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Exact Sciences(EXAS) - 2024 Q3 - Quarterly Report

Revenue and Financial Performance - Total revenue grew 13% year-over-year in Q3 2024, with operating cash flow improving by 114.4millionto114.4 million to 138.7 million compared to Q3 2023[151] - Screening revenue for the three months ended September 30, 2024, was 544.9million,a544.9 million, a 72.9 million increase from the same period in 2023, driven by growth in Cologuard test completions[173] - Total revenue for the nine months ended September 30, 2024, was 2,045.4million,a2,045.4 million, a 192.5 million increase from the same period in 2023, primarily due to increased Cologuard and Oncotype DX test volumes[174] - Net cash provided by operating activities increased to 163.5millionfortheninemonthsendedSeptember30,2024,comparedto163.5 million for the nine months ended September 30, 2024, compared to 86.6 million for the same period in 2023[198] - Net cash used in investing activities was 400.3millionfortheninemonthsendedSeptember30,2024,comparedto400.3 million for the nine months ended September 30, 2024, compared to 116.4 million provided by investing activities for the same period in 2023[198] - Net cash provided by financing activities increased to 221.4millionfortheninemonthsendedSeptember30,2024,comparedto221.4 million for the nine months ended September 30, 2024, compared to 149.7 million for the same period in 2023[198] - Investment income, net increased to 11.6millionforthethreemonthsendedSeptember30,2024,comparedto11.6 million for the three months ended September 30, 2024, compared to 2.1 million for the same period in 2023[189] - The company issued 620.7millionaggregateprincipalamountofnewConvertibleNotesduein2031,withnetproceedsofapproximately620.7 million aggregate principal amount of new Convertible Notes due in 2031, with net proceeds of approximately 259.8 million[203] Product Development and Pipeline - Cologuard Plus, the next-generation colorectal cancer screening test, received FDA approval in October 2024 with expected Medicare coverage and guideline inclusion in 2025[153][157] - Cologuard Plus reduces false positives by over 30% and shows 95% overall cancer sensitivity and 43% sensitivity for advanced precancerous lesions at 94% specificity[157] - The company's blood-based colorectal cancer screening test demonstrated 88% sensitivity for colorectal cancer and 31% sensitivity for advanced precancerous lesions at 90% specificity[161] - The multi-cancer screening test (Cancerguard) detected cancer signals from 21 cancer types with 50.9% mean sensitivity and 98.5% specificity[164] - Oncodetect MRD test for colorectal cancer completed clinical validation, with results to be submitted for Medicare reimbursement approval[158] - The company plans to launch new screening and diagnostic tests in 2025, including Cologuard Plus and Oncodetect MRD[156][157][158] - The company's ASCEND-2 study enrolled over 11,000 participants for multi-cancer screening test validation[164] Expenses and Costs - Cost of sales for the three months ended September 30, 2024, increased by 27.6millionto27.6 million to 196.1 million, driven by higher production costs and personnel expenses due to increased test volumes[179] - Research and development expenses for the nine months ended September 30, 2024, increased by 20.6millionto20.6 million to 331.6 million, partly due to a 25.8millionexpensefromtheterminationofalicenseagreement[182]SalesandmarketingexpensesfortheninemonthsendedSeptember30,2024,increasedby25.8 million expense from the termination of a license agreement[182] - Sales and marketing expenses for the nine months ended September 30, 2024, increased by 35.7 million to 572.3million,drivenbycontinuedinvestmentinhighimpactsalesandmarketingopportunities[185]Personnelexpensesdecreasedby572.3 million, driven by continued investment in high-impact sales and marketing opportunities[185] - Personnel expenses decreased by 3.2 million (3.2%) to 98.1millionforthethreemonthsendedSeptember30,2024,comparedto98.1 million for the three months ended September 30, 2024, compared to 101.3 million for the same period in 2023[186] - Total general and administrative expenses decreased by 0.2millionto0.2 million to 217.2 million for the three months ended September 30, 2024, compared to 217.4millionforthesameperiodin2023[186]Amortizationofacquiredintangibleassetsincreasedto217.4 million for the same period in 2023[186] - Amortization of acquired intangible assets increased to 24.4 million for the three months ended September 30, 2024, compared to 23.0millionforthesameperiodin2023,primarilyduetoacquisitions[186]Impairmentoflonglivedassetswas23.0 million for the same period in 2023, primarily due to acquisitions[186] - Impairment of long-lived assets was 18.7 million and 31.3millionforthethreeandninemonthsendedSeptember30,2024,respectively,comparedtozeroand31.3 million for the three and nine months ended September 30, 2024, respectively, compared to zero and 0.6 million for the same periods in 2023[187] Market and Screening Initiatives - The company delivered test results to 1.2 million people in Q3 2024, including record numbers for Cologuard and Oncotype DX tests[151] - Up to 60 million Americans are not up to date with their colon cancer screenings, and the company aims to increase screening rates through partnerships with health systems and payers using the Cologuard test[169] - The company secured reimbursement for the Oncotype DX test in Japan, where breast cancer is the most common cancer among women, with about 45,000 new diagnoses annually. The test could help more than 100 women per day understand their cancer recurrence risk[170] Financial Position and Risks - The company had an accumulated deficit of approximately 3.63billionasofSeptember30,2024,andexpectstoincurnetlossesinthenearfuture[171]Cash,cashequivalents,andmarketablesecuritiestotaled3.63 billion as of September 30, 2024, and expects to incur net losses in the near future[171] - Cash, cash equivalents, and marketable securities totaled 588.8 million and 432.3million,respectively,asofSeptember30,2024[196]Thecompanymaintainssignificantamountsofcash,cashequivalents,restrictedcash,andmarketablesecuritiesexceedingfederallyinsuredlimits,posingpotentialrisksoflosses[210]AsofSeptember30,2024,thecompanyhadnooutstandingvariableratedebt,butfuturedrawdownsundertheRevolvingLoancouldbeimpactedbyrisingmarketinterestrates[211]ThecompanysfunctionalcurrencyformostinternationalsubsidiariesistheU.S.dollar,minimizingforeigncurrencytranslationgainsorlosses[212]Asmallportionofrevenuesisdenominatedinforeigncurrenciesduetointernationalexpansion,withcertainexpensespayableinforeigncurrencies[212]Thecompanyhadopenforeigncurrencyforwardcontractswithnotionalamountsof432.3 million, respectively, as of September 30, 2024[196] - The company maintains significant amounts of cash, cash equivalents, restricted cash, and marketable securities exceeding federally insured limits, posing potential risks of losses[210] - As of September 30, 2024, the company had no outstanding variable rate debt, but future drawdowns under the Revolving Loan could be impacted by rising market interest rates[211] - The company's functional currency for most international subsidiaries is the U.S. dollar, minimizing foreign currency translation gains or losses[212] - A small portion of revenues is denominated in foreign currencies due to international expansion, with certain expenses payable in foreign currencies[212] - The company had open foreign currency forward contracts with notional amounts of 47.7 million as of September 30, 2024, to mitigate foreign exchange rate risks[213] - Currency fluctuations have had an immaterial impact on financial results historically, but future impacts could become significant[213]