Francis deSouza
Analyst · Evercore ISI. Your line is now open
Thank you, Jackie, and good afternoon, everyone. A few weeks ago, we reported second quarter revenue, which fell short of our expectations. We are very disappointed with this and I would like to take the next few minutes to walk you through the components of the shortfall and the actions we're taking as a result. Consistent with our pre-announcement, second quarter revenue of $838 million was impacted by three factors: the timing of population genomics initiatives; lower than expected DTC revenue; and lower than expected revenue associated with our non-high throughput portfolio. Now that we've had time to analyze the quarter, I would like to share our insights into each of these factors. But before I do, I want to be clear that none of the contributors to our miss in Q2 challenge our conviction about the market, the broad and unbounded genomics opportunity or the competitive position of our technology. Addressing each contributor in turn. First, as we support a growing number of population genomics programs. It is becoming clear that the ramp in the early phases can vary dramatically from expectations. In 2019, due to a number of logistical factors, we saw several programs ramp more slowly than projected, delaying revenue in the second quarter and throughout 2019. To reflect more variable timelines, we are now allowing for slower ramp up trajectories in our forecasting. Next, the ongoing weakness in the DTC market has resulted in a significant shortfall in our array business. We have previously based our DTC expectations on customer forecasts, but given unanticipated market softness, we are taking an even more cautious view of the opportunity in the near term. With limited visibility and when the market will return to growth, we have lowered our full-year expectation substantially to reflect the near-term uncertainties. And lastly, in our analysis over the last four weeks, we have found no consistent contributors to the non-high throughput sequencing and consumables miss. No single theme emerged. Rather, we determined that the miss was linked to a number of customer, program or product-specific factors that routinely impact every quarter, sometimes positively and sometimes negatively. In the case of the second quarter, the net effect of these shifts was negative, but we do not believe indicative of any fundamental changes in the business. Given the revenue shortfall, we're looking carefully at operating expenses to ensure we are spending appropriately through the rest of 2019, but rest assured, we will always prioritize innovation. In summary, with the exception of the transition in DTC, we do not see any structural or fundamental change in the genomics opportunity. We continue to believe that we are in the early stages of a thesis that will play out over the next decade or more. We're confident that Illumina is well positioned to keep playing an important role in improving human health by helping our customers unlock the power of the genome. Sam will get into the details of our financial results, but I'm going to start by focusing on growth drivers. This was a strong quarter for oncology testing, driving growth in both sequencing consumables and systems. While these are still early days, it is increasingly clear that genomic information will transform the standard of care for oncology patients. In the U.S., more than 200 million lives are covered by insurers for targeted or comprehensive genomic testing, and yet of the 18 million cancer patients that were diagnosed in 2018, only a low single-digit percentage of patients who have their tumor sequenced, highlighting the substantial opportunity ahead of us. Researchers and scientists around the world recognized the need for more-personalized therapies, evidenced by the growing number of targeted and immuno-oncology or IO therapies. In 2018, we saw a 67% increase in the number of experimental therapies in the global IO pipeline, and it's estimated that there are over 1,600 clinical trials currently registered for immuno therapies. In fact, in 2018, 12 new drugs were launched with a predictive biomarker, nine of which were approved for oncology indications and four launched with companion diagnostics. Regulatory bodies are also working closely with the industry to help accelerate the introduction of novel drugs and diagnostics to the market. In the last two years, the FDA has granted Breakthrough Device Designation for eight genomic assays, including our companion diagnostic assay based on TSO 500 content. Data continues to emerge on applications for early detection, therapy selection and recurrence monitoring, highlighting the opportunity ahead. With the continued emergence of new genomic biomarkers, it is clear that comprehensive genomic profiling or CGP will offer the best insights to improve patient outcomes. Earlier this year, we launched TSO 500 RUO, our 523 gene assay that includes detection of emerging bio markers such as TMB and MSI. With TSO 500, customers can detect both DNA and RNA variance, which is key for Comprehensive Detection of both known and novel fusions. For example, NTRK Fusions cause cancer across many tumor types and can have multiple fusion partners. So TSO 500's ability to detect novel fusion partners with its hybrid capture enrichment method is crucial to identifying actionable mutations. We have received positive feedback on the robustness of the panel and several customers have become - have begun validating our offering TSO 500, including global CROs. We are pleased to share that TSO 500 performance and demand has exceeded our expectations. We continue to partner with three pharma companies to develop a companion diagnostic or CDx for indications associated with NTRK, RET and TMB. Over time, we believe more partners will leverage TSO 500 to identify actionable mutations for additional CDx indications. Recently, the National Comprehensive Cancer Network updated their prostate cancer guideline with new recommendations, stating NGS is the preferred method when testing patients' MSI status for Lynch syndrome or eligibility for pembrolizumab in castration-resistant prostate cancer. Additionally, the guideline was updated to include NGS as an option when germline testing is recommended. This is a notable development and evidence that NGS-based testing is improving the standard of care. We're excited that our TSO 500 assay could enable testing for both germline and MSI requirements with a single tissue sample. In the second quarter, more than 10 NovaSeq systems in the U.S. were associated with CGP, our liquid biopsy customers. Most of these went to customers scaling their NovaSeq operations, but four systems went to first-time NovaSeq customers, highlighting that oncology testing is starting to move firmly into the realm of high throughput. Genetic testing is also showing momentum, five children's hospitals in the U.S. added NovaSeq this quarter to perform pediatric genomic testing. It's estimated that up to 14% of all pediatric hospital admissions are driven by a genetic condition, because genomic testing is the only way to diagnose some conditions. This equips physicians with the ability to save children and their parents a painful and expensive multi-year diagnostic odyssey. Leveraging the success of Rady Children's Hospitals in genetic disease testing, other hospitals are looking to implement genomics in the pediatric setting. Notably, Florida is funding clinical whole-genome sequencing for critically-ill children at the Nicklaus Children's Hospital in Miami. In the U.S., more than 150 million lives are covered for whole exome sequencing for patients suspected of a genetic disease. And yet, we believe less than 1% of eligible patients have had their exome or genome sequenced. Just recently Blue Shield of California updated their medical policy to cover rapid whole-genome sequencing for children with undiagnosed disease. This is a huge milestone making Blue Shield of California the first major Blue Cross Blue Shield plan to cover whole-genome sequencing following the positive health technology assessment review from Evidence Street earlier this year. Moving to reproductive health. We continue to see NIPT expand its reach in both high risk and average risk pregnancies. We see the largest opportunities in the U.S. and in China, where we currently estimate a combined penetration of only 30%. This means that around 70% or just under 15 million births a year could benefit from access to NIPT. In the EU, less than 15% of pregnancies are covered, and we're seeing steady progress on improving coverage. In connection with continued momentum and reimbursement tailwinds, NIPT had a record revenue quarter with growing awareness and adoption. In Europe, customers of our CE-IVD, VeriSeq NIPT products processed nearly twice as many samples in the second quarter compared to the same quarter last year, driven by the positive reimbursement environment and growing awareness of NIPT benefits. We are very excited to see this level of demand for NIPT and believe continued innovation will drive further growth in adoption. Just last month, we launched the expanded version of VeriSeq NIPT, which is a CE-IVD test that offers the most comprehensive view of the fetal genome compared to other CE-IVD NIPT products. VeriSeq version 2 adds carrier type resolution across the genome, significantly increasing the number of chromosomal abnormalities that can be detected. We're seeing strong interest and expect to upgrade the majority of our partner labs to VeriSeq v2 within a year. Turning to population genomics, we have seen have seen no change to the level of commitment that governments and other stakeholders have shown towards these projects. In fact, the overall population genomics thesis has not changed. Large scale population initiatives offer the opportunity to personalized medicine and improve the overall standard of care to ensure the optimal clinical and economic outcomes for patients. They allow pharma companies to develop more effective therapies and accelerate the time from discovery to market. And they offer the promise of deepening our understanding of the human genome for the benefit of all. It's therefore no surprise that we continue to see a growing list of countries, health systems and pharma companies announcing commitments to large scale genomics initiatives. As expected, these are complex programs with many stakeholders, and therefore, it can take years to gain critical mass and ramp in volume. In 2019, we have seen how these large initiatives can have moving timelines. Let me share some insight into the programs that have impacted the most in the near term, but continued to give us confidence that large scale genomics initiatives will be a long-term growth driver. First, the large deal that we expected to close in the second quarter was one that involved a number of stakeholders. The delays associated with final alignment between all the parties before they can sign off, but it continues to move forward. Second, we have decreased our full-year expectations linked to the All of Us program here in the U.S. due to some risk and the timing of the launch of the 25,000 whole-genome pilot. To be clear, we believe there is no shortage of samples are funding, rather we understand the program is in the process of submitting investigational device exemptions to the FDA, and is working with the IRB to receive approval for the consent process for returning results to volunteers. Additionally, they are in the process of selecting providers for genetic counseling resources. While we remain confident that the program will scale, we now project a 2020 start. Third, we have also decreased our full-year expectations for the NHS commissioning, which you will recall, is the clinical implementation of whole-genome sequencing that is expected to follow the 100,000 genome project in the U.K. Incorporating routine genomic testing into a nationalized health service is not a small undertaking and the NHS is in the midst of making the necessary adjustments and building an information system to support the transition. Beyond these programs, we have seen similar delays in other smaller programs that are also now reflected in our guidance revision. Despite these timing adjustments, we want to reiterate that Illumina is excited to be able to support these efforts to evolve our understanding of human health and disease. While we've seen continued softness in consumer genomics over the past few quarters, we are optimistic about the long-term DTC opportunity. We estimate that less than 10% of individuals in the U.S. and significantly fewer worldwide have ever purchased the DTC test. As such, we do not believe that the DTC market is saturated. In the coming years, we expect to see the level of adoption significantly increase in the U.S. and around the world for applications, including genealogy, wellness, pharmacogenomics, health and entertainment. We view this as a transitory phase of growth which is allowing DTC companies to explore new product offerings that meet evolving consumer interests. Importantly, Illumina is committed to supporting our DTC customers, as we strongly believe genomic insights will empower individuals to become more involved in their daily lives. Let me now turn to research. The human genome project was launched in 1988. With the help of international researchers, the first human genome was finally completed in 2003. Since then, institutions and researchers from around the world have continued to fund and propel sequencing projects to gain valuable insights into human health. We made impressive progress in our ability to diagnose and treat cancer and even develop life-saving vaccines, but we're still in the early stage of developing treatment for most complex genetic disorders, such as Parkinson's disease, Alzheimer's and Autism. These research efforts are invaluable as they inspire scientists to drive their insights into commercialized products that can touch the lives of millions. The immunology and computational discovery at Fred Hutchinson Cancer Research Institute resulted in the spin-out of Adaptive Biotechnologies, who successfully went public last month. Separately, after years of genomic research, Johns Hopkins University spun out CancerSEEK, a potentially groundbreaking liquid biopsy early detection test. And new scientific discoveries will continue to unlock future research efforts. For example, scientists at Harvard University have discovered new microfluidics and novel software that can be used to accelerate single-cell ATAC-seq, which could have a meaningful impact on single-cell genomics. We're excited to see sequencing play such a significant role in these monumental research efforts. According to the SDi Global Assessment report, sequencing technologies are expected to be the most dominant life sciences instruments for research as a percentage of dollar spend. This reinforces our excitement about the Pacific Biosciences acquisition. Integrating workflows for our short technology with PacBio's highly accurate long read sequencing technology will help accelerate research discoveries that we believe will lead to new clinical insights. We continue to work closely with regulators and expect the deal to close before the end of the year. To date, less than 1% of the variance detected in human genomes have a function clearly ascribe to them. Researchers around the world are working to understand the function of the remaining variance in the human genome, not to mention, all of the other biology that's around this. To that end, innovation and quality remain our priorities as we work to deliver industry-leading tools that support researchers globally as they endeavor to understand the genetic basis of life. Before I hand over to Sam, I want to provide some of the key trends from the second quarter that give us confidence about the overall health and trajectory of the business. Excluding the large deal that didn't close as expected, second quarter NovaSeq shipments were ahead of expectations. We continue to expect NovaSeq shipments in 2019 to be flat to slightly up from 2018. Pull through per NovaSeq was once again above $1 million per system per year and was up sequentially. Even with our lower full-year revenue expectations, we continue to expect NovaSeq pull through per system to grow compared to 2018, and to be over $1 million per system. S4 shipments exceeded $100 million for the first time this quarter and more than doubled from the same quarter a year ago. As expected, HiSeq consumables continued to decline, but combined high throughput consumables grew both sequentially and year-over-year. We are pleased with the response to the introduction of S Prime and to the new lower pricing for the S1 and S2 flow cells. Growth in both S1 and S2 revenue more than offset the impact of the price decreases affected in the first quarter, while S Prime Flow Cell shipments, more than doubled in the second quarter of launch. Off note, lower throughput NovaSeq flow cell introductions and pricing adjustments are part of our strategy to catalyze the next wave of NovaSeq conversions. And in the second quarter, nearly 30% of our NovaSeq purchases were from existing HiSeq customers. NovaSeq system ASPs were lower due to several multi-unit purchases in addition to customers taking advantage of our HiSeq trade-in program. Additionally, new to Illumina or straight from desktop customers represented over half of all NovaSeq orders in the second quarter,\ the highest proportion since launch. We also continue to see growth in NextSeq placements with system shipments growing sequentially and year-over-year. We're pleased to report that we placed a record number of NextSeq Dx Systems in the quarter and mid-throughput sequencing consumables associated with our NextSeq system were within our targeted range of $130,000 to $160,000. For the low throughput portfolio, MiniSeq pull through was within targeted range of $20,000 to $25,000, and reflecting the benchtop weakness discussed in the pre-announce, MiSeq pull through was slightly below our $40,000 to $45,000 range. We were encouraged to see that system shipments for the entire low throughput portfolio grew both sequentially and year-over-year. With that, I'll hand over to Sam, to review our second quarter financial results in detail. Sam?