BIODESIX INC annual report, FY2021

Biodesix, Inc. — Form 10-K Summary

Business context and reporting period

Annual report for the fiscal year ended December 31, 2021, with fourth-quarter highlights. Biodesix is a diagnostic testing and services company focused primarily on lung disease. It sells blood-based lung tests, COVID-19 tests and diagnostic research, clinical-trial and companion-diagnostic services to biopharmaceutical companies.

COVID-19 testing remained the largest single revenue source, while the company’s strategy is to grow its core lung diagnostics. The company reported operating as one segment.

Financial performance and liquidity

MetricFY 2021FY 2020 / comparison
Revenue$54.5 million$45.6 million; up 20%
Lung diagnostic revenue$18.7 million$12.6 million; up 49%
COVID-19 testing revenue$30.2 million$28.3 million; up 7%
Biopharmaceutical services revenue$5.6 million$4.6 million; up 20%
Gross profit and margin$24.0 million; approximately 44%$23.6 million; approximately 52%
Operating loss$40.9 million$22.9 million
Net loss$43.2 million, or $1.58 per share$31.4 million, or $6.48 per share
Cash used in operating activities$28.2 million$21.4 million
Cash and cash equivalents at year-end$32.7 million$62.1 million

Gross profit and margin are calculated from reported revenue less direct costs and expenses; margin declined as direct costs grew faster than revenue. Fourth-quarter revenue was $7.2 million, including $5.4 million from lung diagnostics, $1.4 million from services and $0.4 million from COVID-19 testing. Q4 gross profit was $4.7 million, or 65% of revenue, and net loss was $13.3 million.

At year-end, total assets were $76.1 million, total liabilities $56.4 million and stockholders’ equity $19.7 million. Current assets were $43.6 million and current liabilities $29.0 million. The company had $10.0 million principal outstanding under its secured 2021 term loan, following a $20 million repayment in December. The loan carries a floating rate with a 5.25% floor and has an interest-only period through February 2024; final maturity is March 2026.

Material changes versus the prior year

  • Total revenue increased 20%, led by 49% growth in lung diagnostics, principally Nodify XL2 and Nodify CDT. COVID-19 testing revenue increased for the full year, but fell sharply during the year as demand shifted toward point-of-care and at-home tests and the Big Ten contract ended.
  • Direct costs rose 39%, while reported operating expenses rose 39%. Sales, marketing, general and administrative expense increased 45%, reflecting workforce and sales-force expansion, stock compensation and public-company costs. Net loss widened 38%.
  • Operating cash outflow increased by $6.9 million. The year-end cash balance fell by $29.4 million; financing cash flow was only $1.3 million after loan repayments, despite $15.7 million net proceeds from a December at-the-market share offering.
  • The company received forgiveness of its $3.1 million Paycheck Protection Program loan and recorded a gain on debt extinguishment. It also repaid $20 million of its new term loan in December and amended loan covenants.

Outlook, risks, contingencies and unusual items

  • Going concern: The auditor’s report and management state that substantial doubt exists about the company’s ability to continue as a going concern for the following twelve months. Management said its operating plan could result in failure to meet term-loan covenants absent additional capital or covenant relief. Further financing was not secured at filing; if funding is unavailable, management may substantially limit operations.
  • Management outlook: The company expected further improvement in biopharmaceutical services activity in 2022 and viewed declining COVID-19 testing demand as potentially supportive of recovery in lung diagnostics and services. It did not provide a numerical revenue or earnings forecast. Management cautioned that COVID-19 testing demand may moderate and is not a reliable indicator of future revenue.
  • Indi acquisition payment: A milestone triggered a $37.0 million obligation, amended to six quarterly payments of approximately $4.6 million beginning January 2022 and a final payment of approximately $9.3 million in July 2023. The first $4.6 million payment was made in January 2022; future payments require lender consent.
  • Customer concentration: The Big Ten Conference represented 40% of 2021 revenue; Medicare reimbursement represented 18%. The filing also says two customers accounted for 45% of total revenue. The Big Ten contract expired June 30, 2021.
  • Other risks: COVID-19 and variant-related disruption, reimbursement and payer coverage, acceptance of lung tests, competition, regulatory changes affecting laboratory-developed tests, FDA emergency authorizations, single-source suppliers, and dependence on additional capital are significant uncertainties. Bio-Rad is a sole-source supplier for GeneStrat and COVID-19 testing components.
  • Post-year-end financing and facilities: In March 2022, Biodesix entered into a committed, discretionary equity purchase agreement with Lincoln Park for up to $50 million over 36 months, subject to terms and share limits. It also signed a lease for approximately 80,000 square feet in Louisville, Colorado, with a 12-year initial term and substantial future rent and letter-of-credit obligations.
  • Legal matter: A Telephone Consumer Protection Act dispute was settled; a payment of approximately $210,000 was approved in January 2022 and had been accrued in 2021. The company reported no other legal proceedings expected to have a material adverse effect.

Most important facts for investors to verify

  • Whether the company raises sufficient capital and maintains or obtains waivers for its loan covenants, and how the auditor’s going-concern warning affects liquidity.
  • Whether lung diagnostic revenue growth and biopharmaceutical services recovery can offset the decline in COVID-19 testing.
  • The timing, lender consent and cash impact of the remaining $37 million Indi milestone payments.
  • Revenue concentration, especially the loss of the Big Ten contract and the continued importance of Medicare and other major customers.
  • The economics and funding requirements of the new Louisville lease, and the amount of equity ultimately issued under the Lincoln Park facility.