Exagen Inc. (NASDAQ:XGN) Q4 2023 Earnings Call Transcript

Kyle Mikson: Okay. That was helpful. And then Kamal on like cash burn and then cash collections for first on like prior period collections, I know you had some of that in 2023. Is there any way you could kind of parse that out and help us understand the apples-to-apples comparison with the guidance here? because as you alluded to before, the growth year-over-year is not like robust, I guess, even though underlying strengths, like it’s clear. So, that’d be helpful. And then with cash, it just – it sounds like the cadence is similar to 2023 as – like, it’ll be similar to 2023 in 2024. Does that mean that like the first half of the year cash burn is going to be in line with like the full year burn kind of? Does that make sense? Just, I don’t know. Just kind of parse these things out for us.

Kamal Adawi: Sure. Thanks for the question, Kyle. So, let me address the prior period collections first. Full-year 2023, our prior period collections were around $5 million. We’re very pleased with the progress we made there. The revenue cycle management team made great strides in improving the processes, and it was a big driver for our accomplishments in 2023. So, very happy with that. Now, trying to forecast prior period collections or ASP in general is very challenging, but what I can tell you with how prior period collections should be thought about for 2024 is, while we made great strides in improving the processes, one of the things we’re going to see there is improved time to collect on some of these older tests that weren’t in AR or that were older than 12 months.

So, we believe we made good progress there and we’ll see – we expect to see some additional prior period collections at the first half of the year, but by the back half of the year, I don’t think it’s going to be material or be a discussion point because I think revenue cycle management will have caught up by that point. Now, to address your second point on cash, we ended the year with $36.5 million, and I’m very pleased with the progress we’ve made in terms of reducing our burn and being very focused on our cash. We will see what we saw in 2023 with cash and AR offsetting during the year. So, by holding claims, we will see our cash balance drop and our AR increase and then offset towards the end of the year. I think what you saw in Q4 of this year is exactly what we tried to signal all year in terms of this should offset by end of year.

So, I would expect to see that same cadence in 2024 with AR and cash balance.

Kyle Mikson: Right. Okay. That’s helpful. Kamal, thanks for that. And the final one for John on the three new T cell markers launched in 4Q of this year, that sounds exciting. I just wonder where those came from. The companies had partnerships with health systems and academic labs and even like biopharma companies over the time. So, just was wondering if the markers came from them or were those internally developed?

John Aballi: That’s a good question, Kyle, and if you’ll permit just a little bit of extra detail on them. First of all, these markers are going to be a huge benefit to patients and the clinicians who manage these patients, if you leverage the AVISE test. With our test, we anticipate identifying up to 50% of patients with SLE who would otherwise test negative by traditional biomarker testing. I think that’s a metric that should really resonate with clinicians. Certainly, with patients who have had long journeys in their diagnostic odyssey, it’s a dramatic improvement. We’re very proud to bring these to market. We know that much earlier diagnosis of these conditions can impact patient outcome. And so, we’re excited to contribute to improved care in this way.

In terms of financial performance for our company, as I said, these are not included in our guidance as we lock down a launch date, but it’s going to be materially impactful to our organization. These markers we had license to out of Allegheny. We have a longstanding relationship and collaboration with that organization. It’s been very fruitful with the physician researchers there. We have quite a bit of ongoing research that occurs, but we’ve had license to them for a couple of years now, and we had worked on an abstract over the last 12 to 18 months, had that published at the most recent ACR meeting, and are just very excited about the results and the prospect of bringing these markers to patients. So, hopefully, that gives you a little sense of where they were.

They’ve been licensed to the organization for a couple of years, but we had a heightened focus on AVISE CTD, and it really brought some of these opportunities to light over the last year.

Kyle Mikson: Yes, that was great. Allegheny makes sense. Just actually a follow-up. So, they’re kind of compatible to CB comp technology or is it like – it’s like incremental to that?

John Aballi: So, there are three individual analytes. One of them is cell-bound complement as it pertains to T cell. So, right now, our AVISE CTD offering measures cell-bound complement on the erythrocytes, along with B cells. This would be adding the T-cell component, but then additionally it’s looking at cell-bound IgG and IgM antibodies. And that’s a unique aspect of this disease as well, specifically SLE. So, you’re right in talking about cell-bound complement, but two additional markers are specific antibodies.

Kyle Mikson: Okay. Yes, that sounds great. Thanks guys. Appreciate the time.

Operator: Our next questions are from the line of Dan Brennan – TD Cowen. Please proceed with your question.

Dan Brennan: Thank you. Congrats on the quarter. Maybe could you just walk through, we haven’t plugged all the numbers in yet, but just when we think about the burn for the year, we walk through the assumptions you’ve laid out so far, could you just give us a sense of kind of what’s implied for the cash burn for the year?