Q3 2020 Natera Inc Earnings Call
Welcome to the terrorists 2023rd quarter financial results Conference call. At this time all participants are in a recently node.
Management's prepared remarks, we will hold acuity session. That's.
That's the question at that time, Please press star followed by one or your Touchtone phone.
If anyone has difficulty hearing the conference. Please press star zero for operator assistance as.
As a reminder to come calling you reported today November two 2020.
I'd now like turn the conference call over to Michael Bofi, Chief Financial Officer. Please go ahead.
Thanks, operator, good afternoon.
Thank you for joining our conference call to discuss the results of one quarter 2020.
Also on the line, it's Steve Chapman, our CEO Solomon Boskovich General manager of oncology and Paul Billings Chief Medical Officer.
Today's conference call is being broadcast live via webcast we.
We will be referring to a slide presentation that has been posted to the investor Dot Dot com.
A replay of the call will also be available at Investor day, So dot com.
During the course of this conference call, we will make forward looking statements regarding future events and our anticipated future performance.
Such as our operational and financial outlook and goals, our assumptions for such outlook and goals. The impact can be covered Nike I'd make on our business and operations market size partnerships clinical studies opportunities and strategies and expectations for various current and future products, including product capability, especially releases.
It is a small fraction of the size we are today.
We generated revenues of 98.1 million, which is again a record and is up 13% from Q2, 2020, and 26% from Q3 2019.
This revenue growth was largely driven by product revenues, which was up 39% year on year.
As most of you saw after years of effort. We were very pleased to see a position statement from eight coggan S. M. F M supporting N I P T and all pregnancies.
The statement included a table highlighting the superior performance of N I P T and specifically highlighted unique aspects of the Smith based technology, including the detection of triploid. He is a gone city and twin pregnancies.
We've already seen a significant amount of momentum among pairs, adding average risk N I P. T to their coverage policies and we could see significant additions to that list in the near term.
This development of lines nicely with the timing of the completion of the smart trial, the smart trial as a perspective 20000 patient multi site clinical trial with newborn genetic outcomes and that is taken five years to run we think a study of this magnitude and scale will never be repeated and therefore it could be.
Become the gold standard and N I P T for the foreseeable future.
The data has been unblinded to us into the investigators in the trial and we believe the results have the potential to further drive market share. It N I P T and may unlock guidelines and reimbursement for micro deletions, which is already more than 100000 units per quarter for new terror.
We expect the data to be presented at the S. M. S. M Conference early next year.
We've continued to make excellent progress in the transplant space, we executed our full commercial launch this summer after securing a final reimbursement in may and we've continued to develop compelling data on our prosperity and.
In Q3, we published a clinical utility study and we announced a unique program highlighting the overlap of cancer in transplantation.
We've recently made significant strides in a oncology business as well we received a positive final coverage decision for Medicare for sickness here. It in stage, two and three colorectal cancer and we received another draft local coverage decision for our immunotherapy monitoring indication. We just introduced on the August earning.
His call together these indications represent nearly 2 million signature tests poor per year.
Additionally, we continue to see growth in our farm or business. For example, we're excited to announce a trial with Pfizer and another would novartis, where signature was selected to evaluate patients receiving C. D. K four six therapy in early stage breast cancer. If successful we expect that positive data for me.
That other trials would continue to expand the addressable market for sickness Tara.
Finally, we continue to build on our leadership position and published data we expect to present for posters at the <unk> conference in New November followed by significant new data and an oral presentation at the asthma I owe conference to spotlight poster presentation at San Antonio breast in December.
<unk> as well these datasets have all been submitted to talk journals for publication next year.
Based on the success we've had in Q3, we're excited today to significantly raise our twenty-twenty revenue guidance, Mike will get into the specific details of that at the end of the call.
K now, let's get into some of the business trends.
The next slide shows or volume progression over time and highlights a large acceleration of volumes. We saw in Q3. This was a blowout quarter for US. We are pleased with the initial volumes in Oregon health and in the prelaunch phase of taking a chair up those lunches are both on track and doing very well the bulk of this performing.
[noise] comes from the core reproductive health business hitting on all cylinders posted a cog, we're seeing an uptick in account to ordering average risk and I P. T and we have continued to benefit from closing new customers as well also as you would expect when it clinic starts ordering panorama from US we have an opportunity to educate the practice on our carrier screening.
Offering which serves to amplify the effect of these trends in our business.
The next slide shows are total revenue progression and a lot of the same trends are at work here. In addition to accelerating top line revenue as you can see product revenue growth compared to Q3 of last year was also very strong Q3, so revenue contributions from our new businesses as well.
As I said in the introduction. This is a time, we've really been working for over the past five years, where the success that we've had in Oregon health in oncology has now started to contribute to revenues were not breaking out the new businesses for competitive reasons here, but it's exciting to see some of the green shoots and he's very large markets.
The next slide as our standard average selling price per unit and blended Cogs comparison on the E. S. P. As you can see again the business is going very well.
We've continued to grind upward and the women's health business and we're starting to see some of the benefits of average risk reimbursement coming in and as I mentioned, we had a small but noticeable contribution from the new business units as well we're.
We're pleased to see blended cards get back down again in Q3, as we got some scaled benefits on infrastructure investments, we made a Q1 and Q2 like expanding our lab footprint in Austin.
This chart was historically, a great metric for tracking our path to profitability and the women's health business, given our volume growth E. S. P. N context vacation, we now see clear line of sight to reach in cash flow breakeven in the women's health business in the first half of 2021, which is a major achievement for the chair.
It's gratifying to see the key pieces of her longstanding Klan come together like this.
Now that the product mixing shifting a bit this blended E. S. P. N cards approach is gonna lose some relevance as a way to track her progress in women's health for example, even though we keep making progress on Ni P. T and carrier screening cards per unit, we expect blended cards to move up in queue for because we're going to be running a lot more <unk>.
For the first time point at signature of patients will continue to talk about ESPN Cogs and we'll comment on how it's going to a women's health, but we will be moving away from these blended metrics.
Okay next slide speaking of average risk N I P. T. I wanted to spend another minute on some of you for somebody that might be newer 10, a terror. So this next slide shows the practice bulletin that came out in August the statement from eight calling an S. M. S. M supports aneuploidy screening and all patients regardless.
Some maternal as your baseline risk and highlights for the first time, then N. I P. T can be performed in twin pregnancies. The bulletin also highlights unique aspects of snip based technology, including the detection of Tripoli use as early as nine weeks and the ability to assess a golf city and individual fetal fraction when <unk>.
Testing twins as he only snip based N I P. T available today. These advantages are unique to the terror and help us differentiate in the market.
As a reminder, the U S market for N. I P. T consists of about four to 5 million pregnancies per year. It is very underpenetrated, the average resetting, which makes up 80% of those pregnancies. So we still have a significant room to run Indiana P. T space, We think the a cog statement is already having a positive.
Impact on N I P T volumes, and we're seeing momentum with pairs changing coverage policies for both <unk>, both the average risk and twin pregnancies.
The next slide show some of the progress with payers in more detail. The acceleration we've seen in 2020 is really incredible and it's picked up even more since the a Cork bulletin, notably we were very pleased to recently see Paris like Humana and since he joined the majority of payers covering N I P.
P T for all women payers with positive coverage policies now in place comprise more than 200 million covered lives. There are still some notable exceptions of course like United healthcare, but it's been important to see a wave of very large and prominent pairs quickly changing their coverage policies posted a cog. In addition to the average wrist.
Noticed every year with colorectal cancer and about two thirds of them have stage two or stage three disease. So with the repeat testing described in the Medicare coverage policy. This would imply roughly 1 million tests per year as a total addressable market as.
As we expected we now have the final coverage decision for this indication from Medicare, which went into effect on October 18th.
We're continuing to work with CMS to finalize price.
And we are nearing the finish line.
The process for pricing is company and as a specific and the final pricing will not be publicly posted by the agency. So for competitive reasons, we do not plan to disclose final pricing. When it is completed we think we have a good sense. However, on where we are likely to land and we are pleased that the pricing.
Is likely to be consistent with what other companies are receiving for M. R. D testing in oncology.
We expect to be able to bill for patient volumes, starting as of the October 18th effective date.
As a result, we are now moving into the formal commercial launch phase for chicken terror in the clinical setting for colorectal cancer and we plan to build on the momentum we've seen in the prelaunch days.
As Steve mentioned, we are also significantly ahead of schedule with our immunotherapy response monitoring indication that was just introduced an hour lost earnings call in queue to.
More than 200000 patients are estimated to receive immune checkpoint inhibitors every year across a range of cancer types and that number is growing with every successful new farm a trial.
While immunotherapy has revolutionized cancer care in many ways. It is expensive and the majority of patients do not respond to this type of treatment.
One particular challenge is how to determine whether the treatment is working after it has been initiated and when it may be appropriate to discontinue or switch treatment strategies for.
For example, if a patient is not responding to treatment you would expect the tumor to get larger overtime on a scam. However.
However, up to one in 10 immunotherapy treated patients see their tumor get bigger on a scan before it gets smaller 'cause, it's being filled with lymphocytes and swelling up under attack from the immune system with a C. T scan the swelling looks like disease progression, which is why it's called pseudo progression.
As a result of these types of uncertainties.
As illustrated in the graphic current treatment guidelines for immunotherapy suggest that physicians continue treating beyond progression until they see confirmation of progression in a follow up scan approximately six to 12 weeks later.
This extra treatment can significantly delay sick patients for switching to other available lines of therapy that may be more effective or it can also result in premature discontinuation for a patient who may actually be responding to the treatment.
Based on the data that we published just this summer in nature cancer.
We think a serial testing protocol with cigarette Sarah could help improve this picture sitting a baseline C. T D N a measurement before treatment and then following up regularly in conjunction with imaging to help identify true disease progression earlier and to help identify exceptional responders, who have achieved C. T D N a.
Clearance and who may be eligible for a drug holiday.
So if you assume about four cygnets her tests per year for over 200000 patients. We think the addressable market for Signet terror and this indication could exceed 800000 tests per year as we described in August.
The next slide summarizes favorable draft local coverage decision that we received in response to her application to Medicare and iron monitoring.
We submitted the dos here for reimbursement to Medicare. This summer just after we published the nature cancer publication, and we received the draft L. C. D ahead of schedule in September.
And we were very pleased that Medicare proposed coverage for Iowa monitoring across solid tumor types based on the strength of our data.
We now expect to get final coverage and pricing and 2021 previously we had not planned to get there until 2022.
I also want to give a quick example of the type of work we are doing with pharmaceutical companies.
This slide describes the Dare study, where we are working with Pfizer and this study's signature will be used for patient selection and ongoing monitoring in early stage ear positive breast cancer.
Patients, who test M. R. D positive by Signet terror will be randomized into an active arm and which they get pelvis cycling plus full district.
Or into a control arm, where they get the standard of care endocrine therapy.
If studies like these are successful it would pave the way for Signet Terry usage in the large early stage breast cancer recurrence monitoring market.
Farmer demand has been growing rapidly for us we continue to win business from new customers and Ah repeat business from our largest farmer clients is continuing to grow consistent with trends. We described in August.
Finally, as Steve mentioned, we look forward to signal Tara data being presented in three different conferences before the end of this year, including new breast cancer data at the San Antonio breast cancer meeting in December and new bladder cancer data and an oral presentation at M. O I L. Also in December.
These data will be really novel and will contribute meaningfully to the date of leadership position. We have developed in M. R. D.
Now, let me him to call over to my to cover the financials like.
Thanks, Solomon dislike here is just a summary set of results for the quarter, Steve covered volumes revenues and togs product revenues really drove the quarter and the revenue recognition we were getting some as we signed a partnership deals with D. G. I N Foundation medicine was significantly lower in Q3 that development relate.
They'd revenue recognition has largely run its course as the project shipboard commercialization in the future. So despite that transition away. Some partnership revenue recognition, which is very high margin overall gross margins still manage to increase meaningfully over the last year the speak to the improvement an average selling prices and coughing.
[noise] goods sold per unit, let's see presented.
A couple of other items to note on the expensive side. When we spoke in August we describe that our business has responded really well despite the pandemic and we're scaling up particularly in our former operations channel to meet increased demand we.
Four so that that is why we left some range and the guy there, but we do feel comfortable enough with a full year results that we could tightened to the upside as you see on the page Opex investments will continue as we've described and we are pleased to tightened to Casper and guide to load the high end back into our original range for the year as I talk.
About.
So overall, we're very pleased with all the momentum into business and we really appreciate everyone's support.
With that let me hit it back to the operator questions operator.
Thank you, ladies and gentlemen to ask a question you would need to press star one of your telephone to withdraw your question <unk>. Please send out when we compiled the Q&A roster.
Alright first question comes from Duction Cope with Cowan Your line is open.
HM Good afternoon. This is super on production <unk>. Thank you for taking my question first one signature on the draft and city mentioned the possible use a picnic that out for the other solid tumor is this type two patients who have been treated with diet drugs or is it different and have different how much more addressable market with that AD and I have a follow up.
Yeah. Thank you for for asking that question I really appreciate it so I I would say first.
We're super excited about the final L. C. D that we just received for colorectal, which is an enormous market over a million patients per year in stage, two and three and there's an opportunity to expand that further for example, with some advanced colorectal cancer patients on the living room.
Metastatic stage that we published this summer at the the asthma conference. So we we look forward to getting that under coverage and expanding that indication four I owe monitoring the the the initial coverage that we submitted just for that I owe monitoring indications an additional 800000 patients so.
Again like massive expansion of of the market. There is an opportunity for us to expand it further into other tumor types, even beyond I O monitoring and we think that again, we're well positioned to take advantage of that the most important thing is generating data and as you've seen we now.
25.
Oncology sales reps that would help us in that kind of pre launch phase and then after we fully commercialized we to expand that.
You know overtime and I think now that we've gotten the final coverage decision. It puts us in a position to give you able to add more sales reps.
We have incrementally added a few overtime, but we're also making investments in other areas.
Product lifecycle clinical.
Data generation.
Clinical trials like you've seen with the big perspective.
Bespoke registry study that Weve announced.
Society in kalo relationships, so there's a lot of investments.
Across the business and across each functional area going into oncology that go well beyond just sales.
Certainly our strategy is to make relationships with top academic centers in key opinion leaders.
And then in addition.
Cover the community oncology practices, and we're looking to be in a in a position to execute that and.
Continue on the success that we've had the early evidence is looking very very good we're pleased with how we're doing and.
Experienced data if you'd go back and look at what was available at <unk> at <unk> or the summer as well you can see somebody engagement, we have in the commercial and your early pre commercial launch with some of the top key opinion leaders. So we're excited about how things are going.
We think we're gonna be kind of right in there with with the ramps of some of these extremely successful companies you know like Garden Gnome Foundation, when they went out and we're expecting to have kind of similar types of penetration over time to what they've been able to do and frankly, that's what we're seeing right now my <unk> you want to comment on it.
[laughter].
No I think you'd have to well.
Month, or so a month and a half post the guidelines, but also competitive takeaways.
And when you look at.
The unique clinical aspects that the panorama offers for noninvasive prenatal testing and you combine that with the massive data <unk> that we have that really doors, the clinical data than any other N. I P. T has on the market just add that package combined with our.
The dominant position and then we've announced a partnership with the Beijing Genomics Institute in China. So B G. I is the dominant self free DNA in secrecy provider in China.
They've done more testing than anybody they're going to be launching signature on the both clinical setting and then also as a form of service provider. So we've.
I'm pleased with the performance of our team. So we're meeting our plan. Despite the impact of Covid, we're seeing very strong receptivity.
Two business units and and and so you know we're pleased to see that happening as we thought it what.
Great. Thank you so much.
Thank you. Our next question comes from <unk>, Let's test <unk> Carolinas open.
Although I I want to reiterate colorectal.
And I owe together make up around 2 million tests per year.
You know if you compare that to some of the other you know oncology diagnostic opportunities that are out there that are in the range of say 400000 cursed per year.
You know early data sets and.
In lead in this market and Mardi setting.
And CRC and then expanding beyond that into Io just sort of when you look at this market potentially five years out with.
A tumor in form to ask they in hand and.
There there are competitors that have tumor naive assay other products emerging in the space.
Panel and sort of tumor naive approach and so I won't go into that again.
Other than to say some of the data that we've seen coming out.
Being amplified by the payer changes that we've seen over the course of the year.
And really on improving carrier screening and delivering Austin user experience tons of new data tons of new features and we're really making investments in making the women's health franchise. The the leading franchising and we're seeing some of that you know I think play out competitively now some of the things to be done over the last couple of years to put.
Ourselves and Ah <unk>.
Back to launch to pharma companies. This year end is that offering something that you're already discussing with potential pharma partners such at once you're ready to launch there could be some pent up demand there.
Yes, so the partnership with foundations Theo going very well.
They're a great partner.
We really have a ton of respect for their team both commercially and I'd be executive level.
And their scientific came in and said it's been it's been really a pleasure to be partner with them.
We what we've said is that there will be.
You know a sort of a pilot launch to pharma on discussions with pharma starting this year and that's actually ongoing right now and those discussions have been very positive.
And youll be moving towards a more.
Kind of a hard launch at some point later in the future and kind of later 2021, but.
The initial interest has been very positive and everything is on track and there are there are deals that.
They are being signed right now.
Okay got it and if I could sneak one more in on carrier screening I think back in September you had evidence street.
Cogs update that would be great.
Yes. Thanks, So we gave a range.
For the rest of the year, which is really a Q4 guide and the reason why we gave a range is because as you know as you point out there are some variables there.
That there's potential for some volatility I mean, I'll tell you that the underlying trends of the business. So far in the quarter are quite strong and we are feeling very comfortable.
With.
With what we're seeing so far and probably the guide itself implies.
Continued sequential growth in the business over and above this very strong Q3 that we had so I think that baseline expectation is that the trends of the business that we're seeing so far this year remains stable and then the top end gives basically some room for.
Incremental acceleration beyond here and the bottom end gives some room for there to be a little bit of lumpiness and the volumes or the case counts to until the two perhaps slows a little bit with the with the holidays and things like that but I think the baseline is.
Trend stable and we're feeling very good at where we're at.
Great and then in May you asked a settlement with your large sequencing provider should set you up for.
For Cogs improvements I believe in October and beyond so can you just highlight you know when you consider.
The biggest needle mover in that settlement, if you're seeing any impact and just how this plays into your expectations for for gross margins.
It's not going to be something that really impacts the.
The 2020 guide I think thats something that again, I mean, very favorable settlement, great too to get that behind us and.
Clockwork and and the the the Provider's are very comfortable with this sort of releasing tissue. It's something that made you all the time for genomic health or foundation medicine in any of these other tests.
It's pretty straightforward.
Seeing use cases, you're very from this M. R. D time point, you know somebody who's who's just entering into that adjuvant window and the physician wants to make a decision about new adjuvant treatment or they want to inform the adjuvant treatment, we're seeing Ah Ah Ah.
<unk> use their as we thought we would have multiple time points. So we're tracking how many time points were getting and so forth and and it's it's sort of tracking roughly in line with with what we thought we'd expect and then there's actually some patience that.
They're actually coming into.
The fold post the adjuvant window. So these are people that are you know what we we like to think about it is the backlog from the from the account <unk> or the the prevalent population yeah that had previously been diagnosed they previously had surgery they they probably.
May or may not have received adjuvant chemo and now they're in remission and we're seeing a good chunk of patients that come in and enter.
Enter the protocol at that time point, so the doctor sees value, even though they're in remission of going and having us from the Exxon designed to personalize primers and then start monitoring so it's a little bit of a mix of those.
<unk>, we're also seeing usage in in there and the other G. I cancers and then we are although you know not all of its reimbursed we're accepting tissue resetting samples you don't on a limited basis in in <unk> and other cancer types as well there's been a couple.
Pretty good.
Early stage clinical experience posters out there uhm it at at as no and then it <unk>, we'd be happy to kind of shoot out to you as well that highlight some of the initial experience with a couple of the top academic centers, but you know a little bit of both M. R D and recurrence monitoring exactly as we.
Had expected.
That's great very helpful. And then we <unk>, we have seen some big news here with early cancer screening like exact grills mothers not to take away from the huge opportunity to M. R D and recurrence, but I think the terror knows shell three DNA better than anyone.
Can you more effects dignitary technology into an early can't screen and perhaps the better question is would you want to go after this market.
Yeah. So you know obviously, we've we've been aware of of what's going on in in in the space and you know we were at this point, we're really staying focused on this M. R. D recurrence monitoring therapy effectiveness, but I do think that you know expanding into other.
Opportunities, it's something that would make sense for us to do and to to leverage or.
You know to leverage our commercial team Uhm I think <unk> by nature of the signature of technology is not something that can be used for early detection it tumor informed.
It requires one to have been diagnosed previously but certainly.
Yeah, we have whereas you mentioned, you know or large expertise and uhm self free D and and and we have a very big team and and you know if we wanted to look at.
Things like early detection you know, we we would we would have the right team in place to be able to do that but again, it's not.
That's not our main focus right now we're we're pretty laser focused on this enormous opportunity ahead of us in in the M. R D space and and getting our share of there's 2 million tests per year that we think will already be reimbursed uhm and then expanding into that.
18 billion dollar tab.
Yep understood and then just last question can you expand on what the a card guideline does here for Medicaid from both a pricing standpoint of coverage and a usage among state the state just any thoughts there.
Yeah, Yeah. So I think we showed on one of the slides. So the state Medicaid programs have now doubled the number that we're offering average risking I P. T. You know that that was really low before was almost nonexistent and now we're seeing that wrap up so I think that's a good time because.
You know a good portion of pregnancies in the U. S. Today are are are covered by Medicaid and yeah. I think there's a path to reimbursement there uhm, we take the guideline will unlock both you know a <unk>.
Our core signature technology would not just poured over.
But.
There are ways that we could be successful in that early detection space.
Solomon do you want to add any comments there yeah, I think sort of a two part answer here.
So if you're if you're doing early screening in a patient use asymptomatic.
Smart said here in the industry is taking multiple approaches to that all right folks.
Folks you're adding.
Proteomics or they are adding.
Methylation or theyre, adding other capabilities that improve detection.
What you can achieve you cannot achieve with just looking for DNA mutations alone.
And so you have to do that because you don't have any other way to inform your test right. So the terra.
It does have a lot of the tools, if we decided to make a move in that direction.
To be able to compete and you know we've been actually spending a good amount of time investigating some of the other technologies.
And we think we have a good handle on.
The pros and cons there.
Bull run.
Run rate when revenue trickles in and.
Related to that I believe the M&A awarded you guys $802 a few years ago for micro Dell. So can you just help us think about your pro.
Pricing for micro cells.
Yes, that's right.
That's exactly right I mean, we're doing over 100000 microdeletion tests per quarter.
We put into work, we sponsored a five year.
Prospective multi site study of 20000 patients it will never be repeated its the gold standard in an IP and the gold standard in Microdeletions. The results have been unblinded, we've looked at them.
We think there is strong enough to change society guidelines and to drive payer coverage.
We've we've we've gotten a price of roughly $800 from Medicare on the clinical lab fee schedule and if we got even a fraction of that on average it would be you know.
Neely.
Hundreds of millions of dollars.
To the bottom line of the business. So we're in a really.
I think incredible position if we can we can execute on getting that coverage because we don't really have to grow any additional tests. We just have to get paid for the tests that were already doing and meet the usual thing that drives coverage studies clinical data and studies and we've done it now we did the work Thats reading out.
Okay.
SMS them so.
This is this could be it just really incredible.
Opportunity for us that that.
Frankly, we haven't really spent a lot of time talking about.
Just because it's been going on for so long we have so many other awesome things happening within the business, but it's an enormous opportunity.
Yeah, and then just for housekeeping do you expect a publication soon after.
The SMS them annual meeting and do you expect commercial payers to evaluate this and maybe come on.
Sometime in 2021.
Yes, so the publication will be in the first half of 2020, it could be shortly after SMS them or you know, maybe maybe slightly after but.
But I think the data is going to be out there.
The mean.
I think the folks that are that are the key drivers of the decision making.
[music].
Within the societies are the same people that are involved in the paper and you know it and they've seen the results and you know all I can say is that that we think it's.
Data that is strong enough to change society guidelines and if you look at.
Commercial payers there.
The only thing they really care about is society guidelines.
So yes, I think we've we've shot our shot here and this is probably the best possible outcome, we could get you know it's.
As far as setting up to get coverage I mean, 20000 patient prospective multi site trial collected over five years with genetic outcomes.
As never nothing even close to this has ever been done before and to have the results come out.
And.
Have them may be stronger I think will will be a very significant.
Significant readout and the.
Folks that are driving the society guidelines or.
The ones that are involved in and around the.
Fringes around the around the group of people that are involved in the study. So it's a great set up.
It could it obviously takes time once society guidelines change.
How that revenue come through.
Now you need to have the paper published in it doesn't happen overnight, but I think it is something that will be impacting us in the future. We just can't say exactly exactly what the timeline is going to be.
Excellent if I can ask one last one so.
It sounds like you're sitting on pretty good data.
Our breast and bladder.
Have you seen that data yet you've called it very compelling so I assume you've seen it.
But when that data reads out at ESMO in San Antonio is.
Is it reasonable for us to think that.
You could potentially announce cigna terra expanding to both breast and bladder on a standalone basis.
Yeah, we think the data that will be reading out is is extremely compelling and is of the quality that could drive additional reimbursement decisions and we think the way. The current draft coverage decision reads would allow us to submit this and.
Get coverage.