Exagen (XGN) Q4 2024 earnings summary

Executive summary

• Achieved record total revenue of $55.6 million in 2024, a 6% increase year-over-year, driven by improved reimbursement, higher ASP, and new biomarker launches.

• Adjusted EBITDA loss narrowed to $10.1 million, a 40% improvement over 2023, reflecting disciplined expense management and operational efficiency.

• Completed testing of the 1,000,000th patient with Avise CTD and launched new SLE, T-cell, and RA33 biomarker assays, expanding clinical utility, especially in RA and lupus.

• Gross margin expanded to just under 60% for the year, with Q4 gross margin at 62%, attributed to ASP gains and operational improvements.

• Ended 2024 with $22.2 million in cash, cash equivalents, and restricted cash, with a net neutral cash burn in Q4.

Financial highlights

• Full-year revenue reached $55.6 million, up 6% from 2023, primarily due to ASP expansion.

• Trailing 12-month ASP for Avise CTD was $411, up $75 from 2023 and $126 since 2022.

• Q4 2024 revenue was $13.7 million; gross margin was 62.1% in Q4 and 59.5% for the year, up 300 basis points year-over-year.

• Net loss improved to $15.1 million for 2024 from $23.7 million in 2023; Q4 net loss was $3.8 million.

• Operating expenses were $46.7 million, down $5.5 million (10.5%) from 2023, with SG&A down 13% and R&D up 12% (excluding stock-based compensation).

Outlook and guidance

• Q1 2025 revenue guidance is at least $14.5 million, with incremental $90 per test from new markers factored in.

• Expect to achieve positive adjusted EBITDA in Q4 2025 and sustain free cash flow positivity for the full year 2026 and beyond.

• Anticipate continued ASP and gross margin expansion, with gross margins expected to reach the mid-60% range over time.

• Plan to expand sales territories from 40 to mid-40s in 2025 to drive volume growth.

• Full-year 2025 financial outlook to be provided with Q1 results.