Adaptive Biotechnologies (ADPT) Q2 FY26 earnings call: guidance and Q&A

Despite multiple myeloma being a mature indication, it showed 15% sequential growth. What are the drivers, and how can this growth be sustained?

The growth is driven by increased blood-based testing, which facilitates community access and interim surveillance. The company is developing data for clinical actionability use cases (e.g., avoiding transplantation, discontinuing therapy) and noted that multiple myeloma is only 17% penetrated, indicating significant future growth potential.

“We're now only 17% penetrated in multiple myeloma. So there's a long kind of growth runway ahead of us, especially as we continue to move to or incorporate more blood-based testing and penetrate the community.”

asked by David Westenberg · answered by Chad Robins

How confident is management in reaching the $1,400 ASP target for the full year, given the current $1,382 ASP?

Management is confident, citing renegotiated contracts with price increases effective in the second half, expanding coverage in DLBCL/MCL, and ongoing recontracting efforts with two large payers. These factors are expected to drive ASP towards the target, with potential for upside.

“We've got many paths to get to the $1,400. At this point, I would just consider it maybe as upside, but we're confident in the number.”

asked by David Westenberg · answered by Chad Robins

With increasing blood-based testing and serial monitoring, should per-patient economics be a more relevant KPI than per-test ASP, especially with potential coverage gaps?

ASP and per-patient economics are intertwined. The primary strategy is to increase the number of tests per patient over their lifetime. Productive dialogues are ongoing with Medicare/MolDX to expand tests per episode, and commercial payers generally do not limit test numbers based on medical necessity. The goal is to close coverage gaps and ensure payment for increased testing frequency.

“But our main strategy is to increase the number of tests per patient over the life cycle of the patient. That is ultimately what's going to drive the growth in the future.”

asked by Subhalaxmi Nambi · answered by Chad Robins

What percentage of volume comes from top ordering HCPs, and how does this inform the strategy to go deeper versus broader for volume expansion?

The top 100 users account for approximately 10% of volume, and about 2,000 providers contribute to 80% of volume, indicating a distributed user base. The company sees opportunities for both broader adoption, particularly in the community setting, and deeper penetration with existing high-volume users through clinical use cases and EMR-based tools to standardize testing and optimize frequency.

“Takes about 2,000 providers to get to 80% of that volume, and our use has become considerably more distributed over time, which I think is a reflection of our strategy to broaden use, particularly in the community setting.”

asked by Subhalaxmi Nambi · answered by Susan Bobulsky

What is the company seeing in the competitive landscape, particularly regarding Natera Foresight, and how does Adaptive maintain its competitive position?

While competition is present, especially in DLBCL, it has not had an attributable impact on Adaptive's growth. The company believes it has a strong competitive position due to its unparalleled technology, robust evidence base, established reimbursement, strong customer relationships, and EMR integration. The DLBCL market is still early, and increased awareness benefits Adaptive, which plans to further demonstrate the clinical performance of its enhanced ctDNA assay.

“We do believe that we have a winning position here. We have an unparalleled technology platform. It's purpose-built for hematology patients. We have a strong evidence base, substantial real-world experience based on our head start, established reimbursement.”

asked by Mark Massaro · answered by Susan Bobulsky

What does the MRD business look like on its own after the Immune Medicine separation, and will it remain heme-only or expand into solid tumors?

The separation and new capital allow Adaptive to leverage its established platform (clinical evidence generation, market access, reimbursement, RCM, lab operations) into other disease areas, including potentially solid tumors. The company will apply a disciplined approach to capital allocation for inorganic growth, focusing on areas with high gross margin opportunities and differentiated competitive advantages. However, management also emphasized the long growth runway still available in the heme MRD business.

“We look at -- if we can deploy those core competencies and capabilities that we've built to other opportunities, it's something that we are looking at. And that means potentially in solid tumors, but also in other disease areas as well.”

asked by Daniel Brennan · answered by Chad Robins