Exagen Inc (XGN) 2025 Q3 法說會逐字稿

(technical difficulty) So hopefully, this patient is able to get their disease under control soon, and our biomarker testing led to the diagnosis and gave insight to guide the treatment in this patient. This is one of the many examples of our clinical utility these markers can bring and that we are hearing about from our customers.

（技術難題）希望這位患者能夠盡快控制病情，我們的生物標記檢測促成了診斷，並為指導這位患者的治療提供了見解。這是我們這些標記物能夠帶來的眾多臨床實用性範例之一，也是我們從客戶那裡聽到的回饋。

With the launch of these markers, we have now completed the development of one of the most sensitive serologic evaluations for rheumatoid arthritis available on the market today. I'm very proud of the work our team has done to deliver these tests to the clinic and in a field which hasn't historically seen a lot of biomarker innovation. We are setting a course to change that and better personalize care for these patients.

隨著這些標誌物的推出，我們現在已經完成了目前市場上最靈敏的類風濕性關節炎血清學評估方法之一的開發。我為我們的團隊所做的工作感到非常自豪，他們成功地將這些檢測方法應用於臨床，而生物標記創新在歷史上並不多見。我們正在製定計劃來改變這種狀況，更好地為這些患者提供個人化護理。

To remind everyone of the impact our testing now has, conventional biomarker profiling for rheumatoid arthritis consists of rheumatoid factor and anti-CCP antibodies, which are positive in approximately 70% of clinically diagnosed RA patients.

為了提醒大家我們現在的檢測具有多麼重要的意義，類風濕性關節炎的傳統生物標記分析包括類風濕因子和抗 CCP 抗體，在臨床診斷的類風濕性關節炎患者中，約有 70% 的患者呈陽性。

With the addition of RA33 antibody testing and our new assays for detection of anti-PAD4 antibodies, our serologic profiling will be positive in approximately 85% of patients, thereby capturing approximately half of the RA patient population, which would have historically been diagnosed as seronegative RA.

透過增加 RA33 抗體檢測和我們新的抗 PAD4 抗體檢測方法，我們的血清學分析結果將在約 85% 的患者中呈現陽性，從而涵蓋約一半的 RA 患者群體，而這些患者在歷史上會被診斷為血清陰性 RA。

Additionally, these patients, which are positive for RA33 antibodies are more likely to have milder disease, which tends to respond favorably to methotrexate. Patients positive for anti-PAD4 antibodies generally have more aggressive disease, but are likely to respond more favorably to treatment escalation. This level of precision in predicting the disease course and treatment response is exciting to bring to rheumatoid arthritis patients and it is just the start of what we are doing in this field.

此外，這些 RA33 抗體呈陽性的患者病情可能較輕，對甲胺蝶呤的反應往往良好。抗 PAD4 抗體陽性的患者通常病情較嚴重，但對治療升級的反應可能較好。在預測疾病進程和治療反應方面達到如此高的精確度，對於類風濕性關節炎患者來說令人振奮，而這僅僅是我們在這個領域工作的開始。

Lastly, and this is rare for biomarker innovation, these efforts require less than $3 million in investment, and we expect revenue payback in less than 24 months. We won't always be able to contribute to the clinic in such a valuable way with a relatively small investment and quick return, but we do believe that with our current commercial channel, we can innovate long term with decent returns on investment.

最後，也是生物標記創新中罕見的一點，這些努力需要的投資不到 300 萬美元，我們預計在不到 24 個月的時間內就能收回成本。我們不可能總是以相對較小的投資和快速的回​​報，以如此有價值的方式為診所做出貢獻，但我們相信，憑藉我們目前的商業管道，我們可以進行長期創新，並獲得可觀的投資回報。

Switching to AVISE CTD testing volume trajectory. Q3 volume was the highest we've ever recorded for a third quarter period. And notably, we did not see the typical quarterly slowdown. In fact, volume remained strong into October, which is a positive trend for Q4 and indicates to me that our team is back to growing the business after helping our customer base adapt to the billing changes we implemented a couple of years ago.

切換到AVISE CTD測試體積軌跡。第三季銷售量是我們有史以來第三季最高的銷售量。值得注意的是，我們沒有看到典型的季度成長放緩。事實上，銷售量在 10 月依然保持強勁，這對第四季度來說是一個積極的趨勢，也表明在幫助客戶群適應我們幾年前實施的計費方式變更之後，我們的團隊已經恢復了業務成長。

Our expansion into new territories is also starting to pay off. We see meaningful contributions from these regions, and our per territory productivity remains strong. Of note, two of our recent expansion territories emerged as top-performing growth territories this past month, and we have others trending similarly.

我們向新領域的擴張也開始取得成效。我們看到了這些地區所做的重要貢獻，而且我們各地區的生產力依然強勁。值得注意的是，我們最近擴張的兩個地區在上個月成為成長最快的地區，其他地區也呈現類似的趨勢。

Total ordering physicians and orders per clinician continue to trend upward, and we're seeing increased engagement from both new and existing physicians. This is a testament to having the right team in place and the stability and focus we've built over the past 1.5 years.

開單醫生總數和每位臨床醫生的訂單量持續上升，我們看到新舊醫生的參與度都在提高。這證明了我們擁有合適的團隊，以及我們在過去一年半建立的穩定性和專注度。

We currently operate with 45 sales territories, up from 42 at the end of Q3. Our focus remains on profitable growth, and we will continue adding territories where we see clear opportunity, strong physician engagement and can find the right talent.

我們目前營運 45 個銷售區域，比第三季末的 42 個有所增加。我們將繼續專注於獲利成長，並將繼續拓展那些我們看到明顯機會、醫生積極參與且能夠找到合適人才的地區。

Now let's talk about ASP, which is top of mind for me. We've made significant progress over the past two years with our trailing 12-month ASP for CTD now at $441, a 9% increase year over year. However, it's important to acknowledge that we're not seeing the full second half ASP expansion I had anticipated.

現在讓我們來談談ASP，這是我最關心的問題。過去兩年，我們取得了顯著進展，CTD 的過去 12 個月平均售價為 441 美元，年增 9%。然而，需要指出的是，我們並沒有看到我預期的下半年平均售價全面上漲。

The new biomarker reimbursement, while accretive, has not ramped as quickly as I had hoped. We still believe there's a path to further ASP gains and our efforts around appeals, revenue cycle operations and payer education are showing incremental progress. But the reality is these gains are coming more gradually than I expected.

新的生物標記報銷政策雖然增加，但其成長速度並未達到我的預期。我們仍然相信 ASP 有進一步提高的途徑，我們在申訴、收入週期營運和支付方教育方面的努力正在取得逐步進展。但現實情況是，這些收益的到來比我預期的要緩慢得多。

Additionally, we lost a large high ASP direct bill account this quarter, which is weighing on our current ASP as we convert this business into a standard commercial insurance payer mix.

此外，本季度我們失去了一個高 ASP 的大型直接帳單帳戶，這影響了我們目前的平均售價，因為我們正在將該業務轉換為標準的商業保險付款方組合。

Both of these items have temporarily slowed our trajectory. But as I've constantly conveyed throughout my time here, this is why I view it critical to gauge our success relative to a trailing 12-month measure, which does continue to climb. We continue to be very diligent with our revenue cycle operations and have a strong strategy employed to secure the higher reimbursement we ultimately expect, but you are seeing a somewhat muted ASP reflected in our top and bottom lines as we work through these efforts.

這兩件事都暫時減緩了我們的發展速度。但正如我一直以來在這裡所傳達的那樣，這就是為什麼我認為衡量我們過去 12 個月的成功與否至關重要，而過去 12 個月的衡量標準一直在持續攀升。我們繼續非常認真地進行收入周期運營，並採取強有力的策略來確保我們最終期望的更高報銷額，但由於我們正在努力推進這些工作，您可能會看到我們營收和利潤中的平均售價有所下降。

Turning to our pharma and CRO business. We generated nearly $800,000 in revenue this quarter, bringing our year-to-date total to $1.2 million. Our order backlog now stands at $3.5 million and continues to grow. While this revenue stream can be lumpy, it's an important and expanding part of our business. We're encouraged by the momentum we're seeing in this area.

接下來談談我們的製藥和合約研究組織業務。本季我們創造了近 80 萬美元的收入，使我們今年迄今的總收入達到 120 萬美元。我們目前的訂單積壓額為 350 萬美元，並且持續成長。雖然這部分收入可能不穩定，但它是我們業務中一個重要且不斷成長的部分。我們對目前該領域的發展動能感到鼓舞。

As I mentioned, I was recently in Chicago attending the American College of Rheumatology Annual Conference, where we had a strong presence this year, highlighting new abstracts and deepening our interactions with clinicians.

正如我之前提到的，我最近在芝加哥參加了美國風濕病學會年會，我們今年在會上表現出色，重點介紹了新的摘要，並加深了與臨床醫生的交流。

We submitted and had accepted six different abstracts covering the bulk of our pipeline efforts. One ultimately was chosen for a plenary talk and in general, we continue to showcase our company as an innovative presence within the rheumatology field. It was a highly successful meeting in this regard.

我們提交並被接受了六篇不同的摘要，涵蓋了我們大部分的研發工作。最終，我們選中了一位代表進行全體會議演講，總的來說，我們將繼續展示我們公司在風濕病學領域的創新實力。從這個角度來看，這是一次非常成功的會議。

Looking ahead, we remain on track to deliver $65 million to $70 million in revenue with the ability to be cash flow positive at the high end of our range, though the timing of sustained cash flow positivity may be pushed to 2026 as we continue to navigate the ASP challenges I just detailed.

展望未來，我們仍有望實現 6500 萬至 7000 萬美元的收入，並能夠在預期範圍的高端實現正現金流，儘管由於我們仍在應對我剛才詳細說明的 ASP 挑戰，持續正現金流的時間可能會推遲到 2026 年。

Generating cash remains a core near-term goal, and we're committed to achieving it in a disciplined, sustainable way.

創造現金流仍然是近期核心目標，我們將致力於以嚴謹、永續的方式實現這一目標。

In closing, I want to thank our team for their dedication and execution and our partners and shareholders for their continued support. We continue to build something special at Exagen. And while the path is never perfectly linear, our progress is real and our opportunity remains significant. Thank you. And with that, I'll turn it over to Jeff for additional comments on the financials.

最後，我要感謝我們團隊的奉獻和執行，以及我們的合作夥伴和股東們的持續支持。在Exagen，我們繼續打造一些特別的東西。雖然前進的道路並非總是筆直的，但我們所取得的進步是實實在在的，我們的機會依然十分重大。謝謝。接下來，我將把發言權交給傑夫，請他對財務狀況發表更多評論。

Thank you, John, and good morning, everyone. As John mentioned, we delivered another strong quarter, highlighted by our third consecutive quarter of volume growth, continued ASP expansion and a balance sheet that we expect secures our runway to positive free cash flow.

謝謝你，約翰，大家早安。正如約翰所提到的，我們又迎來了一個強勁的季度，其中最突出的是我們連續第三個季度實現了銷量增長，平均售價持續擴張，以及我們預計能夠確保我們實現正自由現金流的資產負債表。

Fourth quarter revenue of $17.2 million was our highest quarter in history, just beating out the second quarter and a nearly 40% increase over the third quarter of 2024. Even considering over $1 million in downside revenue adjustments in Q3 of last year, we still delivered over 25% revenue growth. And this is against seasonality headwinds we typically see in the third quarter, which we curtailed through growth in CTD test volume, up 15% from Q3 of last year and almost 2% sequentially.

第四季營收達 1,720 萬美元，創歷史新高，略高於第二季度，比 2024 年第三季成長近 40%。即使考慮到去年第三季超過 100 萬美元的下調收入調整，我們仍然實現了超過 25% 的營收成長。而且，我們還要應對通常在第三季度出現的季節性不利因素，我們透過 CTD 測試量的增長來抑制這些不利因素，該測試量比去年第三季度增長了 15%，環比增長了近 2%。

Year-to-date through the third quarter, we grew revenue 19% to roughly $50 million with trailing 12-month ASP up over 9% and volume up over 8%. As John mentioned, we're also seeing significant momentum in our Pharma Services business, which generated revenue of $780,000 in the third quarter.

今年截至第三季度，我們的營收成長了 19%，達到約 5,000 萬美元，過去 12 個月的平均售價成長了 9% 以上，銷量成長了 8% 以上。正如約翰所提到的，我們的醫藥服務業務也呈現出強勁的成長勢頭，第三季營收達 78 萬美元。

Year-to-date through Q3, we recognized $1.2 million in Pharma Services revenue versus about $100,000 in 2024. Our business development team has done a fabulous job of securing additional contracts and developing a strong pipeline that we expect will continue to grow. Today, we have up to $3.5 million under contract in pharma services, representing future potential revenue opportunity.

今年截至第三季末，我們確認了 120 萬美元的醫藥服務收入，而 2024 年預計約為 10 萬美元。我們的業務拓展團隊在爭取更多合約和建立強大的業務管道方面做得非常出色，我們預計該業務管道將繼續成長。目前，我們在醫藥服務領域簽訂的合約金額高達 350 萬美元，代表未來潛在的收入機會。

The timing of deliverables and related revenue recognition are often lumpy from quarter-to-quarter, so we remain cautious to guide on specific timing of this revenue.

交付成果和相關收入確認的時間往往因季度而異，因此我們仍謹慎地就該收入的具體時間給予建議。

Our trailing 12-month AVISE CTD ASP grew $37 year over year to $441 per test. The trailing 12-month number remains our best indicator of ASP traction due to the typical ebbs and flows of reimbursement in any one quarter. As John mentioned, we're behind expectations on our ASP acceleration, but we remain confident that we'll drive further expansion through revenue cycle management enhancements, commercial payer engagement and market access initiatives. These remain priorities for us and are core tenets to our success in driving reimbursement gains.

過去 12 個月，AVISE CTD 的平均銷售價格年增 37 美元，達到每次偵測 441 美元。由於任何一個季度報銷額都會出現波動，因此過去 12 個月的數據仍然是我們衡量 ASP 成長動能的最佳指標。正如約翰所提到的，我們在平均售價加速方面落後於預期，但我們仍然有信心透過收入週期管理改善、商業支付方參與和市場准入計畫來推動進一步擴張。這些仍然是我們的優先事項，也是我們推動健保報銷成長並取得成功的核心原則。

As John also mentioned in the third quarter, our most significant ASP headwind was a loss from one of our higher volume, high ASP direct bill accounts. Importantly, we offset the revenue impact of this pullback with an overall increase in volume, which is a testament to our commercial team and ability to drive diversification of our physician base.

正如約翰在第三季提到的那樣，我們最大的平均售價不利因素是來自我們一個交易量較大、平均售價較高的直接帳單帳戶的虧損。重要的是，我們透過整體銷售的成長抵消了此次下滑對收入的影響，這證明了我們的商業團隊以及推動醫生群體多元化的能力。

As to the T cell and RA33 biomarkers we launched in January, we saw a moderate expansion in ASP and related accrual rate versus the second quarter, and we continue to expect over time to realize our long-term target. It's also important to note that while we launched our newest biomarker, PAD4, late in the third quarter and began billing for it, none of this volume was reflected in revenue.

至於我們在 1 月推出的 T 細胞和 RA33 生物標記物，與第二季相比，我們看到 ASP 和相關入組率均有適度增長，我們繼續期望隨著時間的推移實現我們的長期目標。值得注意的是，雖然我們在第三季末推出了最新的生物標誌 PAD4 並開始收費，但這些銷量都沒有反映在收入中。

At the end of Q3, we had not established a payment history on this marker, so we did not record an accrual rate. We should see a moderate expansion in ASP in the fourth quarter for PAD4 as we establish an early payment history and related accrual rate.

第三季末，我們尚未建立該標記的付款歷史，因此我們沒有記錄應計率。隨著我們建立起早期付款歷史和相關的應計率，預計 PAD4 的 ASP 將在第四季度出現溫和成長。

Gross margin in the third quarter was just over 58%, up about 260 bps compared to the third quarter of 2024. Excluding the impact of over $1 million in downside revenue adjustments in the third quarter of last year, gross margin in the quarter was down about 175 bps from just over 60% in 2024.

第三季毛利率略高於 58%，比 2024 年第三季成長約 260 個基點。如果排除去年第三季超過 100 萬美元的下行收入調整的影響，本季毛利率比 2024 年略高於 60% 的水平下降了約 175 個基點。

Year-to-date, gross margin was just over 59% and up about 60 bps over the same period in 2024. Gross margin has been favorably impacted in 2025 by our continued ASP improvements even with an increase in COGS related to our new biomarkers.

今年迄今為止，毛利率略高於 59%，比 2024 年同期成長約 60 個基點。儘管與新生物標記相關的銷售成本有所增加，但由於我們持續改進平均售價，2025 年毛利率受到了有利影響。

In fact, our per test AVISE CTD cost is running favorable to initial expectations, offsetting some of the ASP headwinds and allowing us to maintain our gross margin profile near that 60% level. We still see a path to the mid-60s over time as we remain focused on driving further ASP expansion and aggressively managing COGS.

事實上，我們每次測試的 AVISE CTD 成本運行情況優於最初的預期，抵消了一些 ASP 的不利因素，使我們能夠將毛利率維持在 60% 左右的水平。我們仍然認為，隨著我們繼續專注於進一步擴大平均售價並積極控制銷售成本，最終能夠達到 60% 左右的水平。

Operating expenses for the third quarter were $13.2 million, up from $11.6 million in Q3 of '24, and this increase was in part due to increased R&D spend for PAD4 and other pipeline initiatives as well as SG&A associated with our first sales territory expansion since John took over and another key commercial leadership addition to the team.

第三季的營運費用為 1,320 萬美元，高於 2024 年第三季的 1,160 萬美元，這一增長部分是由於 PAD4 和其他在研項目的研發變動增加，以及自 John 接手以來我們首次拓展銷售區域和團隊新增一位關鍵商業領導人員所帶來的銷售、管理及行政費用。

We expect operating expenses to remain roughly at these levels for the next several quarters, and we'll continue to allocate resources responsibly as we've done in the past.

我們預計未來幾季的營運費用將大致維持在這些水平，我們將繼續像過去一樣負責任地分配資源。

At the same time, we remain focused on disciplined capital allocation to commercial, clinical and R&D initiatives that we believe have a high probability of driving accelerated long-term growth.

同時，我們仍專注於對商業、臨床和研發專案進行有紀律的資本配置，我們相信這些專案很有可能推動長期的加速成長。

From a balance sheet perspective, we have the flexibility to make the investments needed to support these initiatives and invest opportunistically as we see fit. But equally important, we have the ability to modulate spend down or up as needed, all with an eye toward preserving our path to positive free cash flow.

從資產負債表的角度來看，我們有足夠的彈性進行必要的投資來支持這些舉措，並可根據情況進行機會性投資。但同樣重要的是，我們有能力根據需要調整支出，以保持正自由現金流。

Our net loss for the third quarter was $7 million compared to $5 million in the same period last year. But it's important to note that the $7 million loss in the most recent quarter includes about $3 million in noncash expenses related primarily to the fair value adjustments from our new debt facility with Perceptive, which we closed in May of this year.

第三季淨虧損為 700 萬美元，去年同期淨虧損為 500 萬美元。但值得注意的是，最近一個季度的 700 萬美元虧損包括約 300 萬美元的非現金支出，主要與我們今年 5 月與 Perceptive 達成的新債務融資的公允價值調整有關。

Our adjusted EBITDA loss in the third quarter is $1.9 million compared to $4 million in the third quarter of 2024. And year-to-date through Q3, our adjusted EBITDA loss improved $1.5 million or nearly 20% to $6.1 million for the first nine months of 2025.

我們第三季的調整後 EBITDA 虧損為 190 萬美元，而 2024 年第三季則為 400 萬美元。截至第三季末，我們調整後的 EBITDA 虧損減少了 150 萬美元，降幅近 20%，至 2025 年前九個月的 610 萬美元。

We maintain our focus on positive adjusted EBITDA in the near term and believe that ASP growth is the most important lever for achieving this goal.

我們近期仍將重點放在調整後 EBITDA 為正上，並認為 ASP 成長是實現這一目標的最重要槓桿。

Please refer to our earnings release issued earlier today for a reconciliation of adjusted EBITDA to net loss.

有關調整後 EBITDA 與淨虧損的調節情況，請參閱我們今天稍早發布的獲利報告。

Turning to our balance sheet. We ended the third quarter with $35.7 million in cash and cash equivalents, up from $30 million at the end of Q2 with accounts receivable of about $11 million.

接下來來看看我們的資產負債表。第三季末，我們的現金及現金等價物為 3,570 萬美元，高於第二季末的 3,000 萬美元，應收帳款約 1,100 萬美元。

Excluding financing proceeds during the third quarter, we generated net cash of $2.3 million compared to net cash usage of $2.4 million a year ago. We also enhanced our cash position in the third quarter through opportunistic but disciplined placements under our ATM sales agreement with TD Cowen Securities.

除去第三季的融資收益，我們產生了 230 萬美元的淨現金，而去年同期淨現金支出為 240 萬美元。第三季度，我們也透過與 TD Cowen Securities 簽訂的 ATM 銷售協議，進行機會主義但有紀律的配售，從而增強了我們的現金儲備。

We raised just over $3.4 million at an average price of $9.83 per share, taking advantage of share price momentum and higher volume trading days throughout the quarter.

我們利用本季股價上漲動能和交易量增加的有利時機，以每股 9.83 美元的平均價格籌集了略高於 340 萬美元的資金。

We remain very well positioned from a balance sheet perspective with over $45 million in combined cash and accounts receivable at September 30 that we expect will fund our existing business to positive free cash flow and up to an additional $50 million in available future credit capacity if and when needed.

從資產負債表的角度來看，我們仍然處於非常有利的地位，截至 9 月 30 日，我們擁有超過 4500 萬美元的現金和應收帳款，我們預計這將為我們現有的業務提供資金，使其產生正的自由現金流，並且在需要時，我們還可以提供高達 5000 萬美元的未來信貸額度。

In closing, we continue to deliver value to shareholders through solid operating and financial execution. We delivered another quarter of record revenue in Q3, a third consecutive quarter of AVISE CTD volume growth, continued ASP expansion, and we remain on track to deliver from 17% to over 25% revenue growth in 2025. We will now open the call for questions.

最後，我們將繼續透過穩健的營運和財務執行為股東創造價值。我們在第三季度再次實現了創紀錄的收入，AVISE CTD 銷量連續第三個季度增長，平均售價持續擴張，我們仍有望在 2025 年實現 17% 至 25% 以上的收入增長。現在開始接受提問。

(Operator Instructions) Anderson Schock, B. Riley Securities.

（操作說明）Anderson Schock，B. Riley Securities。

Hi, thank you for taking the questions and congrats on all the ASP progress. So first, you mentioned on the second quarter earnings call, $430,000 per territory. Do you have an updated revenue per territory for the third quarter? And how should we think about the productivity ramp of these new territories?

您好，感謝您回答問題，並祝賀您在 ASP 方面取得的所有進展。首先，您在第二季財報電話會議上提到，每個地區 43 萬美元。請問您有第三季各地區的最新收入數據嗎？那我們該如何看待這些新領域的生產力提升呢？

Morning Anderson. And thanks so much for the question. So the was $430,000 per territory was a record for us. And just so that people have kind of the background trajectory, that was from -- up from the high 200s. So we've made -- you're right, we've made material progress in the revenue per territory, all really on the back of the ASP gains that we've seen as an organization.

莫寧·安德森。非常感謝你的提問。所以，每個地區 43 萬美元的收入對我們來說是一個紀錄。為了讓大家對背景發展軌跡有所了解，這個軌跡是從 200 多歲開始上升的。所以，你說得對，我們在每個地區的收入方面取得了實質進展，這完全得益於我們作為一個組織所取得的平均售價成長。

For the third quarter, it was right around that level, slightly below. I think that's more a factor of we added the additional territories. And so you have that denominator growing and give it a little bit of time as we see those territories bearing fruit, and we do expect it to increase over time. So you're just under that $430,000.

第三季度，這個數字基本上維持在這個水準附近，略低於這個水準。我認為這更多是因為我們增加了新的領土。因此，分母會不斷成長，再過一段時間，我們就會看到這些地區結出碩果，我們預計隨著時間的推移，分母還會繼續成長。所以你離43萬美元只差一點點。

Okay. Got it. And then with the launch of your RA markers at the end of the third quarter, so once establishing a payment history for these, is there an incremental uplift to ASP that you're targeting similar to the $90 increase with the lupus biomarkers launched in January?

好的。知道了。然後，隨著你們在第三季末推出 RA 標誌物，一旦建立了這些標誌物的付款記錄，你們的目標 ASP 是否會像 1 月推出的狼瘡生物標記那樣增加 90 美元？

Yes. So we've not broken this out yet, and we hesitate to proclaim a number without having a robust history of collections there. So that's what we're doing right now. We're gathering that information, developing that history and then we'll establish it. Happy to provide an update on a future call.

是的。所以我們還沒有對此進行細分，而且在沒有可靠的收藏歷史的情況下，我們不敢貿然宣布一個數字。所以，這就是我們現在正在做的事情。我們正在收集信息，梳理歷史，然後我們將確立它。樂意在下次通話中提供最新進展。

We expect it to be relatively modest compared to the $90 expectation that we had for the prior markers. This is a set of ELISA-based assays, two markers as opposed to three in the case of RA33 or three also in the case of the T cell analytes.

我們預期此次漲幅將相對溫和，與我們先前對前幾期市場90美元的預期相比，漲幅不會太大。這是一組基於 ELISA 的檢測，與 RA33 的三種標記物或 T 細胞分析物的三種標記物不同，這裡只有兩種標記物。

So less markers, lower cost platform, build on the generic codes. It's going to be in the low single-digit dollars or maybe even in the double digit, but it's not going to be anything like what we had previously.

因此，標記數量減少，平台成本降低，基於通用程式碼建置。金額可能只有個位數美元，甚至可能只有兩位數美元，但肯定不會像以前那麼嚴重。

Okay. Got it. And then you also mentioned on the last call, you're approaching your first pharma partnership with the urine platform. Are there any updates you could provide there?

好的。知道了。然後您在上次通話中也提到，您即將與尿液平台達成您的第一個製藥合作。請問您能否提供一些最新進展？

So we actually completed our first statement of work related to that platform. And just so that everyone is aware, we have some fantastic technology that we've licensed out of Johns Hopkins really with multiple intended use opportunities really to change the way these patients are managed for the better.

所以，我們實際上已經完成了與該平台相關的第一份工作說明書。為了讓大家了解情況，我們從約翰霍普金斯大學獲得了一些非常棒的技術許可，這些技術有很多預期用途，可以真正改變這些患者的管理方式，使其變得更好。

And lupus nephritis affects about half of all lupus patients. This technology has been shown when you look at certain proteins in the urine of lupus patients, there's the potential to diagnose the disease through a noninvasive manner. That's something we continue to pursue and have published on from an abstract perspective.

狼瘡性腎炎影響大約一半的狼瘡患者。這項技術已經證明，透過檢測狼瘡患者尿液中的某些蛋白質，有可能以非侵入性的方式診斷疾病。這是我們正在持續研究並已從抽象角度發表相關論文的研究方向。

We're looking at therapeutic response and then even prediction of long-term kidney function or prognosis really.

我們正在研究治療反應，甚至預測長期腎功能或預後。

And so we have completed our first profiling effort. We're in discussions on subsequent efforts there, but it went successfully. It was a small project and look forward to doing more.

至此，我們的第一次使用者畫像分析工作已經完成。我們正在討論後續的合作事宜，但那次合作很成功。這是一個小項目，期待以後能做得更多。

Okay got it thank you for taking our questions.

好的，明白了，謝謝你們回答我們的問題。

Kyle Mikson, Canaccord Genuity.

Kyle Mikson，Canaccord Genuity。

Hey guys, thanks for the questions. Good quarter. So I guess on the ASP topic, John and Jeff, maybe just level set and provide some more -- some framework of how we should think about approaching $500 because that was the target before. And you had that $90 incremental from the new biomarkers that was just referenced in the last question.

大家好，感謝你們的提問。本季表現不錯。所以我想，關於平均售價 (ASP) 這個主題，John 和 Jeff，或許應該先明確一下，再提供一些框架，說明我們應該如何考慮達到 500 美元的目標，因為那是之前的目標。還有上一個問題中提到的，來自新生物標誌物的 90 美元增量。

So maybe just like if there's a way to kind of think about the progression going forward and maybe just like think of this more realistically when you can get to $500 again or maybe there's some other trailing 12-month metric that we should kind of model out and kind of think about as we look at 2026, the quarters and so forth?

所以，或許我們可以這樣思考未來的發展進程，更現實地思考一下何時才能再次達到 500 美元，或者是否有其他過去 12 個月的指標值得我們建模和思考，以便展望 2026 年、未來幾個季度等等？

Kyle, thanks for the question. So I guess, first and foremost, there's no other metric, and I'd be skeptical if I did provide a different metric as people change targets when they get hard. So that's not the approach we take here at Exagen. From our perspective, $500 is still very realistic. It's really just a timing thing.

凱爾，謝謝你的提問。所以我想，首先，沒有其他衡量標準，而且如果我提供不同的衡量標準，我會感到懷疑，因為人們在遇到困難時會改變目標。所以，這並不是我們在Exagen採取的方法。在我們看來，500美元仍然非常現實。這其實只是時機問題。

And so we outlined a couple of contributing factors in Q3. We actually had a large client bill account that for purely financial reasons, it's a hospital system in the Northeast. They made the determination to no longer to cancel that contract. That had some ASP headwind.

因此，我們在第三季概述了幾個促成因素。我們實際上有一個大額客戶帳單帳戶，純粹出於財務原因，它是一家位於美國東北部的醫院系統。他們決定不再取消那份合約。這在ASP聯賽中遇到了一些不利因素。

We believe over time, we can build it back through the commercial -- the standard commercial insurance route, but it takes a little bit of time. We haven't had as much history with some of those payers, those regional payers in the Northeast, given that we've built through the hospital system through a client bill arrangement.

我們相信，隨著時間的推移，我們可以透過商業保險——也就是標準的商業保險途徑——重建它，但這需要一些時間。由於我們是透過醫院系統以客戶帳單安排的方式建立起來的，所以我們與東北地區的某些付款方，特別是區域付款方，並沒有太多的合作歷史。

Related to the new markers, you're exactly right. You're right on there, $90 was our expectation at the start of the year. We had mentioned on the Q2 call that we were coming in the low 70s, around $72. We're up from there, actually continue to go up almost on a daily basis, but expected to be at the $90 now, and we're not.

關於新標記，您說得完全正確。你說得對，年初時我們的預期是 90 美元。我們在第二季電話會議上提到過，我們的目標價位在 70 美元左右，也就是 72 美元左右。我們已經從那裡開始上漲，實際上幾乎每天都在上漲，但預期現在應該達到 90 美元，而我們還沒有達到。

So I still believe that we're on the path to $90. It's through our standard revenue cycle operations that we'll get there. We believe we'll get there. Additionally, we've launched these new PAD4 markers, and we haven't recognized any revenue there because we don't have a good track record for an accrual rate to establish an accrual rate. So those will be lifts over, call it, the coming quarter or two or three is progress in converting that client bill account, which had some reasonable volume associated with it, continued work on the new biomarkers that we launched at the start of the year, establishing accrual rate for the current product launch and then just our underlying groundswell of efforts that we've continued to work on.

所以我仍然相信我們正朝著90美元的目標前進。我們將透過標準的營收週期營運來實現這一目標。我們相信我們能做到。此外，我們推出了這些新的 PAD4 標記，但我們還沒有確認任何收入，因為我們沒有良好的應計率記錄來確定應計率。因此，在接下來的一個或兩個季度或三個季度裡，我們將取得一些進展，包括客戶帳單帳戶的轉換（該帳戶有一定的交易量）、年初推出的新生物標誌物的持續研發、當前產品上市的應計率的確定，以及我們一直在持續推進的各項基礎性工作。

So I think you'll see over time, that trailing 12-month number continue to rise. I just had expected the trajectory to be a little bit more steep at this point in time, 9% year over year is still reasonable, but we'd like it to be faster. So that's the right metric, and we'll continue to work at it.

所以我認為隨著時間的推移，你會看到過去 12 個月的數字繼續上升。我只是預期目前的成長速度會更快一些，9%的年增長率雖然還算合理，但我們希望成長速度更快。所以這是正確的衡量標準，我們會繼續努力。

Okay. Perfect. And then on just on volume, it seems like that was kind of sequentially flat, I think, like quarter over quarter, if I do the math right. And that's actually -- I think that's actually stronger than your typical seasonality. So that's good, maybe just confirm if that's true.

好的。完美的。然後就銷量而言，似乎季度環比持平，如果我的計算沒錯的話。而且我認為這實際上比典型的季節性影響更大。那很好，或許只要確認是否屬實。

And then if we should think about a drop-off or step down in the fourth quarter, just given ACR and the other seasonal factors.

那麼，考慮到 ACR 和其他季節性因素，我們是否應該考慮第四季出現下滑或下降呢？

And on that point, given the ASP, as you characterize it, the challenges, would you like kind of pull back on rep expansion at this point? Or are you still kind of all systems to building out the team going into next year?

關於這一點，鑑於您所描述的 ASP 及其面臨的挑戰，您是否希望在這個時候減少代表數量的增長？或者你們仍然在為明年組建團隊做準備？

Those are great questions. So just to be clear, volume is actually up in Q3 relative to Q2, a couple of percent. So from that perspective and looking at historical seasonality, that's a meaningful change. And so we're very proud of that. I think the team has worked extremely hard.

這些都是很好的問題。所以說清楚點，第三季的銷售量其實比第二季成長了百分之幾。所以從這個角度來看，結合歷史季節性來看，這是一個意義重大的改變。所以，我們為此感到非常自豪。我認為團隊付出了巨大的努力。

That was really with about the same number of sales territories. We had 42 at the end of the quarter here.

當時的銷售區域數量其實差不多。本季末我們這裡有 42 人。

So contributing territories in Q3 was somewhere still around that 40 level. So from that perspective, I think it was a very strong quarter. We've also seen the volume increase into Q4. October was a fantastic month for us.

因此，第三季貢獻的地區數量仍在 40 左右。所以從這個角度來看，我認為這是一個非常強勁的季度。我們也看到銷量在第四季有所成長。十月對我們來說是個非常棒的月份。

We've now understand what that final volume number is, and it was our highest month in several years. So from that perspective, I think we've got our team with the right incentive structure. We've got the right team, and we're highly focused in delivering the clinical value and the messaging and education around that, that is driving business and adoption. So I think as it relates to the sales expansion question, there's no reason why we wouldn't continue to expand if we have the right opportunities in front of us. Right now, we're making sure that the five territories we've added in the last four months or five months are well supported, well-educated and are set up for success.

我們現在已經知道了最終的銷售數字，這是我們幾年來最高的單月銷量。所以從這個角度來看，我認為我們已經為團隊建立了合適的激勵機制。我們擁有合適的團隊，並且高度專注於提供臨床價值以及圍繞該價值的資訊和教育，從而推動業務成長和產品推廣。所以我覺得，就銷售擴張問題而言，如果眼前有合適的機會，我們沒有理由不繼續擴張。目前，我們正在確保過去四到五個月新增的五個地區得到良好的支援、培訓，並為成功做好準備。

And we'll continue to add as those opportunities arise.

我們將繼續抓住機會，增加投資。

We did add to our sales leadership side that was more opportunistic. Someone I had worked with previously became available and I think very highly of that individual. So we took advantage of the opportunity to bring them on board. And again, it just sets us up for future growth. So we did go up in Q3.

我們確實在銷售領導層中增加了一些更具機會主義精神的人才。我以前共事過的一位同事現在有空缺，我對這個人評價很高。因此，我們抓住了這個機會，將他們招入麾下。而且，這也為我們未來的發展奠定了基礎。所以我們第三季確實實現了成長。

I would expect somewhat of a step down in Q4, just mostly a function of business days. I think in Q4, you've got some pretty significant holidays. We had ACR, the week-long conference that actually occurred in October. So our October performance was in light of ACR occurring in this month. So we're on the right trajectory.

我預期第四季業績會有所下滑，這主要是因為營業日數減少所造成的。我認為第四季有一些非常重要的假日。我們舉辦了 ACR 會議，這是一個為期一周的會議，實際上是在 10 月舉行的。因此，我們10月份的業績是考慮到本月發生的ACR事件而做出的。所以，我們正走在正確的道路上。

I would still expect a slight step down. But overall, we're setting ourselves up very well for continued growth through two mechanisms, ASP and volume.

我仍然預期會有小幅下滑。但總的來說，我們透過平均售價和銷售這兩個機制，為持續成長做好了充分的準備。

Perfect. And then finally, I would love to ask about the pharma business. So that was -- so $800,000 in revenue in the quarter compared to $100,000 for all of last year. That's pretty impressive. So I guess why is so strong now this year?

完美的。最後，我想問一下關於製藥業的問題。所以，本季營收為 80 萬美元，而去年全年營收為 10 萬美元。那真是令人印象深刻。所以我想知道為什麼它今年如此強勁？

And then could that be even more material in 2026? Could that be like a real business line that you could actually start to kind of break out? And kind of additionally, is that an area you would partner or acquire in given the unmet need in autoimmune disease?

那麼，到 2026 年，這會不會成為更重要的議題呢？這有可能成為一條真正的業務線，讓你真正開始著手發展嗎？另外，鑑於自體免疫疾病領域尚未滿足的需求，您是否會考慮在該領域開展合作或進行收購？

Yes. That's a very interesting set of questions. So from my perspective, excited about the progress on the pharma revenue side to deliver $800,000 far and above what we've done historically as it relates to testing services. And so I'm very proud of that, proud of the team and took a lot of energy and effort, but well worth it. And I think we've delivered for our pharma partners.

是的。這是一組非常有趣的問題。所以從我的角度來看，我對製藥收入的進展感到興奮，預計收入將達到 80 萬美元，遠遠超過我們過去在測試服務方面所取得的成就。所以我很自豪，為團隊感到自豪，這需要投入大量的精力和努力，但非常值得。我認為我們已經為我們的製藥合作夥伴實現了目標。

They have time constraints, they have quality requirements. They want flexibility. And in all of those facets, clearly, we're demonstrating our ability to differentiate ourselves in the market, and it's working out for us.

他們有時間限制，也有品質要求。他們想要靈活性。在所有這些方面，我們都清楚地展現了我們在市場上脫穎而出的能力，而且這對我們來說是行之有效的。

So where could this go? I mean the pharma services in general, tends to be a lumpy business. As you know, you complete a project and you tend to get recognized revenue consistent with that project when the work is completed. And so there'll be certain quarters with outsized performance versus others. But for the year or on an annual basis, I do expect this to continue to grow.

那麼，這件事會如何發展呢？我的意思是，醫藥服務業整體來說往往是一個波動較大的行業。如您所知，專案完成後，您通常會獲得與該專案相符的確認收入。因此，某些季度業績會遠超其他季度。但就今年或年度而言，我預計這種情況會繼續增長。

There's a lot of opportunity, a lot of pharma development.

這裡有很多機會，有許多醫藥研發項目。

You see new diseases getting approved for biologics in this space. Sjogren's, for example, is one that just came with Novartis. There's other diseases as well that people are looking for biomarkers and better diagnostic biomarkers and better markers of disease activity, and we believe we're well positioned or well suited for that.

在這個領域，你會看到越來越多的新疾病獲得生物製劑的批准。例如，乾燥症就是諾華公司新推出的藥物。人們也正在尋找其他疾病的生物標記、更好的診斷生物標記和更好的疾病活動標記物，我們相信我們在這方面處於有利地位或非常適合。

Also given that our base methodology within AVISE is flow cytometry, I think that we're well positioned to offer something unique there as well. So we'll continue to refine our business plan, our business model, understand how we can add value.

此外，鑑於 AVISE 的基礎方法是流式細胞儀，我認為我們也有能力在該領域提供一些獨特的東西。因此，我們將繼續完善我們的商業計劃和商業模式，以了解如何創造價值。

I'll just give you one example, but when a pharma organization comes to a service provider, what they're looking for is speed -- at times, what they're looking for is speed to get some of these assays validated and available for them in clinical trial testing at a high-quality level.

我舉個例子，當一家製藥公司找到服務提供者時，他們追求的是速度——有時，他們追求的是快速地驗證某些檢測方法，並以高品質的水平將其用於臨床試驗測試。

We generally meet the quality thresholds given our commercial pipeline and the fact that we have access to so many patients and so many different samples, our ability to validate assays and develop new assays, I think, is really substantial and a huge competitive advantage for us. So that's part of the differentiation we're able to offer amongst many other things, but we'll have to see how it progresses. But yes, it's trending in the right direction.

鑑於我們的商業產品線，以及我們能夠接觸到如此多的患者和如此多的不同樣本，我們通常都能達到品質標準。我認為，我們驗證檢測方法和開發新檢測方法的能力非常強大，是我們巨大的競爭優勢。所以這是我們能夠提供的眾多差異化優勢之一，但我們還得看看它的發展。但沒錯，它正朝著正確的方向發展。

Awesome, appreciate the call, John. Thanks.

太好了，謝謝你的來電，約翰。謝謝。

Mark Massaro, BTIG.

馬克·馬薩羅，BTIG。

This is Vidyun on for Mark. So just one on the sales force expansion. I understand that you just hired these reps. But could you just remind us how you're thinking about targets in terms of per rep and kind of the time that it takes for them to reach maturity and hit their stride?

這裡是Vidyun為Mark報道。所以，關於銷售團隊擴張，就提一點。我知道你們剛僱用了這些銷售代表。您能否提醒我們一下，您是如何考慮每次重複訓練的目標，以及這些目標需要多長時間才能成熟並達到最佳狀態？

So from our perspective, we set profitability targets for -- on a per territory basis. And that has to do with both the compensation structure. So once you reach a certain scale, there's profitability bonuses that end up coming into play. But then as it relates to opportunity, we're looking for a minimum level of profitability or contribution margin that at least sustains the price of having a field-based presence in that area. And so that naturally relates to number of tests, but it also changes as our ASP changes.

因此，從我們的角度來看，我們為每個地區設定了獲利目標。這與薪酬結構密切相關。所以一旦達到一定的規模，就會有獲利獎金發揮作用。但就機會而言，我們追求的是最低獲利能力或利潤率，至少要能維持在該地區設立現場服務機構的成本。因此，這自然與測試數量有關，但也會隨著我們的 ASP 的變化而變化。

So from our perspective, we tend to split our largest territories provided we still believe or have done enough research to believe that there's substantial opportunity there. And so that's really the mechanism that we're approaching the sales expansion process with. And it generally takes -- I mean, it's always tough to generalize, but it generally takes around nine months for -- six to nine months for someone to start to contribute. There's multiple exceptions of that, and I tried to highlight that in the prepared remarks.

因此，從我們的角度來看，只要我們仍然相信或已經進行了足夠的研究，相信某個地區存在巨大的機會，我們往往會將我們最大的地區進行拆分。所以，這就是我們推動銷售擴張進程的真正機制。通常情況下——我的意思是，很難一概而論，但通常需要大約九個月的時間——六到九個月的時間，一個人才能開始做出貢獻。有很多例外情況，我在準備好的發言稿中也盡量強調了這一點。

But we've got two in the Southeast where two territories where they were our highest growth by percentage and two of our top five nationally were some of these expansion territories. So that's exciting for us. I guess it reinforces that we made the right choice from a personnel standpoint. We found the right person to join our team, but we're also doing a really nice job evaluating the opportunity there. So we'll continue to do that, but somewhere in the six month to nine month range.

但是我們在東南部有兩個地區，這兩個地區的成長率最高，而且我們全國排名前五的地區中有兩個也是這些擴張地區。這對我們來說很令人興奮。我想這更印證了我們從人事角度所做的選擇是正確的。我們找到了合適的人加入我們的團隊，而且我們也在認真評估那裡的機會。所以我們會繼續這樣做，但時間大概在六個月到九個月之間。

So I would expect by year-end, heading into '26, we start to really realize the full potential of now this 45.

所以我預計到今年年底，進入 2026 年，我們將真正開始意識到這台 45 的全部潛力。

Okay. Perfect. And then just a follow-up on the kind of slower-than-expected traction with ASP lift for the new biomarkers. Can you just help us think about steps you can take in terms of driving payment for these biomarkers or what it is exactly that's holding up payment here?

好的。完美的。然後，我想就新生物標誌物的平均售價提升速度低於預期這一問題做個後續說明。您能否幫我們思考一下，在推動這些生物標誌物支付方面，您可以採取哪些措施？或者，究竟是什麼原因阻礙了支付？

Yes. Great question. So as it relates to extra color on the ASP side. From our perspective, some of the denials that we're seeing are related to basically medical policy for these new markers and it's the diagnostic code in conjunction with the procedural code being used is not approved from a payer standpoint.

是的。問得好。所以，這與 ASP 端的額外顏色有關。從我們的角度來看，我們看到的一些拒付情況基本上與這些新標誌物的醫療政策有關，而且從支付方的角度來看，所使用的診斷代碼與程序代碼的組合並未獲得批准。

We believe that through an appeals process, a robust appeals process that we've architected and implemented now here over the last couple of years that we can be successful long term, but initial denials are higher than I had originally expected. So that's really the basis for it. There's some other nuances there that we think we can improve upon, for example, out-of-network denials and things like this, but these are unique markers, and we're the only lab that's offering them. And so there is no in-network alternative, especially for this suite of analytes.

我們相信，透過申訴程序，透過我們過去幾年精心設計並實施的健全的申訴程序，我們可以取得長期的成功，但最初的拒絕率比我最初預期的要高。這就是它的基礎。還有一些其他的細微差別我們認為可以改進，例如網路外拒付等等，但這些都是獨特的標誌，我們是唯一提供這些服務的實驗室。因此，對於這組分析物而言，沒有網路內替代方案。

So from our perspective, it has to do with revenue cycle operations probably being the most effective lever in this space. Still working on some physician efficacy advocacy along with patient advocacy, but those will be secondary or tertiary tactics that we employ, and then we'll have to take it from there.

所以從我們的角度來看，這與收入週期營運有關，收入週期營運可能是這個領域最有效的槓桿。我們仍在努力進行一些醫師療效倡議和病患權益倡議工作，但這些將是我們採取的次要或第三策略，然後我們再根據實際情況採取下一步措施。

Perfect, thanks for taking the questions.

太好了，謝謝你回答這些問題。

Ross Osborn, Cantor Fitzgerald.

羅斯·奧斯本，坎托·菲茨杰拉德。

This is [Matt] on for Ross today. I guess just one for me. You reiterated a path to mid-60s gross margin over time. I guess can you kind of expand on what the key unlocks are to get there, whether it's further automation, volume scale, repair mix normalization and how you're thinking about that timeline to start seeing incremental leverage?

今天由馬特替羅斯解說。我猜我只要一個。你重申了隨著時間的推移，毛利率將達到 60% 左右的目標。我想請您詳細說明實現這一目標的關鍵突破點是什麼，例如進一步的自動化、規模化生產、維修組合規範化，以及您如何看待實現逐步效益提升的時間表？

Sure. Yes. How's it going? This is Jeff. Yes, I'll take that.

當然。是的。怎麼樣了？這是傑夫。是的，我要了。

I think multiple levers, right? I think we continue to say and believe that ASP expansion will be the best way to accelerate margin into that mid-60 range. And so as John laid out, there is a strategy to continue to expand ASP with just better revenue cycle management and continued improvements there. We also, as I mentioned, are seeing our COGS per test on AVISE CTD actually well below target, which is very encouraging. And that's been a function primarily of just better optimization of labor, and we really haven't had to make the significant investment in labor that we would have expected to keep up with the volume, particularly with the new biomarkers.

我認為是多管齊下，對吧？我認為我們仍然認為，提高平均售價是加快利潤率達到 60% 以上水準的最佳途徑。正如約翰所闡述的那樣，可以透過更好的收入週期管理和持續改進來繼續擴大平均售價。正如我之前提到的，我們在 AVISE CTD 上的每次測試的 COGS 實際上遠低於目標，這非常令人鼓舞。這主要歸功於勞動力的優化利用，我們實際上不必像預期那樣對勞動力進行大量投資來跟上產量成長，尤其是在新的生物標記方面。

All of that has come before any real optimization we've made in either assay development or lab operations.

所有這些都發生在我們對檢測方法開發或實驗室操作進行任何真正優化之前。

So we do think there is real opportunity for further optimization in workflow. But I would say that the biggest driver is going to be the ASP expansion. And just to add some more color to that. John mentioned that we did see a pullback, and we lost a pretty high volume -- relatively high-volume, high ASP account. If you were to normalize for that, we would already be above the 60% gross margin range for the quarter.

因此，我們認為工作流程方面確實存在進一步優化的空間。但我認為最大的驅動因素將是平均售價的提升。再添點色彩吧。John提到我們確實看到了回調，而且我們失去了一個相當大的交易量——一個交易量相對較大、平均售價較高的帳戶。如果將此因素考慮在內，我們本季的毛利率已經超過 60% 的範圍。

So we're still tracking, and we're really encouraged because our COGS profile is much below where we expect it to be.

所以我們仍在跟踪，而且我們真的受到了鼓舞，因為我們的銷售成本遠低於我們的預期。

Got it super helpful caller. Thanks for taking the questions guys.

收到了，來電者非常熱心。謝謝各位回答問題。

Andrew Brackmann, Will Blair.

安德魯·布拉克曼，威爾·布萊爾。

Hi guys, good morning. Thanks for taking the question. Maybe just on the volume front, accelerated volume growth again here in the quarter. A lot has been asked sort of on rep productivity. But as you sort of think about the drivers of that volume growth, how should we sort of parse out the sort of levers between the expanded commercial team, more efficient rep productivity, but then also just the launch of markers from earlier this year and then there's still just the massive penetration that you have in front of you, the penetration potential that you have in front of you? Thanks.

大家好，早安。感謝您回答這個問題。或許只是銷量方面，本季銷量再次加速成長。關於代表生產力，人們已經問了很多問題。但是，當我們思考推動銷售成長的因素時，我們應該如何區分擴大的商業團隊、更有效率的銷售代表生產力，以及今年早些時候推出的標記產品，還有擺在我們面前的巨大市場滲透率和滲透潛力呢？謝謝。

Good morning, Andrew, thanks a lot for the question. So maybe more of a qualitative answer. It's always tough to pinpoint or address this with precision. But from my perspective, having something innovative and clinically useful to discuss with our client base has reinvigorated our sales team for sure, but also the interest on the customer side. So I think the fact that we launched these new markers is very much a positive, and we're seeing that energy, I guess, kind of rekindle here in the second half of the year with the recent launch of these additional markers -- especially now that we've got unique marker set specific to rheumatoid arthritis, it really does open up the clinical conversation and provide that additional value for folks.

早安，安德魯，非常感謝你的提問。所以，或許應該給出更定性的答案。要準確指出或解決這個問題總是很困難的。但從我的角度來看，能夠與我們的客戶群討論一些創新且具有臨床實用價值的內容，無疑地重新激發了我們銷售團隊的活力，也提高了客戶的興趣。所以我認為，我們推出這些新標誌物是一個非常積極的舉措，而且我們看到，隨著這些額外標誌物的推出，這種活力在下半年似乎又重新燃起——特別是現在我們有了專門針對類風濕性關節炎的獨特標誌物組合，這確實開啟了臨床討論，並為人們提供了額外的價值。

So that's where I would rank that at the top.

所以，我會把它排在第一位。

We've talked at length about having stability and such a high-caliber team in our organization. And I really believe that, that's a significant contributing factor to our growth right now. We've got groups of folks who really take learning the science seriously, really work hard, and you're seeing the results of that. I mean as long as you pretty consistently stay customer-centric, work to satisfy the needs of your customer and are generally concerned with adding value to their clinical practice, I think you can be relatively successful. And this area of medicine is highly driven by relationships.

我們已經詳細討論過組織內部的穩定性以及擁有高素質團隊的重要性。而且我真的相信，這是我們目前發展的重要促成因素。我們有一些團隊非常認真地學習科學，非常努力地工作，你們現在看到了成果。我的意思是，只要你始終以客戶為中心，努力滿足客戶的需求，並致力於為他們的臨床實踐增加價值，我認為你就能取得相對的成功。而醫學的這一領域高度依賴人際關係。

It's very clear that even the patient clinician approach here, it's chronic disease management, the relationship there is very key, and it is with our organization as well. And we we've really worked to build trust and establish that trust.

很明顯，即使是患者與臨床醫生之間的關係，也就是慢性病管理，也至關重要，這與我們機構的關係也是如此。我們確實努力建立和鞏固了這種信任。

We want testing performed where it's going to be useful. And not widely -- our test is not useful in every clinical context when you're trying to diagnose the connective tissue disease. So we really want to understand how clinicians where they're struggling and where this can add value. And our team, I think, as master is probably too strong of a word, but come close and continue to improve in this area. And I think we're seeing the results of that.

我們希望在真正需要的地方進行測試。而且應用範圍並不廣泛—在嘗試診斷結締組織疾病時，我們的測試並非在所有臨床情況下都有效。因此，我們非常希望了解臨床醫師在哪些方面遇到困難，以及這能在哪些方面增加價值。至於我們的團隊，我認為稱其為大師可能有點誇張，但我們已經非常接近大師水平，並且在這個領域會繼續進步。我認為我們正在看到這種做法帶來的結果。

So the new markers, I think, are a very strong contributing factor, stability in the team, along with a heightened focus in the clinical messaging, and that's what you're seeing here.

所以我認為，新的標誌物是一個非常重要的促成因素，團隊的穩定性，以及對臨床資訊的更加重視，這就是你在這裡看到的。

Okay. That's great color. And then just on the loss of that large direct bill customer, any more color you can maybe give on the magnitude of the headwind that, that caused ASPs in the quarter? And then as you look at that entire book of business for direct bill, any other risks out there that you might see popping up in terms of other customers going down this route?

好的。顏色真好看。那麼，關於失去那位大型直接計費客戶這件事，您能否進一步說明一下，這件事對本季平均售價造成的負面影響有多大？然後，當你審視整個直接結算業務時，你是否發現其他客戶採用這種方式可能會帶來其他風險？

Yes. So maybe I'll just share a little bit of how I think about the direct bill opportunity. I think it's an interesting opportunity. It's approaching 20% of our revenue. It's on the order of 8% to 10% of our volume.

是的。所以，我或許可以簡單分享一下我對直接計費模式的看法。我認為這是一個很有趣的機會。它已接近我們收入的20%。約占我們總銷量的 8% 到 10%。

So it gives you a sense of that relationship there. I think it's an interesting part of the business. in the sense that the people or the entity that you're negotiating with from a pricing standpoint also handle medical policy for all intents and purposes, right? So it's a combination negotiation, if you will. And it allows those entities to get access to more innovative technology sooner.

所以它能讓你感受到那種關係。我認為這是業務中一個很有趣的部分。因為從價格角度與你談判的那些人或實體，實際上也負責處理醫療保險政策，對吧？所以，這可以說是一種組合式談判。這使得這些機構能夠更快地獲得更具創新性的技術。

In that sense, they can determine when and if they want access to certain technology. But it also tends to put that offering and that relationship at risk at times because they can decide to switch just as quickly.

從這個意義上講，他們可以決定何時以及是否需要使用某些技術。但這也往往會使這種合作關係面臨風險，因為他們可以很快地決定轉換供應商。

And so our understanding of this transition was it was a financially motivated decision, didn't really take into account the clinical impact or, to be honest, the desires of the rheumatology group at this organization. But nevertheless, it was made and from their perspective in their best interest. And -- but they're still offering our test, using it in clinical practice. We're just converting more to commercial insurance.

因此，我們對這一轉變的理解是，這是一個出於經濟動機的決定，並沒有真正考慮到臨床影響，或者坦白地說，也沒有考慮到該組織風濕病團隊的意願。但無論如何，這件事已經做出，而且從他們的角度來看，這符合他們的最大利益。但是——他們仍然提供我們的測試，並在臨床實踐中使用它。我們正在逐步將更多業務轉向商業保險。

And so we know that that's a little bit longer road in terms of getting back to the ASP that we ultimately aspire to, but it's one that we're well versed in and know the appropriate tactics.

因此我們知道，要回到我們最終渴望達到的 ASP 水平，還有一段更長的路要走，但我們已經很熟悉這條路，也知道合適的策略。

So the client bill opportunity is interesting. I think we're probably at close to the max level of client bill business that I want to take for organization.

所以，客戶帳單這個機會很有意思。我認為我們公司目前的客戶帳單業務量可能已經接近我願意承擔的極限了。

We'll see if other opportunities arise. But long term, I think it's better that we work with insurers. I think it's a better relationship in that regard. It can be tougher short term. But longer term, I think that's a better competitive advantage and a more reliable approach.

我們看看是否還會出現其他機會。但從長遠來看，我認為我們最好還是與保險公司合作。我認為在這方面，我們的關係變得更好了。短期內可能會更艱難。但從長遠來看，我認為這是一種更好的競爭優勢和更可靠的方法。

Great thanks guys.

非常感謝各位。

Bill Bonello, Craig-Hallum.

比爾·博內洛，克雷格-哈勒姆。

Hey guys, I just want to follow up on the question that Andrew was just pushing on to just make sure I understood what you said. So in terms of that client, they are still ordering the test. They simply moved from being client bill to third-party bill? Or -- and then if that's correct, was there sort of any associated impact on volume at that client? Or are you seeing steady volumes and just the change in ASP?

大家好，我只是想就安德魯剛才提出的問題再問一下，以確保我理解了你們的意思。所以就那位客戶而言，他們仍然在訂購測試。他們只是從客戶帳單變成了第三方帳單？或者—如果情況屬實，那麼這是否對該客戶的業務量產生了任何相關影響？還是您觀察到的是銷量穩定，只有平均售價會改變？

Yeah good morning Bill, thanks for the opportunity to expand a little bit more. So specifics related to this account, which happy to go into, probably won't go into as much detail with each of these instances. But with this account specifically, one -- when the contract was terminated, and we were given fairly short notice here, talking about a few days, when the contract was terminated, access to the testing was suspended. So the hospital system froze the EMR and actually paused access for their clinician base.

早安，比爾，謝謝你給我這個機會再詳細說。所以，關於這個帳戶的具體細節（我很樂意深入探討），可能不會在每個具體案例中都詳細闡述。但就此帳戶而言，有一點——當合約終止時，我們只收到了相當短時間的通知，也就是幾天時間，當合約終止時，測試權限就被暫停了。因此，醫院系統凍結了電子病歷系統，實際上暫停了其臨床醫生的存取權限。

They actually stopped drawing it with their in-house laboratory as well drawing the blood, et cetera. So really, everything came to a halt initially.

他們實際上已經停止使用內部實驗室進行抽血等檢測了。所以，一開始一切都停滯了。

Given our close relationships with the rheumatology division there and their desire to continue to have access to this test, they pursued an alternative route, and we worked with them on the logistics to revive that. So where we're at now is the volume has returned because we've been able to logistically provide phlebotomy access for them along with helping them establish a new ordering process, et cetera.

鑑於我們與該醫院風濕病科的密切關係，以及他們希望繼續獲得這項檢測，他們尋求了一條替代途徑，我們與他們合作，在後勤方面恢復了這項檢測。所以現在的情況是，業務量已經恢復了，因為我們在後勤方面為他們提供了採血服務，並幫助他們建立了新的訂購流程等等。

And we're not back exactly to where we were, but it's certainly trending in the right direction and much better than when we were informed of the transition.

雖然我們還沒有完全回到原來的狀態，但肯定是朝著正確的方向發展，而且比我們得知過渡情況時的情況要好得多。

So you did have some suspension related to volume. I believe we're trending back in a very positive way there with optimism on the trajectory. And then most of the impact has been ASP.

所以你們確實遇到了一些與音量相關的問題。我認為我們正朝著非常正面的方向發展，前景樂觀。然後，大部分影響都體現在平均售價（ASP）上。

Okay. That's really helpful and nice to see the acceleration in volume growth even with that. situation. So the second thing because to me, volume growth really seems like the exciting story here, the uptick, but ASP obviously matters. So just on the higher denials than you had expected, a couple of questions.

好的。即便在這種情況下，銷售成長依然加速，這真的很有幫助，也令人欣慰。所以第二點，因為對我來說，銷售成長才是真正令人興奮的地方，銷售量上升，但平均售價顯然也很重要。所以，關於被拒絕率高於預期這一點，我有幾個問題。

Why do you think that's happening? Why do you think you're seeing greater denials than you had expected? And then is that dynamic exclusively related to the new markers? Or are you seeing an uptick in denials across the board?

你覺得這是為什麼呢？你認為為什麼你看到的否認現像比預期的還要多？那麼，這種動態變化是否完全與新的標記有關？或者您發現所有方面的否認率都在上升？

Yes, that's a great question. So our base business, no notable changes in payer behavior that are worth going into a level of detail on this call, right? So we remain on a positive trajectory for the base business. It is related to the new markers as to why we're seeing a higher level of scrutiny than I expected. Well, I think it comes down to incentives for the most part, insurers are oftentimes profitable organizations, and they're looking for ways to curtail utilization.

是的，這是一個很好的問題。所以，就我們的基本業務而言，支付方的行為沒有發生任何值得在本次電話會議上詳細討論的顯著變化，對吧？因此，我們的基礎業務仍保持著積極的發展動能。這與新的指標有關，所以我們看到的審查力度比我預期的要大。我覺得這主要還是激勵機制的問題，保險公司通常是獲利機構，他們會想辦法減少保險的使用。

And this is one way, either through prior authorization, implementations, medical record requests. They throw a lot of hurdles in place to see if the clinicians truly really want this type of offering. And that's what we're seeing. So some of it is related to the ICD-10 code, the diagnostic code being used in conjunction with billing, but this is what we're provided by the client. So not a lot that we can do there.

這是一種方法，可以透過事先授權、實施、醫療記錄請求等方式。他們設置了很多障礙，以檢驗臨床醫生是否真的需要這種類型的服務。這就是我們所看到的。所以其中一些與 ICD-10 代碼有關，診斷代碼與計費一起使用，但這是我們從客戶提供的資訊。所以在這方面我們能做的並不多。

Just tough to simulate all of these situations ahead of time. I think we did a reasonable job on our end in estimating this and still believe that long term, that $90 aspiration is within reach. We're climbing to it. I think we're in the mid-high 70s now. We were in the low 70s a quarter ago.

提前模擬所有這些情況太難了。我認為我們在估算方面做得相當不錯，並且仍然相信從長遠來看，90 美元的目標可以實現。我們正在攀登。我認為我們現在應該在70多華氏度（約攝氏21-21度）的範圍內。三個月前，我們的氣溫還在華氏70度左右。

So even over a 3-month period of time, you've seen almost a 10% change in that new marker reimbursement for the positive. It just is going to take us a little bit of time to work through this. And ultimately, where do we land? Not entirely sure. Is it $85?

因此，即使在短短 3 個月的時間裡，你也看到陽性新標記報銷增加了近 10%。我們需要花點時間來解決這個問題。最終，我們會落腳何處？不太確定。是85美元嗎？

Is it 95? I don't know. But I just think it's important and prudent to be transparent with this, and that's kind of what we're working on.

是95嗎？我不知道。但我認為在這件事上保持透明非常重要且明智，而這正是我們正在努力的方向。

That's really helpful. And then just the playbook, is it radically different what you're trying to do here in terms of working through denials and eventually getting these additional markers paid for than sort of what you've done over the past two years where you've driven a sort of massive increase in ASP through revenue cycle management? Just trying to understand how unique this particular situation might be relative to what you've done in the past?

這真的很有幫助。那麼，就策略而言，你現在在處理拒付問題並最終獲得這些額外指標的付款方面，與你過去兩年透過收入週期管理大幅提高平均售價的做法相比，是否有根本性的不同呢？我只是想了解一下，相對於你過去的經歷，這種情況究竟有多特殊？

Yes. Tactically and procedurally, it's very similar. And so that's why I feel confident that from an architecture standpoint, from a process standpoint, we have the infrastructure in place to address this at scale.

是的。從戰術和程序上看，兩者非常相似。因此，我很有信心，從架構角度和流程角度來看，我們已經具備了大規模解決這個問題的基礎架構。

On the content, now that's obviously going to change because most of what we've been doing is having discussions around AVISE lupus and what the body of evidence is behind that in terms of clinical validity and utility. Now these are new markers. And so the body of evidence is not as deep, although with the rheumatoid arthritis markers, they've been studied for many years, RA33, body of literature out there for 20-plus years, the PAD4 autoantibodies, body of literature out there.

至於內容方面，現在顯然會有所改變，因為我們一直在討論 AVISE 狼瘡以及背後的臨床有效性和實用性方面的證據。這些是新的標記。因此，證據體係還不夠深入，儘管類風濕性關節炎標記已被研究多年，RA33 的相關文獻已有 20 多年，PAD4 自體抗體的相關文獻也有。

So we're able to leverage some of that science that's been conducted by other institutions and infuse that into our appeals process, but it does require us to update the appeal letters and to structure that content a little bit differently. And there's going to be a learning curve naturally with some of that. But the process and tactics remain the same.

因此，我們可以利用其他機構進行的一些科學研究，並將其融入我們的申訴流程中，但這確實需要我們更新申訴信，並以不同的方式建構其內容。當然，這其中肯定需要一個學習過程。但流程和策略仍然相同。

Alright, thank you very much, really appreciate that additional color.

好的，非常感謝，真的很喜歡這個額外的顏色。

Matthew Parisi, KeyBanc.

Matthew Parisi，KeyBanc。

This is Matt Parisi on for Paul Knight at KeyBanc. You've previously mentioned ALJ hearing wins during the prior quarters. And I was wondering if there has been any further ALJ hearing wins for Exagen in 3Q?

這裡是 KeyBanc 的 Matt Parisi，代表 Paul Knight 為您報道。您之前曾提到前幾個季度在行政法官聽證會上取得的勝利。我想知道Exagen在第三季是否還有其他行政法官聽證會勝訴的紀錄？

Matt, none that we disclosed publicly. We have continued a robust appeals efforts. We are, I think, making some material progress there. This past quarter, we actually presented in front of multiple medical directors at various plans. And so we're getting the attention and the audience and the opportunity that we've sought out strategically, and we'll continue to make incremental progress there.

馬特，沒有我們公開披露的任何資訊。我們持續進行強而有力的上訴工作。我認為，我們在那方面取得了一些實質進展。上個季度，我們曾多次向不同醫療機構的多位醫療總監進行報告。因此，我們獲得了我們一直以來策略性尋求的關注、受眾和機會，我們將繼續在這方面取得漸進式進展。

We have filed for future ALJ hearings, but no notable update in that regard.

我們已申請舉行未來的行政法官聽證會，但目前尚未有值得關注的進展。

Sounds great thank you.

聽起來不錯，謝謝。

Dan Brennan, TD Cowen.

丹·布倫南，TD Cowen。

Great thanks thanks for the questions John and Jeff. Maybe just one more on the account, the direct account. I know it was asked, like did you size it just so we can get a sense of as we look forward, if that's still in the comp, kind of we can back that out. And then like what's the difference between the direct realized price versus the commercial realized price?

非常感謝約翰和傑夫提出的問題。或許只要再往這個帳戶，也就是直接帳戶加一筆就行了。我知道有人問過這個問題，例如你有沒有測量尺寸，這樣我們就可以了解未來的情況，如果這還在競爭中，我們就可以把它排除掉。那麼，直接實現價格和商業實現價格有什麼差別呢？

Yeah, good morning, Dan, thanks for the question. So in terms of in-quarter ASP impact, you're talking on a blended rate, a little north of $20, right? So you've got a headwind of about $20 for the in-quarter ASP impact of that account alone.

早安，丹，謝謝你的提問。所以就季度內平均售價的影響而言，你指的是綜合價格，略高於 20 美元，對嗎？因此，僅該帳戶就對季度平均售價造成了約 20 美元的負面影響。

Volume-wise, we didn't cut it out or carve it out because we believe that volume is continuing to come back over time. And so we'll just have to see. It will be a slight headwind near term, but hopefully returning to normal levels or even improving as we continue to add more clinical value in that context.

從銷量來看，我們沒有削減或減少銷量，因為我們相信銷量會隨著時間的推移而逐漸恢復。所以，我們只能拭目以待了。短期內可能會遇到一些阻力，但隨著我們繼續在該領域增加更多臨床價值，希望情況能夠恢復正常水平甚至有所改善。

But the ASP should also start to improve as we develop a history and a better relationship with the payers in that region. So hopefully, that gives you a little bit of a feel. So it was significant, but also something for us opportunity-wise to work on. Does that help?

但隨著我們與該地區的支付方建立良好的合作關係，ASP 也應該開始改善。希望這能讓你對它有一點了解。所以這件事意義重大，同時也為我們提供了一個可以著手處理的機會。這樣有幫助嗎？

Yes. No, that helps. I mean your trailing 12-month ASP, right, still has been ticking up nicely even this quarter, another $13 or so sequentially. So I guess within the context of the $65 million to $70 million guide, is the assumption that the ASP continues to go up? Or is it like maybe flat because of this kind of account loss?

是的。不，那樣很有幫助。我的意思是，你們過去 12 個月的平均售價，對吧，即使在本季度也一直在穩步上升，環比增長了大約 13 美元。所以，我猜想，在 6,500 萬至 7,000 萬美元的指導價範圍內，是否假設平均售價會繼續上漲？還是因為這類帳戶損失導致的，所以情況可能比較穩定？

Just how do we think about that realized price in 4Q from a trailing 12-month basis?

我們應該如何看待過去 12 個月中第四季的實際價格？

Yes. We don't split it out by ASP or volume. And you can see -- I think one of the things is over the course of this year, that $65 million to $70 million guide has generally stayed about the same with a little bit improved clarity at the end of Q1 or Q2, but generally stayed about the same. And we believe that we'll fall within that range even despite some of these headwinds. So again, I'm proud of the team for executing in multiple ways.

是的。我們不按平均售價或銷量進行細分。你可以看到——我認為今年以來，6500萬美元到7000萬美元的預期基本上保持不變，雖然在第一季末或第二季度末有所改善，但總體上保持不變。即使面臨一些不利因素，我們也相信我們能夠達到這個目標範圍。所以，我再次為團隊在多個方面所取得的成就感到自豪。

And I think given the fact that we do have progress on ASP and volume simultaneously, put us in a good position to reach those objectives. From a Q4 specifically, I think we've got a few different ways to get there. We -- even as it relates to the year-end cash flow positivity objective.

我認為，鑑於我們在平均售價和銷售方面同時取得了進展，這使我們能夠很好地實現這些目標。具體到第四季度，我認為我們有幾種不同的方法可以實現目標。我們——即使這與年末現金流為正的目標有關。

From our perspective, we have some things in the works with various payers that could get us there for sure. ASP will be the most sensitive lever to get us there, but we'll also have to see how volume comes in. I think we should be cautiously optimistic as it relates to volume progression because -- just because of the holiday season really.

從我們的角度來看，我們正在與不同的付款方洽談一些事宜，這些事宜肯定能幫助我們實現目標。平均售價將是實現目標最敏感的槓桿，但我們也要看看銷售量如何變化。我認為我們應該對銷售成長持謹慎樂觀態度，因為——這主要是因為假期的原因。

And Dan, just to add to answer your question on the guide, I think about it -- the way to think about it is that the low end of the range would assume very little, if any, ASP expansion in the fourth quarter, right? And clearly, obviously, the high end of the range would include continued and maybe some accelerated expansion, but the low end would really assume that we don't do much in the way of ASP expansion in the fourth quarter.

丹，為了回答你關於指南的問題，我想補充一點——這樣想的話，範圍的下限假設第四季度平均售價幾乎沒有增長，對吧？顯然，範圍的高端將包括持續甚至可能加速擴張，但低端則真正假設我們在第四季度不會在平均售價擴張方面做太多事情。

Got it. I got that. comps, you've done a really nice job, obviously, on the volume as you've kind of optimized for the profitability and the cash burn, and you've had really nice volume growth in Q3 and kind of year-to-date. As we look ahead, like comps do get more difficult. Obviously, the market is large.

知道了。我明白了。就銷量而言，你們做得非常出色，顯然，你們在盈利能力和現金消耗方面都做到了優化，第三季度和年初至今的銷量增長都非常可觀。展望未來，比賽難度確實會越來越大。顯然，市場規模很大。

I mean, is double-digit growth like reasonable to think about as we go into 2026?

我的意思是，展望2026年，兩位數的成長是否合理？

So we've not set a base guide or objective for our top line growth. We think it will be driven by two factors. Volume, we've said likely to grow in the mid- to high single digits, and we're seeing that, if not a little bit higher for this year as we've really established a strong sales organization, but also with the new marker launch.

因此，我們沒有為營收成長設定基本指導方針或目標。我們認為這將受兩個因素驅動。我們曾表示銷售量可能會以中高個位數成長，而我們看到，今年的銷售量甚至可能更高，因為我們已經建立了一個強大的銷售組織，而且隨著新品牌的推出。

ASP is inherently difficult to project and especially timing. And I think you're seeing that play out real time here with these quarterly results, but also just in the past, we've had periods of time where we've seen pretty extreme acceleration. And I think as long as that trajectory continues upwards over time, we'll be in a pretty good spot organizationally with both factors contributing.

ASP（平均銷售價格）本身就很難預測，尤其是銷售時間。我認為，從這些季度業績中，我們可以即時看到這種情況，而且在過去，我們也曾經歷過一些成長非常迅猛的時期。我認為，只要這種上升趨勢持續下去，這兩個因素都會對我們組織的發展起到積極作用，使我們處於相當有利的地位。

Got it. Maybe just one final one. There's been a bunch of questions on denials and payment and your confidence, obviously, with these differentiated markers that you guys will be successful. I think in the past, like when we -- a lot of diagnostic companies, including yourselves, commercial payers tend to really drag their heels and investors like to look at like what the opportunity is over time, maybe not in the next six months or 12 months, but maybe over the next two years, three years, like what's that opportunity set for like where can realized price get to? So I think in the past, maybe you guys have talked about something $500, $600.

知道了。或許就最後一張吧。有很多關於拒付和付款的問題，顯然，你們對這些差異化指標的信心，相信你們會成功。我認為過去，許多診斷公司，包括你們在內，商業支付方往往行動遲緩，而投資者則更關注長遠發展的機會，也許不是未來六個月或十二個月，而是未來兩三年，比如未來幾年，實際價格能達到什麼水平？所以我覺得以前你們可能討論過 500 美元、600 美元之類的東西。

Like any way to think about as we look ahead, no timetable attached to it, but is there any change in kind of what's happened here that would dissuade you from thinking you can get to like kind of $600 plus or minus? Or how do we think about the longer-term opportunity on realized price capture? Thank you.

就像我們展望未來時可以採取的任何思考方式一樣，沒有時間表，但是這裡發生的事情是否有任何變化，會讓你打消認為你能達到 600 美元左右的想法？或者，我們如何看待實現價格的長期機會？謝謝。

Yes. Our relatively near-term goal remains that half of Medicare rate. I think that's still a viable objective for us to meet in that time frame. And so that would put us kind of at that $600 range. And as we achieve that, that continues to dramatically transform our organization.

是的。我們近期內的目標仍是達到醫療保險覆蓋率的一半。我認為在那個時間範圍內，這仍然是我們可以實現的目標。這樣一來，價格就差不多在 600 美元左右了。隨著我們實現這一目標，這將持續大幅改變我們的組織。

We believe that current volume, we'd be a cash flow positive organization at the $500 range.

我們相信，以目前的銷量，每股盈餘達到 500 美元左右，我們就能實現正現金流。

So we're close, and we're close to transforming the organization in a very positive way, and I still think that's a reasonable expectation for us. Longer term, it should be higher.

所以我們已經接近目標，我們距離以非常積極的方式改變組織也越來越近了，我仍然認為這對我們來說是一個合理的期望。從長遠來看，應該會更高。

Higher than the $600 or the $500?

高於 600 美元或 500 美元？

Yes, than the $60.

是的，比 60 美元還貴。

Got it terrific. Okay, thank you.

收到了，非常棒。好的，謝謝。

Ladies and gentlemen, with no further questions in the question queue. I will now hand over to John Aballi for closing remarks.

女士們、先生們，提問隊伍中已無其他問題。現在我將把發言權交給約翰·阿巴利，請他作總結發言。

Thanks so much. Year-end has come or is coming fast. And I really just want to thank the team here at Exagen for their continued dedication and performance.

非常感謝。年末已至或即將到來。我真心感謝Exagen團隊的持續奉獻與優秀表現。

We have an ambitious quarter ahead with key milestones to accomplish, and I look forward to finishing the year strong. Thanks to everyone on the call for their partnership as we work to establish a dominant company in the autoimmune space. Thanks for your time this morning.

接下來的季度充滿挑戰，有很多關鍵里程碑需要完成，我期待今年能圓滿成功。感謝所有參與電話會議的夥伴們，感謝你們的合作，我們將共同努力，在自身免疫領域打造主導企業。感謝您今天上午抽出時間。

Thank you, sir. Ladies and gentlemen, that concludes this event. Thank you for attending, and you may now disconnect your lines.

謝謝您，先生。女士們、先生們，本次活動到此結束。謝謝各位的參與，現在可以斷開線路了。

Portions of this transcript marked (technical difficulty) indicate audio problems. The missing text will be supplied if a replay becomes available.

本文字稿中標示（技術難題）的部分錶示有音訊問題。如果有重播視頻，我們會補充缺少的文本。