0002070849-26-000031
SEC filingRevenue grew 84% to $108.4M, driven by volume and ASP gains, turning to net income of $18.0M.
Revenue for the three months ended March 31, 2026 was $108.4 million, an 83.8% increase compared to $59.0 million in the same period of 2025. The growth was driven by a 44% increase in delivered test volume (to approximately 188,000 tests) and a 28% increase in overall ASP (weighted average selling price). ASP gains resulted from expanded payor contracts and proprietary PLA code benefits. Gross profit rose 108.3% to $79.1 million, with gross margin expanding to 73.0% from 64.4% in the prior year. The margin improvement stemmed from higher ASP and operational leverage, partially offset by a 1% increase in cost per test due to a shift toward higher-cost oncology tests. Operating income was $17.8 million, compared to a loss of $2.3 million, reflecting strong revenue growth and cost discipline. Net income reached $18.0 million versus a net loss of $4.0 million in Q1 2025.
Prenatal testing remains the dominant revenue driver, accounting for 89% of total revenue ($96.5 million) in Q1 2026, up from 95% ($56.0 million) in Q1 2025. Oncology testing revenue grew significantly to $10.8 million (10% of total) from $2.4 million (4% of total) in the prior year, representing a 359% increase. The oncology segment benefited from expanded sales force and new product launches, including Northstar PGx and Northstar Select CH in early 2026. Clinical trial support and other services remained negligible at 1% of revenue. The mix shift toward oncology, which carries higher cost per test, contributed to the slight overall cost increase but was more than offset by ASP gains.
Management highlighted several growth drivers: continued payor contract expansion, new product introductions (e.g., Unity Confirm launch in May 2026, MRD test expected in Q4 2026), and operational efficiency initiatives including automation and AI. The company expects research and development costs to increase in absolute dollars but decline as a percentage of revenue over time. Selling, general and administrative expenses will rise to support sales force expansion and public company costs. The company maintains a strong liquidity position with $537.5 million in cash and equivalents, and believes current funds are sufficient for at least 12 months. Key risks include sustaining positive operating income and cash flows, and successful execution of product launches and payor contracting.
As of March 31, 2026, BillionToOne held $537.5M in cash and cash equivalents, up from $496.0M at year-end 2025, driven by $30.0M in debt issuance and $15.4M in operating cash flow. Total debt, including finance lease liabilities, stood at $90.6M ($90.0M in long-term debt plus $0.6M in financing lease liabilities). The company maintains a strong liquidity position with no marketable securities. Shareholders' equity increased to $505.6M from $480.1M, primarily due to net income and stock-based compensation.
The notes disclose remaining performance obligations under the J&J partnership of approximately $7.6M as of March 31, 2026, expected to be recognized over the next three years. No other material purchase commitments (e.g., inventory or capacity) were disclosed. The company has debt covenants requiring minimum trailing six-month net revenue (e.g., $87.2M for Q1 2026) and gross margin of at least 30%. As of Q1 2026, the company met these thresholds.
Capital allocation activities included the mandatory draw of the third tranche of $30.0M under the Oberland note purchase agreement on March 31, 2026. The company made no share repurchases or dividend payments. Capital expenditures totaled $4.5M (4.2% of revenue), primarily for property and equipment. The company also made $0.5M in revenue participation payments under the debt agreement, classified as interest.
BillionToOne operates as a single reportable segment, but discloses revenue by service line: Prenatal ($96.5M, +72% YoY), Oncology ($10.7M, +392% YoY), and Clinical trial support ($1.1M, +61% YoY). Substantially all revenue is generated in the United States. The prenatal segment remains the dominant revenue driver, though oncology is growing rapidly from a small base.
Operating cash flow (CFO) of $15.4M significantly exceeded the net loss of $4.0M in Q1 2025 and net income of $18.0M in Q1 2026? Wait, net income was $18.0M in Q1 2026. Actually the statement shows net income (loss) for 2026: $17,970 (positive), so net income. CFO of $15.4M is lower than net income due to working capital outflows (accounts receivable increased $19.7M, inventories $1.7M). Stock-based compensation ($6.5M) and depreciation ($1.7M) added back, but working capital consumed cash. Capex increased to $4.5M, reflecting investment in property and equipment, resulting in negative free cash flow (CFO minus capex = $10.9M, though not explicitly stated). Financing activities provided $30.5M, mainly from $30M debt issuance, offset by $0.5M deferred offering costs and $0.2M lease payments. No share repurchases or dividends. The company raised debt to fund operations and capex. The large working capital investment in receivables may indicate rapid revenue growth. Overall, cash flow generation from operations improved dramatically from prior year but remains capital-intensive.