Exagen (XGN) Q4 2024 earnings summary

Executive summary

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

• Narrowed adjusted EBITDA loss to $10.1 million, reflecting a 40% improvement over 2023, and reduced operating expenses by 10.5%.

• Completed testing of the 1,000,000th patient with Avise CTD and launched new T-cell, RA33, SLE, and RA biomarker assays, with strong early adoption and clinical impact.

• Gross margin expanded by over 300 basis points to nearly 60% for the year, with Q4 gross margin at 62%.

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 increased to $411, up $75 from 2023.

• Gross margin for 2024 was just under 60%, up from 56% in 2023; Q4 gross margin was 62%.

• Adjusted EBITDA loss improved to $10.1 million for 2024, a 40% year-over-year improvement.

• Ended 2024 with $22.2 million in cash, cash equivalents, and restricted cash.

• Net loss improved to $15.1 million for 2024 from $23.7 million in 2023.

• 2024 Avise CTD test volume was 123,000 units, down 11% from 2023.

Outlook and guidance

• Expects at least $14.5 million in revenue for Q1 2025.

• Anticipates being adjusted EBITDA positive in Q4 2025 and sustaining free cash flow positivity for the full year 2026 and beyond.

• Plans to expand sales territories from 40 to mid-40s during 2025.

• Additional RA biomarkers expected to launch by year-end 2025 or early 2026.