Exact Sciences (EXAS) 8 May 242024 Q1 Earnings call transcript

Thank you for standing by. My name is Danica, and I will be your conference operator today. At this time, I would like to welcome everyone to the Exact Sciences First Quarter 2024 Earnings Call. [Operator Instructions]. Thank you. to Relations. call like Holznecht, to now Investor Manager, would turn over the Erik I ahead. go Please

Thank Danica, for XXXX thank you Conference First Exact Call. Quarter Sciences' joining us for

and Kevin On Everett today Bloomer, Cunningham, Financial Officer, announced Executive Finance, Commercial Financial Conroy, as CEO; of Aaron Jeff will President our available we the Officer; the Chief and Elliott, are for also Officer. company's who call Vice our Chief our Chief questions. Chairman be recently next

afternoon this presentation earlier our release our news a issued news today's Sciences financial quarter and website This are detailing results. Exact first on at release exactsciences.com. available

During make will forward-looking expectations. on current today's call, statements we based

in may figures are release can our and our Discussions be results risks be from different descriptions of of actual -- through now and such Kevin. uncertainties Sciences over GAAP turn non-GAAP to filings. Exact the associated with statements. SEC Both to accessed available the I'll call earnings Our reconciliations and included press materially are our in website. figures

team Exact start strong the Erik. to The a to is off year. Thanks, Sciences

Gallup first proprietary Workplace, health ordering oncology patients. ExactNexus, and oncology channel. advanced the our towards quarter, of for to our health making to a precision moving federally year-over-year, among in adoption and During systems, Expanding of Oncotype Highlights test on large only organized Being a number Cologuard risk qualified our our programs companies international include XX% our payers increasing portfolio globally eradicate systems, than prestigious payers providers given precision adoption and plan. Cologuard DX our from to quarter XX Exceptional screening million as cancer hereditary in diseases. our more Oncotype than as by recognized people further Launching health guard Increasing progress we [indiscernible] standard the care, of the worldwide. of award onto X internationally clinics. DX IT more cancer relationships first with by testing deepening helping cancer rare embedding and

commitment of study, results Journal evidence England molecular Plus support New including BLUE-C and Medicine These we're to care results for the positioned FDA our pivotal future test. our of disease patients goals to achievements of support financial the quarter. will and will our reflect our health published the providers, solving OncoDetect, now to Announcing needs well our for residual approval year. Jeff and review of the generating Cologuard achieve which

Kevin. Thanks,

Screening $XXX First and grew and X-year billing a X%. increased $XXX Recall was quarter the enhancements on from first very season. revenue quarter last of was million Growth million basis. compounded on flu X% revenue reported revenue Screening systems and our core a XX% and weak of to in of a revenue basis. compliance benefited strong patient year

on of growth than million, year-over-year on to $XXX headwind We our which or basis, was expanded rest of Precision globally. expect the discussed QX a as growth, X by Lab a year. Oncology be or X% Precision for points grew $X last DX, the excluding Oncology revenue Oncotype and were faster agreements M&A. million Group to FX led Reference we of call. core X% X%

GAAP excluding intangibles, were margin margin, acquired was quarter gross was XX%. lower of Non-GAAP First amortization slightly gross Margins year-over-year. XX%.

brought automation weight of cost QX. fixed added The online temporarily in

see rescreened of investments realize gross time million. and lab the an margins mix increased Adjusted million. patients. benefits $XXX we as $XX leverage improve infrastructure in a EBITDA over was loss was Net lab expect We from will automation,

P&L this reduced the million expect to gain year, onetime we million noncash the related items $X by of -- related especially G&A first last acquisition from facilities and to $X $X unique included note, year, related a within was to continue consolidation to expense million In earn-outs of Of G&A noncash leverage earnouts. G&A. quarter across a

taking for quarter, to prepare the Free us business product reinvest to are our seasonal expectations our cash and launches. in steps consistent and We with typical core enabling during $XXX costs new first million efficiency, trends. and optimize operational flow increase further was negative

robust the quarter rest and ended announced cash In of million. for of the expect generation the We We April, flow refinancing. negotiated securities cash year. we primarily our $XXX with

by Our return, accomplished notes and XXXX rates. $XXX primary issuing we net $XXX million maturities. in received XXXX extend goal pro cash We financing have cash million. of existing million by to fees, $XXX was reduced to debt forma In first attractive in smooth and at this our $XXX notes bringing quarter million

priorities allocation remain Our unchanged. capital

Cologuard Our #X growing be to continues and AcatepDx. priority

Second, pipeline focused impacts. on high-return patient we're opportunities large with

to After of guidance to of $XXX the adjusted start $X.XX and revenue achieve our and good EBITDA we're a to between $XXX annual guidance positioned between year, and Turning guidance. billion million billion million. $X.XX well

sales have the Our in pay off second recent started investments to in and marketing already quarter.

we expect in comparisons also faced of easier the but to bigger half. second in We half a see the year, the impact second

addition, Cologuard systems, greater seeing In care QX health QX. typically during by and run we're payers for gap and and programs accelerate demand which

that also thank Exact with a strong a differentiated want the always million be quarter, of second we $XXX between assumes Exact million between earnings $XXX of recurring million During team sciences oncology now over importantly, Aaron. Sciences years. many $XXX we've and I'm growth been helped of we delivered Most and story balance what and Together, sheet. million. healthy accomplished. revenue the revenue, to turn the call and Exact total support future to million It's tests. the $XXX XX and revenue revenue robust have my into The margins follow call. an X of is over screening over extremely to enjoyed between we've This appreciated your interactions. part the is last and past This build I'll bright. Sciences proud $XXX Sciences. I've million analysts investors extremely exact cancer and expect I $XXX million. Precision honor

and Aaron. Jeff, thanks, Thanks,

health millions commercial engagements patients fueling Our is growth and providers. Cologuard through engine with care of targeted

of listed to and XX the bring Cologuard the through older. power of like a Marketing to to Cologuard the investments marketing of ages satisfaction of new XX,XXX to and offering customer year, life experiences, patients start care customers brand Sciences. last compelling quarter. to chose high an became these Cologuard continue health new brand in first Exact Cologuard all-time consistent and flow providers Since We awareness content the

data time test Our educating spend health patients. providers these more Cologuard, show their the the benefits the order more of for we about they care

rates customer our record number sales in growing first for opportunity. patients investing high-impact demand drive initiatives marketing of per a and had among base of and we To continue will productivity to in quarter, The meet Our even we next ordering higher. underway the have visits do that providers, growing their this measure continues systems patient Screening are test and backlogs Cologuard Health increase, into highly times motivated incentives increase. programs. and improve to our population. continue built rescreen and success to financial team colonoscopy to quality improve the wait payers help screening through can in rates sales

addition, standards reporting screening population sampling, the the through In colon at measure level for [indiscernible]. random than evaluate quality new increasing rather metrics payers burden cancer on the

historically care. Cologuard by screening seeking within at-home as close the [ preferred is gaps payers which it's They're metrics. STARs been and choice is credit offers HEDIS in to ] turning quality systems accurate and run guidelines health because a FIT test, these USPSTF highly a and ideal used has an to than Cologuard programs. Cologuard that test it's and programs large Xx in within their organized emerging solution, quality more

by intelligence financial systems Our [ help earn measures quality patient payers compliance their solve the electronic patient and real time required to health efficiencies artificial to gives screening patient data and engine workflows determine patient history, reporting to care and helping This platform, providers health automate systems and leads. also track simplify incentives. to streamline record ] ExecNexus and health in unlock leveraging the payers patient systems health more communications We're outcomes.

quarter during by of unmet with delivered aren't people providers towards deepen team during women international number with making markets a around future provides portfolio increasing our Japan, growth to number also the tested, by across adoption DX. to and Oncology opportunities the DX testing the ongoing of presence There answers results still internationally our need Oncotype especially expanding Building being Precision over world. life-changing quarter. globally is with outstanding progress huge ordering provide a record XX% and Our Italy great first first currently broad relationships We're efforts to are team Oncotype providers broaden and who reach Germany. Dedicated of like in our tests. the

diagnosed, the Over Cologuard includes a test how OncoDetect new efficient to than This imaging XX while of a to systems also treated bragness detect Plus to range blood-based our the earlier colon Sciences MRD as be OncoExtra tissue-based launch a will advanced and for tests next monitored will selection growth. It OncoLiquid disease months, of helping noninvasive test Exact that is well cancer. accelerate cancer offering. also includes bespoke residual we're change as to complement which way screen most therapy can set

our No New overall XX% ], free The of and [ the study cancer XX% powerful be with test powered publication PCR specificity reasonable when year by findings SSLs. offer colonoscopy. test and data with to us BLUE-C second-line our to plan other screening -- XXX,XXX option and polyps this on for proprietary other noninvasive powerful comes colon infrastructure of technology cancer Plus colon BLUE-C achieved unique bar incidental a standard pivotal including Cologuard. Journal advantages database. the And raises cancer colon sensitivity. of XX% our refuse opportunity the [indiscernible]. share very by screening approach XX% We technology for over These a shows supporting test patients performance close. has providers from at cancer England screening Cologuard no care screening. blood sensitivity give cost. specificity including blood-based our cancer with Exact advanced will later ExactNexus, The Medicine identify in dissolutions small our who as care commercial patients a platform health which relationships deep Sciences and unique

Cologuard, preventing, years and by us our providers, built We're of this this an double-digit we momentum our help and engage will achieve to with care growth to guiding cancer set diagnostics unrivaled power added test health patients platform of new personalized earlier gain profitability, are to pipeline have foundation to and eradicate helping detecting platform. each treatment. and DX using it life-changing continued We and Oncotype purpose.

years. partner to enjoys the once him We're Before best he He's X we thank turn We the Jeff Sciences for leader. as Exact been off contributions him invaluable I'd he over last family. miss questions. an and to wish We'll Q&A, well-deserved his time happy departs. business his take all to with to many like now

comes from Catherine first Baird. Your Schulte with Instructions] [Operator question

Congrats to Jeff.

first implies of kind year, XX% more and mid-teens You with in revenue the Starting quarter. will second certainly grew the over like Cologuard, Screening full the X% the for missed. quarter be Guidance back in in XX% half.

what gives growth if growth outlook you through talk about adjusted story just here? you just from excite you confidence the quarter. you the Cologuard decline profitability. in And could in squeeze can one So EBITDA first year-over-year that in and And saw on I

So if talk the you could there, great. just would that be drivers through

Sure. Why to don't take hand it I and Jeff first over part the afterwards.

patients year. opportunity deepen are people tools then excited There size people and will not The growth will -- The systems start are There up-to-date rescreened. of There that consulting colon but provide electronic deepened into new provide their alone. QX, advanced U.S. this customer the why services last due over a Payers, gap today XXX programs to ordering in on IT in have our them, Here's be about we screening. we due get impact the the be rely million are are our XX impact. closure health that area. biggest over in And enormous. are that is will and X million immeasurably really cancer that today over we'll And year. around we're new remains relationships that for significant patients. see XXX,XXX broadened with QX. who and QX

of hit power and QX to for reaction it And the and in then the service, And systems patients. impact positive get into high social payers. engagement terms our the media team, in-line platform, television been of The commercials differentiator health an the brand, digital the will us about of awareness, customer has power and making clearly commercial all-time Everett with an brand customer in a creative that we've our with had. experience ExactNexus talking IT and

we are So a tough all relative of Yes, things to drivers. these QX. comp had

too the the about the down our saw year we you while probably investments, marketing really over approaching know, billion -- And we over the turned year. turned also at of bit as $X back last sales that years, recognize truth last down We little couple much. We is and end that of and last a growth. we of

hitting complement in sales now, we now. investments. investment the reps in the a we -- impact of marketing already primary And marketing of ground seen as who have QX, growth. are starting accelerating of increased new our from care We the We've terms

typically around the months. seeing growth we're X that to to we reps reps. country, of we additional X that, are from So expect those new a see significant adding And takes plus contingent and

Our marketing see [indiscernible]. a deciles assistant, no by 'XX physicians. We be call from And calling The on in in in we more overall result promotional our will than gives it's was that the a reps, in it. straight will positive per at spend added always still orders If see this 'XX. sales more of test an quarter. impact. that line we thing frequently number look to increase response with have on X one know you clear physician of position office will And confidence and the less X That firepower time, it adding is a to us that flattening reps calls not. or or a nurse from the

You orders. an test will increase number of the total see in

of be there, able a take you here. into Jeff, why And Everett pause we'll is I'll areas don't get profitability? these So the to lot

to just comparison. And on these Yes. add remarks to the

said have compare. did remarks, a hard we As I really in my

systems significant really not X-year keep When made late of to look half billing revenue, the whole because that's stacked comp. was pretty up we patient the at repeating. both some so XX%. that and revenue first was last of our bolus back compliance you last year, the helped going led in a way to 'XX, you of consider to QX this is our systems. If really high-margin out-of-period year. to That first strong in part half why Obviously, upgrades out think

in much you half. half, do of we the help growth standpoint, a in very conversions we that revenue is that difficult [indiscernible] a plus up first that high expect in at it XX% compare a comparisons. do easier, revenue through second when came bring margin. profitability half. really The walked because I reason from do face also the So in some the and the get second profits came at the In and comparison

the you look when will QX normal of the at in we So QX, profitability lowest expect be a year, year. QX

I QX, growth you the throughout a revenue revenue at highest that as online. latest automation and lighter nice did margin forward of weighed had will improve in bit. fixed OpEx Again, a expect lower over as were bit in of growth bringing In is a faster of the the -- step revenue. that look short cost percent part OpEx expect We because We a huge on. margins and bit in The percent a a a time. automation. the That margins the the some job they help team term, added we our brought year, comparison When easier. gross that

have come but significant we about but work the care adding EBITDA talked that slightly dollars, QX well. margin at gap as also gross this lower bring it revenue. that of It we'll source bit we've in does is a We way our initiative through, a did that

Our next Vijay Evercore Kumar from with ISI. comes question

versus look it's My that one different competitive a is pretty do It level it, is you consistent some right at this on in Kevin, CAGR related to like on landscape. didn't CAGR way been of on noise question to the ways comp There's over? at basis we pre-pandemic bath when the is that. mention the here, seems the the what at looking perhaps -- this

an the landscape? stool-based competitive on curious I think your one approval. got on FDA approval, an thoughts I'm the companies of

Sure.

age Let the -- Cologuard over superior is we broad number me large performance to Plus. Cologuard Cologuard. care range. that that both performance of Cologuard the back tests cancers, of the and The unequal cancer to offer a advance that significant a with and across And patients studies test is ran of Plus go to studies were standard fit the

ability very go to that broad of deliver a Our that But and are to providers support got plus care And you've to strength platforms aware a teams screening make sure of to test brings who -- market. remember, that. in all have of the we studies the specialized our new anybody Cologuard. health way, clear that the now

Cologuard all excludes Plus a we've to like already has work things to One quality this they is think is We been [indiscernible]. because Cologuard into very of already and the path the relevant quality to is into Cologuard have -- need done. new key in measures do that test that test, a be to measures. quality get that The the Plus, measures, getting the

New online need multiple studies. -- needs broad studies tests coming

measures. in best You then quality XXXX need and all broad be USPSTF, false the Medicare the would new measures. through or an guess aspiring population won't -- as to the that have and entrant talking which Well, advertising infringement against it the We you market. the into may get know, suit a 'XX is patent the case. is next for we way a for about trigger 'XX study way We USPSTF, and quality our is the update be

CAGR don't of our course, will, take question? And the property aggressively. Jeff, why defend We intellectual you

like we XX color [ of Vijay, to add this X-year the lot the had some in of ]. year. the I drivers, rescreens look growth think a in is look do you growth last informative to major case if it, we've X-year Sure. It the talked some rates at informative. on on it's because unusual stack. more growth And at about

stack, over grew that at XX%. first you younger rescreens age consistently over XX group that look X-year of stack age quarter, that's XX-plus and If XX% XX both on the both in and grew X-year a group to

is at look seeing you issue. easier. get comps primarily confidence And comparison when So the that again, the do us that what a gives back half, here we're

after So the year growth Kevin through in investments addition on will that help making leaving we're to what growth table the accelerate some about, talked last underspending.

with Our Doug next Research. from question Wolfe Schenkel comes

Kevin, like about making. and recognizing that your awareness I It's tough the That cutting or thanks large the for underpenetrated. recognize here. do building and saw opportunity, unpenetrated for. all at it's I are folks least last much you comparison you're number smidge told was the not relative the different be to I we market quarter a giving comments hear in every which remains said, And Cologuard think helpful think maybe a to prepared to little to we dropped you're year. things seem us efforts And on that progress what to as as quite per information does practice It us say bit better. fair orders be expected think the

in Or of based How for about good reorder those for So different to I you something question was different was And kind -- this just we we get saw we double-digit lagged comfortable is all do expect a terms but an transitory I in there guess just foreseeable to things. there expected to any X-month then Is maybe what the that look anything Cologuard impact? on anything else be of of Or to maybe want terms of Was of worse meant with making there reps sure the saw and few it opportunities, you is get not building of impact? the you're that that into to quarter, when you're Two, to here a would you future as the based what when this, respiratory? understand quarter? transitory? on we the capturing opportunity, growth something franchise? make term is seeing think progress awareness off a still quicker return X- things. of been of have that there following this on investment? to that importantly, came that can going more make might Like a there give year, trends those just more longer one, the was than All lag? in

from about let Well, more excited that year. -- marketing spend And saw continued that by for raised, one down the the thing start mean you'll months, Cologuard. Yes. see and been items turning you and or that despite sales we me is confident never progress. last seeing X learned we I I've

good of investments with growth in the You we the with large the size have And the news that We the to can't coming first brand we here go we as is the the forever, and in return we back today, them seen without is are that of of it's impactful that We've Cologuard online sit first the quarter. made now. and data a were though investment all the expected. analytics right the as up. already making. most to quarter, And addition of salespeople the

demand systems closure the and who and that thing dozens in be EHR generated on [indiscernible], was the them seen. dozens there. et year. gap this confidence screening Last who's there optimize already we payer come what to population us Health this So have first use this depth. year cancer to get dozens at rate that programs -- us worked into is get And improve team screened. rates. and And to to platforms, health being year have significant we're these With of able more strong help please insight the have health saw programs. colon other programs tools going deliver our with to people are into say, programs. we'll never systems to -- those happening and with are just is deliver kudos And That hard their really then full we is helping we a to so we more have to cetera,

line sight that. not have So have in and That's guess QX, when of into work. say expect we we programs an impact QX those we

do want add Jeff, to color? you So

We to know do providers that different of I cohorts at the of at doctors it's entire grown now. intend misleading. order I -- XXX,XXX based they Doug, asked you initially the this. started. you Yes. the think on for The on doctors math They're large grown when base on Sure. and has look reorder first has looking pool rate. to over so like reordering

say cohort, and continues year. that So go climb. to XX, the And kind what the orders XX in back I'll when they is of cohort on first at providers based ordered look first every unit by of

no The we talked share to years. the about and We about spend time doctor, right. at And you seen response they It now. more have overall as get Kevin that this That's curve. XX% up to we're climbing for still continue going slowing promotion down. the more order. market is point, a

a little get You misleading when that pool providers. of XXX,XXX

have those since of Some retired.

little that strong. the puts but So the math very a underlying downward doing, there pressure trends you're are on

Your year, this year kind bit flew transitory second normal nonexistent, of January, flu almost really was was early. into point on last Yes, impact. and like was little year. a it more A flu February more

to a was more QX got were down year, QX up. That's Again, That that you more year, low typical was of to trend. this it When last was 'XX, we QX, year. we So single typical Cologuard digits. last quarter-to-quarter look of unusual. a progression

the Kevin on this million year. rescreens. year. think year [ asked of to -- become The RIP patients X/X goes by I You grows on X.X It million this last -- On announceable covered question pool ]. from X.X impacts

does continue us. maybe And Cologuard the significant driver to to It's biggest come a rate our back it's growth success growth So getting of this to grow. driver patients for year.

years look This from at down you is pool it just patients QX the becoming works on pool than elder of X basis, the QX. ago. is when a the you larger back When way look quarter-by-quarter significantly in

be So be in [indiscernible] beyond a huge going was it than will QX a It's bigger and QX. to in driver driver.

I A to of line. things impact a rep time could Everett bit is if just And the add more couple little Doug. that. and to color, This

very have deep that were already we all, of experienced hire to care. First primary reps relationships in existing intentional

Exact care they're And in selling know deep the do. reps they intentional the while to second new and relationships to to new not new we the So Sciences, thing again, are that ensure They space. they were, These have already. is, geography. then primary

intentional in next confident hit now. ground of the field training they'll And they're the Kevin week, be in I'm said our So running. and They'll because that nature.

to going than I have think they're impact months. X quicker a

more months. I will be think or it X X

Patrick Donnelly comes next question Your from Citi. with

time. Obviously, upside targets, were side. how rep I your by about up go Kevin, revenue guess a adds can last obviously, EBITDA think seemed continue flowing able when revenue you If you to add do on kind year, to to through? on I raise of guys the I feel more that. mean, obviously like that see these potential lot the just revenue opportunities. base sales here? every additional reps pretty a is the now these do flow-through you've single come You've Do to costs attractive? If times you marketing in you are is be and high-impact back? added the does Or cost going set there upside, mentioned few investing

just don't the adds of if helpful be count of there you in see I it, is know do you magnitude missed upside? are I So coming break head out. if the rep good Or would that but costs revenue more then we in a pretty spot terms could if And here?

But We're the number reps Yes. away math of it the adding. from it's clear. indicating around this, staying -- not we are we is are pretty --

adding by reps. You these leverage get of ton a

there adding. if of amount you -- have a cost a So that you're fixed is

managers Cologuard For continues area the mean is I to of adding of quarter-over-quarter. is seen new orders that the increase force productivity terms rep -- here, we're number not sales per example, matter, about the in makes and call roughly what leverage that for year-over-year we have our our up managers end they new one current territory incredible. oversee. area with that And

the total And pause time make the terms of for is be So investors first in the know this want of reps significant. to we sure XX going took to productivity that Cologuard. here a we promoting we years in as are doing number

of yes, And kept keep what opportunity. saying the taken We probably that adding of probably shouldn't because the should -- we size is, pause. to we're have have

over leverage continue the by that so reps, time to And we we expect thoughtfully get more reps, revenue. adding will more

Yes. Everett?

with addition be more said, beginning In getting we of much what generate access to going there's our not offices. know, only but XXXX. providers said XX,XXX earlier leverage have based XX,XXX that, we there's since existing those to new the that frequency -- providers the on And so Kevin new footprint, our can it into with that was the that reps

we're excited. So

commercial is line. to providers first in drive -- writing footprint continue is goal Our create to simple new and our existing Cologuard to

a So Jeff. more color. just add This is to little

P&L line had be year, same in improvement. of leverage the of had the year. throughout P&L won't points every kind It they we expect like XX this leverage We last

tracking We XXXX for where long-term of to our expect ahead there. we are guidance be

good though, flows very leverage feel we reps, again, about through So new very those hitting you add nice. numbers. When

You gross plus and the margin, think throughout of gross very XX% internal strong P&L.

So pace here. leverage still improvement from of good

Patrick, the mention you upside. did

tieing I the these that being to we I to made. were think would start that investment. investments year, we assume just did when contemplated say guidance the rep you

So the assume reps growth above we're the from I That's and that we wouldn't beyond guidance. market in adding. not already guidance. and the get any That's baked

question Your Arias Dan from next with Stifel. comes

teed for just backlog, them helping then work Kevin, FIT. that DDW, and at colonoscopy relates relates One up through to had guys looking docs one the presentation you of to

doing from colonoscopy on the users? you FIT, field if quick data you I do Where improving how converting time? success point? for collective Is can. think is over at that do this the two ones, just So backlog have then on you're any FIT And

Yes.

around X-month the surprise. X a So the what seen actually. let's we that tick say, months, seeing -- it It's varies to have is last X- up But over we're country. not and around backlog

from in colonoscopy about maybe And changing every million colonoscopies capacity hundred and U.S. of because year year diagnostic colonoscopies. the is X-plus net share a fixed U.S. taking million couple not about FIT. about to We the Cologuard GIs have you million get on average, X screening a in It's of a new X

So been streaming getting been seeing converting FIT. is who increase. have They're utilization to just people past screened. Cologuard colonoscopy Cologuard getting what is the It's not people you're mainly have is going same. who never and with the in And staying they're

high screen. aren't of because wife overdue screening. the family And colonoscopy history. has My so risk is She family for the cancer She's colon is going a backlogs to risk.

is wait And her XX at, months is time, screened. it's months risk. high to X XX her get backlog X to She to

country. in the want not where Everett, you provide can parts the in over that's we So quickly. pretty to true parts of most some get the you color? There country. in that all are country are any of But New seeing York, do

Kevin. colonoscopy is situation, going I've this do the It's Thanks, and mean real. and my No. I've it travels, not field seen away. in backlog I been

all be you're over seeing that's screening, it good and that to As patients screened easy in, along and one make an one of health health patients these that stated hundreds And implemented not of alert a of where C-Suite, their have with their that a patient alert of X-month, with has their that example the we have Cologuard the we have were of examples, easy our positions XX-month they average but would alerted patient And get XXX that partnership that and example, backlog, a had line. they example these a country. system electronically in positions with and making their X-month to is first ordered went with system they, get and for they partnership, it backlog. duper to a met came Florida all X-month, us, a risk

Your next comes question Jack from Nephron Research. with Meehan

wondering there's mark the of think I year. BLUE-C this update mentioned would us timing terms I coming later data Kevin, on success? what around you're if and for in you benchmark from could precision looking the there the provide you any was just more colon blood

now Sure. fall. in data the We more to that had generate be planned the in to likely that summer is

of the data more we cutoff recently specificity have make samples the more test is samples that we've Given sure the the on collect -- we the as robust seen, sure a run and decided X,XXX the more other and about readouts to and test bit and make possible. with little that take we time time to as have luxury

probably So it extra that we -- field. perform right But going we other to we think better thousand maybe thing to And in to similar think to have. that test is We our that's plan readouts position in that our blood test be. we think prospectively you collected the is that with to test have seen let's samples than do. where time the the that blood several going

not of detection. cancer case the specificity We've detection, you done or studies, see greatest around variability around control pre-cancer X and amount

that to version very or assuming the PCR seen. of question is But which have test proprietary mark. a test approach. our our to PCR, the performance day, like thing me, So kind we're is that, at remember the end we it's is is a test the then per of a cost And of low

And a refused so when who we have all screening the data have about test. the frontline people

our payers systems, after ability work them CRC the to to people try have Blood then Cologuard Test screened year switch to with to encourage and to the the get that. with to the in providers, those health We the

this situated Medicare only Part that. Medicare we under Medicare is Medicare opportunity, deliver of -- for today, us, all more opportunity it's of It's our that is stations. the best So think half a clearly and and XX%. Especially look is when about than overall B -- meaningful XX% at you we're is Advantage to the on probably

that advantage to with plan those cost lower the ability what test those X care is of a to they test, which credit with measure the about. we have plans to go clear With a Medicare patients years, switch gets contract in quality a

So we also at we're it and people opportunity, getting to excited this screened Exact. and more growth about can think drive lead

The next with from Andrew William Brackmann comes question Blair.

best away, time the of welcome. luck. enjoy and thanks, Jeff, Aaron,

health nature a But talked just the guys sort maybe years of times of and a of talk now your sort partnerships couple of discussions of couple about groups your You progress ago? can maybe these with with line you additional to of versus about sight systems.

with that's other backlog really, -- piece The have products, addition them can Thanks, that electronically want health it systems, our we of where to sure beyond interfaced product and can go turnover, Yes. Andrew. workflow that they fit our the companies things that help can to they them -- workflow, colonoscopy in with really help great. with make that of partner Yes, with they we're nicely. staff is which

we just that just we're but -- adding is back-end providing of that customer not amazing support tremendous. them, them not service terms product, additional things have helping organization In And an we're to get their screened. patients

analytics health mention systems The I'll provide. we that thing data other the about are and

to they at. So need are get they're a that systems actually health lot a of -- data to of lot blinded

screened need the actually provide or When to to to and So need rescreen be And and that we broader XX just them, seeing XX data first increase go where to time partnerships a quarter-over-quarter. list that we're where population actually we in product. these they we with have than that analytics accurate that's attack. them we're helping

Partners. from with Leerink question Puneet next Your comes Souda

test I And in of and to leverage the this slowed reps that mean, years it appears orders. first had Kevin, reps. you bigger is put the few down on reps similar to Cologuard a ago? for relationship you. as the investments simply a mean had decade the more Cologuard more you question time Cologuard what a is means I

So Cologuard? into as continue to say our lesson to scale is the few the continue the here in is it to get the is, there that Or the if an is Is next that penetration years? question for you continue continue? you safe need to get you'll to have that for sales the force scaling numbers further into has we Cologuard market the leverage penetrate and to investments business will as improved

I think is that "and". answer to the

we will will investments We leverage. get more and increase

category. $X a So $X $X.X billion $X billion, billion, as we become billion,

do to assistants. continue want the the customers. our come will nurses, their in to physician to It's They right And make patients. investment. their the help us do to the physicians, right do. actually It's additional and for thing We educate thing right for it's thing to

months Cologuard do visit on in investment we'll a impact. the pretty orders is X to of of We're get force sales this. to about Because the relative investment number the So terms growth high. takes It a you've X office modest talking to that to made. ability return have the per

weighed number years ago. it than but now was higher XX% it's that think, I out X haven't, what is, We

So it makes and sense. continues to just it grow

You continued us investors sales didn't make -- would be be disappointed would in force. that our in in us we disappointed investments

unlock just payers in the I'll as codes. terms with this and care our federally add to that relationships the field, just think in opportunities. other thing about about ZIP And -- gap relationship year. the We're our health last I'll we doubling systems of is is of one and challenged opportunities geographies with in qualified I Everett. terms talked health that in new in I centers generated down we providers our new

multicultural we account growth, unlock need new going to executives this we're these approaches of driving to sales As reps, segments business.

new for of to adding reps just growth. sake it's the opportunities reps, And not adding of so but these adding at reps get

Sykes from Sachs. comes with question next Our Goldman Matt

will health focused either the question, the fact marketing marketing mine's in whether of systems. the you that leading system? Apologies leverage, about some kind ever operating health leverage the if do upfront, of more leverage increasing revenue. I'm for a systems I'm increasing adopted ask some marketing just from of you're going that once within on terms spend that you of another the call of in that wondering allow mix talking to sort centralized shift larger And towards Or but to creates point?

Just the dynamic? how systems did play that into health

that leverage. that That is doubt seeing no you're there

back terms last over sales dollar force growth, in that going it [ of eking of up is marketing $XXX around details provide was than believe, and ago question a million was spend of the Just I The the The the much spend. it less can years, over last couple keep And was. than the couple of ] do Cologuard the how years, Jeff and XXXX than it is years that X is smaller you leverage obvious. smaller we're the that up? with

group and So a the a those that on because customer of executing is And that team delivering the is very then small experience and people of getting out small really health the IT leverage is leverage getting incredible leverage we're around relationships. systems, payers, payer and our out we're impact. team of that

next -- the payer is a years. over out the as to XX segment is this opportunity So X look we huge

talking team we same are we And Cologuard. we products new channels the care But mainly to even leverage time. here, gets about launch as even this products, Today, through as better better. the sales electronic this over leverage with [indiscernible] gets customer team the new add

leverage. So a the I we're foundation And and of think more lot time, attractive. building some still things over here get getting

TD with comes question Brennan Cowens. Dan next from Your

I good with clarify comment. you working Kevin, Doug's there Great to a off so wanted the luck. earlier something Maybe that. you. start. some good I about was mention -- obviously maybe I to Jeff, quarter Great. question, heard thought just to

just better so of in like can the [indiscernible] to us And haven't we're through wondering half the of the kind you about can growth share half first or XX XX% things of we then sense of the think had what were of we And X.X of about payer million any it with sense back like talked quarter. you color those year, had frame get year-over-year, help just XX, year. You've and Would a that? think underlying contribution of these at on percent those, notable. of in captures kind then Cologuard code. the year? could it terms any last you sounds I these size a like rate? how ZIP test help kind if and in kind us out-of-period it you of in -- those period in in up XXX last million about anything anything talked come could you or heard know you be out like of grew Jeff, programs that We right be we Could I the normalize

We'll keep track all of those questions.

investment I alone, the in think I investment increased QX. was first the on marketing the said one, based what marketing just

We growth in accelerated have QX. seen

with we confidence when guide So for have QX. the the And you then force and confidence. sales given that have have we more adds we've even

So half, terms of millions and back will it year, the right prepared in don't year. the in more we significantly think to than tens programs be half now. this of in Last that of think dollars the back was it in total, that of I we're payer size

clarity as as clarity provide much we'll last will more about earnings goes in his time So that's Jeff but as call. allow probably on,

A here. couple more

look year When million XX about opportunities, them of you to asked are size the million XX. at growth You very turn essentially about screens. on people X XX every and Still people, of XX on strong all here.

approaching huge of in well. XX% today. screening It's revenue Cologuard it's opportunity. revenue of really a fits So And

that strong grew very did QX, growth. tough volumes comp. It with in even double -- So digits

to still long We expect for upping last was investment about the [indiscernible] the impact? strong of of here. of target bit some U.S. growth clues to population. talked year, There's We run. what a sequential ways given some the [indiscernible] a continue. [indiscernible] this have the

saw it, sized a kind in step that then the year, Last We I'll of but normal We expect and you would reiterate to QX the QX. year, down opposite. QX up. haven't saw we

earlier to think things season was flu last almost this close up very I year, it season. the XX%. year, few flu A abnormal a was very One light, more happened. normal of

the The patient systems upgraded IT compliance system. the upgrades the other and were building --

whole that So is delta not out-of-period revenue.

Some of [indiscernible] the that is

Piper comes question Westenberg next from with David Sandler. Your

to of this the and through impact flows But us P&L? March? that flow see as give I comps out did front And implications -- question, the we're think, half wanted think were terms bit utilization a us trends you kind any kind you just pretty in takes I in lay of So actually I can the in I give hospital through, do maybe and sense long challenging. year of of And in back how some of of for to concerned, laboring were the investors the a of know ramp. Dan's And little that of reminder the with kind year it of well. how maybe of the some May. much half the April question

year guidance, really and to versus it. to So much, I bit the this just sorry, just little on right? clarification, in that mean, right? anything very print not up aren't giving the almost to think a maybe asking to ridiculous? but that is habit as And I mean, models why of I You're a change really our going prior of half you're month-by-month then that's not of [ know think step color that's of play, ] right earnings just second a of prior we anyway, on this change the I not I that And -- really initial again, -- kind now, us

achieve Look, Agree, good a year. very is We only longer-term this ability and maintained Jeff. feel we're this I'll Yes, goals. about we long guidance. the to start. our XX in, days year

articulate care the that did front marketing off the impact already get very see inherently then size, seeing challenging Kevin half before. the rep and very we've goes strong growth We confident the the that confident some mid-year Again, half half. we talked demand the The to play investments, of investment gap the the clues program, easier think second kind reps early year of gave comps weighted, We more April done carry there. I beyond. on. there the return, in sales that. very and on as in about investments. we're know seeing very second forward will this looking in in to the is They starting good a and And

of kind of P&L. factors flow-through into asked You our the macro on

from, typical say, typically let's a during face-to-face order, timing Cologuard visit. which physicians visit. a or Oncotype is [indiscernible] The would order from Cologuard a

who think seen, kind and fairly of is need get that to expect and to say, asked there things most people a of is while softer like trend been been have monitor XX we so hospital has still visit screening they today, out screened We not at Wellness and very overall This broadly. can to, million XX months, XX of time we softer. think multiyear typically XX trends. we've more to -- there revenue, be When it's I presents there that have can strong the or utilization, that's tail. even It given still to up year-on-year continue. on So days XX% close happens can fight been a What in opportunity here. growth that recently, longer wellness you That's something be to through to from median a quarters. [indiscernible] the listed visits something we down be early. recent that look I you think we

more might Mark BTIG. with question take and it able to Massaro be comes from We one

you'll Aaron, missed, to Jeff, welcome and be Exact.

So two One questions. for is you, I'll Kevin. ask

XXXX. about perhaps now talked USPSTF You in

or overall expansion 'XX? many I although it maybe for Jeff call bit you a will think one guidance the your XXXX, intact, expand was we on think you were us think you, Kevin, of we other sales order indicated been to your of in a about that spending the Kevin, might bit on also on of keep down investment that Can and increased that OpEx? is to thinking some a be? revenue relative little still bulletin. of R&D? in In I their surprises the Is you delay Certainly, recognize 'XX. marketing will takes expect And and be into just the of then less think 'XX words, line? Or in of go Help what little there's us salespeople. And just with why should total puts

So what than in I still it was be in 'XX. 'XX sales less marketing would said and was expense that

it and overall with our achieve terms spend. in range. again, 'XX we sake, to somewhere we we obviously top lot emphasize resources reiterate our -- that in But confidence line we will this deliver to that. have. modest to we obviously, like be overall in also and So that room sales And of to clarity budget of I'd will and is for from wanted a goals, spend. of able And would guide. in our I increase be marketing And the have bottom all up both the our a have line just

And well. I'll of launches we the we're and repeat really more So the with excited never confident near- been new and we we business, know as Exact. our also about said coming that have know I long-term are I've that trajectory Cologuard it well. what about product earlier

year. first that, what is amount the prior may a the emanates the have when Typically, in And resources. what you And is of of you schedule surprise, document out busy already timing, terms would really out that we it's be a first USPSTF XXXX, pushed is. was X what study group plan in If seen Cologuard the In quarter it whole with that. included laying remember, the a a years USPSTF is heard before that guidelines if in the fixed from not just USPSTF update and got

and then yes. So stated X [indiscernible] is was the years X years. it X included schedule although years,

Yes.

a the was tough those delay, in hard quality to -- to was and was yes, for entrants a for So be was but bit early in Cologuard measures. to a of quality not it's when know deliver critical. market, the Cologuard order to It as get customers it's in there aspiring the unusual little it FIT it we how can come which replacement years measures. on to we weren't There's test,

So strong working another position. -- [ X. We're Cologuard that were don't people here's And ] in thing appreciate. already on a fully

second to to that impact leverage has has proud of remarkable to going just about our And performance we're screening. talking done investing it. been in see They're Everett's organization to improved even so had the we've able none. on And been you're stop deliver. work they've terms it in We've disease. in cancer organization, the from our deliver of heads never of really unquestioned continued -- the we've the We're R&D impact in and and team commercial what results. they've the going Cologuard being positive proud is leader hard And really that colon new this been Plus, to had,

to go to Berstein Bernstein going I'm Eve Research. with

LDT This and here, you're approval. have leader Cologuard, market Oncotype ask of but one an space your some it? in I'll because interesting DX rule Breast actually is FDA case not a about the affects clear competitors question how do about but the FDA the

our test of One, in. couple here. LDT your understanding grandfathered a parts would be is So that

there? if would didn't you body to approval, unlikely. a if approval seems to pursue have? at that decided do And be you FDA which FDA you you already pursue the pursue if tests three, you in Or to test, versus do the FDA-approved that then to so already pretty generated could you literature Is that competitive data of work? you need to need are only choose have to Two, disadvantage did out the choose You FDA you rich approval, need change new the right? more

guidance There document. You the a grandfathering in are provision is correct. new

York in outside is our position the state we're approved. current won't on a in and the New And DX Oncotype That change. So position. in U.S. also based great U.S. regulatory

are there So two okay the we with approach. different current are that ways

future, also the than expect should to have which We with we virtually developed. But to the data anything ability don't approval more ever have DX Oncotype we change any do. for FDA submit diagnostic in

Medicine X publications, total randomized patient Journal or altogether, England of well well million results. X over X.X and think million, probably I X studies New over

the So cancer time. of studied diagnostics, diagnostics in most it of may all be great one We're shape.

benefit DX X that that tests great in multiple Tier because of because Level only test what we're that's nobody able we've ability the been to to are And that randomized perspective. that likelihood of the of to been other Those able we've And has prove able also has the recurrence. from in been controlled to X terms evidence determine studies just evidence important chemotherapy have is not competitive a prove shape Oncotype else show. of with and both been two the that the to level and show predict able benefits

in So we're confident continued growth.

you for ladies you, joining. all appreciate Thank right. today's All and gentlemen. I That concludes call.

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