Myriad Genetics Comments on UnitedHealthcare’s Updated Medical Policy for Pharmacogenetic Testing
Rhea-AI Summary
Myriad Genetics (NASDAQ: MYGN) responds to UnitedHealthcare's decision to restrict access to multi-gene panel pharmacogenetic tests, including GeneSight, under commercial and individual exchange benefit plans effective January 1st, 2025. The company strongly disagrees with UnitedHealthcare's assessment of insufficient evidence for GeneSight's efficacy. The policy change does not affect Medicare Advantage and managed Medicaid plans. GeneSight, approaching 3 million tests to date, is used for medications prescribed for depression, anxiety, ADHD, and other psychiatric conditions. Myriad is actively engaging with UnitedHealthcare to maintain enrollee access and will discuss financial implications in their upcoming Q3 2024 earnings call.
Positive
- GeneSight test has reached nearly 3 million tests performed
- Coverage under Medicare Advantage and managed Medicaid plans remains unaffected
- Recent favorable coverage determinations from other health plans
Negative
- UnitedHealthcare restricting access to GeneSight test from January 1st, 2025
- Potential negative impact on revenue from commercial and individual exchange benefit plans
- Major insurance provider questions test's efficacy
Insights
This policy change by UnitedHealthcare represents a significant setback for Myriad Genetics' GeneSight test coverage. The restriction affects commercial and individual exchange plans starting January 1st, 2025, though Medicare Advantage and Medicaid plans remain unaffected. The timing and scope of this decision are particularly concerning as GeneSight has reached nearly 3 million tests to date.
The immediate financial impact could be substantial given UnitedHealthcare's market position as one of the largest private insurers. The policy change may trigger a domino effect, potentially influencing other commercial insurers' coverage decisions. However, recent favorable coverage determinations from other health plans and state biomarker legislation provide some counterbalance.
The market implications extend beyond immediate revenue impact. With 70-75% of antidepressants prescribed in primary care settings, this policy change could significantly affect Myriad's market penetration strategy. The company's strong response and immediate engagement with UnitedHealthcare suggest they anticipate material financial consequences. Investors should closely monitor the upcoming Q3 earnings call for detailed financial impact assessment and mitigation strategies.
SALT LAKE CITY, Nov. 04, 2024 (GLOBE NEWSWIRE) -- Myriad Genetics, Inc., (NASDAQ: MYGN), a leader in genetic testing and precision medicine, was informed on Friday, November 1, 2024, of an updated medical policy from UnitedHealthcare restricting access to multi-gene panel pharmacogenetic tests, including Myriad’s GeneSight test, under its commercial and individual exchange benefit plans, effective January 1st, 2025.
After initial review of the updated policy, the company strongly disagrees with UnitedHealthcare’s inclusion of GeneSight in its decision to change its coverage policy of multi-gene panels based on its rationale that there is insufficient evidence of efficacy to support coverage of GeneSight. Myriad is actively engaging with UnitedHealthcare to discuss the large body of evidence for Myriad’s proprietary and clinically differentiated mental health medication test, GeneSight, and is seeking to ensure that enrollees continue to have access to the test.
“We are surprised and disappointed by UnitedHealthcare’s actions and reaffirm our conviction in the clinical validity and utility of GeneSight, which we believe is supported by clinical evidence, including peer-reviewed research studies,” said Paul J. Diaz, President and CEO, Myriad Genetics. “We are amidst an ongoing mental health crisis and the primary care setting is where 70
The company does not believe that the updated policy affects coverage of GeneSight by UnitedHealthcare under Medicare Advantage and managed Medicaid plans. Myriad remains encouraged by recent favorable coverage determinations of other health plans for GeneSight based on its clinical validity and utility and state biomarker legislation. The company has no reason to believe that UnitedHealthcare’s position on this topic impacts any other existing or previous coverage determinations for GeneSight.
The company is scheduled to hold its third quarter 2024 earnings conference call after the market closes on Thursday November 7, 2024, and intends to provide additional information regarding its engagement with UnitedHealthcare and its initial views on the potential financial ramifications to the company of this policy change.
About the GeneSight Test
The GeneSight Psychotropic test from Myriad Genetics is the category-leading pharmacogenomic test for more than 60 medications commonly prescribed for depression, anxiety, ADHD, and other psychiatric conditions. The GeneSight test can help inform clinicians about how a patient’s genes may impact how they metabolize and/or respond to certain psychiatric medications. Tens of thousands of clinicians have ordered the GeneSight test for almost three million patients in order to receive genetic information that is unique to each patient. The GeneSight test supplements other information considered by a clinician as part of a comprehensive medical assessment. The clinical validity, clinical utility and economic utility of the GeneSight test have been evaluated in multiple peer-reviewed publications. Learn more at GeneSight.com.
About Myriad Genetics
Myriad Genetics is a leading genetic testing and precision medicine company dedicated to advancing health and well-being for all. Myriad develops and offers genetic tests that help assess the risk of developing disease or disease progression and guide treatment decisions across medical specialties where genetic insights can significantly improve patient care and lower healthcare costs. For more information, visit www.myriad.com.
Safe Harbor Statement
This press release contains “forward-looking statements” within the meaning of the Private Securities Litigation Reform Act of 1995, including statements related to Myriad’s engagement with UnitedHealthcare and seeking to ensure that enrollees continue to have access to the test. These “forward-looking statements” are management’s expectations of future events as of the date hereof and are subject to known and unknown risks and uncertainties that could cause actual results, conditions, and events to differ materially and adversely from those anticipated. Such factors include those risks described in the company’s filings with the U.S. Securities and Exchange Commission, including the company’s Annual Report on Form 10-K filed on February 28, 2024, as well as any updates to those risk factors filed from time to time in the company’s Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. Myriad is not under any obligation, and it expressly disclaims any obligation, to update or alter any forward-looking statements, whether as a result of new information, future events or otherwise except as required by law.
1 Majtabai R, et al. J Clin Psychiatry. 2008 Jul;69(7):106574.
Investor Contact
Matt Scalo
(801) 584-3532
IR@myriad.com
Media Contact
Glenn Farrell
(385) 318-3718
PR@myriad.com
FAQ
When will UnitedHealthcare's restriction on Myriad Genetics (MYGN) GeneSight test begin?
How many GeneSight tests has Myriad Genetics (MYGN) performed to date?
Which insurance plans will still cover Myriad Genetics (MYGN) GeneSight test?
What conditions does Myriad Genetics (MYGN) GeneSight test cover?
