All right. Hi, everyone. Good morning. Thanks for joining us at this year's William Blair Growth Stock Conference. This is my ninth year doing the conference, but it's always a pleasure to have Exact Sciences joining us here again for this year's conference here in Chicago. With us, we have the Chairman and CEO, Kevin Conroy, CFO, Aaron Bloomer, and VP of Investor Relations, Derek Leckow. Format for today, I'll turn it over to Kevin to do a formal presentation, and then we'll do a breakout session afterwards. Lastly, for a full list of research disclosures, please visit williamblair.com. With that, I'll turn it over to Kevin. Thanks, Kevin. Thank you, Andrew, and thank you, William Blair, for having us back for the 16th time. I can't believe it's been that short of a period of time. It seems like it has flown. It was 16 years ago that I had the good fortune of having a meeting at the Mayo Clinic where I met with Dr. David Ahlquist, and he had this, at the time, seemingly crazy vision of being able to solve the number two cancer problem by screening and looking for DNA shedding from colon cancer into a stool sample, and that you could accurately detect colon cancer from a sample collected at home. That was the first, I would call it, hour, two hours of the conversation. The second part of the conversation was even more far out there, which is the idea of one blood test to detect all cancers. That was probably his even bigger passion because he says, look, the prevalence of cancer broadly in a population over 50% is 1%-3%, you know, growing with age, growing with risk level. He said that cumulative prevalence, if you screen a whole person in addition to individual organs, you have the ability to intervene early. One thing we know about cancer is that earlier detection changes outcomes. That is the genesis 16 years ago. Not a lot has changed in terms of the overall vision. The vision you see here, our purpose is to help eradicate cancer by preventing it, detecting it earlier, and guiding treatment. What we want to cover today is, you know, kind of how that vision extends into a business model. What is our business model? What is our technology platform? How does our technology platform that is extendable to customers, both consumers, patients, and health systems, and also payers? The whole ecosystem. How is this platform that we have invested well over $1 billion into? How is that going to fuel growth and the purpose in the future? Our pipeline, we have talked for a long time about the tests that are coming, and here we are now with three product launches this year that we could not be more excited about. Also, Aaron Bloomer, our CFO, will talk a little bit about our growth drivers and our profitability growth. Let's see here. Can we advance the slide? One thing I do not have is a clicker. Here is our safe harbor statement. Thank you, sir. Our safe harbor statement, we will be making forward-looking statements. We have a 7,000-person team of cancer fighters. During the first presentation, I think we had about 10 people. There has been tremendous growth. We start with our people. They've been able to do incredible things. It really starts with our science and our scientists. Everything that has come out of Exact Sciences, whether it's Cologuard, Cologuard Plus, OncoDetect, Cancerguard, is because of unbelievably talented scientists. Then a business model that has allowed us to grow. We expect this year to generate more than $3 billion in revenue and growing profitability. The value drivers that we have that we'll touch upon here is this technology platform. We're able to access these kind of large populations of people that need to get screened, that need to get better tests to help guide therapy. One of the things that we have built that has truly differentiated is our commercial engine. We have a large field force that calls on every square inch of the U.S. If you're in a state, you have reps that call on primary care physicians, PAs, nurse practitioners in that state. We cover all of that. That has driven Cologuard growth. One of the things we're proud of is this value it inners to shareholders. It also inners to the population. If you take a look at where screening rates were in colon cancer when we started this journey 16 years ago, roughly 60% of the population was up to date with screening. This is over the age of 50. Today, that is over 70%. Last we checked, 72%. That is almost entirely due to Cologuard utilization. 20 million people have been screened with Cologuard, and it's protective for three years. Cologuard's is on a three-year interval. You'll hear about this. That, too, is a significant driver of growth, and it's a powerful part of our business model. It leads to this double-digit revenue growth, and we're on that cusp of continued growing profitability, which Aaron will talk about. This is what we call our flywheel. It is how we think about our business. It starts with unbelievably great people. Think our scientists, think our salespeople, our marketing people. They're fundamental to who we are and what we do. We develop tests that actually change clinical practice. We see tests being developed in our field that don't necessarily fundamentally change clinical practice. For example, with Cologuard, you get a Cologuard test. If it's positive, we help you go get a colonoscopy. It's very important to do that follow-up step. That's the step where you can intervene and find and remove a precancerous polyp preventing cancer, which is the goal of screening. You generate rock-solid evidence. I think we're up to six New England Journal of Medicine publications between Oncotype DX and Cologuard and Cologuard Plus. Nobody's ever really taken this approach to just drive this fundamental value through strong clinical trials. That allows us to get access to payers. It allows us to drive adoption in the clinic, in the primary care setting, in the oncology setting, in the specialty setting. You add the accelerator of our technology platform, electronic connectivity between the physician and the patient and also the payer. This is a powerful platform. We did not have it when we launched Cologuard 11 years ago. Today, we have a platform that actually extends, has applications and power that we will talk about here. It drives Cologuard, and it drives Oncotype DX. This is our pipeline of products on the screening side and precision oncology. Think two different businesses, one primarily in the primary care setting, one primarily in the oncology setting, you know, a surgical oncologist, a medical oncologist, pathologist serving people who are actually being treated for cancer. All of these products are powered by our scientific platform and then also this technology platform, which we call Exact Nexus. What is Exact Nexus? Exact Nexus is a platform that is built on Epic, which is the leading platform, EMR system, billing system, you name it, system in healthcare. If you get a chance, listen to Acquired and the four-hour podcast about Epic. If you're interested in healthcare or an investor in healthcare, it's kind of a must listen to. It's the operating system; it has become the operating system for healthcare. We built about several hundred applications on top of this platform, which allow us to do a multitude of different things. A basic thing that we can do because we built our company on Epic allows us to do billing to payers. It allows us, it took us from 60 days down to 22 days to collect. That's powerful. It's powerful also because we're able to do it in an automated way without a lot of people dedicated to this function. We're able to deploy that capital in other areas. We're able to do electronic ordering and resulting. Eleven years ago when we launched Cologuard, doctors actually, or their staff, had to fill out a piece of paper and fax it to us. Today, believe it or not, 30% of Cologuard orders still come in that way. It's a big step up in ease of use and ordering frequency when a physician has access to electronic ordering, electronic resulting. Now for a patient, if you go to our website, cologuard.com, if you are not up to date with screening, do yourself a favor. Go to cologuard.com while you're in this meeting. Listen, listen to the presentations too, but go to cologuard.com and order a test, see how easy it is. Every three years, you'll be reminded. One thing that you can put out of your mind is you don't have to worry about getting screened because Cologuard will take care of you. It's really, truly protective. Over time, this allows us to do powerful things like close care gaps. What is a care gap? It's a big payer or a big health system that looks and sees that 30% of their members or patients are not up to date with screening. Over the last couple, two and a half years, we have grown this capability in large part because of the quality of our test that is good for three years and that you can generate these test orders through directly initiated by the payer or directly initiated by the large health system at scale. We had one of our largest care gap orders in our history with over 100,000 test orders about a month ago for one payer. We're working with nine of the top 10 payers, and we expect that to be 10 out of 10, and we expect it to be 800 out of 800 payers that we work with generally over time. Why do they do this? They are highly incentivized by commercial insurance plans and Medicare Advantage plans to have high colon cancer screening rates because it helps them qualify for Medicare Advantage and commercial bonuses. It's a fundamental part of their business model to drive their preventive scores. Our Exact Nexus platform allows us to do this in a very differentiated way. Others can't build this capability out of thin air. It takes time and investment. Every year, we see another 50-100 health systems connect with the Exact Nexus. They can utilize some of the capabilities that they have in their EMR systems to generate campaigns to alert people that they're due for screening. This is a powerful tool. If you ask us, are we a cancer diagnostic company or are we a technology company, it's hard to answer that question. We're both. Both are equally important to being able to achieve the purpose ultimately of earlier detection as we extend into other areas. Colon cancer this year may be overtaken as the number two cancer killer only by pancreatic cancer and lung cancer. Lung cancer far outstrips all cancers in terms of mortality. It's still a big problem. 53,000 people a year die from colon cancer. 150,000 in Europe, it's not 50,000 deaths, it's 150,000 deaths. There's a global need for screening. There's really no better way to do that than in the privacy of your own home with a highly accurate test. Test accuracy is critically important. In the US there are 55 million people who are not up to date with colon cancer screening. If there is a bigger growth opportunity in healthcare, I don't know what it is. The team is working incredibly hard to continue to grow from approximately 4 million people tested last year to we believe we can get tp at least 14 million people tested on an annual basis. We're really proud of th lab capability, the IT capability, and the quality of the test. Cologuard Plus is a big step up in performance from Cologuard. Cologuard Plus launched this year. Medicare awarded it a price of $592 per test, still significantly below the fallen costs of colonoscopy. It's great, a great value for the health system. It's a great value for people and it leads to earlier detection. It detected 95% of cancers in our big pivotal clinical study with only a 6% false positive rate in people with no findings in their colon, no small polyps, nothing, just what we would call a clean colon. Ninety-five percent sensitivity and 94% specificity, detecting 43% of precancerous polyps. Precancerous polyps take 10 to 15 years to turn into cancer. If you get this test every three years, over time, per these models, you eventually find that and the sensitivity of the test grows as the polyp increases in size because it sheds more DNA, easier to detect. Over time, per these models, you end up detecting over 90% of those precancerous polyps, intervening and actually preventing the disease. That is the power of the science. You can see the growth here. A lot of people ask, you know, is Cologuard an icky thing? Do people not want to do it? Yeah. I have to say, 16 years ago when I first joined the company, it might have been my biggest worry. Over the last, so monthly, we do a survey asking people on an unbranded basis, how would you get screened for colon cancer? In four of the last six months, for the first time, more people say Cologuard than colonoscopy. It's changing. Sometime next year, we believe there will be more daily Cologuard tests than screening colonoscopies. We're at that point where the power of the brand is driving great outcomes in healthcare. We think that we're just getting started here, that this next second decade of Cologuard led by Cologuard Plus technology platform, the commercial organization will lead to sustainable growth. Part of the story is rescreens and automating the rescreen process. What you see here are the number of people who come due each year for their third-year rescreen, either their first third-year rescreen or those, the purple or gray at the top is the second purple, gray third. That starts to stack in a quadratic way. It grows and grows and grows over time. Today, we are successful in getting 55% of these people screened within a year of their due date. Over time, our goal is to drive this to well north of 75% of people. Think about how this leads to sustainable recurring growth from our, again, our business model perspective, which is the single biggest driver of growth. If you stack up all of our growth drivers out over the next five years, right here is the biggest growth driver. Very little friction. We're able to drive this growth, put this into your model, look out over five years. It's pretty exciting. That enables us to invest in other areas. As I mentioned, care gaps continue to be a big part of our growth over time, driven by payers, partly Medicare Advantage plans, maybe mainly Medicare Advantage plans, but also commercial plans and large health systems. They all care about their quality scores. Colon cancer is usually one of the worst scores. How do they drive it? They reach out to us or we reach out to them. We run a program together and we get their unscreened people screened. Over time, we think these programs will continue to grow. It'll be a $500,000,000 opportunity for us. Over time, it will become a $1,000,000,000 opportunity. Oncotype DX, it's changed the way breast cancer is treated. Early stage HR positive, HER2 negative breast cancer, standard of care to get an Oncotype DX test. It is both predictive of benefit of chemotherapy, allowing about 80% of patients not to undergo chemotherapy. Think about the power of that test by peering inside the cells and looking at the RNA activity. The evidence here are two studies that are about 10-year studies, randomized, hard to replicate this level of evidence, just 90% market share, but we have about 80% penetration, 75%-80% penetration in the U.S., only about 25%-30% penetration outside the U.S. Outside the U.S. is growing in a high double-digit way, and we expect that to continue over time. It also gives us reach into the oncology setting, which is very important for some of the products that we listed earlier that are being used to help patients guide treatment who've already been diagnosed with cancer, including Oncodetect. How do we do this? We do it with great science. We look at DNA, RNA, proteins. We have experts in all of these categories. Next-generation sequencing, our proprietary technology, which we call Tulcus, which allows accurate detection and the ability to intervene early. We also have deep collaborations with the best clinical research universities in the world, and we expect that will continue. We have increased our utilization of AI, of large language models, of machine learning to help us guide to better performance. As I mentioned, we are launching three new products this year, and we will also be releasing data on a colon cancer blood test. We've already launched Cologuard Plus. Tens of thousands of people are getting tested with Cologuard Plus, first starting with Medicare Fee for Service patients, and that will change to Medicare Advantage patients and commercial patients and Medicaid patients. We will contract with those payers over the next 12-24 months and then sunset Cologuard. We also launched Oncodetect this quarter. We expect reimbursement yet this quarter, so sometime this month. Excited about that. Cancerguard is our multi-cancer screening test, which goes back to that very first meeting we had with David Ahlquist back in March of 2009, where he laid out the vision of one blood draw, all cancers. This will be differentiated and available not only in the U.S., but we also expect to launch it globally. We'll launch Cancerguard in the back half of this year. We talked a real step up in performance. Just to put this data in perspective, there's just never been a screening test. You think about PSA screening, mammography, cervical cancer screening that has that level of sensitivity and that level of specificity. You just don't have it. Mammography has over a 10% false positive rate, probably about a 13% false positive rate. This is a 6% false positive rate. Detects 95% of cancers. The best estimate for what colonoscopy detects is 95% of cancers. Colonoscopy is better at detecting precancerous polyps, but you only do it once every 10 years. Cologuard, you do every three years, so you have that chance to come back and pick up the interval cancer or the interval polyp. It's very protective. Oncodetect is a powerful test for patients that have already been diagnosed with cancer. Their diagnosis, it's important to ask the question, are they likely to recur? Oncodetect addresses that question. It is a fast-growing field, and we expect this over the next decade to become standard of care for patients to get a test looking at DNA in their blood to detect recurrence. Cancerguard also today, only 14% of all cancer cases are detected through screening. We believe Cancerguard and other cancer screening tests that are in our pipeline that we do not spend a lot of time talking about will also become part of this landscape. That is how we get back to achieving our purpose. I am going to get through our blood test data we expect out in the middle of summer. We are excited about this. Just to put blood testing in perspective, you can take a look. The AGA was involved in a couple of different studies, I think three papers altogether, an opinion piece where they said, "Look, the performance of blood testing for colon cancer screening just isn't there yet." Mainly because blood testing is essentially blind to precancerous polyps, 13% precancer detection, 10% false positive rate. It is just above background. It just does not see precancerous polyps. We think the guideline groups are going to be very cautious about recommending it as a frontline screening test ahead of Cologuard or ahead of colonoscopy. It may be years before the most important guideline group weighs in. That is the USPSTF. It is also pretty expensive to screen. This model was based on $500 a test, but this is all publicly available data for you to take a look at. With that, I will hand it over to Aaron with four minutes left. Good morning, everybody. Just to kind of recap and distill everything Kevin said in terms of our financial profile. We have laid out growth drivers for the future, but maybe take a step back. What have we delivered over the last five plus years? We have delivered on that promise of sustained, durable, double-digit strong growth. A 16% growth rate over the course of the last five years. You can see what that has meant in terms of growth across both our screening as well as our precision oncology portfolio. What we have done this year with the strong start that we had in Q1 and visibility that we had into the second quarter from some of the commercial changes that we have made and the momentum that our sales force has created out into the field is we actually increased our guidance already by $40 million just after the first quarter. All of that really coming from our screening portfolio, which is slated to grow 14% this year. The exciting thing as a CFO is that not only are we driving top-line growth at that mid-teens level, it's that we're rapidly expanding profitability. If you look at, we turned adjusted EBITDA positive just two years ago. From that time, from 2023 to where we're estimating the midpoint of our guide this year, we will double our profitability in a two-year period. Last year, we grew our profitability nearly 50%. This year, we're projecting another nearly 300 basis points of margin expansion. If you look at out into the future, there are several levers that we have at our disposal. It starts with top-line growth. When we're growing the top-line at that mid-teens level, it allows us to be able to not only reinvest back in future growth, but to be able to deliver leverage and in EBITDA expansion to the bottom line. Second is productivity. Really, really proud of the work that our lab, manufacturing, and supply chain team have done to deliver margin expansion and unit cost reduction. You see that in our world-class gross margins that we have, nearly 75% gross margins on the portfolios that we have. The launch of Cologuard Plus, Kevin talked about that before. Through the Medicare process and clinical lab fee schedule, we got an elevated price level due to the value that Cologuard Plus is going to deliver to the health system. That will be a driver of both growth and margin expansion into the future. One of the areas that we see as a large opportunity is G&A optimization. The team is already hard at work at this. We delivered more than 500 basis points of margin expansion in Q1 from G&A alone and more to come into the future. What that is going to allow us to do is deliver on our long-term commitments. We have a long-term revenue objective of mid-teens growth, 15% growth, and to reach that 20% plus adjusted EBITDA level. We are well ahead of our projections at this moment in time and really excited about what this means for the future of Exact Sciences. With that, I will flip it back to Kevin to close. I think the important thing that you heard today is maybe where we started, which is there is a way to bring cancer mortality down, and it is through earlier detection and better guiding of the treatment of cancer. We have the tools to do that now because we understand what is going on inside those tumor cells, looking at DNA activity, RNA activity. That allows us to screen and intervene and hopefully find cancers earlier when they're treatable frequently with surgery alone. We've built a platform, a technology platform, a commercial platform to deliver these incredible tests to physicians and patients who need them. We have a business model that allows us to generate profits, reinvest profits, invest in R&D, invest in our science and our scientists to lead to sustainable growth for a long time. Thank you and look forward to our conversation.
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