Earnings Labs

CareDx, Inc (CDNA)

Q3 2018 Earnings Call· Sat, Nov 10, 2018

$21.98

+0.59%

Key Takeaways · AI generated
AI summary not yet generated for this transcript. Generation in progress for older transcripts; check back soon, or browse the full transcript below.
Transcript

Operator

Operator

Greetings, and welcome to the CareDx Third Quarter Financial Results Conference Call. [Operator Instructions] As a reminder, this conference is being recorded. It is now my pleasure to introduce your host, David Clair with Investor Relations. Please go ahead.

David Clair

Analyst

Good afternoon and thank you for joining us today. CareDx has released financial results for the quarter ended September 30, 2018. The release is currently available on the company's website at www.caredx.com. Peter Maag, Chief Executive Officer and President; and Michael Bell, Chief Financial Officer, will host this afternoon's call. Before we get started, I would like to remind everyone that management will be making 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 1999. 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 2018 financial guidance and our examination of historical operating trends, expectations regarding coverage decisions, pricing and enrollment matters and our future financial expectations and results 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 other forward-looking statements whether because of new information, future events or otherwise. This conference call contains sensitive information and is accurate only as of the live broadcast today, November 8, 2018. This call will also include a discussion of a financial measure that is not calculated in accordance with Generally Accepted Accounting Principles. Reconciliation to the most directly comparable GAAP financial measure may be found in today's earnings release filed with the SEC. I will now turn the call over to Peter.

Peter Maag

Analyst

Thanks, David, and good afternoon, everyone. Thank you for joining us. We hear at CareDx, had another exciting quarter. In the last 12 months, we have provided 2% of kidney transplant patients in the U.S. with an AlloSure results. This quarter, we also achieved a significant financial milestone. We have reached our goal of positive adjusted EBITDA, a quarter ahead of plan. And the team achieved positive operating cash flow. Our strategy to bring high value diagnostic solutions to transplant patients is only beginning to bear financial fruit, and we anticipate continued progress on both of these measures in coming quarters. This afternoon, I will provide an update on the recent achievements across our businesses, Mike will then provide additional financial details on our third quarter performance and discuss our 2018 guidance. It's great to see the acceleration of our top line. With total revenues growing 74% year-over-year to $21.2 million driven by 106% year-over-year increase in testing services revenue. Our third quarter adjusted EBITDA was positive at $0.2 million. The team achieved this one quarter ahead of plan. AlloSure remains the biggest contributor to our robust growth. Penetration of transplant centers is ahead of plan and standing order patient levels are phenomenal. AlloSure's positioning and market acceptance continues to improve and should enable us to deliver continued growth in the quarters and years ahead. At the end of the third quarter, 96 centers had provided AlloSure results to their transplant patients since launch. These 96 centers represent just over 60% of the transplant volume in the United States. CareDx provided 3,708 AlloSure patient results in the third quarter to approximately 2,800 kidney transplant patients. Overall, reimbursement was consistent with previous quarters, with 70% to 80% of our AlloSure volume attributed to Medicare patients. Demand for AlloSure continues to be…

Michael Bell

Analyst

Thank you, Peter. Turning first to the income statement. Our third quarter 2018 testing revenue increased 106% year-over-year to $16.8 million. Our 2018 third quarter testing revenue includes AlloSure volume of 3,708 tests, a 6% AlloMap volume increase from the prior year quarter to 4,080 tests and January 1, increase in the AlloMap Medicare reimbursement rate from $2,840 to $3,240. We continue to be very pleased with the revenue and the momentum of AlloSure following the launch, with test trajectory remaining ahead of our initial plan. Our third quarter product revenue increased 9% year-over-year to $4.2 million and as such, total revenue in the third quarter 2018, was $21.2 million, representing a 74% increase compared to the prior year's $12.2 million. For the third quarter of 2018, net loss was $20.0 million compared to a net loss of $14.3 million in the same period of 2017. Our net loss per share was $0.54 for the quarter compared to $0.63 in the third quarter of 2017. Our third quarter net loss includes the $17.1 million charge for the change in our current stock warrant liability. This charge was incurred because warrants were excised during the third quarter and in addition, there was an increase in the estimated fair market value of warrants that were not exercised. For the third quarter 2018, our non-GAAP net loss was $0.6 million compared to a non-GAAP net loss of $3.3 million in the same period of 2017. Our non-GAAP net loss per share in the third quarter of 2018 was $0.01, compared to $0.15 in the same period of 2017. As a reminder, we defined adjusted EBITDA as non-GAAP net loss before interest, income tax, depreciation, amortization, other expense and net loss attributable to non-controlling interests. For the third quarter of 2018, adjusted EBITDA was…

Operator

Operator

Thank you. We will now be conducting a question and answer session. [Operator Instructions] Our first question comes from Bill Quirk with Piper Jaffray. Please go ahead.

Bill Quirk

Analyst

Congratulations on just an outstanding quarter guys.

Peter Maag

Analyst

Thank you very much, Bill. You following the company for years that our comments has been similar to us. Thank you.

Bill Quirk

Analyst

My pleasure. So first off, I'd like to start the question that I actually pose to Mike last quarter. And it concerns the 2019 guidance, which at that time was called aspirational, albeit very early in the launch, and now you’re into it, it quite candidly looks kind of conservative. So Mike, what are your kind of longer-term thoughts here?

Michael Bell

Analyst

Well, though thanks for raising this one again. We're still not providing 2019 guidance at the moment. But I would say that our focus is still on the AlloSure commercialization. And based on our results to date this aspirational $90 million to $100 million, I'd say we're very confident on our ability to hit that goal. So yes, we're feeling confident on that.

Bill Quirk

Analyst

Okay. Fair enough. And then, Peter, couple of questions for you. One, very nice to see continued centered growth. It looks, if I'm doing the math right here that you’re probably on about 83 or so of the top 100 centers. Have you -- maybe can you talk to us like there's two things; one, is when you’re calling in these centers, has anyone rebuffed you or rebuffed the sales efforts so I’d be curious as to why? And then secondly, can you talk a little bit about some of the test usage for patients that are outside of the standing order group, or are we seeing a lot of dabbling by physicians or are we seeing some patterns emerge even though they're not efficiently in the standing order count? Thank you.

Peter Maag

Analyst

Bill, thank you very much. And two very excellent questions. Given that we're 12 months in, I think we have started to see some patterns in transplant centers. That we are happy to be sharing with you, but it's still somewhat early in the launch. Of the 96 centers that they have been using the AlloSure since the beginning, yes, there are some centers that have used AlloSure a couple of times and have not reordered. That is just very natural. You call them dabblers and we call them dabblers as well. These are the clinicians that would like to be ordering the test and see what it does. We continue to be very focused on the standard use of AlloSure in a significant portion of the patients. And that’s why the K-OAR registry is so important. The number of 40 centers have adopted now K-OAR protocol is really indicative of the value that this can bring to the community. Our strategy has been, get the foot in the door with one or two tests, then establish K-OAR and then from K-OAR, expand the center into multiuse. So of the 96 centers to be more specific, I think 10% to 20% of these centers are really the higher frequency users. And then, there as a substantial number of centers that are in the K-OAR sites, that would be the 40 centers that I've been talking about. And then, there is a tail of centers, that are very, very early in adoption and very few that are -- have just ordered a couple. I don’t think there is a pattern that I would be able to point towards that if they discontinue, they have discontinued for some kind of a reason. It's very individual reasons.

Bill Quirk

Analyst

Okay. Got it. And then, last one for me, and I guess, it's back to Mike. Any update on the commercial side? I wouldn’t -- I guess, I wouldn’t expect still early in the launch that we would see some positive medical policy decisions or anything like that? But just curious to see if you're getting paid by any commercial payers? Are you having discussions with any? This is something -- maybe on the other hand that we should just not be considering as we're adjusting our models? Thank you.

Michael Bell

Analyst

Yes, Bill. We continue to get paid, I’d say on a ad-hoc basis by some of the commercial payers. And we don't have any coverage decisions from any of those payers yet. We’ve still not opened up any dialogue with any of the payers because even now, the level of volume that we got with any one particular payer probably isn't enough to open that dialogue. So we'll be starting to do that in 2019. And so I would continue to include a model of very conservative reimbursement for commercial payers.

Bill Quirk

Analyst

Perfect. Thanks a lot guys. Congrats again.

Michael Bell

Analyst

Thanks.

Operator

Operator

Our next question comes from John Hsu with Raymond James. Please go ahead.

John Hsu

Analyst · Raymond James. Please go ahead.

Good afternoon and nice quarter, guys.

Peter Maag

Analyst · Raymond James. Please go ahead.

Thank you very much, John.

John Hsu

Analyst · Raymond James. Please go ahead.

Excellent. I guess, if we could just start with HeartCare. I know it's still early on, but are you seeing any positive signals in terms of the AlloMap side of things from HeartCare?

Michael Bell

Analyst · Raymond James. Please go ahead.

I would say that the 6% volume growth in the third quarter is good volume growth. But it's really not attributed to HeartCare roll out yet. It's -- we are very early. We have a few centers that are signed up now into the SHORE registry study. We'll be communicating on that in the fourth quarter call. But take the 6% as our mid-single digit type of volume growth that we had anticipated for AlloMap and we continue to track against that, and HeartCare will continue to drive that mid-single digit volume growth going forward, which is basically driven by an increase in utilization and adoption of our routine surveillance protocol as one of our problems -- or there's been an AlloMap that we have a good penetration in a number of centers and good penetration for patients. But not as frequent use of AlloMap per patient. And so HeartCare should really help there.

John Hsu

Analyst · Raymond James. Please go ahead.

Okay, great. Then, just a quick one on the guidance. It looks like at the low end, it does imply that you would actually decelerate from a revenue standpoint in the fourth quarter. So just want to make sure there is nothing that you're that makes that any more likely?

Peter Maag

Analyst · Raymond James. Please go ahead.

Yes. John, I think one thing that we just wanted to always point out is that, third year is usually -- third quarter sorry, of the year is usually the highest volume in the transplant centers during the year. And so, traditionally, Q4 would be a lower than that for AlloMap for example, and there's holiday days. So we'll just be mindful of the slight seasonality that we have on the quarters.

John Hsu

Analyst · Raymond James. Please go ahead.

Okay, great. And then, just last one for me, I'm sure you saw one of the competitors who is -- wants to make an entrance in the space, they just announced pre-submission meeting with CMS. So any thoughts on when they can get reimbursement? I guess, maybe the second part of the question is, regarding your early comments on kind of building a mole [ph]. How do we think about maybe switching costs from either a protocol or other standpoint between you and potentially another cell-free DNA technology? Thank you.

Michael Bell

Analyst · Raymond James. Please go ahead.

Well John, thank you very much for highlighting that. I am probably the second best to comment about the reimbursement efforts. I think in historical, it has taken molecular diagnostics, a significant amount of time to go through the reimbursement process. And we have had a good success with having interactions on the -- with the respective reimbursement authorities. So I think, I will let other companies to point out on their reimbursement timelines, which in the past when I -- when I heard others talking about, it might have been very, very aggressive. And so, I'll let them talk about the time length. On the other element -- just forgive me, what was the second point that you were making?

John Hsu

Analyst · Raymond James. Please go ahead.

Just, how do you think about maybe the motor switching costs associated with AlloSure?

Michael Bell

Analyst · Raymond James. Please go ahead.

I think it's clear that, for me, a switching cost of a standing order patient is extremely high. So I think once we -- you see a patient having a standard script for a 12 months' time or standing order for 12 months' time, switching would be extremely difficult. Once the transplant centers have adopted the new technology, and I'm speaking there from experience in pharmaceuticals, it's incredibly difficult to display, albeit in other product in that center. So I would say that, there is a significant value of having a first mover advantage in being part of that mode. And how to translate this into switching costs. I'm not sure to numerically do that but our goal has been to penetrate very quickly and very specifically in those and that the number of 96 transplant centers within 12 months, I think speaks for itself.

John Hsu

Analyst · Raymond James. Please go ahead.

Excellent. Thank you very much.

Operator

Operator

[Operator Instructions] Our next question comes from Yi Chen with H.C. Wainwright. Please go ahead.

Unidentified Analyst

Analyst · H.C. Wainwright. Please go ahead.

This is Julian on for Yi. Thanks for taking my question. I'm sorry, if I missed it, but can you talk about what is driving the higher than previously guided 2018 revenue? Maybe more specifically, was there a test with volume higher than previous expectations? And if you could give us a sense of how durable this trend might be going into 2019, that will be very helpful?

Michael Bell

Analyst · H.C. Wainwright. Please go ahead.

Yes, this is Mike. I think the main driver for the increase in the revenue guidance is AlloSure. It continues to exceed expectations each quarter. And so that’s the key driver. And so now again, we’ve set revenue guidance for the remainder of the year based on how we see the business at the moment and what we think will be at the end of the year.

Unidentified Analyst

Analyst · H.C. Wainwright. Please go ahead.

Okay. Great. And my last question, I was just curious, how should we be thinking about operating expenses in 2019. Are you able to give any guidance on that at this time?

Michael Bell

Analyst · H.C. Wainwright. Please go ahead.

No, we’re not giving any guidance on that at this moment.

Unidentified Analyst

Analyst · H.C. Wainwright. Please go ahead.

Okay. Thanks very much.

Operator

Operator

There are no further questions. I would like to turn the floor over to Peter for closing comments.

Peter Maag

Analyst

Well, thank you very much for joining the call. We look forward to updating everyone as we continue to commercialize AlloSure, grow AlloMap and our transplant product business and building our initial profitability. Thank you very much for joining this call. Thank you.

Operator

Operator

This concludes today's conference. Thank you for your participation.