Myriad Genetics Earnings Call Highlights Growth Amid Headwinds

Myriad Genetics ((MYGN)) has held its Q4 earnings call. Read on for the main highlights of the call.

Myriad Genetics’ latest earnings call struck an upbeat tone, as management highlighted revenue ahead of guidance, accelerating test volumes in key franchises, and a return to profitability in the fourth quarter. While executives acknowledged meaningful payer and product‑line headwinds, they argued that operational execution and a deep product pipeline leave the company well positioned for its 2026 targets.

Revenue Beats Cap a Strong 2025

Myriad reported fourth‑quarter 2025 revenue of $209.8 million, edging above the high end of its preannounced range and underscoring solid year‑end momentum. For the full year, revenue reached $824.5 million, giving investors evidence that the company’s multi‑year turnaround is translating into sustained top‑line growth.

Test Volumes and Provider Reach Keep Expanding

The company delivered roughly 382,000 test results in the fourth quarter and more than 1.5 million reports across 2025, reflecting broad demand for its diagnostics portfolio. Myriad also emphasized its expanding commercial footprint, serving more than 55,000 health care providers over the year, a key driver for future volume growth.

Hereditary Cancer Franchise Delivers Solid Growth

In hereditary cancer testing, Myriad’s MyRisk platform posted robust gains, with oncology volumes up 14% in the affected population and 11% in the unaffected group year over year in the quarter. Overall hereditary cancer testing grew 9% in Q4 and 7% for the full year, reinforcing this business as a core growth and profit engine.

Prolaris Sees Accelerating Momentum

Prolaris, the company’s prostate cancer test, continued to ramp after recent commercial investments, with revenue up 16% year over year in the fourth quarter. That growth was fueled by a 12% increase in test volumes, suggesting the product is gaining traction among urologists and oncologists as awareness and adoption improve.

GeneSight Rebounds Despite Payer Pressure

GeneSight, Myriad’s pharmacogenomic test for mental health, returned to growth, with Q4 volume up 9% and revenue of $36.6 million, supported by a record base of more than 38,000 ordering clinicians. Management also pointed to positive coverage policies from 12 payers in 2025, including a large state program, which they see as validation of the product’s clinical and economic value.

Profitability and Cash Generation Strengthen

The company delivered a roughly 70% adjusted gross margin in Q4, with adjusted EBITDA of $14.3 million and adjusted earnings per share of $0.04, marking a profitable quarter. Adjusted operating cash flow reached $17.9 million, and Myriad noted it still has access to $225 million in capital, giving it financial flexibility to fund its pipeline and commercial initiatives.

Pipeline and Roadmap Underpin Growth Story

Management laid out a busy product roadmap, including an expanded MyRisk panel launched in Q4 and an AI‑enhanced Prolaris test planned for the second quarter of 2026. The company will begin an alpha launch of its Precise MRD test for breast cancer at select centers and is preparing a commercial launch of its FirstGene test in the second half of 2026, all supporting reaffirmed 2026 financial guidance.

UnitedHealthcare Headwind Hits GeneSight Economics

A coverage decision from UnitedHealthcare weighed on fourth‑quarter results, with management citing an $8.1 million net impact tied to GeneSight. The move contributed to a roughly 2% decline in average revenue per test and added margin pressure, underscoring the broader reimbursement risks that accompany payer negotiations.

Margin Compression and ASP Pressure Seen Continuing

Adjusted gross margin declined about 190 basis points year over year in Q4 to roughly 70%, as mix and pricing dynamics offset volume growth. Executives cautioned that a modest enterprise average selling price headwind of about 1–2% is likely in 2026, driven by payer mix and changes in biopharma revenue rather than broad cuts to contracted rates.

Prenatal Business Rebuilding After System Disruption

Myriad’s prenatal segment remains under pressure, with fourth‑quarter volume down year over year following a Q2 order‑management system disruption that strained customer relationships. Management described the business as being in a rebuild phase and warned that prenatal volumes will likely decline again in the first quarter of 2026 before showing improvement in the second quarter.

MRD Launch Will Be Strategic, Not Revenue‑Driven

The company is moving ahead with an alpha launch of its Precise MRD test for breast cancer, but stressed that the rollout will be carefully paced and limited to select centers. Executives said they expect little to no revenue contribution from MRD in 2026, given uncertainties around reimbursement reviews and payer coverage decisions that largely fall outside their control.

Near-Term Profitability Pressure from Q1 Dynamics

Looking to the first quarter, management expects adjusted EBITDA to be near breakeven, citing multiple temporary headwinds. Deductible resets, continued prenatal softness, normal seasonal patterns, and a modest step‑up in operating expenses as part of more than $35 million in planned investments will all weigh on margins in the near term.

ASP and Payer Mix Shape Revenue Per Test

Despite solid volume growth across the portfolio, Myriad’s average revenue per test fell about 2% in the fourth quarter, reflecting shifting payer mix and lower biopharma revenue. The company reiterated that contracted pricing remains largely stable but warned that these mix effects are likely to keep ASP trends slightly negative in 2026.

Learning from Operational Missteps

Management openly acknowledged that a self‑inflicted ordering and system error in the second quarter created friction with prenatal accounts and contributed to current headwinds. The team outlined process changes, including tighter pre‑launch testing and go‑live controls, as it works to rebuild trust with clinicians and prevent a repeat of the disruption.

Guidance Reaffirmed Despite Headwinds

Myriad reaffirmed its full‑year 2026 outlook for revenue of $860 million to $880 million, adjusted gross margin of 68–69%, and adjusted EBITDA of $37 million to $49 million, signaling confidence in its growth trajectory. For the first quarter of 2026, the company guided to revenue of $200 million to $203 million, up 2–4% year over year, and reiterated that MRD will contribute minimal revenue while it deploys more than $35 million of investments to support upcoming launches.

Myriad’s earnings call painted a picture of a diagnostics company balancing strong growth in core oncology and mental‑health testing against real but contained reimbursement and operational challenges. With revenue and volumes trending higher, a clear product roadmap, and guidance reaffirmed, management argued that the long‑term story remains intact even as investors brace for margin and prenatal headwinds in early 2026.