• Total Revenue: $55.6 million for 2024, a 6% increase from 2023.
• Adjusted EBITDA Loss: Approximately $10 million for 2024, a 40% improvement over 2023.
• Average Selling Price (ASP): $411 for AVISE CTD, a $75 increase over 2023.
• Gross Margin: Expanded over 300 basis points in 2024, close to 60% for the full year.
• Operating Expenses: $46.7 million in 2024, down 10.5% from 2023.
• SG&A Expenses: $41 million in 2024, a 13% decrease from 2023.
• R&D Expenses: $5.4 million in 2024, up 12% due to new marker launches.
• Cash and Equivalents: $22.2 million at the end of 2024.
• First Quarter 2025 Revenue Guidance: At least $14.5 million.

• Warning! GuruFocus has detected 3 Warning Signs with XGN.

Release Date: March 11, 2025

For the complete transcript of the earnings call, please refer to the full earnings call transcript.

Positive Points

• Exagen Inc (NASDAQ:XGN) achieved record total revenue of $55.6 million in 2024, driven by improvements in reimbursement.
• The company successfully launched new biomarkers for AVISE CTD, enhancing its product offering and clinical utility.
• Gross margins expanded by over 300 basis points in 2024, nearing the 60% mark, due to increased ASP and operational efficiency.
• Exagen Inc (NASDAQ:XGN) reduced its adjusted EBITDA loss to approximately $10 million, showcasing a focus on prudent business operations.
• The company plans to expand its sales territories in 2025, indicating confidence in further growth and market penetration.

Negative Points

• Testing volume in 2024 did not meet expectations, with a decline of 11% compared to 2023.
• The company experienced a 4.5% reduction in its unique ordering physician base year-over-year.
• There is uncertainty regarding the full financial impact of the new biomarkers, with precise ASP and revenue effects still being determined.
• Exagen Inc (NASDAQ:XGN) faced challenges with some physicians unable to support necessary documentation for reimbursement, impacting volume.
• The company is still working on optimizing processes to reduce friction in prior authorization and medical record requests.

Q & A Highlights

Q: Could you provide guidance on how the new markers might impact ASP and gross margins for 2025? A: John Aballi, President and CEO, explained that the $90 increase in ASP from the new markers is based on current cash collections and assumptions about the appeals process. While it's too early to provide precise figures for 2025, the ASP could trend upwards, though not doubling. Gross margins are expected to reach the mid-60s over time with the new markers.

Q: Is there a target for operating cash flow positivity alongside the adjusted EBITDA profitability target for Q4 2025? A: Jeff Black, CFO, stated that adjusted EBITDA is a good proxy for free cash flow on a full-year basis. While there will be increased cash requirements early in the year due to working capital impacts, adjusted EBITDA and free cash flow should align over the year.

Q: How does the launch of RA33 impact sensitivity, and are there any improvements expected this year? A: John Aballi noted that the launch included novel T cell biomarkers, improving lupus diagnosis sensitivity. For RA, the new markers capture about 15-16% of seronegative patients, with further improvements expected by year-end to capture up to 40% of this population.

Q: Could you discuss the potential market size for AVISE in RA compared to lupus? A: John Aballi highlighted that the RA market is significantly larger, with RA prevalence being about eight times that of lupus. The enhanced value proposition with new markers broadens the market opportunity, potentially increasing the utility for clinicians.

Q: What are the expectations for volume growth in 2025, and how will you balance this with profitability? A: John Aballi expects volume growth to improve, potentially reaching high single digits. The company plans to expand sales territories and anticipates increases in the number of ordering physicians and overall test volumes, driven by the new markers and enhanced team quality.

For the complete transcript of the earnings call, please refer to the full earnings call transcript.