Kevin Conroy: No, thanks, Jeff, and thanks, Catherine, for the question. I’m really proud of what the commercial team has done over the past years since we’ve launched Cologuard, and we continue to evolve the commercial team. There is many things that are contributing to the productivity. I’ll just highlight a couple of things. Number one is the way in which we’ve evolved our territories, we’ve cleaned up the overlap in territories, which have driven deeper customer relations. And I think that’s driving a lot of the acceptance of why now Cologuard is a preferred choice for screening. Number two, we use data and analytics now in terms of who to call on, when to call on, how often we call on those customers. And we’re just much better now in looking and knowing exactly what to call it for the growth, and we review those analytics and who we’re calling on a weekly and monthly, very rigorous process in our commercial organization.
We just don’t do it centrally, but we’re now doing it as a market and area level of where that execution is happening. And then Jeff mentioned €“ kind of mentioned in terms of we’re going to always invest for growth. We’re really focused on health systems. That’s where a lot of our customers and patients are. We’ve increased our amount of account executives at the health systems level, and the conversations now that we’re having around the screening is our health systems are now coming to us and how can we partner for those hard to screen patients where they need to close the care gaps. We saw a lot of that at the tail end of 2022, and that’s going to continue in 2023. I feel bullish that our productivity will continue to improve.
Operator: Your next question comes from the line of Brandon Couillard from Jefferies. Your line is open.
Brandon Couillard: Hi, thanks. Good afternoon. Just a two-part question in terms of the guide for the year, Jeff, what’s embedded for the stock comp expense? And then, Kevin, conceptually speaking, if the top line is, let’s say, running ahead of plan as we move through the year, would it be your preference to reinvest some of those dollars but still deliver on the profitability target or would you let that drop down? Thanks.
Kevin Conroy: Brandon, this is Jeff. The first one, it’s on comp. I think we’ve given you the €“ kind of all the pieces between when you look at the gap, the deal growth in FX, adjusted EBITDA. So I think you can €“ stock comp is probably the biggest piece between there. If you look at last year, which you have that you’ll have in the case you do already, it’s going to grow from there as if you look back at the headcount growth over time. But I think that’s enough to give you the math between the GAAP number and adjusted EBITDA number. Second question on reinvestment.
Jeff Elliott: So in terms of investment, we’re still making enormous investments in new product programs. We’ve touched on the three big ones, colon cancer, multi-cancer early detection and the MRD program. So we also have some minor programs that we’re working on in liver esophageal cancer and endometrial cancer. We’re making those investments today. We’re making significant investments in our IT infrastructure. So we selectively reinvest some of those profits? Yes. Are we bias towards and leading towards letting that fall through? The answer is, yes. The whole company is on board with that. They are driving to it. We’re all rolling together as one team to show the profitability engine that we have, and that’s very important to us.
Operator: Your next question comes from the line of Matt Sykes from Goldman Sachs. Your line is open.
Matt Sykes: Hi. Good afternoon. Thanks for taking my questions. Maybe the first one just on compliance. Jeff, you mentioned some of the enhancements you were making to compliance. And if we add in the rescreen opportunity over time, could you maybe help us frame where you think compliance can go to for Cologuard over the next year or two? And then €“ and just secondly, I’ll ask them both upfront. But secondly, just on Oncotype outside of the U.S., I think you mentioned that sort of the main growth area for you. Could you maybe talk about what you see as sort of the growth rate for ex U.S. within Oncotype for this year? Thanks.
Jeff Elliott: Yes, this is Jeff. I think I’ll handle both of those. Cologuard patient compliance, the way we typically report this out is looking at statistical 12 to 18 months prior. That rate is in the mid-60s percent, so about two of the three patients comply with Cologuard. Over time, expect that to go above 70% €“ possibly is 75%. The reason why I’m confident we will get there is that on rescreening patients, the overall patient compliance rate is 15 to 20 points higher than first line patients. So over time, that’s going to be a big driver of overall lift in the patient’s compliance rate. And we’re making significant investments to enhance that customer experience, better ways for outreach, better ways inactive similar to Cologuard.
And over time, that will naturally bring that patient compliance rate up. The second question on Oncotype DX international growth, there is a significant runway ahead, thanks to the strength of the team there, the strength of the evidence that Kevin alluded to, Oncotype globally is opening up in new markets through reimbursement and access. What we’ve baked into this year is in the U.S., growth there is approaching prevalence plus a point or so. So I think of kind of low to mid-single digits. International will grow faster. It can be easily into the double digits depending on new markets that launched within a given year. This, you expect Japan, which could eventually be the biggest market outside the U.S. We expect Japan to come on potentially midyear, and that can be a big driver starting midyear and into next year.
Operator: Your next question comes from the line of Jack Meehan from Nephron Research. Your line is open.
Jack Meehan: Thanks. Good afternoon. My questions for Kevin are on the blood screening programs. First, can you give an update on the blood portion of BLUE-C? When you expect that to read out? And then second, on MCAD, talked about validating additional markers, can you just talk about how that might be similar or different to what you presented at ESMO and what that might mean for time line for the SOAR study?
Kevin Conroy: Sure. On the first program, we haven’t given specific guidance as to when the colon cancer blood program will read out. The team that is focused on our colon cancer programs are focused both on stool, Cologuard 2.0 and blood. There is a huge amount of effort that is required to prior to testing samples. So there is a rigorous analytical validation studies that are required verification studies, software development and validation. And so there is an enormous amount of rigor that goes into that and preparing the automation entire program and submission that goes to the FDA. You don’t think changes easily. So you need to make sure that, that €“ the manufacturing capability and all the studies are locked down. So the Cologuard 2.0 next-generation Cologuard is first, and then that team will shift its focus to the validation and verification studies for CRC blood afterwards.
In the coming quarters, we will provide more clarity as to when that pivotal study from the blood portion of the CRC program will be complete. In terms of the MCAD marker validation study, we have interim and full trials of the test designed kind of a lockdown study prior to moving into the large prospective study. That study, we expect to read out this year. So two different studies will read out during the year, and that is a much larger version of the data that you saw at ESMO last year. That is €“ that will lock down our final marker classes. And then we expect SOAR to start next year. We would expect that to start in the first half of next year. And all of the team right now is working on perfecting the test, making sure that, that test and the automation surrounding it is locked down before we start that study.
Again, once you start a prospective study or a cancer screening test, you don’t make changes to that product. So it’s totally lockdown.
Operator: Your next question comes from the line of Mark Massaro from BTIG. Your line is open.
Mark Massaro: Hey guys. Thanks for the question and congrats on the progress. My first one is on MRD. So, it’s great to see your planned LDT launch later this year in colorectal cancer. When can we expect to see additional data, which would support reimbursement? And have you had discussions with any Medicare contractors? And then my second question is on the Thrive multi-cancer initiative. I appreciate that additional data will be rolling out this year. But maybe, Kevin, can you just give us a sense, this is not like you are rolling out an LDT. This is kind of a higher risk, bigger opportunity. What types of factors do you think might change the landscape over the next few years that could perhaps increase the probability of success? And then can you give us a sense for the size of the patient enrollment? Is it somewhere near the 80,000 to 100,000-plus mark?
