BillionToOne, Inc. Class A ((BLLN)) has held its Q3 earnings call. Read on for the main highlights of the call.
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BillionToOne’s inaugural earnings call as a public entity exuded optimism, underscored by impressive revenue growth, a successful IPO, and robust gross margins. Despite facing challenges such as negative mix shifts and the necessity for further investment in electronic medical records (EMR), the company’s substantial achievements and strong market position suggest a promising future.
Successful IPO and Strong Capital Position
BillionToOne marked a significant milestone with its initial public offering on NASDAQ, raising $314 million in gross proceeds. This influx of capital has fortified the company’s balance sheet, positioning it well for future growth and expansion.
Impressive Revenue and Growth Metrics
The company reported an impressive $83.5 million in revenue for Q3 2025, reflecting a 117% increase from the same quarter in the previous year. This growth was driven by a 51% increase in test volumes, with a total of 163,000 tests conducted. The annualized revenue run rate now stands at $334 million.
Strong Gross Margin Expansion
BillionToOne achieved a gross margin of 70% in Q3 2025, a significant 17 percentage point increase from the previous year. This improvement was attributed to growth in average selling prices (ASPs) and cost reductions.
Positive GAAP Operating Margin
For the first time, the company reported a positive GAAP operating margin of 11.5%, with expectations to maintain positive GAAP operating income in the future.
Significant Growth in Oncology Segment
The oncology segment experienced remarkable growth, with revenues increasing by 664% to $8.7 million in Q3 2025 compared to the same period last year.
Key Partnerships and Publications
BillionToOne finalized an exclusive agreement with Johnson & Johnson and published studies validating its technology in prenatal and oncology settings, strengthening its market position.
Negative Mix Shift in Gross Margin
The rapid growth of lower-margin oncology products has resulted in a negative mix shift against the higher-margin prenatal products, posing a challenge to the company’s margin expansion.
Investment in EMR Required for Further Growth
To facilitate large volume health system account switches, significant investment in electronic medical records (EMR) systems is required, highlighting a key area for future development.
Uncertainty in Reimbursement and Coverage
BillionToOne continues to work on expanding payer coverage, particularly in Medicaid and Medicare for its oncology products, indicating ongoing efforts to secure broader reimbursement.
Forward-Looking Guidance
Looking ahead, BillionToOne projects total revenue for the full year 2025 to be between $293 million and $299 million, reflecting a growth rate of 92% to 96% compared to 2024. The company plans to continue investing in its sales force and EMR integration to enhance market adoption, while maintaining profitability and focusing on expanding its oncology products and achieving significant milestones in MRD testing by the end of 2026.
In summary, BillionToOne’s first earnings call as a public company painted a picture of robust growth and strategic foresight. With a successful IPO, impressive revenue metrics, and strategic partnerships, the company is well-positioned for future success. However, challenges such as negative mix shifts and the need for investment in EMR systems remain. Overall, the sentiment remains positive, with a clear path outlined for continued growth and expansion.