EXAGEN Business Summary

Exagen Inc. (XGN) is a commercial-stage diagnostics company that generates revenue primarily through its AVISE brand of laboratory-developed tests (LDTs), which utilize proprietary Cell-Bound Complement Activation Products (CB-CAPs) technology to diagnose and monitor autoimmune rheumatic diseases (ARDs). Its business model is built on a high-complexity laboratory service model, where revenue is driven by test volume and average selling price (ASP) expansion across its core diagnostic segment and a growing Pharma Services division. The company’s flagship product, AVISE CTD, provides differential diagnosis for systemic lupus erythematosus (SLE) and other connective tissue diseases, positioning Exagen as a specialized leader in the rheumatology market. Key competitors include large-scale reference labs like LabCorp and Quest Diagnostics, as well as specialized diagnostic firms such as Myriad Genetics and Natera. Exagen distinguishes itself through its niche focus on ARD-specific biomarkers that offer superior clinical sensitivity and specificity compared to traditional ANA testing. Founded in 2002 by Waneta C. Tuttle and Cole Harris, Exagen is currently led by President and CEO John Aballi, who took the helm in October 2022 after serving as SVP at Veracyte and COO at Decipher Biosciences. The executive team includes CFO Jeffrey G. Black, appointed in September 2024, who previously orchestrated major transactions at Standard BioTools and Apollo Endosurgery, and Chief Scientific Officer Michael Mahler, who joined in 2025 with over two decades of autoimmune research expertise. The company is overseen by Executive Chairman Dr. Tina Nova, a veteran biotech founder (Genoptix, Nanogen) and former CEO of Decipher Biosciences. The board also features notable industry figures such as former Illumina CIO Scott Kahn and Chas McKhann. Major institutional investors include Tullis Health Investors, RTW Investments, and H.I.G. Capital, reflecting a strong pedigree of life sciences backing.