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Exagen Inc (XGN)
NASDAQ:XGN
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Exagen
(NASDAQ:XGN)
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Rating:41Neutral
Price Target:
$9.00
▼(-3.74% Downside)
Exagen's stock score is primarily impacted by its financial performance and valuation. Despite revenue growth, significant profitability and cash flow challenges weigh heavily. Technical indicators suggest bearish momentum, and the negative P/E ratio further undermines valuation attractiveness.
Positive Factors
Revenue Growth
Exagen's record testing volume indicates strong demand for its diagnostic services, supporting long-term revenue growth and market penetration.
Product Innovation
The launch of new biomarkers enhances Exagen's product offerings, potentially increasing market share and reinforcing its competitive position in diagnostics.
Debt Reduction
Significant debt reduction improves financial stability and flexibility, enabling Exagen to invest in growth opportunities and withstand economic fluctuations.
Negative Factors
Profitability Challenges
Negative profit margins indicate ongoing operational inefficiencies, which could hinder Exagen's ability to achieve sustainable profitability in the long term.
Cash Flow Issues
Negative cash flow growth suggests challenges in generating sufficient cash, potentially limiting Exagen's capacity to fund operations and strategic initiatives.
Increased Operating Expenses
Rising operating expenses, driven by R&D and sales expansion, may pressure margins and delay profitability, impacting Exagen's financial health.
Exagen (XGN) vs. SPDR S&P 500 ETF (SPY)
Market Cap
$217.34M
Dividend YieldN/A
Average Volume (3M)331.68K
Price to Earnings (P/E)―
Beta (1Y)0.82
Revenue Growth14.08%
EPS Growth1.34%
CountryUS
Employees209
SectorHealthcare
Sector Strength45
IndustryMedical - Diagnostics & Research
Share Statistics
EPS (TTM)-0.31
Shares Outstanding22,663,100
10 Day Avg. Volume526,522
30 Day Avg. Volume331,680
Financial Highlights & Ratios
PEG Ratio0.13
Price to Book (P/B)7.82
Price to Sales (P/S)1.34
P/FCF Ratio-5.41
Enterprise Value/Market Cap1.13
Enterprise Value/Revenue3.85
Enterprise Value/Gross Profit6.43
Enterprise Value/Ebitda-17.92
Forecast
1Y Price Target
$16.20Price Target Upside73.26% Upside
Rating ConsensusStrong Buy
Number of Analyst Covering7
EPS Forecast (FY)-0.87
Revenue Forecast (FY)$67.29M
Exagen Business Overview & Revenue Model
Company DescriptionExagen Inc. develops and commercializes various testing products based on its cell-bound complement activation products technology under the AVISE brand in the United States. It enables rheumatologists to care for patients through the diagnosis, prognosis, and monitoring of autoimmune and autoimmune-related diseases, including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Its lead testing product is AVISE CTD that enables differential diagnosis for patients presenting with symptoms indicative of various connective tissue diseases (CTDs) and other related diseases with overlapping symptoms. The company offers AVISE Lupus that measures activation of the complement system by quantifying the level of B-cell C4d and erythrocyte bound C4d in the patient's blood; and AVISE APS, which consists of a panel of autoantibody tests that aids in the diagnosis and management of APS. In addition, it provides AVISE SLE Prognostic, a panel of autoantibodies for assessing the potential for complications affecting the kidney, brain, and cardiovascular system; AVISE Vasculitis AAV, which utilizes a testing panel of individual analytes to provide physicians with results in the assessment and monitoring of anti-neutrophil cytoplasmic antibody and associated vasculitis; AVISE Anti-CarP test, which identifies RA patients with severe disease; and AVISE PC4d to measure platelet- bound C4d. Further, the company offers AVISE SLE Monitor, a biomarker blood test; AVISE MTX, a patented and validated blood test; and AVISE HCQ, a blood test to monitor levels of hydroxychloroquine. It has a research collaboration and license agreement with Allegheny Health Network (AHN) Research Institute to develop novel patented biomarkers. The company was formerly known as Exagen Diagnostics, Inc. and changed its name to Exagen Inc. in January 2019. Exagen Inc. was incorporated in 2002 and is headquartered in Vista, California.
How the Company Makes MoneyExagen generates revenue primarily through the sale of its diagnostic tests to healthcare providers and laboratories. The company operates on a fee-for-service model, where it charges for each test performed. Key revenue streams include direct sales of AVISE® tests to clinicians, reimbursement from insurance companies for tests provided to patients, and collaborations with pharmaceutical companies for companion diagnostics. Additionally, Exagen may benefit from partnerships with healthcare organizations that enhance its market reach and credibility, contributing to its overall earnings potential.
Exagen Earnings Call Summary
Earnings Call Date:Nov 04, 2025
(Q3-2025)
| % Change Since: |
Next Earnings Date:Mar 23, 2026
Earnings Call Sentiment Neutral
The earnings call highlighted strong revenue and volume growth, the successful launch of new products, and increased pharma services revenue. However, challenges such as the loss of a high ASP account, slower ASP gains, and increased expenses indicate areas of concern. While the company shows positive operational momentum, financial challenges balance the sentiment.Q3-2025 Updates
Positive Updates
Record Quarter Revenue
Fourth quarter revenue of $17.2 million was the highest quarter in Exagen's history, marking a nearly 40% increase over the third quarter of 2024, even considering over $1 million in downside revenue adjustments in Q3 of last year.
Strong Volume Growth
Q3 testing volume was the highest ever recorded for a third quarter period, with AVISE CTD testing volume up 15% from Q3 of last year and almost 2% sequentially.
Expansion of Pharma Services Revenue
Pharma Services revenue increased to $780,000 in the third quarter, with a year-to-date total of $1.2 million compared to about $100,000 in 2024.
Launch of New Rheumatoid Arthritis Biomarkers
Successfully launched assays for the detection of anti-PAD4 antibodies, differentiating Exagen's rheumatoid arthritis offering.
Continued ASP Expansion
Trailing 12-month ASP for AVISE CTD reached $441, a 9% increase year-over-year.
Negative Updates
Loss of High ASP Direct Bill Account
A large high ASP direct bill account was lost, impacting ASP as the business converted to a standard commercial insurance payer mix.
Slower-than-Expected ASP Gains
New biomarker reimbursement has not ramped as quickly as hoped, with higher denials than expected, impacting ASP growth.
Potential Delay in Cash Flow Positivity
While on track to deliver $65 million to $70 million in revenue, sustained cash flow positivity may be pushed to 2026 due to ASP challenges.
Increased Operating Expenses
Operating expenses for the third quarter were $13.2 million, up from $11.6 million in Q3 of '24, due to increased R&D spend and sales territory expansion.
Company Guidance
During Exagen Inc.'s Q3 2025 earnings call, the company reported a robust 19% year-to-date revenue growth, attributed to an 8% increase in testing volume and a 9% rise in average selling price (ASP). The company launched anti-PAD4 antibodies, its second rheumatoid arthritis biomarker set for the year, although its immediate revenue impact is expected to be modest. Exagen is on track to achieve $65 million to $70 million in revenue for 2025, with the potential to be cash flow positive at the high end of this range, though sustained cash flow positivity might be delayed until 2026 due to ASP challenges. The company also highlighted a significant revenue increase in its Pharma Services business, generating $780,000 this quarter, and continues to see a strong order backlog of $3.5 million. Despite losing a high ASP direct bill account, Exagen's revenue has benefited from volume growth, and the company continues to work on ASP expansion through revenue cycle management, appeals, and payer education efforts.Exagen Financial Statement Overview
Summary
Exagen is experiencing revenue growth but faces significant profitability and cash flow challenges. The reduction in leverage is positive, yet operational inefficiencies and negative cash flow persist, impacting financial stability.Income Statement
Exagen's income statement reveals a mixed performance. The company has shown a positive revenue growth rate of 8.05% TTM, indicating an upward trajectory in sales. However, the net profit margin is negative at -28.85% TTM, reflecting ongoing profitability challenges. The gross profit margin is relatively healthy at 59.42% TTM, but the negative EBIT and EBITDA margins suggest operational inefficiencies and high costs.45
Neutral
Balance Sheet
The balance sheet shows a significant improvement in the debt-to-equity ratio, which decreased to 0.14 TTM from 2.45 in the previous year, indicating reduced leverage. However, the return on equity remains negative at -136.26% TTM, highlighting profitability issues. The equity ratio is not provided, but the overall financial stability appears to be improving with reduced debt levels.40
Negative
Cash Flow
Exagen's cash flow statement indicates challenges in cash generation. The free cash flow growth rate is negative at -31.23% TTM, and operating cash flow remains negative. The operating cash flow to net income ratio is -1.49 TTM, suggesting inefficiencies in converting income into cash. Despite these issues, the free cash flow to net income ratio is slightly above 1, indicating some level of cash flow alignment with reported earnings.35
Negative
| Breakdown | TTM | Dec 2024 | Dec 2023 | Dec 2022 | Dec 2021 | Dec 2020 |
|---|---|---|---|---|---|---|
Income Statement | ||||||
| Total Revenue | 63.60M | 55.64M | 52.55M | 45.56M | 48.30M | 41.98M |
| Gross Profit | 38.07M | 33.11M | 29.46M | 21.35M | 27.71M | 25.42M |
| EBITDA | -13.65M | -11.14M | -19.15M | -43.66M | -23.10M | -13.65M |
| Net Income | -19.04M | -15.12M | -23.69M | -47.39M | -26.85M | -16.69M |
Balance Sheet | ||||||
| Total Assets | 62.82M | 44.69M | 56.94M | 86.22M | 123.44M | 78.38M |
| Cash, Cash Equivalents and Short-Term Investments | 35.65M | 22.04M | 36.49M | 62.39M | 99.44M | 57.45M |
| Total Debt | 28.17M | 23.00M | 23.23M | 35.20M | 28.07M | 26.97M |
| Total Liabilities | 44.69M | 35.15M | 34.25M | 43.76M | 38.51M | 36.54M |
| Stockholders Equity | 18.14M | 9.54M | 22.69M | 42.46M | 84.94M | 41.84M |
Cash Flow | ||||||
| Free Cash Flow | -10.99M | -13.79M | -15.29M | -36.46M | -22.64M | -14.54M |
| Operating Cash Flow | -10.25M | -13.28M | -14.46M | -32.14M | -20.27M | -14.08M |
| Investing Cash Flow | -737.00K | -515.00K | -804.00K | -4.32M | -2.42M | -455.00K |
| Financing Cash Flow | 24.60M | -663.00K | -10.63M | -489.00K | 64.68M | -97.00K |
Exagen Technical Analysis
Negative
9.35
Price Trends
10.67
Negative
9.49
Negative
7.30
Positive
Market Momentum
-0.42
Positive
30.07
Neutral
7.20
Positive
Evaluating momentum and price trends is crucial in stock analysis to make informed investment decisions. For XGN, the sentiment is Negative. The current price of 9.35 is below the 20-day moving average (MA) of 11.01, below the 50-day MA of 10.67, and above the 200-day MA of 7.30, indicating a neutral trend. The MACD of -0.42 indicates Positive momentum. The RSI at 30.07 is Neutral, neither overbought nor oversold. The STOCH value of 7.20 is Positive, not indicating any strong overbought or oversold conditions. Overall, these indicators collectively point to a Negative sentiment for XGN.
Exagen Risk Analysis
Exagen disclosed 71 risk factors in its most recent earnings report. Exagen reported the most risks in the "Finance & Corporate" category.
Finance & Corporate - Financial and accounting risks. Risks related to the execution of corporate activity and strategy
Latest Risks Added 0 New Risks
Exagen Peers Comparison
UnderperformOutperform
Sector (51)
Name | Overall Rating | Market Cap | P/E Ratio | ROE | Dividend Yield | Revenue Growth | EPS Growth |
|---|---|---|---|---|---|---|---|
51 Neutral | $7.86B | -0.30 | -43.30% | 2.27% | 22.53% | -2.21% | |
48 Neutral | $255.66M | -1.72 | -113.23% | ― | -41.87% | -165.76% | |
46 Neutral | $118.75M | ― | -44.24% | ― | 0.93% | 13.99% | |
45 Neutral | $235.61M | -5.44 | ― | ― | 22.56% | 41.62% | |
45 Neutral | $195.65M | ― | -23.93% | ― | 159.45% | 8.59% | |
41 Neutral | $217.34M | ― | -122.81% | ― | 14.08% | 1.34% | |
41 Neutral | $147.93M | ― | -239.53% | ― | 78.62% | 32.39% |
* Healthcare Sector Average
XGN
Exagen
9.35
6.45
222.41%
ACRS
Aclaris Therapeutics
2.32
0.14
6.42%
MDXH
MDxHealth
3.97
2.22
126.86%
STIM
Neuronetics
2.04
1.25
158.23%
PRE
Prenetics Group
13.47
8.66
180.04%
SERA
Sera Prognostics
2.95
-3.49
-54.19%
Exagen Corporate Events
Exagen Inc. Reports Strong Q3 2025 Performance
Nov 5, 2025
Exagen Inc. is a prominent provider of autoimmune diagnostics, specializing in innovative testing solutions for chronic autoimmune conditions such as lupus and rheumatoid arthritis. The company operates in the healthcare sector, focusing on improving clinical outcomes through its comprehensive testing portfolio.
Exagen’s Earnings Call: Growth Amid Financial Hurdles
Nov 5, 2025
Exagen’s Latest Earnings Call: Balancing Growth with Financial Challenges
Glossary
BuyA stock rated as a "Buy" is expected to perform better than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock is likely to deliver higher returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
HoldA stock rated as a "Hold" is expected to perform in line with the overall market or a specific benchmark. This rating indicates that the stock is neither particularly compelling nor unfavorable for investment. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
SellA stock rated as a "Sell" is expected to perform worse than the overall market or a specific benchmark over the near-to-medium term. This rating suggests the stock may deliver lower returns compared to other stocks in the same sector or market index. Note: This is not investment advice; please consult a financial advisor before making investment decisions.
Disclaimer
This AI Analyst Stock Report is automatically generated by our AI systems using advanced algorithms and publicly available financial, technical, and market data. While the information provided aims to be accurate and insightful, it is intended for informational purposes only and should not be considered financial advice. Any content created by an AI (Artificial Intelligence) system may contain inaccuracies and/or contain errors. Investing in stocks carries inherent risks, and past performance is not indicative of future results. This report does not account for your personal financial circumstances, objectives, or risk tolerance. Always conduct your own research or consult with a qualified financial advisor before making investment decisions. The analysis and recommendations provided are based on historical and current data and may not fully reflect future market conditions or unexpected developments. Neither the creators of this report nor its affiliated entities guarantee the accuracy, completeness, or reliability of the information presented. Use this report at your own discretion and risk.