Veracyte (VCYT) 6 Nov 242024 Q3 Earnings call transcript

Good day and thank you for standing by. Welcome to the Veracyte Third Quarter 2024 Conference Call. [Operator Instructions] Please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Shayla Gorman, Senior Director of Investor Relations. Shayla, you have the floor.

Good afternoon, everyone and thank you for joining us today for a discussion of our third quarter 2024 financial results. third Marc Chief Chief press Financial this detailing are Rebecca Officer; release today results. afternoon our financial Chambers, Officer. Veracyte our me Stapley, Executive Veracyte's and earlier With XXXX quarter issued a This release presentation in at Investor the website and section our are of available Relations veracyte.com. a and business financial

during under begin, include forward-looking will I'd you applicable Before call laws. to we that various as defined this remind like statements securities we make statements

company to risks no and Forward-looking can statements the to give they and correct. are prove will subject assurance uncertainties be

refer further Veracyte's we on performance Veracyte that under Additionally, most XX-K. better uncertainties to including not any the you are with quarter. files and we cause the business obligation understand and recent our to to or the could Exchange provide risks XX-Q Commission, and results that updates documents trends the Forms Securities To our actual during differ,

certain the financial of will Veracyte's Reconciliation Stapley, non-GAAP CEO. website. I section call measures. this of included are will from measures directly addition, most release the in today's IR turn to call include Marc In over accessible financial Veracyte's the earnings to comparable now measures these GAAP

during thanks, our incredibly of which to driven serve. QX record an revenue Thank continue team totaled $XXX.X improvements, revenue, XX% expectations. QX of by couldn't we ASP everyone, quarter testing over quarter this confidence our and year-over-year XX% us on demonstrating years, growth robust Shayla trends clearly with up compared growth our year-over-year. Afirma volume growing testing both durability drivers. marked their deliver delivered that next joining to solid outpace consecutive hard This we fueled another have trajectory. Starting was strategic prior-year greater and our represents we strong shared growth portfolio. number of reinforce grew Throughout third long-term categories. XX% and and observed testing Decipher, you, more across outsized bridging localized our a or will the tests are XX% period, by that ninth revenue the proud QX risk Decipher to And this of behalf the quarter the to patients the of today. XX,XXX quarter, we I Veracyte. our year, we NCCN record all for continue for with be of revenue work on of a growth, million, the which

The Annual or for market. clinical in in GRID. Generating durable from top Decipher utilizing drive and differentiation evidence for Decipher disease is could To outcomes, level disease of Prostate data more VANDAAM disease. men, this inclusion, the better is ensure Prostate in a ASTRO treatment in diagnosed this and Society predicts forward population accurately philosophy to classifier of was and such the to on underrepresented prospective has use genomic clinical genomic patients. our Meeting in third showed embrace. Enrolling presentations at the over and likely diverse and potentially than over already passionate trials were This approximately research the more which publications productive of a With plan the is disparities, clinical patients Decipher to population updated industry to our driving and additional men needs incredibly NCCN market-leading according publications, XX quarter abstracts and prostate and test that evidence. Decipher's compared use-only to Cancer alone, we platform. proactively XX clinical have clinical data and the validity XX% about. to populations, prostate to been confirm consisting enable Society. have education test and sought in American focused this, around try Radiation on trial. Data outcome inclusion October, new from our trial guideline in guidelines reduce early which key Despite specifically helping findings prospective of demonstrated us a die to this We urology reimbursement our force, the to adoption something decisions there test reps, from effort our likely place, look utility and with later VANDAAM more studies awareness something this sales American through Decipher on XX the this underpenetrated studies end, GRID, which is sharing further the genomic approach XXXX, report, our XXX few In that utility increased Oncology are data remains examine twice priority ESG to clinical cancer non-African-American presented to that publish with year. of often among early-stage aggressive we at in African-American we as for the the be from cancer

multicenter, Studies presented the of study recently new since population, Phase was was therapy adding randomized, study Barcelona, ESMO XXXX an androgen incidence have each care about data U.K. focused by group that the deprivation has multi-arm can the at Research Cancer supported outcomes prostate trial improve chemotherapy with that shared. XXXX. metastatic important clinical some shown docetaxel X% a patients cancer. for risen year Another by metastatic to III standard Congress on from STAMPEDE, This was in where

receive use who living helping profoundly benefit men for with patients expression tool life to quality for likely significant that of docetaxel However, determine is highlighting won't. findings negatively greatest path This the unnecessary those to for physicians patients. STAMPEDE of patient help best care tool treatment first for will only most. while as as and who advanced quite metastatic demonstrated more who the the benefit will predictive identify could those volume from major benefit positively Decipher from be Decipher to may This and quality can the toxicity drug. patient Today, utility study docetaxel who from gene the The biomarker a the of impact patients tumor that distinguish precise disease. benefit varies the avoid could a impact and many will can the patients blunt to life

setting, the believe the the test prostate covering metastatic patients. the prognostic use With entire address have recently metastatic expression we LCD to market, gene able including finalized in we Decipher's only

currently see for and start back this technical additional planned late are growth for as half by the with of process, or QX, to for expect Medicare year. XXXX of indication metastatic ramp early which we revenue potential this With XXXX in assessment in training we are the as next next following step a will indication finalized for excited enabling about underway beyond to sales reimbursement We expect XXXX. be we driver the

this foreseeable opportunity greenfield as well and as test we penetration population for driven significant both market in meaningful our see Decipher disease, of expansion to broader growth the share into expansion. by the future, expect patient continued for ahead With localized

to Moving Volume Afirma. growth to continues impressively strong. be

prior-year During to up XX% QX, the from period. we tests, XX,XXX close delivered

XX suspicious who Medicare helpful the LCD force tremendous outcome and made tail for of for Our reimbursement test use an our population to reps done and close share with of field. performance By the alongside V of adoption endocrinology diagnostic patients the a penetration cancer. the has durable differentiated both the job evidence nodules for This this of immensely and driving Bethesda level the or the further Afirma long leadership strides went Medicare to we've is physicians quarter, physicians, molecular into sales not ease effect, for thyroid into that Advantage this Afirma. did expanded in patient previously. Also supports are use of adding those the in for a sharing of continued of

date, while we the the While as in momentum solve to well and and Afirma believe, demand to indication, a happier given imperatives, strong investment continued digits stronger three, X revenue impact strategic Nasal to be IVD our assess of profile. such as moderate in delivering this July our market projects our challenges, will, of for novel expect patients in with patients our to year. With into these products to the identified expect course for X size, two, the additional expansion market our bridge growth be more of quarter expanded as the Afirma been Decipher's robust ASP long-term the through exciting leadership we in cancer was innovation Taking to level by appropriate also tailwind and of testing positively account to never Percepta to minimal, the of near of shifting our a XXXX single dynamics, namely deliver high imperatives, next we we midterm us delivering continue growth as balance growth this confidence ensure Afirma differentiated demonstrate globally; to lung the unwavering to has a test Swab residual first we serve of nodule. Critically, into with with disease the strategic expand our XXXX. strong launch and have growth. and driven as These MRD; or X detailed to effective well through we new as of investment couldn't Decipher regularly prioritization position execution penetration over one, revenue journey minimal financial the and X for end patient drivers: also

the year. of result Envisia difficult at end this pause the CLIA we offering test a made decision this, As to the of

led management for require, While the we conclude to us test other imperatives including to clinical put the now. that would need and our low evidence in category of this continued first, the penetration focus development, to patients disease always aim cycle uncommon we life it on

through I'll innovative serve long-term patient journey more share testing. an effort MRD of Turning our on drivers. and recurrence the to to growth those update

our efforts launch and Medicare cancer, our in readying or We secure test of and reimbursement through of in muscle-invasive are MRD half including an XXXX, towards well processes. the operational progressing MIBC, laboratory first to bladder

a be A of about using for ultrasensitive MIBC. patients MRD recently to genome for our continue in ctDNA DNA study clinical detection European the Urology analysis We showed whole with WGS-based MIBC approach. that allows in encouraged utility cell-free very published of

time time current treatment improve to time study management of excited of savings has MRD. clinical the the lead recurrence ahead a detection about radiographic compared accelerate critical the over test opportunities imaging. Such We're the Importantly, for of on clinical patients. potential mean X months based demonstrated between to and the to

to we our a plan include there the indications assume of reimbursement expand As patients pathway, and platform. would closing, MIBC runway given of sales presence. In use front We have is is initial It have into with is another QX represent us. that channel said, exceptional quarter a a you a other assay. was population, and where intended we opportunity our the single in product this while ones already can long not and

relentless patients. and focus a our to expand will their to number sincere for care to turn We cancer deliver across the our growth It apart business updated their to we are as patient we XXXX. will hard primed that in ahead the to to work continue world. With thanks on of robust sets the review patients revenue for that Veracyte our financial the catalysts continue journey. My that, mission to have Rebecca our team results around core us is of the for serve now key transform for quarter outlook remainder third and our care I

of which Decipher was year-over-year, included volume in ASP up would increase QX million, XX% quarter, been was revenue, XX,XXX of tests. Testing was Marc. and testing grew Total approximately collections. approximately the revenue the testing XX% and X% XX% $XXX.X of growth of over $XXX.X a the excellent tests, total prior-year an of to million $X,XXX, another quarter Thanks, was XXXX. Testing XX%, quarter increase the increase by same ASP We period revenue approximately compared XX,XXX Adjusting have $X.X for an period. $X,XXX, with approximately impact over million the the respectively. in approximately volume period. XX% driven prior-period to during prior-year Afirma

portfolio continue As given revenue XXXX an to headwind we decision. approximately absorbing Marc strong growth Envisia $X expect mentioned, planning to while generate million in testing our

product. to Turning

Third tests was $X.X to through and X,XXX supply down continue revenue as approximately million, quarter volume challenges. work XX% we year-over-year was

Biopharma are Given down $X.X we other revenue are currently muted. million, XXXX was expectations year-over-year. product XX% QX and managing and demand, our

Non-GAAP sales up prior-year results. period. margin XX% approximately cost lower margin due to from XX% gross to $XX.X expenses Research operating approximately $X.X and I declined gross the expense acquisition $X.X our basis to by to to were was period. year-over-year Envisia and highlight Testing costs. compared $XX.X Decipher. investments and XXX million. million marketing $X.X development up and the and force Biopharmaceutical expenses, operating costs basis points XX down our compared million fixed development Moving was partially at infrastructure projects. up million given $XX.X related given million, was by million, $XX.X the driven X%, other other offset period. across the additions XX%, will non-GAAP hiring increased reduction up performed gross CXi and gross XX%, increased points year-over-year up expenses personnel to margin prior-year million XX%, prior-year and Product by was by to Sales expenses absorption. Non-GAAP earlier to year, margin this from G&A Afirma were personnel margin in our

to metrics. profitability Moving

$XX.X income from of cash million continued of cash operations generated We to million million We EBITDA $XXX.X $XX $XX.X results. recorded primarily million We quarter, strong with of adjusted delivered ended QX or in the cash and driven cash of GAAP and of demonstrate equivalents. revenue. million $XX net and XX% by of

to revenue to million entering improvement $XXX million. raise to of with of are we our original guidance XX% forward, Looking guidance XX% of year excited reflects $XXX to guidance this expectations to This outlook million approximately from prior growth our prior an business as $XXX testing the XXXX total million our approximately of guidance XX%. $XXX revenue to compared XX% and in our

are million $XXX guidance $XXX in short-term into million $XX million expect investments, approximately milestone $XX We forecasted capital to equivalents quarter. to now also in between with in cash payments raising and taking to cash, and million end cash XXXX account fourth the expenditures and

profitability expect XX%. This to EBITDA be adjusted fantastic now financial short with we've full our metrics. XXXX Additionally, year-to-date, across year margin slightly we than year nothing more been has of the achieved

we look work cash incredibly of this forward our the growth, globally. We'll We now portion into towards Q&A cancer as helping strong generation. revenue call. patients momentum vision delivered XXXX profitability have turn of to carrying the to testing I and

Our Subbu first [Operator Instructions] Nambi Securities. question with comes from Guggenheim

question. First, a high-level

years a tough You ago. joined -- Marc, has the you It joined for been group. X period Veracyte CEO as

growth together you emblematic period, this have being During that solid have FCF team, succeeded and X.X leadership towards Diagnostics team. revenue science, in era, the you expansion. moving with transformed with the of And driving margin

beyond, more that same, good? remains stool and XXXX be about then what be comes course, it which, think next? legs other Is have follow-up. would there this are you As of of to I the Or And unveiled? a to

continued strong together. Subbu. last a portfolio the started during and a your with restructuring do that Thanks, years. obviously of Appreciate foundation. and We leadership lot announce the us we that, companies and X mentioned, to did current put analysis question companies. summary the quarter. below so, We of We of we And Great. X have have you team the as legacy rightly many of and as a you still multiple although layers saw the in quite the rebuilt the lot time of teams

a we so really Xx that scaled, to as not be lab and time, and terms And that. to which In more, our we've a for volume, example, missed been handle able time Decipher has if focused we've turnaround lot And haven't talent scaling. necessary. beat on of like things in many,

and that also we've we knew what team brought talent a And the of were to doing and leaders revenue to for pretty expectations on opportunity set -- today. talking revenue that on growth, and ability to continued shared deliver our expectations our we really a to financial that with deliver our the been our profile importantly, we since. the what had, come our way already doing long exceptional proud I'm I the they credit then and So that. We've they're who about add we've EBITDA know on call adjusted who own

all very that's good. So

look I all -- As backwards. that's and looking

the in and today. the successfully a on and profitability in those that lot we're company deliver revenue the continue growth initiatives, profile those during long-term financial to all to talking very initiatives to forms X-year a and frame, about we focused we that are portfolio that into the forward we're XXXX products is strategic driving acquired And time look We time. future. been deliver CXi one that on We'll I talk we've same invest important much continue X going of of that about growth major MRD. the As this And that beyond, to stay same. of it generating

do but company here. the consider still in partway in done. we're up still our achieve We're -- I -- it. and lot still We're to a long-term to So There's set it. we're not journey

Perfect. strong growth continuing or Could growth level Decipher underlying be new understand us guideline that second, the existing help volume, the volumes upgrade. adopting? year is it both? seems drivers on here? the NCCN of who adoption Or On this increasing on the heels -- to the order you of Is mostly it trend physicians are physicians

Yes.

great Let question. me --

categories high and consistent relatively low, the of NCCN we're dealing we by seeing. risk. with start seeing across are When that me risk intermediate various growth you growth at look levels, Let the

down part biopsy-based risk happy those physicians really able those growth on of entire test it to double see NCCN Decipher guidelines only with that -- which their -- the prognosis driving diagnostic physicians causing and the test as we're and all as new business that's so Decipher address test be to the that. And Level because more categories in Decipher with the XB. to seeing across is that it's -- of XB the adopt existing And coming patient use on to population, Level physicians is well and categories we're RNA-based really the to molecular

that also the in mentioned adds we're working patients. we the as prepared and XXXX. start forward, tech the indication, to of launch ramp XX,XXX And the end of will remarks, Going and metastatic the on I that the another assessment which for in reimbursement course, have

cancer the a goal, we and they ultimately that every get our should be to is And with diagnostic so has patient what really Decipher that benefiting prostate test get should point market-leading molecular -- at been that from. potentially

Perfect.

driver, lives before, early as it, we had talked a maybe significant think that which other should that on a for Decipher path. was, the I about Yes. covered was it was that lot By -- commercial payers a as I of we mentioned QX one it we we're had continuing QX, getting added one as and mention and way, just we've new

that Yes, QX. announced the on quarter, was first as call middle of in the first of quarter

All of above. the

Yes. Thanks.

Sorry.

question. Next

comes Blair. next Brackmann from with Andrew Our William question

volume Afirma But but I on probably or or particular, the Maybe to how next couple in left and play I level, about there start of testing should headwinds there's here. of growth year? other a be we know here Decipher on year, just tailwinds drivers law at XXXX. considering in months is large know still thinking high or numbers for super any that either you're

Yes.

I'll didn't course, for of detail into year on into to only too. level thanks Bethesda not in indicating ready obviously, high that. a volume We're Rebecca which penetrating not than let V through to point Andrew, numbers here, that. more So law market I XXXX we're numbers plan. I the of today start working is of and drive Afirma kind you of Afirma, there. On -- side, that growth Decipher have this jump XX% next gave yet. color some still get point. single-digit But for metastatic growth we're was and that a penetrated. for our revenue in continued the do budget then our give but back and it's large of coming the year more will to there,

at including for XXXX, chemotherapy we the have Decipher patients entire share, I metastatic, more and to talked Decipher care benefit. of moving involving especially attention going prediction, will ESMO, studies and Now any the should in into to evidence and with benefit you won't serve which saw, who to is continue we to penetration the continuum will down able that of drive will, of which prolific in paid benefit and you market And mentioned year. We which next market, prediction the hundreds help that half mentioned, about of given into STAMPEDE more as as test. stuff back we're the patients be I the

to 'XX, bridging So to lots to Decipher not but testing about for why and the come things growth of us exciting excited just beyond we continue quite and drivers. that's our for long-term remain

Absolutely.

and there, Just Andrew, a again on to a basis. add a couple than of revenue volume things speaking more

from an these seeing unfortunately sizes incidence market are grow perspective. We

growth we are Decipher and of a seeing markets. the both mid-single-digit rate kind for low So Afirma to

a basis, million on Additionally, the for called out total Envisia. I $X revenue headwind

considering. And being worth that's we So remarks, product then for revenue spoke year. muted in about also next prepared our

have biopharma into think that account take we So invested and about one being also in. not business the incrementally that

be could so also or bit And year. that plus a minus next

something you Afirma ability we for us entering that our are guiding to not to today, X necessarily long-term -- in it's beyond up, we're Decipher, confident sum when and in next it. drivers given we're dynamics we and that we're our about feel today position again, bridge something investing aren't the but growth very We those 'XX confident for to that all in. But to very that shared excited of and tests year and quite our Marc

this another on end financial question, projections you're the cash about front. Terrific. by projections start cash of or year. you've I'll profitability $XX the mean your I the stick on one finishing the cash since raised and of year million

post it you I and XX%. you months X ago margin was just where EBITDA adjusted threw that think here out target XX%

So about of I related what's this reasonable that, you cash over forward? And do deploy sort to to to time? further model how a way in leverage intend guess here think going

our and and reps channel XX roughly in reps we've is job. a is sales effectiveness really clearly got the the sales and XX mentioned in amazing just second added mean the they're Well, in during sales of categories are a team specialty -- year seeing the doing diagnostics best-in-class an Decipher of team to Afirma. where it, none. I they handful because it I've leverageable both you're is We've in model

think a we'll like generate on should to side. I be able see I've annual grow, a sustainable the some will want don't leverage guide marketing to there I basis. specialty XX% continue to on what always ours to ultimately business be. and the we said, sales margin an as So

got invest million not X that slightly to quarterly continue see important -- order that and choose also to run we that journey, developing a basis in the there, those be up And guidelines fluctuations right? We've the to just product in And the at of beginning what dials at a $XX rate projects because You we'll really linear. year. our about is more in spending appropriate turn, X/X to there's level than will optionality R&D of talked that an I make some said importantly, able creating we is products. We've those support the the more that generate is timely evidence the generate itself. to Veracyte important, and it launch need that and the to reimbursement products ultimately, on as adoption if course, of of support evidence drive important, and assay than not always

And to those we that dials so to deliver make to turn growth we'll our as continue need we in sure order on expectations.

a to X Marc just into thorough And add Yes. very or correct. comment Andrew, But you're that had. comment

an delivering will profitability. differentiating year through saw -- like we XXX XXXX. balance step for on the is through course financial It a XXXX, increasing of won't were -- the quite incremental step XXXX, we're excited have about It just We quite adjusted that's are reasons function. and to and through which coming looking that come levers and a out balanced committed to put we change more in a conference we growth think now forward Marc as of quarter. being and the number we're to over XX% we came feat necessarily that different about between function our going investing XX% for we the be Thanks expansion or long-term your of were in be at this of we But here target, basis off when said, and astounding EBITDA guiding absolutely it. That going the thinking a to points profile. are shared, perspective from earlier further

obviously have cash at had decent an -- also had prior continuously this benefit given flow period basis. ASP on benefit down do collections any year, ongoing But which of decent XXX%. we those a a Additionally, will in period

basis. So on about as a that go-forward think well just

it's a lot have Thanks, require There deployment, business our grow a no around of over development of philosophy question wouldn't and projects we cash change our aren't company focus that going from do in on a paused to standpoint, focused right we've execution but that opportunities because in on in a because thing whole lot just multiple very deploy not to a really to financially, ourselves. And actually evidence accomplish. fact, execute that that significant we're importantly attractive years. is in focused well some on is trying we're our the investment us to what to Rebecca. and your more space resourcing -- require do, we to important. And would way on And the in very a And deployment.

we be to to how teams, attention So, clearly importantly, but we about our have assets capital, in more diligent focus in deploy thinking our other resources, how would that the very management company. deploy and and the

of from comes question next Our UBS. Lu Li

to like I wanted -- guess to I going first the back one, Decipher.

to players? think it? you just it the be can with quantify ASP like some of in benefit going negotiate do because you mentioned that takes And -- pressure you So, to that kind kind way have then of commercial like metastatic going to the benefit the initially second to Any they're time half. the

metastatic think of Great XX% Yes. total it you in about should the let question. of But terms market. the ASP as handle of the I'll benefit, part. Rebecca

XXX,XXX incidences U.S., new -- population, new year, of terms the incidences in or incidences right? about about XX,XXX a So the prevalent are of which So, incidences. but are of it don't metastatic, the think in

X/X it launch test. as related. Think we'll XX,XXX, the of Medicare So

I ramp-up ASP going test of think and that's And it But a be there payers. the creates why commercial well. so the in absolutely don't we're through you're will then as the initially important. the process so will be is ramp volume because tech we And pressure right, of there assessment a seeing

we as think test on grow will So -- the localized way in the you've payers seen test the will grow setting. I on bring commercial the same

Our grown commercial test added more payers. as we've has

I Yes, with right. you. exactly no, that's agree completely

patients, Medicare the Medicare ASP code. same billing RP getting For patients, same we the the on will we -- with as the Advantage be be then absolutely for do should our for and Medicare the And we commercial, biopsy side.

to time will get of there, but to expect So it payers, under all. but get we this for reimbursement not contract take of period the many some some

testing have payers, paid. there do in new that blanket does incremental Some we statements get

going over So, just I to going your to it's Afirma I Decipher, don't any metastatic do with be think ASP on time, to it grind right? and higher like always like so is, be shown just and view our You're different. ability to we've

Okay. Or to My a think XX% decline. It chain mentioned worse on you more question seems in Appreciate Just a the solve there supply bit it's the wanted little an the to issue? product Do on like that. quarter? color it's that. get just issue. mean, getting revenue. was you longer it's taking I second like sequential

intentional. Yes. is some but It of is, it

As Rebecca to our right? impacted we're managing We and customers impacted. patients see mentioned, don't demand, want

doing is so And the supply part risk to what demand. of we're managing chain mitigate

And why go-forward business. product as for of more set muted year. actually next about transition expectation of the so I next a growth Rebecca think that's the year a year

are managing and chain in We're the parallel, for ready we're to through and when developing NGS driving country developing submitted supply Decipher going Prosigna country swab. nCounter tests, these then nasal we're be multiple by on We PCR test also to Prosigna launch. on challenges, and including reimbursement on and our

year. a it the of next think So XXXX, product don't line revenue as is driver

We've with the it the would test fact, the got of and kind we sure launch said, In and right the to time think the hit make at of as, want right behind Rebecca and we it. as there. on right lot strength infrastructure expectations and hold right muted back contrary, markets to a I do,

Stanley. Savant question from next Morgan Tejas comes with Our

On This metastatic previously running back Decipher, for on an the of prostate is campaign Yuko for you awareness on talked Tejas. cancer. call about reimbursement

building much be Decipher broadly do for think how that even do of use population need a you classifiers, will setting? this in new you'll prostate for adoption you facilitate and to to market Given more

benefit training There's same the definitely it some, use metastatic it's will the TR, the but year. in when the and in part. use we'll to sales next same way, It's really, the sales the be the measured out And report how test, -- with the doing starts force is test talking for our here largely customers their then the about base. that early there which with interpret be we're test, so urologists, force, how most the engaging setting, particular, a to the on. to And customer to

do already I is just so same. And a of new what setting. the the lot do we'll some development, anything don't for localized it's continuing there's -- product of market we but it think more

that there And spend I next think about spend for perspective, sales that from out marketing curve the wouldn't inflection as to get well. in a year, of change as just and a of

Agreed.

test volume. that I super That volume it. total XX% think X% also about helpful. Bethesda of Got you're running V then mostly result you LCD. already with understand Afirma volumes Is Or I'm commercial? representing a also well? talked was we the uplift And to as are Medicare you as see ASP volume running of associated addition whether to could your trying in to

Yuko. question, good a That's Yes.

report run out I that think as -- I we when Bethesda perfectly obviously commercial V -- them think to do pieces comes say I payers, I it, And think would related. about why related, some for correlated, do obviously. is the we but not of reason down it

the On mix. it follow the general, in same does --

have though. benefit And the to Again, when it the also for side around we edges, on volume so the it, Bethesda V potentially obviously, it's comes on side. think I and ASP down

driver. think of as population. our being to don't don't of important to population, -- small to I nice So, it's very -- a be an -- tailwind, huge and a opportunity going but the don't it's want proportion therefore, of not I it That it's want I market expand said, a kind

about being there year, think revenue that. just for to that's next execution drive has are a our team to line regard I things shared to, helpful. of the But the error from sight that an expectations kind as other many rounding growth to we that of So, perspective with it so

zone. roughly Yes. to population, Decipher of cancer, X/X And just in population, the Rebecca that I comparison. so. inverted I thyroid it's right. add there, course. And to the the part or exactly And think so that, slightly it's from Medicare the Medicare It's LCD but in covers may more like of be population smallest off actually the the is

that's are said, already as new commercial payers, the Rebecca the So, there. opportunity, some

Our Ji next Scotiabank. Nam with question comes from Sung

such differentiated there the VANDAAM, and on on Congrats Great the like, lot another a on STAMPEDE and one going especially metastatic Decipher. as to studies just as clinical quarter. there Maybe population for the well. obviously, see

growth order U.S. Or are Decipher STAMPEDE then there of as if to for some -- trial the that of market the additional a inclusion in opportunities trial, translate drive you adoption specifically kind in companion U.S. curious diagnostic anticipate further to also, become guideline Just there? And well? there like in for inclusion sort? And well? need you into the -- could as there guideline do do just

Yes.

questions. great So,

further physician caused disease in think guideline And I table guidelines. adoption. based the a improvement positive including that without new that's side, time having what increase a of in literally Decipher Each came we that's Decipher, the the guidelines do got recent a traction that to about the think time you most on localized and the benefits out, on about every lot then if localized, for tells score. happened, the of ones, talked significant

the aren't the at And certainly they're the cohort entire the adoption beginning, be to to entire spectrum. the to XXX,XXX and able disease necessary the drive so on in get metastatic side, across patients expect but same. Guidelines follow across ultimately it order I to necessary to

you and is not only in continue will predictive others, support at with that evidence in whether or the without as question companion even the to being I that's get label it's potentially to positive it's metastatic. On a necessarily guideline either more prediction side, and into setting generation and and it's what expect prognostic your and that use appropriate both here out the localized part a we for diagnostic and treatment we others we inclusion There a to the core Decipher mean, partnering like future, that's to the diagnostic on are determine evidence a way. use that Veracyte, STAMPEDE drive but of guideline one. So, that, both used abilities. help yes, on such companion TBD, do of metastatic others us there STAMPEDE diagnostic, sure, the that inclusion And do

it and today put it them. It figure patient truly more higher using of that out beneficial but is is to the information. is I does docetaxel, what patient patients throughout for the they're what care think volume a this patient's you recognize going The and gives more beneficial aren't. level drives which no for way on and them dealing with more try are risk it's to that which continuum, resolution matter physicians STAMPEDE tumor what gives out, patients and using Decipher demonstrated benefit opportunity to trial one to to figure

those more outcomes think that incorporate the so kinds of adoption better and inclusion better results, And I studies and guidelines. the the in

setting? to want comment on you or usefulness utility the Do in the of STAMPEDE U.S.

same out I the will very yes, physicians one of IVD -- missed the think U.K. Yes, key Europe studies are as the opinion do as being we're its are is Absolutely. because a Rebecca. that involved so They've your global Thanks, been PIs was outside really of part in have locations European U.S. of trials many test aware had somewhat U.S. of in the been Decipher. And excited some from nature. In of look the why that that the Think reasons and other about way, at run Decipher compelling. and -- the U.S. leaders question. already studies. And the I so studies, involved. this of global we've

we whether as in to U.S. the run studies Now well is need determined. smaller to be

populations, including we're to all underrepresented with that dealing want also diverse too. populations, make We sure and

than of on million continuing bit few clinical same studies a drive to little a In about a Afirma so And dollar well. we that extent will and clinical sustaining I R&D talked dollars proportion -- X that strategic to big to Decipher trials, is spend isn't more few of studies have that. that those additional the the -- part supplement with the meaningful, do million as we drivers,

super That's it. follow-up. quick helpful. a And just Got

guys You mention did hurricanes.

of of peers quarter. the an Some mentioned in have that impact kind your as

Just some if will, if not, any? patient -- XQ kind the terms there from be happening any your you early things impact -- XQ? curious you like and of do end that if from of were there at of And some standpoint disruptions, impact could and visits delayed in

a of than would small short is answer of. day's say I thoughts look course, see physicians in a and whether but When we by a And natural weekly worth those But what go hurricanes recovered largely I'd the the impacted who effect And we've the of shipments, you others what think that events. hearts everybody, to say, Rebecca, impacted. graphs less our patients, small areas dent you the saw dent, you where and was out at no. that. were the from is were

quarter, day kind given fall this any on day lab other, the or the in in month in Sung can that really the of X earlier it's less in of nothing side I say Ji. the about would say I category, of of I'd given volume this that Yes. one saw or put the third a and and a quarter areas impacted. we quarter

with from comes DeBourcy Research. next question Our Nephron Thomas

a just I questions here. of cleanup couple guess,

completion guess, updated there I And I any maybe was last of early or on update year. next And study. the just NIGHTINGALE on one, thoughts just timing? this just potential First the -- year end enrollment think at of the

is when would revenue this just experience, is than we enough. others I've forecasting learned Thomas, the chasing The doing to add a study, much than something we outside impacted which extra study. then so at in were when you X the of to Yes. we of lung-based clinical guiding our couldn't -- I've studies be pin we been complexity our control. that And over close we're stopped down seem more became one it are it finish forecasting better at actually the we thing of because years

stopped guiding to we to So, We're continuing it. enroll.

reasonable are you XXX that enrollment. a enrolling clip, to update and close again completed have We at we've next when we'll sites

just one then And question. other

that hit million you there to $XX milestone payment I -- or just agreement is milestones adding kind biopharma where of, any million $XX the other QX a Just just cash, to in context? guess,

Yes, more side. actually that, than side Thomas. It's on it expense provide to context is revenue the happy on some the to

tomorrow in -- are potential $X around have the expense On see a payment we That's in we a have million. paying probability, you'll high side, of the quarter. that fourth the we as milestone Q

'XX. the quarter. fourth that expect quarter CapEx some of then And capital that to similar amount projects to development a off We spend we here the expect is beginning for around kicking working at we in have that also remainder are the the fourth have of in

say it's those I So, X buckets. would

question from comes next Our with Mike Needham. Matson

just year. I talk you driving this be and to good next that sustainable year? would wondering could what's about some -- if was So into you've that pricing pretty been degree had just what

Sure. Happy to, Mike.

a original over the So, have GEC the of I from Afirma we both going from GSC. to looked journey pricing -- the say been would years back change last has at -- that XXXX, as couple to to code

up headwind in And recall, of a period cleaned of we've lot bit of and 'XX, the a there. collections a and course 'XX, that you 'XX we benefited had prior to over If tied doing so. from

care But So, I effectiveness and the I bigger teams. managed driver billing our one driver. is think that's team of been our the think just

Afirma both contracts have something the every and if a coverage you put place they're We are flattening they're And rock of in of of we're they stars pull time else we and team getting Decipher. out. the effectively will, think curve, signed here that kind a number kind up -- effectively for reaching of and

last the the become portion a on. we'll more less a like it's as collections we where of margin a changes we rate But at big step over progress. think now, a to because know get I And ton on we're ready some or flatten And year, it's to close of cash don't that such I points we're that so flatten. look think eye in about we've at next made time, on keeping and of to period eventually, we've both prior have a had something function fully if portion as we've the of story, into the going have unless this And the year had outperformance incremental perspective will X. we a year. say, where point And are and curve to been

in that X big mentioned So piece large And the huge first work obviously, those again, for Decipher They been a payer amazing well I'd that this to like year to they a thanks Marc of work. earlier. together, has commercial the we and say got teams. that do incredibly quarter

those on keeping well the there. all great goal is is to And regard keep on So, teams are with to progress the making. --

then Great. MRD on Okay. test. And just the

there's the I think to this for nasal trial. a swab. your forecast I reluctance case, the So, don't in trial understand But

when you generate about expect meaningful you to can talk really launch revenue? that just some start So, to and

Yes.

launch. the So, to that thanks tech labs for get clinical our study. not It's No, utility to a it's that. it the for It's work and ready process. assessment in full have trial do we

run to have that. with some We everything samples, to obviously, associated validate and else

reimbursement. earlier approach than of very Urology always that genome I other a imaging, by indications It test was And whole identifying for disease more path to opening of And then test us in long-term it's ramp that MRD that -- as to so I a MRD. care by Veracyte's in we've in amount. differentiated, we genome. that in some is because test of and it of the just whole that's the mentioned data in with believe platform, I to that with European is transcriptome will a is made, -- structure. fits it's launched we're where initially a meaningful with makes very well and kind published obviously end well. The remarks going respect the described half getting running And right first both standard as our not whole the data XXXX. our bladder the But about in from of launch running MRD what that a faster talked Mike, fact mentioned I that going being there. to and sense to residual benefit And indication we're But or channel. the

think with forward bladder. test in we're indications years. proof over it our way. able be other so about to if But being And that you looking launch to actually that multiple many start concept, we'll of will That

from next comes Our with Partners. Puneet Leerink Souda question

What covered the to 'XX? the just the and tailwinds that, in you NCCN don't XB, growth? into contribute wondering first Level of rate Decipher I'm the could understand volume way have So, business the is about one sort was to to rate know expecting elevated from earlier. What question of going level? in growth just side. think trying to for Decipher. if this forward this the you're the So, what's on growth an right I mean, volume now sort metastatic I

Well, the of get think indication, you in The the would remarks, mentioned only well. then think key I in my I clear tailwinds. to are you've ramp beyond. was and the that mentioned, Guidelines back year which -- as as the we really half Puneet, commercial metastatic next the of add I starting payers things more that NCCN

as the through you would ready high-single working number. if giving reasons do still on testing Afirma that. Decipher to that about so next -- digits when give I at been to that strong. lot really think yet bullish the not this did a our and growth primary but But into because put we Afirma year commercial for payers Guidelines coming and together, give a year, revenue anticipated. so better some side ready just we yet. look than down year, I so the in the we about did very going has has And without say growth guide for grown why guide you feel Decipher We're forward Decipher we're not NCCN next for

cancer. volume large from might the a commercial are Afirma seeing And Because looking -- helpful. in can have your you test for Decipher that's companies. the start of But they and of commercials payers? in diagnostic what in peers level the savings, -- elaborate what portion look than from test for that and And the some commercial is that a of key on stability one just with different contracted for recently, the terms today then here? you being That's of marketplace Obviously, one classifier maybe payer pressures you're payers your the of to question of saw sort pharmacogenomics. Okay.

decision that excellent was lack available they correctly, I differences there. based And evidence on was way question, Yes, Puneet. the of a perceived it's if of that's for our the think, ongoing. in so much real are those lot understand evidence, I evidence Afirma as Decipher. read an the world It's that that I we yes, that And there's prospective retrospective, And have Decipher guidelines studies tests. not both standpoint, have just for well, in and for NCCN from tests, it

of commercial, as for strength and payers quite much Afirma and been is we've rest XX%-ish into so million standpoint. lives. we're the being bigger think so adding Afirma the call a been or is XXX from it, around having over much split, time. Medicare Medicare think there's fact, your more question of X/X both so commercial And conversations, evidence on proportion million And an And side Medicare, in the then XXX Afirma more contracts. To is which roughly, tests covered bringing commercial as and Decipher opposite Advantage like has some payers. and and I lives for we're more Think the

any our seeing payers. not we're from so And pullback commercial

more. with on contracting actually we're contrary, success some moving to As I the say, having with

Stephens. Mason from comes question with Carrico next Our

is see for those long Mason. be add I sales your slowly remind productive you This was us typically can on standards? where time, to as takes us you Ben you force, And for growing by reps teams time? hoping it as over fully understand relates help reps those could really you over your it how then to

question. Great it And categories; me Decipher, X IVD. let take and Yes. then in Afirma

we've revenue Afirma. in It's to side, same territories, splitting don't year, very got XX of in territories, And you much new last volume relative the the add on said, new experience, up in we've about And changing and dividing the have terms going more added both reps. reps a I be you gradual creating growth. to of If see roughly territories, in the cases, thoughtful as handful I in forward. a that reps, team Decipher bringing sales our and take

of lot to their So, do of we had And when think in But rep answer added territory typically much. we that's new you plan very, what and we've for takes up had X that carefully. To get great about that new that. to a to your question, The months reps, haven't a have I a turnover region. it does typically means we our see. sales haven't very really speed fact job that team to

So, a I reasonable months is estimate. think X

IVD the matter. it's different side, On a

labs to You're case. in that selling

menu, commercial will in to our we And sales countries. country by as be so some selling to we those bear country launch once country in ramp mind, country. see by country we But become the we we'll teams, able And have in reimbursed teams be more already able Prosigna. tests ramp

thoughtful the a like lot come. see very can volume team gradual that And X commercial actually pretty you so those build the much things put It's the it's thing. our grow you a as capability -- have will It's business, of coming. in not hope together -- you revenue you to and opportunity in the can

those then look provide And under you'd Great. wondering to update able there be IVD, on towards any sort Okay. diving sort any of if into timelines of that in we're able was Are future? development. to the I there products

XXXX. we're update. Yes, no several during said developing earlier, I major products

ones and Prosigna next first of transition following nasal as year. And I the expect have launch a swab for PCR that are to Decipher and then that. think ready that year so NGS we

of timelines about kind that's far. so we've so talked the And

with dealing tests launch we're PCR some Prosigna side, some said, more the NGS but the challenges we well. I that's chain want make sure and that fully supply for with we're to we're As ready as nCounter the when dealing is ready those to -- product, on on

like remarks. closing it back to for Marc This concludes Stapley now I would the question-and-answer to session. turn

very Thanks Stacy. much,

team So, margin XX% and of incredibly outstanding EBITDA revenue the growth XX%. this I'm with quarter, adjusted execution delivering of of our proud our

have and previously for margin in are of our financial adjusted sustainable achieving you can diagnostics closing best-in-class on a As profile clearly annually. continue goal a to we specialty a EBITDA see, XX% company stated

opportunity years for in and to in CLIA labs Global announce to excellent an build deep X team, has been position this her the has to to scale thank to that the I further for XX CLIA an to as for change want our opportunity forward organization over revenue, take our continued my future this outstanding for look Ops his growing take to scale. I Keith's months to want to to operations also last I us Keith Clia Operations. leadership Additionally, promoted Gligorich with managing responsibilities. we're expertise important our VP, contributions CFO we SVP, and enabled demand. our meet last out Rebecca her as addition our leadership

to of Finally, the our difference I patients We updating Thanks. look tireless lives at Veracyte the team forward make XXXX thank the a to new in our incredible we for serve. to on XXXX you year. their performance and all want in again work expectations again for

you gentlemen, concludes our call Thank Ladies this joining and for today. us.

may now You disconnect.