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CareDx, Inc (CDNA)

Q2 2017 Earnings Call· Thu, Aug 10, 2017

$21.98

+0.59%

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Transcript

Operator

Operator

Good day, ladies and gentlemen, and welcome to the CareDx 2017 Second Quarter Financial Results Conference Call. At this time, all participants are in a listen-only mode. And later we will conduct a question-and-answer session and instructions will follow at that time. [Operator Instructions] As a reminder, this conference is being recorded. I'd now like to introduce your host for today's conference Mr. Mark Klausner of Westwicke Partners. Sir, you may begin.

Mark Klausner

Analyst

Thank you for participating in today's call. Joining me from CareDx are Peter Maag, President and Chief Executive Officer; and Michael Bell, Chief Financial Officer. Earlier today, CareDx released financial results for the quarter ended June 30, 2017. The release is currently available on the Company's website, www.caredx.com. Before we begin, I'd like to remind you that management will make statements during this call that include forward-looking statements within the meaning of federal securities laws, which are made pursuant to the Safe Harbor provisions of the Private Securities Litigation Reform Act of 1995. Any statements contained in this call that are not statements of historical facts should be deemed to be forward-looking statements. All forward-looking statements, including without limitation, our examination of historical operating trends, expectations regarding converge decisions, pricing and enrollment matters and our future financial expectations are based upon current estimates and various assumptions. These statements involve material risks and uncertainties that could cause actual results to differ materially from those anticipated or implied by these forward-looking statements. Accordingly, you should not place undue reliance on these statements. For a list and descriptions of the risks and uncertainties associated with our business, please see our filings with the Securities and Exchange Commission. CareDx disclaims any intention or obligation except as required by law to update or revise any financial projections or forward-looking statements whether because of new information, future events, or otherwise. This conference call contains time-sensitive information and is accurate only as of the live broadcast today, August 10, 2017. I will now turn the call over to Peter.

Peter Maag

Analyst

Thanks, Mark. Good afternoon, everyone, and thank you for joining us. I'll be talking to you through our business updates focusing on the continued growth of AlloMap, the exciting launch preparation of AlloSure, and the EBITDA focus of Olerup, and then let Mike go over our financial results. Last month you might have seen the news that we provided our 100,000 AlloMap patient result. We are thrilled that we have been able to provide a non-invasive testing solution for so many heart transplant patients, nearly 20,000 patients so far and we are proud of the fact that we are the standard of care for monitoring the probability of transplant rejection. We continue our activities that are aimed at increasing AlloMap adherence. Many centers include AlloMap in this surveillance protocol for heart transplant patients. We launched a program that provides patient coordination services to schedule protocol AlloMap test and alpha convenient phlebotomist solutions including home blood draws. We mentioned on our last quarterly earnings call that we ran pilot studies in three centers and planned to be in 10 centers in the second half of the year. I'm pleased to report that we are currently in nine centers. And we previously mentioned our goal of driving AlloMap underlying volume growth toward the 5% to 10% range. And we are pleased with the progress being made under this patient service program. We participated in a recent meeting in CMS where the clinical lab fee scheduled for 2018 has been discussed. Based on comments made at that meeting, we continue to believe that the implementation of PAMA pricing for 2018 is very likely with the announcement of the new rates as early as September. We anticipate that this will have a positive effect for CareDx, since PAMA will create more certainty on pricing…

Michael Bell

Analyst

Thank you, Peter. This has been my first full quarter with CareDx and I'm very happy with our progress, as well as focusing on the AlloSure launch. This quarter we've also made significant progress with our balance sheet. On the last call, we said we were in discussions to restructure our obligations with the form of majority shareholders in Sweden and I'm very pleased that in July, we reported that we were successful with this effort. As we announced we were able to restructure the obligations and deferred payments from July 2017 all the way out to March 2019. In addition, we're working hard to drive the Company towards profitability and impact of this effort was that net cash used in operations was $3.2 million this quarter. This was a dramatic improvement of the Q1, which had an operating cash burn of $6.7 million. With our cash room way significantly improved and our ability to leverage our existing commercial and laboratory infrastructure for AlloSure, we now have the financial flexibility to get well beyond the October launch of AlloSure. Turning into the P&L, second quarter 2017 revenues was $12 million compared with $10.7 million in the second quarter of 2016. The year-over-year increase in revenue reflects the same three drivers we saw in prior quarters. Firstly, Olerup contributed revenue of $3.4 million in Q1. I know that we completed the acquisition of the Olerup business in April 2016. Secondly, AlloMap U.S. tests volume grew 7% in the second quarter of 2017, compared with the second quarter 2016. Thirdly, I'm pleased to disclose that we continue to improve our internal billing and collections processes. These improvements were reflected in the $8.7 million AlloMap cash collected this quarter compared to $706 million in the previous quarter. These two AlloMap relates to driver resulted in our AlloMap revenue of 8.4% million in Q2, up from $7.2 million in the prior year period. For Q2 our non-GAAP net loss was $3.6 million compared to a non-GAAP net loss of $4 million in the same period of 2016. Turning to guidance for 2017, we've tightened our revenue expectations to be in the range of $46 million to $49 million. Our guidance is based on AlloMap and Olerup revenue and excludes any potential revenue from AlloSure. I'll turn back the call to Peter for closing comments.

Peter Maag

Analyst

Well, thank you very much Mike, great to have you on board. We appreciate you joining the call. We are now happy to address any questions.

Operator

Operator

Thank you. [Operator Instructions] Our first question comes from the line of Bill Quirk of Piper Jaffray. Your line is open.

William Quirk

Analyst

Hi, good afternoon, everyone. Bill Quirk from Peter Jaffray, I guess is where I'm working today. Peter, first question for you, the common period for the LCD ended on July 30, can you talk about any kind of initial feedback from Noridian or Palmetto?

Peter Maag

Analyst

Feedback and communication with our Palmetto and the MolDX program has been excellent. This is Peter Maag from CareDx at this stage. It has been truly excellent. And the communication with the team has been good. We're now in the process of finalizing the coverage and the data development registry commitment and then go into the pricing negotiations. I'm very pleased to mention under the sideline that we filed our pricing dossier already with them, so we're well in line for the October launch.

William Quirk

Analyst

And then Peter just on that last point, can you elaborate a little bit on pricing. Obviously this is an NGS based assay versus real-time PCR for AlloMap. So help us think a little bit about - I guess pricing discussion have yet to happen, but any kind of early indications or anything that you can give us around pricing would certainly be the most welcome. Thank you.

Peter Maag

Analyst

I think you really get the CareDx experience with AlloMap is coming to fruition. We have a great platform in place, leveraging our existing relationships. This is truly a high value diagnostic test as you were mentioning Bill. It's sequencing based. So when Palmetto normally looks at these products, they're looking at three, four important components. One is, what are the analog test in the space? And for of post-transplant surveillance test, it's really AlloMap that is a very good analog when considering pricing of a post-transplant surveillance solution. When they look at the cost, you were mentioning what it takes to develop and bring those tests to make it available to patients. We have a very clear understanding. For us that CareDx was roughly $50 million that we spend on developing the AlloSure test. So a substantial effort went into the development of this product. And then when they're looking at the health economic data, we and post-transplant care really have a little effort here to demonstrate these noninvasive solutions are so far superior to the current surveillance solution provided that our health economic data is always very robots and builds the case for an AlloSure and then AlloMap to be included in the regimen for these patients.

William Quirk

Analyst

Thank you. And then Peter maybe just a word on some of your last comments there. You talked about seven AlloSure test in your one following transplants and then test shifting to a quarterly methodology thereafter. Could you just elaborate a little bit on how you settled on seven? And then if we think about thereafter piece of that, obviously part of - with AlloMap has been challenged to kind of keep those patients on the test kind of once we get a few years post-transplant, because they tend to stabilize. Can you help us think a little bit about what we can do differently here with AlloSure to make sure that we maintain them as patients for a much longer period of time?

Peter Maag

Analyst

Super question. And it's really that's why I mentioned it. I think the ARS protocol, as we call it the AlloMap routine scheduling protocol. This is very important for us to establish. Why did we come up with this number? We saw this in our DART trial as a good way of monitoring these patients. And so we have this seven AlloSure in the first few post-transplant and then the quarterly follow-up as the routine protocol. So we have the experience with DART. We have the experience with AlloMap. Normally these AlloMap's are perfectly in a perfect protocol administered. And then thirdly, we also looked at the KDIGO guidelines. These are the guidelines that are currently established for follow-up of these kidney transplant patients. And these guidelines actually call for a very frequent follow-up especially with serum creatinine. So AlloSure will nicely match into these guidelines. Your last question, I think is a very important one. So what does CareDx do to make sure that these patients are followed up with us? And it's really two things that we mentioned on this call. The first one is we established this routine testing protocol with our registry study. So think of the registry study, it's really a great launchpad on how to use the product. And secondly, we mentioned also our efforts in the AlloMap scheduling service, which will extend into the AlloSure scheduling service where CareDx has been an active contributor to making sure that these patients are compliant. Compliance being a key issue for these transplant patients and we'll address it directly with our service.

William Quirk

Analyst

Okay. Very good. And then just one last one if I could squeeze it in Peter. Given the QTYPE launch, maybe a word on why Olerup was down sequentially?

Peter Maag

Analyst

The Olerup business is really three product lines, the SSP product, the traditional sequencing and then the QTYPE, PCR solution. The PCR solution is ramping up, really big ABI validation is that the core here. We'd love to get that off the ground much quicker. So we're a little bit behind on the QTYPE rollout based on the delay in validation now on the ABI. When you see the overall market potential for HLA testing, there is a significant opportunity for market share gains and that's what we're modeling going forward based on our QTYPE launch. So the Olerup business is probably flattish right now. As we drive this to growth will have a really strong bottom line focus on this business.

William Quirk

Analyst

Great, thank you very much.

Operator

Operator

Thank you. Our next question comes from the line of Kevin Ellich of Craig-Hallum. Your line is open.

Kevin Ellich

Analyst

Good afternoon, Peter. Thanks for taking the questions. Bill asked a lot of good questions and - Piper Jaffray actually. As for your comments about visibility on the 10,000 AlloSure tests over three years in the fall of studies. Just wondering what sort of revenue visibility do you get from doing that post-launch study to be something about $1,500 of test?

Peter Maag

Analyst

This registry study will be actually tailored to Medicare patients. So yes, these tests would be reimbursed under the Medicare regimen and depending on the reimbursement that we achieved with Medicare on AlloSure, the $1,500 is a good benchmark

Kevin Ellich

Analyst

That's helpful. And then sure we understand that 80% of the kidney transplant patients who have Medicare is their primary, secondary insurance? We sell a small portion that will be on commercial. How should we think about commercial reimbursement for AlloSure and had you started any of those discussions?

Peter Maag

Analyst

Our reimbursement efforts are laser sharp focused at the 80% opportunity, which is the Medicare reimbursement. We have had discussions because we have these discussions on a regular basis based on AlloMap and will include AlloSure on into these contracts as the opportunity arises. It's good to have these established relationships with these payers. So we're not coming new to the table. But really our primary focus right now is the Medicare reimbursement, since it's 80% of all the patient population. Keep in mind that many diagnostic tests actually never go beyond the 80% reimbursed test line at all. So we have a huge opportunity just right out of the gate.

Kevin Ellich

Analyst

Gotcha, that's helpful. And then just two quick ones for Mike, Mike you talked about improved cash collections. Just wondering what you guys are doing to improve? We have new cycle management. And lastly what's the cash burn and kind of cash utilization? How should we think about that going forward?

Michael Bell

Analyst

Yes, sure Kevin. On the revenue cycle management, we've put in new head of billing and collections in place. We've been improving our processes. We've been doing a lot of work to focus on getting the claims out quicker and following up with appeals a lot quicker and we did have a backlog. So we're steadily clearing that backlog. I would say now we're at a point where it's sort of business as usual. We've got the processes well in place and we're working pretty efficiently. There's still room for improvement. But I'm pretty happy with where we are. From a cash burn perspective, I just mentioned our cash burn in operations was $3.2 million this quarter, which was a dramatic improvement from the prior quarter. And we're looking at a similar cash burn for the next few quarters and in our 10-Q, we put in an estimation that the current cash that we have will go through to March 2018.

Kevin Ellich

Analyst

Great, thanks guys.

Operator

Operator

Thank you. [Operator Instructions] Our next question is from the line of Nicholas Jansen of Raymond James. Your line is open.

Nicholas Jansen

Analyst

Hey, guys. Congrats on a good quarter. Most of mine have been answered, but maybe one or two follow-ups. First in terms of the gross margin comments, around it's how much that Roche royalty is currently being paid and how do we think about the timing of when that rolls off? Is that 3Q or 4Q?

Peter Maag

Analyst

It's really the - in September timeframe. So think off this is being still in our third quarter numbers, but then rolling off into the fourth quarter. So the 65% gross margin for AlloMap is a realistic number, especially as we then go into launching AlloSure and sharing some of the overhead expenses into multiple products.

Nicholas Jansen

Analyst

That's very helpful. And then my question just in terms of the 100 or so transplant centers that do a majority of the kidney transplant. Maybe just talk us to your strategy and discussions with those right now, obviously there's a lot of overlap with heart transplant customers. So maybe just talk as to how you've been kind of doing dialogue with those, what's the timeline of - how quickly those 100 should ramp up, just trying to get your thoughts on pre-commercial activities? Thanks.

Peter Maag

Analyst

Absolutely, excellent question again and we actually shifted the field force in - as of July 1, 75%, 25% in terms of 75% focus on AlloSure, 25% on AlloMap. So we were in focus pre-launch phase. We targeted 140 centers in July and have now consolidated that number down to 90, which identified key interest in AlloSure. Actually 35 of these centers are keenly interested. So we feel very valid advanced on this very concentrated strategy on getting key senders interested into AlloSure. Being interest in AlloSure is not yet a conversion. But given that we'd like to launch this product at 35 key centers with [indiscernible] registry, which we recruited into in January. You kind of get the strategy being very tailored, very focused on key centers making sure that they adopt AlloSure according to the AlloSure protocol.

Nicholas Jansen

Analyst

Great, thanks for the color. I'll hope back in queue. End of Q&A

Operator

Operator

Thank you. This concludes the question-and-answer session. I would like to turn the call back to Peter Maag for closing comments.

Peter Maag

Analyst

Well, thank you so much for joining the call. We'll continue to keep you updated as we are progressing towards an exciting AlloSure launch and as we're making progress in the business. Thank you very much for joining us today.

Operator

Operator

Ladies and gentlemen, thank you for your participation in today's conference. This does conclude the program. You may now disconnect. Everybody have a great day.