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Redefining Molecular Diagnostics with Single-Molecule Precision JPM Healthcare Conference 2026
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2025 Q3 Business Update This presentation contains certain “forward-looking statementsˮ within the meaning of applicable securities laws. These statements relate to future events and results of BillionToOne, Inc. (the “Company,ˮ “we,ˮ “us,ˮ or “ourˮ) and involve known and unknown risks, uncertainties and other factors that may cause the actual results, levels of activity, performance or achievements of the Company or its industry to be materially different from those expressed or implied by any forward-looking statements. In some cases, forward-looking statements can be identified by terminology such as “may,ˮ “will,ˮ “could,ˮ “would,ˮ “should,ˮ “to,ˮ “target,ˮ “expect,ˮ “plan,ˮ “anticipate,ˮ “intend,ˮ “believe,ˮ “estimate,ˮ “predict,ˮ “potentialˮ or other comparable terminology. All statements other than statements of historical fact could be deemed forward-looking, including, but not limited to: our fourth quarter and full years 2025 and 2026 guidance, any projections of market opportunities; any statements regarding expectations for future reimbursement opportunities and health system adoption; any statements regarding the Companyʼs long-term expectations; and the Companyʼs goals and general business and market conditions. The forward-looking statements are based on our beliefs, assumptions and expectations of future performance, taking into account the information currently available to us. These statements are only predictions based upon our current expectations about future events. Forward-looking statements are subject to known and unknown risks, uncertainties and other factors that may cause our actual results, performance or achievements to be materially different from those expressed or implied by such forward-looking statements including but not limited to: our limited operating history and rapid growth; our dependence on sales of our molecular diagnostic tests for our revenue and success; risks relating to the government and other third-party payors failing to provide coverage and adequate payment for our existing and future tests; risks related to our ability to successfully obtain reimbursement from the Medicare program and state Medicaid programs; risks related to our billing and claim processing; risks related to the inherent variability of the insurance coverage and reimbursement landscape; the loss of key members of our senior management team or our inability to attract and retain highly skilled scientists, technicians, clinicians, and sales representatives; risks of damage to or interoperability of our existing laboratory facilities; risks related to our tests in development, including clinical effectiveness or commercial market acceptance; the commercial success of our recently launched tests; risks related to our products meeting the expectations of patients and customers; risks related to international trade policies, including tariffs, sanctions and trade barriers; risks related to legal proceedings, regulatory investigations and inquiries and other legal matters; and risks related to effectively protecting our proprietary technologies. We discuss these and other risks and uncertainties in greater detail under the captions “Risk Factorsˮ and “Managementʼs Discussion and Analysis of Financial Condition and Results of Operationsˮ in filings we make with the Securities and Exchange Commission from time to time. Though we have attempted to identify important factors that could cause actual results to differ materially from those contained in forward-looking statements, there may be other factors that cause results not to be as anticipated, estimated or intended. The assumptions used in the preparation of this presentation, although considered reasonable by us at the time of preparation, may prove to be incorrect. You are cautioned that the information is based on assumptions as to many factors and that actual results may vary from the results projected and such variations may be material. Accordingly, you should not place undue reliance on any forward-looking statements contained herein. We do not undertake to update any forward-looking statements, except in accordance with applicable securities laws. Certain information contained in this presentation relate to or are based on studies, publications, surveys and other data obtained from third-party sources and our own internal estimates and research. While we believe these third-party studies, publications, surveys and other data to be reliable as of the date of this presentation, we have not independently verified, and makes no representations as to the adequacy, fairness, accuracy or completeness of, any information obtained from third-party sources. In addition, no independent source has evaluated the reasonableness or accuracy of our internal estimates or research and no reliance should be made on any information or statements made in this presentation relating to or based on such internal estimates and research. Disclaimer & Forward Looking Statement 2
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2025 Q3 Business Update Scalable Rapid Growth Zero to $334M ARR* in 5 years $100B TAM US** Patented QCT™ technology enabling single-molecule sensitivity Category-defining products in prenatal and oncology Culture of fiscal discipline & efficient operations incorporating AI GAAP profitability & positive cash flows with 10% of accumulated deficit of public competitors 70% gross margin Significant opportunity for further ASP growth and COGS-per-test reductions smNGS: single-molecule next-generation sequencing; QCT™: Quantitative Counting Templates™; ARR: annualized revenue run-rate; TAM total addressable market; ASP average sales price * Q3 2025 revenue of $83.5M annualized as of Sep 30, 2025. Calculated as Q3 multiplied by 4. ** Our estimated US annual market opportunity includes important assumptions, including the number of eligible patients, frequency of testing and ASPs. See our public filings with the SEC for more information regarding our total addressable market calculations and assumptions. Revolutionary smNGS Platform & Products Superior Gross Margin Profile GAAP Profitability Our 4 Pillars of Differentiation 3
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Revolutionary smNGS Platform & Products
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CONFIDENTIAL & PROPRIETARY Pillar 1 — Platform & Technology5 We believe BillionToOne is ushering in the next paradigm in molecular diagnostics. PCR for infectious disease and genetic testing Advanced PCR + early sequencing with Sanger and early NGS focused on specific mutations Deep sequencing for prenatal and oncology cfDNA testing from blood Single-molecule NGS designed to unlock the full potential of cfDNA 1990s 2000s 2010s Now & Future
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CONFIDENTIAL & PROPRIETARY Decode molecular counts from sequencing data Original sample Artificial molecules QCTs™* Amplification and sequencing Unique variable regions Both amplify at same, unknown rate Our patented smNGS platform has single-molecule precision. ** multiple issued patents* Quantitative Counting Templates™ 6 Proprietary Design** Proprietary Machine Learning** Pillar 1 — Platform & Technology
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Our technology transcends the precision vs. scale trade-off ddPCR-level accuracy with NGS multiplex capability 7 Number of loci assayable Precision of measurement ddPCR NGS BillionToOneʼs smNGS encoding 1 10 100 1000 100% 10% 1% Pillar 1 — Platform & Technology
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8 smNGS powers an engineering biology approach to molecular diagnostics Pillar 1 — Platform & Technology Differentiated products on patented foundational technologies Engineering biology approach Patented & proprietary integration of chemistry & bioinformatics ML leads to quantitative data Predictable accuracy Modeled clinical results match readouts Precise laboratory feedback loops Root-cause diagnosis of process inefficiencies
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CONFIDENTIAL & PROPRIETARY LIMITED TO chromosomal changes LIMITED BY lower sensitivity & measurement noise Competing molecular diagnostics are limited. Pillar 1 — Platform & Technology 9 Prenatal Oncology
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Redefining non-invasive prenatal testing Pillar 1 — Platform & Technology10
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Where others stop we keep going. Aneuploidy Microdeletion Recessive Conditions 10 million base pairs Easiest to detect Requires physical limit of precision & sensitivity single base pairs 1 million base pairs Lower accuracy by other methods Ex. cystic fibrosis, sickle cell disease Ex. 22q11.2 microdeletion DiGeorge) Ex. Down Syndrome 11
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CONFIDENTIAL & PROPRIETARY Motherʼs DNA Test Difficult Conversation & Counseling Fatherʼs DNA Test Difficult Conversation & Counseling Amniocentesis Traditional carrier screening misses >58% of affected pregnancies. Pillar 1 — Platform & Technology 58% not completed or unavailable* 1 positive case per 4 amniocenteses 12 * Choates et al. Prenat Diagn. 2020;403311316.
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CONFIDENTIAL & PROPRIETARY Difficult Conversation & Counseling Difficult Conversation & Counseling UNITY is a single blood test that directly identifies fetal risk, simplifying the workflow. Pillar 1 — Platform & Technology not needed significantly reduced need 13 UNITY cfDNA Test Directly identify fetal risk, reimbursed for maternal carrier status Fatherʼs DNA Test Amniocentesis
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CONFIDENTIAL & PROPRIETARY Wynn J, Hoskovec J, Carter RD, Ross MJ, Perni SC. Prenat Diagn. 2023 Sep;431013441354. doi: 10.1002/pd.6427. Epub 2023 Sep 6. PMID 37674263. Hoskovec J, Hardisty EE, Talati AN, Carozza JA, Wynn J, Riku S, Ten Bosch JR, Vora NL, Genetics in Medicine, 2022, ISSN 10983600, https://doi.org/10.1016 UNITY V1 4/22 UNITY will grow to be the new standard in prenatal care. It detects ~3x more affected pregnancies than other methods. Pillar 1 — Platform & Technology Hypothetical Best-Case Scenario Actual UNITY Actual 93%93% 84% 35% Carrier Screening Single-Gene NIPT Missing Paternal Screening ~3X 14 Misattributed Paternity
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Our ordering providers are our strongest advocates. 15 We’ve always known you have the better test, but we just loved the [competitor] rep. We needed to make this change for our patients and we thank you for not giving up on us. — Physician “ UNITY provided a high-risk call for cystic fibrosis and it was confirmed. I’m 100% confident I would have missed it using the traditional carrier method because my patients’ partners rarely get tested. — Physician “ Pillar 1 — Platform & Technology
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From unknown carrier status to prenatal treatment. 16 ● Unknown carrier status for patientʼs partner ● UNITY showed high risk for cystic fibrosis ● Diagnosis confirmed via amniocentesis ● Prenatal therapy initiated at 27 weeks ● Baby passed newborn screening and is doing well Pillar 1 — Platform & Technology CFTR modulator therapy is not currently FDA approved for in utero use. See manufacturer websites for product indications, safety information, and risks. Real-World Patient Case
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Pillar 1 — Platform & Technology17 Redefining liquid biopsy for cancer care
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CONFIDENTIAL & PROPRIETARY We solve oncologists’ two most important unmet needs. Pillar 1 — Platform & Technology What therapy will work best? Therapy Selection Is the therapy working? Response Monitoring Problem: Conventional liquid biopsies miss actionable mutations Our Solution: An ultrasensitive liquid biopsy that detects 50%+ more actionable variants, enabling better therapies Problem: Scan-based treatment response monitoring is imprecise and lagging Our Solution: Tumor burden tracking at a single-molecule resolution quantifies changes in tumor burden months earlier than scans 18
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CONFIDENTIAL & PROPRIETARY Tumor Methylation Score Comprehensive Genomic Profile Time Points A Baseline D CB Pillar 1 — Platform & Technology19 Patient is diagnosed with advanced cancer. Collect single blood sample for both tests. Consider Northstar Select again if cancer progresses to help understand whether a new treatment may be appropriate. >95% of our providers use Select & Response in tandem.
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CONFIDENTIAL & PROPRIETARY Pillar 1 — Platform & Technology20 In a head-to-head clinical study, Northstar Select detected 51-109% more actionable mutations than comparator assays*. * Bower, X., Wignall, J., Varga, M. G., Zhu, J., O’Sullivan, M., Searle, N. E., Hong, L. K., Dogruluk, T., Li, Z., Farmer, T. E., Rosas-Linhard, E., Luong, J., Lin, E., Simon, M. E., Tsao, D. S., Bosch, J. R. T., Palmer, G., Gajra, A., Huynh, C., & Zhou, W. (2025). Validation of a liquid biopsy assay with increased sensitivity for clinical comprehensive genomic profiling. The Journal of Liquid Biopsy, 100322. Note: The percentages are calculated for actionable/reportable mutations when compared to the comparator products in the aggregate. Actual percentages may vary depending on the individual comparator test.
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CONFIDENTIAL & PROPRIETARYPillar 1 — Platform & Technology21 Northstar Response predicts long-term outcomes for immunotherapy in a pan-cancer cohort. Overall Survival (Days) Probability of Overall Survival TMS Non-Responder TMS Responder Overall Survival (Days) * limit of quantification
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CONFIDENTIAL & PROPRIETARYPillar 1 — Platform & Technology22 Real-world patient impact. ● Patient in their 30s, diagnosed with stage II rectal cancer ● Provider ordered tissue NGS, MSS negative; proceeded with chemotherapy ● Northstar Select clarified MSI status to MSIHIGH, unlocking the opportunity to treat with anti-PD1 therapy IO ● Treatment changed from chemotherapy to anti-PD1 therapy with high probability of cure Northstar Select Report Results Real-World Patient Case
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Scalable Rapid Growth
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Our total test volume is rapidly increasing with 51% YOY* growth. Pillar 2 — Scalable Rapid Growth24 Test Volume Quarterly 163K • Increased geographic coverage via systematic growth of sales team • Growth in each geography, which is only limited by access, logistics & onboarding speed • Land & expand within clinics • Increased in-network status * Withdrawal from AL & OK due to Medicaid non-coverage * * Total test volume estimated in Q3 2025 compared to Q3 2024. Test volume represents the number of tests for which we deliver a result to the ordering provider in such period. 51%
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Multiple levers for further commercial growth. 25 Our existing sales reps have been adding We land and expand within clinics with new clinics every quarter*salesforce size of many of our competitors We currently have <20% 100+ 100%+ net test retention for majority of clinic cohorts** * As of the 4 quarters preceding Sep 30, 2025 Pillar 2 — Scalable Rapid Growth **Net test retention is the net number of tests that are retained quarter over quarter for a particular cohort of clinics commencing in a quarter
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Pillar 2 — Scalable Rapid Growth Our ASP is rapidly growing. • Reached 235M in covered lives* . • More Medicaids loading & covering UNITY carrier panel 0449U Overall ASP** $501 * Represents number of individuals covered under contracts with payors in the US **Overall ASP is the weighted average ASP across all of our prenatal and oncology products. It is computed by dividing revenue for our prenatal and oncology tests by the number of tests that are delivered and billable. The number of tests that are delivered and billable in a given period represents that number of billable tests for which we deliver a result to the ordering provider in such period. 26
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CONFIDENTIAL & PROPRIETARY We believe ASP can increase further with expansion of contracting & coverage. Pillar 2 — Scalable Rapid Growth 27 ASP PRENATAL ONCOLOGY Further contracting from 225M to 300M lives Response MolDx coverage Increased RhD and sgNIPT coverage 22q guideline inclusion Expanded panel guideline Select ADLT pricing via FDA approval
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2025 Q3 Business Update Exponential revenue growth: zero to $334M* ARR in ~5 years. Pillar 2 — Scalable Rapid Growth Total GAAP Revenue Quarterly $83.5M *Q3 2025 revenue of $83.5M annualized as of Sep 30, 2025. Calculated as Q3 multiplied by 4. Exponential defined by percentage growth rate within the same time interval remaining constant for the past 4 quarters (consistent 7590% YOY growth) Percentage growth rates represent growth from Q3 2024 to Q3 2025 117% • 25% QoQ increase in revenue • Driven by rapid increases both in test volumes and ASP across all products 28
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2025 Q3 Business Update Oncology GAAP Revenue Quarterly Pillar 2 — Scalable Rapid Growth 664% $8.7M Q3 Q3 Prenatal GAAP Revenue Quarterly $74.8M* 101% * Includes revenue associated with clinical trial services 29 Percentage growth rates represent growth from Q3 2024 to Q3 2025
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Superior Gross Margin Profile
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2025 Q3 Business Update 70% gross margin* with continuing rapid expansion. Pillar 3 — Superior Gross Margin Profile * For Q3 2025 $348 $384 $444 $455 $501 70% Gross Margin Overall ASP Overall COGS Per Test Gross Margin Quarterly 53% 57% 64% 65% 31
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GAAP Profitability
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Achieved profitability with ~10% accumulated deficits of many other public competitors* Pillar 4 — GAAP Profitability Operating Income/Loss Margin Operating Income $40M $74M $70M $47M $6M*Comparison includes the accumulated deficits reported by public company competitors Caris Life Sciences $2.5B, Guardant Health $2.6B, Natera $2.6B, and Tempus AI $2.2B 33
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CONFIDENTIAL & PROPRIETARY Emerging profitability achieved through continual, multi-pronged cost improvement. Pillar 4 — GAAP Profitability AI and automation is embedded in all our operations to optimize productivity. 50% claims with only 15% higher headcount Reimbursement 50% higher collection with only 15% higher headcount Patient Billing 30% of code is AI-generated Engineering 100 COGS projects contributed to reducing COGS by 50% in 36 months. COGS Focus 4x higher test volume with 2x labor costs Lab Automation 34
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And we’re just getting started. 35
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CONFIDENTIAL & PROPRIETARY $72M $153M We’re achieving profitability while growing exponentially. Pillar 4 — GAAP Profitability36 Previous Projections JPM 2025 Current Projection 80% CAGR Projections Actuals $293M $299M $415M - $430M Projections vs Actuals Historical Projections Previous vs Current
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CONFIDENTIAL & PROPRIETARY We believe our smNGS platform will drive our continued and rapid growth in $100B markets. Carrier Screening Launched 2019 Therapy Selection Launched 2023 Therapy Monitoring Launched 2023 $15B+ Minimal Residual Disease Planned Early Detection Potential $30B+ $6B Aneuploidy Testing Launched 2020 $1B $1.5B $50B+ PRENATAL ONCOLOGY Next Steps37
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Next Steps We are transforming healthcare: one molecule at a time, one patient at a time. Single-molecule level sensitivity with single base pair resolution To build a category-defining company and enter the S&P 500 Unique, paradigm- changing products Exponential growth at scale Extremely efficient operations & emerging profitability LONG-TERM GOAL 38
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Thank you Oguzhan Atay, PhD CEO oatay@billiontoone.com 39