Francis deSouza
Analyst · Evercore
Thank you, Jacquie. Good afternoon, everyone. Illumina had a great start to 2019, generating revenue of $846 million in the first quarter of 2019, up 8% from the same quarter a year ago, and our 10th consecutive quarter of consistent, strong execution. Additionally, this quarter represented the first time in Illumina’s history that our order volume exceeded $1 billion. We continue to see strong demand for sequencing consumables, with first quarter revenue of $481 million, up 14% from the same quarter a year ago. This performance was driven by growth in a broad range of applications across our sequencing system family. Over the last year, we have been working to increase visibility into the application growth drivers of our business. As a result, we are now able to share the approximate size and growth of a number of categories within our sequencing consumable business. We plan to update this on an annual basis with the understanding that these data points are directional. With the analysis complete, I'm pleased to share that about 40% of our sequencing consumable shipments in 2018 was associated with clinical applications. From largest to smallest, this includes testing for oncology, reproductive health, genetic disease, and other. This group includes IDD and LDC validation, in addition to clinical testing, and grew approximately 30% in 2018. Within clinical, oncology testing applications represented a little under 20% of our sequencing consumable shipments in 2018. Positive developments in the regulatory and reimbursement landscape are improving patient access to genomic profiling. For example, FoundationOne CDx received FDA approval in November 2017 and a national coverage decision for CMS in March of last year. Guardant Health has reported growing adoption of Guardant 360 following a favorable local coverage determination for select non-small cell lung cancer patients in September of 2018. This was the first finalized Medicare coverage policy for an NGS based liquid biopsy assay in oncology. Tempus has also seen growing demand for its oncology testing. Tempus combines Illumina sequencing with machine learning to provide physicians a comprehensive report that highlights key findings to support clinical decision making. Finally, in China, our partners that are extending their reach beyond NIPT and developing clinical applications including oncology. For example, Berry Genomics now offers comprehensive tumor gene detection for non-small cell lung cancer and breast cancer as well as TMP detection for many types of cancers. Also, in the first quarter, our TruSight Oncology 500 or TSO500 began shipping as a research use only product. This comprehensive genomic profiling assay is intended to complement the lab services offered by our partners. In the future, with the availability of a globally distributable IVD kit, TSO500 will enable labs of all sizes to offer a world class panel to their oncology patients. Reception has been strong and shipments exceeded our expectations in the first quarter. A number of partners in the US, China, and the UK have announced that they're offering the panel. We also saw strong NextSeq shipments linked to TSO500 in several geographies. The next largest contributor within clinical is reproductive health. In total, this group represented just over 10% of sequencing consumable shipments in 2018. Reproductive health applications include NIPT, in addition to a modest contribution associated with carrier and IVF screening. NIPT revenue includes VeriSeq NIPT as well as consumables supporting partners who offer their own NIPT or lab services. In the US, just over half of all pregnancies are now covered for NIPT, including 97% of high risk pregnancies and 47% of average risk. Despite this covered population of about 2.2 million pregnancies, only 1.2 million NIPT tests were performed in 2018. This highlights both the need for greater education among physicians and pregnant families, as well as the incremental opportunity for NIPT providers. In China, our partners continue to grow their businesses, and the region remains the fastest growing for reproductive health testing. With approximately 4 million tests conducted each year, representing about 25% of births, we remain optimistic about growth. In Europe, VeriSeq NIPT continues to perform well and delivered more than 50% revenue growth in the first quarter. Countries with notable updates included the Netherlands, associated with the progress of the ongoing TRIDENT study; France, now with national reimbursement for trisomy 21; and Germany, where a large lab network has adopted VeriSeq following a competitive render process. In total, our CE-IVD VeriSeq NIPT offerings sequenced more than 100,000 samples in the first quarter, which compares to over 300,000 in all of 2018. Looking to 2019 and beyond, we expect the reimbursement landscape to continue to improve. Finally, our clinical application shipments also include genetic disease testing, which represents a little under 10% of 2018 sequencing consumable shipments. This category captures genetic disease, including neurological, cardiovascular, metabolic, and autoimmune testing. Starting with genetic diseases, the clinical benefits of whole exome and whole genome sequencing for children and adults with undiagnosed genetic diseases are being studied more frequently than ever before. It's still early days, but hospitals, such as the Institute for Genomic Medicine at Columbia University Urban Medical Center, are increasingly incorporating genetic testing. This can help patients receive a faster, more accurate diagnosis, which could lead to changing treatment. In China, the government’s focus on precision medicine and life sciences has generated positive momentum for genetic disease testing. Last year, the government released its first national list of 121 rare diseases to improve resources for the diagnosis and treatment of patients with genetic disease. With growing awareness, independent clinical labs, such as KingMed are providing more genetic disease testing and diagnostic services in China. Their coverage is improving. For example, in the US, CMS’s final clinical lab fee pricing for clinical whole genome sequencing went into effect at the end of 2018. This prices whole genome sequencing at more than $5,000 for a single genome for patients with undiagnosed diseases, this has resulted in certain Medicaid programs covering whole genome sequencing. Additionally, the BlueCross BlueShield Association’s Evidence Street program recently endorsed whole genome sequencing to improve clinical outcomes for children and critically ill infants with undiagnosed diseases. This positive endorsement is the first health technology Assessment Review for whole genome sequencing to-date. Moving to research and applied, these applications represented approximately 60% of our sequencing consumable shipments in 2018 and grew approximately 18% from 2017. This category is split between genetic disease research, cancer research, cell and molecular research, and microbiology and other. Let me share a couple of examples. Researchers at the University of Copenhagen as part of a collaboration between Illumina and the Lundbeck Foundation are sequencing ancient DNA to understand mental health conditions, such as schizophrenia. Also, the single cell NGS market continues to grow rapidly in the field of cell and molecular biology research. Publications continue to grow about 40% per year and are addressing key questions in developmental biology, immunology, neurology, and cancer. Next, advancements in liquid biopsy and the desire to better understand and characterize tumors continue to fuel cancer research with the goal of improving patient outcomes. Finally, we're seeing growth among our CRO customers who are supporting discovery phased research ahead of clinical trials. Moving on, one focus area not included in these categories is population genomics. Depending on the objective of each program, population genomics revenue can be categorized as oncology or genetic disease in our research and applied category or more likely in the future oncology testing or genetic disease testing in our clinical category. Momentum continues to build in population genomics. In 2019, France launched the first two pilot sites of its population genomics initiative, which was initially focused on 12 indications. In the US, [indiscernible] has enrolled over 200,000 participants, which is targeting 150,000 arrays and 25,000 genomes in year one. And the Million Veteran Program continues its efforts to sequence the whole genomes of 78,000 veterans. The announcement of genomic [indiscernible] completing 100,000 genomes and the NHS incorporating whole genome sequencing into routine clinical care has generated strong momentum for others to ramp up their efforts. We continue to have productive conversations with population genomics initiatives around the world, most of which are still in the early planning stages. Countries in emerging markets, such as Saudi Arabia, Qatar, and Brazil, are now beginning to define the scope and priorities for their programs. Sequencing system revenue of $105 million was down as we expected following our record fourth quarter of 2018. NovaSeq orders were in line with our expectations, but timing of shipments pushed a handful of systems later in the year. Most of our first quarter systems were shipped to high seat customers beginning their transition to NovaSeq. Approximately one quarter of NovaSeq orders were new to Illumina are straight from desktop customers. We continue to see a broad range of customer size, location, and application. For example, one customer purchased NovaSeq to build out a microbiome business and another customer purchased NovaSeq to support research on single cell RNA, b cell a d T cell receptors and whole exome and genome sequencing. With the transition from HiSeq to NovaSeq progressing in line with our expectations, we have communicated to our customers that we will no longer be accepting HiSeq orders. As a result, we have seen a number of last time orders for refurbished HiSeq 4000s to be delivered throughout 2019. In the first quarter, we shipped six refurbished HiSeq 4000s. Separately, there were approximately 50 HiSeq decommissions in the first quarter. Our desktop family, which includes the NextSeq to the HiSeq continue to deliver strong results. NextSeq and MiSeq placements saw year over year growth. With NextSeq strength in part driven by the demand for TSO500. HiSeq’s affordability and accessibility continue to support customers across a wide range of applications, including on target CRISPR screening, environmental DNA sequencing, and 16S sequencing. Moving to arrays, total revenue of $147 million was up 11% sequentially. Array consumables were down 15% from the same quarter a year ago, with growth in non-DTC customers partially offsetting a larger than expected decline in DTC revenue. Array service and other revenue of $66 million was up 14% from the same quarter a year ago and reflected a record number of array samples. But revenue was lower than we expected when we guided back in January. Although we continue to see growth in DTC outside the US, we're factoring in even greater caution around the DTC business for the rest of 2019. The growth in DTC has been impressive over the last several years, with our US DTC customers creating new applications and now paving the way for the transition to higher value health-based offerings to extend the reach beyond their existing product portfolios. We believe the positive growth is transitional and expect growth to resume over time. Before I hand the call over to Sam, I'm excited to share that we have taken the next step forward in our relationship with Helix, so that it can operate as an independent company with no equity or board participation from Illumina. This will allow Helix to pursue new opportunities both in population health initiatives and for its marketplace. Former Illumina executive Marc Stapley has been appointed CEO. And we wish Marc and the Helix team all the very best of luck. Helix will continue to leverage Illumina technology, and as such, we look forward to sharing in their success. Sam?