Exagen's Q2 2025: Unpacking Contradictions in Volume Growth, ASP Expectations, and Biopharma Revenue

Revenue and Volume Growth:
- Exagen Inc. reported record revenue of $17.2 million for Q2 2025, representing 14% year-over-year growth.
- The growth was driven by substantial AVISE CTD test volume growth, which was the best since strategic adjustments in 2023, and improved revenue cycle efforts.

Average Revenue per Territory Increase:
- The average revenue per territory reached just over $430,000 for the quarter, a 50% increase since 2021 when John Aballi joined.
- This increase reflects improved commercial leverage and the effectiveness of sales expansion initiatives.

New Biomarkers and ASP Expansion:
- The trailing 12-month AVISE CTD ASP grew $27 year-over-year to $428, driven by new biomarkers launched in January.
- Despite a conservative approach to accrual rates, this expansion is expected to continue as patient deductibles max out and revenue cycles complete.

Pipeline and R&D Progress:
- Exagen's R&D pipeline is advancing, with lupus nephritis and kidney damage markers showing promising results, and the anti-PAD4 biomarkers planned for launch in 2026.
- The company is focused on securing reimbursement for new tools, which will allow for broader patient access.