Myriad Genetics (NASDAQ:MYGN) reported second-quarter 2026 revenue of $190.7 million, down 11% from a year earlier, as a 1% decline in total test volume and a 9% decrease in revenue per test weighed on results. The company lowered its full-year revenue and gross-margin outlook and suspended adjusted EBITDA guidance amid reimbursement pressure and uncertainty surrounding a broad organizational efficiency initiative.
Chief Executive Officer Sam Raha said the quarter included solid demand in the company’s Cancer Care Continuum and mental health portfolios, where test volumes rose 6% and 4%, respectively. Those gains were offset by a 9% decline in prenatal testing volume.
Reimbursement Pressure Drives Guidance Cut
Myriad lowered its 2026 revenue guidance to $770 million to $790 million and projected gross margin of 66% to 67%. At the midpoint, the revenue outlook represents a $90 million reduction from its previous forecast, Chief Financial Officer Ben Wheeler said.
The company cited weaker-than-expected prenatal volume, lower reimbursement levels in hereditary cancer testing, and final resolution of GeneSight accounts receivable as primary reasons for the revision. Management expects third-quarter revenue to be flat to slightly above the second quarter, followed by improvement in the fourth quarter.
Myriad suspended its adjusted EBITDA guidance because the timing and financial effects of its initiatives remain uncertain. The company posted an adjusted EBITDA loss of $16.9 million in the second quarter and an adjusted loss per share of $0.25.
Gross margin was 66.6%, down about 460 basis points year over year. Excluding the $11 million impact from revenue changes in estimate, gross margin would have been 68.4%, Wheeler said. The company ended the quarter with approximately $190 million in available liquidity.
Raha said payer-related revenue-cycle friction became more aggressive during the quarter, particularly for the MyRisk hereditary cancer panel. The pressure included changing prior-authorization requirements, increased medical-record requests and higher denial rates from a limited number of payers. He said the changes did not reflect shifts in medical policy or the clinical value of the tests.
Management said its revised outlook assumes no recovery in average revenue per test from second-quarter levels. Wheeler said reimbursement friction is expected to remain a headwind through the remainder of 2026, although the company does not expect the magnitude of the second-quarter impact to recur.
Company Launches Reimbursement and Efficiency Initiatives
Myriad is implementing revenue-cycle changes intended to improve collections and reduce administrative burdens. These efforts include enhanced coverage verification and prior-authorization workflows, integration with third-party medical-record repositories, and AI-enabled processes for document classification, denial triage, appeals and payer-response management.
The company also launched a payer-by-payer market-access initiative for MyRisk, focused on policy engagement, laboratory-benefit-manager collaboration and reimbursement optimization.
Separately, Myriad has begun an initiative called Ascend, supported by a professional services firm, to assess the company’s organizational structure, operating model and core processes. Raha said the initiative is designed to improve efficiency, productivity and scalability, with meaningful profitability benefits expected in 2027 and beyond.
Management is also conducting a portfolio review to determine the optimal allocation of capital and evaluate actions that could improve shareholder value. The company did not provide a timetable for either the Ascend initiative or the portfolio review.
Cancer Care Results and Product Progress
The Cancer Care Continuum business generated second-quarter revenue of $114.1 million, down 11% year over year. Test volume increased 6%, but average revenue per test declined 15%.
Hereditary cancer testing volume increased 8%, while MyRisk volume grew 10%. Brian Donnelly, Myriad’s chief commercial officer, said testing among unaffected patients delivered its strongest quarterly performance in three years.
During the quarter, Myriad launched Prolaris + AI, an AI-enhanced prostate cancer test combining molecular, AI, biomarker, germline and genomic insights. Donnelly said early feedback from urologists has been positive, particularly for use in active-surveillance decisions.
The company also expanded availability of its Precise MRD test for patients with breast, colorectal and renal cancers and submitted its breast-cancer indication to MolDX for a coverage determination. Myriad said it remains on track for a full commercial launch of Precise MRD in 2027.
Donnelly said the company has seen a growing number of clinicians and sites use Precise MRD, including repeat orders from some providers. Myriad is continuing to improve digital ordering capabilities and customer workflows based on feedback from early users.
Myriad also said it hired, trained and deployed more than 100 new account executives, primarily for the Cancer Care Continuum portfolio. The company expects those hires to begin contributing more meaningfully to volume growth in 2027 and beyond.
Prenatal and Mental Health Performance
Prenatal health revenue was $40 million, down 16% year over year, reflecting a 9% volume decline and an 8% decrease in revenue per test. Donnelly attributed the performance to factors including the timing of the sales-force expansion and competitive dynamics.
The company’s dedicated prenatal sales team is now fully staffed. Myriad commercially launched FirstGene during the quarter, offering simultaneous screening of carrier status, fetal single-gene conditions, fetal chromosome status and fetal RHD status in one report. Management said early customer feedback has highlighted the product’s single-gene and RHD components as well as its turnaround-time characteristics.
GeneSight, Myriad’s mental health test, generated $36.8 million in revenue, down 3% year over year despite 4% volume growth. The business was affected by the aged-receivables write-off, although management said reimbursement trends in mental health have improved with increased payer coverage and biomarker legislation. GeneSight reached more than 40,000 ordering clinicians during the quarter, a record high for the business.
About Myriad Genetics (NASDAQ:MYGN)
Myriad Genetics (NASDAQ: MYGN) is a molecular diagnostics company that develops and commercializes genetic tests designed to assess an individual’s risk for various hereditary conditions and to guide personalized treatment decisions. The company’s core business centers on predictive medicine, with a focus on hereditary cancer risk assessment through its flagship BRACAnalysis® test for BRCA1 and BRCA2 gene mutations. In addition to oncology, Myriad offers tests in women’s health, neurology and pharmacogenomics to support more informed clinical decision-making.
Among its product offerings are the myRisk® Hereditary Cancer test, which screens for mutations across multiple cancer-related genes, and Prequel®, a non-invasive prenatal test for assessing fetal chromosomal abnormalities.
