MDxHealth reported its fourth‑quarter and full‑year 2025 results, posting revenue of $29.5 million—slightly below the consensus estimate of $30.29 million—and an earnings per share of $‑0.17 versus the expected $‑0.13. The company’s full‑year revenue reached $107.9 million, a 20% year‑over‑year increase from $85.9 million in 2024.
The revenue miss was driven by higher operating expenses associated with the ExoDx acquisition, which increased integration costs. Despite a 128% jump in liquid‑based test volumes, tissue‑based test volumes fell 5%, and the mix shift contributed to a modest margin improvement: gross margin rose to 63.2% in Q4 2025 from 62.7% in Q4 2024, and the full‑year gross margin expanded to 64.5% from 61.2% in 2024.
The earnings miss was largely a result of a widened net loss, as operating expenses grew faster than revenue. Management highlighted that operating expenses as a percentage of revenue have been declining over the past three years, underscoring a focus on cost discipline even as the company invests in growth initiatives.
For 2026, MDxHealth guided revenue of $137‑$140 million, representing 27‑30% growth, and an adjusted EBITDA margin of 10% at the end of the year. CEO Michael K. McGarrity said, "We are pleased to report another year of 20% revenue growth which reflects continued operating discipline and commercial execution by our team. Our consistent growth is a result of our strategy to build an incomparable menu of precision diagnostics for urologists and patients navigating the complex diagnostic pathway of prostate cancer."
McGarrity added, "Our growth ambitions go well beyond where we have been and where we are today, which informs our confidence in sustainable growth going forward. We expect our business to accelerate in 2026, reflected in our 2026 guidance of $137‑$140 million representing 27‑30% growth. We also expect to drive improved productivity and operating leverage, leading to a 10% adjusted EBITDA margin exiting 2026."
Investors reacted negatively to the earnings release, citing the revenue and EPS miss as the primary concerns, while the forward guidance was viewed as a sign of management confidence in the company’s growth trajectory.
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