Exagen Inc. (XGN): Marketing Mix Analysis [Dec-2025 Updated]

You're trying to get a clear picture of how Exagen Inc. is actually making money from its specialized autoimmune diagnostics business as we move through late 2025, and frankly, the strategy is more intricate than just having a great test. Honestly, for a company relying on proprietary lab-developed tests like AVISE® CTD, success hinges on navigating a complex web: convincing rheumatologists of the test's utility, managing a centralized lab operation, and, most critically, wrestling with commercial payers for reimbursement. We're going to map out their entire go-to-market playbook-the specific products they push, the channels they use, how they promote clinical evidence, and the tough pricing reality they face-so you can see the precise levers driving Exagen Inc.'s near-term performance. Stick with me, and we'll distill this 4P strategy into actionable insights.

Exagen Inc. (XGN) - Marketing Mix: Product

The product element for Exagen Inc. centers on its portfolio of proprietary, high-complexity, high-value laboratory-developed tests (LDTs) designed to aid in the diagnosis and management of autoimmune diseases. These tests are performed in Exagen Inc.'s laboratory, which is certified for high-complexity testing by the Centers for Medicare & Medicaid Services (CMS) and licensed by all states requiring out-of-state licensure. The clinical laboratory typically reports all AVISE® testing product results within five business days.

The core of the offering is the AVISE® CTD panel, which is continuously enhanced with new biomarkers to improve diagnostic accuracy for complex conditions like lupus, rheumatoid arthritis (RA), and Sjögren's syndrome. The commercial strategy involves integrating new markers to drive up the Average Selling Price (ASP) per test. For instance, the trailing twelve-month (TTM) ASP for the AVISE® CTD test reached $441 per test as of the third quarter of 2025, up from $419 in the first quarter of 2025.

The product development focus includes specific enhancements for systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). New biomarkers integrated into the AVISE® CTD offering for SLE and RA are expected to command initial reimbursement estimates around $90 per test, with some new biomarkers contributing $90 incremental revenue per test. The company also presented research related to the continued development of a lupus nephritis platform at the American College of Rheumatology Conference.

Exagen Inc.'s product line also includes specialized molecular and cellular assays that extend beyond the core CTD panel, such as the recently commercially launched seronegative RA markers for anti-PAD4, which were added late in the third quarter of 2025. The AVISE® MTX test monitors methotrexate drug adherence and toxicity, though specific volume or revenue contribution data for this test alone is not separately itemized in the latest reports. The overall success of the product strategy is reflected in the company's financial performance, with Q3 2025 revenue hitting a record of $17.2 million.

The company also generates revenue from its Pharma Services business, which involves collaborations and specialized testing for pharmaceutical companies and Contract Research Organizations (CROs). This segment contributed nearly $800,000 in revenue for the third quarter of 2025, bringing the year-to-date total to $1.2 million, with a reported backlog of $3.5 million. The overall 2025 full-year revenue guidance remains between $65 million and $70 million.

The performance metrics for the core product line through the third quarter of 2025 are detailed below:

The product strategy is supported by continuous volume and price expansion, as evidenced by the following key product-related statistics:

• AVISE CTD test volume grew 14% compared to the first quarter of 2025 in the second quarter of 2025.
• The rheumatoid arthritis (RA) market represents a broader addressable market of 2.5 million annual tests.
• The TTM ASP increase from Q1 2024 to Q1 2025 was $42 per test.
• The company affirmed its commitment to achieving a medium-term TTM ASP goal of $500.
• Gross margin for Q2 2025 was 60.3%, up from 59% in Q1 2025.
• Q3 2025 Gross Margin was just over 58%.

Exagen Inc. (XGN) - Marketing Mix: Place

You're trying to map out how Exagen Inc. gets its specialized autoimmune diagnostic tests from the lab bench to the ordering physician's office. For a company like Exagen Inc., 'Place' isn't about stocking shelves in retail stores; it's about the precision of clinical logistics and direct access for specialized medical practices. Here's the quick math on their distribution footprint as of late 2025.

Centralized clinical laboratory model in Carlsbad, California

Exagen Inc. operates a highly centralized testing model, which is key for maintaining quality control over complex assays. The core of this operation is the company's laboratory, which is physically located in Carlsbad, California. This facility is not just a processing center; it holds important credentials, being both CLIA-certified and CAP-accredited, which speaks directly to the quality assurance built into their distribution pipeline. The entire testing process, from sample receipt to result reporting, flows through this single, specialized hub.

The volume of work flowing through this centralized place is substantial, as evidenced by recent financial reporting. This scale dictates the logistics required for nationwide service.

Nationwide distribution network for blood sample collection and logistics

While testing is centralized, sample collection must be nationwide to serve its target market. Exagen Inc.'s distribution strategy relies on a logistics network capable of securely transporting biological samples from collection points across the United States back to the Carlsbad laboratory for processing. This network supports the delivery of their full suite of AVISE-branded tests.

The reach of this network is defined by the customer base it supports. The company's strategy explicitly targets a specific segment of the medical community:

• Targeted specialty physicians: Approximately 5,000 rheumatologists across the United States.
• Market penetration (as of Q2 2025): Approximately 10%.

This means the logistics infrastructure must effectively service the practices of the rheumatologists who have adopted their testing portfolio.

Direct-to-physician ordering system for rheumatology practices

The primary channel for placing orders is a direct interface with the physician's office, bypassing broader hospital or large reference lab ordering systems for initial test requests. This direct-to-physician (DTP) model is facilitated by the company's systems, which are designed to integrate into the workflow of rheumatology practices. The goal is to enable clinicians to order tests like AVISE® CTD for differential diagnosis, prognosis, and monitoring of complex autoimmune conditions.

The success of this DTP channel is directly tied to the adoption rate among the target audience. The company's business model integrates testing products with a sales channel focused on these specialists.

Telehealth and remote patient monitoring integration for sample collection

For a diagnostic company, integrating with telehealth and remote patient monitoring (RPM) typically involves facilitating sample collection outside of a clinic or lab setting. While Exagen Inc. is committed to improving care for chronic conditions, the specific, publicly reported metrics for the percentage of their sample collections facilitated directly through a proprietary telehealth or RPM platform as of late 2025 aren't detailed in recent earnings summaries. The focus remains on the core lab function and the DTP ordering system. If onboarding takes 14+ days, churn risk rises.

Exagen Inc. (XGN) - Marketing Mix: Promotion

Promotion for Exagen Inc. centers on communicating the clinical utility and diagnostic accuracy of its specialized autoimmune testing portfolio, primarily targeting rheumatologists and key opinion leaders (KOLs). This involves a multi-pronged approach emphasizing scientific validation and direct engagement.

Direct sales force targeting rheumatologists and key opinion leaders (KOLs)

Exagen Inc. employs a specialized sales force whose training allows representatives to interpret de-identified patient test reports and offer tailored insights during discussions with rheumatologists. This specialized approach is key to driving adoption of the AVISE testing products. The commercial footprint saw expansion through late 2025.

Here's a look at the sales force expansion and market focus:

The company expects the results of territory expansion initiated in Q2 2025 to materialize later in the year.

Extensive clinical data publication and presentations at medical conferences

A core promotional activity involves presenting robust clinical evidence at major medical meetings to build credibility with the medical community. This scientific dissemination is crucial for supporting the diagnostic value of the AVISE tests.

Exagen Inc.'s presence at key 2025 medical and investor events included:

• Accepted abstracts at the 2025 American College of Rheumatology (ACR) Convergence: Six.
• Plenary presentation at ACR Convergence 2025 on a urinary biomarker panel for Lupus Nephritis, in collaboration with Johns Hopkins University.
• Hosting an Innovation Theater at ACR Convergence 2025 focusing on AVISE CTD validation and novel biomarkers.
• Participation in Q4 2025 investor conferences, including Craig-Hallum Alpha Select (November 18) and Canaccord Genuity MedTech Forum (November 20).
• Participation in early 2025 conferences like TD Cowen's Health Care Conference (March 5).

Educational programs and materials for physicians on test utility

The content promoted to physicians heavily features the clinical validation of the flagship product, AVISE CTD, which accounted for 91% of revenue for the first six months of 2025. The company commercially launched seronegative RA markers for anti-PAD4 at the end of Q3 2025, which serves as new educational material to differentiate its offering. The trailing twelve-month Average Selling Price (ASP) for AVISE CTD reached $441 per test as of Q3 2025, reflecting a $37 per test increase over Q3 2024, partly driven by the introduction of new markers.

Digital marketing focused on clinical evidence and diagnostic accuracy

While specific digital marketing spend figures are not itemized, the focus of public-facing communications aligns with clinical evidence. The company's Q1 2025 highlights mentioned that new biomarkers drove a $90 incremental revenue per test. The overall financial commitment to commercial activities is reflected in the operating expenses reported.

Operating Expenses (proxy for commercial/promotional spend, in thousands USD):

The operating expenses for the nine months ended September 30, 2025, were $38,688 thousand, compared to $34,888 thousand for the same period in 2024.

Patient advocacy and awareness campaigns for autoimmune diseases

Exagen Inc. states its mission includes improving clinical outcomes through innovative testing and a focus on patient-centered care. The company's efforts to address the ongoing challenges of autoimmune disease management are supported by its laboratory specialization in rheumatic diseases, delivering precise and timely results for conditions like lupus, rheumatoid arthritis, and Sjögren's disease.

Exagen Inc. (XGN) - Marketing Mix: Price

The pricing structure for Exagen Inc. (XGN) is fundamentally driven by a complex, negotiated reimbursement model with commercial payers, which directly impacts the realized Average Selling Price (ASP) for its diagnostic tests, primarily AVISE® CTD.

The company's pricing strategy is heavily reliant on the success of securing favorable coverage policies from Medicare and private insurers. As of mid-2025, Exagen Inc. reported concluding a two-year process where AVISE CTD was granted a positive medical policy through a Medicare Administrative Contractor (MAC) review process, with contract finalization efforts underway to ensure streamlined billing transactions. Furthermore, there is an external factor affecting future national pricing, as CMS is set to align local MAC pricing with national payment rates for Proprietary Laboratory Code (PLA) codes on the 2026 Clinical Laboratory Fee Schedule (CLFS).

The Average Selling Price (ASP) is subject to payer mix and contract terms, as evidenced by fluctuations and external pressures. The TTM AVISE CTD ASP has shown consistent upward movement through 2025, though growth has been tempered by factors like new biomarker reimbursement ramp-up and the loss of a high-ASP direct bill account.

The company's billing strategy centers on demonstrating clinical utility to justify premium pricing, which is supported by the launch of new biomarkers. For instance, new SLE and RA biomarkers launched in Q1 2025 had an initial expected reimbursement estimate of $90 per test, translating to approximately a $15 increase in the TTM ASP in that quarter. The total revenue generation is tied directly to test volume and successful reimbursement collection. Total revenue for the nine months ended September 30, 2025, reached $49,944 thousand. The company's Q1 2025 billing strategy involved holding claims to maximize reimbursement, resulting in an accounts receivable balance of $14.7 million at that time.

Key financial metrics reflecting realized pricing and volume performance for 2025 include:

• Full-year 2025 revenue guidance is maintained between $65 million and $70 million.
• Record Q3 2025 revenue was $17,244 thousand.
• Year-to-date revenue through Q3 2025 was $49,944 thousand.
• AVISE CTD test volume grew 16% in Q3 2025 compared to Q3 2024.
• The Pharma and CRO business generated $1.2 million in revenue year-to-date through Q3 2025.
• Exagen Inc. ended Q3 2025 with $35.7 million in cash and cash equivalents.