Exagen Inc 2024年度报告

2024ANNUAL REPORT Dear Shareholders, 2024 was a transformative year for Exagen. Over the course of 2024, we intensiƱed ourfocus on delivering the best testing for patients and clinicians – both in accuracy andservice – and the results are energizing. We set ambitious goals to improve every aspectof ourƲagship AVISE® CTD diagnostic platform, from reimbursement rates tooperational eƯiciency, all with an eye toward proƱtable growth. I’m pleased to reportthat we not only achieved those goals, but in many cases exceeded them, positioningyour company for an exciting future. Raising the Bar: ASP Hits a New Milestone One of our proudest achievements in 2024 was dramatically improving our averageselling price (ASP) for AVISE CTD. When I joined Exagen in mid-2022, our trailing 12-month ASP was about $285 per test and facing downward pressure from a Medicarerepricing in early 2023. Fast forward to today: our ASP has surpassed the $400 mark fortheƱrst time. In fact, by the end of 2024 our trailing 12-month ASP reached roughly$411 per test, up $75 from the year prior. This is an exciting milestone that brings usclose to our near-term goal of attaining 50% of the full Medicare (CMS) price for our ASP.Such a gain – over 40% increase in two years – is extremely rare in our industry, and itreƲects extensive work to demonstrate the value of our tests to insurers. How did we achieve this pricing power? Throughout 2023 and 2024, we overhauled ourrevenue cycle operations and appeals process. We invested in better personnel,systems, and documentation to ensure insurers recognize the clinical importance ofAVISE CTD. We even made the tough decision to ask physicians to include detailedclinical notes with test orders (a burden on busy clinics) to strengthen ourreimbursement claims. This change caused a temporary slowdown in test volumegrowth – a one-time reset as we expected – but it was a strategic trade-oƯwe werewilling to make. The payoƯhas been clear - payors are increasingly acknowledgingAVISE CTD’s value, and our payments per test have risen dramatically. We believe thisfoundation of higher ASP not only boosts current revenues but also validates the real-world impact of our diagnostics. As we move forward, expanding test volume on top of ahigher ASP will drive much more proƱtable growth than volume alone ever could. Financial Strength: Growth with Improved EƯiciency OurƱnancial results in 2024 underscore the strength of our revised strategy. Wedelivered record revenue for the year – approximately $55.6 million, the highest inExagen’s history. This represents healthy growth over 2023, fueled largely by the reimbursement improvements mentioned previously and our team’s focus on high-value testing. It’s gratifying to see top-line growth even as we prioritized proƱtability.Gross margins expanded to nearly 60%, up from 56% in 2023, thanks to pursuit of moreproƱtable business and prudent management of business operations. More importantly, we achieved this growth while signiƱcantly cutting our losses. Ouradjusted EBITDA improved by about 40% year-over-year, with a loss of roughly $10million in 2024 compared to a ~$17 million loss in 2023. In other words, we cut ourEBITDA deƱcit nearly in half. We also substantially narrowed our net loss, reƲectingdisciplined cost management and smarter spending. This is a remarkable turnaroundfrom prior years and indicates that the business can sustain itself as we continue togrow. In fact, with our cash on hand of about $22 million at the end of 2024), our runwaynow extends to proƱtability, giving us ample breathing room to execute our plans. Fewcompanies in this space and at our scale manage to reduce expenses and losses byover 70% while still growing revenue, but Exagen’s 2024 performance shows it’spossible with a great product, focus and determination. We enter 2025 on a far strongerƱnancial footing – nearly break-even in cashƲow – and with line of sight to achievingproƱtability in the near future. One Million Patients and Counting Amid theseƱnancial gains, we never lost sight of our core mission - helping patientssuƯering from autoimmune diseases get the answers they desperately need. In 2024,we reached a humbling and historic milestone – Exagen tested its one millionth patientwith AVISE CTD. Think about that for a moment, one million patient lives touched by ourƲagship test. Many of these individuals had spent years searching for a correctdiagnosis. Patients with complex connective tissue diseases endure an average of 6 ormore years of doctor visits before getting a deƱnitive diagnosis. AVISE CTD is helping tocut that agonizing journey shorter by providing clarity sooner. Every test represents aperson – someone’s mother, brother, or friend – who mightƱnally put a name to theirillness and get on the path to proper treatment. Reaching one million patients is atestament to the trust that rheumatologists have in our tests and the tangible impactwe’re making to clinical practice. We cel