Exagen (XGN) Canaccord Genuity's 46th Annual Growth Conference summary

Market and product overview

• Focuses on autoimmune disease diagnostics, especially in rheumatology, serving about 2,800 physicians and holding 3-4% of a $2.2 billion market.

• Proprietary CB-CAPs technology offers disease-specific insights, improving diagnostic accuracy for lupus and rheumatoid arthritis.

• AVISE Lupus algorithm enables diagnosis of lupus 18 months sooner than conventional testing; also improves detection of seronegative RA.

Financial performance and strategy

• Average reimbursement per test increased from ~$280 to $446 over the past few years, driving top-line growth and reducing cash burn to near break-even.

• Strategic shift in 2023 prioritized higher-quality, higher-ASP test volume, resulting in a temporary 20% volume decline but improved profitability.

• Recent quarters show 11% year-over-year test volume growth, with guidance for high single-digit volume and low single-digit ASP growth.

• Q2 EBITDA was near break-even, with sustainable profitability expected at $80 million annual revenue and 63% margin.

Operational improvements and commercial expansion

• Enhanced revenue cycle management and appeals process led to increased out-of-period cash collections and improved reimbursement.

• Sales force expanded from 40 to 45 territories, with revenue per territory rising to $1.5 million.

• Client bill arrangements remain stable despite the loss of a major hospital system partner; strong relationships with remaining partners.