Veracyte, Inc. (VCYT)
NASDAQ: VCYT · Real-Time Price · USD
33.01
+0.09 (0.27%)
May 1, 2026, 11:10 AM EDT - Market open
← View all transcripts

Morgan Stanley 21st Annual Global Healthcare Conference 2023

Sep 12, 2023

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Hey, guys. Good afternoon. My name is Tejas Savant, and I'm the life science tools and diagnostics analyst here at Morgan Stanley. Before we begin, for important disclosures, please see the Morgan Stanley Research Disclosure website at morganstanley.com/researchdisclosures. And if you have any questions, please reach out to your sales rep. It's my pleasure this afternoon to host Veracyte, and speaking on behalf of the company, we have Marc Stapley, CEO, and Rebecca Chambers, CFO. So thanks, guys, for doing this. Marc, maybe to start, you know, you've been in your seat for about a year now. What do you view as Veracyte's, you know, key accomplishments since you took charge, and what are you most excited about heading into 2024?

Marc Stapley
CEO, Veracyte

Yeah, and thanks very much for having us both here again. And maybe before I start, I'd just like to make my own statement regarding, you know, today we may be making forward-looking statements, so I would refer everybody to our safe harbor that can be found at www.veracyte.com and in our filings. So I've actually I've been with the company now for over two years. You know, and if I think about the accomplishments that we've made in that time, I'm very proud of a number of different things, but particularly the way that we've brought our core business to the stage that it's at with our Afirma and our Decipher test. And the strengths that we're seeing there in that core business for thyroid and prostate testing and the level of penetration that we've been able to accomplish in those businesses.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

In addition, you know, our continued investment in funding in the long-term growth drivers that we are very, very focused on, which is, you know, our IVD strategy for making our tests available to patients outside the U.S., as well as our groundbreaking nasal swab test for lung cancer. In addition to that, yeah, a clear strategy that we have and those drivers of the business, the level of profitability that we've been able to achieve and cash flow generation, really balancing our portfolio during that time to get to the stage we're at today. And also the team that we've built. You know, we've been able to bring in a lot of talented executives and team members to help drive this, yeah, this business. So I'm very excited about, you know, the things that we've been able to accomplish over the last couple of years.

Well, frankly, for many, it has been a very difficult environment, and at Veracyte, we've been able to really, I think, shine and differentiate ourselves.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. So let's start with Decipher. I mean, that's been a real growth engine for you since you bought the company. You know, as we think about the penetration for prostate classifiers, it's about 30% today, I believe you said. Decipher holds, you know, I think, majority market share in there. How is the test differentiated from competition? You have sort of Myriad in there, and they've come at it more from a data angle, generating more data, and you have MDxHealth. I mean, they've taken a more portfolio approach in their sort of go-to-market push. So where do you think Decipher really shines, and what is it that physicians are focused on?

Marc Stapley
CEO, Veracyte

Yeah. So just a reminder for everybody that, you know, we acquired that Decipher business in March 2021, which is right around the time just before I joined the company. There's a lot of reasons why we acquired Decipher. It's a very, in our minds, a very differentiated test, and I believe that the performance of that business has, you know, reinforced and validated that. So you're absolutely right. We put the market penetration at around 30%. There's about 288,000 new incidences a year of prostate cancer in the U.S., and that's growing. We do believe we're the market-leading product in that penetration. And the reason for that is a number of different things.

One is the level of evidence that we have developed for the test, with over 75 peer-reviewed publications and studies that support Decipher in, frankly, you know, more than 90% of the indications in that market that I just referenced. In addition to that, that level of evidence that we've generated over many years has led to NCCN Level 1 guidelines-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Marc Stapley
CEO, Veracyte

... which makes Decipher Prostate the only RNA expression test for prostate cancer that has that level of, NCCN guideline, coverage. And we also, one of the things that we've done is we run a whole transcriptome for Decipher Prostate as well, you know, which produces, in our minds, a very differentiated test and also enables us to offer a research-use-only product to, physicians for their practices as well, which cover more broadly than the standard classifier. So yeah, I think when you put all those things together and you layer on top an extremely, effective and dedicated sales team that is executing extremely well, that's why you see the level of growth that you've seen. So for example, just in Q2 alone, the volume, Decipher volume, at around 15,000 tests, grew 50% year-over-year.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

So a very impressive performance by our team and, you know, based on the effectiveness of the product.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. What does it take to get penetration from 30% to, you know, let's say, over 50% or 60%? I mean, both in terms of timelines as well as, is there anything you need to do differently in terms of go-to-market, or is it just a function of time, build... continue building the evidence, continue sort of like reaching out to physicians?

Marc Stapley
CEO, Veracyte

I think in our minds, it's continued evidence development, and it's not just evidence that we develop ourselves. Others develop evidence using the Decipher test in a real-world setting as well, because it's so predominantly used now, at least in the market, to the extent it's penetrated. But to your point, there are so many patients today with prostate cancer who aren't getting a molecular diagnostic, and we clearly need to change that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

You know, where it ends up, it's hard to say because there's not too many analogues out there, but I think it would be reasonable to assume something like 70%-80% penetration, ultimately, where you get to. So to your question of how quickly do you get there? I believe it's continuing to do what we're doing.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

It's a sales team that can be highly leveraged. We don't need to grow our sales force linearly at all. In fact, we've demonstrated that that's not the case. And continue to encourage physicians who don't use any molecular diagnostic to start using Decipher. And, you know, those that are not using Decipher in every instance to increase the utilization. We have customers, physicians who use Decipher 100% of the time, and customers who use it a few times. So, you know, there's every combination there that we can continue to push on in order to make sure patients are getting the access, you know, access to the test, which is ultimately why we're here.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. You know, we've heard some investors ask us about some of these new imaging-based modalities, like Artera. How do you see uptake for them evolving and impacting sort of tests such as Decipher, once reimbursement falls in place? I mean, there's still some way before we start seeing them commercially, but-

Marc Stapley
CEO, Veracyte

Yeah, and remember, you know, it takes a lot of years to generate the evidence that you need to drive adoption.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

And we've been doing that for a long time with Decipher Prostate, and then coverage as well, and reimbursement, as you say, not just with Medicare, but also commercial payers. And we're still, ourselves, in the journey of doing that in terms of driving all commercial payers to cover the test. But what we hear a lot from our KOLs is there's no substitute, the ones that are leveraging molecular diagnostic and particularly Decipher, there's no substitute-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm

Marc Stapley
CEO, Veracyte

... for the diagnosis, the molecular diagnostic test. Looking at the genome level, RNA-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Marc Stapley
CEO, Veracyte

... expression-based information, having the whole transcriptome as well, for example, you can't substitute that with imaging.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

Being able to go from the imaging that we have today to imaging with AI is a step forward in imaging, but it doesn't replace or substitute for molecular diagnostics.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Is there room for... I'm not talking specifically about Artera, but is there room for that sort of modality to coexist within Veracyte as, as sort of perhaps a complement to what you're doing on the molecular front?

Marc Stapley
CEO, Veracyte

That could be. I mean, if you think about Veracyte today, the AI and data analysis is very embedded in the algorithms that we produce-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... the products that we have, the assays that we develop, and we have those skill sets in-house.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

You know, continuing to evolve around that to the extent that we need to is clearly within our wheelhouse. But as I said before, I think the real way to drive further adoption and penetration of Decipher is doing exactly what we've been doing for the last, you know, multiple years and Decipher before that. So continuing with the well-proven formula that is clearly working for us is where we should be focusing our time and attention.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Is there anything different that we should be expecting on the strategy front for the urology business, given the leadership change or not really?

Marc Stapley
CEO, Veracyte

No, not at all. And the leadership change you're referring to is, Tina Nova, after 2.5 years of staying with Decipher and Veracyte, post the acquisition, has decided to stand down and focus on other things that she wants to focus on. She's still working with us.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

But Tina and I knew at some point this, this would be the case, and it typically is after you acquire a company. In fact, I'm, I'm proud and, and very, pleased that we were able to work so closely together for so long. But we, we built the... You know, she built an incredible team behind her, and we hired John Leite as well-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... who both of us have worked with previously, out of Rebecca, to be the leader of our CLIA U.S. business, and with the intention that we would be able to put that business under John at some point. And so that time has come, and I don't see any concerns from that transition at all.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it.

Marc Stapley
CEO, Veracyte

So, you know, Decipher's Decipher in our urology business is very well established. No change in strategy at all there. One things I'm excited about, and I'm sure we'll get to it, is, you know, we are going to submit Decipher as an IVD test for penetration outside the U.S. as well.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah.

Marc Stapley
CEO, Veracyte

Up to this point, everything we've talked about, every number, has been U.S. only. But there's a clearly pent-up demand for a molecular diagnostic test like Decipher outside the U.S. KOLs outside the U.S. are very aware of it. They're already involved in studies using Decipher. They're on publications that have used Decipher, and so we're excited to make that test available to them. So we'll submit it for regulatory approval in 2024 and then, you know, follow through with commercialization.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Where are you on the commercial channel build-out? I think you've got about, you know, approaching 50 reps there. Do you think that's enough? Or as you start to drive penetration, perhaps into, you know, the skeptics or the non-believers or just the late adopters for testing such as Decipher, do you need sort of more feet on the street?

Marc Stapley
CEO, Veracyte

Not to a great extent.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

You've seen the evidence. Like, I said, we grew 50% in Q2, and that was with a sales team that wasn't significantly larger than the sales team we had the same time last year. So it's a very leverageable specialty model.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

The territory is already well established. We don't need to go and distract, you know, and change that significantly. When we need to add sales reps, we do, and we will continue to do so. But at this point, with roughly 45 sales reps today covering Decipher, we have most of what we need.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. How are you thinking about the bladder cancer test in terms of the pipeline? Is that something that you'll put more resources behind starting next year?

Marc Stapley
CEO, Veracyte

Yeah, bladder is a natural extension in that specialty urology-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... channel that we have, of course. It's a smaller market than prostate, with around 80,000 incidences a year, and in the US. And for us, it's continuing to develop the evidence to support the clinical utility of that test in multiple indications, in the same way we did with Decipher, and then leveraging the channel-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... to the urologists to make that available.... So continuing to develop that test, develop the evidence, it's not, I don't see that as a needle mover in the next year or so.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

But certainly, it's part of our long-term strategy.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Switching to Afirma, you know, you took up the revenue expectations there. I think it was low- to mid-teens. Just underscoring strong penetration into new accounts, further penetration into existing accounts, but it is a pretty sort of like established, mature market as well. So how much of the increase is driven by, you know, price versus volume? You know, you got some ASP tailwinds there as well from, you know, the CPT code switch.

Marc Stapley
CEO, Veracyte

Yeah. I mean, I'll talk about the volumes and what's been driving that business, and Rebecca could talk about where we are on the ASP improvements this year. But the real, to me, the real driver of the volume is one, it's a test in a market that's about 50% penetrating.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

It's a market-leading test. So similar to our conversation about prostate, there is plenty of opportunity for that to grow. And again, could it get to 70%-80%? I don't see why not. And so we're trying to drive that ourselves with the market-leading test there. We continue to invest in Afirma. So for example, you know, we launched TERT-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... as an additional, you know, test modality. We've invested in the physician ordering process and portal. We've had multiple reasons to engage with our customers, and our sales team has been effectively doing that, coming out of a, you know, post-COVID environment. They very quickly got back out on the road and visiting customers, and that's proving to have a positive impact. And that's why I think we're seeing both, as you mentioned, new customers and, existing, you know, penetration into existing customers.

Rebecca Chambers
CFO, Veracyte

With regard to the volume versus price impact, about three-quarters of the growth has been volume-related, so only a small amount of the tail would be tied to ASP gains. Those ASP gains aren't just from the CPT code piece. Over the course of 2022, we did have a headwind, as you well know, tied to-

Marc Stapley
CEO, Veracyte

Mm-hmm

Rebecca Chambers
CFO, Veracyte

... a code change back in 2021.

Marc Stapley
CEO, Veracyte

Mm-hmm.

Rebecca Chambers
CFO, Veracyte

Those towards the end of the last year abated. We did have some goodness as we resolved those, you know, pair-by-pair instances over the course of 2023. But even more so than that, just the efficiency and the gains on the managed care side and on the billing operation side have really lent itself to that higher collections rate. And so while the CPT-

Marc Stapley
CEO, Veracyte

Right

Rebecca Chambers
CFO, Veracyte

... headwind has abated and now become a tailwind in the first half of the year, we had about $2 million of prior period collections for Afirma specifically. And so, you know, as we move forward, that's something that we'll try and optimize, but, you know, can't necessarily count on every quarter in advance.

Marc Stapley
CEO, Veracyte

Got it. Got it.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Marc, you know, about your 50% penetration comment, can you just elaborate on, you know, what those areas are that can, you know, help you to move the needle there? Do you really need to expand the sales force, or is it just things like you've already done on the thyroid side, et cetera?

Marc Stapley
CEO, Veracyte

I think it's very similar to what we've already talked about for Decipher. Again, a specialty sales team that is focused on Afirma an endocrinologist. They've been in their role for a number of years, dedicated to that particular indication. They're very effective and very leverageable. Again, we don't necessarily need to grow that significantly. Clearly, you know, it's a case of getting out and visiting those accounts that still, at this stage, surprisingly, haven't adopted any kind of molecular diagnostic in this indication. And then broadening the indications, too, and going beyond where the test currently is able to be utilized, and that comes back to evidence again always in reimbursement. So continuing with that is, I think, a really important part of the story, and always has been.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Do you think there's been any sort of post-COVID catch-up dynamic at play in terms of cancer diagnosis? There was recently a paper out in Lancet about, you know, late-stage diagnoses going up. Is that something that has sort of helped volumes at all or not really?

Marc Stapley
CEO, Veracyte

It's not to the extent that I think it's really driving a lot of what we're talking about here, although we do see, we saw similar data that said the level of prostate incidence is going up by about 7%, and, you know, that there might be a little bit of a post-COVID effect there, but not really. I don't think that's what's driving our numbers today. I think it's the things we just talked about.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Switching to, you know, nasal swab, completion of enrollment into Nightingale, the clinical utility study, you know, that's been pushed out a little bit, I think, by roughly about six months or so. Were there any factors that led to that pushout just beyond staffing shortages?

Marc Stapley
CEO, Veracyte

No, to take a step back and just talk about the nasal swab, I mentioned it earlier, as it's a breakthrough test.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

But for us, the market that we're gonna be going after there is the screening and incidental-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Marc Stapley
CEO, Veracyte

... lung nodule population, and using a very simple nasal swab to be able to classify patients as low, intermediate, or high risk. Nightingale, as you referenced, is our clinical utility study for that. We've been enrolling, initiating sites and enrolling patients now for a while. What we have seen, and I think it's happening more consistently in lung more than any other-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm

Marc Stapley
CEO, Veracyte

... indication in particular, is resource challenges at our customers, at the site, challenges with, you know, some of the PI staffing and resources, and their estimates on how many patients they can enroll per month, have ended up being a little lower than they originally estimated. And so we've taken that into account and conservatively estimated it's gonna take until the second quarter to get to the final patient.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

Same number of patients who we were always planning to enroll, so that hasn't changed at all. Like I said, that will be the middle of next year.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. And would that apply for trial readout? I think you'd sort of talked about perhaps an interim readout as well, and then sort of, you know, perhaps not requiring as much follow-up before you submit for reimbursement. So, what's the latest thinking there?

Marc Stapley
CEO, Veracyte

I think given the timelines for the nasal swab test commercialization, which we've talked about as a long-term growth driver, it's in there. A couple of quarters is within the error bars of those timelines. We still. It doesn't change our strategy or our plan to be able to take in a shorter-term look at the data-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

which we can do and are doing. Following our patients for one year or two years, being able to see the performance of the test with, like I say, that subset of data, and getting to a point where we believe we've demonstrated clinical utility to our satisfaction, which then, of course, we need to go to the payers-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

both Medicare and commercial, and demonstrate the same thing with a peer-reviewed publication. So that whole process takes a number of years, and that's what we're focused on. Once we have a clear path-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

to reimbursement, of course, we'll, we'll be able to launch the test fully commercially.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. How do you think about the competitive landscape for nasal swab? You've got a couple other lung nodule risk classifiers out there. You also got people taking a crack at it on the early detection side of things. You have blood-based assays, which, you know, some people are worried that might sort of, you know, change the size of that patient funnel, so to speak, in terms of who would be candidates for nasal swab. Does that sort of factor into your calculus about the size of the opportunity?

Marc Stapley
CEO, Veracyte

Actually, if anything, you know, that could potentially increase the funnel.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

And let me explain why I think that is. I think the first thing you have to consider is, in a multi-cancer early detection scenario, you've been able to demonstrate the multi-cancer early detection has a mortality benefit, in a way that it is heavily adopted and reimbursed. If that's the case, and a patient is identified using that test as potentially having lung cancer, the very first thing that will happen with that patient is gonna be a low-dose CT. You've got to get an image-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right

Marc Stapley
CEO, Veracyte

...of that lung nodule or even see that there is a lung nodule there. Once you're in that paradigm, you're treating this like a screening patient.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

If anything that can increase the screening funnel would be very beneficial to patients and to us from the nasal swab standpoint. Today, 15 million people in the U.S. alone should be getting screened for lung cancer. A fraction of that, those people are actually getting screened for lung cancer every year, as we know, and that is a USPSTF guideline. So yeah, it's woefully underserved today. So the more people that can get screened, the more people identified with a lung nodule, the more opportunity to utilize nasal swab. In addition-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right

Marc Stapley
CEO, Veracyte

... to the 1.6 million incidental, incidentally found lung nodules that the patients are dealing with today. So that, that's how we think about where nasal swab plays. In terms of other competition relative to that, we're not aware of anything else that uses a simple workflow like a nasal swab, that can be done-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right

Marc Stapley
CEO, Veracyte

in a pulmonologist suite, physician's office, sent to our lab, tested, and a result returned. Yeah, there are the blood-based assays out there, but that's a completely different workflow.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right. Right. So on that point, Marc, you know, given that it's just a nasal brushing and you can get it in the pulmonologist's office, does that essentially insulate you from the point of view? Because the theory is that, you know, if it's a early cancer detection test and it's positive, and then you do detect a lung nodule on the CT scan, you still need to risk classify it, you know?

Marc Stapley
CEO, Veracyte

Yeah. I think the answer... We believe you do.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it.

Marc Stapley
CEO, Veracyte

But the big question, I think, that really matters in that case is, yeah, have you gotten reimbursement for a multi-cancer early detection?

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right

Marc Stapley
CEO, Veracyte

... test for healthy people, and at what level? Then reimbursement for a low-dose CT. You'll... For lung cancer, specifically in multi-cancer early detection, that paradigm would be competing with low-dose CT, which is a relatively straightforward, accessible, and low-cost paradigm. So that, that, I think, is where the challenge is going to be. Once you've got the low-dose CT result, we absolutely believe you, you need the nasal swab to classify that patient's risk.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm. Got it. Switching to nCounter, you submitted the dossier through the IVDR process. I think it was late last year.

Marc Stapley
CEO, Veracyte

Yep.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Can you just remind us, you know, what are the key changes in the new process versus, you know, the prior process, and where are you within the review cycle?

Marc Stapley
CEO, Veracyte

Yeah. So the previous process was much easier in terms of self-certification and so on. And now the regulations are not the same as, but you can think of it a little bit like the what we go through with the FDA-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... in terms of submitting the dossier, answering the questions, and ultimately getting approval. You're 100% right. We submitted Envisia actually in December last year, and we've had that, you know, round of questions back and forth.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

And been very effective, actually, at dealing with those. Our team's done an outstanding job, and consequently, we're now in the final stages, hopefully, of, of getting that approved. I can't tell you how long that's going to take because it's too early in the new process. We don't know. But here we are in September, so roughly 10 months, after we submitted. So we'll wait and see how long that takes to get approval. The learnings from that, with both us and also the notified body that we're working with, will help all of us-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Marc Stapley
CEO, Veracyte

get hopefully to a quicker process for getting prostate approved.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right.

Marc Stapley
CEO, Veracyte

As I said earlier, I do believe there's pent-up demand for that, and then getting our nasal swab approved when we submit that later in 2025. To be clear, we are working on Envisia, prostate, and nasal swab in parallel. It's not a series. We stop one and start another. We're working on them in parallel. There are different stages of completion based on, you know, when we did the bridging from our CLIA assay to the IVD assay. And just one thing, if I can, just to really demonstrate the power of our model.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Marc Stapley
CEO, Veracyte

We do all the R&D work to develop the assay with the algorithms to launch these tests as cleared tests in the U.S. We do a lot of work to develop the evidence and generate the evidence and guidelines and KOL support, and that is leveragable-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

For outside the U.S. We may have to do a little bit of extra work to bridge and do local studies, but we can utilize a lot of the effort we've already put in.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. And in terms of, you know, once you have Envisia IVD approved, will we start to see you sort of gradually ramp up, you know, the commercial push behind nCounter? Or is it still too early and it doesn't have to be a gated approach, it's kind of like, you know, you wait for the three, and then you kind of, like, really push the product?

Marc Stapley
CEO, Veracyte

Yeah, excellent question. The point being that we actually already have developed the sales team and the infrastructure, being commercial, market access, medical teams, and the support functions for all the major countries in Europe-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

to support our Prosigna test, which is already on the market as an IVD. So the beauty of this model, again, is once we launch a new test, which we're then selling to the same labs in each of these countries, we largely have the team in place in order to do it.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm.

Marc Stapley
CEO, Veracyte

Of course, as the revenue opportunity grows, we can increase that team.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it.

Marc Stapley
CEO, Veracyte

The one area where we would need to add additional skill sets would be specific to indications on the medical side. Other than that, it's the same sales team and the same market access team who understand reimbursement country by country, not test by test.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right.

Marc Stapley
CEO, Veracyte

You know, it matters-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right

Marc Stapley
CEO, Veracyte

- country by country.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

How many reps do you have at the moment, you know, on the Prosigna side of things?

Marc Stapley
CEO, Veracyte

There's another-

Rebecca Chambers
CFO, Veracyte

Around 20 reps.

Marc Stapley
CEO, Veracyte

Yeah.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

20 reps or so. And, you think that that's enough for that initial push?

Marc Stapley
CEO, Veracyte

For initial push.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah.

Marc Stapley
CEO, Veracyte

The great part of it is, as we see the opportunity expand, we can be very not reactive. We can be ahead of that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right.

Marc Stapley
CEO, Veracyte

We don't have to be years ahead of that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Right.

Marc Stapley
CEO, Veracyte

We can be six months ahead of that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. And then, in terms of just, insourcing the kit manufacturing, where are you in, in sort of that process? And can you walk us through the impact on, on COGS from, you know, insourcing that?

Marc Stapley
CEO, Veracyte

Yeah, I'll talk about that, and then, Rebecca, feel free to add on the COG side. But the goal there is to transition the manufacturing of those kits-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

so that they're in our site in Marseille, France. We're making great progress on that. The team is working incredibly hard at getting that done. Where you'll see the benefit is when we have scale.

Rebecca Chambers
CFO, Veracyte

Yeah, absolutely. Not much more to add. It'll take, obviously, the volume absorption to really see the benefit over time. But theoretically, we should see, you know, many, many percentage points-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it

Rebecca Chambers
CFO, Veracyte

gain over time as volume ramps. And again, I wouldn't necessarily think about that as being driven by Envisia, but much more, you know, of the Decipher play over time.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Got it. Fair enough. Switching to biopharma, Marc, are you seeing any macro-related headwinds in the pharma business? You know, we've talked about, I mean, others have talked about sort of cancellations, elongated decision timelines, et cetera. And is there anything you can do to sort of mitigate that impact?

Marc Stapley
CEO, Veracyte

We are. And actually, we were probably one of the first to call that out late last year in terms of, you know, certainly the cancellations and then the extended timelines we are seeing, although the pipeline-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

is interesting and,

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

and growing. It's going from a level of interest to engagement, contract and full-blown, you know, working on those pharma contracts. That whole business, biopharma and other, represents, if you look at our guidance for the year.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

represents more like 5% of our total business. So-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Marc Stapley
CEO, Veracyte

... it's pretty small relatively, 'cause the core testing business has grown so well. It's hard to tell when that's going to end. Clearly, at some point it will, but we don't know yet, and it's too early to say whether you see a headwind or a tailwind next year.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. And over what timeframe do you see sort of customer concentration there, you know, not being sort of as much of a factor? And do you envision sort of expanding from... I think you've talked about just biomarker development to CDx development over time. Is that, is that sort of a couple of years process in your mind?

Marc Stapley
CEO, Veracyte

It's multiple years, and that's still the long-term strategy for that business. But oftentimes, these start as small studies-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

but then transform into much-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

larger opportunities. And we have had a customer concentration, and so our goal is to really diversify that customer base.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Switching to the financials, Rebecca, you know, do you still expect the third quarter to step down sequentially, you know, in line with sort of typical, you know, summer seasonality? You saw really strong clinical testing momentum in the first half, so is there a chance that you don't see that sort of materialize at all?

Rebecca Chambers
CFO, Veracyte

Yeah, I wouldn't change our commentary from the earnings call at this point in time in the quarter, Tejas.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Rebecca Chambers
CFO, Veracyte

So I would reiterate, that and refer you back to that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. And then in terms of gross margin expectations, I think you took those up as well from the mid- to high 60s%, or to the mid- to high 60s%.

Rebecca Chambers
CFO, Veracyte

Mm-hmm.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Can you just walk us through the puts and takes on that line in terms of, you know, gross margin expectations, and how much of the benefit was from the out-of-period collections there in the first half?

Rebecca Chambers
CFO, Veracyte

Yeah. The out-of-period collections were call it roughly in the second quarter, I think about a quarter of the benefit.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Okay.

Rebecca Chambers
CFO, Veracyte

So, you know, while they were great, they aren't necessarily really what was driving the sustained expansion of gross margin and that we saw in the first half. In addition to that cash benefit in the first half, we did also have meaningful absorption, given the volume gains-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Rebecca Chambers
CFO, Veracyte

- during the quarter. So, you know, what we have said is the second half is expected to have a slight step down for the reasons cited. And also, we are investing pretty heavily in expanding our capacity as we see such volume gains. And so, you know, when you think about our margin profile, exiting the year, we'll be on a full year basis in that mid- to high-60s%.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm.

Rebecca Chambers
CFO, Veracyte

On the testing side of that, you know, that's being brought up, right? So the testing margin-

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Yeah

Rebecca Chambers
CFO, Veracyte

in the second half is going to be closer to that high-60s%, low-70s% range that we saw in the first half of the year. So lower, but, but close. So I think when it comes down to it, you know, we have a great growth margin story, and I know we're also out of time. I think another piece of our financial profile that's meaningfully differentiated is the fact that we are generating cash this year. And you know, that is something that we're, we're doing while also investing in the many growth drivers that Marc cited. And so when it comes down to it, you know, we're very excited for both the long-term growth trajectory of the, the business, but also with a balanced financial profile that we're, that we have, and, and we can...

You know, we're dedicated to continuing to have.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Marc, last question for you. You know, the FDA, perhaps you might have a bigger push here in terms of LDT regulations. What's the latest you've heard on that, and how do you see that impacting Veracyte?

Marc Stapley
CEO, Veracyte

Yeah, nothing different than what everybody else has heard. We've been dealing with this for many, many years in this industry. I've been talking about this for more than a decade, and in every instance of this, we've seen, you know, there's clearly grandfathering of existing tests in place in every iteration I've seen so far. If we need to go down an IVD pathway, we have, at Veracyte, incredible experience at doing that.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Mm-hmm

Marc Stapley
CEO, Veracyte

... and including, you know, tests that we're launching in Europe. And so we have the optionality. But like, you would expect, as an industry, we'll engage in those conversations and help to shape the right outcome for patients, which ultimately is what matters at the end of the day.

Tejas Savant
Executive Director and Life Science Tools and Diagnostics Analyst, Morgan Stanley

Got it. Well, this was great. So thank you so much, both, for your time here.

Marc Stapley
CEO, Veracyte

Thank you.

Powered by