Peter Maag
Analyst · Piper Jaffray. Your question please
Thanks, Mark. Good afternoon, everyone. As we have done on our previous quarterly calls, I’d like to begin with a patient story. As many of us fly United Airlines, you might have followed the Chicago tribune story about the United CEO, Oscar Munoz. He took over as United CEO in September, suffered a heart attack in October and received a heart transplant in January, back to work in March. This is quite amazing and highlights the life changing potential of successful transplantation. It is life changing story like this one that inspire us at CareDx. 2015 was the year of substantial progress for CareDx. We closed 2015 having achieved all of our strategic objectives, including further development of cell-free DNA with AlloSure, increasing AlloMap patient adoption and pursuing external growth opportunities, including the transaction we announced to acquire Allenex. We’ll start this call by covering our cell-free DNA pipeline then I’ll cover our AlloMap business and provide an update on the transaction. Ken will cover the financials for the fourth quarter and full-year 2015 and then we look forward to your questions. Before we discuss operational highlights, I would like to briefly comment on our overall performance. For the full-year 2015, total revenue for the year was $28.1 million with AlloMap revenue being $27.9 million up 8% over 2014. We provided more than 13,000 AlloMap patient results. AlloMap test volume continues to be a strong foundation for our business. We saw 10% year-over-year volume growth, which underscores the importance of AlloMap as a core product for CareDx. Ken will talk through the dynamics of test growth versus revenue growth in his section. Overall, we believe that having reimbursement and billing in-house is a core capability for a molecular diagnostics company. We are succeeding in building a strong R&D effort centered on our cell-free DNA technology that promises impact on even more patients with focus on kidney transplant surveillance. The increased R&D effort translated into a ramp of R&D expenses primarily associated with the development of our in-house cell-free DNA Assay AlloSure and our ongoing clinical trials. I’m extremely pleased with the progress that we're making and the investments that we have made since that we first outlined our strategy more than a year ago. Let me now focus my comments on the three strategic objectives we pursued in 2015: development of cell-free DNA, AlloMap patient adoption, and external growth opportunities. First, I want to highlight the progress we made on AlloSure, our proprietary next-generation sequencing test that measures the percent of donor-derived cell-free DNA in solid organ transplant recipients. Our initial focus for AlloSure will be kidney transplantation. We completed rigorous analytical validation of AlloSure following professional organization, next generation sequencing guidelines and recommendations such as CAP, AMP, ACMG, and ASHG. We used a specially designed third-party prepared reference standards quantitatively characterized by digital PCR and the National Institute of Standards and Testing human reference genome in the validation to ensure sequence accuracy and quantitation. Computational analysis used customer sample best-in-class software modules and a cloud platform selected by precision FDA, the FDA’s effort in support of President Obama’s precision medicine initiative. AlloSure is accurate, reproducible, and sets a new bar for thoroughness of analytical validation for a cell-free DNA laboratory-developed test. In 2015, CareDx presented NGS analytical validation recommendations at the FDA sponsored workshop in November in Washington. We also opened a dedicated purpose-built CLIA lab for AlloSure in our Brisbane headquarters. This provides us the ability to offer the latest genomic technologies for our growing pipeline of assays, dedicated to improving transplantation management. Additionally, we have made significant progress in our DART trial, an observational study designed to demonstrate the clinical validity of cell-free DNA in detecting rejection in kidney allograft recipients. The study is also designed to demonstrate the correlation of circulating cell-free DNA to renal function estimated from serum creatinine. We initially planned to enroll 200 patients in more than 12 centers and collect patient blood samples. We exceeded plan with 205 patients, enrolled by December 31st, up from 100 in the third quarter in 13 transplant centers, up from 11 reported in Q3. In total, these centers have already collected over 900 samples and associated clinical visit data as of March 19, 2016. We plan to deliver our first analysis in the first half of this year with a timing primarily driven by the number of patient samples that are associated with clinical events, especially rejections. Following this first analysis of the DART study, we plan to begin a clinical drug called ROSE in the second half of this year. The focus of ROSE will be to demonstrate clinical utility in support of reimbursement in a Medicare population. Medicare covers more than 90% of kidney transplant patients. We continue to be on track with our development plan. These milestones are consistent with previous communication. In addition to DART, we have two more clinical studies underway: our Outcomes AlloMap Registry study, or OAR, and our cell-free DNA Outcomes AlloMap Registry, or D-OAR. Enrollment continues to grow in the OAR study. At the end of 2015, we had taken almost 3,000 samples, up from 2,300 at the end of the third quarter from 800 patients up from about 600 last quarter from 24 centers. The long-term outcome data collected will continue to build clinical evidence for the use of AlloMap. We see this not only as a long-term commitment to the field of transplantation, but also as an invaluable source for future scientific insight generation. We are seeing a lot of interest from opinion leaders to use this date to gain further insights into patient management. We continue to make cell-free DNA results available from our CLIA laboratory in combination with AlloMap through our D-OAR registry. As of December 31, the D-OAR trial was in 18 centers, up from 15 at the end of the third quarter with 340 patients enrolled up from 250 and 900 samples collected up from 650. This effort continues to support evidence generation of cell-free DNA in organ transplantation. We continue to build an invaluable repository of well annotated sample that link genomic data with clinical information. Now turning to our second strategic initiative, which is to increase the adoption of AlloMap, our surveillance solution for heart transplant recipients. Out of the 130 heart transplant centers in the U.S., AlloMap was used in 120 during the last 12 months. As of the end of the fourth quarter, there were 64 centers with established AlloMap protocols, up from 62 in the previous quarter and 60 in the quarter before that. During the fourth quarter, we hit an important commercialization milestone in Europe with our partner Diaxonhit, a French leader in specialty in-vitro diagnostics. We completed the technology transfer of AlloMap into Strasbourg University Hospital Central Immunology Laboratory, HUS in France. We established a rigorous multi-step validation process, which demonstrated that AlloMap test results released from the HUS laboratory are equivalent to AlloMap results generated by our laboratory here in Brisbane. Patient samples can now be tested at HUS. This unique partnership with both a prestigious university based laboratory and a strong commercial organization, increases the availability of AlloMap for transplant patients in Europe. I’m also pleased with the execution of our commercial strategy which coordinates AlloMap patient customer engagement, drives establishment and adherence to protocols and supports transplant centers in optimizing their workflow. The three key initiatives that we have been working on are stakeholder engagement to involve patients and physicians in the direction we take our technology, clinical data and education to continue to build the evidence in support of AlloMap and protocol development and adherence to continue to expand the utility of AlloMap. A highlight of our ongoing development efforts is our recent release of AlloMap Score Variability for AMV. That’s an additional tool for heart transplant clinicians. In October, research conducted on AMV was published in journal, BMC Cardiovascular Disorders. This published study is the first to report on positive and negative predictive values, key to informing test use in a patient population. The AlloMap variability assay identifies which patients are at risk of future clinical events, thereby, facilitating adjustments of patient management strategies. In other words, AlloMap variability predicts risk of future allograft events. While each single AlloMap identifies the risk of acute rejection at the time of testing. This is a particularly exciting area for patients that are in the timeframe two years to five years post-transplant. AMV, which is available from for AlloMap test results with in a 24 months period, will provide additional insights to clinicians for patient risk stratification. There are now 40 centers receiving AlloMap variability scores up from nine in the third quarter of 2015. On the reimbursement front, we continue to have positive coverage decisions from most major carriers. As of December 31, 2015 we had been reimbursed for approximately 80% of all AlloMap results delivered in the 12 month ended June 31, 2015. And just a few weeks ago, we announced TRICARE National Insurance came out with a positive coverage policy for AlloMap. TRICARE covers over nine million lives and is heart of the military health care system. This coverage is need to access back one year to February 2015. AlloMap continues to be broadly reimbursed in comparison to other high-value molecular diagnostic offerings. In 2015 AlloMap reimbursement was steady at $2,821. In 2015 we received a CPT code, as we are currently going through the CMS caption [ph] process with AlloMap, we expect reimbursement to remain at this price going forward. On July 1, we brought AlloMap billing and collection activities in-house as we grow and launch new tests we expect to see a reduction in cost of the reimbursement effort and an increase in effectiveness through direct control over the entire process. As mentioned earlier, we think about this as a core competency of a pioneering molecular diagnostic company. Now moving on to our external growth opportunities, as you most of you are aware in December we reached an agreement to purchase 78% of the outstanding share of Allenex. We are currently working through the conditions of closing. Allenex is a transparent transplant diagnostic company based in Stockholm, Sweden that develops, manufactures, market and sells product that match donor organs with potential recipients prior to transplantation. We anticipate to finish the tender offer period with Swedish stockholders and expect to complete the acquisition in mid-April. This combination will create an international transplantation diagnostics company with expanded distribution and additional overall growth potential. Let me tell you why I’m excited about Allenex. The Olerup SSP line, which addresses Human Leukocyte Antigen or HLA testing is used to match transplant recipients with donors organs. The Olerup SSP line is established in the marketplace and is complementary to our product. The majority of Allenex operations are in Europe, which represents 70% of the 2015 revenues. They have five direct reps in Europe and five in the U.S. Their team is very knowledgeable, talented and well respected. The Olerup brand is very well known in the field and important relationships have been established over decades. Pro forma combined revenues for 2015 were approximately $44 million. This represents a unique strategic fit with little over that overlap between our standalone companies, combine CareDx we’ll have product offerings along the pre-post transplant continuum and presence and direct distribution channels in the U.S. and in Europe. We are excited about this combination and look forward to sharing more with you at an Analyst and Investors Day that we are planing to host in mid-April in New York. Before we move onto financial I would like to speak a little bit more about striving to be a best-in-class transplant focused molecular diagnostic company and how we strengthened our organization by bringing on great people. As an example for an incredible team that we have currently in the company and that we are building. In the beginning of 2015 Dr. John Sninsky joined as Chief Scientific Officer to head our product development initiative. Dr. Sninsky is an expert in the diagnostic space with the wealth of experience. He has made significant contributions leading us through the product development milestones we hit this year. And we expect more to come. Now I’ll turn the call over to Ken.