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Guardant Health (GH)
NASDAQ:GH
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Guardant Health
(NASDAQ:GH)
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Rating:54Neutral
Price Target:
$109.00
▲(5.72% Upside)
Action:ReiteratedDate:02/20/26
The score is held back primarily by weak financial performance (large losses, ongoing cash burn, and balance-sheet strain with negative equity and higher debt). Offsetting this, the latest earnings call was constructive with strong 2026 growth guidance and improving cash burn trajectory, while technical signals are mixed-to-neutral and valuation remains challenged due to losses and no dividend support.
Positive Factors
Sustained revenue and oncology volume growth
Persistent double-digit top-line growth driven by oncology volumes indicates durable product-market fit for Guardant360 and related tests. Large, recurring test volumes support predictable revenue, strengthen payer and pharma partnerships, and provide a scale base for multi-year expansion in diagnostics and trial services.
Improving gross margins and lower per-test costs
Sustained high gross margins and material per-test cost reductions (notably Reveal) reflect operational improvements and tech transitions (NovaSeq X). These structural margin gains enable operating leverage, make a profitable core business more achievable, and support long-term margin sustainability as volumes scale.
Large cash balance and strategic investment runway
A sizable cash balance and targeted M&A provide multi-quarter runway to execute Shield commercialization, evidence generation, and R&D without immediate refinancing. The MetaSight deal strengthens the multi-disease pipeline, supporting durable future revenue streams if development and regulatory paths progress.
Negative Factors
High leverage and negative shareholder equity
Elevated debt and negative equity create structural financial strain, increasing refinancing and covenant risk. Persistent losses could force dilutive capital raises or costly debt terms, limiting strategic flexibility and potentially raising the company’s cost of capital over multiple quarters if profitability inflection is delayed.
Ongoing, structural cash burn from Shield commercialization
Large, sustained investments to scale Shield materially depress company-wide free cash flow and delay consolidated breakeven. If Shield uptake, reimbursement mix, or ASPs evolve slower than planned, the multi-year cash drag could persist, forcing continued reliance on financing and compressing returns on commercialization spend.
Regulatory and reimbursement execution risk
Future growth and sustained pricing critically depend on regulatory approvals and payer decisions. Delays, adverse rulings, or narrower coverage would reduce ASPs, limit screening adoption, and impair biopharma revenue potential, creating multi-month to multi-year downside to the revenue and margin trajectory if catalysts don't materialize.
Guardant Health (GH) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$13.90B
Dividend YieldN/A
Average Volume (3M)1.91M
Price to Earnings (P/E)―
Beta (1Y)1.44
Revenue Growth30.38%
EPS Growth24.17%
CountryUS
Employees1,999
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-1.00
Shares Outstanding129,374,420
10 Day Avg. Volume1,749,686
30 Day Avg. Volume1,906,452
Financial Highlights & Ratios
PEG Ratio4.56
Price to Book (P/B)-128.95
Price to Sales (P/S)13.04
P/FCF Ratio-54.94
Enterprise Value/Market Cap1.06
Enterprise Value/Revenue14.96
Enterprise Value/Gross Profit23.21
Enterprise Value/Ebitda-40.24
Forecast
1Y Price Target
$132.05Price Target Upside28.08% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering21
EPS Forecast (FY)N/A
Revenue Forecast (FY)N/A
Guardant Health Business Overview & Revenue Model
Company DescriptionGuardant Health, Inc., a precision oncology company, provides blood tests, data sets, and analytics in the United States and internationally. The company offers Guardant360, Guardant360 LDT, Guardant360 CDx, and GuardantOMNI liquid biopsy-based tests for advanced stage cancer; and GuardantINFORM, an in-silico research platform that comprise a clinical-genomic liquid biopsy dataset of advanced cancer patients. It is also developing LUNAR-2 test for the early detection of colorectal cancer in asymptomatic individuals eligible; and GuardantConnect, an integrated software-based solution for clinical and biopharmaceutical customers seeking to connect patients tested with the Guardant360 assay with actionable alterations with potentially relevant clinical trials. In addition, the company offers Guardant Reveal Test for neoadjuvant and adjuvant treatment selection in early-stage cancer patients; Guardant360 tissue genotyping product; and Guardant-19 for use in the detection of the novel coronavirus. Further, it offers development services, including companion diagnostic development and regulatory approval, clinical study setup, monitoring and maintenance, testing development and support, and kits fulfillment related services to biopharmaceutical companies and medical institutions. The company was incorporated in 2011 and is headquartered in Redwood City, California.
How the Company Makes MoneyGuardant Health generates revenue primarily through the sale of its genomic testing services. The main revenue stream comes from fees charged for the Guardant360 and GuardantOMNI tests, which are utilized by healthcare providers to guide treatment for cancer patients. Additionally, the company collaborates with pharmaceutical companies in clinical trials to provide genomic insights, which can lead to further revenue through partnerships and agreements. Guardant Health also engages in research and development activities, which may lead to new product offerings and additional revenue opportunities. The company's reimbursement framework, where tests are covered by insurance providers, further supports its financial model by ensuring a broader market access for its services.
Guardant Health Key Performance Indicators (KPIs)
Any
Revenue by Geography
Breaks down revenue across different regions, revealing where the company is strongest and where it may face risk or growth potential due to local economic conditions or market share shifts.
Breaks down revenue across different regions, revealing where the company is strongest and where it may face risk or growth potential due to local economic conditions or market share shifts.
Data provided by:
The Fly
The FlyGuardant Health Earnings Call Summary
Earnings Call Date:Feb 19, 2026
(Q4-2025)
| % Change Since: |
Next Earnings Date:Apr 30, 2026
Earnings Call Sentiment Positive
The call presented a largely positive growth and execution story: strong revenue and volume growth across oncology and screening, improved gross margins and reduced per-test costs (notably for Reveal), meaningful commercial traction for Shield (high adherence, ADLT reimbursement, EMR integrations, Quest/PathGroup partnerships), and improved profitability trends with a solid cash runway. At the same time, significant near-term investments—primarily in Shield—continue to drive company-wide cash burn and operating expenses, and several important upside catalysts (FDA approvals, additional reimbursements, co-promotion benefits) remain uncertain and are not included in the base guidance. Overall the company is growing rapidly with improving margins and clearer path to profitability, but execution and reimbursement risks and continued screening-related cash burn temper the near-term financial picture.Q4-2025 Updates
Positive Updates
Strong Top-Line Growth
Total revenue of $281.3M in Q4 2025, up 39% year-over-year; full-year 2025 revenue of $982.0M, up 33% year-over-year; company provided 2026 revenue guidance of $1.25B–$1.28B (+27%–30%).
Oncology Growth and Volume Expansion
Oncology revenue of $189.9M in Q4, up 30% YoY; oncology volumes ~79,000 tests in Q4, up 38% YoY; full-year oncology revenue $683.6M (+26% YoY) with ~276,000 oncology tests (+34% YoY).
Shield Screening Traction
Shield generated $35.1M in Q4 from ~38,000 tests (vs 24,000 in Q3) and $79.7M for the full year from ~87,000 tests; adherence rate of 93% across first 100,000 Shield tests ordered; ADLT reimbursement secured at $1,495 through Dec 2027.
Margin Improvement and Cost Reductions
Non-GAAP gross margin improved to 66% in Q4 and for the full year (up from 63% Q4 prior year and 62% FY2024); Reveal cost per test fell from >$1,000 in Q3 2024 to under $500 in 2025; Shield non-GAAP gross margin improved to 52% in Q4 with Shield cost per test exiting ~ $450.
Biopharma & Data Momentum and CDx Approvals
Biopharma and data revenue grew 18% for FY2025 to $210.1M and Q4 biopharma & data was $54.0M (+9%); company has 25 CDx approvals to date and announced 5 new CDx approvals in the prior 6 months, including first FDA approval for Guardant360 in CRC.
Improving Profitability Trends
Adjusted EBITDA loss improved to -$64.9M in Q4 (vs -$78.4M prior-year quarter) and to -$220.9M for the full year (vs -$257.5M in 2024); free cash flow burn improved to $233M for 2025 (a $42M improvement).
Strong Cash Position and Strategic Investments
Ended 2025 with approximately $1.3B in cash after MetaSight acquisition and financing, providing runway to execute growth plan; acquired MetaSight for $59M upfront plus up to $90M contingent to accelerate R&D and multi-disease pipeline.
Clear 2026 Growth Drivers and Visibility
2026 guidance expects oncology revenue growth of 25%–27% (volumes ~30% growth), screening revenue of $162M–$174M (210k–225k Shield tests), non-GAAP gross margin 64%–65%, and reduced FCF burn of $185M–$195M with the core business expected to be FCF positive excluding Shield.
Negative Updates
Continued Operating Losses and Cash Burn
Despite improvement, adjusted EBITDA remains negative (Q4 -$64.9M; FY -$220.9M) and company-wide free cash flow burn was $233M in 2025; screening accounted for roughly $220M of the company's 2025 burn and a similar screening burn is expected in 2026.
High Operating Expenses
Non-GAAP operating expenses were $260.0M in Q4 (+21% YoY) and $903.7M for the full year (+19% YoY); FY operating expense modestly above guidance due to increased bonus accrual and reinvestment in screening commercial build-out; 2026 non-GAAP OPEX guided to $1.03B–$1.05B (14%–16% growth).
Shield Investment Weighting and Near-Term Profit Drag
Shield requires heavy commercial investment (sales force expansion, EMR integrations, DTC pilots) and is expected to continue burning cash in 2026 (~$220M screening burn), delaying company-wide cash flow breakeven until later (target end of 2027).
ASP and Mix Pressure for Shield
Shield ASP exited Q4 at ~$850 but management guided to a lower blended ASP in 2026 due to mix shift toward under-65 commercial tests, creating potential pressure on near-term per-test revenue compared with Q4 exit levels.
Dependence on U.S. Market and Execution Risks
International contribution expected to be small in 2026; many 2026 upside scenarios (FDA approvals, SERENA-6 pull-through, Quest co-promotion, ACS guideline inclusion) are not baked into the base guide and represent execution/regulatory risk if they do not materialize.
Competitive and Evidence-Generation Uncertainty in MCED
MCED field remains uncertain after peer trial setbacks noted during the call; Guardant is relying on large-scale real-world data collection and opt-ins to support regulatory/regimen pathways, but timelines and outcomes remain uncertain.
Reimbursement and Regulatory Timing Uncertainties
Key reimbursement/regulatory items (Guardant360 ADLT pricing change, FDA approvals for Guardant360 Liquid CDx, additional MolDx decisions for Reveal therapy monitoring) are expected but not guaranteed and were not fully incorporated into 2026 guidance.
Company Guidance
Guardant guided full-year 2026 revenue of $1.25–$1.28 billion (up 27–30%), with oncology revenue growth of 25–27% and oncology volumes ~30%, biopharma & data expected to grow low double-digits (2025 base $210.1M), and screening revenue $162–$174M driven by 210k–225k Shield tests (vs ~87k tests / $79.7M in 2025). Management expects non‑GAAP gross margin of 64–65% (vs 66% in 2025), non‑GAAP operating expenses of $1.03–$1.05B (14–16% YoY; 2025 was $903.7M), and free cash flow burn of $185–$195M in 2026 (improved from $233M in 2025); excluding screening the core business is expected to be free cash flow positive (midpoint implies ~+$30M). Key product-level metrics in Q4/FY2025 were: total revenue $281.3M Q4 / $982.0M FY, oncology tests ~79k Q4 (~276k FY), Guardant360 liquid ASP $3,000–$3,100, tissue ~$2,000, Reveal $600–$700, Shield ASP ≈$850 (ADLT rate $1,495 secured through Dec 2027), Shield Q4 gross margin 52% and cost/test ≈$450 exit-2025, and Reveal cost/test improved from >$1,000 (Q3 2024) to < $500 in 2025. The company ended 2025 with ~ $1.3B cash, expects continued margin and cost improvements (NovaSeq X transition), and noted upside risks not baked into guidance including potential FDA approvals (Guardant360 CDx), SERENA‑6 ESR1 monitoring, Quest co‑promotion, ACS guideline inclusion and expanded Reveal reimbursement.Guardant Health Financial Statement Overview
Summary
Revenue growth improved (2025 +8.8%) and gross margin remains solid (~64%), but financial risk is elevated due to large ongoing losses (2025 net margin ~-42%, EBITDA margin ~-45%), continued cash burn (2025 FCF about -$233M), and a pressured balance sheet with rising debt (~$1.68B) and negative equity (~-$99M).Income Statement
Revenue growth re-accelerated in 2025 (+8.8% vs. ~0.3% in 2024) and gross margin remains solid (~64% in 2025). However, profitability is still a major headwind: net losses remain large (2025 net margin ~-42%), and operating profitability is deeply negative (2025 EBITDA margin ~-45%), even though losses have narrowed meaningfully versus 2022–2023 levels.42
Neutral
Balance Sheet
Leverage and capital structure are the key concern. Total debt increased to ~$1.68B in 2025 while stockholders’ equity is negative (about -$99M), which signals balance-sheet strain and reduces financial flexibility. Total assets rose to ~$2.01B, but the negative equity position and high debt load elevate refinancing and dilution risk if losses persist.18
Very Negative
Cash Flow
Cash generation is still negative: 2025 operating cash flow was about -$185M and free cash flow about -$233M, with free cash flow deteriorating year over year (down ~11% in 2025). The positive relationship between free cash flow and net income is largely because both are negative (i.e., losses and cash burn occurring together), and the company has not yet demonstrated a clear break-even inflection in cash flow.27
Negative
| Breakdown | Dec 2025 | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 |
|---|---|---|---|---|---|
Income Statement | |||||
| Total Revenue | 982.02M | 739.02M | 563.95M | 449.54M | 373.65M |
| Gross Profit | 633.01M | 449.22M | 336.90M | 293.21M | 250.74M |
| EBITDA | -396.56M | -390.12M | -433.31M | -614.91M | -359.62M |
| Net Income | -416.28M | -436.37M | -479.45M | -654.59M | -405.67M |
Balance Sheet | |||||
| Total Assets | 2.01B | 1.49B | 1.79B | 1.61B | 2.20B |
| Cash, Cash Equivalents and Short-Term Investments | 1.20B | 839.98M | 1.17B | 1.01B | 932.75M |
| Total Debt | 1.68B | 1.34B | 1.35B | 1.37B | 1.37B |
| Total Liabilities | 2.11B | 1.63B | 1.63B | 1.55B | 1.56B |
| Stockholders Equity | -99.31M | -139.65M | 158.68M | 60.18M | 645.00M |
Cash Flow | |||||
| Free Cash Flow | -233.07M | -274.94M | -345.46M | -386.92M | -284.05M |
| Operating Cash Flow | -184.76M | -239.86M | -324.98M | -309.46M | -209.02M |
| Investing Cash Flow | -627.20M | -261.31M | 840.25M | 149.82M | -63.16M |
| Financing Cash Flow | 671.13M | -996.00K | 477.38M | -189.09M | -66.82M |
Guardant Health Technical Analysis
Neutral
103.10
Price Trends
106.43
Negative
95.52
Positive
73.03
Positive
Market Momentum
-0.85
Positive
43.93
Neutral
57.23
Neutral
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For GH, the sentiment is Neutral. The current price of 103.1 is below the 20-day moving average (MA) of 108.11, below the 50-day MA of 106.43, and above the 200-day MA of 73.03, indicating a neutral trend. The MACD of -0.85 indicates Positive momentum. The RSI at 43.93 is Neutral, neither overbought nor oversold. The STOCH value of 57.23 is Neutral, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Neutral sentiment for GH.
Guardant Health Risk Analysis
Guardant Health disclosed 68 risk factors in its most recent earnings report. Guardant Health reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Guardant Health Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
73 Outperform | $29.81B | -94.72 | -29.02% | ― | 38.17% | -28.77% | |
72 Outperform | $10.14B | 24.00 | 11.57% | 3.31% | 5.32% | 336.29% | |
64 Neutral | $19.73B | -93.51 | -8.66% | ― | 14.47% | -353.69% | |
64 Neutral | $11.08B | 47.51 | 3.21% | 0.29% | 3.37% | -18.80% | |
58 Neutral | $5.54B | -396.51 | -1.30% | ― | 11.09% | -165.89% | |
54 Neutral | $13.90B | -33.11 | ― | ― | 30.38% | 24.17% | |
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% |
* Healthcare Sector Average
GH
Guardant Health
103.10
60.66
142.93%
EXAS
Exact Sciences
103.43
52.15
101.70%
RVTY
Revvity
100.33
-14.25
-12.44%
QGEN
Qiagen
48.57
8.80
22.13%
RDNT
Radnet
70.08
9.92
16.49%
NTRA
Natera
212.12
53.75
33.94%
Guardant Health Corporate Events
Business Operations and StrategyFinancial Disclosures
Guardant Health Announces Strong 2025 Preliminary Revenue Growth
Positive
Jan 12, 2026
On January 11, 2026, Guardant Health reported preliminary, unaudited results indicating that 2025 was a breakout year, with total revenue for the year ended December 31, 2025 rising 33% to approximately $981 million and fourth-quarter revenue up 39% to about $280 million versus 2024, driven by strong growth in both oncology and screening volumes. The company reported around 276,000 oncology tests for 2025, up 34%, and a rapid ramp in its Shield colorectal cancer screening franchise to approximately 87,000 tests for the year—including about 38,000 in the fourth quarter compared with 6,400 a year earlier—while expanding Shield to include multi-cancer detection findings; despite this top-line momentum, Guardant remained cash-flow negative, with preliminary free cash flow of roughly negative $54 million in the fourth quarter and negative $233 million for the full year, though it ended 2025 with approximately $1.3 billion in cash and marketable securities and plans to release audited 2025 results in February 2026.
The most recent analyst rating on (GH) stock is a Buy with a $120.00 price target. To see the full list of analyst forecasts on Guardant Health stock, see the GH Stock Forecast page.
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.