Exagen Inc. (NASDAQ:XGN) Q4 2022 Earnings Call Transcript

John Aballi: Certainly, I don’t believe or at least I don’t have it right off hand the exact disclosure in terms of number of contracted lives previously. I know it was limited mostly to contracted lives. On a coverage standpoint hasn’t been as relevant. We haven’t had a proprietary code. So as mentioned, this is a newer effort that the Company is working on. And specifically, we’ve disclosed Medicare coverage, but haven’t disclosed total covered lives. Those contracts applied to prior CPT codes that were used, not the current PLA code. So we either are in the process of amending those contracts or seeking new contracts at the newly established rate. So, it’s something we can disclose in the future. I’m not prepared to do so today, but happy to disclose it in the future.

I think from a coverage standpoint, that’s what we’re heavily focused on right now and we’ll provide updates in that sense. But as it relates to what fluctuations we’ll see on the ASP side, it’s tough to tell. I mean you can have — you can have payers that have a fairly large constituency but that aren’t necessarily represented in terms of our case mix. And so what I mean by that is you may have a plan that has 2 million or 3 million covered lives and yet it’s one of our lower volume plans, and then you can have a smaller regional plan where you actually have a significant concentration from our standpoint. And it — sorry, it actually looks like in the past we have disclosed that the Company has had about 100 million lives under contract so just to follow back on that number previously.

But that’s not necessarily applicable to the current PLA code. So little apples to orders.

Dan Brennan: Great. Are there any like early learnings about the timetable at which it takes to convert a contract now that you have the PLA code, like is it — any way for us to frame that process? And is it months? Could it among two, three, four, five, six, anything that would help us think through like the pace at which those — you can turn those over under the new PLA code?

John Aballi: Sure. So, I think a primary question to be answered there is how strong is the data package? And are you getting traction with your current data set amongst payers? And so our answer to that is we have actually gotten positive medical policy with Highmark and Blue Cross Blue-Shield high mark. And so that’s a very positive thing that’s unfolded for the organization. That’s the new PLA code, and that’s our test cited specifically from a medical policy standpoint. We’re evaluating this year how strong our data package is in our payers’ eyes. We feel pretty confident about it from a clinical utility standpoint, certainly a clinical validity standpoint. We also have a fairly strong economic benefit as well. So from what we believe the payers are looking for, we think we have the data, but that needs to be validated through a cycle or two of medical policy review.

And so, since we’re early on in that stage, I think it’s a little premature to comment, be a little bit more on speculation standpoint. But we’ll continue to provide updates and then maybe some regular cadence can be established. But my experience is that these things are fairly lumpy. You go through a medical policy cycle and you may make progress with a few plans that culminate and some meaningful impact to the Company. And then there may be a period or so where there’s no medical policy review or limited. A lot of medical policies are being reviewed here in the first half. So we should know here in the second half how we’re performing.

Dan Brennan: Terrific. And maybe just one other, and I apologize, I joined a few minutes late, and this may have been asked, but just on the balance sheet and the capital need, just kind of walk us through how we think about 2023 from kind of where you sit today and while you’re not guiding annually like the rate of burn and I know you have the ATM in place, but just how do we think of the pieces to kind of while you have the ongoing cost cutting being implemented now under you, John. Just how do we feel from a capital needs basis in ’23?

Kamal Adawi: Thanks, Dan, for the question. I’ll start it off, and then I’ll pass it back to John. Our cash balance at the end of the year was $62.4 million and it’s tough to look at what our burn was in ’22 and carry forward because we went through some cost-cutting measures at the end of the year. And the cost cutting, the reduction in it took place on December 5, so we don’t have a clean full quarter yet to be able to say take this as a run rate. But what I can speak to help with understanding some of the cost cutting as we did mention, there is about $8.6 million in annualized savings just from the headcount reduction. So that’s a savings that we have quantified. What hasn’t been quantified is how this translates to other OpEx mainly around our R&D and project spend, specifically with some of the clinical trials. That’s going to be a significant savings when you look at the cash burn from ’22 to ’23.

John Aballi: Yes. I think you covered most of it, Kamal. I’ll just speak more from a strategy standpoint that we believe we’re well capitalized and are prioritizing projects, which we think will materially positively impact the business. We’re not sacrificing there. We’re full steam ahead in terms of supporting AVISE CTD and so we’re keeping that very much top of mind, serving customers and improving our service to customers in that respect is very important. But I think we’ll have our Q1 call here in the next couple of months, and I think it will be more indicative of the burn rate going forward, and we work obviously throughout the year to improve that rate.