What kind of company is Natera, the largest holding of Druckenmiller?

In the third quarter, Druckenmiller continued to bet on the "number one heavy stock" Natera.

In the latest disclosed third-quarter holdings document, legendary investor and founder of Duquesne Capital, Stanley Druckenmiller, through his global top family office Duquesne Family Office, significantly increased his position in clinical genetic testing company Natera, adding 1.592 million shares to a total of 3.57 million shares, resulting in a substantial increase of 80.61% in his position to 15.34%, with a market value of $453 million.

What exactly is Natera that allows Druckenmiller to spend nearly $200 million?

High Clinical Value and Strong Potential Demand: Promising Prospects for Tumor Testing Business

Public information shows that Natera is a clinical genetic testing platform company founded in 2003, focusing on non-invasive, cell-free DNA (cfDNA) testing technology.

Over the past five years, Natera's revenue has grown rapidly, with a compound annual growth rate (CAGR) of 37.6% from 2019 to 2023, while the expense ratio has continued to decline, and cash flow has turned positive.

According to Huayuan Securities, to date, Natera's business line has evolved into three major sectors: tumor (MRD), organ health (organ transplant rejection detection), and women's health (NIPT, etc.), all of which are industry leaders.

Currently, Natera's women's health business has a market share of about 50% in the United States. Although it is in a leading position, its development is relatively mature, with a penetration rate of about 50%; the organ health business is still in the early stages of development, with a penetration rate of only 10%-15%, a favorable competitive landscape, and the company is actively expanding, being in a rapid growth phase; in comparison, the MRD business has the most promising development prospects.

Huayuan Securities stated that considering the continuous demonstration of clinical value and the broad potential market demand, Natera's MRD testing business has significant competitive advantages.

The report mentions that there is currently a problem of insufficient accuracy in adjuvant therapy plans after tumor surgery, which requires MRD testing to participate in treatment guidance—MRD testing refers to detecting molecular abnormalities originating from tumors through liquid biopsy to detect cancer recurrence early and guide precise postoperative treatment.

Currently, the MRD testing market in the United States is less than $1 billion, far from the theoretical peak of $20 billion, with a penetration rate of less than 5%; in terms of commercialization, no company has yet obtained approval from the U.S. Food and Drug Administration (FDA).

At present, Natera's Signatera is already the most comprehensively validated MRD testing method, with a rich clinical pipeline and first-mover advantages in research and commercialization:

As of now, without FDA approval, the testing volume of Signatera has rapidly increased from 35,000 tests in Q2 2022 to 118,000 tests in Q2 2024, with a total of 305,000 tests conducted in 2023 alone. At the same time, its penetration rate among doctors has quickly risen, with over 40% of oncologists in the U.S. ordering Signatera in Q2 2024.

Thanks to the company's improved operational execution and expected insurance coverage for new indications, the average selling price (ASP) of Signatera has increased from approximately $400 at launch to over $1,000 in Q2 2024.

Huayuan Securities believes that as an industry leader, Natera's Signatera product is expected to become the core driving force behind the company's rapid performance growth