Brandon Perthuis
Analyst · Piper Sandler
Thanks, Ming. We'd like to again express our sympathy to those who have been impacted by this terrible virus. It has been a difficult time for many families in our country in general. The spike in cases in testing that was predicted by medical experts to happen in the fall, indeed, became a reality. During the fourth quarter, we again saw lockdowns increase across many states, which did slow our momentum in our non-COVID-19 business. However, we have seen increasing strength in our business outside of COVID-19. Our non-COVID-19 business grew approximately 43% year-over-year in the fourth quarter. And we signed on over 15 contracts with new customers for services such as hereditary cancer, cardiovascular genetics, carrier screening and neurodegenerative genetics. During the fourth quarter, we worked tirelessly to increase COVID-19 testing capacity, maintain our best-in-class turnaround time and expand our testing footprint nationally. These efforts led to a quarter where we were able to service over 3 million patients with COVID-19 testing. At this time, we had the capacity to handle north of 100,000 tests per day across our 2 laboratories with the ability to continue to scale. During the fourth quarter, we handled accelerating volume while maintaining our best-in-class RT-PCR turnaround time, delivering approximately 90% of tests within 24 hours. We believe our ability to scale our business to roughly 228 times that of what we were handling just 1 year ago is almost unprecedented in our industry and is indicative of everything Fulgent represents. We are a technology platform company with the ability to excel in many areas of health care. We are a team of engineers, geneticists, genetic counselors and business operators with a fierce motivation to make Fulgent a dominant force. We have proven with our platform and infrastructure that we can run a laboratory that far outpaces many genomic labs in terms of efficiency and scalability, which translates to best-in-class growth in operating margins, which Paul will elaborate on in a minute. Early in the pandemic, our COVID-19 patient volume was concentrated around drive-through testing sites and was somewhat limited to select regions in and around Southern California. Today, our COVID-19 customer base is incredibly diverse with a national reach. At this point, we have direct agreements with 11 counties for our services, many large corporations, testing organizations, sports teams, sports conferences, cruise lines, hundreds of nursing homes and assisted living facilities, just to name a few. We announced during the fourth quarter an extension of our New York City Department of Education and test and trace contract. The New York City Department of Education selected Fulgent as a partner after evaluating a number of different COVID-19 testing providers through a competitive bid process. Our ability to retain this business through the 2021 school year demonstrates that our platform is not only capable of meeting the stringent needs of the school system, but our service in doing so resulted in a very positive customer experience for the New York City public school system. We believe we have built an incredible system for back-to-school testing, and we have now had months of experience and many thousands of students tested. We believe this early start in an emerging testing market will help drive additional opportunities for Fulgent. In fact, we are excited to announce we were recently selected by Clark County in the Las Vegas school district to be their back-to-school testing partner. We look forward to continuing to deploy our resources across the U.S. to help students return to school safely. One other exciting announcement, which Ming briefly mentioned, is that Fulgent was selected by the Department of Homeland Security as 1 of 4 labs chosen for a $2 billion, 5-year indefinite delivery, indefinite quantity contract for COVID-19 testing. This is the largest contract we have been awarded to date. We believe with our industry-leading turnaround time, capacity and delivery platforms, we have the ability to take on a meaningful portion of this contract and help our country's first responders stay healthy and safe. The demand for our RT-PCR COVID-19 test remains strong for both existing clients and new opportunities. We continue to build a robust sales funnel in a variety of different areas as the country continues to view testing as a critical tool to fight the virus and reopen our country, and RT-PCR remains the gold standard. While rapid tests are available and being used, they cannot replace the accuracy, meaning sensitivity and specificity, of RT-PCR. Many organizations, government entities and counties are requiring RT-PCR results. However, we do see an opportunity for rapid testing RT-PCR results to work together. To this day, many labs are struggling with turnaround time, which limits the usefulness of RT-PCR. However, we continue to provide results in generally less than 24 hours. We believe that fast RT-PCR test continues to be the best option for testing. We continue to monitor the situation regarding new mutations and strains of the virus. Importantly, we want to make sure our RT-PCR test can detect these new strains, which we have been able to do. Recently, there was information released by the CDC that warned that some of the new variants may be missed in testing and there were, in fact, some labs who had this issue based on the RT-PCR targets used. We are pleased to report that our RT-PCR test can detect the variants published to date. While almost all of our COVID-19 testing volume has been our RT-PCR-based, I'll remind you that we actually introduced a next-generation sequencing-based test prior to launching RT-PCR. We realized quickly that the rapid turnaround time of RT-PCR is critical in controlling the spread of the virus. Therefore, we did not commercialize the next-generation sequencing test as a diagnostic test. Fast forward to today, next-generation sequencing is now on the spotlight of this pandemic due to its ability to identify strains and mutations and screen for potential new mutations. We have now hit a perfect intersection of Fulgent's core competencies. We are primed and ready to take on massive NGS testing volume. With our sequencing capacity and expertise, we can handle approximately 10,000 NGS tests per day. We are currently working with local and federal government on genomic studies of this virus, which are just getting started. We believe our ability to offer both NGS and RT-PCR puts us in a leading position to partner with organizations doing these studies. Another key area of opportunity for us has been our Picture at-home COVID-19 test. This has proven to be an important differentiator for Fulgent and has helped many people by providing convenient access to testing. Picture is being used for employee testing, student testing, pretravel testing and athletes, just to name a few. Highlighting a couple of specific use cases. We partnered with the New York City and JetBlue to provide testing kits to travelers leaving New York airports during the holiday season in response to the testing travel mandates by the state. Also during the holidays, L.A. County launched a new COVID-19 home test collection program, which allows certain county residents to do complementary testing from home. The Picture platform is more than just a COVID-19 testing. It is a platform designed to change the way genomic testing and other testing is delivered. We believe patients become increasingly proactive in their health care and consumer-initiated testing will be a rapidly growing market. With the Picture platform seamlessly integrated with telemedicine, we are uniquely positioned to expand the service offering by adding many new tests in the future. We also believe we have dramatically expanded Picture's visibility and brand recognition due to the role the platform has played in COVID-19 testing. While COVID-19 testing has been unwavering in the demand on our business, we have continued to invest time and resources in our non-COVID-19 operations. We are excited to announce that we have launched a next-generation sequencing-based pharmacogenomic test. Our pharmacogenomic test will target 44 genes and more than 140 drugs to enable personalized dosing in health care and will determine if a patient is a rapid metabolizer of certain drugs or a slow metabolizer, adjusting dosing accordingly, or perhaps a different drug altogether could be recommended. While most pharmacogenomic tests are RT PCR-based and include limited targets and information, applying our expertise in next-generation sequencing allows us to unlock much more information and provide patients a more comprehensive report. We look forward to commercializing this product in 2021 and beyond. In addition to our new pharmacogenomic test, we continue to expand the number of disease-specific panels we offer and the number of conditions we test for it. As published in the NCBI Genetic Testing Registry, GTR, we now offer over 19,000 genetic tests, making the Fulgent menu one of the largest in the world. We intended 2020 to be the year we dramatically expanded our commercial sales team. However, COVID-19 threw an unexpected curveball. That said, we intend to dramatically increase our sales team head count by the end of 2021. We believe we now have the product menu, turnaround time and cost structure to drive significant expansion in the United States and overseas. In addition to a vastly expanded sales team, an important part of our go-to-market strategy has been increasing our managed care contracts. An incremental benefit of COVID-19 testing has been our increased exposure to payers. In the fourth quarter, we billed over 1.8 million more insurance claims than we did in the fourth quarter of 2019. We have become an in-network laboratory with several regional payers and now have close working relationships with several large national payers. We believe we will continue to make meaningful progress becoming an in-network provider for our services. Another opportunity for us is the extension of our software platforms to customers, which Ming briefly touched on. We recently launched 2 new software products, the Fulgent vaccine management platform and the Fulgent community testing software as a service product, with both -- which both leverage the testing platforms we have built to support our massive COVID-19 testing operation. The vaccine management platform is a layer added to our extremely successful technology platform, which is used by drive-through, walk-up and other testing operations. Now on the same web-based platform, patients are able to schedule their vaccination, pick a location, arrive, preregister with a QR code, get a digital confirmation of their first injection and reminders for their second. This will be a fee-per-click product. The second product, the Fulgent community software as a service, is a completely novel approach for us. Some counties and municipalities have their own laboratory and testing operations but lack the platform technology to scale and effectively manage testing. In this case, they can now take a license to our Fulgent community software as a service product. Essentially, it's a Fulgent front end, but instead of pointing the order to our laboratory, it will point it to our customers. This will be a subscription service built annually, along with a fee per click. We have a number of irons in the fire as we work to emerge on the other side of this pandemic, and we look forward to what the future holds for Fulgent. I would now like to turn the call over to Paul Kim, who will walk you through our fourth quarter and full year 2020 financial performance.