Great. I think we're gonna start. I'm Dan Brennan, Life Science Tools and diagnostics analyst from TD Cowen. Really pleased to be up here on stage for the 46th annual Global Healthcare Conference with the senior management team of Quanterix. To my immediate left, we have Everett Cunningham, the recently announced CEO. We have to his left, Vandana Sriram, who is the Chief Financial Officer. Everett and Vandana, welcome and thank you.
Thanks for having us.
Appreciate it.
Awesome. Listen, Everett, you guys just had the quarter, first time at an investor conference, as a CEO role here, which was announced back in January. Would love to hear you just, yeah, just take a few minutes, maybe talk to us a little bit about, you know, the decision to leave-
Yeah
Illumina to join here, and then we'll kinda dig in.
Thanks, Dan, thanks for having us. You know, I'm now the old guy, you know, 30+ years in healthcare, and iconic companies like Pfizer and Quest Diagnostics, GE HealthCare, Exact Sciences, and my recent role at Illumina. When this opportunity, you know, came forward, I looked at it from the standpoint of it's in a space that needs breakthrough technologies, in neurology, in oncology, in immunology, right? The disease state that Quanterix is centered around, you know, they need differentiated solutions that, you know, that we have, which is great. That's one reason. Another reason is I look at the base business that Quanterix has now, mostly in the research tool side of things, and that base business is a solid base business.
Really good install base on the blood side and also on the tissue side with our recent acquisition of Akoya. I love the base business. What also excites me, and it's been a theme over the last couple of days, and it's where we're headed. We're headed into making an impact on the diagnostics side of things, especially focused on Alzheimer's diagnostics. You know, my 30 years, I've been a diagnostics, you know, person from selling diagnostics to leading diagnostics commercially and operationally. I think it's a really good space to be in. The framework that Quanterix has in launching into diagnostics, you know, is a really good framework. I'm sure we'll talk more about that. Lastly, the balance sheet at Quanterix. It's a solid balance sheet.
It's, you know, we did the Akoya acquisition. Vandana and team have done a good job of hitting the synergy targets. We will be at our $84 million synergy target by the end of Q1. We have announced that we will be breakeven from a cash flow standpoint on the second half of the year. We have $100 million of cash on hand and no debt. That balance sheet, and where we need to make really smart decisions and invest, it's a really good fit and timing for me to join Quanterix.
Obviously you've been here, I think 30 days or you know, something like. I'm sure with time and you get your sleeves rolled up here, you know, so kind of everything you just said are, you know, things that the company had going in place, right? When you think about, I'm sure when you looked at the opportunity and you said, "I'm gonna come in here, I'm gonna take this business where it's going, and I'm gonna put my stamp on it," there's maybe different execution levels, but there's also strategy. From the strategy side, I don't know, can you share anything about maybe just big picture?
Yeah
The things you just mentioned, things you might decide.
Yeah
Oh, we wanna go a little bit here or there.
Yeah.
I'm sure we'll learn a lot more about this over the next-
Yeah
12 months.
Yeah. Yeah. exciting, just exciting things. First of all, when I looked at the 2026 plan, to take our base business and all of a sudden start to generate growth, which we talked about at our earnings call on Monday, we're gonna be anywhere between 0%-3%, you know, growth in 2026. I like the plan for this year.
Right.
It's a good solid plan. My, my goal is not to come and just, you know, upheave everything and to change that. I think that Quanterix is headed in the right direction. From a future standpoint, you know, it's all about prioritization for us. I'm gonna take the opportunity with being new to do a holistic kind of review of what our next generation, you know, platforms and technologies are, and we'll make smart decisions based on, you know, what that is. I've been just, like I said, impressed with we have many shots on goal, and what our challenge, good challenge is gonna be is, how do we prioritize to really focus on, you know, those shots on goal that will bring us growth not just this year, but sustainable growth?
Last thing that's been a theme here, we will be and be a diagnostics partner. Building out that plan over the next, you know, 3-6 months.
Mm-hmm
In terms of not just how do we sell, but end-to-end. What is our end-to-end diagnostics plan from, we have a reimbursement strategy. We have, you know, clinical utility studies that are out there that we have really good partners. We have about three partners in the academic space to where we'll release those study results probably mid-year, so that will help us with our reimbursement strategy, to, you know, building an Order- to-C ash in our own lab. When we do and get ready for, you know, our diagnostic strategy, we will be able to obviously support that from building a— and this is my sweet spot, how do we then build a commercial plan to go after the right segments to, you know, to grow our business from a diagnostic standpoint? Lots, lots to do.
I promise that we come out with a more robust end-to-end plan in the second half of this year, but yeah, exciting times.
Terrific. Maybe just as a jump- off point, just on the quarter itself, you know, you had pre-announced, back early in January that things came in better and then when you reported they came in, you know, materially better, I think maybe 15% or 20% better. Just maybe why did the fourth quarter end where it did versus how you originally planned for it?
Yep.
Yeah. We were very pleased with how the fourth quarter landed, you know, that's a testament to all of the execution that the team did in a very short period of time. You know, recall that it's only been our second quarter since the acquisition. What we saw in the fourth quarter was a clear release of some of the pent-up demand that was probably held back a little bit in the third quarter. Most of our growth in the fourth quarter came from consumables, both on the Simoa side as well as on the Spatial side. Recall that the third quarter was a little bit light on consumables, you know, what this told us really was that our consumables truly are sticky.
You know, they may be a little bit bumpy period- over- period, but we're now kind of exiting the year with about 75% of our revenue in a recurring revenue profile, which we felt really good about. That, of course, translated to margin and cash as well, so margins are back to about 30%. Our adjusted cash burn after taking some acquisition stuff out really has come down to about $3 million. Again, recall each business was burning, you know, $15 million-$20 million at a time, and we're now down to about $3 million. All of the synergy stuff is also moving. We're seeing it in action. We're seeing it come through the bottom line.
Maybe just on Akoya, maybe can you reflect on the first, I think, nine months of the business under Quanterix umbrella? Like, synergy stuff's on track, that's great. Like, how has the business performed during these early periods? Like, some of your theses about the customers and the overlap and the complementary nature of it. Like, how has the early time here so far played out?
I'll maybe touch high level and then have Vandana, you know, cover in the gaps. I have the unique experience of, you know, my first 30 days just kind of walking around and talking to many of our leaders and colleagues in the company, and I'll give you kind of my sense of Akoya and where we're at. First of all, the diversification of the business. You know, pre-Akoya, Quanterix was 90% neurology, 10% other, now we're, you know, 60% neurology, 40% oncology and immunology. And you mentioned oncology and immunology, kind of the same story of neurology. Unmet, you know, disease states that need breakthrough therapy. Akoya gives us that diversification and balance, which I absolutely love.
Walking around, again, my past experiences of where Spatial is headed, I'm glad we're in this Spatial business. It's nascent, but with technologies like Akoya, experts that we've brought over from that company, we feel that, you know, we're well-positioned to make an impact from now into the future. The other thing that I've seen walking around, and listen, 34 years in healthcare, and I've been involved in acquisitions and synergy targets and things like that. I love the fact that our we're acting as one company. You know, no one comes up to, "Oh, I'm legacy Akoya," right? They say, you know, "We're Quanterix." We have work to do still.
We have work to do with the integration, but just the mindset of bringing us together as one company is, has been, in my 38 days, has been impressive, so.
Yeah, I think, spot on. The excitement around Akoya remains. The technology is super strong. We feel really good about it. When we were doing our diligence, you know, we talked to a lot of customers, KOLs, gathered a lot of feedback and, you know, we heard some of the things that customers said around, you know, ease of use, conjugated antibodies, more panels, et cetera, and some of those are already now in action. We released a couple of new panels late last year. We've got more in the pipeline for 2026. Everything is proceeding as we expected. There was, you know, some amount of trimming to do. There was a large, companion diagnostics contract that we made the decision to exit.
We had seen that in the diligence phase and, you know, we've kind of completed execution on that as well. Again, nothing that was surprising, just a lot of execution that we need to get through. Now our focus really is on how do we optimize this technology? How do we bring this back to growth?
Maybe just zooming out for a minute before we kind of dive into some of the businesses. I'm sure there's people in the room and on the phone that we think about kind of the future, right? What, you know, what this business is built to do, and you have 0% to 3% growth this year, so it's growth, but it's obviously still a challenging environment. Like, what is the profile of Quanterix, do you think? I mean, you've got this, you know, diagnostics, Alzheimer's opportunity, which, you know, we certainly could be very big, right? Even just on the core business between Akoya, between the Quanterix side, you know, you're in research translation. Like, what's the profile, even if you strip away diagnostics, you know, what's the right profile you think growth for that company when this market normalizes?
Yeah, I can take that. You know, the 0% to 3% growth was really keeping into mind the environment that we're in, and we all, you know, got through a very difficult 2025. That assumes that markets don't really change too much, and almost all of this growth will come through consumables.
We're doing a lot of consumables panels, I mentioned on the spatial side. On the core Simoa side, we've got some interesting things going on. Our diagnostics partners are buying more consumables from us now, which we think is a really healthy indicator that testing is starting to ramp up.
Mm-hmm.
Those factors will contribute to the growth. Anything that happens in the market from, you know, release of funding or, you know, funding kind of starting to flow down faster will be tailwind to the guide.
You know, longer term, our expectation is that these are all high growth areas that we're in. We're in neurology, we're in oncology, immunology. All of these are areas that are high growth. We do think in a normal environment, we would go back to that high single-digit growth rate. For now, of course, you know, we have to watch carefully with the visibility we have.
Terrific. Maybe just before we jump into Alzheimer's and diagnostics, let's just kinda focus on the base business, you know, between Simoa and then on the Akoya side maybe. Maybe just give us some color on kinda where we sit today with Simoa, and you have Simoa HD-1. Just, you know, what the trends are in the marketplace with customers and, you know, what are the key initiatives on that side of the business?
Yeah, maybe I'll touch on Simoa, Simoa Hd-1. Again, early days. I've had a chance to really talk to our technology team around Simoa HD-1. We hit a really important milestone of we had early access with Simoa HD-1 with one customer. We're in the process now of assessing what's coming out of that. We will take kind of that outcome and make decisions with that. I'm also taking advantage of doing a holistic overview of our entire, you know, footprint, our entire, you know, next gen, if you will, opportunities. We're gonna prioritize. We're gonna make sure that we take it, you know, into account, you know, what's coming out of our early access program with Simoa HD-1.
We're gonna take into account, you know, the acquisition of Akoya cause they have a lot of assets that are next gen, and we have to prioritize. We will turn it to the positive. We're gonna make sure that prioritization becomes a key component of Quanterix and not many shots on goal, but the shots that we feel will bring this company sustainable growth. That will be a really key part of our process.
Mm-hmm.
That's it.
Yeah. You know, when you think about the Accelerator Lab, which has always been a really important part of the business, you know, I think you saw a big improvement last year in the number of projects exiting 2025. Maybe just speak a little bit to that side of the business, which is, you know, really a kind of a flagship part of Quanterix.
I'll tee it up.
Vandana can go deeper. I've been impressed with Accelerator. you know, most of the projects now are in that 50K range. My goal will be to how do we focus and invest in our Accelerator business, develop some really key profitable relationships with pharma, and get these projects to be a little bit bigger moving forward in the future. you know, the momentum of Accelerator and the people that we have on it is impressive and will be a lever of growth for us.
Yeah. I would just add for those not familiar with our Accelerator Lab, that is our CLIA-certified lab here in Boston. What's unique about that lab and what, Dan, you were also alluding to is it's kind of a leading indicator for us. It's a great view for us to look into what customers are interested in, what are they working on. It's normally where we get our ideas for next gen assay development. As we see customers really start to pull the thread on particular assays and ask for custom assay development, that then feeds our pipeline to put it on our regular menu. Super valuable to us from the perspective of the insights that brings into what customers are really looking for.
You know, going forward into 2026, really good diversity of pipeline from a customer perspective, also from a disease state perspective. We've generally been very neurology-focused. We're starting to see immunology projects come in as well, which is a very interesting area for us as well. You know, the play for Accelerator for 2026 is very much around how do we expand our insights into what's important to our customers, partner with our customers at very early stages of their drug trials, so we can see them through that entire process.
How much is pharma, like the vagaries of pharma coming out of COVID boom and then obviously a bust for a while, and then, you know, the hope of improvement last year got stymied with a lot of the MFN and the tariffs.
Yeah.
How much was your business impacted by a lot of that macro noise, and what are you seeing today just from more from a high level of, you know, from pharma customers?
Yeah. Most of that actually hit Accelerator, where, you know, in the 2024 timeframe, Accelerator grew exponentially because we had large pharma customers, you know, in late-stage trials. We definitely saw a pullback in terms of outsourcing from pharma customers in 2025. That's all now in our baseline already. As we go into 2026, we're building off that baseline and, you know, any change in pharma spending would be a tailwind to our guide.
Like, is there any commentary just on the tone of pharma, what the funnel looks like? Do you think it's stable? Most of the larger companies have kinda guided for either stability or a bit of improvement in the back half of the year, the hope is that, hey, we could be really low-balling things here because there's no reason why we shouldn't see bigger.
I'm just, I'm looking just at the plan for our Accelerator business. I think the number of projects are stable. It's the size of the projects that have been impacted.
Mm-hmm.
You know, with the, with the funding challenges. That's why I'm saying part of my job is gonna be, you know, making sure that I develop the right relationships with the pharma partners that are out there. Being external, going and talking to the pharma partners, I spent, you know, 2+ decades at Pfizer, so I kinda know how to navigate pharma, that's one of the things we're gonna do.
I wanna ask one more question on a high level, a question on Akoya, and then we'll spend time on, like, Alzheimer's. Maybe just a high level, again, for those in the room or on the phone. If, you know, if and when the environment, you know, when the environment normalizes and you get back to maybe that high single-digit base growth, how would you like, what are the building blocks to that? You know, like, you know, however you wanna frame it, instruments, consumables, end markets. I'm just trying to frame what the normalized profile is for Quanterix. We're sitting here at 0 or low single digits today, and, you know, if we get to that, I'm not saying it's gonna happen this year, but if we get to the high single, what are the building blocks?
Yeah. Let me take an attempt at it, and then, Everett, certainly you have a view here.
Yeah. Yeah.
You know, we would look at this as, again, a very sticky business.
Mm-hmm.
Starting again with tools, have the best tools in the market, both on the Simoa and Spatial side. That brings a really sticky consumable stream. We're right now at about 75% recurring revenue. We think, you know, 80%-85% is very doable and reasonable. That would be one way that we would look at the business. We are very highly sensitive to leverage. As volume comes in, we would expect margins to be well north of where they are right now. We ended the fourth quarter right at about 50%. Our guide is assuming a slight improvement to that. We do think there's a lot of runway for margin as well.
The way we look at the tools business is the most important thing for us is to get the combined tools business to be self-sustaining from a cash flow perspective. We think we have the right infrastructure in place now that supports, you know, the level of growth we're at right now. As that increases, that actually feeds back into, you know, really being a business that returns money versus being a user of cash.
The only thing that I will add and said earlier that we have still work to do around the Akoya acquisition and making sure we're one company. I use the example of my first, you know, two weeks in the company, I went down to the commercial meeting, the global commercial meeting, and I could not tell who was legacy Akoya or who was legacy Quanterix. Just seeing the combined commercial team in a room sharing, you know, their call points, sharing their Key Opinion Leaders, to me, that's what I think about when it comes to synergy, right?
How do we then say, "Hey, how do we link tissue to blood, and does that work?" We're gonna build that strategy out, but early on, just that combined sharing of, you know, customers and call points, I think is gonna give us leverage moving forward.
Maybe on Akoya, how did Akoya come in in the fourth quarter versus expectations? Could you share some color about what's implicit in the growth rate or the guide for 2026?
Yeah. Akoya did better than our expectations for the fourth quarter. You know, we had profiled them to be about $30 million for the second half, and they were, I wanna say about $36 or $37. Really nice performance. Again, you know, seeing really nice uptick on consumables on the Akoya side. Instruments were a little soft 'cause a lot of our Asia customers had bought earlier in the year to avoid tariffs. Instruments a little softer than we liked, but consumables did really well. Going into 2026 as well, our expectation is capital markets will remain constrained, so instruments will remain at, you know, the levels they were in 2025, but we definitely see growth in consumables. We're also working on, you know, how do we create service offerings similar to what we have in the Accelerator Lab?
That's something that, you know, we haven't counted for in 2026 'cause it'll take some time to develop, but we see that as a growth opportunity as well.
Maybe on clinical diagnostics, maybe start with the catalyst calendar this year. I think, you know, last month you published, you know, the FDA, you know, you announced a submission for the multi-analyte blood test for an Alzheimer's. Just, you know, in terms of, I think you mentioned last night, 6 to 9 months is when you expect to hear.
Yep.
Maybe just a little bit more color about the milestones.
Yeah.
The timeline.
Yeah.
Kinda what investors should be watching for, and then we can dig into some of the details.
I again, it's one of the reasons why I joined is because the framework is absolutely there to make an impact in diagnostics on the Alzheimer's side. You talked about the 510(k) submission in January. I love the clinical utility studies that we will be putting out in the second half. I love the fact that, you know, our reimbursement strategy is front of mind in making sure that, you know, we will have the data along with knowing who to go and who to talk to. We have a differentiated test in terms of the 5 biomarker test in LucentAD Complete. We have a great price crosswalk of $897 from CMS.
Our job now will be how do we now put together an end-to-end strategy that we can execute, right? We're not shy. We're already investing in that strategy now. To me, it's like, you know, taking my past experience, we have a lot of people that work for Quanterix right now that have experience in diagnostics and putting that all together. We have very little, Dan, built into 2026 in terms of what that diagnostics is gonna bring for growth. We will be, well suited for, you know, growth 2027 on out in our diagnostics strategy, so.
Oh, pardon me], I don't know if you wanted to add anything.
No.
In terms of an end-to-end strategy, I think one of the things, struggle is the wrong word, but it's just more, there's a lot of different ways you could take this business, right?
Yeah. Yeah.
Because you've got this unique technology.
Yeah.
You can have your own CLIA lab, you could put boxes to centralize, you could put them in core labs, right? You've got large competitors taking different strategies as well. Investors sitting back.
Yeah.
-maybe even clinicians, I don't know. Like there's a myriad of different-
Yeah.
-ways to do this, it's a market that really hasn't done much yet because the cart's before the horse.
Yeah.
Can you define a little bit, and again, it might evolve here?
No, no. Yeah.
Can you define a little bit about like how we think about.
Yeah.
you'll play in the.
Yeah.
diagnostics.
Yeah.
a mean for
Yeah.
for Alzheimer's?
Yeah. I'm a quirky guy. I love the fact that we're getting a ton of diagnostics questions. It's great because it's a nascent market that needs us, right? Which is a good fit. I'm gonna spend my time, 38 days with the company, I'm gonna spend my time of really building out what that end-to-end is. I will say this, it's a yes. I mean, will it be decentralized? We have the capabilities to do that. Will it be centralized? We have a CLIA lab that we can do that. You know, we have the ability to have an end-to-end strategy. Also, and again, this is more of a, I have a dream speech, right? I liken it to experiences I've had in past companies.
You know, when you think of Alzheimer's, a lot of people think of Alzheimer's as cognitive impairment, dementia. I like the fact that we're going to have early biomarker detection, blood-based biomarker tests that move it earlier in the, in the patient journey continuum, right? Maybe it's guideline driven, and that's when I say end-to-end, working on the guidelines piece of it, meaning, you know, you have familial history of cognitive impairment. You know, why can't we be in the guidelines of saying, "Okay, if you have familial history, you're going to use a test like LucentAD Complete, you know, as part of your journey. Pushing that earlier into a, you know, to a getting answers earlier in your journey so it isn't a, "Hey, I have cognitive impairment and it's impacting my life.
FDA, you know a lot of companies in diagnostics don't need FDA approval. Sometimes it matters, sometimes it doesn't. Like, what does FDA do for you?
Yeah. Again, I liken this to my past experiences. It's from a clinician standpoint, healthcare provider standpoint, it provides confidence. It provides an easier workflow. There's a lot of things that FDA approval will do for us. We're confident that we're in the right space now with our 510(k) submission and what we need to do. But it's a confidence lever. I don't know, Vandana, if you wanna-
That's exactly it. You know, a big challenge with anything new is adoption and the speed at which things get adopted. The FDA approval definitely provides help with that.
What's the competitive profile? Obviously, you've talked about in the past the indeterminate zone and, you know, the sensitivity here, but you've got really large players that maybe aren't as sensitive, but they've got scale.
Mm.
They've got reach. Labcorp, Roche, Fujirebio, then you've got smaller competitors. Just Again, the strategy will evolve. Just speak to, like, where you fit, and where you think your, you know, your kinda area to win is.
Yeah. You know, there's been a lot of tests in the market. Some of those tests have had some bumps in the past, and that actually goes back to, you know, our assertion that we really do believe that being the best test really matters. The level of sensitivity and specificity that our LucentAD test brings is still unique in the marketplace and is still somewhat unmatched. You know, for very simple single marker screening, that's a market that we know has a lot of players, it's commoditized. Our focus very much is on how do we take this multi-marker test, which has good reimbursement, good specs, least indeterminate zone, and how do we really broaden the scope for that? We feel really good about that still.
Yeah. You know, you mentioned, you know, companies with scale, and scale is important. I don't wanna minimize that. But my experience, you know, the efficacy, the quality, the sensitivity of the test is what really helps patients in their journey. We're gonna make sure that, you know, our commercial approach and the way in which we train people to tell that story, the quality of the test will be an important piece of our story.
Like is the market primed, do you think, for like blood-based testing today, d octors' needs, like just talk a little bit about like the alternative. Obviously, there's a limited number of PETs, right?
Mm-hmm.
Obviously that's great. Like what needs to happen on. You know, you talked about guidelines.
Mm-hmm.
you know.
Mm-hmm.
On kind of the prescribing side. Is there a lot that needs to change and happen in order to see an uptake here?
I mean, right now you look at the two pharma products that have had, you know, really good surges in the fourth quarter. You know, you now have tools that are out there that pair very nicely with blood-based biomarkers, the timing is very, very good. You know, like anything, you have to get the healthcare provider to understand what and how our solution helps it works in their workflow, how it helps the patient, the patient journey, you know, all of that. We feel while it's a nascent market, the timing is ripe for us to tell that story.
Cool. You guys are giving some color on revenue opportunity. Like when would you be comfortable kinda talking about what you think the opportunity looks like over the next couple years?
You know, I'm gonna use Everett's 38 days.
Yeah.
Yeah. We don't have, from our LucentAD Complete and the diagnostic strategy, we have very little built in the 2026. We will put together that plan in the second half. We look to have our diagnostics plan really contribute to our growth in 2027 and beyond.
Mm-hmm. Okay. Then maybe one between the health system partnerships, the licensing strategy, can you elaborate a little bit, like, where you're seeing the traction today at least?
Yeah. We're seeing really good traction on the p-Tau 217 test. You know, we definitely see a correlation to the drug uptick. As we've seen over the last couple of quarters, drug uptick go up, we've seen customers order more consumables from us p resumably for this testing. The other place that is somewhat underappreciated that we spent a lot of time and effort on is developing the infrastructure outside the U.S. Within the U.S., you know, we have some big names as partners, Mount Sinai, MGH, et cetera. We're also doing a lot of work in Korea and China and other areas where there are large aging populations. One of our partners in China has NMPA certification already. That's gonna be another area of growth that is perhaps underappreciated that is gonna come through our partner channel.
Maybe final quick one, and then I'll let you end it, Everett. Just competitive profile for the from the technology itself. There's a lot of players that see the opportunity and, like, ultra-sensitivity and maybe lower mid plex. Like, how do you think your product kinda stands out?
You wanna take that?
How our product stands up in the-
Yeah, competitive profile. Like, you know, the ultra-sensitive approach that you have. You have other players.
Yeah.
trying to get in there.
Yeah. If I look at the ultra-sensitive approach and the five biomarker test, you know, no one has a 5- biomarker test. You have single markers that are out there. You know, you have other competitors that are trying to break the space. Here's what I would say with that. I like the fact that we have competitors. It talks about the attractiveness of the market. I've never shied away from competition coming out with, you know, solutions. Now, the fact that we have a distinguished, you know, test that's out there that distinguishes itself from the market is a great thing.
Mm-hmm.
Other players coming in and building out the market, I welcome that. It just, again, it talks about the breakthrough solutions that are needed in the space. We're gonna be there to compete and compete hard, which is good.
I think it's good.
Terrific. Well, I think we just ended it there, so terrific. That sounds like a great ending. Everett, Vandana, thank you very much for being here.
Dan, thanks.
Thanks.
Thanks for having us.
Thank you.
Appreciate it.
Thanks a lot.
Appreciate it.
Appreciate it.
Thank you.
Thank you very much.