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NASDAQ: NEO
Time Matters. Results Count!

Company Overview Presentation
February 2014

“Improving Patient Care
through exceptional cancer
genetic testing services!”
1
Forward-looking Statements
This presentation contains statements which constitute forward-looking
statements within the meaning of Section 27A of the Securities Act, as amended;
Section 21E of the Securities Exchange Act of 1934; and the Private Securities
Litigation Reform Act of 1995. The words “may”, “would”, “could”, “will”, “expect”,
“estimate”, “anticipate”, “believe”, “intend”, “plan”, “goal”, and similar expressions
and variations thereof are intended to specifically identify forward-looking
statements. All statements that are not statements of historical fact are forwardlooking statements.
Investors and prospective investors are cautioned that any such forwardlooking statements are not guarantees of future performance and involve risks
and uncertainties, and that actual results may differ materially from those
projected in the forward-looking statements as a result of various factors. The
risks that might cause such differences are identified in our filings with the
Securities and Exchange Commission. We undertake no obligation to publicly
update or revise the forward looking statements made in this presentation to
reflect events or circumstances after the date of this presentation or to reflect the
occurrence of unanticipated events.
2
Investment Highlights

•

Fast growing cancer genetics lab servicing Oncologists,
Pathologists and Hospitals

•
•
•
•

Strategic client partnerships created by “Tech-Only” model

•

Strong Management Team with large cap lab experience

Dynamic, rapidly-growing and consolidating industry
Industry-leading revenue & test volume growth
Strong productivity and operating leverage leading to
accelerating cash flow and net income

3
Consistent Historical Growth
Annual Revenue ($, 000s)

Tests Performed

2013

2012

2011

2010

2009

0

2008

$0

2007

20,000
2006

$10,000

2005

40,000

2004

$20,000

2013

60,000

2012

$30,000

2011

80,000

2010

$40,000

2009

100,000

2008

$50,000

2007

120,000

2006

$60,000

2005

140,000

2004

$70,000

4
Accelerating Cash Flow & Earnings
($, 000's)

2011

2012

2013

$ 43,484
26.5%

$ 59,867
37.7%

$ 66,467
11.0%

Total Gross Margin
Gross Margin %

19,428
44.7%

26,836
44.8%

31,737
47.7%

Sales & Marketing Exp as a % of Rev
Gen & Admin Exp as a % of Rev
R&D Exp as a % of Rev
SG&A Expenses
Total SG&A as a % of Rev

16.0%
28.4%
1.2%
19,837
45.6%

12.5%
26.5%
3.8%
25,624
42.8%

13.1%
26.2%
3.7%
28,563
43.0%

Total Revenue
% Growth

Adjusted EBITDA
% Growth

$

2,134
NA

$

5,997
181.0%

$ 8,515
42.0%

Net Income/(Loss)
Diluted EPS

$ (1,177)
($0.03)

$

65
$0.00

$ 2,034
$0.02

Summary Operating Metrics
Avg. Revenue/Test
% Change

$

570
-4.9%

$

522
-8.4%

$

484
-7.3%

$

315
-2.7%

$

288
-8.6%

$

253
-12.2%

Avg. Cost of Goods Sold/Test
% Change

5
Management Team
•

Douglas VanOort, Chairman & CEO

•

Maher Albitar, M.D., Chief Medical Officer & Director of R&D

•

Robert Gasparini, Director & Chief Scientific Officer

•

Steven Jones, Director, EVP – Finance, & Chief Compliance Officer

•

George Cardoza, Chief Financial Officer

•

Robert Horel, Vice President, Sales & Marketing

•

Steven Ross, Chief Information Officer

Operating Partner, Summer Street Capital Partners;
Chief Operating Officer, Quest Diagnostics
Med. Dir. for Hematopathology & Oncology and Chief of R&D, Quest Nichols Institute;
Director of Leukemia and Molecular Laboratory, MD Anderson Cancer Center
Director of Genetics, U.S. Labs; Worldwide Marketing Mgr., Ventana Medical Systems;
Asst. Director, Prenatal Diagnostic Center (Harvard)
Chairman, Aspen Capital Group; Managing Member, Medical Venture Partners;
Vice President, Merrill Lynch Investment Banking
CFO, Protocol Global Solutions; Controller, Central Region, Quest Diagnostics
Regional Mgr., US Labs; Product Specialist, Ventana Medical Systems; Pilot, U.S. Navy
Vice President Technology, Chico’s FAS, Inc.

6
NeoGenomics’ Cancer Testing Services
Key Testing Methodologies
Cytogenetics: chromosome analysis
- “Neighborhood view of 46 houses from 1000 feet”

Flow Cytometry & IHC: cell surface marker analysis
- “Single house view from 500 feet”

Fluorescence in-situ Hybridization (FISH): gene
analysis - “Door and window view of one house”
Molecular testing: DNA/RNA analysis
-“View of serial number on door lock”
7
Customer Targets
Pathologists & Hospital Pathology Groups (about 72% of Revenue)
•
•
•

Enable community Pathologists to practice using sophisticated tools and tests
Innovative technical component (TC or “tech-only”) services – Flow, FISH, IHC
Outstanding Web-based Lab System & extensive training programs

Oncologists & Clinician Groups (about 25% of Revenue)
• Includes Hematologists, Oncologists, Dermatologists, Urologists
• Disease Panels and comprehensive molecular menus
• Increasing Opportunity to service larger practices with Tech-only model
Clinical Trials & Other (about 3% of Revenue)
•

Contract research/clinical trial support work for Pharma clients

8
NeoGenomics Formula for Success
Industry Dynamics
& Demographics
• Aging U.S. population and
prevalence of cancer
• Diagnostic testing reduces
healthcare costs and improves
clinical outcomes
• Emergence of molecular diagnostics
• Targeted therapeutics and
companion diagnostics
• Capitalize on new healthcare
paradigm

Market Share Gains
• Attract New Customers
– Promote key advantages of
“tech-only” model
– Partner with Clinician Offices
• Grow existing customer base

New Products &
Solutions
• Continue to expand test menu
• Sublicensing of HDC products
– Cytogenetics/Flow/IHC systems
– Prostate/colon/pancreatic Cx Tests
– International opportunities

– Sales force productivity

• Proprietary test development

– Increase share of wallet

• Disruptive technology for select solid
tumor cancers

– Promote product education
– Capitalize on competitor turmoil

• Seek new R&D partnerships

Superior Financial Model
• Sustainable revenue growth opportunity
• Significant degree of operating leverage in
the business model

9
Industry Dynamics
–

Molecular diagnostics enable physicians to better
diagnose diseases and predict therapeutic efficacy

•

–

Clinical Benefits: Effective treatment at an early stage
increases patient survival rates

•

Healthcare Savings: a) forego spending on ineffective
therapies and b) effective intervention at an early stage
generally lowers overall treatment cost

Need for companion diagnostics being driven by rising
drug costs and an increase in targeted therapeutics

•

•

Xalkori® (Crizotinib) - Cost of ~$90,000 annually to treat
non-small cell lung cancer. 50 – 61% effective for the ~3%
of the population with certain genetic characteristics

U.S. Population Demographics

Diagnostic testing can significantly lower
healthcare costs and improve clinical outcomes

–

•

Boomer Impact on Cancer Market

Molecular diagnostics transforming lab services
industry and fueling rapid growth

Diagnostics represents only 2-3% of total healthcare
spend but influence approximately 70% - 80% of
physician decisions

Cancer prevalence expected to increase as U.S.
population ages

–

77% of all cancers diagnosed are in people age 55 or
older, the fastest growing segment of the US

30%

Current

25%

Percent Of Population

•

20%

20%

20%

2030

2040

2050

22%
16%

17%

18%
16%

15%
10%

26%

19%

25%

25%

16%
11%

13%

12%

13%

1990

2000

2010

5%
0%
1980

Age 60 and older

2020

Age 65 and older

10
U.S. Cancer Testing Market Size $10-12 Billion
Hematopoietic Cancers

Solid Tumor Cancers

$3 - 4 Billion

$7 - 8 Billion

~$2 - 3 Billion

~$2 - 3 Billion

Patients in Treatment:

850,000

7.0 million

New Diagnoses/Yr.:

150,000

1.45 million

Bone Marrow (350K/Yr)
Per. Blood (150K/Yr)
Lymph Nodes

Tiss. Biopsies (8-10MM)
Fine Needle Aspirates
Other Bodily Fluids

~80%

~20%

Total Testing Market:
Est. Genetic Mkt. (TAM)

Specimen Types:

Neo Revenue Split:

11
Cancer Testing Market Characteristics
• Cancer Genetics is high growth segment of lab Industry

- ~15-20% annual test volume growth in genetics testing
- ~6-8% annual test volume growth in related AP testing

• Less than 400 Cancer Genetic Labs in the U.S.

- 2/3 affiliated with academic institutions
- Approximately 20% perform 80% of testing
- Only 15-20 labs with national reach

• High pace of consolidation - Recent examples include:
Target
Caris Diagnostics
Genoptix
Clarient
Genzyme Genetics

Acquiror
Miraca
Novartis
GE Healthcare Svcs
LabCorp

TV/LTM Rev
3.5x
1.7x
5.8x
2.5x
12
A Growing Commercial & Facility Footprint
VT

WA

ME
MT

ND

MI
NH

MN

OR

ID

NY

SD

WI

MI

WY
IA

NE

IL

CO

CA

KS

IN

MO

WV

AZ

KY

SC

AR

NM
MS
TX

CT

VA
NC

OK

RI
NJ
DE
MD

OH

NV
UT

PA

MA

AL

GA

LA

Irvine, CA
18k sf

FL

States sending specimens in 2013

Nashville, TN
7k sf
Tampa, FL
5k sf

Ft. Myers, FL
45k sf
13
Accelerating Pace of Innovation
2011
4 molecular
tests

2012

2013

10-color Flow Cytometry

40 new Molecular tests
Add’l NeoTYPE Panels

3 FISH

Implemented State-of-the-art
MolDx platform in lieu of Kits
28 new Molecular Assays

ROS1 FISH

FL – IHC menu

Proprietary method for increasing
sensitivity of Sanger sequencing
7 NeoTYPE MolDx Panels

Plasma/Urine-based
Prostate Test (Patent App)

New Aperio Digital Image Analysis
SVM for FISH (Patent App)
Barrett’s Esoph. FISH (Patent App)
NeoARRAY/SNP Cytogenetics
Internalized 99% of send-outs

Next Generation
Sequencing (48 genes)
NeoSITE Melanoma FISH

SVM-based Cytogenetics
Analysis System
SVM-based Automated
FISH Analysis System v2

14
More than 80 New Assays Launched in 2012 & 2013
Solid Tumor Assays*
Molecular Assays:
1.
IDH1 & IDH2 Mutation Analysis
2.
c-KIT Mutation Analysis
3.
PIK3CA Mutation Analysis
4.
NRAS Mutation Analysis
5.
TP53 Mutation Analysis
6.
NeoARRAY SNP/Cytogenetic Profile
7.
KRAS Mutation Analysis
8.
BRAF Mutation Analysis
9.
EGFR Mutation Analysis
10.
Microsatellite Instability Analysis
11.
NeoTYPE Breast Profile
12.
NeoTYPE Colorectal Profile
13.
NeoTYPE Gastric Profile
14.
NeoTYPE Lung Profile
15.
NeoTYPE Solid Tumor (Other) Profile
16.
TPMT Genotyping
17.
UGT1A1 Genotyping
18.
Kit/PDGFRa Mutation Analysis
19.
HRAS Mutation Analysis
20.
PTEN Mutation Analysis
21.
HOXB13 Genotyping
22.
GNAS Mutation Analysis
23.
MLH1 Promoter Methylation Analysis
24.
MGMT Promoter Methylation Analysis
FISH/ISH Assays:
1.
ISH – Kappa ISH
2.
ISH – Lambda ISH
3.
NeoSITE Barrett’s Esophagus FISH
4.
ROS1 FISH
5.
NeoSITE Melanoma FISH
6.
1p/19q Deletion FISH Test

Hematopoietic Assays*
Molecular Assays:
1.
BCR-ABL1 Translocation, t(9;22)
2.
ABL1 Kinase Domain Mutation Anal
3.
IgVH Mutation Analysis
4.
FLT3 Mutation Analysis
5.
NPM1 Mutation Analysis
6.
JAK2 V617F Mutation Analysis
7.
JAK2 Exon 12-14 Mutation Anal
8.
BCL2 Translocation, t(14;18)
9.
BCL1 Translocation, t(11;14)
10.
MPL Mutation Analysis
11.
MPN Reflex Panel
12.
DNMT3A Mutation Analysis
13.
RUNX1-RUNX1T1 (AML1-ETO)
Translocation, t(8;21)
14.
SF3B1 Mutation Analysis
15.
B-Cell Gene Rearrangement
16.
T-Cell Gene Rearrangement
17.
CBFB/MYH11 Translocation, inv(16)
18.
PML-RARA Translocation, t(15;17)
19.
CEBPA Mutation Analysis
20.
WT1 Mutation Analysis
21.
NeoTYPE CLL Prognostic Profile
22.
NeoTYPE AML Prognostic Profile
23.
ETV6-RUNX1 (TEL-AML1)
Translocation, t(12;21)
24.
CARD11 Mutation Analysis
25.
CD79B Mutation Analysis
26.
MYD88 Mutation Analysis
27.
RUNX1 Mutation Analysis
31.
NOTCH1 Mutation Analysis
32.
EZH2 Mutation Analysis
33.
Chimerism/DNA Fingerprinting
Analysis

34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.

TET2 Mutation Analysis
CBL Mutation Analysis
ASXL1 Mutation Analysis
PTPN11 Mutation Analysis
CSF3R Mutation Analysis
PTPN11 Mutation Analysis
STAT3 Mutation Analysis
ETV6 Mutation Analysis
NeoTYPE Lymphoma Profile
NeoTYPE MDS/CMML Profile
NeoTYPE Spliceosome Profile

FISH/ISH Assays:
1.
NHL FISH Panel (Revised)
2.
MYC/IgH t(8;14)
3.
CLL FISH Panel (Revised)
4.
MDS FISH Panel (Revised)
5.
MPN FISH Panel (Revised)
6.
AML FISH Panel (Revised)
7.
Eosinophilia FISH Panel
8.
IGH/MAFB FISH
9.
PTEN FISH

BOLD = Multi-assay tests customizable
to meet client needs (assays may also be
ordered individually).
* Certain assays may be useful in both solid
tumor and hematopoietic cancers. Each
assay listed in area of primary use.

15
Key Growth Drivers Over the Next 3 Years
• Expansion of Sales Team with seasoned Professionals
• Growth of molecular assays, panels and Next Gen Sequencing
• Recent expansion in FISH and advanced flow cytometry
• New Image Analysis/Immunohistochemistry Platform
• Exclusive strategic alliance with Covance for Clinical Trials
• Proprietary NeoSCORE Prostate Cancer and other proprietary tests
• M&A Opportunities

16
Increasing Margins Despite Lower Average Unit Prices
100%

56.5%

60%

90%

50%

80%

40%

70%

30%

60%

20%

50%

47.1% 47.2%
47.3%48.4% 46.1%
46.3% 45.9% 48.4%
44.8% 45.2%
43.2%
44.5%
44.6% 43.9%
44.7%
41.5%

50.0%

10%

40%

0%

30%

-10%

20%

-20%

Gross Margin %

Cum Change in Avg Rev/Test(2)

Q3 13

Q2 13

Q1 13

Q4 12

Q3 12

Q2 12

Q1 12

Q4 11

Q3 11

Q2 11

Q1 11

Q4 10

Q3 10

Q2 10

Q1 10

Q4 09

0%

Q4 13

-23.4%

10%

-30%
-40%

Cum Change in Productivity(1)

(1) Productivity calculated as the average number of lab tests completed per month per laboratory FTE.
(2) The expiration of the Medicare Technical Component (TC) Grandfather Clause took effect on 7/1/12 and resulted in an ~11% YoY Reduction in Avg Rev/Test.

17
Cost Management & Operating Leverage
Operating Cost per Test & Adj. EBITDA Margin
$800

20%

$723

$700

$642 $642

$671

$649

15%
$618
$576 $565

$600
$500

5%

$400
$300

-1%

$200

0%
-2%

6%

12%
$555

8%

12%

$531 $512 $526

6%

10% 11%

12%

13%

$482 $478
$464 $466 $439

10%
5%
0%

-1%

-5%

-5%

-10%

$100
$0

15%

-12%

-15%

Q409 Q110 Q210 Q310 Q410 Q111 Q211 Q311 Q411 Q112 Q212 Q312 Q412 Q113 Q213 Q313 Q413
Cogs Cost/Test
R&D Cost/Test

G&A Net of R&D Cost/Test
Total Cost/Test

S&M Cost/Test
Adj EBITDA Margin %

18
Quarterly Financial Information
($, 000's)

Q4 12 *

Q1 13 *

Q2 13 *

Q3 13

Q4 13

Total Revenue
% Growth (YoY)

$ 14,893
15.5%

$ 15,657
3.3%

$ 15,603
-0.1%

$ 16,884
18.9%

$ 18,323
23.0%

Total Gross Margin
Gross Margin %

6,434
43.2%

7,246
46.3%

7,157
45.9%

8,171
48.4%

9,163
50.0%

Sales & Marketing Exp
General & Administrative Exp
Research & Development Exp

1,692
4,097
448

1,931
4,175
835

1,971
4,064
616

2,336
4,334
340

2,487
4,823
649

6,237
41.9%

6,942
44.3%

6,651
42.6%

7,011
41.5%

7,959
43.4%

Total SG&A (Incl R&D) Expenses
SG&A as a % of Rev
Net Income/(Loss)
Diluted EPS

$

(113)
($0.00)

Adjusted EBITDA

$ 1,439

$ 1,794

$ 1,825

$ 2,163

$ 2,733

Summary Operating Data
% Growth in Tests Performed (YoY)
Avg. Revenue/Test
Avg. COGS/Test

35.3%
$ 488
$ 277

19.1%
488
$
$
262

12.7%
$ 480
$ 260

19.1%
$ 501
$ 258

27.8%
$ 470
$ 235

$

3
$0.00

$

273
$0.01

$

900
$0.02

$

858
$0.02

* YoY comparisons impacted by a reduction in revenue of $1.3 MM/Qtr as a result of the expiration of the TC Grandfather Clause.

19
Key Financial Information
Recent Share Price (2/18/14):

$ 3.86

Common Shares Outstanding:

49.1 M

Current Market Cap:

$189.0 M

Fully Diluted Shares:

55.8 M

52 Week Low/High:

$2.05/$4.69

Avg. Daily Trading Volume (3 Mos):

279,682

20
NeoGenomics Summary

•
•
•
•
•

Emerging leader in fastest-growing segment of lab testing industry
Robust competitive advantages and product portfolio
Strong Management Team with outstanding industry experience
Accelerating profitability driven by growth and operating leverage
Recent Guidance(1):

Q1 2014(2)

FY 2014(2)

Revenue ($, MMs)

$18.8 - $19.3

$73.0 - $77.0

EPS

$0.01 – $0.02

$0.05 - $0.07

(1) Guidance is before factoring any potential impacts from a negative resolution of the issues re the National Correct Coding Initiative FISH edits.
See 8-K filed on 2/19/2014 for additional information on this topic.
(2) NeoGenomics preliminarily estimates that a negative resolution of the NCCI FISH edits issue would reduce revenue by approximately $3 million
and net income by approximately $0.04 per share in FY 2014, with the impact more heavily concentrated in the first half of the year. Q1 revenue
and EPS would be reduced by approximately $1.0 million and $0.02/share in the event of a negative resolution.

21
Implied 2014 Physician Fee Schedule Rates
Based on our 24% Medicare payer mix through the first 9 months of 2013, we expect
the Medicare 2014 PFS Rates to have less than a 3% impact to total revenue (1).
CPT Proc Code Procedure Description

National
National
National
Unadj Rate Unadj Rate Unadj Rate
2013
2011
2012

88184
88185
88189

FLOW 1ST MARKER

$
$
$

83.92 $
50.29 $
103.29 $

82.71 $
50.04 $
102.45 $

88.80
54.10
106.49

$
$
$

87.77
53.73
110.69

-1.2%
-0.7%
3.9%

88367
88367-TC
88367-26

FISH AUTOMATED PER PROBE

$
$
$

256.18 $
195.36 $
60.82 $

264.13 $
203.89 $
60.25 $

258.23
198.35
59.88

$
$
$

255.77
193.08
62.69

-1.0%
-2.7%
4.7%

88368
88368-TC
88368-26

FISH MANUAL PER PROBE

$
$
$

219.83 $
157.65 $
62.18 $

221.24 $
159.98 $
61.27 $

232.04
170.46
61.58

$
$
$

232.49
167.65
64.84

0.2%
-1.6%
5.3%

88360
88360-TC
88360-26

MORPHOLOGY, EACH ANTIBODY MANUAL

$
$
$

123.33 $
71.01 $
52.32 $

120.49 $
69.44 $
51.06 $

127.25
74.85
52.40

$
$
$

130.04
75.23
54.81

2.2%
0.5%
4.6%

88342
88342-TC
88342-26

IMMUNOHISTOCHEMISTRY

$
$
$

103.92 $
62.86 $
41.11 $

105.52 $
64.67 $
40.85 $

115.34
73.15
42.19

G0461
GO461-TC
G0461-26

IMMUNOHISTOCHEMISTRY (1st Stain)

$
$
$

103.92 $
62.86 $
41.11 $

105.52 $
64.67 $
40.85 $

115.34
73.15
42.19

$
$
$

88.48
57.67
30.81

-23.3%
-21.2%
-27.0%

G0462
GO462-TC
G0462-26

IMMUNOHISTOCHEMISTRY (Add'l Stain)

$
$
$

103.92 $
62.86 $
41.11 $

105.52 $
64.67 $
40.85 $

115.34
73.15
42.19

$
$
$

68.42
55.88
12.54

-40.7%
-23.6%
-70.3%

FLOW EACH ADDL MARKER
FLOW INTERP 16 OR MORE MARKERS

FISH AUTOMATED PER PROBE TECH
FISH AUTOMATED PER PROBE INTERP

FISH MANUAL PER PROBE TECH
FISH MANUAL PER PROBE INTERP

MORPHOLOGY TECH, EACH ANTIBODY MANUAL
MORPHOLOGY INTERP, EA ANTIBODY MANUAL

IMMUNOHISTOCHEMISTRY TECH
IMMUNOHISTOCHEMISTRY INTERP

IMMUNOHISTOCHEMISTRY TECH (1st Stain)
IMMUNOHISTOCHEMISTRY INTERP (1st Stain)

IMMUNOHISTOCHEMISTRY TECH (Add'l Stain)
IMMUNOHISTOCHEMISTRY INTERP (Add'l Stain)

2014 w/
2014 vs
Interim SGR 2013 %
Fix (1)(2)
change

(1) Assumes no other Physician Fee Schedule (PFS) rule changes or limited coverage determinations for 2014.
(2) Calculated using a 2014 CMS Conversion Rate of 35.8228 as enacted in the 'Pathway for SGR Reform Act of 2013’ on December 26, 2013.
This SGR Fix is only in effect to 3/31/14 unless extended further by Congress.

22

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NEOGENOMICS: Accelerating Growth in Cancer Genetics Testing

  • 1. NASDAQ: NEO Time Matters. Results Count! Company Overview Presentation February 2014 “Improving Patient Care through exceptional cancer genetic testing services!” 1
  • 2. Forward-looking Statements This presentation contains statements which constitute forward-looking statements within the meaning of Section 27A of the Securities Act, as amended; Section 21E of the Securities Exchange Act of 1934; and the Private Securities Litigation Reform Act of 1995. The words “may”, “would”, “could”, “will”, “expect”, “estimate”, “anticipate”, “believe”, “intend”, “plan”, “goal”, and similar expressions and variations thereof are intended to specifically identify forward-looking statements. All statements that are not statements of historical fact are forwardlooking statements. Investors and prospective investors are cautioned that any such forwardlooking statements are not guarantees of future performance and involve risks and uncertainties, and that actual results may differ materially from those projected in the forward-looking statements as a result of various factors. The risks that might cause such differences are identified in our filings with the Securities and Exchange Commission. We undertake no obligation to publicly update or revise the forward looking statements made in this presentation to reflect events or circumstances after the date of this presentation or to reflect the occurrence of unanticipated events. 2
  • 3. Investment Highlights • Fast growing cancer genetics lab servicing Oncologists, Pathologists and Hospitals • • • • Strategic client partnerships created by “Tech-Only” model • Strong Management Team with large cap lab experience Dynamic, rapidly-growing and consolidating industry Industry-leading revenue & test volume growth Strong productivity and operating leverage leading to accelerating cash flow and net income 3
  • 4. Consistent Historical Growth Annual Revenue ($, 000s) Tests Performed 2013 2012 2011 2010 2009 0 2008 $0 2007 20,000 2006 $10,000 2005 40,000 2004 $20,000 2013 60,000 2012 $30,000 2011 80,000 2010 $40,000 2009 100,000 2008 $50,000 2007 120,000 2006 $60,000 2005 140,000 2004 $70,000 4
  • 5. Accelerating Cash Flow & Earnings ($, 000's) 2011 2012 2013 $ 43,484 26.5% $ 59,867 37.7% $ 66,467 11.0% Total Gross Margin Gross Margin % 19,428 44.7% 26,836 44.8% 31,737 47.7% Sales & Marketing Exp as a % of Rev Gen & Admin Exp as a % of Rev R&D Exp as a % of Rev SG&A Expenses Total SG&A as a % of Rev 16.0% 28.4% 1.2% 19,837 45.6% 12.5% 26.5% 3.8% 25,624 42.8% 13.1% 26.2% 3.7% 28,563 43.0% Total Revenue % Growth Adjusted EBITDA % Growth $ 2,134 NA $ 5,997 181.0% $ 8,515 42.0% Net Income/(Loss) Diluted EPS $ (1,177) ($0.03) $ 65 $0.00 $ 2,034 $0.02 Summary Operating Metrics Avg. Revenue/Test % Change $ 570 -4.9% $ 522 -8.4% $ 484 -7.3% $ 315 -2.7% $ 288 -8.6% $ 253 -12.2% Avg. Cost of Goods Sold/Test % Change 5
  • 6. Management Team • Douglas VanOort, Chairman & CEO • Maher Albitar, M.D., Chief Medical Officer & Director of R&D • Robert Gasparini, Director & Chief Scientific Officer • Steven Jones, Director, EVP – Finance, & Chief Compliance Officer • George Cardoza, Chief Financial Officer • Robert Horel, Vice President, Sales & Marketing • Steven Ross, Chief Information Officer Operating Partner, Summer Street Capital Partners; Chief Operating Officer, Quest Diagnostics Med. Dir. for Hematopathology & Oncology and Chief of R&D, Quest Nichols Institute; Director of Leukemia and Molecular Laboratory, MD Anderson Cancer Center Director of Genetics, U.S. Labs; Worldwide Marketing Mgr., Ventana Medical Systems; Asst. Director, Prenatal Diagnostic Center (Harvard) Chairman, Aspen Capital Group; Managing Member, Medical Venture Partners; Vice President, Merrill Lynch Investment Banking CFO, Protocol Global Solutions; Controller, Central Region, Quest Diagnostics Regional Mgr., US Labs; Product Specialist, Ventana Medical Systems; Pilot, U.S. Navy Vice President Technology, Chico’s FAS, Inc. 6
  • 7. NeoGenomics’ Cancer Testing Services Key Testing Methodologies Cytogenetics: chromosome analysis - “Neighborhood view of 46 houses from 1000 feet” Flow Cytometry & IHC: cell surface marker analysis - “Single house view from 500 feet” Fluorescence in-situ Hybridization (FISH): gene analysis - “Door and window view of one house” Molecular testing: DNA/RNA analysis -“View of serial number on door lock” 7
  • 8. Customer Targets Pathologists & Hospital Pathology Groups (about 72% of Revenue) • • • Enable community Pathologists to practice using sophisticated tools and tests Innovative technical component (TC or “tech-only”) services – Flow, FISH, IHC Outstanding Web-based Lab System & extensive training programs Oncologists & Clinician Groups (about 25% of Revenue) • Includes Hematologists, Oncologists, Dermatologists, Urologists • Disease Panels and comprehensive molecular menus • Increasing Opportunity to service larger practices with Tech-only model Clinical Trials & Other (about 3% of Revenue) • Contract research/clinical trial support work for Pharma clients 8
  • 9. NeoGenomics Formula for Success Industry Dynamics & Demographics • Aging U.S. population and prevalence of cancer • Diagnostic testing reduces healthcare costs and improves clinical outcomes • Emergence of molecular diagnostics • Targeted therapeutics and companion diagnostics • Capitalize on new healthcare paradigm Market Share Gains • Attract New Customers – Promote key advantages of “tech-only” model – Partner with Clinician Offices • Grow existing customer base New Products & Solutions • Continue to expand test menu • Sublicensing of HDC products – Cytogenetics/Flow/IHC systems – Prostate/colon/pancreatic Cx Tests – International opportunities – Sales force productivity • Proprietary test development – Increase share of wallet • Disruptive technology for select solid tumor cancers – Promote product education – Capitalize on competitor turmoil • Seek new R&D partnerships Superior Financial Model • Sustainable revenue growth opportunity • Significant degree of operating leverage in the business model 9
  • 10. Industry Dynamics – Molecular diagnostics enable physicians to better diagnose diseases and predict therapeutic efficacy • – Clinical Benefits: Effective treatment at an early stage increases patient survival rates • Healthcare Savings: a) forego spending on ineffective therapies and b) effective intervention at an early stage generally lowers overall treatment cost Need for companion diagnostics being driven by rising drug costs and an increase in targeted therapeutics • • Xalkori® (Crizotinib) - Cost of ~$90,000 annually to treat non-small cell lung cancer. 50 – 61% effective for the ~3% of the population with certain genetic characteristics U.S. Population Demographics Diagnostic testing can significantly lower healthcare costs and improve clinical outcomes – • Boomer Impact on Cancer Market Molecular diagnostics transforming lab services industry and fueling rapid growth Diagnostics represents only 2-3% of total healthcare spend but influence approximately 70% - 80% of physician decisions Cancer prevalence expected to increase as U.S. population ages – 77% of all cancers diagnosed are in people age 55 or older, the fastest growing segment of the US 30% Current 25% Percent Of Population • 20% 20% 20% 2030 2040 2050 22% 16% 17% 18% 16% 15% 10% 26% 19% 25% 25% 16% 11% 13% 12% 13% 1990 2000 2010 5% 0% 1980 Age 60 and older 2020 Age 65 and older 10
  • 11. U.S. Cancer Testing Market Size $10-12 Billion Hematopoietic Cancers Solid Tumor Cancers $3 - 4 Billion $7 - 8 Billion ~$2 - 3 Billion ~$2 - 3 Billion Patients in Treatment: 850,000 7.0 million New Diagnoses/Yr.: 150,000 1.45 million Bone Marrow (350K/Yr) Per. Blood (150K/Yr) Lymph Nodes Tiss. Biopsies (8-10MM) Fine Needle Aspirates Other Bodily Fluids ~80% ~20% Total Testing Market: Est. Genetic Mkt. (TAM) Specimen Types: Neo Revenue Split: 11
  • 12. Cancer Testing Market Characteristics • Cancer Genetics is high growth segment of lab Industry - ~15-20% annual test volume growth in genetics testing - ~6-8% annual test volume growth in related AP testing • Less than 400 Cancer Genetic Labs in the U.S. - 2/3 affiliated with academic institutions - Approximately 20% perform 80% of testing - Only 15-20 labs with national reach • High pace of consolidation - Recent examples include: Target Caris Diagnostics Genoptix Clarient Genzyme Genetics Acquiror Miraca Novartis GE Healthcare Svcs LabCorp TV/LTM Rev 3.5x 1.7x 5.8x 2.5x 12
  • 13. A Growing Commercial & Facility Footprint VT WA ME MT ND MI NH MN OR ID NY SD WI MI WY IA NE IL CO CA KS IN MO WV AZ KY SC AR NM MS TX CT VA NC OK RI NJ DE MD OH NV UT PA MA AL GA LA Irvine, CA 18k sf FL States sending specimens in 2013 Nashville, TN 7k sf Tampa, FL 5k sf Ft. Myers, FL 45k sf 13
  • 14. Accelerating Pace of Innovation 2011 4 molecular tests 2012 2013 10-color Flow Cytometry 40 new Molecular tests Add’l NeoTYPE Panels 3 FISH Implemented State-of-the-art MolDx platform in lieu of Kits 28 new Molecular Assays ROS1 FISH FL – IHC menu Proprietary method for increasing sensitivity of Sanger sequencing 7 NeoTYPE MolDx Panels Plasma/Urine-based Prostate Test (Patent App) New Aperio Digital Image Analysis SVM for FISH (Patent App) Barrett’s Esoph. FISH (Patent App) NeoARRAY/SNP Cytogenetics Internalized 99% of send-outs Next Generation Sequencing (48 genes) NeoSITE Melanoma FISH SVM-based Cytogenetics Analysis System SVM-based Automated FISH Analysis System v2 14
  • 15. More than 80 New Assays Launched in 2012 & 2013 Solid Tumor Assays* Molecular Assays: 1. IDH1 & IDH2 Mutation Analysis 2. c-KIT Mutation Analysis 3. PIK3CA Mutation Analysis 4. NRAS Mutation Analysis 5. TP53 Mutation Analysis 6. NeoARRAY SNP/Cytogenetic Profile 7. KRAS Mutation Analysis 8. BRAF Mutation Analysis 9. EGFR Mutation Analysis 10. Microsatellite Instability Analysis 11. NeoTYPE Breast Profile 12. NeoTYPE Colorectal Profile 13. NeoTYPE Gastric Profile 14. NeoTYPE Lung Profile 15. NeoTYPE Solid Tumor (Other) Profile 16. TPMT Genotyping 17. UGT1A1 Genotyping 18. Kit/PDGFRa Mutation Analysis 19. HRAS Mutation Analysis 20. PTEN Mutation Analysis 21. HOXB13 Genotyping 22. GNAS Mutation Analysis 23. MLH1 Promoter Methylation Analysis 24. MGMT Promoter Methylation Analysis FISH/ISH Assays: 1. ISH – Kappa ISH 2. ISH – Lambda ISH 3. NeoSITE Barrett’s Esophagus FISH 4. ROS1 FISH 5. NeoSITE Melanoma FISH 6. 1p/19q Deletion FISH Test Hematopoietic Assays* Molecular Assays: 1. BCR-ABL1 Translocation, t(9;22) 2. ABL1 Kinase Domain Mutation Anal 3. IgVH Mutation Analysis 4. FLT3 Mutation Analysis 5. NPM1 Mutation Analysis 6. JAK2 V617F Mutation Analysis 7. JAK2 Exon 12-14 Mutation Anal 8. BCL2 Translocation, t(14;18) 9. BCL1 Translocation, t(11;14) 10. MPL Mutation Analysis 11. MPN Reflex Panel 12. DNMT3A Mutation Analysis 13. RUNX1-RUNX1T1 (AML1-ETO) Translocation, t(8;21) 14. SF3B1 Mutation Analysis 15. B-Cell Gene Rearrangement 16. T-Cell Gene Rearrangement 17. CBFB/MYH11 Translocation, inv(16) 18. PML-RARA Translocation, t(15;17) 19. CEBPA Mutation Analysis 20. WT1 Mutation Analysis 21. NeoTYPE CLL Prognostic Profile 22. NeoTYPE AML Prognostic Profile 23. ETV6-RUNX1 (TEL-AML1) Translocation, t(12;21) 24. CARD11 Mutation Analysis 25. CD79B Mutation Analysis 26. MYD88 Mutation Analysis 27. RUNX1 Mutation Analysis 31. NOTCH1 Mutation Analysis 32. EZH2 Mutation Analysis 33. Chimerism/DNA Fingerprinting Analysis 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. TET2 Mutation Analysis CBL Mutation Analysis ASXL1 Mutation Analysis PTPN11 Mutation Analysis CSF3R Mutation Analysis PTPN11 Mutation Analysis STAT3 Mutation Analysis ETV6 Mutation Analysis NeoTYPE Lymphoma Profile NeoTYPE MDS/CMML Profile NeoTYPE Spliceosome Profile FISH/ISH Assays: 1. NHL FISH Panel (Revised) 2. MYC/IgH t(8;14) 3. CLL FISH Panel (Revised) 4. MDS FISH Panel (Revised) 5. MPN FISH Panel (Revised) 6. AML FISH Panel (Revised) 7. Eosinophilia FISH Panel 8. IGH/MAFB FISH 9. PTEN FISH BOLD = Multi-assay tests customizable to meet client needs (assays may also be ordered individually). * Certain assays may be useful in both solid tumor and hematopoietic cancers. Each assay listed in area of primary use. 15
  • 16. Key Growth Drivers Over the Next 3 Years • Expansion of Sales Team with seasoned Professionals • Growth of molecular assays, panels and Next Gen Sequencing • Recent expansion in FISH and advanced flow cytometry • New Image Analysis/Immunohistochemistry Platform • Exclusive strategic alliance with Covance for Clinical Trials • Proprietary NeoSCORE Prostate Cancer and other proprietary tests • M&A Opportunities 16
  • 17. Increasing Margins Despite Lower Average Unit Prices 100% 56.5% 60% 90% 50% 80% 40% 70% 30% 60% 20% 50% 47.1% 47.2% 47.3%48.4% 46.1% 46.3% 45.9% 48.4% 44.8% 45.2% 43.2% 44.5% 44.6% 43.9% 44.7% 41.5% 50.0% 10% 40% 0% 30% -10% 20% -20% Gross Margin % Cum Change in Avg Rev/Test(2) Q3 13 Q2 13 Q1 13 Q4 12 Q3 12 Q2 12 Q1 12 Q4 11 Q3 11 Q2 11 Q1 11 Q4 10 Q3 10 Q2 10 Q1 10 Q4 09 0% Q4 13 -23.4% 10% -30% -40% Cum Change in Productivity(1) (1) Productivity calculated as the average number of lab tests completed per month per laboratory FTE. (2) The expiration of the Medicare Technical Component (TC) Grandfather Clause took effect on 7/1/12 and resulted in an ~11% YoY Reduction in Avg Rev/Test. 17
  • 18. Cost Management & Operating Leverage Operating Cost per Test & Adj. EBITDA Margin $800 20% $723 $700 $642 $642 $671 $649 15% $618 $576 $565 $600 $500 5% $400 $300 -1% $200 0% -2% 6% 12% $555 8% 12% $531 $512 $526 6% 10% 11% 12% 13% $482 $478 $464 $466 $439 10% 5% 0% -1% -5% -5% -10% $100 $0 15% -12% -15% Q409 Q110 Q210 Q310 Q410 Q111 Q211 Q311 Q411 Q112 Q212 Q312 Q412 Q113 Q213 Q313 Q413 Cogs Cost/Test R&D Cost/Test G&A Net of R&D Cost/Test Total Cost/Test S&M Cost/Test Adj EBITDA Margin % 18
  • 19. Quarterly Financial Information ($, 000's) Q4 12 * Q1 13 * Q2 13 * Q3 13 Q4 13 Total Revenue % Growth (YoY) $ 14,893 15.5% $ 15,657 3.3% $ 15,603 -0.1% $ 16,884 18.9% $ 18,323 23.0% Total Gross Margin Gross Margin % 6,434 43.2% 7,246 46.3% 7,157 45.9% 8,171 48.4% 9,163 50.0% Sales & Marketing Exp General & Administrative Exp Research & Development Exp 1,692 4,097 448 1,931 4,175 835 1,971 4,064 616 2,336 4,334 340 2,487 4,823 649 6,237 41.9% 6,942 44.3% 6,651 42.6% 7,011 41.5% 7,959 43.4% Total SG&A (Incl R&D) Expenses SG&A as a % of Rev Net Income/(Loss) Diluted EPS $ (113) ($0.00) Adjusted EBITDA $ 1,439 $ 1,794 $ 1,825 $ 2,163 $ 2,733 Summary Operating Data % Growth in Tests Performed (YoY) Avg. Revenue/Test Avg. COGS/Test 35.3% $ 488 $ 277 19.1% 488 $ $ 262 12.7% $ 480 $ 260 19.1% $ 501 $ 258 27.8% $ 470 $ 235 $ 3 $0.00 $ 273 $0.01 $ 900 $0.02 $ 858 $0.02 * YoY comparisons impacted by a reduction in revenue of $1.3 MM/Qtr as a result of the expiration of the TC Grandfather Clause. 19
  • 20. Key Financial Information Recent Share Price (2/18/14): $ 3.86 Common Shares Outstanding: 49.1 M Current Market Cap: $189.0 M Fully Diluted Shares: 55.8 M 52 Week Low/High: $2.05/$4.69 Avg. Daily Trading Volume (3 Mos): 279,682 20
  • 21. NeoGenomics Summary • • • • • Emerging leader in fastest-growing segment of lab testing industry Robust competitive advantages and product portfolio Strong Management Team with outstanding industry experience Accelerating profitability driven by growth and operating leverage Recent Guidance(1): Q1 2014(2) FY 2014(2) Revenue ($, MMs) $18.8 - $19.3 $73.0 - $77.0 EPS $0.01 – $0.02 $0.05 - $0.07 (1) Guidance is before factoring any potential impacts from a negative resolution of the issues re the National Correct Coding Initiative FISH edits. See 8-K filed on 2/19/2014 for additional information on this topic. (2) NeoGenomics preliminarily estimates that a negative resolution of the NCCI FISH edits issue would reduce revenue by approximately $3 million and net income by approximately $0.04 per share in FY 2014, with the impact more heavily concentrated in the first half of the year. Q1 revenue and EPS would be reduced by approximately $1.0 million and $0.02/share in the event of a negative resolution. 21
  • 22. Implied 2014 Physician Fee Schedule Rates Based on our 24% Medicare payer mix through the first 9 months of 2013, we expect the Medicare 2014 PFS Rates to have less than a 3% impact to total revenue (1). CPT Proc Code Procedure Description National National National Unadj Rate Unadj Rate Unadj Rate 2013 2011 2012 88184 88185 88189 FLOW 1ST MARKER $ $ $ 83.92 $ 50.29 $ 103.29 $ 82.71 $ 50.04 $ 102.45 $ 88.80 54.10 106.49 $ $ $ 87.77 53.73 110.69 -1.2% -0.7% 3.9% 88367 88367-TC 88367-26 FISH AUTOMATED PER PROBE $ $ $ 256.18 $ 195.36 $ 60.82 $ 264.13 $ 203.89 $ 60.25 $ 258.23 198.35 59.88 $ $ $ 255.77 193.08 62.69 -1.0% -2.7% 4.7% 88368 88368-TC 88368-26 FISH MANUAL PER PROBE $ $ $ 219.83 $ 157.65 $ 62.18 $ 221.24 $ 159.98 $ 61.27 $ 232.04 170.46 61.58 $ $ $ 232.49 167.65 64.84 0.2% -1.6% 5.3% 88360 88360-TC 88360-26 MORPHOLOGY, EACH ANTIBODY MANUAL $ $ $ 123.33 $ 71.01 $ 52.32 $ 120.49 $ 69.44 $ 51.06 $ 127.25 74.85 52.40 $ $ $ 130.04 75.23 54.81 2.2% 0.5% 4.6% 88342 88342-TC 88342-26 IMMUNOHISTOCHEMISTRY $ $ $ 103.92 $ 62.86 $ 41.11 $ 105.52 $ 64.67 $ 40.85 $ 115.34 73.15 42.19 G0461 GO461-TC G0461-26 IMMUNOHISTOCHEMISTRY (1st Stain) $ $ $ 103.92 $ 62.86 $ 41.11 $ 105.52 $ 64.67 $ 40.85 $ 115.34 73.15 42.19 $ $ $ 88.48 57.67 30.81 -23.3% -21.2% -27.0% G0462 GO462-TC G0462-26 IMMUNOHISTOCHEMISTRY (Add'l Stain) $ $ $ 103.92 $ 62.86 $ 41.11 $ 105.52 $ 64.67 $ 40.85 $ 115.34 73.15 42.19 $ $ $ 68.42 55.88 12.54 -40.7% -23.6% -70.3% FLOW EACH ADDL MARKER FLOW INTERP 16 OR MORE MARKERS FISH AUTOMATED PER PROBE TECH FISH AUTOMATED PER PROBE INTERP FISH MANUAL PER PROBE TECH FISH MANUAL PER PROBE INTERP MORPHOLOGY TECH, EACH ANTIBODY MANUAL MORPHOLOGY INTERP, EA ANTIBODY MANUAL IMMUNOHISTOCHEMISTRY TECH IMMUNOHISTOCHEMISTRY INTERP IMMUNOHISTOCHEMISTRY TECH (1st Stain) IMMUNOHISTOCHEMISTRY INTERP (1st Stain) IMMUNOHISTOCHEMISTRY TECH (Add'l Stain) IMMUNOHISTOCHEMISTRY INTERP (Add'l Stain) 2014 w/ 2014 vs Interim SGR 2013 % Fix (1)(2) change (1) Assumes no other Physician Fee Schedule (PFS) rule changes or limited coverage determinations for 2014. (2) Calculated using a 2014 CMS Conversion Rate of 35.8228 as enacted in the 'Pathway for SGR Reform Act of 2013’ on December 26, 2013. This SGR Fix is only in effect to 3/31/14 unless extended further by Congress. 22