NeoGenomics Inc. (NGNM)
Wall Street Analyst Forum Presentation
November 28, 2007 10:30 am ET
Robert Gasparini – President & Chief Science Officer
Steven Jones - Chief Financial Officer
Good morning ladies and gentlemen. I’d like to go ahead and introduce the next company in this morning’s healthcare program. NeoGenomics is a high-complexity clinical laboratory that specializes in cancer genetics diagnostic testing, the fastest growing segment of the laboratory industry. The growing awareness of genetic roots behind most cancers combined with advances in technologies in genetic research, including the complete sequencing of the human genome, has made possible a whole new set of tools to diagnose and treat cancer. This has opened up a vast opportunity for fast growing laboratory companies like NeoGenomics to address this rapidly growing market segment. Speaking on behalf of NeoGenomics will be Robert Gasparini the Company’s President and Steven Jones, the Chief Financial Officer.
Thank you and good morning everyone and thank you very much for being here. Its my pleasure, with Steve Jones, to sort of take you into our world, the world of laboratory testing as it currently exists across the United States, but specifically the world of cancer genetic testing which is a specialty arena that has evolved over the last 10 or 15 years based on an industry that’s been around for probably five decades.
NeoGenomics laboratories is a CLEA-certified laboratory that focuses only on cancer testing. Our customers are not the patients themselves. Our customers are the physicians that touch these patients. They may be oncologists; they may be pathologists working with cancer specimens. They may be urologists interested in bladder cancer. It may be the hospitals or even other reference laboratories across the United States that don’t do this specialized test called cancer genetics testing. I’ll talk about the landscape and who’s out there and how many of us actually work in this particular sector in a few slides.
Being a CLEA-certified laboratory, the expectation is quality, quality, quality and so we don’t talk about it perhaps as much as we should. The competitiveness comes through turnaround times, superior turnaround times. How quickly, when a patient is potentially diagnosed with a type of cancer, they’re on a treadmill, they’re waiting for a particular result, so the real competitive edge is how quickly can you get that quality result back to that individual physician so he or she can then translate that information to the patients themselves? And we are one of really only a few pure-play publicly-traded cancer genetic testing laboratories.
This is probably the most complex slide and I’m not going to spend too much time on it but I would like to draw your attention to at least the two boxes that are there. In the first box, you can see that 100% of our revenue, unlike the Quests and the Lab Corps and the Bio-References and the Clarients of the world, our 100% comes from gene-based testing. And second you can see that we are growing, as fast if not faster, than any of our traditional competitors. We’ll come back when we talk about the landscape and talk a little bit more about the competitors. But our growth, and we’ve just recently had our Q3 webcast where we demonstrated almost 95% growth sequentially year-over-year and 33% growth sequentially quarter-over-quarter.
We are in a sector that’s rapidly growing. Conservative estimates say it maybe as much as 25% a year. Non-conservative estimates, 40-50% a year. This is highlighted or accentuated by the fact that 50% of what we do today in November 2007 didn’t exist three years ago. Genes that were subsequently discovered since 2004, brought to market and then offered as a clinical test. So again half of what we do today. So we’re not growing on the backs of our competitors, who may be slower and less nimble, but we’re growing because there are new opportunities, new applications and new markets to be able to go into.
Over the last three years since I’ve been there, January of ’05, all of our early stage work is completed. We’re just now starting to really scale. We have laid down an established laboratories corporate headquarters in Fort Myers, Florida with 26,000 square feet, 10,000 square feet in Nashville, Tennessee and about the same in Irvine, California. We’ve added new testing platforms including all that I’m going to talk about in a few slides and that is FISH this fluorescence in-situ hybridization, a genetic test if you will. Flow cytometry, morphology and of course cytogenetics.
And we have a management team that’s done it before. I’ve spent the bulk of my career, almost 24 years, in the academic community. I left Boston about seven years ago to go out to California. Some of these people in this slide, I’ve worked with before out in California, including Dr Feeney, including Dr Moore. This is the team that has recently done this, recently, since the year 2001 and are doing it again now.
The landscape that I referred to, there are only 300 of us across the entire United States. This is a highly specialized sector. It’s a very large TAM or market opportunity. Most of those laboratories that deliver genetic testing in America are found in academic institutions. In 1985 there were no private laboratories. This, genetics was delivered in the academic centers, the universities of the colleges across America. 240 or 80% of those still continue to deliver it but the 60 commercial private laboratories do 80% of all the testing in America. It’s truly a 20:80 or 80:20 rule. So 80% of all testing done by those 60 laboratories. Why? Because some of those 60 laboratories are 10, 30, 50 or 100 times bigger than some of the academic labs across America.
The landscape is changing. Of the top 10 labs as defined by size, the number of specimens if you will, or the revenues that are produced or done each year, numbers four through ten have been rolled up. So the big three, numbers one, two and three, Quest, Lab Corp and Genzyme just keep getting bigger and bigger and bigger. And although there’s a new number four, five, six, seven, eight, nine and ten, they’re not as large as they used to be.
Our vision at NeoGenomics laboratories within its competitive landscape is really to develop a series of regional cancer laboratories. I mentioned the three that we currently have now in high profile geographies and we have mentioned in webcasts and press releases that there will be at least one more. The trick or the challenge is going to be really to be able to connect those with what we’re calling the Neo backbone which is a combination of IT and leadership and a host of other categories. The ability to service and play the local card against the national competitors and say we have a courier, we’ll pick up your specimen, we’ll bring it to our laboratory. By the time Fed-Ex delivers your specimen to a national laboratory we’ll already have a result because at our laboratories we have evening shifts, couriers come in anywhere from six in the evening to twelve at night. The idea is the ability to get this result back to your customer as quickly as possible. If this was your patient, if this was your result, either your personal result or your patient result if you were the doctor, you wouldn’t want to wait more than the minimum number of time.
Collectively we are on our way to becoming one of the country’s largest laboratories and the idea is that if we can develop proprietary new tests through, perhaps, intellectual property, to push our distribution network, it will help us get there. This is how we differentiate, I’m not going to spend a lot of time going through all of these with you, I’m going to focus on just a select few of them. As I’ve already mentioned, turnaround time is probably the number one differentiator across the laboratory industry. It was virtually unheard of when it was an academic lab putting out a result, but in the eighties, what happened is, the moves towards privatization of genetic testing services started to occur.
There really was not much cancer testing going on in the mid to late eighties. However, there was prenatal testing and it was - prenatal fetal testing was in vogue, and the concept of getting a result back to an expectant mother on whether she had a normal or abnormal fetus came into play and really started to drive at least the genetics testing industry. Turnaround times went from three weeks in the late eighties to about seven to ten days in the early nineties. And that’s for prenatal testing which grows faster. For cancer, it’s still in the seven to ten day range but that’s better than a decade ago when it was 21 to 28 days. Imagine waiting a month. Its unheard of now, it’s a completely different mindset. But ten years ago it might have taken you a month to get back that complex genetic test analysis.
Customer service, and the ability to interact with our customers which is probably the most, if not probably, which is the most important thing that we do on a daily basis. Our IS backbone, that holds things together and allows our customers to come in through IS portals and view their reports, do some of the interpretation with a unique product that I’ll talk about in a minute. Testing algorithms and I will spend a little bit of time talking about the pipeline.
Okay, I’ve mentioned genetic testing at least a half a dozen times in the last 15 minutes. What is genetic testing? Well this is it. There are four platforms, categories, areas, arenas, that’s it. If it’s a genetic test, on this planet, it falls into one of these four categories. And that is, cytogenetics, flow, FISH or molecular testing. Whether it’s done on a child, pediatric testing, the down-syndrome test which was the original genetic test going back to the seventies, whether it’s a prenatal test done on a fetus as I’ve alluded to or whether it’s a cancer test, if its genetic it’s going to be one of these four categories. How do we differentiate them? And I’m not going to spend too much time on the science but I want to try to give you a feel for our world and what we do and how we look at things.
Cytogenetics is one of those technologies that give us a 1000 foot view. We have an opportunity to look down on an entire neighborhood or an entire ballpark. The neighborhood and the analogy is those houses in the neighborhood are your chromosomes. Chromosomes are your DNA components that make up the nucleus of which genes are contained.
Flow cytometry, which has been around since the early eighties but really didn’t develop into modern laser based technologies and high throughput technologies until the nineties gives us an ability to drop down even closer. And we can start to see the Christmas tree lights around the house, the shrubbery, the walkways, we can start to more clearly define. We may not be able to see the entire neighborhood but we can start to talk an awful lot about that particular house or those particular cell surface markers which is the analogy.
FISH, which didn’t come about until the late eighties and didn’t make it across America out of the academic institutions until the early nineties gives us that ability to drop right down on the street. We dropped down on the street and we can look at the doors and the windows or the genes, if you will, and answer questions about those genes that we couldn’t have prior to the early nineties with the other existing technology platforms.
And then finally, by the mid nineties, we had this molecular genetics. The person who introduced mentioned the Department of Energy’s human genome sequencing. Well the serial number on the lock that you look at with a magnifying glass gives you that human genome or base pair sequencing and the ability to look at a gene that is composed of 2 million base pairs. 2 million of these alpha numerics and identify one mistake out of those 2 million is the power of molecular technology. The problem is you have no idea what port you are on, you have no idea what street you are on and you have no idea what neighborhood you are on but you can answer a whole lot of information about that one particular human genetic or human genome sequence.
FISH is really the, if genetics is the engine that drives this type of specialized testing, at NeoGenomics laboratories FISH is the engine that drives our company. More than 50% of our business is FISH based. It’s the fastest growing segment of the market. It is among the most well reimbursed and the most well known. Again, its been around since the late eighties, CPT codes since the early nineties and new CPT codes, these are the codes that we use to bill, since 2005. So it’s well established, well reimbursed and well known.
There are three categories that we focus on and that is bone marrow testing. Probably 95% of the work that we do on the leukemia and the lymphoma patients, these are the blood cancers are done on bone marrows. For the solid tumors, the breast cancer, the bladder cancer, the cervical cancer we actually will get a piece of that tumor.
Again, laboratory medicine, including genetics is still in its relative infancy. We can diagnose and we can do that well. We can prognosis, we can tell you based on the genetic tests we do how good or how bad that cancer is. And how does that translate? In other words, what is the overall survival expectation for that particular cancer based on its genetic profile? What is the disease free survival expectation? And these are all done based on statistical, what we call Kaplan-Meier curves.
We can even to some degree predict a patient response. Some of these that you see on this list, including the one that’s in color there, we can predict a patient response to an individual therapy. What we cant do is tell you that cancer is coming. And that’s the last and final holy grail of the laboratory testing industry led by either proteomics or genomics and that is the ability to predispose the patient prior to disease. Science fiction five years ago, we’re getting closer and we’re probably within 15 years and I’ll speculate a little about that in a few minutes.
This is just a karyotype, if you will, of a neighborhood. This is one of those tests, if you look at the metaphase spread on the top that’s what we actually see under a microscope, that’s digitized and analyzed by a certified licensed genetic technologist. If you look at the completed product on the bottom you can see that this patient has a particular form of leukemia known as Chronic Myelogenous Leukemia. We know a lot. This had been a poster-child or a prototype leukemic model for not only diagnosing this but also for prognosis, overall survival of 64.2 a month and for prediction to response to a new antikinase therapy known as Gleevec or as it was known in the scientific community as TI571 for about ten years.
The addressable markets, you can see, what the Medicare reimbursement rates are. We try to be conservative. I try to be conservative whenever we are up here talking about numbers. Medicare is typically on the lower end of the reimbursement. It’s a federal program but still, 48% of our revenue comes from or up to 45% of our revenue comes from Medicare. We see incremental gross margins of 50% to as high as 85%. FISH and components of flow are very well reimbursed as I mentioned earlier in the procedure, earlier in this talk. And the average reimbursement, addressable market, we don’t cap all of it for all patients. It’s a really simple business model. The more specimens that come in the door, the higher your revenue.
I mentioned a unique product. We have two of them. We launched in December of 2006 formally, but we had beta tested it for most of 2006, a product that we call NeoFISH. It is a product where we do the hard technical wet-lab work and we teach our physician customer, i.e. the pathologists, how to do the interpretation. This is not quite as difficult as you might expect because this one particular test, unlike flow which is more complicated, unlike cytogenetics which is very complicated and unlike molecular which is off the charts, it is not impossible, especially if you are qualified as an MD and you are board certified in pathology, for a pathologist to interpret this genetic test even if they’ve not had exposure to this earlier in their career. Forget about medical school and stuff like that, they wouldn’t have been exposed to this because this is all brand new stuff as I said. Its been since the late nineties that we really had it and the types of FISH testing that we’re doing now didn’t even exist two, three, four and five years ago.
So this is an ability to, instead of leading with our hands and a handshake and saying we’re a new lab, we’re young, we’re hungry, we’re growing, we lead with a revenue share program. We will put our money where our mouth is. We will lead with a financial arrangement where we will teach the physician, not qualify them, they’re qualified to do that based on their credentials and their degrees. But we’ll teach them, if they’ve not had exposure to FISH signal interpretation or technology, how to interpret these tests. We do our part and bill for it. They do their part and bill for it. And we have been very, very, very successful. This is the one and only product where we’ve actually had customers call us and say I’ve heard about this, sign me up or where do I sign up? And I don’t say that tongue in cheek, I say that realistically.
We were the first to market. We had a jump on this. There are only maybe one or two other labs in America now that are starting to come out with it. There are other labs that are starting to talk about it. We’ll probably see more labs in 2008 that actually offer this but in the meantime we’ve got a one year window and part of this product, this Tech-Only or NeoFISH product helped drive us to almost 100% year-over-year sequential growth and 33% growth last quarter over Q2.
Our sales and marketing strategy continues to differentiate high quality service, focus on our turnaround times, NeoGenomics does excellent work, high quality work, CLEA-certified, appropriately licensed by both federal and by state, across all of the states that we operate in, and focus on turnaround times.
We provide, unlike the mega-laboratories, the billion dollar laboratories, a competitive choice for the pathologists. As I said, we lead with our hand, and not with our, we lead with a financial arrangement and not with our hand, and we are not a threat to take over and put out of business the community pathologists as the large laboratories have gone on record with.
We do have one other new product, there are maybe three or four laboratories in the United States that have this, we call it GPS, as you can see down in the second from the bottom bullet, Genetic Pathology Solutions. This is not aimed at the pathologist, but this is aimed at the oncologist, another one of the healthcare segment that really focuses on touching and interacting with cancer patients.
It is the ability to take a cytogenetics, FISH, flow, morphology, and molecular analysis and put them all together, think about it, and there’s a specially trained pathologist-geneticist, we call it a hemato-pathologist/genetics team that looks at all of these lab results and then does some interpretation across all modalities, across testing.
So again, GPS in terms of leading the way, how are we going to get to a simple one page report where a clinician, who doesn’t necessarily know the difference between a neighborhood and a serial number on a lock, but who may somewhat speak the language but certainly understands the implications of what information he or she is being given, prognostic information, certainly diagnostic information, predictive information, and we see in the not too distant future perhaps some predisposition information.
Okay, as we look back over the last 18 months, 22 months perhaps, we have been able to acquire and grow the laboratory in Nashville, Tennessee and build from scratch the laboratory in California. Acquiring this very small lab, we’ve more than tripled the size of our footprint in Nashville, Tennessee. That laboratory was not even non-material. It was not that expensive in building, building a lab is not that expensive. You are talking about less than $1 million and probably significantly less than that, being able to then service a local market.
The barriers to entry, though, are significant because human resources continue to be the number one bottleneck. If you don’t have access to that very elite group of licensed genetic technologists than you can build whatever you want for $1 million but you’re not going to be able to drive anything.
I’ve mentioned GPS, I’ve mentioned the Tech-Only NeoFISH program. Our sales force just a year ago was at four people. We went to nine for most of 2007 and within the last three months we’ve driven that to sixteen or seventeen individuals. And so, and third, we’ve talked about continuing to drive that into 2008. We did raise up to $4 million of equity earlier, I believe it was April or May of 2007. We paid off all of our longer term debt and we have virtually no debt with the exception of our lease, outstanding lease money.
And I’ve talked about our sequential revenues. Right now our plans are to roll out our GPS product and our NeoFISH and to drive those hard. Those differentiate us in the marketplace.
As I said, with regard to the GPS or the global tying together, there really only two companies that are doing that anywhere, anything like that across the United States and both of them are located out on the west coast, and so we have a really good opportunity here on the east coast and across the country to really target the oncology office.
The ability to expand our market penetration, having recently going from nine sales reps to seventeen sales reps, our focus now, over 50% of our business now comes from outside of Florida, we are in something like I don’t know the number, I mentioned it on the webcast, 26 states, and the goal is by next year to be in 40 or more states. Now that we’re starting to put more people on the ground we have that depth and we have that breadth, and again, I keep coming back to it. It’s a really simple business model and that is the more specimens that come in the door the higher the revenues, both top line and bottom line.
The ability to increase internal capacity and hire technologists has never, never been a problem with this company and that’s because we’ve done it before. We hired over 100 technologists, myself, and my team when we were out in California. One of the reasons we were in California is because a lot of those techs are still there. Again, Nashville, Tennessee, rich in technologists, Florida again corporate headquarters, we have the ability to attract.
We continue to look for merger and acquisition capabilities and the ability to influence to influence or drive new testing algorithms is something that is important. I’m going to turn this over now because I’d like our CFO, Mr. Steven Jones, to sort of take you through some of the financial information and then both of us will be available to talk and handle your questions at the conclusion. Steve.
Thank you, Bob. This next chart shows some of our basic statistical information. Our share price was $1.35 when I did this presentation. About 31.3 million shares outstanding, just under 40 million on a fully diluted basis. Most of those were financing related warrants and other warrants like that. Current market cap around 42 million.
Average daily trading volume, like every other microcap company out there, our volume has diminished somewhat this fall. On the next chart there you’ll see what our statistical information looks like historically in terms of requisitions and tests. You can see that we’ve more than doubled our requisitions in each of the last two years. This year we’re expecting to finish the year somewhere around 20,000 requisitions, same thing with tests, and that has translated into approximately triple revenue from’04 to ’05, double from ’05 to ’06, and we should more or less double again in ’07. We have announced publicly that we expect to do $10 million to $12 million of revenue. Through the first nine months of this year we were at $7.7 million.
In terms of our core growth drivers, just to review, Bob mentioned the 25% per year core growth rate. The genetics testing segment is very, very fast growing right now with a lot of new technologies coming out. Being a smaller company we are very fleet of foot, we are able to access new opportunities. I think we got a heck of a jump on the larger labs with the FISH testing that came out.
As Bob mentioned, more than 50% of our revenue didn’t exist three years as a technology that you could sell. We’re adding more sales people. We have announced that we expect to be 18 or more by the end of this year and probably on the order of 26 to 30 through the end of 2008.
Opening up new geographic territories, all you need to do is look on a map and see where we’re not and you can see where we’re thinking about. There’s lots of ways you can do this. You can build a lab, you can buy a lab, you can joint venture with somebody who’s got an existing lab. We’re looking at all of those. Don’t have anything to report on that just yet.
We think a great way to get more leverage out of our business is to increase the penetration of our current customer base. You do this by doing more tests per requisition, or tests per case, if you will. We currently averaged about one and a quarter, 1.25, tests per requisition. We think we can take that up with some of these new products like the genetic pathology solutions product that Bob mentioned.
Here is our share price, as you can see we had very nice growth during 2006. 2007 we sort of treaded water in the same place as we’ve been most of the year, as have most of, or a lot of the small cap companies.
Why invest in NeoGenomics? Well, we are an emerging leader in one of the fastest growing segments of the lab testing industry. There are, we have some very strong competitive advantages. Our turnaround times are second to none in the US that has attracted the attention of several large customers. We’re really just beginning to scale. We made, our Board of Directors made a conscious decision this year to go ahead and invest in both physical infrastructure and personnel infrastructure. As a result, we operated the company profitably for most of 2006. I think we finished the year with something like $130,000 loss.
This year we became more concerned that some of our competitors were getting bigger, faster than us, so we invested in people and physical space and we are not profitable right now. We expect to return to profitability probably in Q1 of next year.
Our management team is probably one of the things that is maybe not as obvious to some of you who haven’t heard our story before, but Bob is a guy who took the genetics division of a company called US Labs from zero dollars in revenue to about $32 million in revenue in about 30 months. He and his team did that between 2001 and 2004. For those of you who don’t know the US Labs story it was acquired by Lab Corp for about $155 million in cash. At the time they had two divisions, the genetics division, which is what Bob ran, and the anatomic pathology division. They finished 2004 with about $70 million or so of revenue.
So, you know, a lot of what we’re doing here is stuff that has been done before by the existing management team. We have many people that followed Bob to NeoGenomics, and we’re quite excited about the ability to do it again without making quite as many mistakes as perhaps we made before.
Also we believe that the introduction of proprietary tests over time is a huge advantage. If you look at the laboratory testing companies that have proprietary tests, they traded significantly greater multiples than the ones that don’t have proprietary tests. Toward that end, we have been looking at creating some of those ourselves. We haven’t actually announced anything but we do have a research and development division that’s focused on that.
That’s all of our prepared remarks at this point in time I’d like to open it up for questions. Sir.
Your SG&A is growing at the (inaudible). At some point I assume that’s going to reverse. What are your intentions in this regard?
It’s an excellent question; it’s something that I watch very, very closely. The question was SG&A seems to be growing about the same pace as revenue in 2007, at some point that should reverse. What is our intentions with respect to that?
We have now hired, I’m going to say, somewhere around the order of 10 more sales people this year, significant more management people. We have almost all of our core management team. Bob has mentioned that we will be hiring a CEO here sometime in the near future. At some point in time we’ll beef up with a couple of other in-house legal counsel, that sort of thing. But most of the high priced SG&A personnel are hired. The only high priced SG&A personnel that remain to hire are sales people, and those come with, typically revenue following them within two, three months. So I would expect in 2008 to begin to see the SG&A as a percentage of revenue not growing anywhere near as fast as the overall revenue.
In 2008 I would expect to see SG&A grow significantly slower than overall revenue. Also in 2008, we will have some litigation that has cost us a fair amount of money this year behind us, and so I think the year-over-year comparisons will start to be much more, much easier on us.
How long will your cash position carry you with your current burn rate?
We’re right now; the question was how long will our current cash position carry us with our current burn rate? As we announced in our recent quarterly filing we are in the process of putting in place a $3 million working capital accounts receivable based facility. That is actually scheduled to close next week, so with that we feel like we’ve got adequate liquidity to reach well into 2008. Now having said that if we could engage in strategic activities we may readdress that but as of the current time we don’t have any anticipation or expectation of doing an equity raise at this point in time.
At what revenue level do you need to be at to break even?
At the current level, let me answer it a different way. We estimate at about a $20 million annualized revenue run rate we will break even on a monthly basis. When you work the math out on that that’s about $1.67 million dollars per month of revenue, and that’s a full GAAP net income break even, not a cash flow break even. There’s a couple of hundred thousand dollars a month of non cash expenses. So in the order of $1.5 million a month of cash revenue will cover the cash expenses.
That’s with 17 sales people?
Yeah, that’s with the 17 sales people.
So when you get to 30?
Yeah, we have largely, I’m sorry, that’s at year end based on the 18 to 26 people. That’s what we would expect at year end. Not currently.
We’ll we are hoping we’ll be profitable as soon as Q1 next year. We’re growing very rapidly at this point in time. The fourth quarter is always a funny quarter because we have Thanksgiving and Christmas, and we think about our business in terms of laboratory intake days, and there’s about seven fewer laboratory days in Q4 than there is in Q3, so perhaps it may not be possible to maintain the sequential growth rates we had from Q3 to Q4 but we certainly expect to have sequential growth.
Are there other questions?
Well on behalf of NeoGenomics, we’d like to thank you guys for coming out. We are going to be next door or a breakout session to the extent that anybody has any further questions and please feel free to call or email me if you would like some follow up later on. Thank you.
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