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    MDXH
    Earnings call· Jun 2026(Q2 FY26)

    MDxHealth SA Q2 FY26 earnings call MDXH

    Aug 13, 2026 Source

    Executive summary

    MDxHealth Q2 FY26 — Strong Sequential Revenue Growth and De-risking

    MDxHealth delivered a strong rebound in Q2 FY26, marked by significant sequential revenue acceleration and the successful wind-down of its Resolve UTI business, eliminating a substantial contingent liability. The company is now solely focused on its urology market prostate cancer franchise, leveraging recent study publications and AI initiatives to drive future growth. Management reaffirmed full-year revenue guidance and expects to return to adjusted EBITDA profitability by year-end, supported by a strengthened balance sheet.

    Highlights

    5

    • Generated a 14% sequential revenue increase, or $3.3 million, representing the largest quarter-over-quarter revenue acceleration in company history.

    • Achieved recovery in tissue-based business with a sequential increase of greater than 1,400 tests, following Q4 and Q1 impacts from sales force restructuring.

    • Successfully transitioned all Resolve customers by the end of Q2, maintaining strong customer credibility.

    • Strengthened balance sheet with a $20 million registered direct financing, resulting in a pro forma cash balance of $39.2 million as of June 30, 2026.

    • Eliminated a $10.4 million contingent liability to Novitas by discontinuing Resolve UTI testing and winding down Plano, Texas lab operations.

    Concerns

    3

    • Gross margins decreased by 2.9 percentage points to 65.7% compared to 68.6% in Q2 FY25, primarily due to tissue versus liquid mix.

    • Operating loss increased to $5.1 million compared to $1.5 million in Q2 FY25, driven by increased headcount and operating expenses from the ExoDx acquisition.

    • Adjusted EBITDA was negative $2.3 million, down from positive $1.1 million in Q2 FY25, primarily due to ExoDx acquisition-related expenses.

    Guidance & targets

    2
    CategoryTargetConfidence
    Full-year revenue
    $110 million to $115 million
    high materiality
    High
    Adjusted EBITDA profitability
    positive adjusted EBITDA
    high materiality
    High

    Segment performance

    1
    SegmentRevenueYoYQoQMargin
    Core Operations (Prostate Cancer Franchise)
    Revenue for the second quarter ended June 30, 2026, was $27.2 million, an increase of 16% over the second quarter of 2025. Generated a 14% sequential revenue increase or $3.3 million, representing the largest quarter-over-quarter revenue acceleration in company history. Revenue in the second quarter of 2026 was comprised of 73% from tissue-based tests compared to 96% for the same period last year. Recovery in tissue-based business delivered with a sequential increase of greater than 1,400 tissue-based tests.
    Tissue-based tests revenue contribution: 73% of total revenueTissue-based tests sequential increase: >1,400 tests
    		$27.2 million16%14%—

    Operational metrics

    5
    Adjusted EBITDA
    negative $2.3 millioncompared to a positive $1.1 million for the second quarter of 2025
    Q2 FY26

    Adjusted EBITDA for the second quarter was a negative $2.3 million compared to a positive $1.1 million for the second quarter of 2025. Note that a reconciliation of IFRS to non-IFRS financial measures has been provided in the tables included in this press release.

    Gross Margin
    65.7%compared to 68.6% for Q2 '25
    Q2 FY26

    Gross margins were 65.7% compared to 68.6% for Q2 '25, a decrease of 2.9 percentage points, primarily attributed to tissue versus liquid mix.

    Cash and Cash Equivalents
    $19.2 million
    as of June 30, 2026

    Cash and cash equivalents as of June 30, 2026, totaled $19.2 million.

    Pro Forma Cash Balance
    $39.2 million
    as of June 30, 2026

    In addition, on August 11, we executed a $20 million registered direct placement with existing shareholders. After taking this transaction into account, our pro forma cash balance as of June 30, 2026, would have been $39.2 million.

    Contingent Liability to Novitas
    $10.4 millioneliminated
    prior to Q2 FY26

    Following the discontinuation of Resolve UTI testing, we completed the cessation of our Plano, Texas lab operations and eliminated the $10.4 million contingent liability to Novitas from our corporate structure as a discontinued operation through an organized wind down of that independently operated entity.

    Industry KPIs

    2
    MetricValueDetails
    Pipeline read out calendarOxford PROTECT study
    Clinical trial efficacy safety dataOxford ProMPT study data

    Deals & partnerships

    1
    Existing shareholdersRegistered direct placement of shares$20 million

    On August 11, we executed a $20 million registered direct placement with existing shareholders. After taking this transaction into account, our pro forma cash balance as of June 30, 2026, would have been $39.2 million.

    Risks & headwinds

    4
    Sales force restructuring and integration impactQ4 FY25 and Q1 FY26

    Q4 and Q1 impact on tissue-based business, leading to "choppy" results.

    Mitigation: recovery with a sequential increase of greater than 1,400 tissue-based tests in Q2 FY26; sales force focused solely on this significant market opportunity.

    Seasonality in Q3Q3

    a little bit of a wildcard

    Mitigation: Expects acceleration in Q3 and Q4 in linear-ish overall.

    Gross margin compression due to product mixQ2 FY26

    decrease of 2.9 percentage points to 65.7% in Q2 FY26 from 68.6% in Q2 FY25.

    Mitigation: Expected to be absorbed by revenue growth and return to adjusted EBITDA profitability.

    Increased operating expenses from ExoDx acquisitionQ2 FY26

    Operating loss increased to $5.1 million (vs $1.5 million Q2 FY25); Net loss increased 36% to $9.5 million (vs $7 million Q2 FY25).

    Mitigation: confident that our guidance and associated revenue growth will absorb this increase in acquired operating expenses and return to our trend of adjusted EBITDA profitability as we exit this year.

    What to watch in Q3 FY26

    4

    Full-year revenue guidance achievement

    FY26
    CurrentQ2 FY26 revenue $27.2M, 16% YoY growth
    Target$110 million to $115 million

    Why it matters

    Verifies the company's ability to maintain sequential acceleration and meet its annual revenue targets after strategic shifts.

    All of this progress in Q2 reinforces our commitment to and confidence in meeting or exceeding our full year guidance of $110 million to $115 million in revenue while returning to adjusted EBITDA profitability as we exit this year.

    Q&A highlights

    6

    Inquired if the Q2 sequential increase in tissue-based tests indicated that prior challenges were internal (sales force restructuring) rather than competitive, given competitors' growth.

    Management confirmed that the challenges were internal, stemming from sales force restructuring and territory reorganization in Q4 and Q1. They expect Q2 to signal a return to full sales force focus on their core menu, with no disruption to market position.

    “I kind of signaled we expected Q4 and Q1 to be a little choppy, really a function of the restructuring of the sales organization, right? We had a territory reorganization and then cross-training of the new reps, remapping of the customer base of the combined businesses, and that's really what we saw.”

    asked by Thomas Flaten · answered by Michael McGarrity

    1 min read5 chapters

    Detailed Narrative

    01

    Q2 Performance & Strategic Focus

    The company achieved a 14% sequential revenue increase in Q2 FY26, the largest in its history, demonstrating a strong rebound after the discontinuation of Resolve UTI testing. This performance reflects a renewed focus on the core urology market and prostate cancer franchise, which management believes is a "blessing in disguise" for the company's strategic direction.

    02

    Resolve UTI Wind-down & De-risking

    MDxHealth successfully completed the wind-down of its Resolve UTI business, ceasing operations at its Plano, Texas lab and eliminating a $10.4 million contingent liability to Novitas. This action significantly de-risks the business and allows for a singular focus on the prostate cancer diagnostic pathway.

    03

    Sales Force & Integration Recovery

    Following a period of sales force restructuring and integration post-ExoDx acquisition in Q4 and Q1, the tissue-based business showed recovery with a sequential increase of over 1,400 tests. The sales team also successfully transitioned hundreds of Resolve customers, primarily prostate cancer customers, to other solutions, demonstrating strong execution and customer relationship management.

    04

    Clinical Data & AI Initiatives

    The peer-reviewed publication of data from the Oxford ProMPT study is gaining recognition among urology customers. The company also has "clear visibility" into the potential of the landmark Oxford PROTECT study to transform the active surveillance market for prostate cancer, aiming to establish GPS as the only diagnostic test with NCCN Level 1 evidence in this population. Additionally, AI initiatives are expected to deliver incremental value to customers.

    05

    Financial Outlook & Capital Position

    The company reaffirmed its full-year revenue guidance of $110 million to $115 million and expects to return to positive adjusted EBITDA by the end of 2026. A recent $20 million registered direct financing strengthened the balance sheet, bringing pro forma cash to $39.2 million as of June 30, 2026, providing significant runway for the business.

    AI-generated summary of the company’s earnings call. Not investment advice.