GH: Underpenetrated Market, Catalyst-Rich, + ASP Upside Potential; Initiate Coverage at Outperform

Research evidence excerpt

GH: Underpenetrated Market, Catalyst-Rich, + ASP Upside Potential; Initiate Coverage at Outperform

utilization on top of ASP upside

potential (list price of $8,455 vs. $5,000 prior).

• Third, growing uptake of Guardant Reveal for therapy response

monitoring should have positive knock-on effects for G360 demand, as

Reveal positives could be reflexed to G360 — a dynamic we think could

drive testing frequency well above its current ~1.3x per patient.

2026 potential catalyst calendar far from exhausted. Guardant has

already delivered two of the marquee 2026 catalysts — FDA approval

of Guardant360 Liquid CDx and inclusion of its Shield colorectal cancer

screening test in updated American Cancer Society (ACS) guidelines —

but the calendar remains well-stocked. The two most significant pending

catalysts that could be near term are Medicare coverage decisions for

Guardant Reveal -- a test for minimal residual disease (MRD) -- across two

indications: breast cancer and therapy response monitoring.

Near-term ASP upside. We see several near-term opportunities to expand

ASPs across Guardant's portfolio. First, Guardant360 Liquid CDx carries

a list price of $8,455, up from $5,000 for its predecessors — and we

expect the test to receive advanced diagnostic laboratory test (ADLT) status,

which would allow Guardant to be reimbursed at list by Medicare. Second,

expanding reimbursed indications for Reveal should lift its ASP from the

low-$600s (our estimate) toward ~$1,000 over time. Third, updated ACS

guidelines should improve Shield's reimbursement profile, as ~12 states

mandate commercial payers cover a test once in ACS guidelines.

Valuation: Our $185 price target for Guardant is based on ~12x EV/sales, a

premium to its peer group median of ~6x, which we believe is warranted