their budgets work. The fourth quarter tends to be our strongest quarter of the year. So, we would anticipate an uptick in fourth quarter over second quarter. Speaker 500:25:39Okay. Thank you very much. Speaker 200:25:42Thanks, Bill. Operator00:25:44Thank you. And our next question comes from Thomas Flaten of Lake Street Capital Markets. Your line is open. Speaker 600:25:55Good afternoon. I appreciate you guys taking the questions. Hey, Scott, just reflecting back on some of the numbers you laid out in your prepared comments, and I realize I'm splitting hairs here, but you talked about greater than 100% growth in the primary care driven orders. Do you have a growth number for the pulmonology? What I'm trying to figure out ultimately is as you increase the emphasis on primary care, what happens to the growth from the pulmonology community? Speaker 600:26:19That's where I'm trying to go with this question. Speaker 200:26:21Yeah, it's a great question, Thomas. One of the things that we've stated is in some pulmonology practices, we won't see growth, right, because they're moving ordering out into their referral networks. Now we will see growth collectively as an organization as we bring new ordering pulmonologists on. Some of those pulmonologists that have their referral networks ordering, they're still ordering, but it's less than what they were, say, a year ago. So, numbers, we keep track of them, we monitor them as closely as we can. Speaker 200:26:56And in the field, our team structure out there is focused on ensuring that no patients slip through the cracks. That ultimately whatever a pulmonologist was ordering in the past, now that we're in his or her referral network, we should see an increase in ordering because we've gone further upstream. Is that helpful, Thomas? Speaker 600:27:16Yes. That's super helpful. And then sticking with the sales team, I think you said on the last call that you had your goal was to put 50 pulmonology reps in the 50 territories and supplement them with more junior folks, including those calling on primary care. Can you give us an update on kind of what that distribution looks like today with the new reps having come on board? Speaker 200:27:37Yeah, no, you're thinking about it exactly right. So 49 territories, we stated we'll have 50 by year end. Every territory will have a pulmonology sales consultant. That still is the primary focus here. The associate sales consultant and the general practitioner sales consultant, those are going to be a blend. Speaker 200:28:00They're not going to be equal in every territory. We're going to allow what that referral network looks like and pulmonologists supporting us, what guidance they give us. We stated we had our first class that just left. We can share now. We've got less than 10 general practice focused sales consultants out there today. Speaker 200:28:23That will continue to grow. We'll give updates later in the year as to what that mix looks like. But right now, the majority of the focus is on getting those primary care physician support sales reps out there as quick as we can. Speaker 600:28:38Awesome. I appreciate it. Thank you so much. Speaker 200:28:40Thanks, Thomas. Operator00:28:42Thank you. And our next question comes from Kyle Mixon of Canaccord Genuity. Your line is open. Speaker 700:28:53Hi. This is Alex Cason on line for Kyle Mixon. Thanks for taking my question. Congrats on the quarter. One another question on primary care. Speaker 700:29:01So, the ordering from primary care increased about 100% over the pilot program in 2024 that we're running. And as of right now, I guess as of June, about 9% of test orders are going from PCPs. Just curious, where do you think the volume mix could ultimately level out to over time in terms of volume from PCPs and pulmonologists in pulmonology? Thanks. Speaker 200:29:25Hi, Alex. Appreciate the question. It's difficult for us to forecast right now, and we wouldn't want to be presumptuous. Part of the reason we're doing this is to reach that untapped potential in the marketplace. Every territory is going to convert to that differently or at a different cadence. Speaker 200:29:45And just as a reminder, we're not out knocking on doors for primary care physicians. We're following the lead of our pulmonology partners who are helping introduce us back into their referral network. That makes this much more doable Instead of looking at a 250,000 plus primary care physician population, we're utilizing claims data from Definitive Health where we know that eighty percent of those patients really are stuck with about fourteen thousand to 15,000 primary care practices. So we've mapped it out pretty closely, but we want the support of our pulmonology partners in that pulmonology community. So we don't really have an ideal goal. Speaker 200:30:27I think the way we're really looking at success longer term is we want to continue to become the predominant player here that can provide solutions to pulmonologists across the board. The goal for us is to get to more patients with incidentally found nodules so that we can provide value as soon as possible, hopefully positively impacting their long term outcome. Speaker 700:30:51Got it. Thank you. And just one more for me. So we've been talking about the potential impact of HEDIS quality measures for some time now. Is the expectation that these could potentially get in 2025? Speaker 700:31:02And once these are finalized and released, do you believe that they could have an immediate meaningful impact on test volume? Thanks. Speaker 200:31:09Yeah, Alex, great question. I'm glad you brought it up. HEDIS just provided an update. I believe it was the June, maybe the July. Unfortunately, they stated that they're going to put it on hold for this year. Speaker 200:31:25The statement really stated that it's too difficult of a challenge and too complex for them. Specifically, they stated they had concerns about the technical readiness of health plans to adequately capture and report smoking history, the risk of potential harm to patients due to inappropriate or over screening, and the absence of shared decision making within the systems. From our perspective, we're extremely disappointed by this, especially from a patient perspective, but it reflects some of the challenges that we've stated over the last five years. And we've heard from many, many physicians that it is very difficult to implement screening programs within this lung cancer population. The good news for us is our tests work in both lung cancer screening and incidentally found nodules, and so this will be a win for us when it happens because it will increase the number of patients that are eligible for notified testing. Speaker 200:32:25But without that, it still does not impact our forecast in 2025 or 2026. So, we'll continue to work with others to ensure that the decision makers within HEDIS consider this because we all know that the only way we're going to make an impact with the deadliest cancer is to get to these patients sooner, and screening is one of the main ways by which we'll be able to do so. Speaker 700:32:50Got it. Thank you. That's very helpful. Speaker 200:32:52Thank you, Alex. Operator00:32:54Thank you. Our next question comes from William Ruby of TD Cowen. Your line is open. Speaker 800:33:06Hi. This is William on for Dan. I guess my first question would be, what is your view on your capital needs over the next year and a half? Do you still think you have enough room to get to breakeven with some cushion? Just how are thinking about that? Speaker 800:33:18I guess that'll be my first question. Speaker 200:33:21Thanks, William. Appreciate it. Robin, you want to answer that? Speaker 300:33:24Yeah, absolutely. Hi, William. Thanks for joining today. We are absolutely focused on getting to not just adjusted EBITDA breakeven, but also cash flow breakeven. And we think with our existing plans and our growth that we can get there and we can get to cash flow positivity. Speaker 300:33:46And we're doing everything we can to both grow those revenues and keep our expenses as tight as possible to achieve those goals. Speaker 800:33:54Got it. Got it. And then kind of going over to the primary care reps, how confident do you feel that these new reps will be able to maintain $1,000,000 per rep productivity after they ramp? If so, what gives you the confidence? And do you maybe see some upside to that $1,000,000 number given you're expanding in this new market? Speaker 200:34:17Yeah. Great question, William. We appreciate that. What gives us confidence is we saw it in the pilot. And so the pilot really demonstrated that they could ramp similarly to what we've seen with our pulmonology sales consultants, and they were paying for themselves in a similar timeframe. Speaker 200:34:36Now, it's early, but we've seen that with the most recent hires also. They're on a very similar trajectory and path. It's really not about speculating, it's allowing performance to demonstrate that we can do that. And then, on your other question, there is potential to unlock kind of a higher sales rep productivity. That's our average. Speaker 200:34:59We do see some reps in some territories that perform significantly higher than that, and that gives us promise. And so we know that there's a lot of opportunity for upside, And we continually focus on providing a lot of different values to these physicians. Most importantly, our tests, right? They provide significant clinical insights and value to them, but also the support that we provide. So, we'll provide additional success stories as we move forward, specifically to your question around the primary care physicians, but we feel confident that they can continue to contribute at that rate. Speaker 200:35:33But I think you bring up a good question, which is there might be some different value adds we can provide in primary care that allows us to grow and scale faster, and we're excited to explore that. Speaker 800:35:44Awesome. Thank you very much. Speaker 200:35:46Thanks, William. Operator00:35:48Thank you. I show no further questions at this time. I'd like to turn it back to Scott Hutton for closing remarks. Speaker 200:35:56Thank you, operator. In closing, I want to express my gratitude to all the remarkable members of the Biodesics team who've shown unwavering belief in and dedication to our mission, vision, and culture. Our collective commitment and daily contributions are centered around making a positive impact in the lives of patients through their health care providers who are our customers. I'm truly thankful for your efforts. Thank you. Operator00:36:21This concludes today's conference call. Thank you for participating and you may now disconnect.Read morePowered by Earnings DocumentsPress Release(8-K)Quarterly report(10-Q) Biodesix Earnings HeadlinesBiodesix, Inc. (BDSX) Q2 2025 Earnings Call TranscriptAugust 9, 2025 | seekingalpha.comBiodesix Announces Second Quarter 2025 Results and HighlightsAugust 7, 2025 | globenewswire.comBig Changes Coming in August — Is Your IRA Ready?Banks aren’t waiting for the headlines to catch up. They’ve already started moving their wealth out of paper and into something tangible—something with real history behind it. If your retirement savings are still stuck in stocks or bonds, you could be exposed.August 14 at 2:00 AM | Reagan Gold Group (Ad)Biodesix to Present at the Canaccord Genuity 45th Annual Growth ConferenceAugust 5, 2025 | globenewswire.comBiodesix, Inc. to Announce Second Quarter 2025 Financial Results on August 7July 24, 2025 | quiverquant.comQBiodesix to Report Second Quarter 2025 Financial Results on August 7, 2025July 24, 2025 | globenewswire.comSee More Biodesix Headlines Get Earnings Announcements in your inboxWant to stay updated on the latest earnings announcements and upcoming reports for companies like Biodesix? Sign up for Earnings360's daily newsletter to receive timely earnings updates on Biodesix and other key companies, straight to your email. Email Address About BiodesixBiodesix (NASDAQ:BDSX) operates as a data-driven diagnostic solutions company in the United States. The company offers blood-based lung tests, including Nodify XL2 and Nodify CDT tests, together marketed as part of Nodify Lung Nodule Risk Assessment testing strategy, to assess the risk of lung cancer and help in identifying the appropriate treatment pathway and help physicians in reclassifying risk of malignancy in patients with suspicious lung nodules. It also provides GeneStrat ddPCR and NGS, and VeriStrat tests, which are used in the diagnosis of lung cancer to measure the presence of mutations in the tumor and the state of the patient's immune system to establish the patient's prognosis and help guide treatment decisions. In addition, the company, through its partnership with Bio-Rad Laboratories, Inc., provides Bio-Rad SARS-CoV-2 ddPCR, a COVID-19 Test under Biodesix WorkSafe testing program; and Platelia SARS-CoV-2 Total Ab test, an antibody test for detecting a B-cell immune response to SARS-CoV-2 that indicate recent or prior infection. Further, it offers diagnostic and clinical research, as well as clinical trial testing services to biopharmaceutical companies; and discovers, develops, and commercializes companion diagnostics. The company was formerly known as Elston Technologies, Inc. and as changed to Biodesix, Inc. in 2006. Biodesix, Inc. was incorporated in 2005 and is headquartered in Louisville, Colorado.View Biodesix ProfileRead more More Earnings Resources from MarketBeat Earnings Tools Today's Earnings Tomorrow's Earnings Next Week's Earnings Upcoming Earnings Calls Earnings Newsletter Earnings Call Transcripts Earnings Beats & Misses Corporate Guidance Earnings Screener Earnings By Country U.S. Earnings Reports Canadian Earnings Reports U.K. Earnings Reports Latest Articles Brinker Serves Up Earnings Beat, Sidesteps Cost PressuresWhy BigBear.ai Stock's Dip on Earnings Can Be an Opportunity CrowdStrike Faces Valuation Test Before Key Earnings ReportPost-Earnings, How Does D-Wave Stack Up Against Quantum Rivals?Why SoundHound AI's Earnings Show the Stock Can Move HigherAirbnb Beats Earnings, But the Growth Story Is Losing AltitudeDutch Bros Just Flipped the Script With a Massive Earnings Beat Upcoming Earnings Palo Alto Networks (8/18/2025)Home Depot (8/19/2025)Medtronic (8/19/2025)Analog Devices (8/20/2025)Synopsys (8/20/2025)Lowe's Companies (8/20/2025)TJX Companies (8/20/2025)Intuit (8/21/2025)Workday (8/21/2025)Alibaba Group (8/21/2025) Get 30 Days of MarketBeat All Access for Free Sign up for MarketBeat All Access to gain access to MarketBeat's full suite of research tools. 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There are 9 speakers on the call. Operator00:00:00Good day and thank you for standing by. Welcome to the Biodesix Q2 twenty twenty five Earnings Conference Call. At this time, all participants are in a listen only mode. After the speakers' presentation, there will be a question and answer session. To ask a question during the session, you will need to press 11 on your telephone. Operator00:00:21You will then hear an automated message advising your hand is raised. To withdraw your question, please press 11 again. Please be advised that today's conference is being recorded. I would now like to hand the conference over to your speaker today, Chris Brinsey. Please go ahead. Speaker 100:00:39Thank you, operator, and good afternoon, everyone. Today, Biodesix released results from the 2025. Leading the call today will be Scott Hutton, Chief Executive Officer. He is joined by Robin HarperCowie, Chief Financial Officer. An audio recording of today's call and the press release announcement with the quarterly results can be found in the Investor Relations section of the company's website at biodesix.com. Speaker 100:01:08As today's call includes forward looking statements, we encourage you to review the statements contained in today's press release and the risks and uncertainties described in our SEC filings, which identify certain factors that may cause the company's actual events, performance and results to differ materially from those contained in the forward looking statements made on today's webcast. In addition, we will discuss non GAAP financial measures on this call. Descriptions of these non GAAP financial measures and reconciliations of GAAP to non GAAP financial measures are included in today's press release. I would now like to turn the call over to Scott Hutton, Chief Executive Officer. Scott? Speaker 200:01:50Thank you, Chris, and thank you all for joining us today. At Biodesics, our mission is to transform patient care and improve outcomes through personalized diagnostics that are timely, accessible, and address immediate clinical needs. We leverage a multimodal approach that includes genomics, proteomics, and radiomics combined with AI to discover, develop, and commercialize innovative diagnostic tests for physicians, biopharmaceutical, life sciences, and diagnostic companies to help improve patient care. In 2025, we are focused on three main goals, growing our top line revenue, improving operational effectiveness and efficiencies that will result in a positive adjusted EBITDA in the fourth quarter, and advancing our pipeline for future growth and expansion. In the second quarter, we made progress on all three by growing revenue by 12% year over year, improving our already strong gross margins by 150 basis points to 80% and presenting clinical data on multiple pipeline products. Speaker 200:03:01Starting with the clinical offering in lung diagnostics, our major focus is on lung nodule management, where nodules are either found incidentally when the patient has an image taken for another purpose or during low dose CT screening for lung cancer. In our recent earnings calls, we've provided detailed information about our plan to expand our commercial sales efforts to better address gaps in care for patients with lung nodules. Throughout last year, a growing number of ordering pulmonologists provided important feedback stating that ordering the Notify XL2 and Notify CDT test within their referral network would help optimize nodule management. If the tests are ordered earlier, those patients who are at higher risk of lung cancer should be referred on to the interventional pulmonologist. While lower risk patients may remain with the primary care physicians for monitoring. Speaker 200:03:56This feedback was instrumental in the formation and implementation of our territory based sales strategy to engage both pulmonologists and their referral network, including primary care. In the first quarter, we implemented this change and reconfigured our sales team to 49 territories. Each territory is anchored by a pulmonology sales rep with a mix of primary care sales reps and associate sales reps providing support in driving adoption in pulmonology and through their referral network. The specific combination of the sales roles in each territory is tailored to the local clinical need. We believe this approach allows us to directly address the nearly fifty percent of patients with lung nodules currently being managed by primary care physicians outside of pulmonology. Speaker 200:04:50In the second quarter, we completed training of our first full class of primary care sales reps who entered the field in late June. While the first full class has only been in the field for a few weeks, the response from primary care physicians has been encouraging, with physicians recognizing the clinical need and the benefits of improved lung nodule risk assessment with notified testing. Prior to the initiation of our primary care pilot conducted in the 2024, approximately four percent of notified tests were ordered from primary care. And as a result of our targeted efforts, that number has increased to approximately nine percent in June. We're also working on ways to make it easier for clinicians to order and implement our test in their practices. Speaker 200:05:36In fact, one added benefit to our updated sales strategy is the availability of on-site blood draw capabilities within the primary care setting. This has historically been a challenge in pulmonology where we frequently need to leverage our extensive mobile phlebotomy network to collect blood samples for testing. Once a patient leaves the physician's office, we face the all too common challenge of patient compliance to ensure the blood draw is completed. Completing the blood collection on-site before a patient leaves the facility results in 30% more tests delivered than if the patient leaves and needs to schedule a blood draw at another time. Ordering the test in the primary care setting and collecting the sample on-site helps to address this challenge. Speaker 200:06:23In addition, electronic ordering streamlines the process and ease of use for the physicians in their office. Customer retention in those offices who utilize digital ordering is 40% higher than those who do not. Since Notify launch, we've expanded our digital test ordering capabilities through our Biodesix physician portal and a number of early EMR integrations. Through these efforts, our digital ordering has increased by 63% over last year. In the second quarter, we had an average of 74 sales reps in the field who delivered 15,100 total lung diagnostic tests and just under $1,000,000 in annualized revenue per sales rep. Speaker 200:07:08Looking forward, we expect to have an average of 83 to 87 reps in the field in the third quarter and 93 to 97 reps in the fourth quarter, allowing us to drive patient access to cutting edge diagnostic test regardless of where they're being managed. In addition to our commercial efforts, we continue to build the book of clinical evidence supporting the use of our notified test. In the second quarter, health economic and outcomes research data supporting our tests were presented at ISPOR twenty twenty five. And an independent study from a clinical user of the test was presented at ATS twenty twenty five. We are also continuing to make progress with our CLARIFY study, which is a retrospective chart review evaluating the use of notified testing in real world clinical practice. Speaker 200:07:58This trial is expecting to enroll approximately 4,000 patients. Since launch of the study in late October twenty twenty four, we've already accrued over 1,100 patients and anticipate releasing interim data from the study in the second half of this year. Finally, we're pleased to provide an update on our prospective randomized clinical study, ALTITUDE. The data and safety monitoring board met and determined that the study has enrolled a sufficient number of patients to reach statistical power and recommended that patient enrollment close. Patient enrollment closed in late July, and now the investigators continue the mandated one year patient follow-up to track outcomes. Speaker 200:08:42As the company is blinded to the data while the study is ongoing, we do not have any additional information on potential results, but are pleased to see that the sufficient number of patients have been enrolled as we move to the next phase of follow-up. We will provide additional information on the study as it becomes available. Moving to our pipeline. We had multiple presentations on our products and development. Our current pipeline consists of our combination proteomic and genomic MRD tests, expanded indications for Veristrat into several new tumor types with immunotherapy selection, and digital diagnostics. Speaker 200:09:20Multiple presentations on our MRD test were presented in April and May, including at AACR twenty twenty five. Our unique MRD test combines the proteomic information from our risk of recurrence test that can give insights into a patient's immune status, along with tumor informed genomics that leverages the high sensitivity of droplet digital PCR for disease monitoring. At ASCO, new data was presented from the prospective registry study Incyte demonstrating the potential of the Verastrat test in helping to guide first line immunotherapy treatment strategies in patients with non small cell lung cancer and PD L1 of greater than fifty percent. At ASMS, we shared data on the use of the Verastrat test in identifying hormone treatment responses in men with metastatic castration resistant cancer. Finally, we will also share more data on the prognostic significance of Veristrat in multiple MSI high solid tumors in patients eligible for treatment with Keytruda. Speaker 200:10:25These data will be presented by our collaborators at the upcoming ESMO meeting in the fall. Shifting to development services, we continue to see strong interest in our development services offering that leverages our multi omic approach and R and D expertise to help deliver insights that our biopharma, life science tools and diagnostic partners use to personalize patient care and help improve disease detection and treatment decisions across various disease types. In the second quarter, we delivered $2,100,000 in revenue, growing 53% year over year. The funnel has also continued to grow and we exited the quarter with $12,500,000 under contract, representing a 54% increase over last year at this time and an all time high. In early July, Thermo Fisher announced their new NGS assay received FDA approval as a companion diagnostic. Speaker 200:11:23The announcement recognized Biodesics as a key collaborator in the validation of the test. This partnership and approval are key examples of the strength of the Biodesics development services offering, including the test discovery and development, clinical trial testing, and regulatory support for companion diagnostics. We look forward to providing further updates on additional progress with Thermo Fisher and this initiative. Overall, we are very encouraged by the continued strong year over year growth in this business and believe there is significant potential for upside. With that, let me turn it over to Robin to review our financial performance for the quarter. Speaker 200:12:03Robin? Speaker 300:12:05Thanks, Scott, and good afternoon, everyone. Second quarter total revenue was $20,000,000 a 12% increase over the prior year. Lung diagnostic testing revenue in the 2025 was $17,900,000 from approximately 15,100 tests as compared to $16,500,000 from approximately 13,900 tests for the 2024, representing 9% growth in test volumes and representing 8% growth in revenue. Development services revenue was $2,100,000 in the quarter, representing 53% year over year growth. We ended the second quarter with $12,500,000 under contract, and as Scott previously mentioned, this represents an all time high. Speaker 300:12:52Our gross margin percentage in the second quarter twenty twenty five was 80%, up 150 basis points from 78.4% in the 2024. Despite increases in supply costs and existing macroeconomic uncertainty, we expect gross margins to remain in the upper 70s through the rest of the year. Overall operating expense, excluding direct costs and expenses, was $25,700,000 in the second quarter, which was a 15% increase over the 2024. Total SG and A was $22,400,000 versus $19,700,000 a 14% increase, driven primarily by the addition of 13 more active sales representatives, or 21% growth in the number of reps in the field, and the planned expansion Scott has talked about in detail. As Scott noted before, we are continuing to scale the sales team and expect 83 to 87 active sales reps in the field in the third quarter and 93 to 97 in the field in the fourth quarter. Speaker 300:13:54R and D expense was $3,300,000 versus $2,600,000 or a $700,000 increase due to the investment in clinical studies to help advance adoption of our lung diagnostic tests and advancement of our pipeline. Net loss for the second quarter twenty twenty five was $11,500,000 an increase of 6% year over year. Adjusted EBITDA, which excludes non cash and other one time items, was a loss of $7,200,000 which was an increase of 29% year over year. We ended the quarter with $20,700,000 in unrestricted cash and cash equivalents. Cash in the second quarter included the drawdown on the $10,000,000 tranche C loan from Perceptive Advisors. Speaker 300:14:37Cash used from operations in the second quarter was $6,600,000 a 23% improvement over the $8,600,000 in the 2025. We are maintaining our guidance of 80,000,000 to $85,000,000 of revenue for the year. Because of our strong gross margins and the planned and actual expansion of the sales team and the rep productivity achieved to date, we expect to achieve adjusted EBITDA positivity in the fourth quarter. Now I'll turn it back to Scott for some closing thoughts before the Q and A. Scott? Speaker 200:15:10Thank you, Robin. To summarize our achievements, we grew the size of the sales team to an average of 74 sales representatives in the field during the quarter, an increase of 13 reps, up 21%. We increased primary care ordering of lung diagnostic tests over 100% during the quarter versus levels seen prior to the pilot program in 2024. We achieved an all time high in development services business dollars under contract of $12,500,000 up 54%. We announced new clinical and economic data supporting notified lung test at the ISPOR twenty twenty five annual meeting and the ATS twenty twenty five international conference. Speaker 200:15:55We reached patient enrollment requirements in July 2025 for ALPITUDE, with patient follow-up expected to continue for approximately one more year. We presented data on three pipeline initiatives, including the combination genomic and proteomic MRD test at the AACR Annual Meeting, the use of Veristrat in first line immunotherapy treatment selection at the ASCO Annual Meeting, and Verastrat in hormone resistant cancer at ASMS. And we were honored to be recognized as a top workplace for the second consecutive year, a strong reflection of our exceptional team and thriving culture. Before moving on to questions, I want to restate that we have the best lung focused team in diagnostics and continue to make significant progress in building a market in an area that has not historically used diagnostics in the way that other medical or oncology specialties have. With first mover advantage in lung nodule management and an ever increasing body of robust clinical and health economic data, we are generating the momentum to drive greater clinical and payer adoption as we move through 2025 and beyond. Speaker 200:17:07With all that's happening, it's a very exciting time here at Biodesics. We look forward to sharing more with you in the coming quarters. Let's now move to questions. Operator, let's start the Q and A session. Operator00:17:19Thank you. And our first question comes from Andrew Brackmann of William Blair. Your line is open. Speaker 400:17:43Great. Hi, Scott. Hi, Robin. Good afternoon. Thanks for taking the question. Speaker 400:17:47Scott, you gave a lot of commentary on the primary care opportunity and what you're seeing so far. Can you maybe just unpack that a little bit more for us? Perhaps why are you more confident now that this is the right strategy versus maybe the pilot? And I guess related to that, anything with respect to trends that you're seeing now that may be different than the pilot? Thanks. Speaker 200:18:07Yeah. Thank you, Andrew. Great questions. I don't know that there's really anything different. It's just as we gain more experience, it's continuing to reaffirm what we learned during the pilot. Speaker 200:18:18So, if confidence is going up, it's just because we have broader or deeper experiences. And they remain consistent. So, we knew all along that nearly fifty percent of patients are stuck in primary care. That's a big problem. I think what we're finding now is with the support of our pulmonology partners, we're tapping into that. Speaker 200:18:40And so, we think that this is going to expand that market opportunity and maybe more importantly our access to that. We'll continue to provide updates on the progress we see. As we stated, we just had our first class exit. They're in the field. We're continuing to invest and we're always recruiting and expanding the sales force as we disclosed. Speaker 200:19:03So, we'll continue to provide additional progress reports and feedback. But pulmonologists more and more are supporting the strategy. More and more of our existing and ordering pulmonologists want to reach out to their primary care physicians because they see the value. So, it really is why you do pilots like we did. It gives us a lot of insights. Speaker 200:19:24It increases the confidence that we're making the right decisions. And now we're just back out demonstrating that it was the right decision, and we're going to continue to highlight those successes. Speaker 400:19:35That's great color. Thanks for all that. And then with respect to the commentary on electronic ordering, is there anything maybe you can share with respect to the utilization uptick you've seen in those accounts that have begun ordering electronically? And related to that, how do you think about this as a potential way to maybe even open up new customer doors? Thanks. Speaker 200:19:56Yeah, great question, Andrew. I think it may surprise most, but the majority of healthcare practices and hospitals still prefer to utilize facts as the means by which they order or communicate with diagnostic companies and others. And so for us, that is not high-tech, it's not fast, it's not the most accurate means by which we can communicate. And so whether it's full EMR integration or something like our Biodesix physician portal, there are faster means by which we can communicate. And so for us, it's really been around utilization of our portal and EMR integration, kind of the combination of the two. Speaker 200:20:38When individuals use our portal, compliance with the test order improves significantly. And so a way to think about that is when they go to fill out the order request form, utilizing a portal, you can't progress until you've filled in all of the sections of the form. If you submit a fax, there could be spots that are left empty, so that would require one of our customer care representatives to get on the phone, call a practice, and ask for that information. Just in hearing that explanation and example, you can see that that's going to provide a delay. Knowing that lung cancer is the deadliest of all cancers and time matters, we really are focused on being not only as effective as possible, but really how efficient can we be. Speaker 200:21:25So when somebody utilizes a digital ordering platform, whether it's EMR or portal, because of that, we see less tests cancel, right? We see less tests that are submitted without all of the appropriate clinical factors. They're just going to enable that that patient not only stays in the system, but they get the results they need. Is that helpful? Speaker 400:21:48Very helpful. I'll leave it at two. Thanks, everyone. Speaker 200:21:51Thank you, Andrew. Operator00:21:53Thank you. And our next question comes from Bill Bonello of Craig Hallum. Your line is open. Speaker 500:22:02Hey, guys. What a nice turn from last quarter. Couple of questions. Robin, can you help us sort of bridge to EBITDA positive in Q4? I mean, really that's substantial move from this quarter. Speaker 500:22:23And so just trying to understand how much of it is just leverage of revenue growth. Is there cost cutting involved? How do we think about that? Speaker 300:22:34Yeah, absolutely. Hi, Bill. So, it is primarily driven by revenue growth. So, last quarter we talked about the cadence of hiring and how last quarter we were not where we wanted to be, and that we needed to shift to adding the 10 reps per quarter, which we saw this quarter and are well on track for third and fourth quarter. That really catches us up to our original plan of getting to about 95 reps in the field in the fourth quarter. Speaker 300:23:08So, between that and the normal sort of uptick we typically see in our services revenue in the fourth quarter, that's the biggest driver of bridging from where we were in the second quarter to where we expect to be in the fourth. Speaker 500:23:22Okay, that's helpful. So, not necessarily any specific initiatives around operating expenses or anything like that, just leverage? Speaker 300:23:34Yeah. No, we have run very lean for a very long time, and we continue to do so. We've made a lot of operating improvements, and you saw an uptick in our gross margin again this quarter, for which we're very proud, and we're continuing to focus on those. So, the focus on operating expense remains cost containment, running lean, being efficient, and trying to find more operational efficiencies, not just in COGS, but also throughout the rest of the business. But our plan does not include any major cost cutting measures in the third or fourth quarter. Speaker 500:24:16Sure. Okay, that's helpful. And when we think about the acceleration, the revenue growth that's going to happen that's implied in your guidance in the back half of the year. Should we think of that as primarily volume driven and because you're adding the additional reps or is there anything on the ASP side? Speaker 300:24:41Exactly. It's rep driven and volume driven. We've seen nice stability in our ASPs. We're not forecasting in any major changes in ASP at this time. So, yes, it's rep and volume driven. Speaker 500:24:59Okay. And then one last question, if I could, which is, again, when you're thinking about that ramp, how are you thinking about the Development Services? Is Q2 sort of steady from there? Was it outlier high? Does it grow from there? Speaker 500:25:19How are you thinking about that? Speaker 300:25:22Well, we typically see a nice uptick in the fourth quarter, just because of the cadence of how pharmaceutical companies work and their budgets work. The fourth quarter tends to be our strongest quarter of the year. So, we would anticipate an uptick in fourth quarter over second quarter. Speaker 500:25:39Okay. Thank you very much. Speaker 200:25:42Thanks, Bill. Operator00:25:44Thank you. And our next question comes from Thomas Flaten of Lake Street Capital Markets. Your line is open. Speaker 600:25:55Good afternoon. I appreciate you guys taking the questions. Hey, Scott, just reflecting back on some of the numbers you laid out in your prepared comments, and I realize I'm splitting hairs here, but you talked about greater than 100% growth in the primary care driven orders. Do you have a growth number for the pulmonology? What I'm trying to figure out ultimately is as you increase the emphasis on primary care, what happens to the growth from the pulmonology community? Speaker 600:26:19That's where I'm trying to go with this question. Speaker 200:26:21Yeah, it's a great question, Thomas. One of the things that we've stated is in some pulmonology practices, we won't see growth, right, because they're moving ordering out into their referral networks. Now we will see growth collectively as an organization as we bring new ordering pulmonologists on. Some of those pulmonologists that have their referral networks ordering, they're still ordering, but it's less than what they were, say, a year ago. So, numbers, we keep track of them, we monitor them as closely as we can. Speaker 200:26:56And in the field, our team structure out there is focused on ensuring that no patients slip through the cracks. That ultimately whatever a pulmonologist was ordering in the past, now that we're in his or her referral network, we should see an increase in ordering because we've gone further upstream. Is that helpful, Thomas? Speaker 600:27:16Yes. That's super helpful. And then sticking with the sales team, I think you said on the last call that you had your goal was to put 50 pulmonology reps in the 50 territories and supplement them with more junior folks, including those calling on primary care. Can you give us an update on kind of what that distribution looks like today with the new reps having come on board? Speaker 200:27:37Yeah, no, you're thinking about it exactly right. So 49 territories, we stated we'll have 50 by year end. Every territory will have a pulmonology sales consultant. That still is the primary focus here. The associate sales consultant and the general practitioner sales consultant, those are going to be a blend. Speaker 200:28:00They're not going to be equal in every territory. We're going to allow what that referral network looks like and pulmonologists supporting us, what guidance they give us. We stated we had our first class that just left. We can share now. We've got less than 10 general practice focused sales consultants out there today. Speaker 200:28:23That will continue to grow. We'll give updates later in the year as to what that mix looks like. But right now, the majority of the focus is on getting those primary care physician support sales reps out there as quick as we can. Speaker 600:28:38Awesome. I appreciate it. Thank you so much. Speaker 200:28:40Thanks, Thomas. Operator00:28:42Thank you. And our next question comes from Kyle Mixon of Canaccord Genuity. Your line is open. Speaker 700:28:53Hi. This is Alex Cason on line for Kyle Mixon. Thanks for taking my question. Congrats on the quarter. One another question on primary care. Speaker 700:29:01So, the ordering from primary care increased about 100% over the pilot program in 2024 that we're running. And as of right now, I guess as of June, about 9% of test orders are going from PCPs. Just curious, where do you think the volume mix could ultimately level out to over time in terms of volume from PCPs and pulmonologists in pulmonology? Thanks. Speaker 200:29:25Hi, Alex. Appreciate the question. It's difficult for us to forecast right now, and we wouldn't want to be presumptuous. Part of the reason we're doing this is to reach that untapped potential in the marketplace. Every territory is going to convert to that differently or at a different cadence. Speaker 200:29:45And just as a reminder, we're not out knocking on doors for primary care physicians. We're following the lead of our pulmonology partners who are helping introduce us back into their referral network. That makes this much more doable Instead of looking at a 250,000 plus primary care physician population, we're utilizing claims data from Definitive Health where we know that eighty percent of those patients really are stuck with about fourteen thousand to 15,000 primary care practices. So we've mapped it out pretty closely, but we want the support of our pulmonology partners in that pulmonology community. So we don't really have an ideal goal. Speaker 200:30:27I think the way we're really looking at success longer term is we want to continue to become the predominant player here that can provide solutions to pulmonologists across the board. The goal for us is to get to more patients with incidentally found nodules so that we can provide value as soon as possible, hopefully positively impacting their long term outcome. Speaker 700:30:51Got it. Thank you. And just one more for me. So we've been talking about the potential impact of HEDIS quality measures for some time now. Is the expectation that these could potentially get in 2025? Speaker 700:31:02And once these are finalized and released, do you believe that they could have an immediate meaningful impact on test volume? Thanks. Speaker 200:31:09Yeah, Alex, great question. I'm glad you brought it up. HEDIS just provided an update. I believe it was the June, maybe the July. Unfortunately, they stated that they're going to put it on hold for this year. Speaker 200:31:25The statement really stated that it's too difficult of a challenge and too complex for them. Specifically, they stated they had concerns about the technical readiness of health plans to adequately capture and report smoking history, the risk of potential harm to patients due to inappropriate or over screening, and the absence of shared decision making within the systems. From our perspective, we're extremely disappointed by this, especially from a patient perspective, but it reflects some of the challenges that we've stated over the last five years. And we've heard from many, many physicians that it is very difficult to implement screening programs within this lung cancer population. The good news for us is our tests work in both lung cancer screening and incidentally found nodules, and so this will be a win for us when it happens because it will increase the number of patients that are eligible for notified testing. Speaker 200:32:25But without that, it still does not impact our forecast in 2025 or 2026. So, we'll continue to work with others to ensure that the decision makers within HEDIS consider this because we all know that the only way we're going to make an impact with the deadliest cancer is to get to these patients sooner, and screening is one of the main ways by which we'll be able to do so. Speaker 700:32:50Got it. Thank you. That's very helpful. Speaker 200:32:52Thank you, Alex. Operator00:32:54Thank you. Our next question comes from William Ruby of TD Cowen. Your line is open. Speaker 800:33:06Hi. This is William on for Dan. I guess my first question would be, what is your view on your capital needs over the next year and a half? Do you still think you have enough room to get to breakeven with some cushion? Just how are thinking about that? Speaker 800:33:18I guess that'll be my first question. Speaker 200:33:21Thanks, William. Appreciate it. Robin, you want to answer that? Speaker 300:33:24Yeah, absolutely. Hi, William. Thanks for joining today. We are absolutely focused on getting to not just adjusted EBITDA breakeven, but also cash flow breakeven. And we think with our existing plans and our growth that we can get there and we can get to cash flow positivity. Speaker 300:33:46And we're doing everything we can to both grow those revenues and keep our expenses as tight as possible to achieve those goals. Speaker 800:33:54Got it. Got it. And then kind of going over to the primary care reps, how confident do you feel that these new reps will be able to maintain $1,000,000 per rep productivity after they ramp? If so, what gives you the confidence? And do you maybe see some upside to that $1,000,000 number given you're expanding in this new market? Speaker 200:34:17Yeah. Great question, William. We appreciate that. What gives us confidence is we saw it in the pilot. And so the pilot really demonstrated that they could ramp similarly to what we've seen with our pulmonology sales consultants, and they were paying for themselves in a similar timeframe. Speaker 200:34:36Now, it's early, but we've seen that with the most recent hires also. They're on a very similar trajectory and path. It's really not about speculating, it's allowing performance to demonstrate that we can do that. And then, on your other question, there is potential to unlock kind of a higher sales rep productivity. That's our average. Speaker 200:34:59We do see some reps in some territories that perform significantly higher than that, and that gives us promise. And so we know that there's a lot of opportunity for upside, And we continually focus on providing a lot of different values to these physicians. Most importantly, our tests, right? They provide significant clinical insights and value to them, but also the support that we provide. So, we'll provide additional success stories as we move forward, specifically to your question around the primary care physicians, but we feel confident that they can continue to contribute at that rate. Speaker 200:35:33But I think you bring up a good question, which is there might be some different value adds we can provide in primary care that allows us to grow and scale faster, and we're excited to explore that. Speaker 800:35:44Awesome. Thank you very much. Speaker 200:35:46Thanks, William. Operator00:35:48Thank you. I show no further questions at this time. I'd like to turn it back to Scott Hutton for closing remarks. Speaker 200:35:56Thank you, operator. In closing, I want to express my gratitude to all the remarkable members of the Biodesics team who've shown unwavering belief in and dedication to our mission, vision, and culture. Our collective commitment and daily contributions are centered around making a positive impact in the lives of patients through their health care providers who are our customers. I'm truly thankful for your efforts. Thank you. Operator00:36:21This concludes today's conference call. 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