BillionToOne — Third Quarter 2026 Earnings Summary

Financial Performance:

• Total revenue reached $123.0 million in Q3 2026, a 47% increase year-over-year from $83.5 million in Q3 2025.
• Prenatal clinical testing revenue was $104.3 million in Q3 2026, up 41% from $74.1 million in Q3 2025.
• Oncology clinical testing revenue was $17.1 million in Q3 2026, a 96% increase from $8.7 million in Q3 2025.
• Clinical trial support and other services revenue was $1.6 million in Q3 2026, up 115% from $0.8 million in Q3 2025.
• Gross profit margin was 71% in Q3 2026, compared to 70% in Q3 2025.
• Total tests delivered were 206,000 in Q3 2026, a 25% increase from 165,000 in Q3 2025.
• Overall Average Selling Price (ASP) was $589 in Q3 2026, an 18% increase from $501 in Q3 2025.
• Income from operations was $11.0 million in Q3 2026, compared to $9.6 million in Q3 2025.
• Net income was $17.4 million ($0.32 per diluted share) in Q3 2026, compared to $1.5 million ($0.10 per diluted share) in Q3 2025.
• Free cash flow was $8.6 million in Q3 2026.
• Cash and cash equivalents were $561.5 million as of September 30, 2026, compared to $496.0 million as of December 31, 2025.
• Long-term debt was $88.98 million as of September 30, 2026, compared to $57.23 million as of December 31, 2025.
• Deferred revenue decreased to $1.91 million (current) and $28,000 (non-current) as of September 30, 2026, from $2.19 million (current) and $1.29 million (non-current) as of December 31, 2025.

Guidance and Future Outlook:

• Full year 2026 revenue guidance was raised to a range of $460 million to $470 million, representing 51% to 54% growth over 2025.
• Previous guidance for full year 2026 was $450 million to $465 million.
• Management expects to continue generating profitability similar to current levels despite significant continued investments.

Business Segments and Product Lines:

• Northstar Clear, a tissue-free MRD test for all solid tumors, is scheduled for commercial launch on December 15, 2026.
• Northstar Response data published in The Journal of Liquid Biopsy showed 94% agreement with the most widely used tumor-informed assay in patients on active treatment for advanced cancer.
• Unity Fetal Risk Screen data published in The Green Journal (Obstetrics & Gynecology) validated the product as a first-line prenatal screen with 94.4% sensitivity and 99.5% specificity.
• Oncology products are growing faster than prenatal products, contributing to higher overall costs per test.

Market and Competitive Landscape:

• Northstar Response demonstrated head-to-head performance against a tumor-informed assay in colorectal cancer.
• Unity Fetal Risk Screen was validated in the largest prospective study of its kind in the intended-use population, conducted with nine U.S. institutions.

Risks and Challenges:

• Forward-looking statements regarding revenue, income, and financial information are subject to risks and uncertainties, including factors beyond the company's control.
• Actual results could differ materially from forward-looking statements due to various factors discussed in the company's Form 10-Q and Form 10-K filings.
• Overall cost per test increased slightly in Q3 2026 due to the faster growth of higher-cost oncology products and a slight increase in prenatal cost per test.

Management Commentary and Tone:

• Dr. Oguzhan Atay, Co-Founder and CEO, described the quarter as a period of "strong execution" with rapid growth and continued GAAP profitability.
• Management noted that more clinicians are choosing tests in both prenatal and oncology segments.
• The CEO expressed pride in the performance and stated the company is in the "early chapters" of what the platform can achieve.

Other Key Points:

• The company announced the upcoming launch of Northstar Clear, a blood-only MRD test available for all solid tumors.
• Net cash provided by operating activities for the nine months ended September 30, 2026, was $37.1 million.
• Purchases of property and equipment for the nine months ended September 30, 2026, were $12.5 million.
• Proceeds from the issuance of debt were $30.0 million for the nine months ended September 30, 2026.
• Proceeds from the exercise of stock options were $12.2 million for the nine months ended September 30, 2026.
• The company hosts a conference call on November 4, 2026, at 1:30pm Pacific Time.