Illumina at JPM 2026: Strong Q4, Clinical Growth, and BioInsight Launch

By Allison Proffitt

January 13, 2026 | Jacob Thaysen returned to the J.P. Morgan Healthcare Conference stage Tuesday with a message of momentum: Illumina is back to growth, and clinical sequencing is driving the train. In his third annual presentation as CEO, Thaysen unveiled preliminary fourth quarter results that exceeded expectations and introduced BioInsight, a new business unit aimed at accelerating drug discovery through AI-powered biological insights.

"I am proud of what the Illumina team delivered in 2025," Thaysen said. "We remain focused on expanding the NGS ecosystem, supporting our customers and accelerating our growth into 26 and beyond."

Q4 Beats Across the Board

The headlines came early: Illumina's Q4 revenue grew 4% on a constant currency basis and 7% excluding China, with earnings per share between $1.27 and $1.30. For the full year, EPS reached approximately $4.76 to $4.79—representing earnings growth of over 15% despite what Thaysen characterized as a year "full of geopolitical changes."

Perhaps more telling was the placement number: 95 NovaSeq X instruments in Q4, surpassing the 91 placements from the prior year's fourth quarter. During the Q3 earnings call, Thaysen had suggested placements wouldn't reach those levels. What changed?

"We were definitely very pleased with the placement of our NovaSeq X," Thaysen said during the Q&A. "It really shows that the performance and the reliability and the number of things you can do on the NovaSeq X is really resonating with our customers." The bulk of placements went to clinical customers "doubling down" on the platform as they prepare to scale new products, though research customers also contributed more than expected, he said.

The consumables story was equally strong. By year end, the NovaSeq X accounted for approximately 80% of high throughput gigabases shipped, up from 75% in Q3. "The math is working and it's working according to the expectations," Thaysen said, referring to the company's long-articulated thesis that volume growth would offset pricing declines as customers transitioned to the X platform.

Clinical Dominance

Perhaps the most significant revelation came in the breadth of clinical strength. While many analysts track Illumina's largest US clinical customers—companies that have been publicly reporting strong results—CFO Ankur Dhingra emphasized that "the strength in clinical business was not just centered in the large US clinical players only. The clinical strength was fairly broad based not just in the US—in Europe and Asia as well."

Clinical customers now represent roughly 60% of Illumina's sequencing consumables revenue, and their sequencing volume continues to grow above 30%. The driver? Deeper, more comprehensive testing. "Many are now converting assays from exome sequencing to whole genome sequencing, which require approximately 15 times increase in sequencing volume," Thaysen explained, citing rare genetic disease testing as one example.

When asked about the timeline for this shift to whole genome approaches, Dhingra noted that whole genome still represents a small fraction of overall clinical volumes today. "A lot of the historical tests were built on exomes and are still validated tests," he said. But new whole genome-based tests are launching, and "we see a long runway from a sequencing volume growth perspective."

China Complexity

The China question inevitably arose. "I guess we can never escape the China question," Thaysen acknowledged. The company spent much of 2025 navigating sanctions resulting from its placement on China’s Ministry of Commerce’s Unreliable Entities List. Illumina was prohibited from exporting sequencers to China and imposing other restrictions due to alleged violations of market rules and discriminatory practices against Chinese enterprises.

In Q4, Illumina was allowed to import instruments back into China for OEM customers, representing about 20% of the opportunity. Thaysen himself traveled to China to meet with officials. "The sanctions have been lifted," he reported, though the company remains on the Unreliable Entities List. "That will be the ultimate goal to get that eliminated at this point. We're working on that, but I still know clear outcome."

The Q4 beat included a China component—roughly a third of the overall beat, according to Thaysen—but it came entirely from consumables, not instruments. "Our customers continue to want to work with us," Thaysen said. "They know who is the innovator in the industry, and they know who is actually providing the highest quality sequencing."

BioInsight: The AI Play

The most forward-looking announcement was BioInsight, Illumina's new business unit focused on generating proprietary datasets and AI models for drug discovery. Thaysen framed it as a convergence of four capabilities: sequencing at scale, CRISPR-based perturbation tools, dedicated compute power, and AI. 

"This fundamentally changed drug discovery," Thaysen said. "Instead of relying on years of iterative wet lab experiments, pharma and biotech companies can increasingly build, test, and refine biological models digitally, accelerating timelines, and improve success rates."

The Illumina Billion Cell Atlas is the first data product to emerge from BioInsight, the world's largest genome-wide genetic perturbation dataset, being built to accelerate drug discovery through AI across the pharmaceutical ecosystem. The company describes the Billion Cell Atlas as, “the first tranche of its program to build a 5 billion cell atlas over three years, and will be the most comprehensive map of human disease biology to date.”

Under an alliance framework with AstraZeneca, Merck, and Eli Lilly as founding participants, the Atlas is already in build for a curated set of cell lines to drive drug target validation, train advanced AI models at scale, and advance research into fundamental disease mechanisms that have previously been out of reach. According to the announcement, Merck will leverage the Atlas to accelerate precision medicine approaches across their drug discovery pipelines. The data will help train the company's proprietary AI/ML foundation models and build virtual cell models, with the aim of improving prediction of disease indications.

The ambition extends well beyond the initial dataset. "Having now both the single cell capabilities, sequencing, compute power, and AI capabilities under our roof, we can really scale this into something that individual customers can't do on their own," Thaysen explained during Q&A.

The BioInsight business ties into Illumina's broader multi-omics strategy, which includes recent launches in single cell sequencing, proteomics (through the acquisition of SomaLogic from Standard BioTools), and an ex-situ spatial solution predicted for the first half of 2026. "You can buy one platform and then you can look at it from the genome all the way up to the proteome," Thaysen said. "Biology is much more complicated than understanding the genome and so getting the additional layers on top of that is going to be very powerful."

Competition and Innovation

Asked about the competitive environment, Thaysen struck a confident tone. "Competition is always good; it keeps us on our toes," he said. But he emphasized that customers aren't simply looking for lower prices—they want comprehensive solutions.

"Customers do not want to pick and choose different components. They want to focus on outcomes," he said, highlighting the combination of NovaSeq X's flexibility with Illumina's Dragen compute power and interpretation software. "The more we can provide our workflows, the more successful we make the customers."

Illumina continues to invest heavily in innovation, including the constellation technology discussed last year at JPM, which has been "getting rave reviews in early access" and is on pace for a launch in the first half of 2026. Constellation reduces library prep requirements and captures information previously difficult to obtain with short-read techniques. "We believe this technology will lead to development of several new clinical application areas," Thaysen said.

Looking Ahead

While Illumina will provide full 2026 guidance during its February 5th earnings call, Thaysen indicated the framework shared during Q3 earnings still holds: "26 is looking like second half 25." He expects clinical demand to remain a key driver, while the research academic environment, though showing some improvement in sentiment, will likely remain "muted" through 2026.

On capital allocation, the company returned $740 million to shareholders via share repurchases in 2025 and maintains strong cash flow generation of approximately $1 billion annually with 140% free cash flow conversion. Priorities remain: invest in innovation, pursue targeted bolt-on acquisitions, and return excess capital to shareholders.

"We feel very good about the progress we've made and where Illumina stands today," Thaysen concluded. "We have a strong core business, growing momentum in clinical markets, and a clear strategy to expand our footprint through sequencing, multi-omics, data, and software."

With preliminary results exceeding expectations and new growth vectors in BioInsight and multi-omics, Illumina's "return to growth" narrative appears increasingly credible. Whether the company can maintain momentum through 2026's uncertainties—geopolitical and otherwise—will be a key question for investors watching the February earnings call.