Ladies and gentlemen, thank you for your standby and welcome to the Quanterix Corporation Q4 2020 earnings call. At this time, all participants are in listen-only mode. Later, we'll conduct a question and answer session, and instructions will follow at that time. If anyone should require assistance during the conference, please press star and zero on your touchtone telephone. As a reminder, this conference call is being recorded. I would now like to turn the call over to Amol Chaubal, CFO of Quanterix. Please go ahead, sir. Thank you, Charlie. Good afternoon, everyone, and thanks for joining us today. With me on today's call is Kevin Hrusovsky, our Chairman and CEO. Before we begin, I would like to remind you about a few things. Today's call will be recorded and will be available on the investor resources section of our website. Today's call will contain forward-looking statements that are based on management's beliefs and assumptions and information available as of the date of this call. We may not actually achieve the plans, intentions, or expectations disclosed in our forward-looking statements. Forward-looking statements involve known and unknown risks, uncertainties, assumptions, and other factors that may cause our actual results, performance, or achievements to be materially different from any future results, performance, or achievements expressed or implied by the forward-looking statements. The risks and uncertainties that we face are described in our most recent filings with the Securities and Exchange Commission. During today's conference call, we'll discuss some financial measures that are not presented in accordance with U.S. Generally Accepted Accounting Principles or non-GAAP financial measures. In the Q4 earnings release and in the appendix of our presentation, which are available on our website, you will find additional disclosures regarding these non-GAAP measures, including reconciliations of these measures to comparative GAAP measures. We believe that these non-GAAP financial measures provide investors with relevant period-to-period comparisons of our operations. These financial measures are not recognized under GAAP and should not be considered in isolation or as a substitute for a measure of financial performance prepared in accordance with GAAP. With that, I will turn the call over to Kevin. Thank you very much, Amol, we did do a pre-announcement. Basically going to go through the strategy charts, the numbers, we will once again go through them through Amol after I go through the higher level presentation. I will discuss just the advances we made in Q4 in 2020 with our focus being primarily on COVID, Alzheimer's, and oncology. Most important is the payer disruption and the way we think this is going to transform our overall value creation opportunity. We'll ensure to continue our dialogue around Powering Precision Health, which is a phrase we coined about six, seven years ago, and it's actually guiding the proteomics evolution that we think can really become a revolution in the way proteins are being deployed. Let me start on slide four, where we basically made some pretty significant advances. I think the whole company has probably put out at a pace of about 200% of previous years, I think the pandemic has reached each and every one of us from an employee level at Quanterix and enabled us to really go after and help the nation as well as the world battle COVID. It starts with us getting two EUAs in the last several months, one for serology, that's a semi-quantitative ability to measure the actual level of antibody, which we think is key with vaccinations, particularly in the durability questions that remain. Also an antigen test that we have also submitted for nasal swab anterior, and we've also submitted for saliva, and we expect shortly to submit for dried blood spots, which we think measuring the antigen in blood is a very significant differentiator given the long hauler effect which many individuals, unfortunately, are continuing to be plagued with even months after having had COVID, which we think enables us to be able to measure small trace amounts of the antigen still in many of these long haulers' blood. So this will be key for future therapy trials as well as trying to get health back for many of those that have suffered from COVID, even with just lack of taste and smell. We also were given $20 million, granted $20 million by the RADx, a subset of NIH, and that's linked and created very strategic ties with the FDA that we'll utilize not only for COVID, but for neurology as we evolve our advances in the neurological diagnostic framework. The payer adoption, we think, has been critical. UnitedHealth Group particularly has been doing a lot of work with us. Population trials are being run as well as future opportunities we think to disrupt healthcare by utilizing payer group adoption. We also believe this leading edge long hauler menu that we've created and capability is going to be important to allow researchers to figure out how to prevent many of the longer-term issues that we expect and many suspect will be linked to COVID. On the right-hand side here, neuroaccelerators, the p-Tau-181, which is a differentiator, allows us to stratify out Lewy body dementia as well as frontotemporal dementia from cohorts for Alzheimer's disease drug trials. This is very important. Also, we've shown evidence of being able to see Alzheimer's disease 16 years through researchers using our biomarkers before the presentation of dementia, this is key as well, we think, for getting an Alzheimer's drug across the line with the FDA. We also launched the NeuroPlex and plan to continue to evolve our NeuroPlexes that include NfL, amyloid betas, as well as the p-Taus. Alzheimer's drug trials, never been more important than they are right now. There's even beginning of links to early Alzheimer's from those that had COVID. We think this is going to be a really important area for our growth, not only on the research side, but ultimately, longer term on the diagnostic side once a drug is approved. We also had two MS drugs approved this past year, and also a major study just came out on aging profile, measuring our NfL with a lot of quantitation. The higher the NfL level, the older you are, creating that correlation. 48% of our fleet now is the HD-X, and new sales are also tracking about that same pace. Our growth really in neuro has been unprecedented in 2020, record publications and new biomarkers, as well as this 100X sensitivity advance that we have at a pilot level now. We're planning to advance that into product lines by no later than the end of 2022. The Abbott license put $10 million upfront payments and $25 million of earn-outs, associated with milestones, as well as royalty payments, as Abbott evolves Simoa inside of their technology. We did do a raise in 2020, did another one in January. Lab services expansion continues. You can see our growth on slide five continues at really a double the pace level versus when we were private. Our investors are actually doing a lot of introductions to the C-suites of our biopharma customers that are trying to get drugs approved using our biomarkers. It's a real win-win for investors, to have both our growth as well as helping get drugs approved at their portfolio companies that are focused on that as being their value creator. Our growth has really gone almost to 55% the last three years. We did state that we feel very comfortable 30%-40% research growth over the period of 2019-2023. This is key, I think, as you look at our growth projections for this year. 80% increase in our accelerator revenue we thought was really key last year, given many of our customer labs were down. We also now have 180 instruments installed with 93 HD-Xs. We think this is also very important in the HD landscape. Our consumable growth recovered in Q4 to a very strong clip, and we see utilization rates being almost twice what we originally set out for those to be. This has shown a lot of usage of our technologies. This slide just gives you the breakdown of the instruments, consumables, lab services, and you can see that the growth rate continues to be really strong in Q4 recovery for the consumables, which we think is important. We had a really strong instrument year that I think most were very excited to see, and we do expect that we'll continue with strongest growth in consumables, slowest growth in instruments, but we think services will be right in the middle. This is great because the appreciation of gross margin is going to be greatest with our consumable growth. Slide seven just shows the biomarker growth as well as these publications, which validate our technology, and really, that's what differentiates us from many of the others that have tried to revolutionize proteomics, is our publications validating third-party peer-reviewed achievement with our technology. We've democratized it with now 535 instruments around the world. You can see our number of drug trials in red on the right, even inside of our own company. Obviously, we've got large CRO relationships with Quest and LabCorp, as well as Frontage and others, Rules-Based Medicine. Even in-house now, we're running some really important drug trials and helping rescue many drugs that couldn't get approved without the biomarkers. Then on slide eight, you can see that the overall demographics continue to strengthen our, what we'll call it, our Asia position. We do think that 2021 will be a real strong Asia growth year now that we've hired our general manager, and we just did the WuXi contract. Customers continue to be mostly pharma biotech, but the academics continue to be an important focus because of publications. While neurology represents for the past 12 months, not the strongest growth, it's a significant portion of our overall installed base, and we know that's recovering in Q4 given the labs reopening. Ultimately, our instruments have been continuing to grow at a very strong pace, and you can see our Accelerator growth this past year. We think this represents a pretty good opportunity for strong growth in 2021 given our 30%-40% CAGR for the five-year period starting in 2019 through 2023. Slide nine just goes back through and says we've got very strong validation on the left-hand side where our TAM has been $1 billion, and we see evolution over the next five years to $20 billion, particularly with a lot of the new entrants that are coming in doing drug, we'll call protein discovery, bringing molecules into the pipeline that we then really expand TAMs with our ability to see them with a lot of sensitivity and to see them from home care samples, particularly the less invasive samples. That's key to our evolution. We did put a lot of cash on the balance sheet. We've gone from basically no revenue to $85 million over this six-year period and $450 million is currently on the balance sheet. Our valuation continues to evolve, but we're really in the first or second inning of what we think is a very strong valuation creation strategy on the left-hand side, where there's very low regulatory and reimbursement risk. You can see our growth talents and this menu expansion in these drug trials clearly are the area that really creates significant opportunity for low risk growth, which creates and drives a lot of our future valuation. These new entrants, I think, is just a real good sign, further validating the pipeline and creating what we think is a great complementary relationships upstream. I'm also the chairman of 908 Devices, which is one of those upstream companies, gives us great intel across the proteomics pipeline. On the right-hand side, where we think the TAMs are 10x, and really got a significant opportunity. We've got validation now from the Abbott deal, the Siemens deal, and all the pharma data. NIH and RADx and FDA relationships have never been greater, and we still look for single site LDT, ultimately IVD in our neuro franchise, starting with MS, but we think Alzheimer's has got a shot on goal over the next couple of years, depending on what happens with drug trials. COVID and neuro Alzheimer's continue to be our focus. Liquid biopsy, we're partnering with companies in that landscape and feel it's a better low risk way for us to manage liquid biopsies. It's a very crowded market, and drug companies typically are worried about reducing the size of their markets because response levels in oncology are at very low levels compared to other areas and other disease categories. We think from a payer standpoint, this leapfrog where we've struck these relationships is really catalyzing the opportunity for value creation on both the left and the right, but particularly the right. As they, I think, look for trying to reinvent the diagnostics industry, basically looking for disease before symptoms when it's much more therapeutically beneficial to intervene with a patient, and then ultimately, prevent these diseases by having very early detection, is a chance to really create a very different kind of outcome with biomarkers. I think our right-hand side is more of an evolutionary story now instead of aspirational, given the NIH's investments in helping us build this bridge going from the left to the right. Our overall strategy hasn't changed. Current detection levels shown in red on slide 10, and the second part of slide 10 shows how we are moving them into the asymptomatic region with less invasive testing in the areas of cancer, neuro, and COVID. Protein, we think, is vitally important. It's more phenotypic, giving great utility. It's been attempted for really 50 years, and we know that there are some pretty big players already measuring proteins, but the proteomic landscape is still very under-discovered. We do think the identical twin study is really the protein is what's different when one twin grows up to get cancer, when the other one grows up to get diabetes, even though they have the same DNA and RNA. We think this is really indicative of the utility of the protein being it's telling you when you have the disease versus you having a probability for it. Slide 12 does show, hey, there's 200 proteins that Abbott, Siemens, and Roche are measuring today, creating $20 billion of revenue. On the left side in research, you can see Luminex and ProteinSimple and some others are playing very successfully in that 1,300 protein regime. When you bring sensitivity on, you can see we significantly expand the landscape and also provide the less invasive opportunity for measuring these biomarkers. This is ultimately, we think there could be 1,000 proteins measured versus today's 20 proteins. This is 5x the current level, and 5x $20 billion brings $100 billion to TAM just in the diagnostic side alone. As the computer industry and this whole revolution of technology has evolved the genomic landscape of sequencing, we believe the proteomics is now ready to be revolutionized. On slide 14, we just show that ultimate opportunity that Illumina was able to create, and they spun GRAIL out, and then brought GRAIL back in. A lot of the current value in this overall genomic landscape is downstream with those companies on the right. I think three times the market cap sits on the right. We know that the GRAIL move was a smart move by Illumina, and we think that there's a lot of lessons here. We have the same founder of Illumina founded Quanterix, and so we're trying to learn from those lessons and try to get some value downstream and try to make sure that we don't lose a lot of that downstream value. We're building, as you can see in slide 15, we're using greater sensitivity to enable the less invasive biomarker subtypes and multiplexing for disease specificity, and single molecule is what we're able to achieve. That does create this new paradigm of measuring proteins in home care samples to see disease before symptoms. This is going to be an awesome technology for disease progression monitoring across all areas, but we're prioritizing ourselves for neurology first, where we don't think the landscape is crowded, and there's just tremendous focus right now, particularly on Alzheimer's. When you look at our pipeline on slide 16, Quanterix starts on the right-hand side where the drug trials are. We're focused today primarily on brain and COVID, but we're evolving into oncology and heart. On the right, you can see that the TAM grows to $30 billion by just moving into COVID, Alzheimer's, MS, and TBI. Here's where we are trying to create a direct presence. We do also have relationships that we've signed with Siemens and Abbott as partners that we think can further validate our opportunity. Roche is one of our largest customers as well. Then you can see with this next slide, this final slide, liquid biopsies we're partnering, we do think health screens from UnitedHealth Group, as well as Aetna Cigna. We think these are great opportunities to further advance the field of medicine by seeing disease before symptoms. On the final slide here, when you look to the left, you can see many of these companies. We're hoping to add new companies like Nautilus and OSI and others, that QSI, that have further evolved through SPACs and continue to put a lot of investment into the left-hand side. We think it's getting very crowded, but that only brings more proteins into the pipeline that we can expand TAMs with the sensitivity that we talked about earlier. What we did do is build a TAM narrative that starts with today, pre-COVID, about $0.4 billion in neurology and oncology and research. And then once we go post-COVID and cut across with these EUAs, it does create a $12 billion TAM. But mostly what we're doing is a strategic Trojan horse strategy of moving into diagnostics with neuro and then going back upstream into research for COVID. Now we have the validation of EUAs and the long hauler ability to see the virus in blood. We think we really can start to evolve the research side of COVID, which we think will be around for the next 10 years. This next phase of disruption that we have with the payer groups, we think really allows us to evolve downstream then into immunology and oncology, further building out this TAM. Ultimately, we do think further bringing sensitivity upstream into the discovery side of this, where most of those new players are entering. We think discovery will actually benefit from the less invasive sample, but we don't feel like that's a priority. We think it's a longer-term piece of our TAM story. Hayden, when you lock and load right into slide 18, where we are today, biomarker discovery leads to biomarker adoption by those companies that we show with a 300% increase in probability of a drug being approved when they use our technology. That's why we focus on neurology, where these drugs like Alzheimer's disease have never been approved. It's key to get them across the goal line. On the number two area, demonstrating clinical validity, you can see those six markers right now are very important as our story continues to evolve with Lilly and with Biogen and Glaxo and Pfizer, as well as Takeda and Novartis and Roche. Then you can see getting to the actual health screens, bringing many of these patients into the cohort and/or once the drug's approved, getting those therapies into patients before presentation of symptoms is what really transforms this landscape and leads to new biomarkers being discovered. The slide 19 just shows all the biomarkers that used to be done with $5,000 CSF spinal taps. That's cerebral spinal fluid, very painful, very expensive. It's very hard to get patients in drug trials even to have a spinal tap or a $5,000 PET image. That's a lot of what today's world is on the left, and what we're doing is across and forming and standing up tests across all these different diseases and research using blood. Initially, venous draws. Ultimately, we think the ability to get dried blood spots like we're getting with a new EUA submission for COVID. We think it's important to demonstrate home testing for many of these different technologies, and that's where the sensitivity further enhances that ability. Slide 20 just shows those two drugs that were approved in 2020. Key here, MS drugs approved secondary and primary endpoints using NfL, our neurofilament light, where we've locked down. We acquired Uman, as you know, a year and a half ago. This has been key because they've got 100% of the publications, over 200 of them now are using those antibody pairs. It's exclusively using those pairs with Simoa. That's where we've got both ends of this, we feel very importantly, locked up to support our customers' research in these areas. We really are excited about slide 21, where we could see Alzheimer's and the TAM for doing that. Seeing it early, we thought, was more of a research play to allow cohorts to be recruited. On the right, you can see primarily Lilly and Biogen right now, very close to driving through with the FDA towards approvals. In the center here, this advance we made with p-Tau-181/217, this new neurological publications coming out of Europe from neurologists allow us to create correlations with amyloid disease and pathology using our p-Tau-181 to 217. This is key to allowing a simple blood test now to be able to reveal not only Alzheimer's early and stratify it out, but we think it someday could become a key for the diagnostics. On slide 22, you can see all the drug companies that are deploying our technology. We think this is a big piece of our story, they're reference selling at conferences and summits like the Powering Precision Health Summit allows other customers to see the usage of the technology across all disease categories. In slide 23, we do think that while we're going to have a lot of growth, no matter if an Alzheimer's drug is approved this year or not, because the need for our technology to get drugs approved. Once one's approved, we think that creates the diagnostic opportunity, that's where we're looking at first. We'll call it single site LDT initially then evolving into single site IVD. In the area of COVID, this has really allowed the world to see just what's possible with sensitivity. You can see that the coronavirus is really most contagious before symptoms, unlike any other virus, and that makes it very difficult to really control, because the other types of immune system responses to the antigen, the first one is the adaptive immune system, where you have the cytokines. Many times it's created a cytokine storm that led to pneumonia in many of the deaths because the immune system is not really able to manage it, particularly with compromised immune systems. On the right, I'm sorry, the left is the innate immune system, on the right is the adaptive. This is where we're measuring the IgG, which we think is an important measurement, particularly for vaccines. This detection window of today's technologies, when they only look at the tops of these curves, has really led to a lot of these false positive negatives that you've seen with Elon Musk and the Indianapolis Colts and even the governor from Ohio. This next slide, you can see that when you can see the entire range, it allows you to see a broader detection window. That's where we believe our technology ultimately will be very valuable for asymptomatic COVID testing, which is what's key for screening students and workers to get them back to work. Across all these categories now, we've got technology, even in the NFL, for loss of taste and smell, we can measure it, and there's three publications now supporting this from neurologists. This is that key linkage to early Alzheimer's as well, that we think, for long hauler studies, this is a key measurement that we think will help us not only with the Alzheimer's approvals, but all Alzheimer's drug approvals, but also with the long hauler of the COVID itself. Looking at the entire kinetic spectrum of COVID, we think, is key for this long hauler assessments. Right now the NIH is running a 10-arm trial using our technology with some of the therapies like the antibodies from Lilly and Glaxo, as well as remdesivir from Gilead. These are important to be able to see the virus in blood for those trials. Slide 26 just shows a full menu of different types of biomarkers that allow us to assess the symptoms of COVID and to see if in fact the technologies and the therapies being deployed are going to eradicate the virus and those symptoms associated with the virus, which sometimes kill, and we know about a lot of follow-on cardiac issues, respiratory issues, strokes, as well as brain fog, and we think someday, neurodegeneration. Our company really, unlike many that is technology driven and they try to find a killer app, we're market driven and we actually use a process. Many of us have been associated with Powering Precision Health for some time. It allows us to see a lot of where the industry is going to be with respect to many of the critical diseases that are most lethal, like cancer and like brain neurodegeneration and COVID. Quanterix is key to this with their sensitivity. Slide 28 basically shows how this PPH ecosystem tries to bring innovation very quickly to patients. All those constituencies down below are the most senior levels from all of those areas, whether it be investors, whether it be scientists, whether it be hospital groups, even the advocacy groups and the various research groups and CROs. We have them all attend, even the agencies. That allows us then on slide 30 to get information from these various constituencies into Quanterix to allow us to stay ahead of the game and guide where the proteomics opportunity is going to be. You can see how we also interconnect with Leroy Hood's group as well as Michael Milken and many of the top thought leader groups to try to advance our own thinking. Slide 32 just shows some of the key C-suite relationships that we think is what's allowed us to uniquely bring precision health collaborations into connectivity with each other. That allows us to catalyze the proteomic revolution by connecting these dots. I'll end with just the payer groups disruption. We think that there's ultimately three ways that they create better outcomes. Initially, there's already today biomarkers and therapies for MS, diabetes, and COVID, where they could deploy now create better outcomes by seeing a disease before symptoms. B is where they're trying to get a therapy approved. We think that the payer groups can be incredibly effective in recruiting patients with our biomarkers for those drug trials, which would give them an advantage to move very rapidly into getting approved drugs into their membership group. Finally, in the category C, we think that there's an awesome opportunity with large payer groups to do large-scale trials to identify biomarkers for some of the more serious illnesses like pancreatic cancer, and many of the long-term surveillance of their membership could lead to the next breakthrough biomarker. What I'm going to do now is turn it over to Amol for some financial updates, and then we'll close out with Q&A. Thanks a lot. Thanks, Kevin. I'm going to provide some additional financial details about our Q4 and full year 2020 performance. We'll be referring to slide 34 or webcast page 55. As Kevin noted, GAAP revenue in Q4 of 2020 was $26.1 million and included $4.5 million of revenue from our RADx awards. Excluding these non-recurring items, our non-GAAP Q4 2020 revenue was $21.6 million, a 36% increase versus prior year Q4. Consumables revenue increased by 49% in Q4, and instrument revenue increased by 21%. Service revenues increased 28% in Q4, driven by a 46% increase in Accelerator Laboratory revenue. GAAP revenue for full year 2020 was $86.4 million and included $11.2 million revenue in connection with our non-exclusive license agreement with Abbott in Q3 and $6.4 million in revenue from our RADx awards across Q3 and Q4. Excluding these non-recurring items, our non-GAAP full year 2020 revenue was $68.8 million, a 21% increase versus prior year, despite challenges in accessing customer sites for installations and customers facing interruptions in their operations due to COVID-19. As previously discussed, we have proactively expanded our accelerator services capacity to support our customers sustain their research and clinical trials. This resulted in a 50% increase in our service revenue, driven by an 80% increase in full-year accelerator services revenue. Coming to RADx, we are accounting for our RADx awards under IAS 20, accounting for government grants and disclosure of government assistance. Under IAS 20, we expect that approximately half of the total RADx work package 2 milestone payments of approximately $9 million will be recognized as grant revenue, of which approximately half was recognized as grant revenue in 2020. We expect the remainder, approximately $4 million-$5 million, will be recognized as grant revenue in 2021. The remaining approximately $9 million of contract milestone payments that relate to reimbursement for the purchase of property and equipment will be recorded as a reduction in the carrying value of these assets and will have no grant revenue associated with them in our profit and loss statement. As previously stated, we are not providing revenue guidance. We have recently seen customer activity return to pre-COVID levels. A potential spread of new coronavirus strain may force renewed lockdowns, resulting in challenges such as limitations in accessing customer sites or drop in consumables utilization due to interruptions in certain customer laboratories in U.S. and Europe. On a non-GAAP basis, Q4 gross margin was 50.8%, versus prior year Q4 gross margin of 47.3%, an increase of approximately 350 basis points. Our non-GAAP gross margin excludes the impact of our RADx awards as well as non-cash acquisition related purchase accounting adjustments relating to our 2019 acquisition of UmanDiagnostics, thus providing investors with relevant period-to-period comparison of our operations. We believe we have a significant opportunity for gross margin expansion in the future as we evolve our mix towards high margin consumables and accelerator services, scale our overall business, and reduce product costs. On a GAAP basis, our Q4 gross margin was 57.6% and was favorably impacted by our RADx grant revenue versus prior year Q4 gross margin of 43.1%. Our GAAP operating expenses totaled $25 million in Q4 2020, and non-GAAP operating expenses, which primarily exclude non-recurring expenses associated with our RADx grant revenue, totaled $22.6 million. During Q4 2020, our cash balance increased by $8.4 million, driven by $10 million milestone payment received in Q4 from Abbott, timing of RADx payments, and proactive working capital measures. We closed the year with $181.6 million unrestricted cash balance, and during Q1 2021, we raised approximately $270 million in net proceeds through our public offering. Basic weighted average shares outstanding for EPS totaled 31.7 million for Q4 2020 period. Overall, we are pleased with our Q4 and full year 2020 performance and progress made on our strategic priorities and remain committed to delivering a solid 2021 result in line with expectations. With that, I will pass back to Kevin. Thank you, Amol. We'll open up for Q&A. Ladies and gentlemen, if you have a question at this time, please press the star and the number one key on your touchtone telephone. If your question has been answered or you wish to remove yourself from the queue, press the pound key. Again, that's star one to ask a question. Your first question comes from the line of Puneet Souda with SVB Leerink. Your line's now open. Yeah. Hi, Kevin. Thanks for taking the questions. The first one is on proteomics. I mean, obviously, there's significant interest here in proteomics and more investment is flowing into early-stage technologies. Obviously, proteins and more importantly, the detection of proteins in the most sensitive way is something you do very well with Simoa. Just trying to understand, how is Quanterix positioned in the continuum of the overall research from the early stage sort of screening research, where you're looking at large panels and large number of proteins, to more targeted side of things and then into the diagnostics. Where do you sit into that continuum, and what should we be looking out for as signposts for Quanterix to be positioned even more in proteomics? Very good question, Puneet, and it's interesting. I get more questions in all of our one-on-ones with investors about where they should be making their investments upstream, given all of these new entrants, than I do sometimes even about us, because I think there's a lot of confidence and belief. They understand that we are executors that have been doing this for really 20 years with a lot of execution prowess, and we've spent a lot of time studying this landscape before even entering it. As you know, I came out of retirement seven years ago, but most of the 100 people we have in the company now from some of the former companies and are very experienced at driving execution in a landscape like this. We've been very measured in the way we've approached it. What we've been finding is that there is a lot of misinformation around those. There's a lot of people that can say things like, "We can see these markers." What we find out is that when they can see these markers, these would be some of the upstream companies, they're seeing them in very invasive samples, and/or they're basically saying that they can see them. The challenge is being able to see them through the continuum of health to disease. When you're healthy, you're at the lowest level, the lowest level of concentration of these proteins. What really is the magic around where we sit, which is downstream of much of the discovery, where the mass spec and many of these new entrants are trying to play a role in discovery, and some of them call themselves unbiased. I think to a great extent, many of them are unbiased, but they're not really totally unbiased because if a marker, a biomarker, a protein is at a really low concentration in a, let's say, a less invasive sample, and the patient is healthy, as an example, what you will find is that their technology won't be able to see it in that condition, which makes it actually biased against sensitivity. One of the big areas that I think that's important for everyone to understand is we are not trying right now to be a discovery house. There are a lot of really good companies entering that we think in invasive samples are going to be really good at discovery. Where we really bring our value to it is when you start to then say, what you can see in CSF, let's now see it in blood or see it in saliva, or even see it in breath condensate. That's when we think the utility of that protein goes way up, when you can see it in a non-invasive sample. Then if you can also see it from health to disease, even in the youngest population, where once again, the younger you are, many times the protein levels for like an NfL are even lower. It's that complete continuum that brings greatness into the discovery opportunities. Most of our customers understand that ultimately, they're going to want to have that sensitivity to allow you to see that very low abundance in that less invasive sample. Many times too, cleaning up the sample with dilution and getting around false negatives and false positives is another use of the sensitivity. Being able to quantitate and being able to say how much there is, particularly in COVID, when there's a real question around people getting antibodies. What's the quantitative level of those antibodies? Ultimately, is it neutralizing the actual virus, which it seems to be very personalized. A lot of diversity we're learning from the NIH between different people, but even within the same person for different weeks that they have the virus. There's so much diversity that you just need to be able to quantitate what you're seeing in order to unravel this mystery of COVID. This is where I think we play fairly uniquely with a lot of the drug trials, getting those drugs approved ultimately opens up the opportunity to screen people into the drugs that get approved. That's really where we sit, right now we sit fairly uniquely there, this is where the body of evidence is really in these third-party peer-reviewed, validated studies that validate our ability. NfL has been a key franchise, now we're evolving it into the p-Taus and looking at subtypes. It used to be that many of the competitors would look at total tau in invasive samples. Seeing the subtypes in non-invasive samples, dried blood spots, is really when you create the utility for that p-Tau franchise that allow you to differentiate amongst those that have dementia to only those that have Alzheimer's. Anyway, those are some of the pieces of this puzzle, and I think it's a real important question because there's a lot of money flowing now into proteomics, and you just want to make sure that it's flowing with long-term value creation, or we could end up in a scenario where people will not be happy with the long-term investment. That's great. That's very helpful, Kevin. I want to touch briefly on the neurology trials. You have done well here throughout 2020. We saw a major uptick in trials as Alzheimer's and multiple sclerosis and Parkinson's and other neurology indication trials have ramped up. Any measure you can provide us in terms of the number of trials that you can potentially get involved in as a result of more data and more confidence on the Alzheimer's end? Just broadly, in terms of neurology trials, what's your level of confidence for further growth in 2021 given the sort of base we saw in 2022, which was still a bit of a pandemic-impacted year? We feel very confident about 2021 and 2022 relative to the neurological drug trials and the current level of our very embryonic penetration. That penetration is actually embryonic in a field that you needed to start in because in order to conform to the FDA guidelines for biomarkers to be used in a drug trial, you have to have approved drugs to validate and quantitate the clinical validity of that biomarker for showing drug efficacy. MS has 16 approved drugs that allowed companies like Novartis and Roche to look at previously approved drugs to validate in retrospective trials, biomarkers like NfL, and then deploy them and downstream prospective trials for new drugs. That's why MS really is where it started, and even there, we feel like we're only 10% penetrated. That's where we see a lot more phase III trials and phase II trials, because we've been at that for several years. Alzheimer's is an area where there's no approved drugs, and so it's been harder for the Alzheimer's companies to prove out these biomarkers. Many times, they're proving them out with existing technologies like imaging and like cerebrospinal fluid, spinal tap samples. Those are so invasive and so expensive that they don't translate into longer-term utility. There's where we enter is by being able to ultimately see this in a blood sample, and then someday in saliva samples, we're unearthing the utility of those biomarkers for longer-term diagnostic and health screening purposes, as opposed to just to get the drug approved. Many of the Alzheimer's trials to date have not utilized our technology for those trials. If you look at the Biogen data, it's really based on CSF, highly concentrated samples. We know that They're one of our largest customers, as is Lilly. We know longer term, there's a lot more opportunity for the less invasive samples to get recruitment for patients to actually run these trials, and that's where we're bridging up and teaming up now with some of the payer groups to actually enable leading-edge drug trials utilizing what we would consider to be the payer group's membership as a great place for the biomarkers to be deployed. It allows the payer group to really showcase their leading-edge capability that almost anybody, when they start to see this, are going to want to be part of a payer group because of what they're going to bring as the next generation of medicine for deploying pre-symptoms or asymptomatically. I do think that we're on the first inning for Alzheimer's. We see tremendous upsurge for the next several years utilizing our biomarker technology for those trials, and we see it for two reasons. One is early recruitment before presentation of dementia, when it's easier for a drug to be efficacious. Secondly, to enrich the cohort by removing Lewy body dementia and removing frontotemporal dementia using the stratification capability of the technology. Once the drug gets approved, we look downstream at triaging and health screens to move patients more efficiently than imaging and/or spinal taps into the drug. Okay. Thanks for those details. If I could ask a more near-term question. First of all, that's great to have thoughts on the longer term as you're seeing these trials ramp up. I think you pointed out 30%-40% research CAGR here in 2019 to 2023, I believe. You have a number of growth drivers here. You have easy comparables for 2020 as well. Just tell us, why shouldn't we expect a meaningfully higher growth in 2021 versus that CAGR that you pointed out? Well, first of all, I've warned you, Puneet, and I try to say this to all the analysts. I think 30%-40% CAGR is plenty to create a lot of value, and trying to model things that go beyond that, I think, just represents risk that's not really justified for our investors. So I would almost criticize anyone that starts to throw CAGRs much higher than that. We feel very comfortable that that's a CAGR we can manage and execute against, because a lot of the value creation of our company is in the narrative of what we're really evolving to on diagnostics. You really can see the beginnings of many new investors. We did a raise back a few weeks ago. I think we had $1 billion of demand in the 24-hour period because there's a lot of interest of new investors into this category because of the longer-term opportunity. In the short term, I do agree that we've got some good comps because we had headwinds more than we had tailwinds for COVID. As a result, when you look at the CAGR or you look at the growth rate in 2021 versus 2020, it probably will be greater than the CAGR because our growth in 2020 was less than the CAGR, because it was headwinds from COVID. Again, I wouldn't buy our stock based on that. I think that's trying to time it in the short term, and I think that we're going to try to remove any tailwinds we get from COVID on the diagnostic side, just because we're going to remove it from and make it a non-GAAP measure so we don't create hard comps for 2022. We don't want people to see the tailwinds of what we do in diagnostics for COVID that might be short-lived. We don't want that to be a reason for people to surge into our stock. It's going to give us the pathway to get into these institutions, these research institutions, with the EUAs for really screening students in those research institutions. It's going to then give those installations an opportunity for the long hauler effect of COVID, which is more of a five-year play. That's where we see the sustainability of COVID value for our investor base. Sure. That's fair, Kevin. Thanks. I'll hop back in the queue. Absolutely. Your next question comes from the line of Sung Ji Nam with BTIG. Your line's now open. Hi. Thanks for taking the questions. Kevin, thank you so much for all the color around how Quanterix fits into the overall proteomics landscape. I was curious about just your multiplexing capabilities. You guys have obviously made a lot of progress in terms of sensitivity, attaining greater sensitivity, but haven't talked about multiplexing capabilities in a while, in my view. I am kind of curious, as you think about as Quanterix fits kind of in the downstream area compared to maybe some of these early discovery players, is multiplexing not as critical in your view? What is the right multiplexing capability, I guess, that we should think about going forward? Perfect question, Sung Ji. I think that this is a slide that I'm working on, we're working on for future presentations because it's really interesting. In the research phase of things, particularly in discovery, where you're trying to identify a linkage between pathology of the disease and protein signatures, you really want to have a very broad multiplex capability. The mass spec has been an example of this. It's a very broad-based shotgun looking at a lot of different proteins. I see evidence of these new entrants like Seer and SomaLogic. SomaLogic is not a new entrant, but they're also very capable. I looked at Olink Nautilus There's a lot of companies that I think will bring a lot of value to the multiplex shotgun to kind of identify the pathology that's rich for evolving utility of the biomarker into drug trials and then ultimately into diagnostics. There's where you want the less invasive sample, and you want to be able to quantitate, and you want to be able to dilute samples, and that's when the sensitivity becomes really important. Someday I'm going to have a slide that shows the role of the multiplex for the different stages of the pipeline. What you see is to the upstream side, where you're doing discovery, you want to have a lot of plex, but the overall TAM and the value creation is probably not going to be as significant there. It's going to be as it goes down the pipeline, it's used for drug trials, and then it's ultimately used in diagnostics. That's where we think the TAMs get much bigger and the value gets created. I look at, for instance, today, there's three companies, Roche, Siemens, and Abbott, that have nearly $20 billion of TAM on basically 200 proteins, but 100% of that revenue is basically single plex. You can see what I mean here, that once you hone in on the protein of interest, you can create a lot of TAM and a lot of value for single plex. You get this situation that you do need a lot of plexing upfront, but once you get into the utility zone, 10 plex to maybe 20 plex is probably going to be more than is needed for a panel that gives you the specificity and gives you the disease specificity and gives you the ability to create utility. I think that there will be the number of tests that are run. You'll find that the volume of testing run will be greatest for the high plexing, but the value of where a lot of dollars sit is going to be in 10 plex and lower. I think Roche, Abbott, and Siemens have demonstrated that with their incredible ability to create a lot of value for a very key number of proteins that are all single plex. Does that help, Sung Ji? Yes, that's super helpful. Thank you so much for that. It's fantastic to hear you guys partnering with the payer groups. Just kind of curious, though, are there specific studies that are currently underway where you might have visibility into the timeline of when we might be able to see the data readout? Yeah. I think that what you'll see is probably it's up to the payer themselves on what they want to publish. I can't really say at this moment how public they're going to want to be with the surveillance data that they're collecting. We are running three different IRBs right now and see a lot of opportunity for additional ones that I think are informing them at more of a population level. Eventually, we think that this is giving them introduced to what biomarkers can do, and that then can lead to that slide that I showed at the end, one, two, and three, where you could even see biomarker discovery as well as teaming up with pharma companies. I think you might have saw the announcement about two months ago from UnitedHealth Group and Lilly teaming up. That was an example of the payer groups teaming up with pharma to try to get drugs that haven't been able to be approved by utilizing their membership for some of the disease cohorts. I think that that's where the opportunity really gets started. Longer term, you'll see them, I think, practicing biomarker surveillance of all their members, probably at a quarterly level, hopefully using home care. How much they publish between now and when they get to that state is kind of their call, and we will be continuing to invite them. There's an independent conference summit called Powering Precision Health that we will continue to invite the payer groups to. That's incredibly aligned with what they're trying to do with outcomes. It makes it a really easy putt for their involvement there. That's probably where you'll see a lot of the readout for some of the learnings that they're getting from their IRBs. Great. That's super helpful. Lastly from me, just kind of curious on the COVID antigen test. Obviously, very interesting insight into the disease there. It sounds like you guys are using it largely for research applications currently. Do you foresee kind of in the future, as you look at the whole field of infectious diseases, your capabilities of being able to detect antigen, viral antigens at such a high sensitivity could potentially disrupt how the clinical diagnostics field might look at detecting viruses and pathogens going forward? I do think that there are some potential differentiating opportunities in that field of diagnostics COVID. We are trying to treat it as a measure, though, of revenue. We would probably subtract it out because we don't know how long-lived it would be given the vaccines and given the timing of the overall COVID. We do think that it's easy to mislead investors in this part of the landscape. We do expect there'll be some tailwinds, and one area would be in just looking at anyone, we call them long haulers, people that are still suffering from symptoms, many of them six months later. There are still people that don't have recovery of taste and smell, and that's a critical CNS function that could be linked to sometimes longer term neurodegeneration, or we've seen evidence of stroke and heart attack and other types of issues from those that have had COVID previously. The innate immune system being fatigued is another area that there's a lot of focus. I do think that there'll be an opportunity for some diagnostics looking at the virus in blood to ensure that these patients have eradicated all of the virus from their body, where they might, if they measure it using the traditional nasopharyngeal or nasal swabs, the virus may have left the respiratory tract and it's only in the systemic blood tract, or vascular tract. There I do think there'll be a diagnostic opportunity. I think the whole field of asymptomatics, if we could get the right samples and the right IRB run, we think we could play a role there to see the virus before symptoms hit when it's more important to manage, because that's when you're most contagious, the 24-hour period before symptoms. I think those two areas, there's a potential chance for some tailwinds in 2021. Again, we don't want people to buy us based on those tailwinds. It's more an entry for us to get into those research institutions that will really be looking at that long hauler effect. Unfortunately, we are going to have to cut off. If there's other questions, I got to give a keynote on another meeting here at 5:30PM. If there's other questions, feel free to write those in to us. We really appreciate all the support that the investors have been giving us over the last three and a half years since going public. We appreciate this opportunity to keep updating you and let us know if any of you would like us to reach out to you one on one. Thank you very much for your time today. Ladies and gentlemen, this concludes today's conference call. Thank you for participating. You may now disconnect.