Q2 2026 Exagen Inc Earnings Call Transcript
Key Points
- Record quarterly revenue of $19.9 million, up 16% year over year, with record AVISE test volume, trailing 12-month ASP, and Pharma Services revenue.
- Adjusted EBITDA loss narrowed significantly to $0.1 million, nearly breakeven, compared to a $1.7 million loss in Q2 2025.
- Trailing 12-month ASP expanded to $446, marking the 13th consecutive quarter of growth, driven by successful revenue cycle management and commercial payer progress.
- Pharma Services revenue crossed $1 million for the first time in a quarter, with contract backlog growing to over $6 million.
- Raised full-year 2026 revenue guidance to $72 million-$75 million, reflecting strong first-half execution and confidence in continued growth.
- Published a systematic review validating AVISE lupus performance, showing it identifies 25% of SLE patients missed by conventional markers, strengthening clinical evidence.
- Adjusted EBITDA is not expected to sustain at near-breakeven levels in the second half of 2026 due to typical seasonality and fewer working days.
- The company remains dependent on continued revenue cycle management improvements, with a significant portion of ASP growth tied to collections on older claims.
- The local coverage determination (LCD) from MolDX remains pending with no update, creating uncertainty around future Medicare reimbursement.
- Sales force expansion contributions are still ramping, with newer territories taking 6-12 months to meaningfully impact top-line growth.
- Gross margin, while improved, is still below the mid-60s target, and the company faces ongoing reimbursement risks that could impact future performance.
Greetings, and welcome to the Exagen Inc., Q2 2026 earnings call. (Operator Instructions) As a reminder, this conference is being recorded.
It is now my pleasure to introduce your host, Tina Jacobson, Investor Relations. Thank you. You may begin.
Thanks, Operator. Good morning, and thank you for joining us to discuss Exagen's financial results for the quarter ended June 30, 2026. Today, I'm joined by John Aballi, our President and Chief Executive Officer; and Jeff Black, our Chief Financial Officer. The recording of this call, the press release announcing our financial results, and a slide presentation can be accessed on our website at www.exagen.com.
Today's call will include forward-looking statements. We encourage you to review the statements contained in today's press release and the risks and uncertainties described in our SEC filings, which identify certain factors that may cause the company's actual events, performance, and
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