Strong Revenue Growth
Q4 total revenue of $140.6M (management also cited ~$141M) representing 19% year-over-year growth; full-year 2025 revenue of $517M, up 16% year-over-year and at the high end of preliminary range.
Testing Revenue and Volume Expansion
Q4 testing revenue of $135.8M, up 21% YoY; total testing volume ~48,000 tests in Q4 (+16% YoY) and testing volume ~45,500 tests (+16% YoY). Afirma Q4 volume ~18,250 tests (+12% YoY); Decipher Q4 volume ~27,200 tests and marked the 15th consecutive quarter of >20% YoY volume growth.
Improving ASP and Gross Margin
Testing ASP of ~$2,984 in Q4, +4% YoY (normalized ASP $2,875, +1% YoY after PPC adjustment). Non-GAAP gross margin of 75.1% in Q4 (up 580 bps YoY); testing gross margin 76.1% (up 380 bps YoY), driven by operational efficiencies (v2 transcriptome) and PPCs.
Industry-Leading Profitability and Cash Generation
Adjusted EBITDA Q4 $42.3M (30.1% of revenue); full-year adjusted EBITDA margin 27.6% (exceeding 25% target more than a year ahead). GAAP net income Q4 $41.1M and $66.4M for FY2025. Generated $52.6M of cash from operations in Q4 and ended the quarter with $412.9M cash and cash equivalents; cash balance increased by >$120M over the year.
Platform Execution and Operational Efficiency
Completed full transition of Afirma to the more scalable, lower-cost v2 transcriptome (lower no-result rate: 2% improvement Q/Q), restructured Veracyte SAS, and fully moved Afirma volume to v2 enabling better throughput and cost structure.
Decipher Clinical Momentum and Adoption
Decipher ordering physicians increased 18% YoY in Q4; >300,000 prostate patients tested since launch with >100,000 tested in 2025 alone. Management cites ~33% market penetration for Decipher and forecasts sustained double-digit growth (Decipher revenue grew 27% in the quarter).
Evidence and Research Engine
Substantial publication and abstract activity: Decipher prostate >100 clinical utility/validity publications plus ~100 GRID research publications; numerous ASCO GU abstracts for prostate and bladder; Afirma GRID research continues to drive publications—supporting adoption and future product additions (new signatures).
Product Pipeline and Launches Scheduled for 2026
Two major product launches planned in 2026: TrueMRD (whole-genome MRD for muscle invasive bladder cancer) targeted H1 launch after MolDX technical assessment, and Prosigna LDT (PAM50) planned for U.S. launch over the summer on the new transcriptome workflow.
Digital Pathology and Data Assets
Implemented slide scanning as standard production workflow: scanned >210,000 slides from >150,000 patients with outcomes data, creating a large combined digital pathology + transcriptome dataset for future AI and biomarker development.
2026 Guidance Reiteration with Growth Targets
Reiterated 2026 revenue guidance of $570M–$582M (10%–13% YoY); testing revenue growth guidance of 14%–16% with Decipher ~20% growth and Afirma mid- to high-single-digit revenue growth; adjusted EBITDA margin targeted at ~25% for 2026.