Q4 2020 CareDx Inc Earnings Call
Greetings and welcome to the Coeur Dx, Inc, fourth quarter, 'twenty and 'twenty earnings Conference call. At this time all participants are in a listen only mode. A question and answer session will follow the formal presentation. If anyone should require operator assistance. During the conference. Please press star zero on your telephone.
And Pat as a reminder, this conference is being recorded I would now like to turn the conference over to your host Greg how to check managing director.
Good afternoon, and thank you for joining us today earlier today <unk> released financial results for the quarter and year ended December 31, 2020. The releases currently available on the company's website at Www Dot <unk> Dot com.
Raj Sito, Chief Executive Officer, and Marcel Conrad Chief Financial Officer will host this afternoon's call.
Before we get started I would like to remind everyone that management will be making statements. During this call that include forward looking statements within the meaning of the federal Securities laws, which are made pursuant to the safe Harbor provisions of the private Securities Litigation Reform Act of 1995.
Any statements contained in this call that are not statements of historical facts should be deemed to be forward looking statements.
All forward looking statements, including without limitation, our examination of historical operating trends operating trends expectations regarding coverage decisions pricing and enrollment matters and our future financial expectations and results are based upon current estimates and various assumptions.
These statements involve material risks and uncertainties that could cause actual results to differ materially from those anticipated or implied by these forward looking statements.
Accordingly, you should not place undue reliance on these statements for a list and descriptions of the risks and uncertainties associated with our business. Please see our filings with the Securities and Exchange Commission.
The information provided in this conference call speaks only to the live broadcast today February 24th 2021.
<unk> disclaims any intention or obligation, except as required by law to update or revise any information financial projections or other forward looking statements, whether because of new information future events or otherwise.
This call will also include a discussion of certain financial measures that are not calculated in accordance with generally accepted accounting principles.
Reconciliation to the most directly comparable GAAP financial measure maybe found in today's earnings release filed with the FCC and now I'll turn the call over to rich.
Thanks, Greg Good afternoon, everyone and thank you for joining us.
Welcome to <unk> fourth quarter, and full year 2020 earnings conference call.
Before getting into our results I want to thank all of our employees and partners.
And the many challenges of 2020 with COVID-19, and all of Us and <unk> rallied together and worked tirelessly to develop and deliver new and unique solutions to improve transplant patient lives.
This plan has been on 100% focused and more than 20 years, and we're extremely proud that 'twenty and 'twenty was a year, we can seem to cell transplantation and the trends. Thank you mean now.
Now turning to results.
2020 was an exceptional year to cash.
As demand continued unabated from innovative first in class suite and high value health care solutions and <unk>.
And so on patients and caregivers.
Our full year revenue was $192 to me and representing over 51% growth over the prior year.
For the fourth quarter from 2020 total revenue was $58 six me and increasing 64% compared to the year ago quarter.
The majority of the growth in the quarter was driven by our testing services revenue, which increased 73%.
Product revenue for the quarter was $5 9 million and digital and the other revenue was $2 for me and to the topline.
GAAP net loss for the fourth quarter and full year was $3 5 million and $18 7 million respectively.
Adjusted EBITDA for the fourth quarter and full year 2020 was $4 nine and 8 million respectively.
Digging deeper into our testing services for the fourth quarter.
<unk> provided on the 25000, and Alice Shaw and Allomap results to the transplant patients and this quarter growing approximately 78% from Q4 2019.
And 40% of our testing volume originated from mobile phlebotomy and.
At the end of December over 55 transplant centers in the United States have adopted and Alice Shaw testing protocol in the standard of care.
Yeah.
And the fourth quarter product revenue increased 17% compared to a year ago quarter.
L seek soccer game LLC cash 70, each generate revenue in 2020, we expect both products will begin to produce stronger growth is more COVID-19 vaccines and rolled out in 2021.
Revenue from our digital solutions was $2 4 million for the fourth quarter in 'twenty and 'twenty. One we expect our software solutions will continue on a direct incentive strategy.
And the order workflow as we expand our digital offerings and more U S based transplant centers and adopt our solutions.
Again, 2020 was a transformational year for <unk>.
And I would like to highlight several significant product and.
Service offerings, we announced last year.
Firstly and.
In March as COVID-19 infections began to accelerate we announced the launch of <unk>.
Our solution, enabling remote on based monitoring of transplant patients.
This offering wasn't response on need from transplant centers and patients and we're very proud to be able to put this together within a week.
By early April we established a nationwide network of more than 10000, and maybe also partners and by the end of April close to 50% of rollout value testing volume originated from mobile phlebotomy.
And as at the end of December approximately 6000, kidney heart and lung transplant patients Havent wrote and our <unk> offering to.
Good day more than 150 centers using my track.
Secondly in April we introduced <unk>, our surveillance solution for patients who received engineered cell transplants to allogeneic cell therapy.
With allogeneic cell therapy, being a rapidly growing clinical development area and oncology.
Neovascular neurological autoimmune and infectious diseases, we believe asset balance solution is a perfect partner for companies developing allogeneic cellular therapies.
Early this month at the annual transplantation and cellular therapy meeting full abstracts were presented showcasing a sailor transplant therapy portfolio, including without partner of tower Biotherapeutics.
This is just the beginning of and also offerings as we will continue to develop our products and part and with other companies developing trends on these cell therapies.
Thirdly and all.
October data from our pivotal clinical study for our short and long as published and transplantation direct.
The study demonstrated that Alice Shaw alone and identify patients with acute seller rejection.
Critical need for lung transplant patients, whose only option and deck projection is and invasive bronchoscopy.
With lung transplant patients, having one of the lowest survival rates the solid organ transplant. We believe our show along is a powerful noninvasive tool and monitoring the health of the transplanted organ.
As a reminder, Alice Shaw for lung transplant patients has been available on the compassionate use in February 2019, and in June 2020, we submitted our alcohol on dossier to Palmetto moldings and for Medicare reimbursement.
And finally in November we received final reimbursement pricing from Palmetto and mold ex the Alice Shaw Hot.
As we look to 2021 and beyond and we remain very excited about phosphate.
And Alex you're testing volumes continue to impress.
And our decision to focus first on the transplant centers without direct to Sensus strategy has allowed our show to be used and grades and 70% of transplant centers and more than 55 transplant centers have adopted and Alice Shaw named protocol as of the end of December.
We continue to add more transplant centers and protocols, we can now start our director community strategy.
As you mean nephrology team was hired at the end of last year and we are very encouraged about the job our team is doing.
Combined with our direct to patient strategy. We've now started that last mile with the patient.
We recently launched allocate and Thats designed by transplant patients and physicians.
This atlas designs make managing patients' day to day healthier by allowing them to easily track progress and health activities manage medications and set reminders and communicate without patient care managers to scheduling labs.
Moving to the heart franchise.
Allomap heart testing experienced strong double digit growth.
Thrilled with the approval of Alice Shaw Hot when used in combination with Allomap known as hard cash.
As I previously mentioned, we received Medicare reimbursement to Alice Shaw Hot at the end of last year.
Well, our growth and hard this past quarter stem from an increase and Allomap testing in December we began submitting Alice Shaw Hot tests for reimbursement from Medicare patients.
Regarding reimbursement from non Medicare patients, we are working with health care providers to procure commercial reinvestment.
Regarding our digital offerings, we recently announced the acquisition of <unk>.
A provider of electronic health record software supporting the needs of U S transplant centers the true.
And so on acquisition is another cog and our digital offerings.
<unk> auto transplant with electronic medical record software and Zane coffee transplant quality management solutions.
With this acquisition our EMA coverage now extends to over 90 centers and total.
As part of the transplant acquisition, we also quiet T X connect a leading provider of human biologics donation and transplantation software.
T X connect allows us to help from the upstream and the patient journey and connect the centers with the dialysis centers.
Last but certainly not least.
I'll also offering is beginning to bear fruit.
And I'll leave this month, along with our partner <unk> Therapeutics, We announced we were presenting data on <unk> and a poster titled a sensitive and precise universal surveillance solution and pharmacokinetic monitoring of off the shelf cell therapies.
This was presented at the transplantation and cellular therapy meeting and described the potential use of alfalfa standardized pharma kinetic assessment and clinical trials and highlighted data on Ala heme and L. C. A T T for climbers and and return the balance of stem cell transplant patients and we're very excited about the central valley. So that we're in very early stage.
And the significant greenfield opportunity.
2020 was an exceptional year for <unk> as we continued to build out our product offerings, while driving robust growth and marketed products.
That being said we believe we are just getting started.
Everything we do and <unk> has one focus and that is to be the leading partner for transplant patients and the transplant ecosystem.
Focus and commitment to the transplant community and the driving forces behind DAU growth and.
And I expect 2021 to be another exciting year for <unk>.
In summary, the 2021, the key growth drivers and milestones at two <unk>.
Alright, I'll direct incentive strategy.
Continue on waiting for them and it by adding Alice Shaw kidney and heart care protocols and continue EMR integrations.
Build out direct to patient strategy with rima attract Alistair as.
And as well as throughout patient care managers.
Start the directed community strategy with meaningful allergy field team, which was hard at the end of last year and create the new businesses and cell therapy and stem cell transplant.
A few key milestones to highlight over the coming quarters include in Q1, and the launch of our new digital offering TX connect this really provides an opportunity for us now to build a connection with the dialysis centers.
And the signs it is truly exciting as we continue along that patient journey continuing.
In Q2, we will provide the kayo 1000 readout at ATC largest transplant conference held annually.
In Q3, we expect to share Alice Shaw lung Medicare reimbursement update as we hear back from moldings and and twofold.
And we expect to continue the exciting multi modality work first challenge and HOKA, but now starting with kidney care as we get clear validation that allomap kidney.
With that I'm going to turn the call over to Marcel discuss our financials and 2021 guidance.
Thank you rich.
Turning first to the income statement, our fourth quarter of 'twenty and 'twenty testing services revenue increased 73% year over year to $50 3 million.
The growth and the fourth quarter testing services revenue was driven by our short kidney and on my part patient results.
Our fourth quarter product revenue increased 17% year over year to $5 9 million and.
And our digital and other revenue was $2 4 million.
Our gross margins continued to improve year over year for the fourth quarter of 'twenty and 'twenty. The GAAP gross margin was 68% compared to a gross margin of 65% in the same period of 2019.
The non-GAAP gross margin for the quarter was 70% compared to 68% in the prior year quarter.
For the fourth quarter of 'twenty and 'twenty net loss was $3 5 million compared to a net loss of $4 8 million and the same quarter of 2019.
Our net loss per share was seven <unk> for the quarter compared to a net loss per share of 11 cents in the fourth quarter of 2019.
For the fourth quarter of 'twenty and 'twenty, our non-GAAP net income was $4 3 million compared to a non-GAAP net income of $1 6 million in the same period of 2019.
We are making good progress with our earnings per share.
Our basic and diluted non-GAAP net income per share in the fourth quarter of 2019 was nine cents.
And eight cents respectively.
Compared to a basic and diluted non-GAAP net income of four cents in the same period of 2019.
As a reminder, we define adjusted EBITDA as a non-GAAP net income before interest income tax depreciation and amortization and other expense.
For the fourth quarter of 'twenty and 'twenty, we recorded positive adjusted EBITDA of $4 9 million compared to an adjusted EBITDA gain of $1 5 million in the fourth quarter of 2019.
Cash cash equivalents and marketable securities at December 31, 2020 was $224 7 million.
We continue to strengthen our balance sheet in particular, our cash position.
Earlier. This month, we successfully completed a public offering of approximately $2 2 million shares of common stock raising roughly 189 million after deducting underwriting discounts and commissions and estimated offering expenses.
In January we also repaid the CMS advance payment of approximately $25 million to CMS in full.
On an operating basis in the fourth quarter, we generated record cash from operating activities of $7 2 million.
Now turning to guidance, we are providing our initial 2021 revenue expectations to reflect the continuous growth of allo shore as well as the other growth drivers outlined by rich.
And as such and anticipate 255 million to 265 million revenue for the year.
And our guidance balances the continued uncertainties around COVID-19 pandemic, but emphasizes further market penetration.
We feel well positioned to continue to lead the field in bringing novel solutions to the transplant clinic.
With that I will open the call for questions.
Yes.
At this time, we will be conducting a question and answer session. If he would like to ask a question. Please press star one on your telephone keypad and confirmation tone will indicate that your line is and the question. Kim you May Press star two if he would like to remove your question from the camp.
And for participants using speaker equipment and may be necessary to pick up your handset before pressing the star keys, one moment, please while we poll for questions.
Okay.
Yeah.
Our first question is from.
Brandon Couillard with Jefferies.
Please proceed with your question.
Hey, guys. This is Matt on for Brent on this afternoon and thanks for taking the questions to start off with guidance. You know 2020 reps came in and well ahead of your initial guidance pretty impressive feat given the backdrop last year.
Part of it tied to your quick turnaround and with remote track, but and number of other positive growth developments as well. So as we look out to 2021 Reg can you perhaps talk about some of the key growth drivers for this year and where you see.
The greatest potential for upside as well thanks.
Yeah, Thanks, Matt So I'm.
No.
Actually build a really nice.
Engine of growth and I think you know testing serves as the area that we've focused on we've really great winning formula and we will continue to.
And when protocols with incentives and add new centers and that sort of.
On the the winning pull new and established.
And then secondly, what's really exciting as we built out the commute for all G team at the end of last year is the ability now to expand and community and this will be Eric incremental opportunity and growth for us as an organization.
The third is how we look at Alice Shaw Hot and with the recent approval reimbursement with most modality. This will be another area of incremental growth and reimbursement for us as well so.
And certainly some really strong potential growth drivers as we move into 'twenty and 'twenty, one and we look really forward to continue and what we do for patients every day.
Thanks, and then on Ala and <unk> as you mentioned in your prepared remarks, you presented some pretty interesting data with your partner of Tyra.
At the transplantation and cell therapy meeting earlier this month and the opportunity is clearly there is still on the pretty early innings, but curious if you could elaborate on how if at all conversations have evolved here clearly being out there with a known cell therapy entity that has multiple programs and its pipeline is pretty impressive validation for you guys. So just curious how.
Conversations with other partners are progressing from here. Thanks.
You know Alex so, it's really an exciting opportunity and it's part of the future longer term growth as we as we see it replicating what we did with with Alice Shaw by trading and new market.
Universal surveillance to allogeneic cell therapies.
With the tower, and we're really proud to be able to share that partnership because the way out agreements are written is that we actually cant disc.
Disclose what we're working on who we're working with them and I think with their lunch and we built there and they feel comfortable about sharing information.
Information of what we're doing in terms of all the partners that we've spoken to particularly those in the clinic.
There's a lot of excitement about working with a new standard one which.
And we'll help them to create I think the importance for us as you know it's not about driving you know.
Meaningful revenue and start building partnerships with as many of these allogeneic cell therapy companies as we continue to build out this space together on this.
This is a wonderful opportunity took as more of these get approved and.
In the future as a reminder, there isn't.
Any allogeneic cell therapy approved today, but we believe that is the way in the future.
Thanks, and then just one last quick one on and be much but you said it was 40% of volume share and the fourth quarter any thoughts on how youre thinking about that and the first quarter here full year 'twenty, one and then any tweaks or improvements you've made to the program as you get more data and feedback.
And we approach the one year launch coming up next month, thanks, guys.
Yeah, No I think with.
Pretty much that this is something that you know.
The highlight of.
Last year, what we did as an organization as we as we rallied around it.
Supporting patients and transplant centers, and such an unmet need and we were able to put it together so quickly and had such a fantastic response sitting on more than 150 centers and using it in terms of just thinking in terms of margin we have.
And 40%.
We used in Q2.
And then in Q Q3 that went to about 30% and in people. We went back up to the higher and a 40% and so we expect to have <unk> as a core part of our business, it's really something which patients want with nine out of 10 patients you know highly satisfied and it's like the transplant centers now that they've had the service want us to.
Keep as well so it'll be a core part of our business moving forward I think in terms of the additional.
Learnings it really this ability to directly connect with the patient which was extremely valuable having net direct consent with a 6000 plus patients has been extremely valuable and now we can interact and many time point and the other thing is it's really helped with that introduction of Ala kit.
Now as an example, we can start bringing additional offerings to these patients allocates, one and others that we had planned during the course of this year.
Super Thank you.
Thank you again.
Our next question is with Rachel that and style with Piper Sandler. Please proceed with your question.
Hey, everyone and this is Rachel on for Steve. Thanks for taking my questions and congrats on a really nice year on.
And so first off you've had some really nice success at Hardcastle to launch in mid November can you tell us about the attachment rate for hard cash. So the number of Allomap heart cash that Youre seeing currently Iran, along fine and those Alisher heart and.
And where do you think that attachment rates and go over the next one to two years.
Yeah Hot Hot carry was truly.
Summit, which was exceptional because we.
<unk> multi modality, which had never been done before and so having this combination diagnostic was something thats, adding clinical utility space. So that's one thing I want to give a shot out so the innovation. We continue to bring the second thing is you know before the.
Crude will be attachment rate was.
Around the $60 <unk> and it's only in the end of last year that we actually were able to start talking about.
Hardcore directly.
The attachment rate is.
Kris around the 70% to 80% Mark So we see this as something where you bring additional clinical utility and there'll be increased usage.
From clinicians and also centers.
The one thing to note is that we expect to continue to see this.
<unk> right.
Progress during the course of this year and now that we started the ability to talk about it actively.
Great and Glenn and awful lot clinically utility, especially given up testing so that just from a technical alliance and can you give us some more color on your conversations that you're having with commercial payers about reimbursement. Obviously, you guys had a really high reimbursement rate on Alastair heart, which is great. So tell us about some of those conversations are high.
And do you think you'll hit that high number with that as well I know, what's the feedback and so far.
Well with Allomap.
Firstly, we.
And I'd say and commercial coverage all the major.
And I think with the addition of Alice Shaw Hot where we anticipated.
Building on the team for this which was specifically done.
Had some some initial.
Wins, which has probably happened.
Because of our preparation as you look at it and but Kaiser and and Geismar at two of the accounts that started looking at Alice Shaw Heart for example, and commercial pay. So this is an area that we continue to work on but we've built a lot of experience we built a new team as we look at how we drive this commercial pay adoption.
Yeah.
Right. So the last question from me and so lately, you've talked a lot about getting closer to the patient and how that's driving further adoption.
Can you talk about the success you've had from hiring patient care manager is declining pools like green on tracking Alastair and really how much that has driven and not additional adoption and then.
And how much room do you have to growth via tools like that.
Patient care managers is something that we've invested heavily and because we believe it's the way the future. We believe it's also.
As we manage the patient from pre transplant Peri transplants post transplant patient came in and just play a critical role and we've already started that process. We have patient came in and just look out to the patient pre transplant already and some of these patients come on just actually call the patients into.
The post transplant space as well, so that continuum, and especially really important.
What I would share is.
The advent of.
These pcm's.
They've had a sniff and impact on on the.
Business and the way that we operate so for example.
When we had the ability to call patients.
At a transplant center the adherence rate.
She buyouts patient came and as double of that and win win a sensor for example cost up the patients to schedule. So we noted by offering.
And why club premium service the patient command just had a lot of success in driving and maintaining adherence.
But I would also say that if you look at add on opportunities I think we saw that with <unk>.
And that was something that was introduced and added to our.
And patients that we had this interaction with and that was obviously something that was administered throughout those sites, where outpatient camera and just so we really see this as a strategic assets and the goal is to get that last mile to the patient and that's really what we're ready to do at the start of last year and again I would remind you that and as we look at for example, getting early and pre transplant.
And we talked about on T X connect offering this is something that we see is and also an opportunity to start earlier in terms of that patient journey. So our commitment is to the patient along all stages of that transplant journey.
Great Congrats again on the year. Thanks.
Thank you.
Our next question is with.
Alex Nowak with Craig Hallum Capital Group. Please proceed with your question.
Great. Good afternoon, everyone I'm, just curious what the latest Alice share penetration numbers are just given all the new data that you're seeing and then and the 55 centers, where you do have Alisher and protocol does that mean, you're mostly fully penetrated within those accounts or are there still opportunities for growth and those centers and then just word of the room and a 200 transplants.
And center sit and the pipeline for protocol.
Yeah. Thanks, Thanks, Alex I mean, I think our focus is our direct incentive strategy, so you're right.
The 200, plus centers and the in the U S that has been where we built a moat around focusing on you know.
And so not just having account managers and clinical staff, but also how do we improved net operational workflows and that's really important for us. So we have 70% of the.
Centers that we've mentioned and released that we we cover in.
Terms of the protocols. The good thing about the protocols is that some are higher than the <unk>.
Schedule summer at the out schedule and some are below the art schedule, but said there's continued opportunity.
The protocols more importantly, we and now.
Based on 2019.
2020 data sorry is one and three patients started on.
And I started on <unk>. So we see there's continued opportunity to even grow.
At a much faster rate than what we've done with Allomap, which is after 15 years, one and two patients and so we continue to focus on that point of initiation and that's really important for us to do that maybe one thing just to.
Highlights is not only do we have this penetration of the.
And the 70% centers Dallas show, but we also have more.
More than 90 centers now more than 90 centers that had this EMR interfaces and so as you think of what we're doing Alex and developing this competitive moat, it's how do we get deeper and deeper within these centers as.
And as well and that's also why we did the recent trend.
And shot acquisition.
Okay very helpful. And then maybe could you just preview the <unk> data that you do have coming out in the middle of this year, just how should we be gauging or looking for success comparing Alice share to Korea, and then and then remind us what sort of data do you need to show to Medicare with regards to the original coverage with.
The evidence development.
We're really excited by cable I mean, it's such a large dataset.
Built across you know and more than 50 centers and.
Over 1000 patients and say one.
1000, and we the the time of one you call out with and share some.
Really.
On a large datasets, which I think is important so the community I think you know kols and observational study based on looking at correlation with Egfr and also looking at how it did with some of the biopsy cohort. So you know we'll be sharing information that at ATC, but we're excited by this dataset and it'll also.
B.
Notice that CR, there's going to be also the admiral dataset, which is commercial.
Experience and patients also another large data set.
And with Alice Shaw.
I think the key thing is by the time, we get to the middle year. It would be a large sets of data showing the experience with Alice Shaw and how we continue to bring insights and innovation in this space I look forward to those coming forward in terms of your question on.
The study and originally this was part of the.
C D D. When we had.
I had this the <unk> study setup and mezzanine debt.
We've met the commitment with as part of the study design and also with the follow up so that was one that was originally part of the mold X approval.
Okay got it and then you had mentioned at the and your prepared remarks regarding Allomap kidney and I think I missed it was that Q4 milestone and when you expect to submit for reimbursement and respect the mol Dx or what was that milestone.
Yes, the milestone was just to share when we got him CLIA validation clear as one of the gating steps and <unk>.
Paul Rod commercial application and also to four.
Approval and so it was really just to share.
A key milestone for us because it means that it's now being valid.
Validated and CLIA lab.
I see got it and then soon.
And 2022, Okay understood. Thank you.
Thanks again Alex.
Our next question is with Andrew Cooper from Raymond James. Please proceed with your question.
Hey, Thanks for the question.
I guess, maybe first on thinking about sort of the community nephrology opportunity.
I know, we've talked about it a little bit before but as you get deeper there.
And Theres a lot more surviving patients than there are patients moving through a transplant center in any given year once you've got a lot more nephrologists as well.
What sort of tools can you add and continue to sort of bring to bear there to really attack.
What is a much larger sort of a space to go after as opposed to a couple of hundred transplant and it just how should we think about kind of strategically the way youre going after that.
Yes, Thanks, Andrew.
And we have a pretty efficient process and it's that straightforward. The first is we have patients that transition.
Transition from the center to the community. So we have processes in place there I think thats main maintained and managed by outpatient care and maintenance. So does this continuum.
Scheduling and continuum of communication and that's the first thing. The second thing is at the end of last year, we built out to me and nephrology team and.
And they're managing the 1000 comedian Prologist, who actively involved with transplant patients and the community and so there's a subset.
And have been identified that take more of an active role and the setting and then there's another eight.
8000, plus can you Paul just so you don't play so much of an active role in and transplant, but may have and interest, particularly some of the changes and the executive order and say we.
And also have an indirect.
Still would approach and reaching out to.
This growth through an inside sales team. So we had the reach that's necessary and it's fairly efficient and we've been experiencing some some really good not on the insights that success in that space.
Okay. That's helpful.
And then maybe one one more just on our cell but.
Obviously, you're early on like you said and building and sort of the.
The market in general, but when you think about this is it.
It's reasonable to expect that over kind of on a couple of years it could be.
One of the de facto sort of have to have components of a clinical trial, if you're a pharma company and sort of from that perspective, when theyre looking at assessing their trial what else is out there that competes with what <unk> is trying to do from that perspective.
Well that's why we're so excited by all so there is.
No no standard out there and so.
Some companies are trying their own internal home Bruce in terms of how they can do these did the monitoring but it really what.
And what you're seeing what we're doing is a universal standard that can be applied to.
Any.
Yeah therapeutic that comes on as we measure.
That therapeutic cell concentration and I think thats why.
It's really really exciting as we firstly use clinical studies and correlate the outcomes. This is like that.
And sort of opens that initial discussion and I think as the future.
And as these companies start learning with us and doing it together then there's the opportunity to say how do you use us.
More proactively either in decision, making as part of their process, but what I would say so far as it has been very positive given that we're creating the space and this.
This is something that again is dependent on allogeneic cell therapies makes it to market, but by partnering so early we abilities.
And our clinical and some even preclinical stage company allows us that opportunity to create the standard.
Sure.
Great I'll stop there I appreciate the time.
Thanks again.
Our next question is with some genome with BT and EE. Please proceed with your question.
Hi, Thanks for taking my questions I, just have a couple of quick ones.
And the Admiral study that you guys are presenting at the cutting edge of transplantation meeting and a couple of and a few days.
Just kind of curious is this the first long price February you'll be showing long term outcomes data, obviously, you have a kay or coming up and the second quarter.
Yes. This is really exciting because it's a large again a large dataset.
On multi center collected set of data which is.
Representing commercial real commercial experience and not under a.
Study setting and you know we're looking at.
A thousand patients hybrid and multi year periods. So I think it's exciting to.
That and also timing it with what will come with scale.
As part of that as well.
I might also just come on we actually had sham on.
And medical Szent joined and make any more comments as well.
Yes, so we're excited and very much about <unk>, because it really sort of set the scene for what kao because he is going to show us where not only are we talking about the validation of the performance of Alice Shaw and Helicop protection, but clinically indicated and subclinical, but also the other sequela of disease that we see and transplant patients.
Ability to see and predict de Novo DSA, and we need model Egfr decline, which is the standard for outcome and so.
And more really sets the same thing monitoring patients with auto show this debate and still waiting now can abrogate.
Course of their outcome and now it creates potential real intervention and studies that will really youll see a paradigm shift from us going forward, where carriers sort of that first step towards that journey.
Yeah.
Got you a fantastic that's great and then.
And just on ourselves just kind of curious I'm not sure if I should know this already but obviously measure cellular kinetics. I believe is this also on multi modality testing solution I think you talked about allo Keane and allo speak.
And being performed as well from just kind of try to get a better sense of that.
Composition of this platform.
Platform.
Yes, so allo cell is specifics to.
Allogeneic cell therapy therapeutic so.
There we're looking at you right the pharmacokinetics, which includes what you described as we look at different.
C. Max we look at the and <unk>.
Systems and so.
But it's not part of multi modality, so it's not saying, which we've been doing for example, with kidney care.
Hot cure.
And lung cancer for example, so it's a difference there and solid organ, where we have multi modality and this is in.
Allogeneic cell therapy, and we're really just measuring the.
So.
Concentrations and then seeing if there's any.
Clinical interventions and and.
Decisions that need to be make as we work with the partners on this.
Gotcha that makes sense and thank you so much.
Thank you.
Our next question is with the E Chen with H C. Wainwright. Please proceed with your question.
Hi, this is mobile and dialing in for each and I have a couple of questions. So the first one how much more do you think you'll need to spend on operating expenses to support growth and 2021.
Oh, yes.
That cross sell.
I guess, there's more so so so we came out in and in Q4 with over $58 million of revenue we had a.
And eight 8% EBITDA margins over and we continue to invest in the business, we want to grow a sustainable business and as we go throughout the year, we'll update on the on the specific expense line items zone.
Alright, that's helpful and is it 'twenty 'twenty, one revenue guidance leaning towards the Pennsylvania side. Thanks, so much.
Yeah, Hi, it's Richie I mean, I think we.
We think it said, it's really the best number we have at this time point and <unk>.
And we do have a history as a.
And date, but I do think it.
It's early with a lot of the different opportunities.
Opportunities like you mean histology, we mentioned so I think we'll have more insight as the year progresses, but you know and there's also some of the uncertainties with Covid as we look through the course of this year, which were seen as well, but yeah. We feel good about the numbers and we look forward to continued growth.
That's it from me thank you.
Thank you.
Ladies and gentlemen, we have reached the end of our question and answer session and I would like to turn the call back to Red Cedar for closing remarks.
Well well, thank you again and.
All those listening in.
It was great to see wide.
To share the great year that Kt X had during 2020 and more importantly, we're really excited about what 2021 will bring so again, we look forward to many more interaction during the course EBITDA, but what we say is and stay safe and be well and we'll continue our mission as a company, which is putting transplant patients says thank you.
And.
This concludes today's conference you may disconnect your lines at this time. Thank you for your participation.