Tempus AI (TEM) ☆

Acquired February 2025. Menu spans hereditary cancer, heart conditions, neurological disorders and rare disease; ordered largely by genetic counselors and increasingly by oncologists.

The filing names GeneDx, Variantyx and Baylor Genetics as hereditary competitors with no ranking and no share figures. Absolute contribution is disclosed (about 460,500 hereditary tests and a $362.7M revenue increase in FY2025 from the February 2025 acquisition) but no market size is supplied against which to band it.

A 2012-vintage franchise with real breadth (CancerNext at 40 genes, CancerNext-Expanded at 77, ExomeNext analyzing approximately 20,000 protein-coding genes) and a cited technical differentiator, "+RNAinsight," paired DNA/RNA testing that "analyzes both DNA and functional RNA data to provide more accurate variant classification, potentially resolving variants of uncertain significance," operated from a CAP/CLIA laboratory. It sits at moderate rather than deep because the filing discloses payment on only approximately 50% of hereditary tests in the measured window and names three direct competitors without claiming any advantage over them.

Acquired August 2025 (Paige, Inc., founded 2017); deployed applications for cancer detection from digitized pathology slides plus a pathology foundation model for research and life-sciences use.

The filing gives Paige no share, revenue or volume figure, and names PathAI as a digital-pathology competitor. A first-in-category regulatory clearance is not a market-share position.

The claim here is specific and structural: Paige "has developed and deployed several applications, including the first FDA-cleared AI application in pathology"; its products were refined on "a dataset that includes almost 7 million digitized pathology slide images and associated clinical and molecular data"; and it built "the first million-slide foundation model for cancer." First-in-category clearance plus a proprietary slide corpus at that scale is a real barrier. One caveat: all three characterisations are the filing's own, and the asset has only been inside Tempus since August 2025.

Suite of algorithmic diagnostics computed largely off nucleic-acid data from separately ordered genomic or transcriptomic tests, plus ECG-based cardiology models.

The filing names direct competitors for every Algo (Tumor Origin test: Roche Holdings, Caris Life Sciences, Guardant Health, Illumina; HRD: Myriad Genetics, Caris; digital pathology: PathAI; cardiology: HeartFlow, Anumana, Eko Devices) and quantifies no share, revenue or volume for the Algos line individually.

The cardiology models are "trained using a de-identified subset from approximately 3.5 million ECGs, across more than 800,000 patients, with decades of longitudinal clinical data," and "The FDA granted Tempus breakthrough status for our first ECG software device" for AFib risk; the oncology Algos (Tumor Origin, HRD, DPYD, Purist) inherit the sequencing base because each "uses sequencing data generated as a part of a separately-ordered" Tempus assay. Monetization is explicitly constrained in the same section: "we expect reimbursement will be limited for most Algos at launch and may grow over time as we build additional evidence to support the clinical utility and benefit of each Algo."

Licenses libraries of linked, de-identified clinical, molecular and imaging data plus analytic and cloud-and-compute tools; sold per file or through multi-year data licensing agreements.

What the filing discloses is customer penetration, not share: "We currently work with 19 of the 20 largest public pharmaceutical companies based on 2024 revenue," plus "over 250 biotech companies" and "more than 8,500 physicians" since inception. Named competitors Flatiron Health, IQVIA and ConcertAI are listed without rank or size comparison, and no real-world-data market size appears in the document. Segment revenue is $316.4M for FY2025 (+31%) with no denominator.

The input asset cannot be bought forward: "more than 700 unique data connections... across more than 5,000 healthcare institution sites," a provider network "connected in some way to more than 55% of all oncologists practicing in the United States" and "more than 65% of all academic medical centers," supplying "broad data rights, including the rights to longitudinally updated data from time to time." Stickiness is quantified rather than asserted: net revenue retention was "approximately 126%" for FY2025 against the same prior-year customer cohort. The corpus is fed by the company's own clinical volume, which a pure data licensor does not have.

TIME Trial just-in-time trial-matching network launched June 2019; Tempus Compass (formerly Highline Consulting, acquired January 2022) manages and executes early and late-stage oncology trials.

The filing supports no positional claim here. It names IQVIA, PPD, ICON and Syneos Health as primary Trials competitors without rank or share. Absolute traction is disclosed — "more than 1,400 clinical trials signed into the network," "More than 40,000 patients were identified for potential enrollment... as of December 31, 2025," and site activation "taking approximately 10 days on average in 2025" — but Trials revenue is not broken out in the MD&A comparison, so no share inference is available.

The filing's strongest statement is belief-framed rather than factual: "Prior to Tempus, we believe it would have been virtually impossible to even attempt to build this type of just-in-time program across oncology." It then lists four required ingredients — a widely adopted sequencing business, near-real-time clinical structuring, direct provider and lab data pipelines, and an analytic engine tracking enrollment — which is a genuine interlock with the rest of the platform. It is not deep because the named competitors are the largest CROs in the world and the filing claims no exclusivity, only that the program has "not been implemented at scale in the United States by any other organization," again as a company belief.

Core clinical solid-tumor assay, paired with xR for RNA full transcriptome; part of a portfolio including xF (liquid biopsy), xM (MRD/response monitoring), xE (whole exome) and xG (hereditary cancer risk).

The filing quantifies no market share or rank for xT or for Tempus in precision oncology. The strongest positional language is hedged and company-level ("one of the largest sequencers of cancer patients, and patients with other diseases, in the United States"), and Competition lists Foundation Medicine (Roche), Caris Life Sciences, Guardant Health, Natera, Neogenomics and ResolutionBio (Agilent) without ranking any of them. Absolute volume is disclosed (Oncology tests of about 270,800 in FY2024 rising to about 340,500 in FY2025) but no market denominator appears, so share is not derivable from this source.

The assay is a substantial build: a "Fourth generation test that covers 648 genes at 500x coverage spanning approximately 3.6 Mb of genomic space," a "10-day quoted turnaround time," "Premarket approval (PMA) obtained from the FDA in April 2023" and "Awarded Advanced Diagnostic Laboratory Test (ADLT) status," run through five CAP-accredited and CLIA-certified laboratories. It is not a deep barrier because the filing places Tempus behind peers on this assay's economics: the stated reimbursement goal is to get "more in line with other NGS providers who have adopted similar strategies, such as FMI and Guardant," and payment was received on only approximately 55% of clinical oncology NGS tests performed in the measured window. Several named competitors hold comparable FDA-approved CGP assays, making the PMA a capital-and-time barrier rather than an exclusive one.