Q3 2021 Burning Rock Biotech Ltd Earnings Call
Okay.
[music].
Sure.
[music].
Good day and thank you for standing by welcome to the pending 2021 third quarter earnings Conference call.
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And now I'd like to hand, the conference over to your first speaker today, Mr. You shouldn't Hutt C. E. O also burning rock. Thank you Sir Please go ahead.
Thank you.
I'll come to burning rock Q3 conference call.
The CEO and founder of.
So today, we have our Oh Shannon.
T O, Joe and CFO Lille intervene.
So first I will go through some exciting highlights of our recent progress.
I would feel Shannon will elaborate on our product line expansion and I would say a wholly or walk us through the financials.
So, let's turn to page four.
So we all know that Bernie started the therapy selection business in 2014 and has grown to them I'll get later into the Sakhalin.
The leading position have laid a good foundation.
The bank is moving forward to new business, all early detection and Marty and pharmaceutical collaborations.
Well, what we are what we have described last time.
Stone, Brett branding some of our technology and product quality will help us attract talent.
We have built across thousands of oncologists and hundreds of hospitals cannibalize rapid initiation of RMB started as all new products as well as SaaS.
Tradition, when I go to the market.
The existing high testing volume makes it possible for us to continue to lowering the cost and that's why we aim to.
So we tackled destocking selection and Marty and therapy selection.
The early detection market in parallel in the coming two years.
And then let's turn to page four with some highlights on our recent progress.
So.
But first of all I would talk about the commercialization preparation after six cancer early detection.
We will just got that locked in.
And so I have to say that it's got the preparation is going on well we have strong confidence to find six hospitals by the end of this year sorry in college I was gonna slip hospitals by the end of this year.
However, since multi cancer early detection is a new category of product in the market.
Consumers instead of doctors are the real customer we plan to run the Juicy adaptation campaign together with the hospital and doctors.
So we will see.
He goes Ah Hi, how are you.
Go ahead, our next our next year.
And in terms of the trials are already traction, we expect that mine cancer product development to read out.
In March one 2022 with the potential to demonstrate performance improvement.
Versus the six cancer tests, no matter sensitivity specificity and also our appeal.
And that's the last time, we talked about our tumor informed and Marty Tech knowledge 'cause b are appropriate.
He has shown very promising outperformance with sensitivity on par with what has what was being shown.
In no time, right and arches publication.
The lung cancer readout.
We'll be in the first half year 2022.
And we have already launched the trials for Colin and if a Pedro Kansas.
For therapy selection, we recorded 37 volume increase and QC.
For the in hospital model.
Decided COVID-19 carefully in August.
Proving that the hospital model, it's a much more stable and a reliable model.
And last a lifetime and I also introduced it.
Optical in pharmaceutical collaboration business.
If you remember correctly last time buy by Q2.
The contract number was.
90, 898 billion RMB and.
By the end of Q3, the number went to.
144 million.
And which is a four five times after a total year of 2020.
So yeah.
Elusive and detail on that space. So if we turn to page five.
Two to remind that the business, we have to I think I need to explain.
Why we separated the pharmaceutical collaboration.
Independent business unit.
So pharmaceutical business is not a new business for industry in U S that this market hasn't been major in China until about a year and half ago.
So some recent trend.
Paradigm shift drivers include first.
M P a.
Moving to where regulation targeted therapy drug approval pdx model, which means that the targeting targeted drugs needs out tap to pay.
Go to the to go to the market together.
The second driver is with the pressure of volume based government procurement more domestic innovative pharmaceutical companies seeking for global expansion opportunities.
Targeted therapy job the needs for pharmaceuticals.
Includes high quality product.
The available.
<unk> and liquid biopsy samples and registration capabilities in both U S and China sometimes.
Developed countries like Japan and Europe.
And the third.
<unk> is the handling fees and yet the company that can do <unk> in China. However is very challenging for.
Companies to operate.
To operate registration trial in Chile, due to the regulation of human genome regulation community.
And the Chinese and just tell me with global operation is their idea of choice.
So that's seen this trend with it about U S lab, which now is clear.
Cap sort of indicated.
In a high quality.
The.
Broad portfolio.
The global registration capability and strong.
Registration team our unique advantages for this business.
And.
Let's turn to.
Page six.
So this fits our.
For that lie progress.
And Oh well.
We'll let our.
Oh Shannon to go through that.
Thanks Pedro Shannon.
Shannon Okay. Okay. Thank you.
So let's move to page six and we have actually short this overview of our product pipeline lifetime golf get most of the content on the page and digital coupons.
First we now have more clarity.
On the timeline for launching that's really very important product in Q1 next year.
We.
Actually you mentioned about the commercialization of these three products, but now we have a clear timeline of launching them in in the first quarter and we're gonna start of commercialization.
The tomo rack switches for adjuvant chemotherapy benefit predictions for early stage lung cancer patients.
Our <unk> product using off be on profit technology acquisitions as mentioned for early stage solid tumor, which won't become available to those clinicians and also our pharmaceutical customers.
And as long as our six cancer early detection product. So we in fact no.
Call backs to make significant contribution to our growth in the coming years.
And then for our kids are early detection program for the Knight cancer product development program, we now have more visibility.
Sure we will most likely see some data readout in the first half.
Up next year.
I'll give more detail exactly what.
On page 10, and then for RMR D program. Besides the lung cancer study, which is called motto.
<unk> previously talked about the model well have data readout released early next year.
You had before.
And also in the past few months, we have also extended validation into other solid tumors, including colon esophageal and gastric stagger and at least that we expect to have validation data available in 2022, we watch risk prediction on these kinds of attacks from Rachel <unk> co.
So there are also quickly.
Increasing interest in the China market on M. R&D, driven adjuvant therapy studies for drug development, and we think beyond profit will be very well positioned to collaborate with our pharmaceutical partners.
Now because most of the liquid biopsy products available in the China market are perfect panels.
So beyond profit will be a very innovative technology.
Technology in terms of the personalize the panel for MIP approach.
So, let's now move directly to page 10, now I'd like to walk you through more detail.
Some of the wild cancer early detection program.
For the six cancer early detection product, we expect to launch a proof that flash intervention study.
Can be youth population in the first half of 2020 to this study we think will provide us with key inputs for the design of the future of pivotal studies for the six cancer test lack of tissue in China.
And then our 19th of product one key update is that we have finished accrual a pilot keep control validation study, including over 2000 participants.
We call. This study the promise study and we expect to release some data readout for the promise than in the first half of 2022.
And then in the Meanwhile, the predict study, which is the main validation study plan, while 19, so product with more than 14000 participants to be enrolled if you still remember its recruiting I think right now with about 30 centers contributing to enrollment.
We remain our anticipation of having the first data readouts will predict around the end of 2022. We also wanted to emphasize that both predict and questions, which is the keep control validation study.
I tend to kill cancer product development both of them.
These studies have gained approval from the human genetic resources or the nutrition in China.
Because all studies with more than 500 subjects need to go through.
Their approval process. So from what we can tell them, we wanted to share that predict and question on software are the only large scale multi cancer early detection trials going on in China.
So that's about all I wanted to elaborate on two now I'll I'll turn to our CFO to walk you through our financials.
Sure.
Thank you Shannon.
Let's go to page 17, please before hitting into our financials I'd like to quickly recap on the Covid curve for China.
China's current defense against Covid is primarily through laughter appear to me.
Or the offtake, it's freedom.
Freedom movement and business as usual.
These cases are reported.
Followed by contact tracing.
Large scale testing and if there is sign of cases, spreading we would see containment measures via tightens movements or travel restrictions.
And just to recap what happens for Q3, we saw a significant wave back in August.
Spreads through multiple cities impacted Beijing, which is a key market for us this impacted our volumes for August.
Go into exact numbers a little later, but in terms of the trend we saw significant impact in August.
When will you be coverage and resumed our volume growth in September and October.
But we're right in the middle of another wave now in November 19.
Now turning to page 18, which shows our volume trends.
Just to come back to the page on the numbers on page 18 combines both our central lab and in hospital segments.
And in aggregate you can see that our volumes grew by 38% year over year. During the first nine months of this year, which will leave US. We believe is higher than industry average that we're tracking and also higher than some of the growth numbers that we saw from <unk>.
Yes, or even PCR peers in China.
For the third quarter, our volumes grew 14% year over year within the quarter.
July so good volume growth of about 35% in August was hit by Covid wave and restrictions we recovered in September growing at high single digits year over year.
That accelerated to 38% year over year growth in October so we see that we've had good double digit volume growth during the periods, where COVID-19 is clients in China.
Getting back from the Covid.
We believe the key of our industry.
Industry volume growth. This year is the results of our in hospital strategy. This has allowed us to take dominant share at a hospital.
Being the engine test supplier to the hospital.
Hospital is already half more than half of our testing volumes.
The second quarter this year.
And also that remains the case for the third quarter. We expect this proportion to grow even further going forward.
However, this doesn't mean that our blended asps across the central lab and hospital segments will be dragged down.
We supply hospitals at a lower ASP.
This is the price that we charge directly to patients in the out of pocket.
Central Lab segment. This drag will proceed for a few quarters as we execute this transition towards more in hospital testing.
This is worthwhile doing.
For the reasons, we laid out on page 18, and fundamentally we think the in hospital sector is a bit.
A more sticky.
Hey, Thanks on quality segments that we should get more volumes going forward.
And then go into our numbers.
Which is on page 21.
We grew our revenues by 2% year over year in the third quarter within the quarter is similar to the volume trends that we explained previously that August was the hips and July and September was okay.
Overall revenue growth rate is lower than our volume growth rates because of the ASP drag that we just explained.
And by segments Central Lab was impacted law and was down year over year during the third quarter in hospitals headwinds maintained good groups growing 48% year over year and these are primarily recurring revenues.
The vast majority is good revenues don't instrument revenues, we believe our market share gains through the in hospital strategy is the key for achieving above industry growth for the in hospital segments during the second quarter.
The pharma segment is coming off a small base our pharma pipeline has been building rapidly. This year as we showed on page five and these are typically multiyear projects. So the pipeline will convert to revenues over a multiyear period.
Moving on to our guidance, which is at or around 500 million RMB.
For the full year of 2021 and based on our run rate up to October we would feel confident of achieving our guidance.
<unk> Covid wave, which is hitting US now is having an impact on our fourth quarter is the current wave where to buy downs today and if we were to go back to normal today, we would feel confident about our guidance.
However, given what's happening on the ground will have to flag that risk and see how much of an impact and how long of an impact. This current wave we will tackle them.
And I guess moving beyond 2021, as we look out qualitatively for 2022.
We will see commercial launches of multiple products this year.
As I mentioned at the start of the call we have been preparing for the launch of our <unk> cancer detection.
<unk> test, which will go live next year in addition, and as.
Shannon walk through on page six we will see the commercial launch of a new two new products for early stage cancer patients in 2022.
So 2022 is even important here that we'll be looking forward to and.
And we will be providing updates on those commercial initiatives and our future earnings calls.
And lastly, we announced today the dates and agenda of our annual shareholders' meeting.
At the meeting our board is pushing forward a long term share incentive plan for a shareholders' votes.
The sheer incentive is long term in nature.
Our senior management and key talent and incentives to achieve and also linear growth.
Loan normally new breakthroughs on our company's vision on a collective basis.
Typically half of this year incentive amounting to 5% of our total shares outstanding will vest, if our market cap, which is 10 billion U S dollars.
5% of total shares outstanding will vest, if our market cap, which is 15 billion.
The timeframe for reaching the 10 and the 10 billion market cap is targeting five years.
And after which the options with elapsed.
Timeframe for reaching the 15 billion market cap target within seven years.
The details about this plan and our annual shareholders meeting is available on our IR website under the shareholder meeting section under news and events tab.
After we conclude the.
Opening remarks of the call and Oh.
Opening two questions.
Thank you, ladies and gentlemen, well begin the question and answer session if.
If you wish you ask a question. Please press star one on your telephone and like for your name to be announced.
If you wish to withdraw your request please press the pound or hash key please standby, while we compile the question and answer roster.
Once again, ladies and gentlemen that star one for questions.
Our first question comes from the line of Max Masucci from Cowen <unk> Company. Please ask your question.
Hi, Thanks for taking the questions.
So if you look at your key geographic regions and cities, where the Covid impact was the strongest during Q3 can you just help us understand.
The central lab volumes were impacted more by the Covid resurgence or if there is any impact from customers shifting to in hospital testing and with all of these factors in mind.
With new product launches.
It would be great to hear and how we should be thinking about.
Return to grow through the patient growth in central lab volumes in 2022.
Yes, hi, Matt Thanks for that question.
So on.
On the Covid impacts.
The key markets for us are the major tier one cities in China.
Beijing and Shanghai represents.
A large share of that market. So these are the cities that took.
Typically you get impacted.
When when Covid goes on in the move.
Movements were impacted so patients cannot visit hospitals in those locations.
So I would say Covid has had an impact on the industry for this year.
And what's different for us.
Is the ability to gain share through the in hospital.
Channel, which we believe allowed us to outgrow the markets.
The Covid impact so I think thats what.
That's what we're seeing primarily this year.
And looking out for.
Next year, we think.
We will be I mean, China's current strategy scaled COVID-19 their case and that either.
E the strategy.
For a period of time, and we will be having this paying tax while that is the key.
Defense metabolism against Covid for China, So that will that will go on but I think that will at some point.
Exactly when but at some point.
We would expect.
China will.
Go back to normal so that will help alleviate some of the impacts.
We're seeing that we have been effective and in addition, adding named the.
New product launches, which we will launch via the Central Lab channel initially.
That will add on to the hospital.
Lab revenue growth going forward, we are launching in licensed products for.
For early stage lung cancer, a risk stratification product.
Chinese cohort validation data that we're launching that Q1 next year as Shannon mentioned.
So that will help.
Providing us incremental revenue for the central lab revenue going forward as well so that's a <unk>.
<unk>.
Thoughts for next year, and then as we come back for our fourth quarter results next year, we will be providing our guidance for 2022.
And so and then additional common.
Hello.
Matt. This is that you still have additional comments.
Total classroom, so just to let you know the impact.
COVID-19.
It's bigger than winter.
So I think.
The Altair <unk> after the spring.
The situation will be significantly better.
According to the.
The situation this year.
And the second thing is that although our central lab model, the new product rely on the central model.
Central App model.
But we can see that central lab model if not.
If not stop growing it's growing.
Slowly, but with the new product.
With the hospital down our our associates can really go in thinking.
They can really add.
More revenue because.
More.
Indications suitable for the for the new product.
Great that makes sense and then just as it relates to the implied Q4 guidance just curious if there's been any changes to your access to customers here halfway through November.
Or is it remains largely the same.
Like the full year guidance implies about 10% sequential growth in revenues in Q4 compared to Q3. So it would just be great to hear about the factors related to volume growth in ASP that will determine that.
Your ability to grow your revenues quarter over quarter in Q4 than any other embedded assumptions.
The implied guidance that we should be keeping an eye.
Yes.
In the middle of November.
Closed.
A strong month for October we saw good volume growth that month.
That follows a disciplined recovery after the Covid hits back in August so that was all going well, but as we sit in the middle of another wave.
There is uncertainty about how long and how large of an impact staging tightened a bit further.
Within this week, so it's hard to predict how much and how much further impact currently will drive volume. So we're just going to have to bear that risk in mind, but we were happy about what we gave back in October.
Regarding the current wave for November and December. So we believe the guidance will be around $500 million for the full year.
What's the certainty.
The Covid impact.
Okay and one final question if I could.
<unk>.
We've seen some recent reimbursement updates for MRV monitoring tests in the U S.
Oncologists they seem to be very excited about the launch of this test application would be curious to hear whether you feel that oncologists in China are equally receptive and ready to adopt MRV monitoring tests when theyre broadly commercially launched.
And whether or not you feel that oncologists in China are more comfortable with a tumor informed <unk>.
Coach versus maybe using a blood only fixed panel approach.
Well.
Yes.
Okay I can take that question I'll try well first of all we have seen a marine.
Yeah.
Rather dramatic change in the in the combination comes out according to their acceptance or interesting MRV product.
In the past few months.
Last year around this time, we didn't feel like the MLP market looks ready anyway.
Most recently, especially in among the lung clinicians and also some of the coaxial Dr.
Dr Glassman oncologic.
Start to show very strong interest in MRV Val Tex.
Are they pick on product.
In their day to day applications.
However, most of the interest.
So far.
Of course still remain.
More of our research related are adjusted out months biomarker.
Studying related application realm.
But we are going to.
And whether some of them are really believing that you kind of take the clinically with Trinity.
Shang, which we think is very very strong and.
And Hercules debt, so we do have pretty high hopes.
Markets, but frankly speaking we are not 100% sure how fast.
The adoption ranked <unk> among the Chinese coordination so that I can say right now is that from what we have upfront over the past few months.
Coming more and more common thing and because the utility in these early stage cancer patients or so.
We I think scientifically we also have very solid reason to be loved that eventually this well this all play out and in terms of the tumor informed the works at the.
It looks like panel actually.
There are pros and cons, but we are seeing clearly that comes up is the most important utility which it's done.
Launch just monitoring for surveillance.
Relapse, whereas good monitoring for early stage patients.
Most of the clinician in China.
Think that MTV or negative predictive value.
For for the MRV applications, it's the most important thing.
Just wanted to put a product which means that sensitivity is.
It's a quote unquote more important benefits, especially because they want to make sure that all the.
Already active patients really are fine.
So.
And in that situation and to make informed methodology clearly have.
And advantage right now.
<unk> two fixed panel approaches.
But with that said.
It does have some comp compared to the fixed kind of approaches, including you know about 10% to 15% of patients who have secondary primary second primary tumor you will miss them and then so the turnaround time.
Did you make informed approach is very concerning.
So again we.
You will see their response Glenn.
And they really start to experience.
Yes.
I hope that does that great. Thank you.
Hum.
That's great. Thank you.
Okay.
Thank you. Our next question comes from the line of Sean <unk> from <unk>.
Morgan Stanley. Please ask your question.
Thank you very much for taking my questions and also congratulations on your progress towards early screening.
So I have a couple of quick question one question from declined.
So looking back over the last few quarters, you would see a pretty kind of.
Picking up of selling expense ratio of revenue and our revenue growth.
Via business slowing down.
ASP type of situation.
Uh huh.
Maybe can you give us a bit of color about the breakdown between the pro business and central lab businesses.
Bad debt ratios of hitting expenses differ from doses towards high power businesses. This is the first question.
This would.
Before deal another question for sure.
As for the early kind of screening part your nine cancer readout. There has been moved up from Penndot.
At the end of next year too.
First handful.
Plenty of color Thats great.
And what are the reasons behind that.
Yeah.
We have any kind of color for that and also for the probably true.
Because of the type of screening.
You would have the first readout in 'twenty to 'twenty four.
Before that we have an accountable important critical milestone.
Two paths.
That's my two questions then a follow up question from Mackay.
So let me come back on the selling expense question first then.
Shannon will talk about.
The question on the Readouts and future milestones.
Selling expenses I think the first factor to bear in mind is that we have started building the commercial organization for early detection of this year.
So that has gone into the sales and marketing expenses line already that includes a few functions.
A sales team for getting our products.
Into the hospitals health Checkup Department, so theres a team.
In double digits personnel on that Andy.
<unk> had some breakthroughs as youre, saying explained.
Out of this call.
In addition, all other sales related functions are also booked under this line for example, a customer service team that has been built over time this year.
As this product.
What's required customer services.
Pre sales and after the taste in some cases.
I think the first build up is related to the early detection and commercial organization.
And that at the moment.
Does not have meaningful revenue so.
<unk> that would have a.
All matching impacts on our selling expenses ratio. So that's I think the first factor.
A factor within the.
Patient testing business that is already revenue generating we have also been expanding our team. This year as we have explained previously that we're building out sales coverage.
Four more in hospital penetration.
And also as we look at our product launches for next year.
We will have products going after early stage patients. So we have been ramping up sales coverage.
Across a few regions in China as well so that.
That added towards the overall head count.
And then related to the selling efficiency.
Across central lab versus in hospital channels, we don't provide the breakdown quantitatively, but qualitatively in the hospital is a more productive.
Channel and in terms of selling expenses.
And that's.
Having lower ASP.
It's <unk>.
Margin profile at the operating margin level, we believe he is actually better than.
Central Lab and importantly, this is a institutionalized channel that allow us to differentiate so we think.
That's that is an important channel going forward.
And looking forward I think.
In oncology.
Oncology.
Hum.
Commercial organization build out is largely complete complete meaning the.
Sales headcount add for the patient testing business.
That's primarily done within this year so.
Next year, we should see we shouldnt see huge changes compared to this year.
Have you actually and I think that's more dependent on our commercial progress if we're making good progress we.
We will be adding more head counts.
So that's it.
Qualitative outlook for next year.
Thank you Shannon.
Oh, yes.
So in terms of the the readout time, thanks for the question.
We did the the difference here is that Oh, originally when we talked about.
Read out for for.
Well our 19 Sir.
Early detection product, we were referring to predict.
The first stage the first phase of.
However.
I did.
In addition, now sort of a proof of concept cohort.
Top off predict.
Promise.
<unk> has about 2000 and actually a little bit more than 2000 participants.
And if you remember predict accuray has more than 14000 participants in it.
Hum.
It's a trial that's designed to have enough statistical power for all of my team for type.
To be able to give a precise enough estimate for since the Caribbean, but that's perfectly for each cancer type.
Idea right.
However, before the readout for predicts that we now have the additional.
Pilot cohort.
To give us a little bit carotid clean Hum.
So does it correctly, that's a cool performance as well as beyond.
<unk> outperformance that we could achieve with the 19 sorry.
Early detection product and from what we have seen we feel like it's on.
So.
It's worthwhile to to be shared the data looks actually create interesting. So that's why we have removed.
A little bit ahead on the on the readout plan.
So that's that's just to clarify on the LIBOR readout timeline and actually for predict I'll read out timeline has remained the same which is that the data.
Mindful predictably well release, the data I've already at the end of 2022.
And then for the second question in terms of additional milestones.
As laid out on page 10.
We will.
Actually I have three different product lines or product development programs in terms of already taxing the six cancer lung cancer and Chris I'm sorry.
So in terms of the six concern on the map.
The milestone.
So that I can.
The interventional flash goes back to cohort that we just mentioned.
Back to to kick off early next year and the fourth.
Half of next year to be more precise and then lift.
The results from that trial, we are really I'm anticipating that we will be able to enter the pivotal Registrational study design.
What we have.
Dan.
And then for the 19th or I think the next important.
<unk>.
Throughout the second.
Second thing I'll forget the week 12.
Single blinded.
Which means that we will have this blinded multicenter case control study.
It goes back to like to have.
<unk>.
A robust estimate our NIE cancer product performance.
And and then for the 22 cancer.
On the milestone will be the pregnant study, which also has.
Close to 12000 participants, but it will cover 22 major cancer types.
Collectively will cover about 90% of the AR.
Cancer patients in China, and that study will have a readout by 2020, but.
Again, a case control study.
So in terms of the <unk>.
Registrational pathway moving forward for the Nike brand to cancer.
We don't feel like we have enough visibility at this point to share more.
Accurate timeline.
So with that see what's the GAAP.
From the predicted question and Dan come down from there, we will be able to pan out a more accurate path to registration.
Probably not just in China, but also on the country.
Okay.
That answer your question. Okay. Thank you very much I have a final question from my clients that he's saying he was wondering if you can grow.
Your Central lab testing volume getting 122, given that you have not grown borderlands for four quarters now.
So I I suppose.
COVID-19 situation has something to do with that type of course also some quarters. It lost maybe also coming out can you just gave you.
The kind of person some guidance.
To the volume growth that we're testing.
Yeah.
Sure. Thanks.
All the trends that we saw.
At the end of October I think Thats.
That's something we would look forward to for next year.
Bear in minds.
Separate COVID-19 out of vacuum in China. So that's always going to be a leader in factor I think.
For some part of next year and beyond Covid.
I do believe there is potential for us to cover to cover additional oncologist.
Additional centers.
Central Lab channel inhibition to the new products that we'll be launching so I think that channel shifts come back to growth.
In a normal period of time, although it's hard to predict exactly when so.
So we can't give a precise.
Estimate at this point, but you know something.
Quantitative that would tend to look out for.
Great. Thank you very much that's all.
All my questions.
Thank you Joe.
Thank you there are no further question at this time with that we conclude our conference for today. Thank you for participating all disconnect.
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Yes.
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Right.