DermTech Inc (DMTK) 2023 Q3 法說會逐字稿

Ladies and gentlemen, thank you for standing by. Welcome to DermTech's third-quarter 2023 financial results call. At this time, all participants are in a listen-only mode. After the speakers' presentation, there will be a question-and-answer session question. (Operator Instructions) Please be advised that today's conference is being recorded. I'd like now to turn the conference over to Steve Kunszabo. Please go ahead.

女士們先生們，謝謝你們的支持。歡迎參加 DermTech 2023 年第三季財務業績電話會議。此時，所有參與者都處於只聽模式。演講者演講結束後，將進行問答環節。 （操作員指示）請注意，今天的會議正在錄製中。我現在想把會議交給 Steve Kunszabo。請繼續。

Thank you, operator. Welcome to DermTech's third-quarter 2023 earnings call. With me on today's call are Bret Christensen, our President and Chief Executive Officer; and Kevin Sun, our Chief Financial Officer. Our call today will include forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements made on this call that do not relate to matters of historical fact, are considered forward-looking statements.

謝謝你，接線生。歡迎參加 DermTech 2023 年第三季財報電話會議。與我一起參加今天電話會議的有我們的總裁兼執行長 Bret Christensen；和我們的財務長孫凱文。我們今天的電話會議將包括 1995 年《私人證券訴訟改革法案》含義內的前瞻性陳述。本次電話會議中所做的所有與歷史事實無關的陳述均被視為前瞻性陳述。

Forward-looking statements made during this call, including statements regarding projections of the future performance or financial outlook of DermTech, the performance, patient benefits, cost effectiveness, commercialization, and adoption of our products, and the market opportunity for our products, are based on management's expectations as of today, and are subject to various factors, assumptions, risks, and uncertainties, which change over time. Actual results could differ materially from those described in such statements.

本次電話會議期間所做的前瞻性陳述，包括有關 DermTech 未來業績或財務前景的預測、業績、患者利益、成本效益、商業化和我們產品的採用以及我們產品的市場機會的陳述，均基於截至目前管理層的預期，並受到各種因素、假設、風險和不確定性的影響，這些因素、假設、風險和不確定性會隨著時間的推移而變化。實際結果可能與此類聲明中所述的結果有重大差異。

Several factors that may continue to cause such differences are described in today's press release and our most recent filings with the SEC, including our annual report on Form 10-K filed on March 2, 2023, and our quarterly report on Form 10-Q filed on November 2, 2023. We undertake no obligation to update these statements except, as required by applicable law. Our third-quarter 2023 earnings press release and SEC filings are available on our Investor Relations website. A recording and transcript of this call will be available on our website later today. With that, let me turn things over to Bret.

今天的新聞稿和我們最近向SEC 提交的文件中描述了可能繼續導致此類差異的幾個因素，包括我們於2023 年3 月2 日提交的10-K 表格年度報告以及2023 年3 月2 日提交的10-Q 表格季度報告2023 年 11 月 2 日。我們不承擔更新這些聲明的義務，除非適用法律要求。我們的 2023 年第三季財報新聞稿和 SEC 文件可在我們的投資者關係網站上取得。本次通話的錄音和文字記錄將於今天晚些時候在我們的網站上提供。接下來，讓我把事情交給布雷特。

Thank you, Steve, and thank you, everyone, for joining us. We're really excited by the significant improvement in many of our top-line and operating metrics. We're just a few months into our strategy of prioritizing reimbursed tests and revenue growth, and we're already seeing faster progress than we expected. In the third quarter, ASP for DermTech Melanoma Test or DMT, and test revenue grew at solid year-over-year in sequential rates.

謝謝你，史蒂夫，也謝謝大家加入我們。我們對許多營收和營運指標的顯著改善感到非常興奮。我們實施優先考慮報銷測試和收入成長的策略才幾個月，我們已經看到比我們預期更快的進展。第三季度，DermTech 黑色素瘤測試（DMT）的平均售價和測試收入連續較去年同期穩定成長。

We also reported an improvement in the Medicare proportion of billable samples to an all-time high mark, which is about half of our addressable market, as well as an increase in our total proportion of reimbursed tests. We recorded a positive gross margin and significant expense in cash burn reductions. Nearly all of our key performance indicators are heading in a positive direction, and we believe that with more time to refine our commercial tactics, we will continue to improve our operating results. Before I take you through several elements of our recent progress, let me take a step back to reframe the opportunity.

我們還報告說，醫療保險計費樣本的比例已達到歷史最高水平，約占我們潛在市場的一半，並且報銷測試的總比例也有所增加。我們的毛利率為正值，並在減少現金消耗方面產生了大量費用。我們幾乎所有的關鍵績效指標都在朝著正面的方向發展，我們相信，透過更多的時間來完善我們的商業策略，我們將繼續改善我們的經營績效。在我向您介紹我們最近的進展的幾個要素之前，讓我先退後一步重新定義這個機會。

First, we have a great technology that can significantly enhance the standard of care for evaluating melanoma. Melanoma is the most aggressive form of skin cancer and claims approximately 8,000 lives annually in the US. Dermatologists are working hard to provide great patient care, but they face capacity constraints and limitations, with traditional methods such as surgical biopsies. The DMT detects genomic markers that are correlated with an increased risk for melanoma and can aid decisions (technical difficulty) by clinicians.

首先，我們擁有一項偉大的技術，可以顯著提高評估黑色素瘤的護理標準。黑色素瘤是最具侵襲性的皮膚癌，每年在美國奪走約 8,000 人的生命。皮膚科醫生正在努力為患者提供良好的護理，但他們面臨手術活檢等傳統方法的能力限制和限制。 DMT 檢測與黑色素瘤風險增加相關的基因組標記，可以幫助臨床醫生做出決策（技術難度）。

Second, we believe there is a place for the DMT in every dermatology office, alongside established protocol. The DMT is non-invasive and rules out melanoma with a 99% negative predictive value. Whether it's using the DMT in a sensitive area such as the face or providing clinicians and patients with peace of mind for a clinically suspicious lesion that the clinicians don't want to biopsy, there is room for it to be used in several ways. As an example, if we capture just 5% of the approximately 4 million surgical biopsies performed each year, at a price that's in line with the Medicare rate, the revenue potential is over $150 million annually.

其次，我們相信每個皮膚科診所都可以使用 DMT，並制定既定的方案。 DMT 是非侵入性的，可以以 99% 的陰性預測值排除黑色素瘤。無論是在臉部等敏感區域使用 DMT，還是讓臨床醫生和患者安心地處理臨床醫生不想進行活檢的臨床可疑病變，它都有多種用途的空間。舉例來說，如果我們每年進行約 400 萬例手術活檢中的 5%，且價格與 Medicare 費率一致，那麼每年的收入潛力將超過 1.5 億美元。

And third, we can lower the cost to the healthcare system by ruling out the need for certain surgical procedures, while also providing a better patient experience. Insurance providers continue to expand access to our tests, and we've cleared administrative and billing hurdles with certain payers, where a favorable coverage policy and agreement were in place earlier this year. For example, we're now seeing consistent reimbursement from two national government payers and one of the regional Blues plans. We also signed an agreement with Highmark during the third quarter, bringing the DMT as an in-network benefit to one of the largest Blues plans in the US, with approximately 7 million members.

第三，我們可以透過排除某些外科手術的需要來降低醫療保健系統的成本，同時也提供更好的病患體驗。保險公司繼續擴大我們測試的範圍，我們已經與某些付款人清除了行政和計費障礙，今年早些時候，這些付款人制定了有利的承保政策和協議。例如，我們現在看到兩個國家政府付款人和一個地區藍調計劃的一致報銷。我們還在第三季與 Highmark 簽署了一項協議，將 DMT 作為網絡內福利引入美國最大的 Blues 計劃之一，該計劃擁有約 700 萬會員。

We will continue to reinforce our message around the clinical and health economic benefits of the DMT with payers that don't yet cover our test and continue to improve reimbursement patterns where coverage already exists. There's more to do, but we're on the right track with 133 million covered lives today. Our visibility with payers also improves through state legislative efforts. Bills mandating insurance coverage of genomic testing or biomarker bills are gaining visibility across the US, as lawmakers advocate for improving access to potentially lifesaving genomic tests.

我們將繼續向尚未承保我們測試的付款人強化有關 DMT 的臨床和健康經濟效益的信息，並繼續改進已承保的報銷模式。雖然還有更多工作要做，但我們已經走在正確的軌道上，今天已經覆蓋了 1.33 億人的生命。透過州立法努力，我們在付款人中的知名度也提高了。隨著立法者倡導改善獲得可能挽救生命的基因組測試的機會，強制要求對基因組測試或生物標記物進行保險的法案正在美國各地獲得關注。

One example was the recent passage of the California Biomarker Bill, which mandates coverage based on specific criteria, effective in January of 2024. California's profile as a large state with a significant Medicare population, makes this an important step in strengthening access for patients. More than 10 states have now passed Biomarker Bills, and several states currently have bills making their way through the legislative process. Our TRUST 2 Study, which we initiated in 2022, should provide additional real-world evidence regarding the DMT's performance.

一個例子是最近通過的《加州生物標記法案》，該法案要求根據特定標準進行覆蓋，該法案將於2024 年1 月生效。加州作為一個擁有大量醫療保險人口的大州，這使得這項法案成為加強患者獲取醫療服務的重要一步。目前已有 10 多個州通過了生物標記法案，有幾個州目前正在通過立法程序。我們在 2022 年啟動的 TRUST 2 研究應該提供更多有關 DMT 表現的現實證據。

The results, if positive, may support reengagement with payers. This study is designed to follow a cohort of 2,000 to 3,000 patients with negatively tested lesions for up to one-year, and also assesses the histological diagnosis of up to 1,000 lesions that tested positive with the DMT. We expect to have top-line data before the end of 2023. As we consider the evolution of our commercial business during the quarter, it's worth quickly reviewing the tactical initiatives we undertook in July to prioritize reimbursed tests and maximize revenue.

如果結果是正面的，可能會支持與付款人的重新接觸。這項研究旨在對 2,000 至 3,000 名病變檢測呈陰性的患者進行長達一年的跟踪，並評估多達 1,000 個 DMT 檢測呈陽性的病變的組織學診斷。我們預計在 2023 年底之前獲得頂線數據。當我們考慮本季商業業務的發展時，有必要快速審查我們在 7 月份採取的戰術舉措，以優先考慮報銷測試並最大化收入。

We're still in the early days of evaluating feedback from the field and our customers, but it is evident that the immediate impact has been positive on boosting ASPs and test revenue. First, we aligned incentive compensation for our sales team, with prioritizing reimbursed tests and revenue over volume growth. We've also improved reporting and made our operating dashboards more robust to support the field with targeting reimbursed tests. Throughout the rest of the organization, we've aligned incentive compensation and projects to prioritize ASP and revenue growth.

我們仍處於評估現場和客戶回饋的早期階段，但很明顯，其直接影響對提高 ASP 和測試收入產生了積極影響。首先，我們調整了銷售團隊的激勵薪酬，優先考慮報銷測試和收入而不是銷售成長。我們還改進了報告並使我們的操作儀表板更加強大，以透過有針對性的報銷測試來支援該領域。在組織的其他部門中，我們調整了激勵薪酬和項目，以優先考慮 ASP 和收入成長。

We've also dissolved certain territories and merged others to focus on reimbursed samples where we already have insurance coverage or where we have healthy volumes that can facilitate positive discussions with payers. As a result, we've reduced our sales territories from approximately 70 to roughly 60. Third, we've shifted our spending more closely to sales team enablement rather than broad-based marketing efforts. We've improved our customer and patient-facing collateral and highlighted key insurance providers that cover our test.

我們也解散了某些地區並合併了其他地區，以專注於已擁有保險範圍或擁有可促進與付款人積極討論的健康數量的報銷樣本。因此，我們將銷售區域從大約 70 個減少到大約 60 個。第三，我們將支出更側重於銷售團隊支持，而不是基礎廣泛的行銷工作。我們改進了面向客戶和患者的抵押品，並重點介紹了承保我們測試的主要保險提供者。

We still plan to participate in national dermatology conferences such as Fall Clinical, which we attended in mid-October to meaningfully engage key opinion leaders and support presentations that highlight the clinical value of the DMT. We're also recalibrating our direct-to-consumer marketing tactics, to capitalize on areas where we have insurance coverage. Lastly, we appointed Mark Aguillard in September as our Chief Commercial Officer. Mark is a proven commercial leader with over 20 years of experience driving the commercialization of multiple novel molecular diagnostics.

我們仍然計劃參加國家皮膚病學會議，例如我們在 10 月中旬參加的秋季臨床會議，以有意義地吸引關鍵意見領袖並支持強調 DMT 臨床價值的演講。我們也正在重新調整直接面向消費者的行銷策略，以利用我們有保險的領域。最後，我們在 9 月任命馬克·阿吉拉德 (Mark Aguillard) 為我們的首席商務官。 Mark 是一位久經考驗的商業領導者，在推動多種新型分子診斷的商業化方面擁有 20 多年的經驗。

He served in commercial leadership roles with leading healthcare companies, directing sales, marketing, medical affairs, customer success, and market access teams. We're grateful to have him on our team during this transformational period. As we've shared, we are intentionally pursuing a strategy that prioritizes robust ASP and revenue growth over volume growth in the short-term. The third-quarter results reflected this shift.

他曾在領先的醫療保健公司擔任商業領導職務，指導銷售、行銷、醫療事務、客戶成功和市場准入團隊。我們很高興在這個轉型時期有他加入我們的團隊。正如我們所分享的，我們有意追求一種優先考慮強勁的平均售價和收入成長而不是短期銷售成長的策略。第三季的業績反映了這種轉變。

In addition, we anticipate that the reduction and realignment of sales territories, could further impact billable sample growth over the next few quarters. We'll prioritize test volume again when we're further down the path of sustained revenue growth. In closing, my vision is for the DMT to be deployed universally as part of the melanoma care pathway. We've begun taking important steps to execute against this goal.

此外，我們預計銷售區域的減少和重新調整可能會進一步影響未來幾季的計費樣本成長。當我們進一步沿著持續收入成長的道路前進時，我們將再次優先考慮測試量。最後，我的願景是 DMT 作為黑色素瘤治療途徑的一部分而普遍部署。我們已經開始採取重要步驟來實現這一目標。

We're prioritizing reimbursed tests over volume growth to grow revenue, engaging clinicians with a clearer message to improve traction in communicating the DMT's clinical value proposition, we're continuing to improve payer coverage for the DMT. And finally, our total operating expenses and cash burn are at the lowest levels in approximately two years, while we're generating higher revenue. I look forward to a strong finish in 2023. With that, let me turn the call over to Kevin for a more detailed financial review.

我們優先考慮報銷測試而不是數量增長，以增加收入，向臨床醫生提供更清晰的信息，以提高溝通 DMT 臨床價值主張的吸引力，我們將繼續提高 DMT 的付款人覆蓋範圍。最後，我們的總營運支出和現金消耗處於大約兩年來的最低水平，而我們的收入卻在增加。我期待 2023 年取得優異的成績。接下來，讓我將電話轉給 Kevin，進行更詳細的財務審查。

Thanks, Bret, and good afternoon, everyone. I'll summarize our key financial and operating metrics for the third quarter, then recap how we're thinking directionally about our outlook for the rest of 2023. I'll wrap up by outlining our liquidity profile and cash runway targets. All comparisons are to the same quarter of the prior year, unless otherwise noted.

謝謝布雷特，大家下午好。我將總結第三季的主要財務和營運指標，然後回顧我們如何定向思考 2023 年剩餘時間的前景。最後，我將概述我們的流動性狀況和現金跑道目標。除非另有說明，所有比較均與去年同一季度進行。

Test revenue was up 8% to $3.7 million and increased 4% sequentially, largely due to higher ASP for the DMT. Billable sample volume declined 13% to approximately 15,710 and was down 10% sequentially. The year-over-year and sequential decrease was partly due to the impact to the field from our prioritization of reimbursed tests and the overall reduction in the size of our sales force. As previously noted, we also stopped testing samples from pediatric patients and certain [cystparick] skin types earlier in the year, based on guidance from our lab accrediting organization, which also affected the year-over-year comparison.

測試收入成長 8%，達到 370 萬美元，季增 4%，這主要是由於 DMT 的平均售價較高。可計費樣本量下降 13% 至約 15,710 個，較上季下降 10%。年比和季減的部分原因是我們優先考慮報銷測試以及銷售團隊規模的整體縮減對該領域的影響。如前所述，根據我們實驗室認證組織的指導，我們在今年稍早也停止了對兒科患者和某些 [cystparick] 皮膚類型的樣本的測試，這也影響了同比比較。

The sequential decrease was also partly due to typical seasonality we see during the summer months. Contract revenue was $0.2 million compared to $0.1 million, the increase is from activity related to clinical trial progress of our biopharma customers. Total revenue increased 10% to $3.9 million, primarily on higher test (technical difficulty). Drilling into our test revenue drivers: First, ASP was up 24% to $235 per sample and up 15% sequentially.

環比下降的部分原因是我們在夏季看到的典型季節性。合約收入為 20 萬美元，而先前為 10 萬美元，成長來自與我們的生物製藥客戶的臨床試驗進展相關的活動。總收入成長了 10%，達到 390 萬美元，主要是由於更高的測試（技術難度）。深入研究我們的測試收入驅動因素：首先，平均售價上漲 24%，達到每個樣本 235 美元，比上一季上漲 15%。

The Medicare proportion of billable sample volume improved again, increasing sequentially from 25% to 27%. In the last two quarters, this proportion has increased by 4-percentage-points and has been a key component of ASP improvement. As Bret noted, we're finally benefiting from the new payer coverage we brought on this year. It took multiple quarters to clear administrative and billing obstacles, but we're now being consistently paid by TRICARE, [the VA] and one of the newer regional blues plans.

醫療保險佔計費樣本量的比例再次提高，從 25% 連續增加到 27%。過去兩個季度，這一比例增加了 4 個百分點，成為 ASP 改善的關鍵組成部分。正如布雷特指出的那樣，我們終於受益於今年推出的新付款人保險。我們花了多個季度的時間才清除了行政和計費障礙，但我們現在一直由 TRICARE、[VA] 和一項較新的地區藍調計劃支付費用。

We're working with the other regional blues plans where we have a favorable coverage policy and an agreement, to achieve consistent payment behavior. Net prior period adjustments had a negligible impact on test revenue during the third quarter. Even with favorable payment trends and the onboarding of new payers, ASP fluctuates as payers have and could continue to update their administrative procedures, documentation requirements, or indications for use, among other things, for obtaining reimbursement, even those payers with positive coverage policies and or contracts.

我們正在與其他區域藍調計劃合作，我們在這些計劃中擁有有利的承保政策和協議，以實現一致的付款行為。前期淨調整對第三季測試收入的影響可以忽略不計。即使有有利的支付趨勢和新付款人的加入，平均售價也會波動，因為付款人已經並且可能繼續更新其管理程序、文件要求或使用說明等，以獲得報銷，即使是那些擁有積極承保政策和費用的付款人。或合約。

Second, we had approximately 2,250 unique ordering clinicians in the third quarter, down 7% sequentially. With approximately 4,210 unique ordering clinicians during the last 12 months, we've penetrated 47% of our total current market of 9,000 dermatology clinicians. Third, our average quarterly utilization or average number of tests ordered per unique ordering clinician was, 7 billable samples in the third quarter versus 7.2 in the second quarter and 7.5 in the year ago period.

其次，第三季我們大約有 2,250 名獨特的訂購臨床醫生，比上一季下降 7%。在過去 12 個月裡，我們擁有約 4,210 名獨特的訂購臨床醫生，佔目前 9,000 名皮膚科臨床醫生市場總數的 47%。第三，我們的平均季度利用率或每個獨特訂購臨床醫生訂購的平均測試數量在第三季度為 7 個可計費樣本，而第二季度為 7.2 個，去年同期為 7.5 個。

Turning now to operating expenses. Cost of test revenue was $3.7 million, an increase of less than 1%, yielding a test gross margin of 1%. The increase in cost of test revenue was primarily due to higher infrastructure costs related to our new lab. Sales and marketing expenses were $8.1 million, a 44% decrease, largely due to lower employer-related and marketing expenditures.

現在轉向營運費用。測試收入成本為 370 萬美元，成長不到 1%，測試毛利率為 1%。測試收入成本的增加主要是由於與我們的新實驗室相關的基礎設施成本較高。銷售和行銷費用為 810 萬美元，下降 44%，主要是由於雇主相關費用和行銷費用減少。

Research and development expenses were $3.6 million, a 37% decrease, primarily due to lower employee-related and lab supplies costs. General and administrative expenses were $8.3 million, a 6% decrease, driven by lower employer-related costs, offset by higher infrastructure costs related to our new facility. Total operating expenses decreased substantially due to the restructuring actions we implemented in the second quarter. On a full-year basis, using the third quarter as a benchmark, our operating expenses could be lower than the $25 million to $30 million in annualized cost savings, identified (technical difficulty) when we announced the restructuring plan.

研發費用為 360 萬美元，下降 37%，主要是因為員工相關成本和實驗室用品成本降低。一般和管理費用為 830 萬美元，下降 6%，這是由於與雇主相關的成本降低，但被與我們的新設施相關的基礎設施成本增加所抵消。由於我們在第二季實施的重組行動，總營運費用大幅下降。以全年為基礎，以第三季為基準，我們的營運費用可能低於我們宣布重組計劃時確定的（技術難度）年化成本節省 2500 萬至 3000 萬美元。

Net loss was $19.2 million, which included $3.2 million of non-cash, stock-based compensation expense, compared to a net loss of $28.8 million, which included $4.9 million of non-cash, stock-based compensation expense. Moving now to our 2023 outlook, we believe DMT volumes for 2023 will be flat to modestly down compared to last year, primarily due to our prioritization of reimbursed tests and the impact in the field due our change in tactics. ASP and test revenue are moving in the right direction, and we believe these top-line metrics should increase versus 2022. Providing specific guidance remains difficult until we see a good trend for several quarters in payer reimbursement behavior and the sustained effectiveness of our new commercial tactics.

淨虧損為 1,920 萬美元，其中包括 320 萬美元的非現金股票補償費用，而淨虧損為 2,880 萬美元，其中包括 490 萬美元的非現金股票補償費用。現在展望 2023 年的前景，我們認為 2023 年的 DMT 數量將與去年持平或小幅下降，這主要是由於我們優先考慮報銷測試以及我們策略的改變對現場的影響。 ASP 和測試收入正在朝著正確的方向發展，我們相信這些頂線指標應該比2022 年有所增加。在我們看到付款人報銷行為幾個季度的良好趨勢以及我們新商業的持續有效性之前，提供具體指導仍然很困難策略。

And lastly, a review of our liquidity profile and balance sheet. At quarter end, we had cash, cash equivalents, restricted cash, and marketable securities of $71.7 million, which includes net proceeds of approximately $0.5 million from stock issuances under our At the Market or ATM facility during the period. When excluding non-recurring costs related to our restructuring plan, our net cash burn has declined from approximately $100 million for 2022 to approximately $65 million, based on an annualized third quarter run rate, a 35% decrease. We'll continue to be rigorous with our capital allocation and look for additional efficiencies and cost savings as we finalize our plan for 2024.

最後，檢視我們的流動性狀況和資產負債表。截至季末，我們擁有 7,170 萬美元的現金、現金等價物、限制性現金和有價證券，其中包括在此期間根據我們的市場或 ATM 工具發行股票的淨收益約 50 萬美元。在排除與重組計畫相關的非經常性成本後，根據第三季年化運作率，我們的淨現金消耗已從 2022 年的約 1 億美元降至約 6,500 萬美元，下降了 35%。在最終確定 2024 年計畫時，我們將繼續嚴格資本分配，並尋求更高的效率和成本節約。

We believe we have cash runway into the first quarter of 2025. In addition to these significant expense savings, driving ASP and revenue is a key factor that helps preserve and potentially extend our cash runway. In summary, we've significantly improved many of our key operating and financial indicators in the third quarter. Our new commercial tactics are taking hold and supporting our strategy of increasing the proportion of reimbursed tests and growing revenue. We believe this approach is the best way to reach a meaningful revenue inflection point while sustaining our cash runway. With that, I'll turn the call back to the operator for Q&A.

我們相信我們的現金跑道可以持續到 2025 年第一季。除了這些顯著的費用節省之外，推動平均售價和收入成長是有助於維持並可能擴大我們的現金跑道的關鍵因素。總而言之，我們在第三季的許多關鍵營運和財務指標都得到了顯著改善。我們的新商業策略正在紮根並支持我們增加報銷測試比例和增加收入的策略。我們相信，這種方法是在維持我們的現金跑道的同時達到有意義的收入轉折點的最佳方式。這樣，我會將電話轉回接線生進行問答。

(Operator Instructions) Thomas Flaten, Lake Street Capital Markets.

（操作員說明）Thomas Flaten，湖街資本市場。

Thank you. Good afternoon and thanks for taking the questions. Kevin, with respect to the significant cost reduction that we see in the P&L, is the third quarter a nadir or do you expect additional savings as we roll through fourth quarter as well?

謝謝。下午好，感謝您提出問題。凱文，關於我們在損益表中看到的成本大幅下降，第三季是最低點還是您預計第四季也會出現額外的節省？

Yeah, we originally said that using the fourth quarter of 2023 would be the benchmark moving forward. So while we also said that we are pleased that we're a little bit ahead of where we thought we would be, we are still working to find some additional savings. So it's yet to be determined, I would still point to the fourth quarter is probably the best benchmark for what the cash burn should be going forward.

是的，我們最初說過以 2023 年第四季為基準。因此，雖然我們也表示很高興我們比我們的預期稍微領先了一點，但我們仍在努力尋找一些額外的節省。因此，尚未確定，我仍然認為第四季可能是未來現金消耗的最佳基準。

Got it. And I think in Bret's prepared comments, you mentioned that you were starting to see some flow through from recently contracted payers. Are you guys specifically calling those payers out from a sales rep messaging perspective? Or how are you going about educating the docs on which payers pay and which don't?

知道了。我認為在布雷特準備好的評論中，您提到您開始看到來自最近簽約的付款人的一些資金流。你們是從銷售代表訊息傳遞的角度專門稱呼這些付款人的嗎？或者您將如何對文件進行哪些付款人付款、哪些付款人不付款的教育？

Yes, hi, Thomas, this is Brett. What we've done is -- again, we changed a lot of the tactics just to get to reinforce revenue, and that's how salespeople are paid, there's incentives across the organization, it is our focus. We've got some really good tools that we gave the salespeople that allows for them to see where claims are coming, that helps them prioritize where we've got reimbursement and where we don't. We also realigned the territories. So in general, the territories we've got today have pretty good reimbursement, that's how they're aligned and that's how they were selected.

是的，嗨，湯瑪斯，我是布雷特。我們所做的是——再次，我們改變了很多策略只是為了增加收入，這就是銷售人員的報酬方式，整個組織都有激勵措施，這是我們的重點。我們為銷售人員提供了一些非常好的工具，使他們能夠了解索賠的情況，幫助他們優先考慮我們哪些地方得到了報銷，哪些地方沒有得到報銷。我們也重新調整了領土。所以總的來說，我們今天擁有的地區有相當好的報銷，這就是它們的調整方式和選擇方式。

And we're also giving them tools to help them understand the practices and where the opportunity exists within their own territory. So all of it is with a focus on the ASP and more reimbursed tests in the door. We're still welcoming all tests, but anything that we know we can get paid for is the priority with the field.

我們也為他們提供工具來幫助他們了解實踐以及他們自己的領域內存在機會的地方。因此，所有這些都集中在 ASP 上，並且即將進行更多可報銷的測試。我們仍然歡迎所有測試，但任何我們知道可以得到報酬的東西都是該領域的優先事項。

But you're not specifically engaging the doctors in a conversation about which patients have paid or likely to be covered versus not?

但您並沒有專門與醫生討論哪些患者已經付費或可能獲得承保，哪些患者沒有付費？

No, we're not.

沒有，我們沒有。

Got it. Appreciate it. Thank you.

知道了。欣賞它。謝謝。

Yeah.

是的。

Mark Massaro, BTIG.

馬克·馬薩羅，BTIG。

Hey, guys, this is Vivian on for Mark, thanks for taking the question. So in terms of update for national plan, I think I heard in the prepared remaks that you are getting paid by some plans today. Is this a precursor to a formal contract? I'm just curious how dialogue on that front has been progressing? I also think I heard you talk about TRUST to moving the needle here shortly. So I just wondering if you'd comment on that. Thanks.

嘿，夥計們，我是馬克的薇薇安，感謝您提出問題。因此，就國家計劃的更新而言，我想我在準備好的重做中聽說，今天您將通過某些計劃獲得報酬。這是正式合約的先決條件嗎？我只是好奇這方面的對話進展如何？我還想我聽到你談論信任，以很快推動這裡的發展。所以我只是想知道你是否對此發表評論。謝謝。

Yes, hi, Vivien, thanks for the question. This is Brett. So we've got really strong coverage today. Again, we're about 45% of all covered lives, and that's a 45% increase just this year in reimbursement for the DermTech melanoma test. As far as a national payer goes, depending on how you define a national payer, if it's one of the big four: United, Aetna, Cigna, Anthem, we have yet to get a positive policy addition from any of those four.

是的，嗨，薇薇安，謝謝你的提問。這是布雷特。所以我們今天的報道非常有力。同樣，我們約佔所有承保生命的 45%，光是今年 DermTech 黑色素瘤測試的報銷就增加了 45%。就國家付款人而言，取決於您如何定義國家付款人，如果它是四大航空公司之一：聯合航空、安泰保險、信諾、安瑟姆，我們還沒有從這四家中的任何一家獲得積極的政策補充。

But we are billing for those tests, we are running appeals, PAs, and we've got really strong coverage with the blues plans having seven of the largest 10 blues plans covered across the US. So between Medicare, those large blues plan, and other regional payers, we're in a pretty good spot with coverage and we're continuing to have pretty good conversations with the national payers that we believe will come onboard eventually. The value proposition, the clinical utility, everything's just to good, we just need to continue to pressure those payers and have meaningful conversations, so we can get them on board.

但我們正在為這些測試付費，我們正在上訴，PA，並且我們的藍調計劃覆蓋範圍非常廣泛，其中覆蓋了美國最大的 10 個藍調計劃中的 7 個。因此，在醫療保險、那些大型藍調計劃和其他地區付款人之間，我們的承保範圍非常好，我們正在繼續與國家付款人進行良好的對話，我們相信他們最終會加入。價值主張、臨床效用，一切都剛剛好，我們只需要繼續向這些付款人施壓並進行有意義的對話，這樣我們就可以讓他們參與其中。

Okay, perfect. And if I could just squeeze in a follow-up, in terms -- I think you've added around 133 million plus covered lives year-to-date. So in terms of the contribution of these recent payer wins here in Q3, should we think about all that as having been operationalized already? Or is there some remaining benefit to ASPs that could happen in Q4?

好的，完美。如果我能擠出後續行動的話，我認為今年迄今為止您已經增加了約 1.33 億人的受保生命。因此，就第三季最近付款人獲勝的貢獻而言，我們是否應該將所有這些視為已投入實施？或者第四季可能會為 ASP 帶來一些剩餘的好處嗎？

Yeah, Vivian. So the 133 million is the total amount of covered lives we have as today. That's the increase from, call it, 91 million from the end of last year. And so in Q3, as we were bringing on those new payers throughout 2023, it was really Q3 which really the first meaningful quarter that we had any benefit from those plans. And as we mentioned, the government plans of TRICARE, VA started paying us consistently in the third quarter.

是的，維維安。因此，1.33 億人是我們今天的受保人口總數。這比去年年底增加了 9,100 萬。因此，在第三季度，當我們在 2023 年全年引入這些新付款人時，這確實是我們從這些計劃中受益的第一個有意義的季度。正如我們所提到的，維吉尼亞州 TRICARE 的政府計劃從第三季開始持續向我們付款。

We also had one of the regional blues plans start paying consistently. There's other plans that have not started paying consistently and some of that those new covered lives in 2023 that actually haven't paid hardly at all. So we do have additional benefit that we will get in the future as we continue to bring on those new plans. And even within Q3, it wasn't, I'd say even the full quarter that those few plans that did start paying was benefiting us. So there is definitely upside still from the coverage we have. And as we continue to bring on new coverage, again, we'll look to accelerate the ramp-up period to get the benefit in the future.

我們也讓一項區域藍調計畫開始持續支付。還有其他計劃尚未開始持續支付，其中一些 2023 年新承保的生活實際上根本沒有支付。因此，隨著我們繼續實施這些新計劃，我們確實會在未來獲得額外的好處。即使在第三季度，我想說，即使是整個季度，那些開始付款的少數計劃也沒有使我們受益。因此，我們的報道肯定還有好處。隨著我們繼續提供新的保險範圍，我們將再次尋求加快啟動期，以便在未來獲得收益。

Okay, perfect, understoood. And if I could just squeeze in one more here, so I understand you're not providing formal guidance, how do we think about volumes trending into Q4 from here sequentially? And then if you could just give any more granularity on the trade-off you've been making recently and between volumes and ASP with the recent reorg initiatives? And that's it for me. Thanks.

好的，完美，明白了。如果我可以在這裡再擠進一個，所以我知道您沒有提供正式的指導，我們如何看待從這裡開始依次進入第四季度的銷售趨勢？然後，您是否可以更詳細地說明您最近在最近的重組計劃中在銷售和平均售價之間進行的權衡？對我來說就是這樣。謝謝。

Sure, Vivian. The strategy change and focus change that we announced really on the last call after Q2 was -- really trying to prioritize ASP and revenue versus volume. It was really important for us early in the lifecycle of the DMT to make sure the volume was growing. That gets the attention of payers, it creates a lot of utilization and awareness with dermatologists and patients.

當然，維維安。我們在第二季後的最後一次電話會議上宣布的策略變化和重點變化是——真正嘗試優先考慮平均售價和收入與銷售。在 DMT 生命週期的早期，確保數量不斷增長對我們來說非常重要。這引起了付款人的注意，它引起了皮膚科醫生和患者的大量利用和認識。

So prior to really Q2, the volume was really our focus as an organization. The change that we made, the shift, was around making sure we monetized that volume. Because we've seen some pretty good volume growth in the past, but we wanted to make sure that ASPs were going up. And frankly, with all the wins that we've had in market access, this 133 million covered lives that we have (technical difficulty) we want to get the test volume in the door more representative of reimbursement.

因此，在第二季之前，銷售量確實是我們作為一個組織的重點。我們所做的改變，即轉變，是為了確保我們能夠將這數量貨幣化。因為我們過去已經看到了一些相當不錯的銷售成長，但我們希望確保平均售價不斷上升。坦白說，隨著我們在市場准入方面取得的所有勝利，我們擁有的這 1.33 億人的生命（技術難度），我們希望讓測試量更能代表報銷。

And so all the changes that we made were around incentives, targeting, activities, messaging, everything with a focus of ASP. And what we said was: we were okay with that pretty dramatic shift in focus if volume was flat or even declined and we did see it declined slightly this past quarter. And that could persist for quarter or two as we continue to ramp ASPs and keep the focus on revenue. And we've said we'd be okay with that, because again, we've got to make sure that we're monetizing the volume and making sure we get the right percentage of reimbursed tests in the door. And we'll start growing volumes again after that, but we want to make sure that's the focus (technical difficulty) in the near-term.

因此，我們所做的所有改變都是圍繞著激勵、目標、活動、訊息傳遞以及以 ASP 為重點的一切。我們所說的是：如果成交量持平甚至下降，我們可以接受這種相當戲劇性的焦點轉變，而且我們確實看到上個季度成交量略有下降。隨著我們繼續提高平均售價並繼續關注收入，這種情況可能會持續一兩個季度。我們已經說過我們會接受這一點，因為我們必須再次確保我們能夠將數量貨幣化，並確保我們獲得正確比例的報銷測試。之後我們將再次開始增加產量，但我們希望確保這是近期的重點（技術難度）。

Awesome. Thank you for taking the question.

驚人的。感謝您提出問題。

Alex Nowak, Craig Hallum.

亞歷克斯·諾瓦克，克雷格·哈勒姆。

Okay, great. Good afternoon, everyone. Going back to the national payers, the team here has been working for years to get it, but let's say one are the top four payers to come in and reimburse the DMT test. As you join, I don't know, six months or so ago, when you reviewed how the team was communicating with the payers and what they're providing the payers with, whether it be the trust data or economic data or any of the details, what changes have you made there and the communication with the payers to hopefully make this more likely, we'll get one of those big guys over the finish line?

好的，太好了。大家下午好。回到國家付款人，這裡的團隊多年來一直在努力獲得它，但假設其中一個是進來並報銷 DMT 測試費用的前四名付款人。當你加入時，我不知道，大約六個月前，當你回顧團隊如何與付款人溝通以及他們向付款人提供什麼時，無論是信任數據還是經濟數據或任何細節，你在那裡做了什麼改變，以及與付款人的溝通，希望使這更有可能，我們會讓那些大人物之一衝過終點線？

Yeah, thanks for the question, Alex. Of the four national payers, we did have three reiterate a negative policy decision early in the year, really prior to my arrival. When we look at the story, the messaging, everything that a payer should look at to evaluate coverage of the DMT, it's a great story, it's a great story for payers. There's a ton of cost savings here for payers if they just cover the test.

是的，謝謝你的提問，亞歷克斯。在四個國家付款人中，我們確實有三個在今年年初重申了負面政策決定，實際上是在我到達之前。當我們審視這個故事、訊息傳遞以及付款人評估 DMT 覆蓋範圍時應考慮的所有內容時，這是一個很棒的故事，對於付款人來說也是一個很棒的故事。如果付款人只需參加測試，就可以節省大量成本。

What my understanding is, what we saw from those negative policy decisions was the lack of sighting of the most recent data, or health economic data that shows these tremendous savings to the system. That's probably true, we are we're a small company, it's hard to get these payers' attention. We've got a really strong story we'll keep hitting them with. The trust to date that we will see at the end of the year is an opportunity once we publish that, too, to revisit the test with some of those payers that have given us this negative policy decision.

我的理解是，我們從這些負面政策決定中看到的是，缺乏最新數據或健康經濟數據來顯示系統的巨大節省。這可能是真的，我們是一家小公司，很難引起這些付款人的注意。我們有一個非常有力的故事，我們將繼續用它來打動他們。到目前為止，我們將在今年年底看到的信託，一旦我們發布該信託，也是一個機會，可以重新審視對那些給予我們這一負面政策決定的付款人的測試。

And then there's a whole bunch of advocacy that we've stepped up and need to continue to step up with patients, dermatologists, and anyone that's going to advocate for this test, which really is superior. It's superior patient care, it's great for patients, it's good for payers, it really does benefit all of our stakeholders, and it's just a comprehensive message that we need to continue to hit them with. We're confident we're going to get there, really. And then, look, if we get continued to have more regional wins, more blues wins, all that puts pressure as well on national payers. We know we're going to get there. It's just it takes a little bit of time.

然後，我們已經加強了一大堆宣傳，並且需要繼續與患者、皮膚科醫生和任何支持這項測試的人一起努力，這確實是優越的。這是優質的患者護理，對患者有好處，對付款人有利，它確實使我們所有的利益相關者受益，這只是我們需要繼續向他們傳達的全面信息。我們有信心能夠實現這一目標，真的。然後，看看，如果我們繼續獲得更多地區性勝利，更多藍調勝利，所有這一切都會給國家付款人帶來壓力。我們知道我們會到達那裡。只是需要一點時間而已。

I think, Alex, if you remember, I have said, my experience, it takes a lot of time sometimes with these national payers. At my previous organization, I joined that organization 15 years into the product launch and we still don't have coverage for many of the national payer. So it does take a lot of time, we've got a really attractive value proposition that I know is going to resonate with payers, it's just going to take us a little bit to get there.

我想，亞歷克斯，如果你還記得，我說過，我的經驗，有時與這些國家付款人一起需要花費很多時間。在我之前的組織中，我在產品推出 15 年後加入該組織，但我們仍然沒有為許多國家付款人提供保險。所以這確實需要很多時間，我們有一個非常有吸引力的價值主張，我知道它會引​​起付款人的共鳴，只是我們需要一點時間才能實現這一目標。

One of the things I've talked to the team about over the years covering DermTech was, if we need to get AAD guideline out there for DMT, what's your view on it? I mean, guidelines, obviously, super important from the old employer, other health care names is super important, and it's always been a little bit dismissed that we need AAD guidelines. But what's your view?

多年來我與團隊談論 DermTech 的一件事是，如果我們需要為 DMT 制定 AAD 指南，您對此有何看法？我的意思是，顯然，來自舊雇主的指導方針非常重要，其他醫療保健名稱也非常重要，而且我們需要 AAD 指導方針這一點總是被忽視。但你的看法是什麼？

Well, I think it certainly would help. I don't know that we need it. Honestly, if you think about some of the headwinds that we have within dermatology, it isn't that dermatologists, in my opinion are waiting for guidelines, it really is they need to understand where this test fits within their practice. Some of the changes that we've made for messaging is about helping them understand exactly what it is.

嗯，我想這肯定會有幫助。我不知道我們需要它。老實說，如果您考慮我們在皮膚科領域遇到的一些不利因素，我認為皮膚科醫生並不是在等待指南，而是他們需要了解該測試在他們的實踐中的適用範圍。我們對訊息傳遞所做的一些更改是為了幫助他們準確地理解訊息是什麼。

Remember genomics is still fairly new to the dermatology specialty. So we're explaining what the test is, what it is not. It isn't a diagnostics, so we're not diagnosing melanoma, we're ruling out melanoma. And has a tremendous value to patients and dermatologists, because again, there's some lesions that they see that are very suspicious that they're going to go right to biopsy. That's fine with us. But when there's a lesion that you're uncertain about that is mild to moderately atypicals, somewhat suspicious, you don't want to do biopsy in many of those cases.

請記住，基因組學對於皮膚科專業來說仍然是相當新的。所以我們正在解釋測驗是什麼，不是什麼。這不是診斷，所以我們不是在診斷黑色素瘤，而是在排除黑色素瘤。對於患者和皮膚科醫生來說具有巨大的價值，因為他們再次看到一些非常可疑的病變，因此他們將直接進行活檢。這對我們來說沒問題。但是，當您不確定病灶是輕度到中度非典型、有些可疑時，在許多情況下您不想進行活檢。

We want to start there. We want to get those biopsies because they don't want to deal with them, and the DermTech Melanoma Test is non-invasive and a perfect solution with a really good patient experience. So look, I think we've had maybe some missed opportunities with the messaging that we've remedied and we're just now getting that rolled out. I think that's going to resonate with dermatologists.

我們想從那裡開始。我們想要獲得這些活檢，因為他們不想處理它們，而 DermTech 黑色素瘤測試是非侵入性的，是完美的解決方案，具有非常好的患者體驗。所以看，我認為我們可能錯過了一些我們已經糾正的訊息傳遞的機會，而我們現在才剛剛推出。我認為這會引起皮膚科醫生的共鳴。

And look, if we get 10% of the 4 million biopsies that are done every year, that's 400,000 tests, that would be a pretty good start to where we want to go. And so that's what we've done. Look, guidelines would help and we'd certainly welcome that. But I don't think it's a critical piece that's missing.

看，如果我們每年進行 400 萬次活檢中的 10%，即 40 萬次測試，這將是我們想要實現的目標的一個很好的開始。這就是我們所做的。看，指南會有所幫助，我們當然會歡迎。但我不認為這是一個缺失的關鍵部分。

Okay, makes total sense. And then lastly, the Biomark fulfills, your home state now passed one, a number of other larger states have passed some recently and they go into effect next year. Could that actually, I guess, what the work internally that you've done, could that actually be a material boost to the ASP next year?

好吧，完全有道理。最後，生物標誌實現了，你的家鄉現在通過了一個，其他一些較大的州最近也通過了一些，它們將於明年生效。我想，您在內部所做的工作實際上是否會對明年的 ASP 產生實質推動？

Well, what it should do is it should boost policy and contracting with our market access teams. Because these biomarker bills are pretty explicit with what should and should not be covered. And depending on the state, in California, it's one of those that we did call out in the script here, that is really going to be positive and should influence payers to cover the DMT. And so with the teams do, as you're aware, we're taking these legislative headlines as they happen, and we're taking them to payers and just incorporating that into our message to again encourage them to cover the DMT sooner. Look, they should have an effect, this is why we called it out in the script. We're really optimistic with this trend and hope that it continues.

嗯，它應該做的是推動政策並與我們的市場准入團隊簽訂合約。因為這些生物標記法案非常明確地規定了哪些內容應該涵蓋，哪些內容不應該涵蓋。根據加州的情況，這是我們在劇本中提到的其中之一，這確實是積極的，應該會影響付款人支付 DMT。因此，正如您所知，對於這些團隊來說，我們會在發生這些立法頭條新聞時將其帶給付款人，並將其納入我們的訊息中，以再次鼓勵他們更快地涵蓋 DMT。你看，它們應該有效果，這就是我們在劇本中提到的原因。我們對這一趨勢非常樂觀，並希望它能夠持續下去。

And the mountain momentum of these biomarker bills in various states, right? This is when, say a national payer has to cover in a number of states and also for Medicare advantage populations, if they don't cover more broadly now, they've got disparities of coverage within their populations, which makes it difficult to administer. So again, it's not something that we view is going to be the one silver bullet, but it's a mounting piece of action that should help bring on coverage in the future.

這些生物標誌法案在各州的勢頭如山般強勁，對嗎？比方說，國家付款人必須涵蓋多個州以及醫療保險優勢人群，如果他們現在不涵蓋更廣泛的範圍，那麼他們在其人口中的覆蓋範圍就會存在差異，這使得管理變得困難。再說一遍，我們認為這並不是萬能的靈丹妙藥，但它是一項不斷增加的行動，應該有助於在未來擴大報道範圍。

Yeah, I totally agree. Appreciate the update. Thank you.

是的，我完全同意。感謝更新。謝謝。

Thanks, Alex.

謝謝，亞歷克斯。

Thanks, Alex.

謝謝，亞歷克斯。

(Operator Instructions) [Joe], Cowen.

（操作員指示）[Joe]，Cowen。

Hey, this is Joe, out for Dan. Just first, now that gross margins have turned positive, is there any way to think about how fast these might shape up. You can start driving some leverage here despite volume maybe being sustainably lower for a bit, closer to that 1,500 billable sample level for a few quarters?

嘿，這是喬，為丹出戰。首先，既然毛利率已經轉為正值，是否有辦法考慮這些毛利率可能會以多快的速度出現。儘管數量可能會持續下降一段時間，在幾個季度內接近 1,500 個計費樣本水平，但您可以在這裡開始發揮一些槓桿作用嗎？

Yeah. Hey, Joe, the margin, right, it's at this early stage and it's impacted by a couple of big things. So ASPs will certainly help margins quite a bit even if we keep everything else equal. So as our focus on ASP and revenue growth, that that will help the margins. And then as we've moved into our new laboratory which we completed back in Q1, we can now focus on finding additional cost savings and efficiencies, and we have a number of efforts focused on those things. So, that, along with getting some additional capacity absorption of our fixed costs will help in those margins.

是的。嘿，喬，利潤，對吧，現在還處於早期階段，並且受到幾件大事的影響。因此，即使我們保持其他條件相同，平均售價肯定會對利潤率有很大幫助。因此，當我們關注平均售價和收入成長時，這將有助於提高利潤率。然後，當我們搬進第一季完成的新實驗室時，我們現在可以專注於尋找額外的成本節約和效率，並且我們在這些事情上做了很多努力。因此，加上我們的固定成本獲得一些額外的產能吸收，將有助於提高這些利潤。

So we do believe that over time, we've got runway to bring the COGS below the $200 mark. And again, we're working on those things now. It's not just through the capacity absorption, but also a number of process improvements. So we're working on those things, and it's something that some of them can take a little bit longer if we're talking about technology changes and such. But we do see a pathway of having some meaningful gross margins in the future.

因此，我們確實相信，隨著時間的推移，我們有能力將 COGS 降至 200 美元以下。再說一遍，我們現在正在研究這些事情。這不僅僅是透過產能吸收，還包括一些製程改進。所以我們正在研究這些事情，如果我們談論技術變革等，其中一些事情可能需要更長的時間。但我們確實看到了未來獲得有意義的毛利率的途徑。

Great. And then just in terms of the Medicare proportion of billable samples, is there some range that you think can drive that number into the next year or two? And how do you think that might affect ASP in like an optimistic scenario?

偉大的。然後，就計費樣本中的醫療保險比例而言，您認為是否存在某個範圍可以在未來一兩年內推動該數字？您認為在樂觀的情況下這可能會如何影響 ASP？

Yeah, Joe. We just know it can go higher. So it's 50% of the opportunity by itself, just because 50% of biopsies done in dermatology are Medicare claims, and so it's such a massive opportunity for us. Along with other reimbursed covered tests have just been a focus of ours and something we're watching closely. We just know it can go higher and we'll find out where it settles in in the future. But that is the focus today.

是的，喬。我們只知道它可以走得更高。所以這本身就是 50% 的機會，因為皮膚科進行的活檢中有 50% 是醫療保險索賠，所以這對我們來說是一個巨大的機會。與其他報銷的核保測試一起，一直是我們關注的焦點，也是我們正在密切關注的事情。我們只知道它可以走得更高，我們會在未來找到它的落腳點。但這是今天的焦點。

Yeah. Like many things, we have this quarter showed some really good progress when we've been flat for a while. And so before we're ready to really give any detailed forward-looking guidance on any of these metrics, we do want to see a little bit of a trend, so we can see if we can sustain that improvement.

是的。與許多事情一樣，我們在本季度表現出了一些非常好的進展，儘管我們已經停滯了一段時間。因此，在我們準備好真正就這些指標提供任何詳細的前瞻性指導之前，我們確實希望看到一點趨勢，這樣我們就可以看看我們是否能夠維持這種改進。

Great. Thanks a lot.

偉大的。多謝。

Jake Evans, Stephens.

傑克·埃文斯、史蒂芬斯。

Hey, guys, this is Jake Evans for Mason. A lot has been covered today, so I'll just keep to one. So on the TRUST 2 Study timeline, if we were to think about a best-case scenario, the timeline for results to readout. You said results might readout by the end of this year, top-line results, but then for results readout for to get published for you to submit the payer, the payer to review it, and adopt coverage and then you start getting paid. How should we think about that? I know that there's a lot of variables there but any way to give us a general timeline on what that would look quite look like if everything went right?

嘿，夥計們，這是梅森的傑克·埃文斯。今天已經講了很多，所以我只講一個。因此，在 TRUST 2 研究時間表上，如果我們要考慮最好的情況，即讀出結果的時間表。您說結果可能會在今年年底公佈，頂線結果，但隨後公佈結果，以便您提交付款人，付款人對其進行審查，並採用承保範圍，然後您開始獲得報酬。我們該如何思考這個問題？我知道其中存在著許多變數，但有什麼方法可以為我們提供一個總體時間表，說明如果一切順利的話，情況會是什麼樣子？

Yeah, Jacob, this is Bret. Really, really good question and really insightful. So what we said is we expect to see top-line data by the end of the year, and we're still going through our publication strategy. So we're trying to decide where and when that can be published, and we'll have a probably a better view of that as the year comes to a close and as we start to see that top-line data. But for now, it's a consideration, we still think we'll see the data this year, but publication is something we just haven't talked about that. But that will take a little bit of time.

是的，雅各布，這是布雷特。真的，真的很好的問題，而且很有洞察力。因此，我們所說的是，我們預計將在今年年底前看到頂線數據，並且我們仍在製定我們的發布策略。因此，我們正在努力決定在何時何地發布，隨著今年接近尾聲，當我們開始看到主要數據時，我們可能會對這一點有更好的了解。但就目前而言，這是一個考慮因素，我們仍然認為今年會看到數據，但我們還沒有討論過發布的問題。但這需要一點時間。

And the publication timeline, it's really dependent on which and source it gets published in. And so then as it relates to like the payer review, it depends on when the payer of these cycles kick in. So if it's published after the first cycle, then a year, if it's say a payer has two cycles in the year, then they won't get a chance to review it until ahead of the next cycle. So again, there's a lot of depends here, but it really is dependent upon which publication we choose, when the timeline is, and then what does the cycles are for each of the payers.

發佈時間表，它實際上取決於它發布的來源和來源。因此，當它與付款人審查等相關時，它取決於這些週期的付款人何時開始。所以如果它在第一個週期之後發布，那麼一年，如果說付款人一年中有兩個週期，那麼他們只有在下一個週期之前才有機會審查它。再說一次，這裡有很多取決於，但這實際上取決於我們選擇的出版物、時間表是什麼，以及每個付款人的周期是什麼。

Okay. Got it. I'll just keep it to one. Thanks, guys.

好的。知道了。我就把它保留為一。多謝你們。

Please stand by for the next question. The next question comes from Andrew Brackmann with William Blair. Your line is open. I show no further questions at this time. This will conclude the Q&A session and the conference call. Thank you for participating. You may now disconnect.

請等待下一個問題。下一個問題來自安德魯·布拉克曼和威廉·布萊爾。您的線路已開通。我目前沒有提出任何進一步的問題。問答環節和電話會議到此結束。感謝您的參與。您現在可以斷開連線。