Exagen's Q4 2024 Earnings Call: Contradictions in ASP, Testing Volumes, and Growth Projections

These are the key contradictions discussed in Exagen Inc.'s latest 2024Q4 earnings call, specifically including: ASP and gross margin expectations, testing volume impact due to natural disasters, ASP expectations and market opportunity for new markers, and volume growth projections:



Record Revenue and Profitability Improvements:
- Exagen Inc. reported record total revenue of $55.6 million for 2024, with an adjusted EBITDA loss narrowing to approximately $10 million.
- The revenue growth was driven by continued improvement in reimbursement and effective operational management.

AVISE CTD Sales and Expanded Market Opportunity:
- The trailing 12-month average selling price for AVISE CTD increased to $411 per test, contributing to gross margins expanding by over 300 basis points.
- This was primarily due to significant progress in reimbursement and the introduction of new biomarkers.

Launch and Impact of New Biomarkers:
- The company developed and commercialized new biomarkers, including T cell and RA33 markers, which added $90 per AVISE CTD test in incremental revenue.
- These markers enhanced the clinical utility of AVISE CTD, leading to increased test volume and reimbursement.

Volume and Sales Strategy:
- Exagen saw a decline in testing volume by 11% in 2024 compared to 2023, primarily due to strategic focus on profitable volume and attrition of ordering physicians.
- The company plans to expand its sales territories to increase patient reach and test volume, focusing on profitable growth.