Exagen Inc. (NASDAQ: XGN)

Exagen Inc. is a medical technology company that designs develops and commercializes innovative testing products under the AVISE® brand. The company focuses on differential diagnosis prognosis and monitoring of complex rheumatic autoimmune and autoimmune related diseases including systemic lupus erythematosus rheumatoid arthritis and Sjögren’s syndrome. All testing is performed in its approximately 13,000 square foot laboratory in Vista California which holds CLIA certification and CAP accreditation for high complexity testing. The flagship product AVISE® CTD was launched in 2012 and aids clinicians in distinguishing various connective tissue diseases by providing unique biomarker information that reduces the need for repeat testing and speeds diagnosis. Since its introduction Exagen has delivered over 1,000,000 AVISE® CTD tests and continues to expand the panel with additions such as T cell biomarkers RA subprofile biomarkers and PAD4 biomarkers. The company also offers standalone assays like AVISE® Lupus which has obtained a Proprietary Laboratory Analyses code from Noridian Healthcare Solutions.

The company generates revenue primarily from the sale of its AVISE® testing products especially the AVISE® CTD test. Revenue also arises from agreements with pharmaceutical companies and contract research organizations for the use of its testing products and or the de identified data generated from those tests. Payors include commercial insurers health maintenance organizations government programs such as Medicare and Medicaid client entities such as hospitals and other laboratories and patient self pay. The AVISE® CTD test accounted for approximately 89% of revenue for the 9 months ended September 30, 2025 and 91% for the same period in 2024. In addition to product sales the company has experienced growth in average selling price driven by the addition of new biomarker assays which has contributed to gross margin expansion. Revenue cycle management initiatives have also influenced cash collection patterns and accounts receivable balances.

Exagen Inc. operates within the specialized autoimmune diagnostics segment of the broader in vitro diagnostics industry. The company competes with large diagnostic manufacturers such as Roche Diagnostics Siemens Healthineers and Thermo Fisher Scientific as well as specialized assay providers like Quest Diagnostics and LabCorp. Its competitive advantages stem from proprietary biomarker panels included in the AVISE® portfolio the CLIA certified CAP accredited laboratory and a sales force with deep rheumatology expertise that can interpret test results and provide tailored insights to physicians. Additionally the company benefits from intellectual property licensed from Johns Hopkins University and ongoing research and development efforts that aim to expand its test menu and improve clinical utility. Exagen has secured a Proprietary Laboratory Analyses code for its AVISE® Lupus assay and has obtained a Z Code identifier from Palmetto GBA under the Molecular Diagnostic Services Program. The firm also pursues collaborations with pharmaceutical companies to co develop biomarkers and to leverage its biorepository for research purposes which further differentiates it from pure play diagnostic providers.

The company serves rheumatologists primary care physicians other specialists and the patients they treat. It also works with hospitals independent laboratories pharmaceutical companies and contract research organizations that utilize its testing services or de identified data for research and development purposes. Specific customer names are not disclosed in the filing but the payer mix includes major national health plans regional insurers and government Medicare and Medicaid programs. The specialized sales force covers 40 territories across the United States allowing direct engagement with ordering physicians and their support staff.