Exact Sciences Corp (EXAS) 2024 Q3 法說會逐字稿

Hello.

你好。

At this time, I would like to welcome everyone to the Exact Sciences third-quarter 2024 earnings conference call.

此時，我歡迎大家參加 Exact Sciences 2024 年第三季財報電話會議。

(Operator Instructions)

（操作員說明）

I would now like to turn the call over to Erik Holznecht, Director of Investor Relations.

我現在想將電話轉給投資者關係總監 Erik Holznecht。

You may begin.

你可以開始了。

Thanks operator.

感謝運營商。

Thank you for joining us for Exact Sciences third-quarter 2024 conference call.

感謝您參加 Exact Sciences 2024 年第三季電話會議。

On the call today are Kevin Conroy, the company's Chairman and CEO; and Aaron Bloomer, our Chief Financial Officer.

今天參加電話會議的是該公司董事長兼執行長凱文康羅伊 (Kevin Conroy)；以及我們的財務長 Aaron Bloomer。

Exact Sciences issued a news release earlier this afternoon detailing our third-quarter financial results.

Exact Sciences 今天下午早些時候發布了一份新聞稿，詳細介紹了我們第三季的財務表現。

This news release and today's presentation are available on our website at exactsciences.com.

本新聞稿和今天的演示可在我們的網站 exactsciences.com 上取得。

During today's call, we will make forward-looking statements based on current expectations.

在今天的電話會議中，我們將根據當前預期做出前瞻性陳述。

Our actual results may be materially different from such statements.

我們的實際結果可能與此類聲明有重大差異。

Discussions of non-GAAP figures and reconciliations to GAAP figures are available in our earnings press release and descriptions of the risks and uncertainties associated with Exact Sciences are included in our SEC filings.

我們的收益新聞稿中提供了對非 GAAP 數據的討論以及與 GAAP 數據的調節，並且與 Exact Sciences 相關的風險和不確定性的描述包含在我們向 SEC 提交的文件中。

Both can be accessed through our website.

兩者都可以透過我們的網站存取。

I'll now turn the call over to Kevin.

我現在將電話轉給凱文。

Thanks Erik.

謝謝埃里克。

During the third-quarter, the Exact Sciences team made several advancements for patients while strengthening our platform and growing our business efficiently.

第三季度，Exact Sciences 團隊為患者取得了多項進步，同時加強了我們的平台並有效地發展了我們的業務。

Highlights include delivering test results to 1.2 million patients including a record number with Cologuard and oncotype DX.

亮點包括向 120 萬名患者提供測試結果，其中 Cologuard 和 oncotype DX 的測試數量創紀錄。

Growing total revenue 13% year over year while holding operating expenses flat.

總收入年增 13%，同時營運支出持平。

Expanding adjusted EBITDA by 75% year over year to $99 million generating record free cash flow of $113 million an improvement of the same amount year over year.

調整後 EBITDA 年成長 75%，達到 9,900 萬美元，自由現金流達到創紀錄的 1.13 億美元，較去年同期改善。

Increasing Cologuard customer satisfaction and brand awareness to all time highs.

將 Cologuard 客戶滿意度和品牌知名度提升至歷史新高。

Receiving FDA approval for Cologuard Plus, our next generation Cologuard test.

我們的下一代 Cologuard 測試 Cologuard Plus 獲得 FDA 批准。

Showcasing data at the ESMO Congress for our liquid biopsy colon cancer screening test and also our multi cancer screening test.

在 ESMO 大會上展示我們的液體活檢大腸癌篩檢測試以及多種癌症篩檢測試的數據。

And securing acceptance from a peer review journal for the first publication of oncodetect, our molecular residual disease or MRD test.

並確保同行評審期刊接受我們的分子殘留疾病或 MRD 檢測 oncoDetect 的首次發表。

While we've made progress, our execution during the third quarter and updated outlook for the full year don't reflect our full potential.

雖然我們取得了進展，但我們第三季的執行情況和最新的全年展望並沒有反映出我們的全部潛力。

Though we're disappointed with the growth in Cologuard testing frequency among our expanding provider base, we remain excited about our ability to continue enhancing value through our impactful industry leading tests and our powerful ExactNexus platform.

儘管我們對不斷擴大的供應商群體中 Cologuard 測試頻率的成長感到失望，但我們仍然對我們能夠透過有影響力的行業領先測試和強大的 ExactNexus 平台繼續提升價值感到興奮。

First, we have a large core of nearly 250,000 health care providers who rely on Cologuard as an important screening tool.

首先，我們擁有近 25 萬名醫療保健提供者的龐大核心，他們依賴 Cologuard 作為重要的篩檢工具。

This number continues to grow every day.

這個數字每天都在持續成長。

We are improving the guidance and tools we give to our motivated field force, helping them educate providers with the greatest potential to screen large numbers of their patients with Cologuard.

我們正在改進為積極主動的現場人員提供的指導和工具，幫助他們教育最有潛力的醫療服務提供者，利用 Cologuard 篩選大量患者。

Cologuard Plus will give us even greater access to and more time with our customer base as we explain the heightened benefits of our new test.

當我們解釋新測試的更大優勢時，Cologuard Plus 將使我們能夠更好地接觸客戶群並有更多時間與客戶群相處。

Access is key, especially given how busy primary care providers are today.

獲得服務是關鍵，特別是考慮到當今初級保健提供者的繁忙程度。

Second Cologuard plus will launch in the second quarter of 2025 and it sets a new performance standard with 95% cancer sensitivity and 94% specificity.

第二款 Cologuard plus 將於 2025 年第二季推出，它設定了新的性能標準，具有 95% 的癌症敏感性和 94% 的特異性。

This will help convince more primary care providers to consider Cologuard plus as at least a co-equal standard of care as colonoscopy and even as a first choice due to strong patient preference.

這將有助於說服更多初級保健提供者將 Cologuard plus 視為至少與大腸鏡檢查同等的護理標準，甚至由於患者的強烈偏好而將其作為首選。

Pricing for Cologuard plus will initially apply to Medicare patients followed by commercial patients.

Cologuard plus 的定價首先適用於醫療保險患者，然後是商業患者。

This price increase will likely provide a top line growth tailwind for 2025 and beyond as access grows.

隨著訪問量的成長，這種價格上漲可能為 2025 年及以後的收入成長提供動力。

Third, the opportunity to re screen patients continues to increase.

第三，重新篩檢患者的機會不斷增加。

This year, 1.6 million people become due for their next Cologuard test.

今年，將有 160 萬人接受下一次 Cologuard 測試。

In 2025, that number grows to 2 million and in 2026 2.6 million.

2025 年，這一數字將增至 200 萬，2026 年將增至 260 萬。

This year, we expect to screen about 1 million people in this re screen setting with Cologuard.

今年，我們預計將使用 Cologuard 在這種重新篩檢環境中篩選約 100 萬人。

And next year, we would expect that number to grow to at least 1.3 million.

明年，我們預計這個數字將成長到至少 130 萬。

Our re screen success rate continues to steadily improve because of our ExactNexus technology and service platform.

由於我們的 ExactNexus 技術和服務平台，我們的重篩成功率持續穩定提高。

Over time, our unique data set customer, relationships and digital outreach capabilities will fuel even greater growth.

隨著時間的推移，我們獨特的數據集客戶、關係和數位推廣能力將推動更大的成長。

We expect re screens will go from about 25% of Cologuard volumes today to well over 50% in the future.

我們預計 re 螢幕將從現在佔 Cologuard 銷量的 25% 左右增加到未來的 50% 以上。

Fourth, our ExactNexus platform will continue fueling growth and care gap screening programs, a key growth driver for Cologuard.

第四，我們的 ExactNexus 平台將繼續推動成長和護理差距篩檢計劃，這是 Cologuard 的關鍵成長動力。

Large payers and health systems are increasingly turning to Cologuard to solve the challenges faced by declining wellness visits and quality measures.

大型付款人和衛生系統越來越多地轉向 Cologuard 來解決健康就診和品質措施下降所面臨的挑戰。

This year, we have run nearly 50 programs to help screen a large number of people with Cologuard.

今年，我們已經運行了近 50 個項目，利用 Cologuard 幫助篩選大量人員。

We are becoming more adept at driving adherence with our ExactNexus digital tools and tailored customer experiences.

我們越來越擅長推動 ExactNexus 數位工具和客製化客戶體驗的遵守。

This will help double the adherence rate from slightly more than one in five today in care gap programs.

這將有助於將護理缺口計劃的遵守率從目前略高於五分之一的水平提高一倍。

When a test is ordered directly by a patient's health care provider, approximately two and three complete Cologuard.

當患者的醫療保健提供者直接要求進行測試時，大約需要兩到三個完整的 Cologuard。

Growth from care gap volume and adherence improvements will provide significant tailwinds over many years.

護理缺口量的成長和依從性的改善將在多年內提供顯著的推動力。

Next, our rich pipelines of new products including oncodetect, our blood-based CRC screening test and our multi-cancer screening test will help drive new sources of growth and impact over the long term.

接下來，我們豐富的新產品系列，包括 OncoDetect、基於血液的 CRC 篩檢測試和多癌症篩檢測試，將有助於推動新的成長來源和長期影響。

Finally, the other important leg of the Exact Sciences value creation story is leverage.

最後，精確科學價值創造故事的另一個重要面向是槓桿作用。

Top line growth will be coupled with steady improvement in profitability.

營收成長將伴隨著獲利能力的穩定提高。

The third quarter demonstrates the power of our platform to deliver growth while holding the line on expenses.

第三季展示了我們平台在控制開支的同時實現成長的能力。

Over time, we expect to continue to see leverage across the P&L particularly G&A giving us great flexibility.

隨著時間的推移，我們預期損益表中的槓桿作用將繼續顯現，特別是一般管理費用，這將為我們帶來極大的彈性。

I'll now turn the call over to Aaron to discuss third quarter results and updated guidance in more detail.

我現在將把電話轉給亞倫，更詳細地討論第三季業績和更新的指導。

Thanks Kevin and good afternoon everyone.

謝謝凱文，大家下午好。

Total revenue grew 13% year over year to $709 million.

總營收年增 13%，達到 7.09 億美元。

Growth was led by broad based momentum and Cologuard adoption along with international expansion, oncotype DX.

成長是由廣泛的勢頭和 Cologuard 的採用以及國際擴張 oncotype DX 帶動的。

Adjusted EBITDA margin expanded 500 basis points to 14%, highlighting another strong quarter of operational execution from the team.

調整後的 EBITDA 利潤率擴大了 500 個基點，達到 14%，凸顯了該團隊另一個強勁的季度營運執行力。

We generated a record $113 million in free cash flow, up nearly 60% sequentially and ended the quarter with cash and security of more than $1 billion.

我們產生了創紀錄的 1.13 億美元自由現金流，環比增長了近 60%，本季末現金和證券超過 10 億美元。

Screening revenue grew 15% to $545 million driven by Cologuard volume.

在 Cologuard 銷量的推動下，放映收入成長了 15%，達到 5.45 億美元。

Precision Oncology revenue grew 5% to $164 million (sic – see slide 4, "$162 million") Growth was led by oncotype DX which expanded 28% internationally.

精準腫瘤學收入成長 5%，達到 1.64 億美元（原文如此 — 參見投影片 4，「1.62 億美元」）。

We generated $99 million in adjusted EBITDA, an increase of $42 million year over year.

我們的調整後 EBITDA 為 9,900 萬美元，年增 4,200 萬美元。

Adjusted EBITDA margin expansion was driven by volume and expense controls.

調整後的 EBITDA 利潤率擴張是由數量和費用控制所推動的。

As a percentage of revenue, adjusted G&A improved about 550 basis points year over year.

調整後的一般費用佔收入的百分比比去年同期提高了約 550 個基點。

This more than offset a decline in non-GAAP gross margin of about 85 basis points.

這足以抵消非 GAAP 毛利率約 85 個基點的下降。

We are making strong progress, expanding profitability and generating free cash flow allowing us to reinvest in growth and innovation.

我們正在取得強勁進展，擴大獲利能力並產生自由現金流，使我們能夠對成長和創新進行再投資。

Turning together we now expect full year revenue between $2.73 billion and $2.75 billion including full year screening revenue between $2.08 billion and $2.095 billion and Precision Oncology revenue between $650 million and $655 million.

綜合來看，我們現在預計全年營收在27.3 億美元至27.5 億美元之間，其中全年篩檢收入在20.8 億美元至20.95 億美元之間，精準腫瘤學收入在6.5 億美元至6.55 億美元之間。

Recall, on our earnings call in July, we outlined four key reasons for accelerated Cologuard growth in the second half of 2024: typical seasonality, care gap programs, re screens and recent sales and marketing investments.

回想一下，在7 月的財報電話會議上，我們概述了Cologuard 在2024 年下半年加速成長的四個關鍵原因：典型的季節性、護理缺口計劃、重新篩選以及最近的銷售和行銷投資。

Although we are pleased with progress on rescreens and care gap programs which are powered by our ExactNexus platform and capabilities, we fell short of driving demand at faster rate within primary care offices.

儘管我們對 ExactNexus 平台和功能支援的重新篩選和護理缺口計劃的進展感到高興，但我們未能以更快的速度推動初級保健辦公室的需求。

Excluding care gap programs since August Cologuard orders have grown below the historical rates which our prior guidance assumed.

不包括護理缺口計劃，自 8 月以來，Cologuard 訂單的成長速度低於我們先前指導假設的歷史速度。

This impacted third quarter screening revenue and will have a bigger impact on fourth quarter revenue due to the normal 30 day timing between a Cologuard order and a completed test.

這影響了第三季的篩檢收入，並且由於 Cologuard 訂單和完成的測試之間通常有 30 天的時間間隔，因此將對第四季度的收入產生更大的影響。

Second, disruption from hurricane Helene and Milton negatively impacted Cologuard orders and results in September and October.

其次，颶風海倫和米爾頓造成的干擾對 Cologuard 9 月和 10 月的訂單和結果產生了負面影響。

Historically, about 18% of Cologuard tests are from patients who live in affected areas.

從歷史上看，大約 18% 的 Cologuard 測試來自居住在受影響地區的患者。

Our thoughts are with those who suffered from the devastating storms.

我們與那些遭受毀滅性風暴的人們同在。

We continue to monitor these situations closely with expected impacts incorporated into our updated guidance.

我們將繼續密切監控這些情況，並將預期影響納入我們的更新指南中。

Third, we are seeing positive contributions from the new cohort of reps who joined Exact Sciences beginning in May.

第三，我們看到從 5 月開始加入 Exact Sciences 的新一批代表做出了積極貢獻。

This progress has been more gradual than our prior guidance assumed and we expect the return on those investments will increase in the near and long term.

這項進展比我們先前的指導假設更加漸進，我們預期這些投資的回報在短期和長期內都會增加。

Lastly, at the beginning of the third quarter, we moved our Precision Oncology portfolio onto ExactNexus.

最後，在第三季初，我們將精準腫瘤學產品組合轉移到 ExactNexus。

We face transitional challenges that we expect will have a one time negative impact on Precision Oncology revenue in the second half of 2024.

我們面臨轉型挑戰，預計這些挑戰將在 2024 年下半年對精準腫瘤學收入產生一次性負面影響。

These challenges impacted our ability to collect on some of the tests we performed.

這些挑戰影響了我們收集我們執行的一些測試的能力。

Over time, we expect this upgrade will enhance the efficiency of our teams and systems and the challenges we faced have been resolved.

隨著時間的推移，我們預計這次升級將提高我們團隊和系統的效率，我們面臨的挑戰也將得到解決。

As a result of our updated revenue outlook, we're revising adjusted EBITDA of guidance to be between $310 million and $320 million.

由於我們更新了營收前景，我們將調整後 EBITDA 指引值修改為 3.1 億美元至 3.2 億美元之間。

This implies our full year adjusted EBITDA margin at midpoint expands 270 basis points year over year to 11.5%.

這意味著我們全年調整後 EBITDA 利潤率中點較去年同期擴大 270 個基點，達到 11.5%。

Although we're facing near term challenges, we expect growth will accelerate in 2025 and margins will continue to expand.

儘管我們面臨短期挑戰，但我們預計 2025 年成長將加速，利潤率將繼續擴大。

We are well on our way to achieving our 2027 financial target of 15% compounded revenue growth and greater than 20% adjusted EBITDA margin.

我們正在順利實現 2027 年複合收入成長 15% 和調整後 EBITDA 利潤率超過 20% 的財務目標。

Back to you, Kevin.

回到你身上，凱文。

Thanks, Aaron.

謝謝，亞倫。

Cologuard is an open-ended growth story because it's become synonymous with colon cancer screening.

Cologuard 是一個開放式的成長故事，因為它已成為大腸癌篩檢的代名詞。

Our sophisticated ExactNexus platform allows us to connect electronically with nearly a quarter of a million providers who've ordered Cologuard so far this year, 24 million patients, more than 370 US health systems and over 800 payers.

我們先進的 ExactNexus 平台使我們能夠與今年迄今訂購 Cologuard 的近 25 萬提供者、2,400 萬名患者、超過 370 個美國醫療系統和 800 多個付款人進行電子連接。

Over time, the power of our ExactNexus platform continues to increase both Cologuard order and adherence rates in the primary care and care gap settings.

隨著時間的推移，我們的 ExactNexus 平台的強大功能不斷提高初級護理和護理差距設定中的 Cologuard 訂單率和依從率。

Our platform will help us address the 60 million people who are not up to date with screenings by sharing data and insights with key stakeholders.

我們的平台將透過與主要利害關係人分享數據和見解，幫助我們解決 6,000 萬人未能及時了解篩檢的問題。

It also allows us to build lifelong relationships with patients who are new to screening and those who have previously completed Cologuard.

它還使我們能夠與剛開始篩檢的患者和先前完成 Cologuard 的患者建立終生關係。

We expect this will drive Cologuard growth for years to come and expect similar benefits in Precision Oncology.

我們預計這將推動 Cologuard 在未來幾年的成長，並預計在精準腫瘤學領域也能帶來類似的好處。

Our precision oncology team guides treatment decisions for more than 600 cancer patients every day. oncotype DX helps early-stage breast cancer patients determine whether they will benefit from chemotherapy and assess their risk of recurrence.

我們的精準腫瘤學團隊每天為 600 多名癌症患者指導治療決策。 oncotype DX 幫助早期乳癌患者確定他們是否會從化療中受益並評估其復發風險。

It's globally recognized as standard of care with 90% of US oncologists ordering an adoption expanding internationally.

它是全球公認的護理標準，90% 的美國腫瘤學家要求在國際範圍內擴大採用。

Through this same channel oncodetect can aid in the early detection of residual or recurring cancer and better-informed therapy decisions.

透過這個相同的管道，OncoDetect 可以幫助早期發現殘留或復發的癌症，並做出更明智的治療決策。

We're excited to share clinical validation data this January in a peer reviewed journal, highlighting oncodetect's accuracy in detecting residual disease in colon cancer patients.

我們很高興今年 1 月在同行評審期刊上分享臨床驗證數據，強調了 oncodetect 在檢測結腸癌患者殘留疾病方面的準確性。

We're on track to launch oncodetect with reimbursement in colon cancer next year.

我們預計明年推出針對結腸癌的可報銷的 OncoDetect。

We're also conducting clinical studies to expand into multiple other solid tumor types including breast cancer.

我們也正在進行臨床研究，以擴展到包括乳癌在內的多種其他實體瘤類型。

Results from these studies will be shared at regular intervals over the next few years supporting our goal to cement this technology as standard of care.

這些研究的結果將在未來幾年定期分享，支持我們鞏固這項技術作為護理標準的目標。

We achieved another major pipeline milestone by receiving FDA approval for Cologuard plus, our next generation Cologuard test.

我們的下一代 Cologuard 測試 Cologuard plus 獲得 FDA 批准，實現了另一個重要的產品線里程碑。

Cologuard Plus sets a new performance standard in colorectal cancer screening.

Cologuard Plus 為大腸癌篩檢設立了新的性能標準。

Cologuard Plus detects 95% of cancers with 94% specificity.

Cologuard Plus 可檢測 95% 的癌症，特異性為 94%。

Relative to Cologuard, this represents approximately a 40% improvement in both the false negative and false positive rates.

相對於 Cologuard，這意味著假陰性率和假陽性率都提高了約 40%。

Per the modeling assumptions that inform USPSTF guidelines only Cologuard Plus and colonoscopy will be on the efficient frontier which defines the best colon cancer screening strategies.

根據 USPSTF 指南的建模假設，只有 Cologuard Plus 和大腸鏡檢查將處於定義最佳大腸癌篩檢策略的有效前沿。

Next, we plan to establish a higher price through an available Medicare pathway before launching the test with Medicare coverage and guideline inclusion.

接下來，我們計劃在啟動醫療保險覆蓋範圍和指南納入測試之前，透過可用的醫療保險途徑確定更高的價格。

Our blood-based colon cancer screening data presented at ESMO in September demonstrated meaningful progress towards another option to screen 16 million Americans who remain on screen.

我們 9 月在 ESMO 上公佈的基於血液的大腸癌篩檢數據表明，在篩檢 1,600 萬仍在接受篩檢的美國人的另一種選擇方面取得了有意義的進展。

Results of a large well-designed study showed our test achieved 88% overall cancer sensitivity and 31% sensitivity for advanced precancerous lesions at 90% specificity.

一項精心設計的大型研究結果表明，我們的測試對癌症的整體敏感性達到 88%，對晚期癌前病變的敏感性達到 31%，特異性為 90%。

These data reinforce the power of our unique scientific approach which delivers an unrivaled cost profile and extends beyond colon cancer.

這些數據增強了我們獨特的科學方法的力量，該方法提供了無與倫比的成本概況，並擴展到結腸癌之外。

We expect to have the best tool and blood-based screening options available with the technology and commercial platforms necessary to engage patients.

我們希望擁有最好的工具和基於血液的篩檢選項，以及吸引患者所需的技術和商業平台。

We see a clear path to accelerating growth and expanding profitability in 2025.

我們看到了 2025 年加速成長和擴大獲利能力的明確路徑。

The progress we're making with commercial execution, our ExactNexus platform, rescreens, care gap programs and new product launches reinforces our positive outlook.

我們在商業執行、ExactNexus 平台、重新篩選、護理缺口計劃和新產品發布方面取得的進展強化了我們的積極前景。

This positions us to continue making a positive impact on the lives of millions of patients around the world with our portfolio of innovative cancer diagnostics.

這使我們能夠透過我們的創新癌症診斷產品組合繼續對世界各地數百萬患者的生活產生積極影響。

We're now happy to take your questions.

我們現在很樂意回答您的問題。

(Operator Instructions)

（操作員說明）

Brandon Collier, Wells Fargo.

布蘭登‧科利爾，富國銀行。

Hey, thanks, good afternoon.

嘿，謝謝，下午好。

Kevin or Aaron.

凱文或亞倫。

Do you just kind of walk through what changed in the second half outlook relative to where you stood 90 days ago.

您能否簡單回顧一下下半年前景相對於 90 天前的情況發生了哪些變化？

Would be helpful if you could maybe unpack some of the moving parts and contribution be it between care gap, the hurricane disruptions, slow ramp from new reps and have you seen any bounce in orders following the hurricane in those effective areas?

如果您可以解開一些活動部分以及護理差距、颶風中斷、新代表緩慢增長之間的貢獻，以及您是否看到颶風過後這些有效區域的訂單有任何反彈，那將會很有幫助？

Thank you.

謝謝。

Sure.

當然。

Why don't I take this at a high level and then hand it over to Aaron.

為什麼我不把這件事放在高位上，然後交給亞倫呢？

First of all, I'd say that a long term trend for Cologuard remain intact.

首先，我想說 Cologuard 的長期趨勢保持不變。

With that said, I take accountability, our management team takes accountability for the lessened performance and guidance for Q3 and Q4 respectively.

話雖如此，我承擔責任，我們的管理團隊分別對第三季和第四季的業績和指導下降負責。

We can do better.

我們可以做得更好。

And we have our arms around these execution issues, and we have clear plans in place to address them.

我們全力解決這些執行問題，並制定了明確的計劃來解決這些問題。

We'll talk more about that on the call.

我們將在電話中詳細討論這一點。

Let me say that Cologuard is and remains promotionally responsive.

我要說的是，Cologuard 一直以來都積極響應促銷活動。

It's responsive -- the most and the newer health care providers that have begun ordering Cologuard since the pandemic, we are calling on those that cohort of decisions the least and that is an opportunity for us to execute much better as we have in the past.

它反應靈敏——自大流行以來開始訂購Cologuard 的大多數和較新的醫療保健提供者，我們呼籲那些做出最少決定的人，這對我們來說是一個機會，可以像過去一樣更好地執行。

We're disappointed, but at the same time, we see a very clear path to improvement.

我們很失望，但同時，我們看到了一條非常明確的改進之路。

The size of the opportunity remains unchanged.

機會的大小保持不變。

There are 60 million Americans who are not up to date with screening.

有 6000 萬美國人沒有及時進行篩檢。

We are seeing a change in the way that patients are consuming health care with a decrease over time in face to face office visits in the primary care setting that has changed most significantly since COVID that provides on one hand, a challenge another real opportunity because of the ExactNexus platform and our ability to reach people as we are with care gap programs initiated by our customers where health systems and payers, we'll talk about that more.

我們看到患者消費醫療保健的方式發生了變化，隨著時間的推移，初級保健機構中面對面就診的次數減少了，自新冠疫情以來，這種變化最為顯著，一方面，這是一種挑戰，另一方面是真正的機遇，因為ExactNexus 平台以及我們接觸人們的能力，就像我們透過客戶、健康系統和付款人發起的護理缺口計劃一樣，我們將更多地討論這一點。

And then I just want everybody to keep in mind that 2025 tailwinds and why we believe that growth in 2025 and beyond will continue starting with rescreens, which continues to grow.

然後我只是希望每個人都記住 2025 年的順風車，以及為什麼我們相信 2025 年及以後的增長將繼續從重新篩選開始，並繼續增長。

We'll unpack that a little bit and we believe over time that growth from 25% to 50%.

我們將對此進行一些分析，我們相信隨著時間的推移，這一數字將從 25% 增長到 50%。

The Care gap programs which are becoming a larger part of our overall Cologuard volumes.

護理缺口計劃正在成為我們整體 Cologuard 數量的重要組成部分。

Cologuard Plus the introduction of it and the price increase that we will seek in 2025 and then finally, stronger commercial execution than you saw in Q3 and we expect to see in Q4.

Cologuard Plus 的推出以及我們將在 2025 年尋求的價格上漲，最後，比您在第三季度看到的以及我們預計在第四季度看到的商業執行力更強。

Aaron?

亞倫？

Yeah.

是的。

Hey Brandon.

嘿布蘭登。

So as we laid out on the last call, there were really four key reasons for why we expected growth to accelerate into the back half of the year: typical seasonality, re screens, care gaps and then the recent sales and marketing investments that we've made.

因此，正如我們在上次電話會議中所闡述的那樣，我們預計今年下半年成長將加速的原因實際上有四個關鍵原因：典型的季節性、重新篩選、護理差距以及我們最近的銷售和行銷投資。

Really proud of what's what's going on in the team execution around re screens and care gap, driving significant growth for us in the back half of the year.

我們對團隊在重新篩選和照護差距方面的執行情況感到非常自豪，這推動了我們在今年下半年的顯著成長。

If you look at kind of what's driving the shortfall; first, as we laid out, we typically see the highest volume of Cologuard order growth really from that kind of early August through late October, that's the steepest part of our growth curve.

如果你看看是什麼導致了短缺；首先，正如我們所指出的，我們通常會在 8 月初到 10 月下旬期間看到 Cologuard 訂單量的最高增長，這是我們成長曲線中最陡峭的部分。

And while we have seen increases over this period of time, it's not been at the levels that we expect or that we've seen historically.

雖然我們在這段時間看到了成長，但並未達到我們預期或歷史上看到的水平。

The second key reason would be we've seen a positive signal on recent sales and market investments that we've made.

第二個關鍵原因是我們在最近的銷售和市場投資方面看到了積極的信號。

But that signal is, is a bit more gradual than the prior guidance assumed.

但這個訊號比之前假設的指導要漸進一些。

The third key driver really comes down to hurricanes and as outlined on the call, those that live in the affected areas of the two hurricanes that hit, that represents roughly 18% of Cologuard volumes historically.

第三個關鍵驅動因素實際上是颶風，正如電話會議中所述，那些生活在兩次颶風襲擊影響地區的人，約佔 Cologuard 歷史銷量的 18%。

And that has had an impact on orders and results in September and October and obviously given the 30 day time lag between, when we see an order and a result, this has a bigger impact on the fourth quarter.

這對 9 月和 10 月的訂單和結果產生了影響，顯然考慮到我們看到訂單和結果之間有 30 天的時間間隔，這對第四季度的影響更大。

Tycho Peterson, Jefferies & Company.

第谷彼得森，傑富瑞公司。

Hey, thanks.

嘿，謝謝。

I'm going to pick up right there.

我要去那裡接。

So you're not willing to quantify each of the impacts.

所以你不願意量化每一個影響。

And then how long do you expect care gap and rep productivity issues to linger.

然後，您預計護理差距和代表生產力問題會持續多久。

And then fourth quarter guidance, you're down sequentially.

然後第四季的指導，你會連續下降。

I'm just curious as to why that, that would be the case.

我只是好奇為什麼會這樣。

And then lastly anything you're willing to say about '25 at this point.

最後，關於 25 年，你願意說些什麼。

Thanks.

謝謝。

Hey, Tycho.

嘿，第谷。

Yeah.

是的。

As we look at -- in the fourth quarter, it is down sequentially, we're not going to size each one of the kind of four -- key three key reasons that we outlined.

正如我們所看到的，在第四季度，它是連續下降的，我們不會逐一衡量我們概述的四個關鍵原因中的每一個。

The single biggest reason for why revenue would be down sequentially from Q3 to Q4 is the hurricanes.

收入從第三季到第四季連續下降的最大原因是颶風。

Again, as we look at patients who in affected areas and we closely monitor on a week to week basis, what's been happening both with orders and results.

同樣，當我們觀察受影響地區的患者並每週密切監測時，訂單和結果都發生了什麼。

We know that this is going to have an outsized impact on Q4 relative to Q3.

我們知道，相對於第三季度，這將對第四季產生巨大影響。

Again, those that live in affected areas make up roughly 18% of Cologuard volumes.

同樣，居住在受影響地區的人約佔 Cologuard 總量的 18%。

As it relates to care gaps.

因為它與護理差距有關。

Care gap continues to be a strong growth driver for us into the back half of the year.

護理差距仍然是我們今年下半年強勁的成長動力。

The pacing between Q3 and Q4, we actually saw some of the payer programs pull forward from Q4 into Q3 and some of the care gap programs we had contemplated in Q4 are happening a little bit later in the quarter.

從第三季度和第四季度之間的節奏來看，我們實際上看到一些付款人計劃從第四季度提前到第三季度，而我們在第四季度考慮的一些護理缺口計劃將在本季度晚些時候發生。

So some of that revenue will be recognized in 2025 as we result those orders.

因此，部分收入將在 2025 年我們完成這些訂單時確認。

Turning to 2025, just to reiterate what Kevin said before, we've got four key reasons to be excited about growth heading into next year.

展望 2025 年，重申 Kevin 之前所說的話，我們有四個關鍵理由對明年的成長感到興奮。

First is re screens.

首先是重新篩選。

Second is Care gap programs.

其次是護理缺口計劃。

Third is the launch of Cologuard Plus and the pricing increase that we expect to see.

第三是 Cologuard Plus 的推出以及我們預計會看到的價格上漲。

And then fourth would be commercial execution.

第四是商業執行。

Yeah, and adding on to that new products with our launch of MRD occurring next year too in the first half.

是的，明年上半年我們也會推出 MRD，補充這些新產品。

Andrew Brackmann, William Blair.

安德魯·布拉克曼，威廉·布萊爾。

Hi, good afternoon.

嗨，下午好。

Thanks for taking the question.

感謝您提出問題。

You know, I think one of the things folks are going to want some comfort around is just your ability to forecast the business, especially in the context of how things sort of played out this quarter.

你知道，我認為人們想要安慰的事情之一就是你預測業務的能力，特別是在本季情況如何發展的背景下。

But can you maybe just sort of talk about the signs that you saw inter quarter that this was sort of playing out against your favor?

但你能否談談你在季度間看到的跡象，表明這對你不利？

And I guess specifically how those changed or evolved over the last couple of years and I guess bigger picture here, the number of variables in the model.

我具體猜測這些在過去幾年中是如何變化或演變的，我想這裡有更大的圖景，模型中變數的數量。

How are those sort of moving in and out of your control as we look forward?

當我們展望未來時，這些是如何進入或脫離你的控制的？

Thanks.

謝謝。

Hey, Andrew.

嘿，安德魯。

Yeah, the biggest thing that I would say from an intra quarter perspective is just obviously, again, reiterating that growth that we expect to see and have seen over time from August through October and that's been a very reliable period of growth in the past.

是的，從季度內的角度來看，我想說的最重要的事情顯然是，再次重申我們預計會看到的增長，並且從8 月到10 月的一段時間內已經看到了增長，這在過去是一個非常可靠的成長時期。

We did see growth in orders during that time period, just not at the levels as we have historically and to reiterate some of the points Kevin made, this comes down to commercial execution and we're taking actions to address that heading into 2025.

我們確實看到了這段時間內訂單的成長，只是沒有達到我們歷史上的水平，並重申 Kevin 提出的一些觀點，這歸結於商業執行，我們正在採取行動來解決 2025 年的問題。

The second thing that we saw play out intra quarter was obviously the the two large hurricanes which kind of hit back to back and we monitor those effective areas very, very closely and are able to predict what's happening both in terms of orders as well as results heading into the fourth quarter.

我們在季度內看到的第二件事顯然是兩場大型颶風，它們連續襲擊，我們非常非常密切地監控這些有效區域，並且能夠預測訂單和結果方面發生的情況進入第四季度。

Doug Schenkel, Wolfe Research.

道格‧申克爾，沃爾夫研究中心。

Hey, good afternoon.

嘿，下午好。

So question on the guidance and then just thinking ahead from here for the next couple of years.

因此，請對指導意見提出質疑，然後從現在開始思考未來幾年的情況。

So Aaron, doing some quick math, if we assume 18% of your revenue went to zero for one month, I think that would equate to $35 million to $40 million in revenue.

Aaron 快速算了一下，如果我們假設一個月內 18% 的收入為零，我認為這相當於 3500 萬至 4000 萬美元的收入。

You cut guidance for the year by more than half that.

您將今年的指導方針削減了一半以上。

So just want to make sure I'm in the right neighborhood.

所以只是想確保我在正確的社區。

I want to be crystal clear that even if it were not for the hurricanes, you would be cutting guidance here because of your lack of visibility and just not executing to plan.

我想明確表示，即使不是因為颶風，你們也會因為缺乏可見性並且沒有執行計劃而削減這裡的指導。

So that's my first question.

這是我的第一個問題。

My second is your guidance implies that Cologuard fourth-quarter volume growth is going to moderate, I think, to around 10%.

我的第二點是，您的指導意味著 Cologuard 第四季的銷售成長將放緩至 10% 左右。

And this is in a period where you talked about again, material care gap benefits coming in, the reps you hired that were completed in May but were hired earlier than that in some cases starting to become more efficient as they're supposed to be.

在這個時期，您再次談到，物質護理缺口福利即將到來，您僱用的代表在5 月份完成，但在某些情況下比該日期更早被雇用，開始變得更加高效，正如他們應該的那樣。

And then the opportunity to convert reorders from three years ago, as we look at the second half of this year, that's as big as ever.

然後，當我們看到今年下半年時，轉換三年前重新訂單的機會與以往一樣大。

So if that's what's going on with Cologuard, your other major product line, Oncotype, great product, but it's mature.

因此，如果這就是 Cologuard 的情況，您的另一個主要產品線 Oncotype 是很棒的產品，但它已經成熟了。

That's a mid-single-digit growth franchise.

這是一個中等個位數成長的特許經營權。

Pulling those things together and acknowledging the tailwinds that you talked about in your prepared remarks, let's just cut to it -- recognizing a key part of the buy thesis for Exact is your ability to grow revenue double digits, can you do that over the next one to two years unless you get the ASP increases or get help from other products like MRD or Cologuard Plus?

將這些事情放在一起，並承認您在準備好的發言中談到的有利因素，讓我們直接切入正題——認識到Exact 購買論點的關鍵部分是您實現收入兩位數增長的能力，您可以在接下來的時間裡做到這一點嗎？

Thank you.

謝謝。

Doug, thanks for that.

道格，謝謝你。

Let me take the first part and then hand it over to Aaron.

讓我先完成第一部分，然後交給亞倫。

When you zero-in on the biggest impact in terms of the fourth quarter, it is on the responsiveness to -- in our core customer base, the customers who are seeing patients.

當你將第四季度的最大影響歸零時，那就是對我們核心客戶群中正在看病的客戶的回應能力。

And there is a change that is ongoing in the way that Americans are consuming healthcare with a decrease in primary care visits.

隨著初級保健就診次數的減少，美國人的醫療保健消費方式正在改變。

That's a fact.

這是事實。

There's also a transition going on in the way that Cologuard is being delivered through these care gap programs.

透過這些護理缺口計劃提供 Cologuard 的方式也正在發生轉變。

Well, let's come back to our ability to grow our customer base.

好吧，讓我們回到我們擴大客戶群的能力。

The reason that we're confident that we'll continue to grow at that in the primary care setting is because we have seen tremendous growth in new users and new healthcare providers.

我們之所以有信心在初級保健領域繼續成長，是因為我們看到新用戶和新醫療保健提供者的巨大成長。

And we haven't called on them very frequently.

我們也沒有經常拜訪他們。

We're calling on the cohorts of new ordering physicians from 2020 and beyond at half the rate that we're calling on the more tenured.

從 2020 年及以後開始，我們對新開診醫師的召集率是長期任職醫師的一半。

So there's an opportunity for us to execute.

所以我們有一個執行的機會。

And one thing that we see and we can see this from our data is when you call on those healthcare providers, you see a response in terms of how frequently they order Cologuard.

我們從數據中看到的一件事是，當您致電這些醫療保健提供者時，您會看到他們訂購 Cologuard 的頻率方面的回應。

And so refocusing our efforts there, we have done the math and we know what -- that we have confidence that will lead to growth.

因此，我們重新將精力集中在這方面，我們已經做了計算，我們知道——我們有信心實現成長。

But there are other growth drivers that provide kind of a minimum floor of double-digit growth next year.

但還有其他成長動力可以提供明年兩位數成長的最低底線。

Maybe Aaron you can touch upon those.

也許亞倫你可以談談這些。

Yeah.

是的。

So the floor, it really comes down to re-screen those care gap programs, and then Cologuard Plus pricing sets a solid base for double-digit-plus growth in our screening business.

因此，實際上歸根結底是重新篩選這些護理缺口計劃，然後 Cologuard Plus 定價為我們的篩檢業務實現兩位數以上的成長奠定了堅實的基礎。

And as we turn around on the commercial execution side, that obviously provides upside to that.

當我們轉向商業執行方面時，這顯然提供了好處。

Coming back to kind of the fourth quarter deceleration Doug, you had decent math on the hurricanes.

回到第四季的減速，道格，你對颶風有很好的數學計算。

Still, we'd still be cutting the guide, right?

儘管如此，我們仍然會削減指南，對吧？

The larger impact for us is ultimately on not accelerating growth during that critical time period from August through October.

對我們來說更大的影響最終是在八月到十月這個關鍵時期沒有加速成長。

There is a smaller but maybe less of an impact on the recent sales and marketing investments.

對最近的銷售和行銷投資的影響較小但可能較小。

We have seen a positive signal from those and look forward to a greater contribution impact from those heading into 2025.

我們已經看到了這些正面的訊號，並期待這些人在 2025 年能做出更大的貢獻。

On the Q3 to Q4 sequential, the biggest impact there, Doug, is the hurricane.

道格，從第三季到第四季度，最大的影響是颶風。

Absent the hurricane, you would see a sequential growth from Q3 to Q4.

如果沒有颶風，您會看到第三季到第四季的連續成長。

And as I called out earlier to a lesser extent, if you just look at care gap, from a year-over-year perspective, we saw higher growth year over year in Q3 than we would in Q4.

正如我之前在較小程度上指出的那樣，如果你只看護理差距，從同比的角度來看，我們在第三季度看到的同比增長高於第四季度。

Dan Brennan, Cowen.

丹布倫南，考恩。

Great, thanks.

太好了，謝謝。

Since there's been a lot of questions on the quarter in care gap, maybe I could focus on 2.0. Kevin, you talked about the upside driver a couple of times for 2025.

由於有關本季護理差距的問題很多，也許我可以關注 2.0。 Kevin，您多次談到 2025 年的上行驅動因素。

Can you just kind of remind us of the pricing strategy for 2.0. Sounds like ADLT will be the focus given the clinical fee schedule.

您能否提醒我們 2.0 的定價策略？鑑於臨床費用表，聽起來 ADLT 將成為焦點。

I think the interim update didn't go your way.

我認為臨時更新並沒有如你所願。

So can you let us know what price you look to seek with ADLT status?

那麼您能否告訴我們您希望獲得 ADLT 狀態的價格是多少？

You talked about it'll apply to Medicare.

您談到它將適用於醫療保險。

Just remind us what percent of volumes it'll apply to.

請提醒我們它將適用於多少百分比的捲。

And then how do you deal with the commercial payers?

那麼你如何與商業付款人打交道呢？

Like any kind of thoughts about what commercial payers will sign up for it and won't.

就像關於什麼商業付款人會簽署和不會簽署的任何想法一樣。

And then if that's the case, then how do you deal with maybe running two tests in terms of the margin profile of that?

如果是這種情況，那麼您如何處理可能針對其利潤概況進行兩次測試？

Thank you.

謝謝。

Thanks, Dan.

謝謝，丹。

So first, I'll start with Cologuard Plus, it's a major advancement.

首先，我將從 Cologuard Plus 開始，這是一個重大進步。

We got the final safety and effectiveness data and the final label for Cologuard Plus.

我們獲得了 Cologuard Plus 的最終安全性和有效性數據以及最終標籤。

And this sensitivity ended up at 95% and 94% specificity when you adjust to the census by age, which the agency allowed us to do, and look at what's called category six specificity, the true normals, those patients without any polyps in their colon.

當你根據年齡進行人口普查時，這種敏感性最終達到95% 和94% 的特異性，該機構允許我們這樣做，並查看所謂的六類特異性，真正的正常值，那些結腸中沒有任何息肉的患者。

And so that 95% sensitivity, 94% specificity is unmatched by any non-invasive approach.

其 95% 的敏感性和 94% 的特異性是任何非侵入性方法都無法比擬的。

In terms of how we intend to price that, we are still before Medicare with the clinical fee schedule process that plays out before the end of the year.

就我們打算如何定價而言，我們仍然領先於醫療保險，臨床費用表流程將於年底前完成。

And we remain -- we continue to engage with CMS on getting a clinical -- the CDLT process to seek a price increase.

我們仍然 - 我們繼續與 CMS 接觸以獲得臨床 - CDLT 流程以尋求價格上漲。

But if not, then we will go the ADLT path, and the AD LT path, it's just a slightly longer path.

但如果沒有，那麼我們將走 ADLT 路徑，AD LT 路徑，它只是一條稍微長一點的路徑。

We get -- there's a benefit that you probably start with a higher price than the CDLT path.

我們得到的好處是，您可能會以比 CDLT 路徑更高的價格開始。

The process then takes a couple of years to transition from Cologuard to Cologuard Plus.

從 Cologuard 過渡到 Cologuard Plus 的過程需要幾年時間。

The patients who have access to Cologuard Plus will get Cologuard plus and over time, we will start with the Medicare patients and then move into the commercial and then Medicaid patients.

能夠使用 Cologuard Plus 的患者將獲得 Cologuard plus，隨著時間的推移，我們將從 Medicare 患者開始，然後進入商業，然後是 Medicaid 患者。

That process probably takes 12 to 24 months to play out.

這個過程可能需要 12 到 24 個月才能完成。

Obviously, there are a lot of benefits for payers and their members to have access to Cologuard Plus including the performance.

顯然，使用 Cologuard Plus 可以為付款人及其會員帶來許多好處，包括性能。

And also the price of the -- the cost make up of Cologuard Plus is lower, and it will take some time, but we're confident about what that process will look like.

而且 Cologuard Plus 的價格較低，而且需要一些時間，但我們對過程的外觀充滿信心。

We will create value and increase price because of the innovation that we're delivering.

由於我們提供的創新，我們將創造價值並提高價格。

Matt Sykes, Goldman Sachs.

馬特·賽克斯，高盛。

Yeah, thanks for taking my questions.

是的，謝謝你回答我的問題。

Maybe just to dig a little bit deeper on the commercial side, Kevin, you talked about the response you see from some of those newer doctors and systems that you brought on post-COVID.

也許只是為了在商業方面進行更深入的挖掘，凱文，你談到了你從新冠疫情後帶來的一些新醫生和系統中看到的反應。

But clearly, the calls weren't going into them, and you've been dealing with sort of the lack of in-office visits for some time now.

但顯然，這些電話並沒有打到他們身上，而且一段時間以來，你一直在處理缺乏辦公室拜訪的問題。

So could you maybe just talk a little bit about what the breakdown was?

那麼您能否簡單談談故障是什麼？

I know you've had some turnover in sales management.

我知道您在銷售管理方面有一些人員流動。

Was it a sales management issue?

是銷售管理問題嗎？

Was it turnover of reps?

是代表的更替嗎？

Was it just new reps ramping up?

只是新代表的增加嗎？

It seems like something that you had focused on previously where the focus was lost.

這似乎是您之前關注的事情，現在卻失去了焦點。

So I'm just wondering kind of what the breakdown was there.

所以我只是想知道那裡發生了什麼故障。

Thanks.

謝謝。

I don't want to look backwards.

我不想回頭看。

I want to look forwards, because there are just -- there's a whole list of things that we can do to execute better.

我想展望未來，因為我們可以做一整套事情來更好地執行。

We have an incredible sales team.

我們擁有一支令人難以置信的銷售團隊。

They're trained.

他們受過訓練。

They're hungry.

他們餓了。

They're motivated.

他們很有動力。

They have integrity.

他們有誠信。

And we are giving them better tools to be able to be more successful in what they do.

我們正在為他們提供更好的工具，以便他們能夠在工作中取得更大的成功。

Remember, there are almost 200,000 healthcare providers that ordered Cologuard during the quarter, and we know they are responsive to visits by our field force, but that our base of customer continues to grow.

請記住，本季度有近 200,000 家醫療保健提供者訂購了 Cologuard，我們知道他們對我們現場人員的訪問做出了回應，但我們的客戶群仍在不斷增長。

So you have a dilution effect in terms of our ability to focus.

因此，就我們的專注能力而言，你會產生稀釋效應。

We are going to provide -- we are providing tools to our field force to allow them to really focus on the physicians and nurses and PAs that are most responsive to their calls.

我們將向我們的現場人員提供工具，使他們能夠真正專注於對他們的呼叫最敏感的醫生、護士和私人助理。

We owe that to them.

這是我們欠他們的。

We can deliver that.

我們可以做到這一點。

We take accountability here at headquarters to help them achieve that success.

我們在總部承擔責任，幫助他們成功。

And remember there's a significant stickiness to the providers that order Cologuard.

請記住，訂購 Cologuard 的供應商具有很大的黏性。

I'll give you one example for a reason that we believe that we will continue to grow in this core part of our business.

我舉一個例子，因為我們相信我們將在業務的這一核心部分繼續發展。

If you take a look at providers who ordered for the first time, let's say, before 2020 and compared them to healthcare providers who ordered 2020 or beyond, in their initial couple of quarters of ordering, these newer providers are ordering at a 50% rate -- more than 50% higher rate when they first start ordering.

如果你看一下在2020 年之前首次訂購的供應商，並將他們與2020 年或之後訂購的醫療保健提供者進行比較，在最初的幾個季度的訂購中，這些新的提供者的訂購率為50% -- 首次開始訂購時的比率高出 50% 以上。

So they want to use Cologuard.

所以他們想使用 Cologuard。

They know about Cologuard.

他們了解 Cologuard。

Patients are asking for Cologuard.

患者正在尋求 Cologuard。

We can do a better job of giving them the tools that they need to be successful so that they're even more sticky than, than older cohorts.

我們可以更好地為他們提供成功所需的工具，使他們比年長的群體更具黏性。

So this is about execution, and this starts with me, and it extends to the whole team and everybody is confident about our ability to address this.

所以這與執行有關，這從我開始，擴展到整個團隊，每個人都對我們解決這個問題的能力充滿信心。

Vijay Kumar, Evercore ISI.

維傑·庫馬爾，Evercore ISI。

Hey, guys.

嘿，夥計們。

Thanks for taking my question, Kevin, maybe to back up those comments you made, when you look at them -- how third quarter played out and you look at the guidance for Q4, is the change here between the 45 to 49 age group or is this the above-50, first-time screening -- screened patients?

感謝您提出我的問題，凱文，也許是為了支持您所做的評論，當您查看第三季度的表現以及您查看第四季度的指導時，45 歲至 49 歲年齡組之間的變化或這是上述50 位首次篩檢的患者嗎？

Was there any regional variants?

是否有任何地區差異？

I guess, what were the learnings?

我想，學到了什麼？

And when you say commercial execution will improve, what is going to change here that resolves or fixes the execution issues?

當你說商業執行力將會改善時，這裡會發生什麼變化來解決或解決執行問題？

Thank you.

謝謝。

Yeah.

是的。

We're not going to go into all the details about what we're doing from a commercial execution standpoint.

我們不會從商業執行的角度詳細介紹我們正在做的事情。

I'll just keep going back to the ability for us to access offices and to drive re-screens, care gaps.

我將繼續回到我們進入辦公室並推動重新篩選和護理差距的能力。

Cologuard Plus is significant.

Cologuard Plus 意義重大。

Let me zero-in on Cologuard Plus for an example.

讓我以 Cologuard Plus 歸零為例。

Cologuard Plus is such a step up in terms of performance.

Cologuard Plus 在性能方面取得了巨大進步。

As we have done research and focus groups on Cologuard Plus, there's a clear excitement among our customers to be able to have access to the data.

由於我們對 Cologuard Plus 進行了研究並建立了焦點小組，因此我們的客戶對能夠存取這些數據感到非常興奮。

And they need -- and we need to get out there and do that with our field force.

他們需要——我們也需要走出去，與我們的現場部隊一起做到這一點。

The new data will provide us greater access and time with the healthcare providers, and that is something that, we believe, will help us help drive greater volumes for both Cologuard and Cologuard Plus.

新數據將為我們提供更多與醫療保健提供者接觸的機會和時間，我們相信，這將有助於我們提高 Cologuard 和 Cologuard Plus 的銷售量。

But there are a whole range of areas where we can improve.

但我們還有很多方面可以改進。

Not going to -- again, not going to go into them now.

不打算——再說一次，現在不打算深入討論它們。

We know that this is disappointing to you, to investors.

我們知道這讓你們、投資者感到失望。

We're confident in our ability to grow and achieve or exceed our long-range plan as we've laid out.

我們對成長、實現或超越我們所製定的長期計劃的能力充滿信心。

And Vijay, just maybe a little bit of additional color on the breakdown, both in Q3 and expectations for Q4, we did see growth obviously across care gaps as well as re-screens and new ordering providers.

維傑（Vijay），也許只是對第三季度和第四季度的預期的細分進行了一些額外的說明，我們確實看到了護理差距以及重新篩選和新訂購提供者方面的明顯增長。

The biggest contribution and growth coming from care gaps and re-screen.

最大的貢獻和成長來自護理差距和重新篩選。

Double-clicking on re-screens, this is a really great source of revenue for us.

雙擊重新篩選，這對我們來說是一個非常好的收入來源。

It's obviously highly predictable, recurring, high-margin revenue.

這顯然是高度可預測的、經常性的、高利潤的收入。

Last year, we disclosed that represented roughly 20% of screening revenue in 2023.

去年，我們透露這約佔 2023 年放映收入的 20%。

We're at 25% now here in the back half of the year.

今年下半年我們的進度是 25%。

And thinking about new providers, new users, this is an area as Kevin alluded to.

考慮新的提供者、新的用戶，這是凱文提到的一個領域。

This is an area we know we can grow faster, particularly amongst the 45 to 49 cohort, which remains a very large unpenetrated cohort, many of whom are still unaware of CRC screening.

我們知道，這是我們可以更快發展的領域，特別是在 45 至 49 歲的人群中，這仍然是一個非常大的未滲透人群，其中許多人仍然不知道 CRC 篩檢。

And one of the things that we've been seeing is with the care gap program is it represents an opportunity to get at this 45 to 49 age cohort.

我們看到的一件事是，護理差距計劃為 45 至 49 歲年齡層的人群提供了一個機會。

Dan Arias, Stifel.

丹·阿里亞斯，斯蒂菲爾。

Hi, guys.

嗨，大家好。

Thanks for the questions.

感謝您的提問。

Kevin or Aaron, I'm sure you don't want to give exact numbers on total number of reps in the field, but I'm hoping you can sort of provide us with a 4Q snapshot if you will on commercial, just when it comes to how many more reps you'll have in the field come mid-4Q when everybody should sort of be up and running versus 4Q of last year.

凱文或亞倫，我確信您不想給出現場代表總數的確切數字，但我希望您可以在商業廣告中向我們提供 4Q 快照，就在它出現時到第四季度中期，與去年第四季度相比，每個人都應該能夠正常運作時，您將在現場增加多少代表。

It would just be helpful to try to understand the productivity difference year over year as you're finishing the year this year versus finishing the year last year.

當您今年完成這一年與去年完成這一年時，嘗試了解逐年生產力差異會很有幫助。

Yeah, we're not going to get into the number of reps that we have in the field.

是的，我們不會透露我們在現場的代表人數。

It won't be appreciably different in Q4 than it was in Q3.

第四季與第三季不會有明顯不同。

It's -- as you know, we talked on our Q1 call about our step-up in that field force, where we added about 100 reps.

如您所知，我們在第一季電話會議上討論了我們在現場隊伍中的升級，我們增加了大約 100 名代表。

That group of reps has shown the ability to have an impact on the physicians, healthcare providers that they call on, maybe not quite at the rate that we expected, but we see that positive impact that continues to grow month over month.

這群代表已經表現出了對他們所要求的醫生和醫療保健提供者產生影響的能力，也許達不到我們預期的速度，但我們看到這種積極影響逐月持續增長。

And that clearly is going to be -- have been a good investment to make.

顯然，這將是一項很好的投資。

That's where we are in terms of the sizing of the field force.

這就是我們在現場人員規模方面所處的情況。

And if you look at the productivity, we saw leverage again, not only in Q2, but also on the sales and marketing line.

如果你看看生產力，我們再次看到了槓桿作用，不僅在第二季度，而且在銷售和行銷方面也是如此。

So we got operating leverage on sales and marketing expenses.

因此，我們透過銷售和行銷費用獲得了營運槓桿。

And obviously, we'll continue to expect that moving forward.

顯然，我們將繼續期待這種情況的發展。

Jack Meehan, Nephron Research.

傑克·米漢，腎單位研究。

Thank you.

謝謝。

Good evening.

晚安.

Wanted to ask more about care gap.

想詢問更多有關護理差距的問題。

Kevin, just more directly, has the recent Medicare star situation led to increased engagement with large payers?

凱文，更直接地說，最近的醫療保險明星情況是否導致與大付款人的接觸增加？

Is it possible to talk about your hit rate and then use of Cologuard relative to FIT?

能否談談您的命中率以及 Cologuard 相對於 FIT 的使用情況？

And for Aaron, not sure if I heard this wrong, but just wanted to be clear, are the care gap sales expected to be lower in 4Q sequentially?

對於亞倫來說，不確定我是否聽錯了，但只是想澄清一下，第四季度的護理缺口銷售預計會依次下降嗎？

If you could just talk about why some programs were pulled forward versus pushed out, that would be great.

如果你能談談為什麼有些項目提前而不是被推遲，那就太好了。

Yeah, let me first give background on care gap programs.

是的，讓我先介紹一下護理差距計劃的背景。

Care gap programs are initiated by payers and health systems -- probably three parts payers, one part health systems.

護理缺口計劃是由付款人和衛生系統發起的——可能三部分是付款人，一部分是衛生系統。

But I think over time, that changes.

但我認為隨著時間的推移，情況會改變。

Driven by quality measures, both payers and health systems care about their quality measures and historically have used the FIT test to reach those patients who are under screened or who've never been screened.

在品質措施的推動下，付款人和衛生系統都關心他們的品質措施，並且歷史上一直使用 FIT 測試來接觸那些正在接受篩檢或從未接受過篩檢的患者。

And typically the FIT test seats about -- they ship out 10 fit tests for every one they get back, a 10% compliance rate.

通常情況下，FIT 測試座椅大約為每返回一個座椅進行 10 次適合性測試，符合率為 10%。

Now note that last year with our care gap programs, we saw about a 18% compliance rate.

現在請注意，去年我們的護理缺口計劃的合規率約為 18%。

That has grown to about 22% this year but 24% in the third quarter.

今年這一數字已增長至約 22%，但第三季增長至 24%。

So we keep getting better at that compliance rate.

因此，我們的合規率不斷提高。

And just imagine as that doubles.

想像一下，當這個數字翻倍時。

So today, the care gap program, I think, is bigger than people appreciate.

因此，我認為今天的護理差距計劃比人們想像的要大。

And over time, we think this is going to be a major avenue for how people get screened for colon cancer and probably other services too that we're able to provide over time.

隨著時間的推移，我們認為這將成為人們篩檢大腸癌的主要途徑，也可能成為我們隨著時間的推移所能提供的其他服務的主要途徑。

But the doubling, let's assume that we go from 22% to 44%, which is still 22% less than we're at with our core base of customers and their compliance rate.

但是，如果翻倍，我們假設從 22% 增加到 44%，這仍然比我們的核心客戶群及其合規率低 22%。

So if we were to double that, we wouldn't be talking about the challenge in the quarter today.

因此，如果我們將其翻倍，我們今天就不會談論本季的挑戰。

It would be a -- it would be just another leg of large growth.

這將是大幅成長的另一個階段。

And we know that the tools that we provide through the Exact Nexus platform, our service capabilities, will drive that improvement in the kit return rate over time.

我們知道，我們透過 Exact Nexus 平台提供的工具以及我們的服務能力將隨著時間的推移推動套件退貨率的提高。

Yeah.

是的。

And so just speaking Q3 to Q4, we would expect roughly similar revenue sizes, Q4 versus Q3 maybe up slightly.

因此，僅就第三季和第四季而言，我們預期營收規模大致相似，第四季與第三季相比可能會略有上升。

Jack, I think the other thing just to reinforce what Kevin was talking about this being larger than I think most people appreciate our thing.

傑克，我認為另一件事只是為了強化凱文所說的，這比我認為大多數人欣賞我們的東西更大。

We've talked a lot about how significant of a growth driver for us this is in 2024 but maybe just to size this a little bit, historically there's been about 3 million FIT tests completed through care gap programs run by Med Advantage plans each year.

我們已經討論了很多關於 2024 年這對我們的成長驅動力有多麼重要，但也許只是為了稍微衡量一下，歷史上每年有大約 300 萬個 FIT 測試通過 Med Advantage 計劃運行的護理缺口計劃完成。

And if you zoom out beyond Med Advantage plans, we would estimate that the addressable opportunity is between 4 million and 5 million completed FIT tests per year.

如果你把目光放遠到 Med Advantage 計畫之外，我們估計每年可完成 400 萬到 500 萬次 FIT 測試。

And keep in mind, those are at about roughly a 10%-ish compliance rate.

請記住，這些合規率大約是 10% 左右。

As Kevin just talked about, we've already demonstrated the ability to double that compliance rate, and we'd obviously look to double from the roughly 22% we're at today.

正如 Kevin 剛才談到的，我們已經展示了將合規率提高一倍的能力，而且我們顯然希望將目前的合規率提高一倍，大約是 22%。

And so if you kind of get this even to the 40% to 50% level Kevin talked about, you adjust for interval and apply our Cologuard average sale price, this is a multi-billion dollar opportunity for us over time, and we're really, really excited to go after it.

因此，如果你能達到Kevin 談到的40% 到50% 的水平，你可以調整間隔並應用我們的Cologuard 平均銷售價格，隨著時間的推移，這對我們來說是一個數十億美元的機會，我們真的非常非常興奮去追求它。

Patrick Donnelly, Citi.

派崔克唐納利，花旗銀行。

Hey, guys.

嘿，夥計們。

Thanks for taking the questions.

感謝您提出問題。

Kevin, maybe the first one just in terms of the headwinds.

凱文，也許是第一個就逆風而言的人。

Curious how they developed as the quarter went.

很好奇他們在本季的發展如何。

Was this something you guys picked up steadily as the quarter progressed?

隨著本季的進展，你們是否穩步發現了這一點？

Was it a little later?

是不是有點晚了？

Obviously, the hurricanes and when those happened, but just curious in terms of when you guys realized the shortfall is going to happen and the headwinds were there.

顯然，颶風以及颶風何時發生，但只是好奇你們何時意識到短缺將會發生並且逆風已經存在。

And then secondly, just on the EBITDA guide down, how you guys are thinking about the cost structure going forward.

其次，就 EBITDA 指南而言，你們如何考慮未來的成本結構。

It sounds like you reiterated the confidence in that EBITA target a few years out, but just how to think about the trajectory near term here and launching off into '25 on the EBITA piece would be helpful.

聽起來你重申了對幾年後 EBITA 目標的信心，但如何思考近期的軌跡以及在 EBITA 部分上進入 25 年將會有所幫助。

Thank you, guys.

謝謝你們，夥計們。

Right.

正確的。

So the number that we look at most intently is that daily and weekly number of orders.

因此，我們最關注的數字是每日和每週的訂單數。

And what we saw in the first half of the year was the typical seasonal growth that you see in the spring where you see typically week-over-week improvement in or increase in the number of orders driven by office visits and by what we would call our point-of-care delivery.

我們在今年上半年看到的是春季典型的季節性增長，通常情況下，由辦公室訪問和我們所說的推動的訂單數量逐週改善或增加我們的護理點交付。

And over -- starting in August and going into October, we saw an increase, we just didn't see the increase, as Aaron mentioned, that we typically would see at that time of year.

從八月開始到十月，我們看到了成長，但我們只是沒有看到成長，正如亞倫提到的那樣，我們通常會在一年中的那個時候看到這種增長。

So when did we know that there was going to be a challenge that -- really, it's starting in September and into October, we realized that there was a greater challenge there than we had seen in past falls during that time period of the year, which we have described as typically the steepest increase.

所以我們什麼時候知道將會有一個挑戰——實際上，從九月開始到十月，我們意識到那裡的挑戰比我們在一年中的那個時期過去的秋天所看到的更大的挑戰，我們將其描述為通常最陡的增長。

Yeah.

是的。

And Patrick just turning to EBITDA, so we're very confident in our ability to achieve our 20%-plus adjusted EBITDA guide.

派崔克剛轉向 EBITDA，因此我們對實現 20% 以上的調整後 EBITDA 指南的能力非常有信心。

We've made meaningful progress on profitability ahead of expectations.

我們在獲利能力方面取得了超出預期的有意義的進展。

If you turn to the full year, it's up at midpoint roughly 270 basis points.

如果你看一下全年情況，你會發現中間值上漲了大約 270 個基點。

Unpacking that, it starts with growth.

拆開它，它從增長開始。

Obviously, double-digit revenue growth is an important part of our value-creation story and drives a lot of meaningful leverage.

顯然，兩位數的收入成長是我們價值創造故事的重要組成部分，並推動了許多有意義的槓桿作用。

And we're seeing that play out here in 2024.

我們將在 2024 年看到這種情況的發生。

Kevin alluded to, we have reasons to be confident that that's going to accelerate even more as we head into 2025, really driven by again, re-screens, care gap, new product launches as well as pricing.

Kevin 提到，我們有理由相信，隨著我們進入 2025 年，這種速度將會進一步加快，這實際上是由重新篩選、護理差距、新產品發布以及定價推動的。

But if you look at it, we're driving leverage across the P&L right now.

但如果你看一下，我們現在正在推動損益表上的槓桿作用。

So whether that's sales and marketing efficiency on the investments that we're making, we've seen a slight decline in gross margins in the near term, largely driven by some of the one-time ASP benefits we've talked about as well as a temporary headwind from care gap due to the lower adherence.

因此，無論是我們正在進行的投資的銷售和行銷效率，我們都看到短期內毛利率略有下降，這主要是由我們討論過的一些一次性平均售價收益推動的由於依從性較低，護理缺口暫時出現逆風。

That should flip to a tailwind for us in 2025 with the launch of Cologuard Plus, which will give us added ASP as well as a lower cost of goods.

隨著 Cologuard Plus 的推出，這應該會在 2025 年為我們帶來利好，這將為我們帶來更高的平均售價和更低的商品成本。

And then looking at G&A just so proud of the efforts from the team thus far this year.

然後看看 G&A，我們對團隊今年迄今為止所做的努力感到非常自豪。

We saw more than 500 basis points of operating leverage on G&A.

我們看到 G&A 的營運槓桿超過 500 個基點。

But there's a lot more that we can and will do to address G&A.

但我們可以而且將會採取更多措施來解決一般管理費用問題。

It's come down on an adjusted basis from roughly 35% to a roughly 30% where we were in the quarter.

經過調整後，該比例從本季的大約 35% 下降到大約 30%。

And we know and we'll take plans to make sure that we address that, to continue to bring that down moving forward.

我們知道，我們將採取計劃來確保我們解決這個問題，並繼續向前邁進。

Dan Leonard, UBS.

丹‧倫納德，瑞銀集團。

Thank you.

謝謝。

Just a couple of questions on the Cologuard Plus mechanics.

關於 Cologuard Plus 機械裝置的幾個問題。

I think, Kevin, you mentioned the launch would be in Q2.

我想，凱文，你提到過將在第二季發布。

For some reason, I thought it might be Q1.

出於某種原因，我認為這可能是 Q1。

So could you educate me on why Q2?

那你能告訴我為什麼是 Q2 嗎？

And then secondly, on the ADLT pricing mechanics, I just would like to better understand the way that mechanism works.

其次，關於 ADLT 定價機制，我只是想更了解機制的運作方式。

If you went the ADLT route, you get paid list price by nine months -- or for nine months by Medicare.

如果您選擇 ADLT 路線，您將在九個月內獲得標價的付款，或透過 Medicare 獲得九個月的付款。

But your list price for Cologuard is actually quite a bit higher than your ASP.

但你們的 Cologuard 標價其實比你們的平均售價高很多。

So are you going to get an increase from that list price and then get paid at a far, far higher rate from Medicare for a period of time?

那麼，您是否會在標價的基礎上提高價格，然後在一段時間內以高得多的費率從醫療保險中獲得報酬？

But I'd just like to understand that better.

但我只是想更好地理解這一點。

Thank you.

謝謝。

Yeah.

是的。

So first the launch timing is kind of the end of Q1, beginning of Q2 is what we're shooting for.

因此，首先，發佈時間是第一季末，第二季開始是我們的目標。

Is that going to adjust one way or the other by a little bit?

會以某種方式進行調整嗎？

It could, but that's what we're shooting for.

可以，但這就是我們的目標。

In terms of the mechanics, yeah, you have that essentially right that you have a list price.

就機製而言，是的，您基本上有權制定標價。

You pick that list price.

您選擇該標價。

You get paid by Medicare for that list price.

您將按照該標價獲得 Medicare 的付款。

And then, at the end of a period, it reverts to the median of the commercial rate if there's commercial rates that are, where there are claims that have been processed.

然後，在一個時期結束時，如果有商業費率，並且有已處理的索賠，則它會恢復到商業費率的中位數。

And you can dig into how the mechanics of the ADLT process works.

您也可以深入了解 ADLT 流程的機制是如何運作的。

That's the essence of it.

這就是它的本質。

And then you get that price for two years, and then it readjusts in every year after that.

然後你會得到兩年的價格，然後每年都會重新調整。

So you do have the ability to control that price.

所以你確實有能力控制這個價格。

And you get paid on the Medicare claims.

您將獲得醫療保險索賠的報酬。

Initially, it would be the Medicare fee for service claims over time as you get commercial contracts or your commercial contracts that exist cover Cologuard Plus, you would start to have those patients access Cologuard Plus and then with the commercial deals.

最初，隨著時間的推移，這將是服務索賠的 Medicare 費用，當您獲得商業合約或現有的商業合約涵蓋 Cologuard Plus 時，您將開始讓這些患者訪問 Cologuard Plus，然後進行商業交易。

And that just takes time to work through all of that.

而這只是需要時間來完成所有這些工作。

Puneet Souda, Leerink Partners.

Puneet Souda，Leerink 合夥人。

Yeah.

是的。

Hi, thanks, Kevin.

嗨，謝謝，凱文。

Thanks for taking the question.

感謝您提出問題。

So just a clarification.

所以只是澄清一下。

Is there any air pocket that you saw from switching due to the Nexus or due to the care gap switching of the patients?

您是否看到因 Nexus 或患者護理間隙切換而導致的氣穴？

And just a quick follow-up on there was a launch of a product in early August in blood just wondering if you're seeing that in any of the accounts.

快速跟進一下，八月初在血液中推出了一款產品，只是想知道您是否在任何帳戶中看到了這一點。

I'll just leave it at that.

我就這樣吧。

Thank you.

謝謝。

Yeah.

是的。

In terms of -- I think you referenced an air bubble.

就——我認為你提到了氣泡。

We saw an impact as we moved Oncotype DX onto the Exact Nexus platform.

當我們將 Oncotype DX 遷移到 Exact Nexus 平台時，我們看到了影響。

Because some of the claims of the test that we processed, we believe we will not get paid for it.

因為我們處理的一些測試索賠，我們相信我們不會因此獲得報酬。

I won't go into all of those details, but that was a component of the -- really what's going on in the fourth quarter.

我不會詳細討論所有這些細節，但這是第四季度真正發生的事情的一部分。

In terms of an impact in the quarter by a blood-based colon cancer screening tests, no, we've stayed close to that and we anecdotally and also based on research, we have seen no impact on our business based on that competitive dynamic.

就本季基於血液的結腸癌篩檢測試的影響而言，不，我們已經接近這一點，而且根據研究，我們沒有看到這種競爭動態對我們的業務產生任何影響。

Subbu Nambi, Guggenheim Securities.

Subbu Nambi，古根漢證券。

Hey, guys.

嘿，夥計們。

Thank you for taking my question.

感謝您回答我的問題。

Regarding 2025 revenue growth, your comments suggest that you're confident in the outlook for high-single-digit or even double-digit screening revenue growth and continued low- to mid-single-digit Oncotype growth.

關於 2025 年收入成長，您的評論表明您對高個位數甚至兩位數的篩檢收入增長和持續的低至中個位數 Oncotype 增長的前景充滿信心。

Is that right?

是這樣嗎？

If so, are you confident you can do this while growing operating spend at mid-single-digit levels?

如果是這樣，您是否有信心在實現這一目標的同時實現中等個位數水準的營運支出成長？

And finally, is your 2027 20% EBITDA target still intact?

最後，您的 2027 年 20% EBITDA 目標是否仍然完好無損？

Yes, to the last question.

是的，到最後一個問題。

To the first question, we expect next year to -- we are not giving guidance now for next year, but the 15% growth target over the next three years is intact.

對於第一個問題，我們預計明年——我們現在不會給出明年的指導，但未來三年 15% 的成長目標不會改變。

And again, the re-screens, care gaps, Cologuard Plus commercial execution can deliver a mid-double-digit increase or greater.

再次強調，重新篩選、護理差距、Cologuard Plus 商業執行可以實現中兩位數或更高的成長。

So we -- and we'll spend more time talking through this, but there's a floor, and the floor is at a very attractive level.

所以我們——我們會花更多的時間來討論這個問題，但有一個底線，而且這個底線處於一個非常有吸引力的水平。

Yeah.

是的。

Just to reiterate, screening growth this year while we're disappointed is at 12% at midpoint.

重申一下，今年的放映成長率為 12%，儘管我們對此感到失望。

And as Kevin alluded to earlier, for those four key reasons, we actually expect growth will accelerate in screening in 2025.

正如 Kevin 之前提到的，由於這四個關鍵原因，我們實際上預計 2025 年放映量將加速成長。

Turning to adjusted EBITDA, it is absolutely still intact.

至於調整後的 EBITDA，它絕對完好無損。

I want to reiterate, we are very confident in our ability to get to 20%-plus adjusted EBITDA by 2027.

我想重申，我們對 2027 年調整後 EBITDA 達到 20% 以上的能力充滿信心。

We will have expanded from just under 9% profitability last year to approaching 12% profitability in 2024.

我們的獲利能力將從去年略低於 9% 擴大到 2024 年接近 12%。

You could expect meaningful margin expansion again in 2025, both coming from a double-digit screening growth, but importantly, also coming from addressing our cost base, particularly in G&A.

您可以預期 2025 年利潤率將再次大幅成長，這既來自兩位數的放映成長，但更重要的是，也來自解決我們的成本基礎，特別是在一般管理費用方面。

Andrew Cooper, Raymond James.

安德魯庫珀，雷蒙德詹姆斯。

Hey, everybody.

嘿，大家。

Thanks for the question.

謝謝你的提問。

A lot already asked.

已經問了很多了。

So maybe just one more on sort of the comments that you've reiterated in response to a couple of questions on the docs being promotionally responsive, but at the same time saying, it's taking longer to ramp these new reps and kind of some of the comments there.

因此，也許只是您在回答有關文檔促銷回應的幾個問題時重申的評論，但同時說，需要更長的時間來提升這些新代表以及一些那裡有評論。

Can you help us adjudicate those two things?

您能幫我們裁決這兩件事嗎？

And what gives you the confidence that doctors are truly as responsive as they -- or receptive as they always have been versus potentially a change in their behavior, not as much directly tied to your execution as we think about 3Q and 4Q and beyond?

是什麼讓您相信醫生確實像他們一樣積極響應，或者一如既往地接受，而不是潛在地改變他們的行為，而不是像我們認為的第三季度和第四季度及以後那樣與您的執行直接相關？

So tying those together, as we move into the fourth quarter and next year, we're able to provide tools and deployment of our field force in a way that focuses their efforts on those HCPs who are the most responsive.

因此，當我們進入第四季度和明年時，將這些結合在一起，我們能夠提供工具並部署我們的現場人員，將他們的工作重點集中在那些反應最快的 HCP 上。

And we have a plan to do that.

我們有一個計劃來做到這一點。

In terms of knowing that that responsiveness exists, we're fortunate to have a ton of data.

就知道這種響應能力的存在而言，我們很幸運地擁有大量數據。

And our data allows us to look at HCPs that we call on versus HCPs that we don't and the frequency of calling on them and then what the responsiveness is.

我們的數據使我們能夠了解我們拜訪過的 HCP 與我們沒有拜訪過的 HCP，以及拜訪他們的頻率以及回應能力。

And based on that data, we're confident that with a greater amount of analytics and focus, we will expect to see stronger growth in that core part of the Cologuard business.

基於這些數據，我們相信，透過更多的分析和關注，我們預計 Cologuard 業務的核心部分將出現更強勁的成長。

Mark Massaro, BTIG.

馬克·馬薩羅，BTIG。

Hey, guys.

嘿，夥計們。

Thank you for taking the questions.

感謝您提出問題。

The first one is, Kevin, did you make any changes in the field to people's territories?

第一個是，凱文，你對人們的領地領域做了什麼改變嗎？

And if you did, are those folks sort of in their new territories at this time?

如果你這樣做了，這些人此時是否已經進入了他們的新領域？

And then the second part is on the transition to Cologuard Plus next year.

第二部分是明年向 Cologuard Plus 的過渡。

So I'm just curious, if a clinician orders a Cologuard for someone with a commercial health plan -- let's just call it in Q3, if there's no contract there, what happens?

所以我很好奇，如果臨床醫生為有商業健康計劃的人訂購了 Cologuard——讓我們在第三季度稱之為，如果那裡沒有合同，會發生什麼？

Do they automatically default to Cologuard 1.0?

它們會自動預設為 Cologuard 1.0 嗎？

I'm just really asking how you can prevent potential zeros or no pays?

我只是想問如何防止潛在的零薪或無薪？

Yeah, sure.

是的，當然。

So as you know, we have about 800 payers with contracts around Cologuard Plus or with Cologuard, and we see north of 96% -- I don't know, Eric, what is the latest -- 96% to 98% recovery on every dollar billed.

如您所知，我們有大約800 個付款人與Cologuard Plus 或Cologuard 簽訂了合同，我們看到超過96% - 我不知道埃里克，最新情況是什麼- 每個付款人都恢復了96% 到98%美元計費。

So we're proud of that.

所以我們為此感到自豪。

We're also proud of the depth of our relationships with those payers.

我們也為我們與這些付款人的深厚關係感到自豪。

So when we start to make this transition to Cologuard Plus, we'll be able to deliver the test, whether it's Cologuard or Cologuard plus that the patient has access to and our system has the ability to look that up and deliver the right test to the patient.

因此，當我們開始過渡到 Cologuard Plus 時，我們將能夠提供測試，無論是患者可以訪問的 Cologuard 還是 Cologuard plus，並且我們的系統能夠找到並提供正確的測試患者。

It's very important that we do that in a thoughtful way and not deliver those -- what you call zeros.

非常重要的是，我們要以深思熟慮的方式做到這一點，而不是交付那些——你們所說的零。

We haven't seen zeros in many, many years, and we don't plan to see zeros as we look into 2025 and beyond, because it's very important that people get screened and remember.

我們已經很多很多年沒有看到零了，而且在展望 2025 年及以後，我們也不打算看到零，因為讓人們接受篩選並記住這一點非常重要。

Cologuard is a great test with 92% sensitivity and 90% specificity.

Cologuard 是一項出色的測試，靈敏度為 92%，特異性為 90%。

So the patients will get one of those tests, whichever they have access for, we have the ability to deliver.

因此，患者將接受其中一項測試，無論他們可以進行哪一項測試，我們都有能力提供。

In terms of territory changes and that level of commercial execution, we have total confidence in our sales and marketing leadership.

就地理變化和商業執行程度而言，我們對我們的銷售和行銷領導力充滿信心。

We're excited about some of the changes we're making.

我們對我們正在做出的一些改變感到興奮。

The team is fired up.

團隊充滿了鬥志。

I've been out, and I've talked to many of those teams, and the energy is high.

我已經出去了，並且與許多這樣的團隊進行了交談，並且精力充沛。

The engagement is very high.

參與度非常高。

I want to make one other point as you look into 2025 and beyond -- and I want to really drive home this point around re-screens, care gaps, Cologuard Plus commercial execution, and new products like Oncodetect.

當您展望 2025 年及以後時，我想提出另一點——我想真正圍繞重新篩選、護理差距、Cologuard Plus 商業執行和 Oncodetect 等新產品來闡述這一點。

But let's talk about re-screens for a minute.

但讓我們來談談重新篩選一分鐘。

This year, there were 1.6 million people who are eligible for re-screens.

今年，有 160 萬人符合重新篩檢的資格。

Next year, it's 2 million people.

明年，這一數字將達到 200 萬人。

The year after that, it's 2.6 million people.

隔年，人數達 260 萬人。

They get delivered the new orders for Cologuard through the Exact Nexus platform largely.

Cologuard 的新訂單主要是透過 Exact Nexus 平台交付的。

And we get a ton of leverage because we built that ExactNexus platform.

因為我們建立了 ExactNexus 平台，所以我們獲得了巨大的影響力。

And we know what the adherence rate is today.

我們知道今天的遵守率是多少。

And we also know very discrete things that we're doing, and there dozens of them to improve the adherence rate of that population.

我們也知道我們正在做的非常離散的事情，其中​​有幾十個是為了提高該人群的依從率。

So we're confident about the base level of growth that we expected to see next year, but I also want to come back to where we started.

因此，我們對明年預期的基本成長水準充滿信心，但我也想回到我們開始的地方。

We as a management team are accountable for this.

我們作為管理團隊對此負有責任。

We've never been more focused in doing our job to make sure that this doesn't happen in the future.

我們從未像現在這樣專注於工作，以確保未來不會發生這種情況。

There is a big transition that is occurring, and we are in a unique and competitively unique position to be able to deliver for these health systems and payers who are facing these same challenges of getting people screened.

正在發生一場重大轉變，我們處於獨特且具有獨特競爭優勢的位置，能夠為這些衛生系統和支付者提供服務，他們面臨著同樣的篩檢挑戰。

That's through the care gap program.

這是透過護理缺口計劃實現的。

We're excited about that, and we're truly excited about Cologuard Plus and the improved performance there, setting a new standard of care.

我們對此感到非常興奮，並且對 Cologuard Plus 及其改進的性能感到非常興奮，從而設定了新的護理標準。

We look forward to completing this year, heading into 2025, and talking with you in the near term.

我們期待今年結束，進入 2025 年，並​​在短期內與您交談。

Thank you.

謝謝。

Thank you.

謝謝。

And that is all the time we have for our questions.

這就是我們提問的全部時間。

Thank you so much for joining the Exact Sciences third-quarter 2024 earnings conference call.

非常感謝您參加 Exact Sciences 2024 年第三季財報電話會議。

Have a pleasant evening.

祝您有個愉快的夜晚。