MDxHealth SA Q4 FY2024 earnings call

Key Points

• 2024 was transformational with 28% revenue growth achieved without expanding the commercial sales organization.
• Q4 total billable volume was ~24,000 tests, 26% unit growth. Tissue-based tests grew 50% Y/Y in Q4 and 31% full-year; liquid-based tests grew 10% Y/Y in Q4 and 28% full-year.
• Gross profit for Q4 2024 was $15.5M, up 22%; operating loss declined 27% to $4.6M; net loss decreased 36% to $6.8M; adjusted EBITDA was negative $1.4M, a 68% improvement over Q4 2023.
• Cash and cash equivalents as of Dec 31, 2024 were $46.8M, with a pending second tranche of debt facility to strengthen the balance sheet.
• Commercial team's strength, clinical value of tests in urology diagnostics, and focus on execution were highlighted.

In the fourth quarter of 2024, total billable volume was approximately 24,000 tests, with total test unit growth of 26%. Tissue-based tests (including Confirm mdx and GPS) had Q4 volumes near 12,000, a 50% increase over the prior year period, and grew 31% for the full year. Liquid-based tests (including Select mdx, Resolve mdx and Germline) had Q4 volumes exceeding 12,000, a 10% increase over the prior year period, and grew 28% for the full year. Q4 2024 revenue was $24.7 million, up 28% from $19.4 million in Q4 2023. Gross profit for Q4 2024 was $15.5 million, up 22%, with gross margins at 62.7% compared to 65.3% in Q4 2023.

• Confirmed 2025 revenue guidance of $108 million to $110 million.
• Aim to achieve 20% revenue growth and cross the adjusted EBITDA threshold in the first half of 2025.
• Germline offering expected to contribute in 2025 but guidance not contingent on significant contribution from it.

Forward-looking statements are subject to inherent risks and uncertainties detailed in the company’s filings with the Securities and Exchange Commission, specifically in the company’s annual report on Form 20-F.

Q: Thomas Flaten asked about how Germline would contribute to 2025 growth.

A: Michael McGarrity said Germline expected to contribute in 2025, with a conservative approach to revenue recognition and payer experience, and not contingent on significant contribution to guidance.

Q: Thomas Flaten asked about gross margins moving forward.

A: Ron Kalfus said they don't give specific guidance on gross margins but expect them to be in the mid-60s for the next few quarters.

Q: Andrew Brackmann asked about OpEx and adjusted EBITDA positivity.

A: Ron Kalfus said growth strategy remains the same, rigorous in evaluating opportunities, and unlikely to be transformative M&A; Michael McGarrity talked about growth strategy and NCCN guidelines impact.

Q: Thomas Vranken asked about test menu and Select Medicare impact.

A: Michael McGarrity said unit revenue growth drives the day, market access team driving coverage expansion with commercial and private payers.

Q: Jason Bednar asked about EBITDA milestone and OpEx.

A: Michael McGarrity said no additional sales investments needed for 2025 targets, focus on execution; on EBITDA milestone, will follow up on KPIs.

Q: Vidyun Bais asked about GPS penetration.

A: Michael McGarrity said significant growth opportunity in GPS with market conversion and market share as growth levers.

Q: Dan Brennan asked about Exact Sciences earn-out.

A: Michael McGarrity said earn-out payments in Q2 each year, incorporated into business plan.