Capital Markets Day Transcript - LH 2026-09-10

Operator

Good morning, everyone. We're going to get started. Please welcome Dewey Stedman, Senior Vice President, Investor Relations.

Dewey Sedman, Head of Investor Relations

Welcome, everyone, to LabCorp's 2026 Investor Day. Before we get started, please note that our presentations will include forward-looking statements. These statements are subject to change based on various factors, many of which are beyond our control. More information is included in our most recent annual report on Form 10-K and subsequent quarterly reports on Form 10-Q and other filings with the SEC. Our presentation today will include adjusted financial measures, and please see the Use of Adjusted Measures section within our presentation for more information about the use of adjusted non-GAAP financial measures. We'll kick off today's Investor Day with our Chairman and CEO, Adam Schechter, outlining our strategy, market differentiation, and avenues for enterprise growth. Then we'll have business overviews from Brian Vaughn, our president of our diagnostics unit, Brian Cavaney, president of biopharma laboratory services segment, and then we'll have a break. Refreshments will be provided in the foyer during the break, and then we'll kick off our science and technology updates with Shaq Ramakasun on our specialty business and Bola Oagama on our technology and AI. We'll close our presentations with a financial update and our 2026 to 2029 outlet from Julia Wong, our chief financial officer. We'll then take your questions, and we hope to be done by noon today. And with that, I will give a brief overview of who we are at LabCorp, and then after that, we'll turn it over to our chairman and CEO, Adam Schechter.

Speaker 5

We are always innovating because science never stops. And with our scientific expertise supercharged by new technologies, there's no limit to the impact we can make. Today, we're leading with the broadest portfolio in neurology and helping diagnose Alzheimer's earlier than ever. We're using personalized MRD testing to find recurring cancer before it shows up on scans. Supporting global clinical trials that are impacting the future of medicine. and designing experiences that empower consumers wherever they are. We do these things because faster insights lead to faster breakthroughs, turn advanced science into clear answers, and give patients more confidence to partner with doctors for their care. We are a company of scientists, technologists, innovators, and healthcare professionals building on the strength of our global laboratory capabilities. And when technology becomes a multiplier for our efforts, that is how we create value, improve health, and improve lives. Welcome to the future of LabCorp.

Operator

Chairman and CEO of LabCorp.

Adam Schechter, CEO

Good morning for those of you joining us here in New York. Good morning, good afternoon, good evening for those of you joining us by webcast around the world. It is my great pleasure to welcome all of you to LabCorp's 2026 Investor Day. When I joined LabCorp as CEO in 2019, I knew what LabCorp did was important. I knew it because I go to the doctor myself. I get my blood drawn. I get the results. We talk to my doctor about what we were going to do. I knew it because I was on the board for six years, and I understood the importance of the work that LabCorp was doing. I knew it because I worked for Merck for over 30 years, and I saw the importance of central laboratories in our clinical trials. When COVID came in 2020, the whole world understood the importance of what LabCorp does every day, the importance of diagnostics and drug development. As I stand here today, six years later, I don't think there's ever been a more important time in LabCorp's history. In fact, LabCorp has never been more important. If you think about the laboratory insights that we provide to help power better health, what we do to help bring breakthrough therapies to market, the future of medicine and personalized care to improve outcomes, all of this is intended to build a better, more sustainable health care system. When people ask me, what am I most concerned about in the next 10 years in health care, it's the fact that health care costs keep growing, they keep going up, and we have to find a way to curve health care costs while we also improve quality and length of life. I believe what we do every day can be part of the solution to unsustainable health care cost increases. In fact, healthcare is entering an entirely new era. We have a growing and aging population. Whether you look at the United States, Japan, France, we see the aging population. As populations age, they require and utilize more healthcare, driving up costs. We're seeing more and more use of personalized medicine. You've seen cell and gene therapies. You saw a couple weeks ago in a publication of a vaccine for an individual patient. There's no doubt in my mind that personalized care is the wave of the future and that we'll be able to bend the healthcare curve by utilizing personalized care. There's no doubt that consumers are playing a much more active role in their healthcare today in every country in the world than they've played before in wellness and in their overall health. And science and innovation in drug development is continuing to increase. The number of targets, the new computational capabilities with quantum, the things that the industry will be able to do in the future will drive new breakthrough therapies that we will be a part of. All of this, all of this has been driven by advanced technologies, which will completely transform health care over time. In fact, when you look at those market forces, they reinforce the importance of LabCorp today. Health care will become more data-driven, more personalized, technology-enabled, and more consumer-friendly. And as all that happens, what we do, laboratory services, will become even more essential. More essential for wellness and prevention of disease, for finding disease earlier and earlier, for finding what treatment should be used for which patient, and ultimately to monitor that treatment for that patient over time. All of this becoming more personalized, all of this hopefully bending the curve on health care costs, improving health, improving lives, while reducing health care costs. And LabCorp will be right in the middle of that. LabCorp has been built, has been put together, has been working for years and years to be ready for this moment, to be ready to help make the largest difference that we can make in helping health care on a global basis. In fact, we are a global leader in laboratory services. we have our early development central laboratories diagnostics and we're involved from prevention all the way through monitoring of therapies in every part of that system we are part of an interconnected ecosystem that has insights and partnerships and science and innovation that are all reinforcing one each other they're coming together and our integrated interconnected connected ecosystem gives us a truly competitive advantage. In fact, if you look at LabCorp, we have an experienced, focused, mission-driven team with a huge amount of experience. We're all lined behind a mission to improve health and to improve lives. Our 71,000 employees around the world are all trying to make sure that we do this with our core values of adhering to our mission, putting the customers at the center of everything we do. Innovate, innovate, innovate. Be agile. Move fast. In this environment, you have to be quick. And in everything that we do, our operations have to be excellent. Each part of what we do, operations have to be excellent. All these things together differentiate us in the marketplace. If you look at LabCorp, science and innovation is at the core of everything that we do, and we have a global scale. In fact, we have over 1,200 PhDs, MDs, scientists, and physicians that publish more than 1,000 publications and presentations a year. We have a broad test menu of over 6,500 tests available on our menu. And we develop and launch more than 100 new tests each and every year. In fact, last year, we launched 165 new tests. And the vast majority of those tests were in our core therapeutic areas that we'll talk about in a moment. We have more than 50 major laboratories around the world. We're involved in more than 85% of drugs that have been approved by the FDA, and we have scale. Boy, do we have scale. We do more than 750 million tests each and every year, and we're involved in more than 400,000 patients in clinical trials across over 100 countries. I think our scale is truly a differentiator.

Shaq Ramkasun, Other

We are a trusted partner to customers across the health system.

Adam Schechter, CEO

It's interesting. If I were to call you on my mobile phone, it would come up as LabCorp. Every time I call a senator, a congressman or woman, a scientist, a family member, they answer the phone. They answer the phone because they think it's LabCorp calling to give them a test result. It's amazing to me how many people answer. But for a while, I didn't even know it said LabCorp when I called people. I'm like, wow, they just answered the phone. And then one time a senator said, oh, I thought you were delivering lab results. I said, why did you think that? He says, it comes up as LabCorp when you call. They answer the phone because we are a trusted partner and the information that we have is important to them. If you look at our biopharma colleagues, we are working with 20 of 20 of the largest global pharmaceutical companies. We're involved in more than 2,400 active clinical trials. Hospital and health systems, you'll hear us talk more and more about this, but we did 12 acquisitions since 2023, and we're working with more than 4,000 hospitals across the United States. When it comes to providers, they trust us, and we work with over 550,000 physicians in the United States and Canada. When it comes to our payers, they trust us. We had 100% renewal rate on the large managed care plans and more than 90% of all managed care lives are covered for LabCorp. And when it comes to consumers, we interact with more than 76 million. Think about that number. 76 million consumers that we serve in a given year. And our net promoter score with them is very high. We are truly trusted to the customers that we serve. But at the same time, we are using advanced technologies to power innovations and drive performance in new ways. New ways that will enable our customers to trust and want to work with us more. When I think about these technologies, whether it be robotics or artificial intelligence, and you're going to hear a lot more about that, it's about improving the customer's experiences. If you see LabCorp's test finder, if you look at my LabCorp, you'll get great examples of that. Ways to enhance productivity, and you'll see we're finding every opportunity we can to be more efficient while being more effective. And then we're trying to look at ways to fundamentally change parts of our business and use technology to transform the way in which we work. And you're going to get plenty of examples of each of these things in the next couple hours. Based upon all of that information, our strategic priorities, our focus is clear. And we're focusing on impactful, scientifically driven, innovatively driven, high growth areas of opportunities. The four pillars of our growth strategy are one, lead in specialty testing. That includes oncology, neurology, autoimmune disease, and women's health. You'll hear a lot about that from Dr. and also from Brian. To be the partner of choice for health systems and leading pharma, we want them to come to us first. And you're going to hear a lot more about that from Dr. Cavani and also from Brian. I believe that a core part of our strategy is to drive personalized health solutions to help reduce cost. It's always been amazing to me that diagnostics represent less than 5% of healthcare cost, yet diagnostics are involved in almost every single decision that a healthcare provider makes. We have to find ways to use that information to help reduce cost and drive more personalized health solutions. And all of this, you're going to hear from Bola, and you'll actually see it across the presentations, will be driven by innovation, technology, AI, and robotics across many, if not all, of the parts of our business moving forward. It's truly an exciting time to be part of LabCorp. When you look at this strategy and you look at the market tailwinds we have, it leads to a very compelling long-term outlook with revenue growth of 5% to 8%, double-digit EPS growth at the midpoint, driven by margin expansion. We think this is a very achievable plan. We achieved our plan that we presented three years ago, and we have confidence that we'll be able to achieve the plan that we're laying out today. So I'm going to leave you with four key takeaways at the end of the day today. It's one, we have a consistent track record of delivering strong performance, and that should to make us feel confident of our future ability to deliver. Number two, we have multiple, multiple, tremendous growth opportunities before us, and you'll be hearing about those in each of the presentations. We have a differentiated platform that's global, and it's powered by science, technology, and innovation. And all of this together leads to a very compelling longer-term outlook. We appreciate you being here today. Thank you. And at this point, I'd like to ask Brian to come up and to talk about our diagnostic business. Brian Vaughn is the head of diagnostics. Thank you.

Brian Vaughn, Other

Thank you, Adam. It is great to be with you here today. My name is Brian Vaughn, the president of diagnostics. I took over this role earlier this year, but I've been with LabCorp since 2009. And in that time, I've been in business development. I've worked in marketing. I've worked in finance. I led our health system strategy for a number of years. I've run a P&L for one of our regions. And across all those experiences, I've always been very optimistic about LabCorp's future. But I've probably never been as excited about LabCorp's future as I am right now. Technology is going to change everything around us. Technology is going to change health care, I believe, for the better. technology or sorry healthcare is going to run more and more on data and insights especially from diagnostic testing and LabCorp is so uniquely positioned to deliver those insights at unprecedented scale. So I'm going to cover four things today. I'm going to talk about the market in which the diagnostics business operates. I'm going to talk about our scale and our network and how advanced technology will amplify the impact of that network. I'm going to talk about our growth strategy, how we're going to lead in specialty testing, our mergers and acquisitions and health system partnerships, and how we drive consumer-centric solutions, and how all of this positions us to lead in this time of change. So first, as a market backdrop, we operate primarily in the U.S. It's a $90 billion market growing in the low single digits. It's still a highly fragmented market with hospitals, independent labs, specialty labs, and even physician-owned labs providing the services in this market. Adam mentioned some of the market tailwinds, but specifically for the diagnostics business, scientific advancement is only going to speed up with technology. That means specialty tests, new biomarkers are going to come to market and need adoption at an ever faster pace. Consumers, all of us, are walking around with essentially superintelligence in our pockets. We're going to be able to ask our LLMs, our AI companions, more about our health. Many, many people are interested in understanding their health in new ways. So consumer engagement is going to drive utilization of tests. And then demographics. We have an aging population. We still have far too high a prevalence of chronic disease. older more complex patients are naturally going to need more laboratory testing over time the diagnostics business has a track record of executing at above market growth so over the last several years it's averaged out to about seven percent and we grow our business in several different ways first of all we grow volume through both sessions or patient encounters as well as tests. We can grow organically as well as inorganically. We mix our business up with specialty tests that are higher value. And then we have an underlying base of very stable unit pricing across many different clients and across our health plan partners. And Adam mentioned a moment ago, hundreds of different health plan partners where we have great strategic relationships and they see the value of working with LabCorp. We operate a very large and connected network. It is connected to a very diverse and very complex healthcare ecosystem. But that network powers our impact. So when we talk about doing 750 million tests a year through 175 million patient encounters, it's fueled by our scale and infrastructure. And when you go around and talk to our people, Our couriers, who are part of these 22 million stops, our lab technician working in the 50 large labs, they know that our impact in that patient and that test tube is a patient waiting for a result, potentially a life-changing result. When you talk to the scientists across LabCorp about bringing a new test to market, they are genuinely excited that once it's on the menu and ready in the laboratory at LabCorp, 40,000 EMR connections can make it available very quickly to healthcare providers. They know that 2,200 patient service centers will be able to draw that test. Over 7,000 in-office phlebotomy locations will be able to draw that test and send it into the LabCorp network. Our patients deal with enough complexity when it comes to healthcare billing. It's peace of mind for them to know I can send all my laboratory testing to one in-network lab, almost no matter where I am across the country. So simply put, our impact on patient care and our mission rides on this interconnected network, but also our growth strategy is powered by it. That network, as we apply technology and artificial intelligence, is only going to grow in its impact. So Bola is going to talk more about this in a few moments, but I just want to give you two examples of why this is going to be really important. First of all, we're connected to hundreds of thousands of physicians and providers. When we deploy a tool like LabCorp Test Finder that helps them navigate this immense number of specialty tests that are available to them, we save potentially hundreds of thousands, if not more, hours of time searching for these things. These are ways in which our providers are more satisfied. We save downstream time and cost by getting the right test for the right patient at the right time. So this is one way in which we can improve satisfaction and make health care a little bit better with technology. Similarly, on the operational side, every one of those 750 million tests leaves a little digital trail of when was the test ordered? When was the test drawn? When did it hit our laboratories? When was it resulted? And we have long had the ability to optimize many different things and use software to optimize lab workflows or logistics routes. But as we think about AI in abundance across this infrastructure, we will have immense ability to build a smarter operation, a smarter operation that can not only be more efficient, but can also produce better service, better turnaround time, ultimately better satisfaction and growth for the providers and patients that rely on LabCorp. So let me turn to our growth strategy now. I'm going to go through three parts of our growth strategy. Each of these is distinct, but they're also interconnected. So I'm going to cover our specialty growth strategy, our acquisition and health system partnerships, as well as consumer-centric solutions. So let's start with specialty. You're going to hear more from Shaq in just a few minutes about the incredible science that underlies all of this. We've called out four specialty testing areas. Oncology, neurology, autoimmune, and women's health. Women's health, especially, we're focused on the genetics portfolio within women's health. Collectively, these areas are growing about three times faster than the market overall growth rate. And they represent about a $2 billion franchise for LabCorp Diagnostics. You can see over the last few years, each of these franchises has grown quite healthy at healthy growth rates. And we're not only focused on growing the tests that are in these franchises, we're also focused on the whole patient within it. So when a patient comes and gets one of these tests, they tend to have a lot more tests ordered at the same time, which gives us the ability to do all of the laboratory testing that that patient needs. It gives us the ability to take care of all the testing needs of that client, not just the specialty test. We also compete in a very unique way in this market. So when we bring an Alzheimer's test to market, terrible disease, and I really hope that the diagnostic innovation, the therapeutic innovation gives us all hope of having some treatment for something as terrible as Alzheimer's. When we bring an Alzheimer's test to market, I just want to share with you how we compete. So we'll, of course, take it to new clients, but we take it to our existing clients. So imagine you're a health system, many, many sites, serve many, many patients, a lot of different physicians. You already use LabCorp. We bring the Alzheimer's test to you. All we need to do is update a simple interface. No new interface build, no new portal to learn, no new connectivity to put in place. When it comes to phlebotomy or logistics solutions, no new phlebotomy. We already covered dozens and dozens of sites across your network with either PSCs or your own clinics. No need to do anything different with phlebotomy. No need to learn any new shipping, packaging, how to get it to the laboratory. We already do that. No need to educate the patients that they might have a different deductible for a different laboratory. It's all part of what we do. Simply put, we're the easy button for the adoption of new tests because those new tests can work on the same platform of all your existing tests. Let me give you just one other example. Speaking of a health system, we monitor how all of these specialty franchises are growing with our largest customers. One of our top five largest health systems in the company has grown about 10% year over year. Two-thirds of that growth is coming from these four specialty franchises. And that's a story that we see over and over and over of our existing customers adopting new specialty tests. I want to talk about mergers and acquisitions and health system partnerships as our second pillar. So we have a significant track record in this space. And given the complexities of health care, the cost pressures that Adam mentioned, the regulatory changes on the horizon, this is going to remain an attractive opportunity. And our pipeline shows that today. So we have a track record of executing on acquisitions. We know how to get these done. We know how to integrate them. We know how to stay financially disciplined in doing them. when we think about our health systems in particular they make up a subset of these acquisitions but we don't think of our health systems just as an acquisition or a deal we think of them as very long-term partnerships so yes they might include an acquisition but we think about that health system much more broadly and i often talk with our teams about we don't want to be the laboratory partner that you do a deal with we don't just want to be that we want to be the partner you renew with years later. So we have announced several major renewals the last few years with big partners, and we're continuing to invest in the capabilities that we know our health systems need. We're continuing to invest in reference testing capabilities, in our lab management capabilities. We manage a little over 200 hospital laboratories, and we're investing in the analytics and the benchmarking and the inventory controls, all of which can be enhanced through advanced technology, analytics, and AI. We're investing in the digital experiences and the connectivity experiences. You saw us earlier this year announce a major partnership with Epic where we're going to put the whole LabCorp test compendium into Epic Aura so that any Epic customer can get the whole LabCorp test compendium straight out of their Aura connection. No need to build and maintain point-to-point interfaces, reducing friction, reducing time to market for new and specialty things. And then we collaborate with our health system partners. Here are just two examples where we're collaborating with Fox Chase on MRD development. We're going to collaborate with Children's Hospital of Philadelphia on some pediatric development. But our health systems are great sources of innovation for us. They make LabCorp better. Turning to consumer, we mentioned earlier consumers are taking more charge of their health than ever. they have more intelligence in their pockets than ever before. We think about the consumer strategy for LabCorp in a few different buckets. First, we have our on-demand business, LabCorp On Demand. That's our channel. If you want to self-initiate laboratory testing, we want you to think about LabCorp. We want you to come to LabCorp On Demand. We continue to invest in new tests in this space. We recently launched Marker by LabCorp, which is not only a genetic test to understand your genetic risk profile, but it's an experience where you get to consult with a genetic counselor to more deeply understand what your results may mean. We partner with many consumer-forward companies that are thinking and curating experiences that are specific to the consumer. So we've long had relationships in the consumer ancestry space, but we've also partnered with traditional providers and new providers alike to carefully craft and curate special experiences, frictionless experiences, so that those consumers have a great experience with those organizations. We will do more of that over time. We also think about every one of those 70 plus million consumers that have some experience with LabCorp every single year, we want them to have a great experience. Whether their experience is through billing, making that easier, simpler to understand, whether their experience is making a digital appointment with us or rescheduling their appointment, or whether their experience is asking questions of their results on the LabCorp app. We want all of those things to be powered by technology and very simple and easy to use with LabCorp. And then lastly, we have a very powerful network and infrastructure with scale, but we want to keep extending that. That may mean things like opening up our pscs for extended hours and weekends we've we've opened up our patient service center network over 30 percent more weekend hours just since the beginning of the year we're doing capillary blood collection uh in canada for for hormone testing our venture fund is investing in alternative specimen collection and more home technologies and when those things are ready, we will launch them more broadly. So that's how we're meeting the consumer where they need to be and expanding the reach and convenience of our infrastructure. Let me bring this home with just a couple of customer lenses here. So RWJBarnabas was a relationship that began in 2022 with an acquisition. We have expanded that relationship in multiple ways since that time. We currently do a lot of their oncology and precision medicine testing today. And they're just a great example of our health system and our specialty strategy working together. Optum, we have long served a number of the Optum Health practices and network affiliates over the years. We're part of the preferred lab network of Optum Health, but we've also partnered with Optum AI to develop solutions for patients to make their experience even better. It's a great example of an innovative partnership. And we've long worked with One Medical, an organization I'm sure many of you are familiar with. They carefully, carefully think about the digital and physical experiences that patients of One Medical have. We continue to work with them to make our connectivity, our API, our embedded scheduling just a little bit easier so that consumers that use One Medical have a great laboratory experience. It's a great example of our consumer strategy in action. So in closing, we work in a great market with significant tailwinds, and we have a track record of outperforming the market. Technology will amplify the impact that our network and our scale has over time. We have multiple growth opportunities, each of which is distinct, but they also work together and reinforce one another. And in all of this, it positions us to lead as science and technology changes in this era. So on behalf of myself and the 50,000 or so LabCorp Diagnostics colleagues, we're excited for this moment and we're ready for this moment. With that, I'd like to introduce my colleague, Dr. Brian Cavney.

Brian J. Caveney, M.D., Other

Okay, thank you, Brian. I'm the other Brian, Dr. Brian Cavney. For my nine years here at LabCorp, I've had the honor of being the chief medical officer. For several years, I was president of diagnostics, and now I lead our biopharma laboratory services business. You've just heard why our diagnostics business is the clear leader in the diagnostics clinical market. In addition, our biopharma lab services business is the unparalleled global leader in laboratory services for bringing new therapies to market in drug development. Today, I'll describe a little bit about the breadth of services we have in our BLS business and why it is differentiated in that fashion. Some of the market factors and tailwinds that have enabled us to hit our targets over the past three years and some things that give us reason to believe we're confident in our plan for the future. Quite a few different new capabilities, both scientifically and technologically, that we're adding to the portfolio in accordance with what our clients need to achieve their objectives. And in particular, why the synergy between our BLS business and our diagnostics business gives us not only a right to win, but a virtuous cycle of innovation where each part of the business helps each other and all of the clients and patients that it serves. First, the breadth of the scientific organization of our business that underpins all that we can do today. As Adam mentioned, we have our early development business, central laboratory services, and diagnostics. Obviously, as you know quite well, the early development global market has been under quite a bit of challenge for the past several years. Both the inflationary and macroeconomic environment, the venture funding environment, softness in the biotech, companies that are the core customers for that part of the business, that's starting to change, as you all know, in the recent marketplace. We've also made quite a bit of change in both the geographic and operational footprint of that business. We've now substantially completed all of the strategic actions that we announced last year in the early development business, and we're starting to get a terrific amount of new proposals and new work that we believe will lead to long-term work throughout the rest of the pipeline of our BLS business. In addition to the early development business, we have all of the safety, toxicology, safety assessment, bioanalytical services, molecular bio-way, chemistry and manufacturing controls, and all of the clinical trial capabilities as part of our central laboratory business that biotech companies and pharma companies need to move through all of the different regulatory gates to submit a therapy to the regulatory agencies for approval around the world. That gives us the full breadth of the scientific capabilities that we need to perform all of those different services from discovery all the way to commercial diagnostics once therapies are approved. And underpinning that, as Dr. Ram Kassoun will explain, we have one unified global scientific and medical community that works together across every aspect of laboratory medicine and science to understand everything that's happening in all of the different therapeutic and specialty areas, new techniques and mechanisms of action, new scientific capabilities that we need to perform in our laboratories around the world in order to move to the next gate. with over 1,200 scientists, physicians, PhDs, veterinarians, statisticians, and others to help bring these things to life. As Adam mentioned, we're constantly working with our biopharma partners and with clinicians around the world to identify new tests that will help doctors make better, faster, more precise diagnoses and can help them make better decisions for getting the patients on the right therapies. Our scientific contribution is often in parallel with academic collaborators, with co-authors from our customers and clients, so that we're advancing the field of science, developing the evidence it takes to get adequate insurance coverage in our diagnostics business and adoption across the clinical trial universe as credible information submittable to regulatory bodies. In all of that, last year, we received clinical trial specimens from 103 countries and constantly working to add more capabilities, as you'll hear in a minute. In spite of all this, our combined BLS business, even with some of the softness in the early development business, still grew at a combined 6% CAGR over the past three years since our last Investor Day. And we believe, as many of you know well, there are a significant number of macroeconomic and global factors in the biopharma marketplace that we believe fit perfectly with our strategy and capabilities going forward. One, as pharmaceutical companies address the patent cliff that they have and they're both making more acquisitions of earlier stage assets like biotech companies, which is the very client base of our early development business, we hope that it's that work that we've been doing early on as they make those acquisitions will be able to continue the studies underway and do all of the other clinical studies necessary to get those assets that they just acquired across the finish line to the regulatory bodies. There is an increased globalization of trials, whether regulatory agencies in different countries and regions around the world wanting more patients from their own communities being reflected in the clinical trial cohorts, as well as just the logistic network it takes and the fact that more and more work is moving to other countries, including the greater Asia-Pac region, where we are very well positioned with our current footprint to take advantage of that trend. Because the mechanisms of actions of new therapies, more large molecules versus small, more new mechanisms of action, is requiring more complex clinical trial protocols. That plays perfectly into our favor. With our global scientific capabilities, The harder the trial, the more complex the science it takes to perform the studies necessary as part of those clinical trials, that's where LabCorp really excels and performs at our best. And there are more and more specialty therapeutic areas or types of procedures required in clinical trials, whether it be antibody drug conjugates, CAR-T therapies, radioligand therapies, other cell and gene therapy-type protocols. That's the exact scientific capabilities that we have. and are continuously adding to that separate us from our competition and make us the clear partner of choice for biopharma companies bringing these novel therapies to market. One quick case study of a client for whom our entire BLS business has performed work along the way. Our early development business worked with this middle-sized biotech company that has a very novel oncology therapy with a totally new mechanism of action to perform all of the preclinical safety assessment and toxicology aspects, molecular and BioA procedures to make sure that we can understand the mechanism of action of it. We developed a specialized custom flow cytometry assay specifically to work with this particular mechanism of action in oncology. And right now, we're in phase three trials with this partner around the world using all five of our central labs, laboratories, to identify whether or not this new therapy is going to work for this particular subtype of cancer. If the clinical trial goes well, if it comes to market, we will have been able to perform all of the different steps along the pathway to help this company achieve its very aggressive timelines for submission to regulatory agencies and potentially bring an amazing new therapy to market for cancer patients around the world. That's exactly the type of situation where having all of the different aspects and components of our BLS business as part of one organization sets us apart from the competition and helps us achieve what our clients want us to do, which is deliver high-quality science with speed and seamless handoffs from study to study along the regulatory pathway to get their therapies approved. In addition to doing the early development work that I mentioned, I'll just explain for a minute the complexity of the journey of a clinical trial specimen and why it's a lot more than just having a lab and doing some lab testing for clinical trials, although that is a very important part of our business. On the front end, once something has passed all of the early development safety assessment benchmarks, it's enabled to go first in human for clinical trials. We often consult with the scientists and experts at our biopharma partner to design the appropriate clinical trial protocol with the right biological and physiologic clinical endpoints along the way that are going to be able to measure whether or not that particular therapy can demonstrate safety and efficacy for the particular condition or disease it's intended to treat. Then we can very quickly automate that around the world using our global footprint to help them identify patients to enroll in the clinical trials that will be necessary to demonstrate those endpoints. We have a fully automated robotic kit production around the world within continents so that we can design exactly the right kit with the right components for all of the biomarkers that need to be drawn for each individual clinical trial clinic visit for that particular drug for that particular client and get it there in time for that clinic visit so that the nurses and doctors taking care of that patient as part of that clinical trial know exactly the right biomarkers to draw and get it to us very quickly. That often requires a pretty significant amount of specimen preservation techniques to make sure that whether we need to center view should put it on dry ice, have a particular buffer, have a particular other analyte mixed with it, that it's exactly according to specifications, for then traveling through our global logistics network to the appropriate laboratory, whether it's one of our five large central laboratories as part of our CLS business, or one of our amazing specialty esoteric business unit labs as part of our clinical diagnostics business, which is going to perform the analysis on that specimen for whatever biomarker we're looking for. That all comes into one of our laboratories, is appropriately accessioned, entered into the system, matched with the patient consent, matched with the patient information, the investigator, the clinical trial, the biopharma sponsor, the test article that's being given in that trial, so that everything is matched perfectly and the data will be combinable at the end. Then, of course, we perform the actual lab testing. We're known for the laboratory services. that's critically important. We're the best in the world at that with unbelievably high quality standards, automation, and technology. That produces the specific result for whatever biomarkers are necessary for that clinical trial visit for that trial. That result gets put into all of the appropriate confidential databases so that our sponsors can log onto our brand new portal and see exactly what the patient's test results are from that visit. In addition, the site investigator, the doctor who's actually taking care of the patient in trial with the particular disease, can both get the lab test results so they understand the right next clinical action for the patient sitting in front of them, but also so that they understand the data coming back that is going to be part of the submission package for the clinical trial, so they understand both the clinical and the investigational aspects of what has happened. We have an expert data integration and management team around the world that works with unbelievable amounts of data that we generate as part of this process, along with the scientists from our sponsors. Because our laboratories are so highly standardized, perfectly calibrated, and we use the same equipment, the same software version control numbers, often the same reagent lot number in all of our laboratories around the world, we have the most combinable, the most credible, the most scientifically accurate ability to combine lab testing that was performed in any of our labs around the world at the grade necessary for submission to regulators as part of a clinical trial. That's an incredibly important part of how we make sure that our laboratory testing is best in the world because of the use of submitting it in that way. After that, we have biobanks around the world so that we can preserve those precious specimens from the clinical trials, whether it be a tissue from a biopsy of a cancer or whether it be some genomic markers, so that we have it available if that biopharma company, as it's doing its data analysis, as it's seeing the results of one of its trials. Perhaps it wants to do a sub-cohort analysis. Perhaps it wants to do some more retrospective genomic testing on the specimens that we've preserved. Because we're so automated in the lab testing we do, we preserve the maximum number of specimen or tissue after each performance of the test so that we can go back and enable them to do other statistical analyses or follow on testing where necessary to find out how to optimize the therapy that is in development so that it's a virtuous cycle and we're constantly delivering whatever's necessary for our clients to be able to do that. And we have a global client delivery organization all around the world that works with our biopharma partner every single step along the way. Now, there are other vendors, other companies, other institutions that do each of these individual activities as a solo exercise, But our biopharma partners want speed, quality, and seamless handoffs, and we have an integrated platform to be able to do all of it together with alliance managers and global client delivery professionals that are helping babysit this molecule all along this process and make sure that it's a seamless handoff of the data and information between the different scientists and between the different people involved in the study to make sure that it's effective. Now I'll discuss three of the competitive advantages that we believe we have versus other central laboratories competing in this space with biopharma sponsors. First, of course, is our scale. We've been doing this for 40 years. We have the entire globe of developed countries where most clinical trials are performed covered. We have five large, fully integrated, standardized central laboratories geographically positioned not just where the work has been and is currently being performed, but where we know the future of biopharma work is going to be performed. And in particular, with the increase over the past five years or so of more and more new molecular entities and early phase clinical trials being performed in China and other Asia-packed countries, we are incredibly well positioned to have the high-throughput, high-volume laboratories to perform that work now and into the future. with our flagship laboratories in Indianapolis, Indiana, and in Geneva, but also in Singapore, Japan, and Shanghai, China. And we've recently added new capabilities, new technologies, new platforms, such as spectral flow cytometry, to these laboratories around the world, again, fully standardized across our footprint. One of the really important parts of the clinical trial work, as I mentioned on the last slide, is the development of highly specialized kits for each individual clinic trial. That is, in our different facilities around the world, fully automated and robotic, so that we can be sure exactly the right components and no more and no less goes into the clinical trial visit kit that we produce. And we continue to expand. Just a couple of days ago, we announced a small but strategically important acquisition in our central laboratory services business of MLM Medical Labs. We are now the only central laboratory company in the world that has a fully CAP-accredited central laboratory and pathology services and kit production in Africa. As many of our large pharma company sponsors in particular are wanting to get access to the large number of potential clinical trial participants in Africa, we now have a footprint for localized kit production and laboratory services in accordance with our standards there. That also came along with some other highly specialized novel biomarker scientific expertise that will fit right into our portfolio of being able to develop new biomarkers for our biopharma customers. Our second competitive advantage is the science that we have that you've been hearing about. And after our break, you're going to hear even more about the science and technology that we're able to bring to bear to our biopharma customers. Adam mentioned that we have participated in 85% of all of the newly approved drug and therapeutic products recently. We have the global scale, the scientific expertise. We're constantly partnering with the R&D teams of our biopharma customers to understand not just what they need for the trials they're in planning now, but what's coming down the future. I mean, recent conversations we've had around things like radioligand therapy and doing the planning necessary to hire the expertise, buy the equipment, build some of the other facilities required to handle very specific types of specimens like that, that it takes the expertise and foresight of LabCorp's entire scientific community to make sure we get that right and on time for our customers. as other different types of new modalities are coming online we're constantly because of the partnership between our diagnostics and bls scientists we're constantly thinking about what is going to come working with the global suppliers that we have to tell them the specifications of things we're going to need to put into all of our different laboratories over time and you've you've heard us mention the four main areas of specialty testing where we're particularly focused. One of the many reasons for that is because that is a very significant portion of the pharmaceutical R&D pipeline in oncology and neurology. In our book of business, that is more than half of all of the studies that we perform. Now, we've also added an enormous amount of new GLP-1 studies over the past couple of years with pretty long-term cardiovascular outcomes studies as part of that. It's been a terrific piece of business. But oncology and neurology both have an enormous amount of unmet need. They have an enormous amount of unknown science yet. There's a tremendous amount of more differentiation needed to understand how to precisely diagnose subtypes of cancer, and certainly in the neurodegenerative diseases such as Alzheimer's, Parkinson's, myasthenia, graphes, and others. And we're adding both the biomarkers for that, but also performing the clinical trials globally with those very large patient populations to bring those forward. And in addition, the innovation and technology that we're applying to the business that we have is enabling us to, again, meet what our customers want us to do, deliver speed and quality at the trust that they know that we can deliver with the credibility of LabCorp science, whether it be thinking through every single individual step, of study startup, from a whiteboard in a scientist's mind to how we get the first patient enrolled in the first clinic at the site investigator so they can start the process of generating the data it takes. Once they're on the patent clock, you know the pressure they're under to deliver on time. Bola's going to tell you more about the LabCorp Global Trial Connect program that we just announced a couple of weeks ago, adding a completely new, fully digitized, and automated sponsor portal and investigator portal so that they can see the data in real time as it's being generated by any of our laboratories, either in our CLS business or in our diagnostic specialty laboratories, so that they can make the next right action on a patient enrolled in a clinical All parts of our business, from early development, central laboratory services, and our diagnostics business, have made announcements and are investing very heavily in AI-enabled digital pathology for all of the different types of specimens we read. And another one in particular for this, if you have a rare subtype of cancer, if it's very difficult to get a piece of tissue, if one of our expert specialist pathologists is reading that case, with our digital pathology platform, they can have one of the scientists or pathologists at one of our sponsors be looking at it together, potentially get a secondary consult overread from another expert somewhere in the world, and make a very quick decision about both the clinical need and the data collection need for that patient enrolled in a clinical trial. They have to be able to make both of their decisions in real time when that patient is ready. And in addition, we're continuing to add to our data capabilities. We've announced our Alzheimer's real-world data platform, combining all of the biomarkers that we've been able to perform on patients in the U.S. by clinical physicians, making that available so that we can identify patients that might be appropriate for clinical trials, but also things like trying to measure and identify the natural progression of disease using the large diagnostics database that we have to identify what are the combinations and correlations between different biomarkers that different doctors may have ordered for different reasons, but are somehow potentially suggestive of the development of a disease that you can potentially identify years before an actual eventual diagnosis is made. That's exactly the target-rich population to try to identify and get into a clinical trial earlier so we can deliver faster, better therapies over time. Those are the competitive differentiators of our CLS business versus other central labs. But the real special sauce and why LabCorp is so unbelievably uniquely positioned by having our BLS and diagnostics business together is the synergy between them when they each can rely on the other part of the business to be even better and more effective for the customers that we serve. Simple examples in the BLS business working with biopharma partners using the resources we have from our diagnostics business that Brian described so well. We serve so many patients in the U.S. and Canada. We see so much pathology. We can identify so many people with rare diseases, genetic mutations, very specific diseases that are very hard to find for clinical trials. We can work with our biopharma trial sponsors to identify patients that might be appropriate for clinical trials, or treating physicians who have patients in their practice that might have specific markers or mutations that could be appropriate for that and speed up the patient identification process, which is so often tricky in rare diseases. In addition, because it is so difficult to get patients to enroll in clinical trials, modern life has become so busy. Not everybody wants to drive 200 miles to an academic medical center for a follow-up appointment for a clinical trial. Our biopharma sponsors want more and more for us to be able to offer other ways to collect appropriate information along the way in addition to the main visits as part of a trial. Whether it be adding more and more digital health tools, wearables, other sensors, continuous glucose monitors, whether it be coming to just get a safety testing blood draw at one of our patient service centers without having to go back to the cancer center for that, whether it be one of the other ways that we can help them in the interim because our diagnostics business is so broad and has that capability. That can accelerate our ability to deliver for our biopharma clinical trial sponsors. More and more of clinical trials lately have wanted some of these decentralized and hybrid characteristics in order to reduce patient attrition from clinical trials, improve retention, get more data so that they can submit their regulatory packages ever more quickly. And just one simple example of how the businesses work together so well, our early development business might be helping identify a novel biomarker for a new mechanism of action. Our central laboratory services scientists might be developing a very specific human clinical test as part of a biomarker for a clinical trial that also can become a companion diagnostic that might be in the label of the therapy that we're doing the clinical trials for. We have the ability to both make manufactured IVD-CDX kits that are available on our clinical diagnostics menu, as well as to be able to perform those assays in our specialized diagnostics clinical laboratories for doctors to get that information on their patients once that therapy has been approved. Perfect example of how all of our scientific community can work together to help our biopharma sponsors launch these products faster, and we can participate every step along the way in our ED business, our CLS business, and obviously our diagnostics business along the way. So all in all, I think our biopharma laboratory service business is the unparalleled leader at what it does on its own and even better together. We have significant competitive differentiation because of our scale, our science, and the technology that we're adding to our portfolio along the time. Our global scientific community for all of LabCorp enables us to work with all of the best new inventions and technologies around the world to bring these to all of our customers and clients and patients, wherever they may be. We have very long-term partnerships with every single one of the largest pharmaceutical companies that are fully invested in continuing to bring new therapies to the world for the patients who need them. This gives us tremendous visibility, particularly in our CLS business, with a backlog that gives us tremendous visibility to the revenue that can be delivered over the coming years with those long-term clinical trials underway. All of this and the scale that we have gives us the ability to deliver on our promises to our customers and improve the drug development process all along the way. BLS is built for this moment, and we are ready to help bring new novel biomarkers to doctors around the world and new therapies to the patients who need them.

Speaker 1

Thank you.

Operator

Thank you, everybody. Welcome back. Please welcome Dr. Shaq Ramkasun, Senior Vice President, Enterprise Oncology and Diagnostics Medical Affairs.

Shaq Ramkasun, Other

All right. All right. Thank you, everyone. Welcome back from the break. My name is Shaq Ramkasun, Senior Vice President for Enterprise Oncology and Diagnostic Medical Affairs. And when I'm not doing those roles, I'm actually a practicing pathologist at LabCorp. And if you ever come down to the basement of LabCorp, you will find me sitting in a microscope sometimes looking at slides or interpreting data as it comes off of the sequencers to help interpret that and put it into reports for patients. And one thing we are very cognizant at LabCorp is the fact that behind every one of these samples is a patient. I think Adam mentioned this earlier. They're waiting for an answer. They're waiting to develop a treatment plan. And they're oftentimes just waiting for hope. And that patient perspective is really the right starting point for what I'm going to share with you today, which is about how we spend a lot of time thinking about turning innovation into access. So there are three themes I'd like to cover with you today. The first is around this concept of LabCorp as an innovation engine and how we leverage our scientific expertise, the work we do across all the different parts of the organization to turn science and innovation into tests that patients in the real world can access. And that's how we have the greatest impact in patient care. We take that approach and then we apply it to certain areas which we've called our specialty areas, neurology, autoimmune, women's health, and oncology. because there's two factors happening there. There's a great unmet need today and there's growing demand in the coming years. And then finally, how do we address what I like to think about as the last mile challenge in healthcare? How do we operate within the healthcare ecosystem to ensure that the tests we bring onto our menu actually reaches the patients in the community setting, in the real world, in the rural settings? How do we do that? How do we close that gap? So that's the other part we'll talk about. And you heard a little bit about it from Brian Vaughn and I think you'll hear more about that from Bola as well. Okay, so let me introduce you to this concept of the innovation engine at LabCorp because I think it's actually very exciting. We're one of the few organizations, if maybe the only, that exists across the entire continuum of precision medicine. That includes drug development, diagnostics, day-to-day care delivery, and real-world data generation. And so let me make this real for you. So it all starts with a biomarker where a partner may be developing a therapy and they want to create a diagnostic that runs alongside that therapy. And so there's a biomarker, we'll create the test for it and we'll work that up in our drug development business. And then we'll move it into clinical trials, generate the evidence that that combination of biomarker and therapy is really the right path forward for that patient. Now, after this therapy gets approved, we need to actually move it into the real world. So we have to shift it from our drug development business into diagnostics, and that's where we can scale and commercialize these tests across the U.S. so that all patients can access that test. Once that gets adopted, the other part about it is we see the overall adoption, we see the therapies being utilized, but we also get insights because all that data is running through our labs, and we're able to see mechanisms of things like resistance, mutations developing, and we can create the next wave of diagnostics that feeds into the machine. So it creates a virtual cycle, I think Brian Cavani mentioned earlier, where we see this continuous loop. We iterate on the process and we feed the insights from, we generate on our diagnostic side of the business back into the development side. Now, we take that approach, that energy, that insight, and we apply it specifically to these four areas. Neurology, autoimmune, women's health, and oncology. These are the areas where there's a convergence of forces, emerging technologies, more biomarkers are being discovered. The diagnostic complexity around these categories is increasing, and the unmet need is high and growing. So what I'm going to do is walk you briefly through three of these areas, and then we're going to go very deep into oncology. Okay, I started you off with neurology because this is the perfect example of unmet need and growing demand. By 2050, we're estimating about 150 million patients worldwide will be living with a neurodegenerative condition. It's actually really hard to diagnose some of these neurological conditions because a lot of the features between them actually overlap. And so what you need is to go see a specialist. The challenge, though, is that we don't have enough specialists. In some parts of the world, there's less than one neurologist per 100,000 individuals. goals. So how is this going to work out? We have growing demand, and we don't have enough folks to do the workups. And these workups are oftentimes long, they're complicated, lots of imaging, lots of unsatisfactory results. And so our solution to this is to build out diagnostic assays that help shrink the time and support neurologists and even primary care physicians as they think about categorizing some of these patients with neurological conditions. In the last five years alone, we have brought online 10 simple blood-based tests that are for Alzheimer's related biomarkers. We have supported in our drug development business almost 500 clinical trials in neurology and across our business tested over 350,000 patients. That's an incredible amount of work in neurology, and that's just the beginning. That's already what we're doing today. So we're already leading in this space, but because of that innovation engine, when we see what's coming down the pipeline, we know that's still not enough. We have to spend the next several years building out the next wave of neurology diagnostics, because there's a whole group of other disease categories in neurology that we need to build out the testing for. That's coming. There's going to be therapies coming down the line, we need to be prepared for it. Autoimmune disease. This is a very difficult chronic condition. Today in the U.S. there are about 15 million patients who are impacted by at least one autoimmune condition. And over time, about a third of those patients will go on to develop a coexisting autoimmune condition. Yet the path to diagnosis can be very long and very frustrating. And when I say it's a path, I mean, that sort of implies something linear. It's more of a diagnostic odyssey, because it takes about three to five years for a patient with an autoimmune condition to achieve a definitive diagnosis. So think about what that means for a patient. Three to five years, not weeks, not months, three to five years. That's endless doctor visits, a whole series of very unrevealing testing, and a patient and family dealing with a condition that they don't have a name for, they don't know what it's going to evolve into, and they're trying to figure out what to do to manage their symptoms. So to address this, we have spent a lot of time working through the process of building out diagnostic tests that allow providers to actually screen, diagnose, and monitor for disease activity in autoimmune conditions. And when those patients go on to receive a therapy, we're able to perform therapeutic drug-level monitoring. and watch them as they move into surveillance. So we're not just thinking about building a portfolio of assays that just diagnoses disease. We want to actually change the way we think about managing patients with autoimmune conditions from across the entire spectrum or continuum of their care. Women's health. This is, I think, that typifies unmet need and growing demand. Today in the U.S. there are about 17 million women who are overdue for at least one guideline-recommended cancer screening. There are another 8 million or so who are eligible for a hereditary risk cancer assessment but have never been tested. And millions more are living with menopause-related symptoms but have never been appropriately worked up. Those are pretty big numbers, and they're going to get bigger, but behind every one of those numbers is a woman who is missing the opportunity for earlier intervention, preventative care, and better symptom management to improve her quality of life. To address these gaps, what we've done is built out a comprehensive portfolio of over 650 tests focused on women's health. We've put that together with a market-leading genetics portfolio and one of the largest teams of in-house genetic counselors. That last piece is very important because it allows you to take a lot of very complicated genetic and laboratory information, distill it down into conversations and clinically actionable insights the genetic counselor can have with the patient, provider, and their family. So we've talked about these three areas, and you get the sense that there's unmet need and hopefully growing demand. But if there's one area of our specialty business where this exists, but at another scale, it has to be oncology. So we're going to jump into this right now. There are about 18 million patients in the U.S. living presently with a history of cancer. 20 million patients will be diagnosed this year globally with a new diagnosis of cancer. Now, the way we treat cancer in the last 15, 20 years has changed dramatically. We've moved away from thinking about cancer and treating cancer just based on where it started, colon, lung, breast. and we've moved towards managing these diseases based on the molecular biology and biomarker profile of these tumors. Now, at the same time, more than 60% of patients in the U.S. with advanced cancers do not receive comprehensive biomarker profiling. So think about that. That's a huge gap in terms of what patients should be getting and they're missing. So that's not a science problem. That's not a test problem. We have more targeted therapies available now than ever before, and that list will continue to grow. This is the last mile challenge. We have the right tests, we have the therapies, but patients are not receiving the right workup. And this is where LabCorp can intervene. And I mentioned that innovation engine before, and Brian Cavney alluded to it as well. This is exactly how we do it in oncology. Last year, in 2025, 80% of the U.S. FDA approved oncology therapeutics came through our, we support it in our drug development business. When those combinations of biomarker and therapy move into the real world, we can scale and commercialize it. Add it to our diagnostic test menu with the other 450 oncology tests a provider needs to take care of their patient. And it's resonating because right now, 65% of oncologists in the US rely on LabGor for diagnostic testing. When they go to our menu and when they sort of come into the lab core ecosystem, they don't need one test. They don't need two tests. They need an entire series of tests to take care of a single oncology patient. They may need precision oncology testing, a tissue-based profiling, liquid biopsy, MRD, germline testing, and even immunohistochemistry to look at protein levels on the surface of the tumor. And below that, they still need all of the baseline CBCs and chemistries and liver function tests because it's not enough to understand the biology or the status of the tumor. You need to know about the overall health of the patient, and that's where we can offer everything that oncologists need. So we have the menu built, but how do we actually address this last mile challenge, this gap between available testing and where patients are? And that's where you'll hear more about this from Bola, and I think Brian Vaughan mentioned this as well, But we're investing a lot in simplifying the process. So EMR and EHR connectivity. So ideally what we want is an oncologist, when she's writing up her note for her patient and filling out all of the, catching up on all the details from the clinic visit, and she realizes she needs a series of tests. She doesn't have to think about where to order this test or who to order it from or what is the right test. She can just log right into her account, into her patient chart, and click on all the appropriate tests from LabCorp and have them all ordered right there. And if she's not sure about which test, no problem. The Bolin team have built out an AI-enabled test finder that has a lot of details about each of the tests so she can know which one to order. And for patients, when they get back home and they need a liquid biopsy or a longitudinal MRD test, no problem. You don't have to drive two hours each way back to your provider just to get a blood draw. you can actually get that done at one of our 9,000 patient access points. That's a huge benefit to patients and providers. We want them spending more time thinking about how to best take care of their patient and not worried about how to order testing. We can solve that. We'll take that off. Now, the innovation engine is always running in the background. And because of that, I also want to give you a view of what we know is coming down the pipeline because we have line of sight to it. And so I want to preview for you what the future of LabCorp oncology looks like. This is what we're building in the next several years. And I'm going to walk you through each of these so you get a pretty good sense of all of it. In tissue-based molecular profiling, we are moving away from just looking at several hundred genes to more of a genome-wide approach for DNA and RNA sequencing. We're going to learn on top of that AI-enabled algorithms that allow us to take a lot of this data and simplify it down to key actionable insights a busy provider can use. In liquid biopsy, we're going to add on matched Buffy code sequencing. That does a couple of things for us. It allows us to have the true tumor signal better distinguished from underlying background biological noise. So when you get back your LabCorp liquid biopsy result, you have a lot of confidence that you should be acting appropriately based on that result. In heme malignancies, we are moving towards a whole genome approach for diseases like AML or acute myeloid leukemia and building on an MRD program for heme malignancies so we can monitor these patients over time. And whether it's a solid tumor or a blood-based cancer, we've talked about the importance of understanding the drivers of that patient's tumor, but it's equally important to understand if that patient was predisposed to developing that cancer in the first place. So think BRCA mutations in breast cancer or revereign cancer. We're going to be combining somatic and germline testing as part of our oncology strategy. This does a couple of things. The first being, obviously, we need to think about therapy selection, so we'll be able to take care of that. But we're also going to be able to do things like inform family risk. And maybe for patients who are not affected by cancer yet, but are family members of the affected individual, we can start thinking about earlier detection and maybe even prevention. So that's the value-add about combining somatic and germline testing. Digital pathology. This one's very near and dear to me because I'm a pathologist. I don't actually have to sit at the microscope and look at my glass slides anymore. But it's more than just convenience, although it is going to be very convenient. It's going to be about seeing the same digitized glass slides in front of me on a screen. But I'm also going to be able to augment the way I operate, right? because now I can layer algorithms on top of that digitized image that allows me to pull out features of the tumor that I can't reliably and reproducibly do as a human and quantify it and put it onto reports that a biopharma partner can use to understand whether or not their drug is having an appropriate response. This is really exciting. It's going to change everything about pathology, how I operate, how I share cases, efficiency, workload, everything's going to change for the better. Our CDX strategy, our kit strategies, really focus on addressing that access challenge. How do we move testing closer to where the patient is? And that's why we're building out these kits. The kits are, we have a strong regulatory strategy around it. And our goal here is to just keep adding companion diagnostic claim on top of these kited products, or CDXs. And as Brian mentioned, Cavani mentioned, we have global labs and so the idea is to deploy these tests into our laboratories our central laboratories around the world and so if you're a pharma partner for us and you're trying to think about how do i do a global clinical trial with a fda-approved kitted ngs product no problem we have it all over the world and so we can not just do the testing for you we can manage the entire trial. That's a pretty unique feature. Okay, all very exciting areas, but if there's one area I'm sure you're very interested to hear more about, it's our MRD strategy. This has the potential to fundamentally change the way we practice oncology. So let me introduce you to LabCorp Plasma Detect Genome MRD, and I'll do it in the context of maybe a clinical situation we face, which is oftentimes a very challenging one for us as doctors. Imagine a patient who just underwent surgery for colon cancer. We went in, we took out a segment of the colon, the tumor's out, got sent to pathology. And now they're in the recovery room, surrounded by family. And whenever they sort of wake up or kind of become more aware, there's one question they typically ask us. And that is, did you get it all? Did you remove all the tumor? Am I essentially cure it at this point? It's a very simple question. It's a very practical question, but it's actually kind of hard to answer because we don't really know. We have not historically known. So what we do is we put together all the information we have, which is things like what we saw during the surgery, maybe the pathology findings, the imaging findings, and published statistics. And we say, here's what we think is likely to happen based on your current profile. but that uncertainty actually has a cost because we don't really know who's going to recur and who's not going to recur we end up treating a lot of patients with chemotherapy because we can't be sure who's going to be the patient likely to recur but only 10 to 20 percent of patients actually benefit from that chemotherapy so there's this large population of patients we're over treating and on the flip side there's a population of patients we think are cured and we actually just observe them with serial imaging over time. And about a year, year and a half later, they may come back when the tumor is so big we can finally see it on imaging. And so we've sort of missed in the other direction. And this is exactly why we built Plasma Detect Genome MRD. This is why MRD testing is going to change the way we manage patients. Because now we have the ability to create a signal for tumors that's residual in the body. And so let me explain to you how our test works. What we do is we sequence, it's a tumor-informed whole genome sequencing assay. So what does that mean? What we do is we take the tumor that came out of the patient's body, we sequence it, and we essentially develop like a fingerprint of that patient's tumor. And then we go looking around in the patient's blood to see whether or not we find evidence of that fragment of DNA for that tumor in the patient's blood. If we find the signal, that means there's somewhere in the patient, there's a residual tumor. We don't necessarily know where it is. And in fact, it's so small, we can't actually know where it is. But we know it's in there. And so maybe those are the patients who are likely to intervene earlier with chemotherapy or other interventions. If we do not find a signal, we'll say it's undetected. And that means that patient's at a lower likelihood of recurrence. And that right there is, I think, the promise of precision medicine. We want to be able to give that specific patient the right information at the right time. And that 14-day turnaround time is really important. I want to call that one out. Because all of this decision-making has to happen post-operatively within a window where you need to know whether or not to treat or not treat. And if I give you back this result six months later, it's no help to you. You've already had to make a decision. So getting all of this information back to you within 14 days is really important. So a highly sensitive test with a rapid turnaround time. That's the win for patients and providers in these complex decision-making situations. Okay, I said a lot there, so let me back this up with some actual data, as you may want to see. This is a study we published last year. It's called the Provence 3 study. It focused on patients with stage 3 colon cancer. There's a lot of great information on the slide, but I want you to focus on one number, 7.6. So what does a 7.6 mean? Well, it's the amount of time, on average, 7.6 months, that we were able to detect tumor recurrence before it was clinically detected. So we're finding tumor 7.6 months before it shows up on imaging or the patient's clinically symptomatic. That's not just a number. That's found time. That's the time a patient can intervene when the tumor is so small We can't actually find it in the body on imaging, right? That's the best time to intervene. Now, if that's not exciting enough, we've already moved forward with our version two of this assay. It's called Plasma Detect Genome MRD Ultra because it's more of an ultra-sensitive version. And what we've done is we've improved the sensitivity of finding that tumor fingerprint in the blood by tenfold. So all we're going to be able to do now is move that window up when we're looking for a residual tumor in that patient's body. so even when the tumor is smaller and you can potentially intervene sooner. That is the value of our MRD program. And as much as I wish I could just show everybody this data and everybody would adopt the testing, reimburse for the testing, that's not how it works. But we are not just launching a single test. We're building an entire platform around our MRD program. And to do that, we are working across multiple tumor types shown here and there's another longer list. I can't even fit on the slide. But I've highlighted these because some of these are the most prevalent tumor types, lung, breast, colon. But also, these are the tumor types where a patient oftentimes will undergo surgical resection with curative intent. That's the patient population for MRD testing. We are in the process of clinical utility studies across all of these tumor types and Our mission is to generate the evidence, publish the papers, and work with clinicians to guide adoption, reimbursement, and maybe inclusion into guidelines. We are going to build a body of evidence around our MRD program, whether it's colon cancer, lung cancer, breast cancer, all of the solid tumors. Our goal is to not just have one study in each of these tumor types, but across multiple stages within each of these tumor types. This is going to be a very comprehensive strategy around MRD evidence generation. And we work with our academic partners, our technology partners, or health systems to do this all together because this can't happen in isolation. We have to work together with everyone. So as I wrap here, I want to give you three takeaway messages. The first being LabCorp sits at a very unique spot in the precision oncology ecosystem. We are at the intersection of drug development, diagnostics, real-world care delivery, and real-world data generation. And we iterate on this loop over and over and over across all disciplines but certainly in our specialty areas and then finally we've worked and we continue to work to address this last mile challenge by combining a leading oncology portfolio with our physical and digital infrastructure to close that gap between testing and patients because there's the true value of any of these breakthroughs or innovations isn't when it's discovered, it's actually when it reaches the patient who needs it the most. So thank you for your time. And let me introduce our next speaker, our Chief Information Technology Officer, Bola Oyegunwa.

Bola Oyegunwa, Other

Good morning, everyone. I know at this point I'm standing between everybody hearing from Julia, so I'm not going to keep you waiting too long. But before Julia comes up here, I am going to be speaking to how technology is going to be a key enabler of the things that Julia is going to be talking about. My name is Bola Oegoa, and I am the Chief Information and Technology Officer at LabCorp. I've been at LabCorp for about seven years, and during that period, I've been the Chief Information Officer for our biopharma lab services business. I've also been the Chief Information Officer for our diagnostics business. And I'm going to be speaking to you today about how we're deploying technology across all areas of the business to provide a frictionless experience for our customers, for our patients, how we're using technology to unlock efficiencies across all areas of operations at LabCorp, and how we're using technology to digitize the business to shape and build the future of healthcare. You know, it is an exciting time to be a technology leader in healthcare because healthcare, it's having a technology moment. You see, historically, technology adoption in healthcare has been slower than technology adoption in other industries. However, that is beginning to change, and it's changing quite rapidly. Currently, technology adoption in healthcare is outpacing technology adoption in other industries, or at least keeping pace with technology adoption in other industries. And that is positioning healthcare for an unprecedented era of innovation and transformation. And that is why I am excited to be leading technology at LabCorp at this moment, because our science, our operational scale, our data, and our innovation, and the technology that you're going to hear me discuss today are exactly the assets that are required to lead in the era of technology-enabled healthcare transformation. Undoubtedly, you've heard it from Adam, technology is going to fundamentally change healthcare. And advanced technologies such as multi-parameter optimization, quantum machine learning, machine learning, neural networks, agentic frameworks, digital twins, are going to accelerate drug development and increase discovery of new therapies, biomarkers, and druggable targets. They're also going to help unlock intelligent insights and data from healthcare data that is going to result in accelerated clinical, medical, and scientific breakthroughs. And you've already heard my colleagues discuss our biopharma lab services business, our diagnostics business, and our science. And this is going to create significant growth opportunities within our core businesses. To capitalize on those opportunities, we are concentrating and focusing our technology strategy around three core pillars that drive financial outcomes. We're using technology to provide a frictionless experience for our patients and our customers so we can accelerate revenue growth. We're using technology to enhance productivity within operations so we can unlock efficiencies that allows us to scale and grow profitably. We're also using technology to digitize and to transform our business to accelerate the innovation that is going to allow us to build a durable competitive advantage. So now I'm going to be discussing how we're using technology to improve the experience within our core customer stakeholder groups. For our providers, we're using technology to reduce the administrative burden and to help them make faster and more informed decisions. Brian Vaughn mentioned the announcement of our partnership with Epic. Through Epic Aura, we're going to be able to accelerate health system access to our broad menu of 6,500 tests, which is going to allow providers to rapidly gain access to start ordering both routine and specialty tests. It also allows us to innovate and evolve away from point-to-point interface building. So when we're bringing one of those new 100 tests to market every year, we can accelerate how quickly we can provide access to health systems. It also allows us to share more discrete data with the health systems as well across specialty areas such as genomics. One of the key competitive advantages that LabCorp has is we offer routine testing, but also specialty testing. neurology, oncology, so providers have a one-stop shop to order the test. We have a broad test menu of 6,500 tests, and no clinician or provider is going to know exactly what type of test to order and have that memorized and when to order that test during the diagnostic walk-up. And that is exactly why we built LabCorp Test Finder, which is our generative AI-powered solution. LabCorp TestFinder simplifies our providers' find and other diagnostic testing. They can simply use LabCorp TestFinder to describe the name of the test, describe the condition, describe the symptoms. They don't even need to know exactly what that test is. and LabCorp test finding uses AI to return a curated list of clinically relevant tests for that condition. We have trained a set of clinical agents that are grounded in clinical guidelines with the appropriate clinical context and content that helps the providers find and select the right test. The agents are also trained on clinical decision support as well, guiding that provider along every step of the diagnostics walk-up. And coming very soon, we're also going to be providing a frictionless experience. So now, when that provider, when they identify that test, they can order that test directly from that interface without having to navigate to a different page visibility during the treatment of care continuum is also very important and that's why we're providing visibility across that care continuum through lab call link and lab call diagnostics so when they order a test they know that we've received a test they know that the test is in our lab and they know that we're actually performing the test and they can receive notifications and statuses on the tests that have been resulted and the test partial results as well. And this always provides the transparency that is needed to the provider so they always know when to expect the patient results to make that very important diagnosis for the More on visibility, we're using diagnostic assistance to provide integrated and aggregated results for you across diagnostics lab, clinical data, and prescription in one single EHR interface. So providers have longitudinal ELT insights across these categories over time. So they can spot ELT trends and use that to make better clinical decisions for their patients. We've actually had instances where providers were able to spot and diagnose diseases that were missed by previous providers. because LabCorp provides visibility across all the tests that LabCorp performs, whether it was performed by the health system or by that provider. And this was serious diseases such as oncology, and they've been able to rapidly initiate treatment for these diseases. So when we use technology to simplify the lives of our providers, it translates directly to improving overall patient health and patient care. It also allows us to differentiate LabCorp to our health system customers as well, which allows us to capture more others. And now we're applying the exact same principles to our patients and to our consumers. We're using technology to deliver exceptional experiences for the stakeholders. My LabCorp, our AI-powered application, allows patients and consumers to seamlessly schedule appointments, blood draws, and lab services at any of our patient service center locations nationally. It also delivers statuses on open others, so they can go to the PSCs, get their blood drawn, receive the lab services. That's going to make their health better. It also allows us to convert open others into revenue-generating visits. And when they get their results, they can use the AI assistant that is built in into my lab call to evaluate their results, to analyze their results trends, so they can increase the understanding of their results. We have built clinical agents that have been trained on clinical data interpretation. And we've also embedded the trustworthy analytics within these agents. So we're able to validate the queries in real time to ensure accuracy for the information that we're providing to patients. They can have a dialogue with the AI assistant and say, explain to me what my HBAC means. Explain to me my cholesterol, my HDL, my LDL, my triglycerides. What should I do next? What questions should I ask my physician? My lab or AI assistant can actually help them prepare for upcoming physician visits. In addition to providing health insights, personalized health insights and education about their lab results as well. And when they have the self-insights, it actually translates in patients taking more action about their health. MyLabCore also simplifies how patients navigate their care. They can use it to seamlessly pay for their bills and also initiate follow-on consumer-directed testing through on-demand. When we use technology to simplify the lives of the patients and provide a frictionless experience, it allows us to build a direct and lasting relationship with the patients that we can build upon within our consumer business. It also allows us to convert open orders into revenue-generating visits. Dr. Cavani already mentioned that we're using technology within our bio-pharma lab services segment to deliver value to investigators and customers. And I'm very excited about the capability that we are delivering to the market in this area. We recently announced Global Trial Connect that digitizes key investigator and clinical trial workflows, such as kit ordering, kit management, sample tracking, and sample management to reduce the number of disparate applications and systems that are being used during clinical trials. One of the bottlenecks and pain points in clinical trials is investigator sites are often using up to 11 or 12 different systems, point solutions, that are all disconnected. and they have login credentials and sometimes at the sites they have paper where they're writing the passwords and Global Trial Connect is able to now provide one system one application that is able to do all of those things to digitize that experience and because we're digitizing that experience we're also now able to provide end-to-end visibility to investigators and to our biopharma lab services customers. Matter of fact, Global Trial Connect provides near real-time operational insights into key protocol milestones, such as patient recruitment trends, biopharma customers and investigators. They want to know how quickly they are recruiting for their patients and are they meeting their recruitment targets. Startup metrics. How quickly are they initiating sites and activating sites and getting kids to those sites and monitoring the kid experience as well? And then the test status. And Global Trial Connect provides visibility across all of these key metrics so operators and customers can spot operational trends earlier, intervene, and make data-driven decisions that increases the probability of success for their drugs but also helps to accelerate drug development. We're also using technology to help accelerate patient recruitment and scientific discovery. We announced several months ago, Altamers Insights Patient Engine, which we co-developed with AWS. And Insights Engine uses AI to evaluate and analyze the biomarkers that both Dr. Cavani and Dr. Rami Kasun described, such as APOE4, a genetic risk marker for Alzheimer's disease, PETAO217, to identify the clinically relevant patient cohorts that can be targeted and recruited for clinical trials. This type of analysis used to take several months, and now, using Insights Engine, we've been able to compress it to just a few minutes. which delivers actionable insights to our biopharma customers. When we use technology to simplify the experience for our biopharma customers and investigators, we're able to differentiate our offerings within our biopharma lab services segment, which increases our win rate. We are deploying technology across all areas of the business to enhance productivity. Robotic process automation, automation, robotics, neural networks, convolutional neural networks, agenti-KI, AI agents. We are using all of this technology to unlock key efficiencies that allows us to continue to grow profitably. and to enable our operational scale. You may already be aware of our large robots propel in our regional labs, which is delivering significant operational efficiencies. And now we're introducing automation and robotics within our smaller labs to increase throughput and quality. We're also deploying multi-agentic systems across pre-analytical and analytical operations for more intelligent document processing, faster issue resolution, reagent utilization optimization, and also automation of key lab workflows, which is, again, delivering key efficiencies within those domains. You've already had Dr. Amkasun and Dr. Kavanis speak about, I were introducing AI workflows within digital pathology, digital cytology, and microbiology. And this allows us to provide the near real-time predictive analytics that helps our pathologists make faster decision and better clinical decision, in addition to accelerating the detection of pathogens within microbiology. It also does one important thing as well, which is it allows us to build digital signatures, particularly within cytology and digital pathology, that turns into digital biomarkers that we can combine with other data assets, such as the patient's clinical records, that we can extract intelligence from. And I'm going to be speaking more about this in a few. Within revenue cipher management, we're using AI multi-agentic frameworks to automate our generating appeals. We're using AI to reduce bad debt and denier rates. We're also using AI to optimize our outreach to patients with outstanding invoices. so we can maximize revenue recovery. Within patient services, we're also deploying technology within this area to accelerate how quickly we can respond to patient queries. When patients contact LabCorp and they have questions about their invoices, their bills, and their lab results. In fact, by using technology within this vertical, we've been able to accelerate how quickly we can respond to this patient queries by over 60%, which allows us to free up very important time for our associates to focus on high-value activities that moves the business forward, such as providing exceptional experiences and care to our patients and providers. When we use technology across all areas of the business within operations, it allows us to unlock efficiencies to support our operational scale. I mentioned at the beginning of my talk that technology is going to fundamentally transform healthcare. And that is how we're going to achieve a lot of the objectives that my colleagues have mentioned. Improving health care quality, reducing cost of health care, accelerating drug development, and providing the ability to be able to find better drug targets to treat a lot of these complex diseases, particularly within oncology. And you, Dr. Ramkusen, speak a lot about that. And I believe that organizations that are going to lead in this era of technology-enabled health care transformation are going to need a platform that is going to accelerate innovation and a mechanism to bring new and innovative solutions to market much faster. And this is why we've invested in LabCorp Build, which is LabCorp's AI platform that seamlessly integrates humans, AI agents, enterprise data, agentic workflows, and the secure and governed frameworks that is required to scale AI and multi-agentic systems across the enterprise. It will also allow us to rapidly build, deploy, and scale innovative software solutions for our operators, for our customers, our patients, and our scientists. This is not just a platform. This is how we're going to agentify aspects of our business, such as within our session, where we can now build multi-agentic systems to streamline that process and accelerate turnaround time. This is how we're going to continue to provide a frictionless experience by using technology to accelerate startup processes within our bio-pharma lab services business. This is how we're going to use technology to accelerate onboarding of new acquisitions and customers so we can pull in revenue faster. This is how we're going to deploy and scale virtual agents within our contact center so we can continue to free up time for our associates to focus on what matters the most. this is how we're going to go from idea to product rapidly products that are going to improve health and improve lives within revenue cycle management this is how we're going to continue to agentify that value chain that workflow to ensure that we continue to minimize or continue to reduce our denier rates. This is not just a platform. This is how we're going to redefine how we deliver services to our customers and to our patients. LabCorp is deeply embedded within the healthcare ecosystem. We are both contributors and consumers of data within that ecosystem. You've already had my colleagues speak about some of our scale. 750 million tests performed annually, 6,500 tests in our test menu, and we're introducing over 100 new tests to market annually. We perform clinical trials in over 100 countries globally, enabling 200,000 investigators. With 400,000 patients that are participating in clinical trials, 4,500 active clinical trials, and we supported 85% of FDA-approved drugs and therapies in 2025. We partner with 4,000 hospitals, and we enable 550,000 providers annually. A contactable list of 76 million patients that can receive and access LabCorp services at thousands of locations globally, both diagnostics and central labs services. And this has really led to one of the industry's leading multimodal data assets that we can build upon. We believe that the next frontier, a very important area of growth, will be the ability to extract intelligent insights from all of this health care data and move beyond episodic diagnostics monitoring to actionable and intelligent insights that can transform care. and LabCorp is building for this future because when we build for this future, it allows us to answer very important questions for our customer stakeholders. For our providers, it allows us to answer very important questions such as who should be tested, when should they be tested, and what is the next best test to other. So we can accelerate how quickly they're able to detect disease and diagnose disease. For our clinical trial customers, we will be able to help them answer important questions such as what is the most optimal protocol for them to design for a particular indication within a therapeutic area? And also, what is the ideal patient cohort to target and recruit for their clinical trials, which helps them accelerate bringing new drugs to market but also increase their probability of success during clinical trials as well. And for our scientists, and you saw some of this during Dr. Ramkasun's presentation, it allows us to be able now to provide deeper insights on biomarker expression and progression of disease. and provide deeper insights on the gene variants and the pathogenicity of this gene variants on disease progression and for the patients. It allows us to be able to provide deeper and more meaningful insights about their health and compassing their entire medical records, looking at close claims, looking at their clinical data, looking at the image and building upon these digital signatures and digital biomarkers that I mentioned earlier. And this is going to be an important growth area within healthcare. Before I close and invite Julia up to the stage, I would like to share with you a few key takeaways. LabCorp is deploying and scaling technology across all areas of the business to drive important business outcomes. We're using technology to improve overall health care outcomes. We're focusing on improving and enhancing the customer experience so we can provide a frictionless experience to our patients and our customers. We're using technology to unlock efficiencies during operations, which is going to help achieve a lot of the things that Julia is going to be sharing with you in a few moments. And we're using technology to transform and digitize the business to redefine how we are delivering services to our customers. And we're building on the future where data plays a very important role, where data becomes intelligence, it becomes action. that could be life-saving. And that is why I continue to be excited about technology and innovation at LabCorp. Because our science, our operational scale, our data, and the technology that I just shared with you are exactly the assets that are required to lead in the era of technology-enabled healthcare transformation. And LabCorp has never been better prepared for this moment. LabCorp is ready for this moment. I would like to invite Julia Wong to the stage.

Julia A. Wang, CFO

Hello, everyone. It is great to be with you today, and thank you for spending time with us. You have heard from Adam and our leadership team this morning. Lab Insights are more important today than ever in advancing health care outcomes while reducing health care costs. LabCorp is uniquely positioned to drive this transformation through our industry-leading diagnostic business and BLS business. Having spent the past two decades across diagnostics and biopharma, including two largest national labs in our country and three global biopharmaceutical companies that are the important clients of our BLS business, I have rarely seen an organization at the intersection like LabCorp with our combination of market leadership, growth opportunities, and equally importantly, the ability to deliver cash. From a financial perspective, our message today is straightforward. Number one, we are delivering on the commitments made at our 2023 Investor Day. Number two, we are entering the next phase with multiple levers to drive durable growth. And number three, we are deploying our capital in a disciplined manner to create long-term shareholder value. this strength supports the outlook we are introducing today for the next three years throughout 2029 which remains in line with our prior outlook at the enterprise level specifically we expect to deliver revenue category of 5% to 8% margin expansion of 75 to 150 basis points by the end of 2029. Adjust the EPS growth of 8.5 percent to 11.5 percent. Of course, strong free cash flow growth in line with adjusted earnings growth. And the opinion of this outlook is the fact that LabCorp connects scientific discovery, clinical development, and diagnostics in a way that very few organizations can. This enables us to leverage our global scale, scientific innovation, and data insights to create a differentiated value for our biopharma clients, our health provider partners, and most importantly, the millions of patients that we are privileged to serve. So simply put, LabCorp has demonstrated our ability to deliver, and today we believe we are even better positioned to create long-term shareholder value. Before discussing long-term outlook, let me start by reiterating our guidance for 2026 for year. This guidance reflects another year of strong growth and execution across revenue, profitability, and cash flow simultaneously. Specifically, at the midpoint of our guidance, on a year-over-year basis, we expect to deliver revenue growth of almost 6%, adjust the EPS growth of over 11%, along with continued margin expansion and, of course, strong free cash flow generation. As we wrap up 2026, these expectations provide a very strong foundation for us to head into the next phase of growth more importantly our confidence in our outlook for the next three years is not based on an aspiration instead it is grounded in a consistent track record of delivering our commitments to our investors talking about track record let me provide you with a little bit more context. At our 2023 Investor Day, we established a three-year financial outlook between 2024 to 2026. Today, based on actions for 2024, 2025, and the midpoint of our 2026 guidance, we are delivering at or above that outlook, including revenue CAGR tracking at 7%, adjust EPS CAGR at 11%, and free cash flow CAGR at 14%. So this consistent track record of delivery is what gives us confidence in our outlook for the next three years. Of course, strong financial performance matters the most. when that also translates into shareholder returns. Our consistent track record of delivery has translated into meaningful shareholder returns. These results speak for themselves. Whether you measure it over the longer term or over the 2023 investor day outlook period, LabCorp has delivered total shareholder returns that significantly exceeded S&P 500 Healthcare Index. But more importantly, at a fundamental level, we believe this TSR outperformance is driven by our proven value creation framework, whereby we consistently convert growth into earnings, earnings into cash flow, and cash flow into shareholder returns. A key enabler of our value creation framework is our disciplined capital deployment approach. Let me give you a little bit more context in that track record. Between 2023 to 2025, we delivered $6.1 billion cash from operations, including the cash distribution to LabCorp from our strategic action of the Fortria SPIN. During the same period of time, we fully deployed that $6.1 billion. Specifically, we invested $3.7 billion behind growth, including $2.3 billion into acquisitions. Acquisitions continue to be an important driver as part of our growth algorithm. Over the past three years, acquisitions have contributed $900 million of revenue, equating to an approximately 2.4% revenue CAGR, towards the very high end of our target range of acquisition contribution between 1.5% to 2.5%. During the same period of time, we also returned $2.4 billion to the shareholders through a combination of dividend and share repurchases. The takeaway here is straightforward. We consistently balance investment into the business with returning capital to the shareholders, creating a capital deployment framework that proves to be effective and repeatable. Turning to the next three years, our objective remains unchanged. We expect to deploy our strong operating cash flow generation in a way that will enable us to invest into the business, pursue disciplined M&A to accelerate growth, and then return excess cash to the shareholders. Between 2027 to 2029, we expect to generate operating cash flow between $6.3 billion to $7.2 billion, creating significant flexibility across multiple levels to create value. And then if you think about our capital deployment priorities, they are clear and straightforward. Let me start with reinvesting into the business. We expect capital expenditures to be about 4% of revenue, reflecting our multi-year investment into a state-of-the-art CLS lab to support future growth. So the 4% is slightly above our historical levels. In addition to that, we continue to expect acquisitions to be a meaningful contributor to our growth. Specifically, we are expecting 1.5% to 2.5% of CAGR from acquisitions for revenue growth. This is in line once again with the last three years, and once again, we also delivered almost 2.4% revenue CAGR in the last three years. In terms of returning capital to the shareholders, we remain committed to our dividend policy and continue to target the payout ratio of 15% to 20% of our adjusted earnings. Of course, finally, share repurchase remains an important pillar within our overall capital deployment framework. It is a flexible and strategic lever that we can deploy to offset dilution at a minimum, but also potentially deploy more capital at times that acquisition opportunities are less attractive. When you put all of this together, there's just one key takeaway. That is, we have approached capital deployment with discipline and balance that enables us to deliver durable growth while creating long-term value. Then the next question is, where do you expect the growth to be coming from? So let me break down the key drivers for our revenue outlook for the next three years. Once again, we are expecting enterprise revenue to grow 5% to 8% on a capital basis between 2027 to 2029. In terms of the growth, let me start with organic. Organically speaking, we expect revenue CAGR to be 3.5% to 5.5%. When you think about the key levers behind that growth, it's very consistent with what you've just heard from business leaders, including Brian and Dr. Kemeny. They both detailed for you our global scale, our advantaged business portfolio, and our focus on driving faster growth in specialty in both diagnostics and BLS. Of course, all of these drivers against the anticipated backdrop of strong healthcare demand and healthy utilization environments. And then from an inorganic perspective, we expect that to drive a revenue category of 1.5% to 2.5%. Once again, from an acquisition perspective, we continue to be looking for assets that would help us strengthen our competitive leadership position while also accelerating growth above and beyond the organic contribution. So when you think about the drivers between the organic side and the inorganic side, that gives us the 5% to 8% of enterprise revenue expectation for the next three years on a CAGR basis, and we believe that we have multiple proven growth levers that gives us confidence of our ability to deliver. Of course, revenue growth creates value when we can translate that into a higher level of growth for earnings and cash flow. Here is where margin expansion comes into play. For the next three years, we are expecting margin expansion of 75 to 150 basis points by the end of 2029. And there are really two broader groups of complementary drivers for that margin expansion outlook. To start with, it's always taking advantage of the revenue growth and the drive operating leverage. So our infrastructure is already in place. To the extent that we drive revenue growth through volume, it carries very attractive economics. In addition to the fact that our heightened focus on specialty, on esoteric testing, as well as the increasing pace of number of tests per session from a mixed availability perspective, is giving us confidence about one lever of margin expansion as an enterprise. The second lever is really the continued efforts in our operating efficiency through the Launchpad program enabled by advanced technologies. You've heard from Bola earlier that we're not just viewing technology as a tool to improve workflow or optimize network. Most importantly, we actually expect technologies to serve as a productivity engine that helps us scale global growth, lower costs to serve, and then create capacity for future growth. You've heard from Bola as well that we're utilizing digital capabilities to achieve the following three objectives. Number one, simplify the way that the healthcare providers interact with us, including accessing our broad and extensive testing menu. Number two, to create connected and personalized experiences for our patients and our consumers. And number three, to help our biopharma clients execute their phase two and phase three studies efficiently and expeditiously. So when you put all these layers together, we are confident about the margin outlook of expanding 75 to 150 basis points by the end of 2029. Now by this point, I've walked you through in details The key neighbors, including revenue outlook, margin outlook, disciplined capital deployment. So let me try to bring this together in one place at the very high level for you for the next three years in terms of what you can expect from LabCorp. Revenue CAGR at the enterprise level, 5% to 8%, supported by both organic growth and contribution from acquisitions. Margin expansion, 75 to 150 basis points by the end of 2029, supported by both revenue growth and operating efficiencies, enabled by advanced technologies. All of this are expected translating to adjusted EPS, CAGR, of 8.5% to 11.5%, and then free cash flow growth in line of adjusted earnings growth. I do want to highlight a few key planning assumptions that is underneath this outlook for the next three years. This outlook has incorporated the potential return of PAMA. In addition to that, we've built in an annual savings target from a launchpad initiative of $125 million to $150 million. From a balance sheet perspective, we continue to target a financial leverage of 2.5 times to 3 times. Currently, we are operating towards the low end of that range, which gives us flexibility as we continue to invest and return. So if I would leave you with one key takeaway about this outlook, That is, we have delivered against this framework in the past three years, and we believe we have a clear path to deliver it again over the next three years. Okay, let me wrap up this formal presentation for this morning. Clearly, LabCorp is entering this next phase from a position of strength and momentum. I wanted to leave you with three strengths in particular. Number one, we have two powerful growth engines that complement each other. Number two, we have a consistent track record of delivering on our commitments. And number three, we have a disciplined operating model that converts growth into earnings, cash flow, and shareholder returns. So looking ahead, we believe that we are uniquely positioned to capitalize on the growth opportunities and drive broad impact across scientific discovery, diagnostic clinical development, as well as diagnostic testing in a way that very few other organizations can. Taken together, these competitive advantages position us very well to drive durable growth, compound earnings and cash flow, and create long-term value for our shareholders. With that, thank you very much.

Dewey Sedman, Head of Investor Relations

That's a good-looking group up there. So I'm Dewey Stedman again, Head of Investor Relations at LabCorp. We are going to now take questions probably until about 12.05-ish or so. To ask a question, just raise your hand. Ami and I will run with a mic to you. I see hands already. When you ask a question, please identify yourself, name, and affiliation, just for the sake of the transcript and future listeners of this webcast. And then please try to limit yourself to one question and then hand us the mic back. And then we'll try to get to everybody. So hands up. Let's see, David.

Dave McDonald, Analyst — Truist

Yeah, thank you. Dave McDonald from Truist. Just had a technology question. I mean, look, the company historically has done a great job driving cost savings and efficiencies. You talked a lot about technology adoption and AI and what looks like a pretty meaningfully expanding number of areas where you could drive margin expansion. So can you talk about, you know, just the opportunity there that that affords? And also, I don't know if this is too early, but is there any perspective that you guys can provide in terms of what kind of lift you're seeing in satisfaction from your customers, your patients, and your providers as you roll these tools out?

Adam Schechter, CEO

Yeah, great questions, David. And I'll ask Brian and Brian to talk about the satisfaction number. You know, we built in a launch pad savings that's slightly higher these three years than the last three years. And a big part of that is from the technology and what we're expecting to gain from technology productivity. And, you know, historically, we've done a lot of the easier things, like, you know, procurement and moving jobs overseas and so forth. So now a lot of the savings that we expect into the future will be based upon technology. But why don't Brian and Brian talk about satisfaction and then maybe either Bolo or Julie can add just a little bit about the savings from the technology. Sure.

Brian Vaughn, Other

In the diagnostics business, we can see especially, Actually, we have very broad patient surveys. Those patient satisfaction metrics are very strong and continue to tick up a little bit. All the little things that we do, whether it's just a little bit easier to reschedule your appointment or move it around, we're doing patient reminders now. All of these little things that we're doing, we can see the impact in the scores and the patients come back expecting that experience. We also see it in the provider scores. We don't have as many of those data points, but we hear it from providers and see it in the scores as well, sort of making their lives a little bit easier. If you're a physician or clinician out there, that's really what you want. You want to be able to access and take care of your patients.

Brian J. Caveney, M.D., Other

And David, in the BLS business, we've just launched several of these tools this year or in the last couple of months, so it's early for us to have reported NPS changes. But just anecdotally, in testimonials from sponsors, so the pharma companies love the ability to see real-time results coming back and specimen tracking around the world so they can know the speed with with which their trials are being filled and when they can expect data to be coming, that's terrific. But really, for me as a physician, what I love is the good feedback we're getting from site investigators, so physicians around the world taking care of patients in clinical trials. As Bola mentioned, they're currently having to log in to a bunch of different systems to get this data. We're bringing it all together so that the doctors, the nurses, and the clinical research coordinators in these clinics around the world can see this information, understand what the clinical trial protocol is, give the right information back to the patient, and be reporting correct data in the right formats back to the sponsors. So it's win-win, and we just know that this is going to really build over time and give us good results.

Julia A. Wang, CFO

What I would add is that earlier I shared with you all that from a capital expenditure perspective for the next three years, we are expecting that to be about 4% of our revenue. that investment actually includes investment dedicated to technologies and AI and everything in between. Now, from a capital allocation perspective, I would say that investment into technologies is not its own spending category. It actually has to compete against other investment opportunities, whether it's acquisitions, facility investments, or other growth opportunities. And the areas that we are particularly interested in investing are really strictly aligned with our strategic priorities from a business perspective, but also investments that we can clearly measure the return for the consumers, the patients, and the shareholders. That's why you are saying that we are very much prioritizing investments into digital pathology, the revenue cycle management, lab automation, customer-facing solutions, because all of those initiatives are expected to help us improve top line while also improving margin expansion.

Adam Schechter, CEO

Okay, next question.

Lisa Gill, Analyst — J.P. Morgan

Good morning, and thanks for the comments. Lisa Gillis, J.P. Morgan. I just want to talk about PAMA for a minute. So it's embedded within your guidance, but can you give a little more color around a couple of things? One, what the anticipation is around participation by the hospitals. Would the dollar value be roughly what we've seen in the last few years, about $100 million, dollars, and what's the potential for an offset? And then secondly, obviously we have midterm elections coming up. What do you think the chances are for some type of bipartisan support for results or something else when we think about legislation?

Adam Schechter, CEO

Yeah, I'll talk a little bit about PAMA. I'll ask Julia to just talk about the impact that we've built in through the guidance that we provided, and we did include and assume PAMA would happen. I'm still very hopeful that it will not happen. I spent so much time talking to congressmen and women, senators, Republicans, Democrats. I have not found one person yet that doesn't believe the results legislation is the right path forward and that we should move away from PAMA and move into something that's more durable, that makes sense, and will achieve the objectives they set forth in the beginning. If you look at the data that's been submitted, we have no insight to the number of hospitals that may have submitted this time versus last time. But if you ask my personal opinion, I do not think we'll see a significant difference. The way in which you collect the data, the difficulty to pull the data together, it's just not simple. Us as LabCorp, it takes a lot of effort for us to get that data together in a cohesive manner. We do a lot of deals with hospitals. We see how disparate their systems can be, how they've been accumulating over years from integrations and acquisitions. So it would be very hard for me to believe they would have put the level of resources needed in order to submit data. So in our assumption, we assume that the impact in terms of the pricing and so forth would be similar to what we saw last time if PAMA happens. I have no idea what's going to happen in the midterm elections. I'm hopeful that either way we can get results passed by the end of the year. But hope is not a strategy, so therefore we've built it into our base case that it occurs, and we will work to offset as much of it as we can.

Julia A. Wang, CFO

Yeah, so as Adam said, right, we essentially built an assumption that was similar in the past. In the past, we have sized the PEMO impact to be about $100 million in both the bottom line and top line in year one, and with that impact to be significantly reduced in year two. That's the same assumption that is including the current outlook range. Of course, as we continue to make progress, particularly as we get ready to set the guidance for 2027, we would be in a position to provide an update based on what we know at that point in time.

Adam Schechter, CEO

The only other thing I would add, which is kind of an interesting thought, is that if PAMO does occur, I think there's certainly a short-term impact. but our pipeline for deals I think will actually get even stronger from an already strong pipeline because where we can withstand that where we can offset some of the PAMA impact these smaller local regional laboratories hospital laboratories will feel increased pressure so I think although we'll feel some pain in the short term I actually think over time it's actually a benefit to us in terms of our acquisition strategy take next question great thank you Aaron Wright

Aaron Wright, Analyst — Morgan Stanley

Morgan Stanley. There was a big, sorry, there was a big focus today on oncology, and can you give us a little bit more around how you think about the contributions of that over time, something that maybe you could break more out going forward, what the contribution is to organic growth over the longer term. We do think it's kind of underappreciated here, and just anything you can give us to better model that out and understand the opportunity would be great.

Adam Schechter, CEO

Yeah, I'll ask Brian Vaughn to talk a little bit about how he's thinking about it within his portfolio, and then we'll see if there's anybody else that wants to add to that.

Brian Vaughn, Other

Yes, thanks, Aaron. First of all, we broke out $2 billion of specialty across four specialty franchises. Oncology is the largest of those franchises, and they vary in size. And when you think about our oncology portfolio, there's a lot of things in it. There's more legacy technologies that have been around for a while that are growing more slowly. There's also next gen sequencing. There's tumor profiling. There's liquid biopsy. Those sorts of things are growing much, much faster, although on a smaller base. Over the long haul, we expect oncology to continue to be a really material growth driver for LabCorp, especially as the MRD portfolio and other things unfold. But if you go back to the way we think about it, we also want to serve the entire oncologist. We also want to serve the entire oncology patient. So part of our strategy is not only to grow the individual specialty tests, but also to take care of that patient while they're on a journey that may need a lot of other lab testing over time, or take care of the oncologist that may need a lot of routine and other oncology tests over time.

Adam Schechter, CEO

Okay, next question.

Elizabeth Anderson, Analyst — Evercore

Hi, good morning. Elizabeth Anderson from Evercore. Looking forward in the BLS guidance, obviously that market has had a turbulent time as we had the COVID and then funding came down and you were sort of still able to hit that revenue guide. As we think about the recovery of that, it seems like that guide may still be on the lower side. Is there anything in sort of the changing business mix or is that just sort of a level of conservatism given the volatility of that market over the last few years?

Adam Schechter, CEO

Yes, I'll give a couple of thoughts and I'll ask Brian Cavani to give some thoughts as well. You know, as I look at the biopharma laboratory services business, obviously it's driven by central laboratories. The good news about central laboratories is that's driven by large pharma and typically phase three trials. Those are very safe. They're long-term. We have great insight to them. The book to bill looks good. The early development business, which is the smaller business, is where we see more volatility. And that's where we continue to watch for signs of funding from private equity and smaller biotech companies. Anything you would add, Brian?

Brian J. Caveney, M.D., Other

Yeah, that's right. About two-thirds of our early development business is in that venture fund biotech space, and so that's what we need to look on the front end of that. But by and large, the overall business is relatively in line with the growth in pharmaceutical R&D spending over time. So as that is having early green shoots of improvement over time, that is the market by which we think we'll be able to continue growing and hit the guidance that we've placed.

Adam Schechter, CEO

And I agree there and in the back that our oncology portfolio is under kind of valued, that we have a lot of value there. I also think our central laboratory business is undervalued. When you look at the durability of that business, when you look at the long-term growth prospects of the business, when you look at where it's focused on phase three trials, I believe that that's a really good growth driver for us moving forward. Next question.

Michael Cherny, Analyst — Lear Capital Partners

Michael Cherney from Lear Inc. Partners. Maybe to follow up on Aaron's question, but go a step further. So oncology was a deep focus, but there's some other, three other priority areas on autoimmune, neurology, and women's health. Is there any way to rank order where you think the growth opportunities come from those and what needs to happen in terms of test development to continue to achieve the growth that you've had above market?

Adam Schechter, CEO

Yeah, so maybe, Brian, you could talk about the relative size of the markets and, you know, a sense of what the growth is in the past.

Brian Vaughn, Other

Thanks, Michael. So oncology is the largest of the portfolio that we broke out today. Neurology is actually the smallest. And then women's health and autoimmune are in the middle. And like I mentioned with oncology, some of the tests in those portfolios are growing very quickly. So if you look at the neurology portfolio, the Alzheimer's testing is growing incredibly fast, much faster than some of the other markers. And for all the reasons Shaq mentioned, neurology and with the development and scientific discovery that's happening is going to be a very meaningful growth driver for us going forward. But same thing in autoimmune, where there's a lot more to uncover. Same thing in women's health, where there's still unmet needs. I mean, these are all areas where we see meaningful growth opportunities. And then I just come back to the, we not only want to grow in those specialty areas, but also in everything around it as well.

Speaker 1

Thank you, Luli, Bank of America. two-portal question on the specialty testing part I think you mentioned you guys are launching more than 100 tests per year and I guess most of that will probably coming out from specialty testing. I'm wondering how do you prioritize internal development, partnership or acquisition so that's number one and second I think last time in the analyst day you mentioned about 8-9% growth in that area. I'm wondering if you can reiterate that range or maybe you see potential to go faster. Thank you.

Adam Schechter, CEO

So I'll ask Brian Cavani to talk about how we prioritize. Shaka, I'd like you to jump in a little bit about how we think about licensing versus building ourselves. And then Brian, you can answer the last part.

Brian J. Caveney, M.D., Other

Terrific. That's a great question. We look at all of the different possibilities of bringing on new technology and figure out what is going to be the most efficient, what's going to be the most scalable given that we need to have it standardized in all of our different laboratories for both our CLS business as well as our diagnostics business. We have our own venture fund. We have about 50 different scientific business advisory teams that scour the world and look for what we think the most promising technologies are. We work with all of the instrument manufacturers of the world to understand how their instruments are becoming more precise, more sensitive over time, and what's going to fit our portfolio. We talk to the scientific expertise that we have around the world, academic collaborators in all sorts of other ways. And we figure out what is at the brink of fulfilling an unmet clinical need that clinicians who are often telling us what they need to take better care of their patients to replace a less sensitive or less specific prior technology that they were using on their menu. We also think deeply about what evidence is going to be required to get adequate reimbursement in the different markets that we serve to make sure that we're going to be able to add that to the portfolio, improve a clinician's ability to deliver good care, and have some foreseeability to how we're going to be able to make it profitable in our diagnostics business.

Shaq Ramkasun, Other

Yeah, I can add on to that, Brian, that when we think about servicing our providers and our patients, again, we're really thinking about this from a very comprehensive perspective. We don't want them to come to our services, our menu, and find that they can get 99% of things, and we're still missing 1%. so our goal is to achieve that full comprehensive menu and that's either a buy build or partner strategy and it sort of depends on what the assay that we're missing or the biomarkers that we need to test for and is that something we already have lots of data and evidence to build out our own assay or is it just faster and easier to just license in the technology and deploy internally or sometimes it really is just an acquisition and that's really the best path forward but the goal to make sure that the provider and the patient have simplicity when it comes to accessing all of the testing they need to take care of their patient.

Brian Vaughn, Other

And lastly, on market growth, what we framed up is the overall market in diagnostics is growing in low single digits. We've called out, in the way we've defined these specialty franchises, that market's growing about three times faster. But I just call out certain pieces within that, within the oncology portfolio, within the neurology portfolio, are growing much faster. So there are sub-markets within it, and we think about it as being very targeted. We want the Alzheimer's portfolio or the MRD portfolio or something growing, even at a much higher rate than three times the market.

Adam Schechter, CEO

Okay, next question. We've got to get a mic on this side of the room, too, because it seems like I can see you're about to jump out of your seat. Why is there no mic on my side?

Speaker 11

All right, David Westenberg from Piper Sandler. So I wanted to talk about maybe some of the specialty diagnostics. You spent some time on minimal residual disease. I believe that was Shaq's area, if I'm not mistaken. It's clearly a large and growing opportunity. I do think investors view the market as structurally concentrated or potential to be, well, right now it is structurally concentrated, but the potential to kind of stay structurally concentrated. However, saying that, you were, or maybe not you necessarily, Invitae slash Archer was very early to the game. So I don't know if you can talk about maybe some of the opportunities there. How the market will shape up in your belief over time. And if it does tend to be structurally concentrated, do you still see yourself as maybe one of those top five players in MRD, given the fact that Invitae was fairly early on that and you did acquire that.

Adam Schechter, CEO

Yeah, so I'll give some context and maybe Shaq, you can jump in a bit. You know, when I think about MRD, you think about the number of tumors and the types of tumors out there. I don't think there'll be any one company that's small that will necessarily be able to be successful across all those tumor types. When you'll see the tumor types that we were focused on, most of them very large, complicated tumor types, I think we stand a chance to be successful in each of those, but there's still a lot more tumor types that we're going to have to partner with and license in order to have a full menu. So I do believe that there will be multiple successful players in this market. I believe that it'll be very difficult to be specific to one tumor over time, and physicians are going to want to go to one company that offers multiple different tumor types, and I think that's where our competitive advantage will be. But Chuck, do you want to add some context?

Shaq Ramkasun, Other

Yeah, it's a great question. I think, again, the way we think about taking care of our patients, it's a very holistic approach. We mentioned 65% of oncologists today in the U.S. rely on LabCorp for diagnostic testing. And so that means they can get all their precision oncology testing, biomarker-directed testing, and just routine labs, all from LabCorp. And when we layer on our MRD testing into that ecosystem, it just simplifies the process where they can order everything from LabCorp. And if their patient moves from New York to Florida over the winter, it's not a problem because we have PSCs in Florida where you can get your blood draw for longitudinal MRD testing. So it's easier for them to just stay within the lab core ecosystem for testing. Okay, next question.

Speaker 7

Thanks. Peter Chukrin, Deutsche Bank. I'm going to actually ask that cancer question a little bit differently. We've talked about this sort of in the past here. Can you talk about the cancer tests today in the market that you utilize exomes versus whole genomes and how are you using AI to crank through the data from the whole genomes? How many tests have you validated sort of using this sort of new sort of digital versus more of an analog experience? And where do you see exome versus full genome testing for cancer in the next few years? Shaq, that one's yours.

Shaq Ramkasun, Other

That one's, I thought, I was going to give that one to Julia, but I think I'll... Paula, that's yours. No, it's a great question. So we think, so what do we know, right? So we see the therapies under development because we're working with them on the biopharma side of the business. So we know what's coming down the line. And what the trend is away, just like in the early days, we moved from single gene testing to large panels today, the trend is also to move to larger and more comprehensive testing. And so once you get beyond a panel, you're either talking about an exome, a genome, and a transcriptome. There's not that many options, right? And so actually our strategy is a combination of both. It's going to be a genome backbone with a modular exome built on top of it. So you can have the depth in certain areas across the genome where certain genes are like EGFR and ALK and ROS, but you also have the broad coverage across the entire human genome. That's important not just for taking care of patients today, but also we're going to have that data in the background. So for our biopharma partners, when we do that kind of service and testing, if they need to go back and retrospectively analyze that data, the entire genome is available, the entire transcriptome is available, so if they need to reanalyze that data set to identify maybe different strategies for the next trial, it's already available, there's no additional testing that's needed so we think solid tumors are going to move this way, hemalignancies are going to move this way, liquid biopsy over time, it's possible, but for right now I think the depth of sequencing that's necessary for a therapeutic selection liquid biopsy assay like LabCorp Plasma Complete is not really set up for what I would think of as an exome today, but maybe over time. We're adding tools like matched Buffy code sequencing, which will even improve that tumor signal as well. But I think the MRD approach using a whole genome sequencing approach there makes the most sense because it's fast. You can get very good signals. We're not limited by just a few sort of variants we're tracking over time. That's more of that AI algorithm approach, machine learning approach to identify that tumor fingerprint.

Dewey Sedman, Head of Investor Relations

All right, we have time for two more questions.

Eric Coldwell, Analyst — Baird

Thanks, Dewey. Hi, Eric Coldwell with Baird. I wanted to stick on the MRD topic for a second. I realize you would be giving us more information if it was a material driver at this point. You've got a lot going on. But that being said, it'd be amazing to get some updates on where you stand with reimbursement, what you expect both commercially as well as government Medicare. where you are with investment, breakeven targets, regulatory pathways, FDA breakthrough or New York CLEP. I mean, there's three dozen companies out there we could identify in this category. There's a lot of information flowing, and I feel like we need some more milestones or things to gate as we track your progress versus the market.

Adam Schechter, CEO

Okay, so there's a lot in there. I'm going to ask Shaq to talk a little bit about the registration pathway and the reimbursement pathway, and then Brian, maybe you can talk about how you're thinking about the market size and how things are progressing there.

Shaq Ramkasun, Other

Yeah, so we launch tests every year, and so we understand the reimbursement pathway very well. It's actually relatively clear we're in a Moldex jurisdiction, and so that means we oftentimes actually meet with them, discuss the study designs, what kind of data is going to be required at the end of the study in order to come back with a publication that drives reimbursement. So this is a process we've done. We know how to do it. We're doing it right now. And the key is to developing the studies, the clinical utility studies. Like we've put out some press releases for a couple of them. There's some we have not yet. But we are in the process of enrolling patients, generating the data. We will publish those papers, and we will use that as the evidence needed to drive the reimbursement discussion, as well as adoption with KOLs and oncologists who will be looking at some of these different tools for MRD. So if they're already ordering their liquid biopsy from us, they're already ordering their germline testing for us, they're going to want to say, hey, my patient's coming in for that blood draw for those other tests. Can you just do the blood draw for the MRD testing at the same time? I don't want to have to send them somewhere else to get a blood draw for a different MRD test. It just doesn't make sense. It's not how we practice medicine, and it's more burden on the patient, and we already know it's going to be a challenge for them to come in, get that appointment scheduled, and show up for it to get all of that testing done. So I think simplifying the process, putting everything together into one easy-to-access package, I think is the right step forward for us and our patients.

Brian Vaughn, Other

I mean, that was well said. MRD is going to be a nice market opportunity for us longer term. We're still in the early innings of it. But just like Shaq said, I mean, the way we think about it is, and Shaq laid out the platform we're going to build, it's going to require evidence generation. You see us announcing partnerships with health systems to do trials and studies and generate that evidence. So we'll be able to show you those sorts of things along the way. But also, you know, we're very interested, just like Shaq laid it out, how do we get in now with oncologists, with health systems, with hereditary cancer, with routine testing, with other sorts of things so that when the MRD things are ready, when they're reimbursable, when they're more accessible, we're right there. And we're competing in this way that we're the ease-of-use solution for everything that the client and the patient need.

Adam Schechter, CEO

And the only thing I'd add, Eric, is Brian Cavaney had shown that more than 50% of the clinical trials today are in oncology and neurology. And the vast majority are in oncology. In order to be state-of-the-art and to win those trials, we have to be state-of-the-art in MRD, in cancer diagnostics and testing. So it helps us in winning clinical trials. It will help us ultimately in winning oncology business in the marketplace. And then I think Brian Vaughn showed some data that showed that you get 50% more tests per patient in the specialty areas than you would for just a routine testing. So not only do you get that one test, but you get all those other tests that give us a good return as well.

Dewey Sedman, Head of Investor Relations

Okay, great. We have time for one more question from Kevin.

Kevin Caliendo, Analyst — UBS

Hi, it's Kevin Caliendo from UBS. I want to talk a little bit about the organic growth assumption that you have. How much of that is volume growth? How much of that is sort of rev rec or pricing? And we've seen this uptick in number of tests per session. And I'm wondering how much further that can go. Are we peaking there, or is there still room for that? Is that part of the assumption of the growth going forward?

Brian Vaughn, Other

Yeah, Kevin, thanks for the question. I mean, I think of volume. I know it shows up in the financials as volume and price. A lot of price is actually tests, which is also volume. I don't think we've peaked there at all. I think with the scientific innovation that's coming with the value of these new specialty biomarkers and what they're able to do for patient care, I think consumers being more interested is a whole other driver, right? The appetite for understanding more about what's going on in your body through biomarkers, I think test per session has a long runway, as well as our session or patient volumes along the way.

Adam Schechter, CEO

Anything you want to add to that?

Julia A. Wang, CFO

Yeah, I would definitely echo that. And the only thing I want to add is, as you have seen over the last few years, every single quarter we've seen a consistent yet a slight increase in test per session. So I think to build on what Brian just shared, we continue to expect that to be a favorable driver going forward in light of the demographic kind of assessment and assumptions as well as our focus on specialty in general, right? But I also would say that we continue to expect that to be at a pace that is consistent yet a slight improvement because we conduct 750 million tests every single year to be able to move that portfolio at that pace is going to be conducive for the organic revenue growth that we laid out this morning.

Dewey Sedman, Head of Investor Relations

All right, thanks, everyone.

Adam Schechter, CEO

Okay, so thank you all for joining us today here in New York City. For those of you who joined us by webcast, we appreciate you joining us as well. I hope you walk away with a few takeaway messages. I hope you're as excited about the future as I am. As I hear each of our speakers talk today, I get more enthusiastic. I feel even more confident about the future each and every day. I'll leave you with a few thoughts. One, we have a consistent track record of delivering strong performance. That should enable you to feel confident that we will continue to deliver on our commitments. We have tremendous growth opportunities before us. We have multiple different ways to find growth. And we're focused on those. We're putting money and investment behind those. And we feel like there's multiple ways for us to achieve the objectives that we've set forth today. We have a differentiated platform. We're differentiated in our global nature, in our mix of business, in our science, our technology, and our global scale. and all that combined together leads to what we believe is a very compelling long-term outlook that we are confident in. Thanks for joining us today. We look forward to seeing you all soon and travel safely.