Myriad Genetics Bets on Growth Amid Profit Squeeze

Myriad Genetics ((MYGN)) has held its Q1 earnings call. Read on for the main highlights of the call.

Myriad Genetics’ latest earnings call struck an overall constructive tone, as management highlighted double‑digit hereditary cancer growth, strong GeneSight momentum, and resilient gross margins even as profitability lagged. Executives acknowledged near‑term pressure from elevated spending and prenatal weakness but argued that current investments should set up a stronger back half and path to positive adjusted EBITDA.

Revenue Holds Within Guidance Range

Myriad reported Q1 revenue of $200.4 million, up about 2% year over year and squarely within its guidance range. Management reaffirmed full‑year revenue guidance of $860 million to $880 million, signaling confidence that modest early‑year growth will accelerate as commercial hires ramp and new products scale.

Hereditary Cancer Testing Drives Core Growth

Hereditary cancer remained the primary growth engine, with testing volume rising 14% year over year, an acceleration from 11% in Q4. Affected population volume grew roughly 10% while unaffected population volume climbed about 16%, pointing to tangible market share gains in both segments.

GeneSight Mental Health Franchise Accelerates

The GeneSight pharmacogenomic test continued its strong run, delivering Q1 revenue of $38.3 million, up 24% year over year on 7% volume growth. The ordering base expanded to more than 39,000 clinicians and reimbursement improvements tied to biomarker legislation boosted average selling prices and revenue per test.

Gross Margins Support Ongoing Investment

Adjusted gross margin came in around 68.7% to 69% in Q1, roughly 20 basis points higher than a year ago and aligned with full‑year targets. This healthy margin profile gives Myriad room to continue funding commercial expansion and R&D while it works toward restoring consistent profitability.

Advancing Pipeline and New Product Launches

Management spotlighted multiple pipeline milestones, including an alpha launch of Precise MRD for breast cancer in March that is showing promising early adoption and assay performance. Prolaris+AI remains on track for a June debut, while FirstGene prenatal testing is in early access with strong CONNECTOR trial enrollment and a full launch planned for the second half of 2026.

Commercial Build‑Out to Power Back‑Half Growth

The company has expanded its commercial team by more than 100 account executives year over year to support its broader portfolio. Myriad plans to commit roughly $35 million over the next several years to commercial capabilities, demand generation, and launch execution, aiming to drive a meaningful revenue acceleration in the back half of the year.

Operational Discipline and Balance Sheet Flexibility

Operationally, MRD assay yields and turnaround times are tracking to internal expectations, helping de‑risk upcoming launches. The company reported access to $199 million in capital and reaffirmed its adjusted EBITDA target of $37 million to $49 million for 2026, underscoring balance sheet capacity to fund current growth plans.

Improving Average Revenue Per Test

Average revenue per test improved about 2% year over year in Q1, helped by mix shift toward hereditary cancer and better GeneSight reimbursement. This pricing tailwind, while modest, adds incremental leverage on top of volume growth and supports the gross margin outlook.

Profitability Shortfall and Seasonal Cash Burn

Despite topline progress, Myriad posted an adjusted EBITDA loss of roughly $4.5 million to $5.0 million and an adjusted EPS loss of $0.09 in Q1. Management emphasized that the first quarter is typically the heaviest cash burn period and that accelerated commercial spending weighed on near‑term profitability by design.

Prenatal Segment Under Pressure

The prenatal business remained a weak spot, with revenue of $41.9 million down 15% year over year and test volumes lower versus the prior year. Although sequential volumes improved, management pointed to disruptions from a new ordering system that led to lost accounts, and the recovery trajectory in this segment remains uncertain.

Higher Operating Expenses Weigh on Earnings

Adjusted operating expenses rose by about $8 million year over year in Q1, primarily reflecting targeted investments in commercial expansion and R&D. While these costs pressured earnings in the near term, management framed them as necessary to unlock the next leg of growth across oncology, mental health, and reproductive testing.

ASP Outlook Includes Ongoing Headwinds

While Q1 saw an uptick in average selling prices, Myriad reiterated expectations for modest longer‑term ASP headwinds as payers continue to scrutinize diagnostics spending. The company views recent reimbursement wins as incremental but cautioned that sustained improvement will require continued payer engagement and evidence generation.

Sales Ramp and MRD Adoption Risks

With more than 100 new account executives added, management acknowledged that it will take several quarters before the salesforce reaches full productivity, creating timing risk around the anticipated back‑half revenue surge. Early Precise MRD feedback is encouraging, but broader MRD adoption, especially in community oncology and reimbursement, is still in the early innings and represents a key execution swing factor.

Guidance and Outlook Emphasize Back‑Half Acceleration

Looking ahead, Myriad reaffirmed its full‑year revenue guidance of $860 million to $880 million, gross margin of 68% to 69%, and a path toward positive adjusted EBITDA. Management expects low single‑digit sequential revenue growth in Q2 with momentum building into the back half, supported by hereditary cancer strength, GeneSight growth, commercial ramp, and upcoming launches in Prolaris+AI and MRD.

Myriad’s earnings call painted a picture of a diagnostics company leaning into growth despite short‑term profit pressure and prenatal softness. For investors, the core story hinges on whether robust hereditary cancer and GeneSight trends, coupled with new product launches and commercial investments, can translate into sustainable top‑line acceleration and a return to meaningful adjusted EBITDA over the next two years.