Myriad Genetics, Inc. (MYGN) Earnings Call Transcript & Summary

June 12, 2024

NASDAQ US Health Care Biotechnology conference_presentation 34 min

Earnings Call Speaker Segments

Matthew Sykes

analyst
#1

Thanks for joining us today. I'm Matt Sykes, Life Science Tools and Diagnostics Analyst at Goldman Sachs. I have the pleasure of hosting Myriad Genetics this afternoon. I've got Paul Diaz, President and CEO; and Scott Leffler, CFO. Paul, Scott, thanks for joining me today.

Paul Diaz

executive
#2

Thank you.

Scott Leffler

executive
#3

Thank you.

Matthew Sykes

analyst
#4

Maybe we'll just start off sort of, Paul, as you said in the stage, you're coming off to a really great start to the year. Maybe just talk a little bit about what drove that strong start? And how you see things progressing over the second quarter and the course of this year?

Paul Diaz

executive
#5

Well, thank you. Great to be here. It's really a progression. I think what you're seeing is a lot of hard work from our team coming together. I think customers really embracing our value proposition. We saw that at ASCO last week among new customers and existing customers and really building off of the last 2 years, quite frankly. And so organic growth across all our products, really strong ASP, good management of cost, even as we're investing in R&D and our tech build. And I think that we're going to build off of this Q1 momentum, the balance of the year.

Matthew Sykes

analyst
#6

Got it. And if you keep up this growth throughout the year, it seems like there could be some upside to the guidance. Are there any kind of offsets or headwinds we should think about? Or is this just sort of a measured approach and what is still kind of uncertain time?

Paul Diaz

executive
#7

Yes, I was joking around with friends, 84 quarters as a public company CEO, taught me never to raise guidance after Q1. And so I think measured as appropriate. We're going through still our Lab of the Future and transitioning products to new labs and new sequencing technology, and there's a lot of volatility in the marketplace. . But as we sit here today, I think the road is pretty clear for us. We don't see any headwinds and in fact, see building momentum and tailwinds. And so it just seems prudent not to get ahead of ourselves and hopefully be in a position to continue to beat and think about raising later.

Matthew Sykes

analyst
#8

Got it. When you think about sort of the durable higher organic growth that you guys have generated pretty consistently now. And I think investors are starting to see that and the evidence of that happening. Can you just talk about sort of the room to run in each -- at a very high level in each of your 3 segments, women's health, oncology and mental health, maybe some quick points on each where you really kind of want to highlight the strength and what could continue that durability?

Paul Diaz

executive
#9

Yes. So a lot of questions when I joined the company about the durability of hereditary cancer testing and the profile, both in terms of growth, the competitive landscape and pricing. And I think we've demonstrated that there is expanding use cases for hereditary cancer testing across a number of indications. We have seen that our -- myRisk with risk score is a differentiated hereditary cancer test and that has demonstrated itself in terms of ASP as well. Similarly, I think that the GeneSight has shown itself to be a resilient product and one that is addressing the mental health crisis in America. And we've seen great growth in prenatal, our product lines there. And so I think the piece that I'm most excited about going forward is the ability to address the key issues that our customers are telling us. They want differentiated clinical products. They want fast turnaround time. They want ease of use in terms of ordering and reporting. They don't want to work in 4 or 5 different labs for different products. So they want a comprehensive set of services. And we came out of ASCO last week with a great deal of energy around Precise Tumor and the launch of precise liquid and the evidence that we're building on MRD. And so we think that we're going to be continuing to come to market with Firstgene and our precise products to really address what a community oncologist need to care for patients. And that -- and to be able to do that in a more efficient way, I think, will create a lot of value for shareholders as well.

Matthew Sykes

analyst
#10

Got it. Maybe we drill down a little bit on hereditary cancer because it's been a nice growth driver for you. You talked about the competitive landscape. But maybe talk a little bit about sort of the additional potential for share gains in hereditary cancer and sort of what the level of runway there is in that business. I agree with you. I think it's -- it gets a bad rap for being commoditized and to mature and yet it continues to grow. There's clearly a tailwind from some market share gains you're doing. But I'm just curious in terms of like as you see that kind of happening, how long do you think you have that sort of share gain story to play out? And what's sort of the duration and durability of that growth?

Paul Diaz

executive
#11

So I think that the share gains are just starting to emerge. These things take time. Hereditary cancer testing is not first of mind for a community oncologist or an OB/GYN. We've talked about the unaffected population of Americans, both men and women that meet guidelines for hereditary cancer testing. So our breast cancer risk assessment program, what we're doing with Prolaris and urology channel. So I think the market growth is a lot bigger than people think. And I think that our ability to gain share in a consolidating market among 3 or 4 other players, all of which will probably gain share at the expense of a lot of smaller LDTs that are going to be under pressure because of cash and regulation and other things. So the transition, though, takes longer than I think people realize that from the beginning of a customer engagement, thinking about some of the transactions that are happening and thinking about their alternatives to converting that customer into our system and issuing a report and a bill, that could be a 6-month journey. And so I think that's just starting to kick in.

Matthew Sykes

analyst
#12

Got it. And just curious, is there any -- given the sort of the competitor that came out of the market, there tend to be some irrationality in pricing. Have you seen a price benefit? We really don't talk about price benefit in diagnostics, but just how has the market dynamics and pricing changed?

Paul Diaz

executive
#13

Yes. So Scott can add to this. But it's interesting, we have not seen as much pricing pressure from the payers here recently. I mean we typically see and historically -- and this sort of seems strange to me given the price that the challenge that the payers are having right now, particularly Medicare Advantage. But I think the instability in the marketplace has given some of the payers a little pause. And part of the tailwind we have in ASP right now is we're not seeing sort of -- maybe we're too conservative, but some of the pricing that we modeled in. And so we think that those trends will continue. But Scott, maybe you can add some color.

Scott Leffler

executive
#14

Yes, absolutely. And just to remind everyone, we reported 12% organic revenue growth in Q1 and that included a 2% lift from ASP contribution, which is different from what we have historically expected. And the great thing about what you saw in Q1 is that the drivers there were very much Myriad specifically. We've been talking for a while about efforts and investments that we've been making in our revenue cycle management, whether it's more strategic energies around engaging with payers around medical policy and things like that or more tactical frontline efforts, such as making sure that we have all of our prior authorization capabilities in place in order to comply with time lines. And so in that way, we were able to generate some incremental lift. But on top of that now to have this opportunity from kind of the evolution of the competitive landscape, we really see an opportunity where there's going to be an alleviation of some of the historical pressure around ASPs, and we think that gives the opportunity for incremental and sustainable lift over time.

Paul Diaz

executive
#15

I actually think that maybe in contrast to some of my competitors, I don't think this is a zero-sum game. I think this is a tide that can lift all the boats, and I think you're seeing many of the companies improve ASP. I think that will continue. I think that's good for the industry. And certainly, we're seeing that, and we think we'll continue to see that as the industry consolidates. So I think that's good for everybody.

Matthew Sykes

analyst
#16

Scott, I want to follow up on the revenue cycle management comments you made, because I remember years ago, you guys were talking about it and nobody else really was, and now everyone is talking about revenue cycle management. And I think that it often seems like it's sort of an event, but it's actually a process and just continues. So like when you think about sort of additional upside you can get from revenue cycle management, I know it continually evolves. But where do you think you are in terms of getting to sort of the goal that you had when you first sort of established revenue cycle management? How much more is there to go?

Scott Leffler

executive
#17

Well, first of all, I give Paul some credit for several years ago for having prioritized efforts around this as part of the company's broader strategic prioritization of profitable growth and obviously getting paid on the test that you're running, is a critical element of that. But I would say, overall, as a company, we're still hovering around that 45% to 46% pay rate that we've talked about in the past. And so there is just absolutely a ton of runway there and not to take away from the very successful efforts of the team to date, but there's just a lot more opportunity that they're continuing to drive.

Matthew Sykes

analyst
#18

Got it.

Paul Diaz

executive
#19

So every 1% is $8 million to the bottom line. So this is very high on our priorities. We want to maintain access for patients. So we're not going to keep people from having necessary clinical information to treat. But I think the industry is coming around to -- we can't be giving away test for free either. And nobody else in health care does that. And so there's a lot of runway here still left.

Matthew Sykes

analyst
#20

Got it. Switching to GeneSight, you've shown really solid volume growth in GeneSight over the last few years, more recently increasing traction on ASPs. Can you just talk about the opportunity that remains there from a growth perspective as well as on the coverage side? And kind of how are you driving progress in those areas?

Paul Diaz

executive
#21

Yes. Really excited about the progress that the GeneSight team is making. Look, we have a huge mental health crisis in America. This is GeneSight proving itself to be a tool to help people get on the right medications faster and that makes a difference for anybody who's had a family member with -- struggling with severe depression and anxiety. Our #1 customer there, nurse practitioners are the front line of health care today in America. And as we've talked about, 4,000 or 5,000 new prescribers every quarter, we're adding. So markets 15% penetrated. So there's a lot of runway for GeneSight to continue to grow. On the payer coverage standpoint, the biomarker laws, we're really getting some traction there. California goes in place on July 1. So right now, we're very actively engaged with the plans in California to expand coverage to GeneSight among the Blues plans and [ MedikAll ] and others, those efforts have continued in Arizona and other states. So it is giving us the ability to really engage with payers at a different level and whether it's through the governor's office or through the state insurance commissioners. The thing that I would point out a little bit is I think you're going to see a little bit of a slowdown in the volume of GeneSight while you continue to see ASPs grow. And the reason for that is everybody is on a revenue-based commission plan now. And so our teams, our sales folks are really working with Scott's rev cycle teams to make sure that we're educating our customers about the need to get prior offs, the needs to make sure we have coverage when possible. And not to deny care, but to make sure that we're getting paid. And so you've seen and we'll continue to see, I think, a nice drop in no pay for GeneSight. Net-net, that's highly accretive to earnings and cash flows. But as the team gets a little pickier on which customers we're targeting and those kind of things, you may see that 20% growth in GeneSight slow down a little bit, but the revenue growth should be more than make up for that.

Matthew Sykes

analyst
#22

Okay. And that's more of just sort of the structural nature of the incentives versus some temporary?

Paul Diaz

executive
#23

It's amazing when [Audio Gap] so we're seeing the right behaviors and the team working together in a way that they hadn't before. That's a credit to Mark and the whole team.

Matthew Sykes

analyst
#24

And that's kind of in line with the way you've been treating your other markets where there's [Audio Gap] necessarily profitable or as good. And so it's not unique to the mental health category, it's just more about the...

Paul Diaz

executive
#25

Correct. And I think you've seen some of our other competitors be more thoughtful about that, too. I think there's a -- the whole industry is undergoing, as you described earlier, a stage of maturity. And I think that's good for everybody. And -- but it also means that a combination of financial pressures, regulatory pressures, and the importance of getting to scale would mean that a lot of the smaller players will probably not be able to move forward. And I think that, again, bodes well for us and the 3 or 4 other larger, more scaled players in the industry.

Matthew Sykes

analyst
#26

Got it. And do you think you need to provide an additional clinical data for increased coverage for GeneSight or you kind of have -- we need -- I know the biomarker builds are a big tail.

Paul Diaz

executive
#27

No, no. Look, I think it's incumbent upon us to continue to build the [Audio Gap] products all the time. So I think one of the things that we've done is develop a deeper product management cycle for all of our existing products and all our new products. For new products, we're not going to go to market without a line of sight on getting paid. Similarly on existing products, we need to continue to build the body of clinical evidence to be differentiated. And that's going to be important in the regulatory environment with FDA and others. So I think we're continuing to invest incrementally in getting Prolaris to Level 1 to continue to build a body of evidence for GeneSight. We had a nice readout from Optum Genomics on GeneSight in terms of clinical utility, but there's more work to do there to keep solving to the proof points that some people are concerned about.

Matthew Sykes

analyst
#28

Got it. Shifting to Prenatal, you saw really good sequential growth there to start the year and continued ASP improvements seems to be a trend. I'm talking about. Do you have any update on market share in that segment as you're going to continue to take advantage of some of the dislocations there?

Paul Diaz

executive
#29

Yes. I think that's where you're starting to see, as we talked about more of the early ones. So if you think about the market disruptions at Sema4 and Invitae earlier this year. When Invitae sadly, unfortunately, was getting out of prenatal earlier this year. So you've seen those market share gains start coming to us. I mean, you've seen it come into others too. The [ Teva ] has picked up a lot of share, too. I think we've picked up good share and the right share, and I think you'll see a continued acceleration of volume [Technical Difficulty] and prenatal, and that's what we're seeing. And so I -- my hats off to Melissa and the team. And keep in mind that the profit center there is hereditary cancer in that channel, which we have uniquely I think, positioned ourselves with folks. And so really excited about Melissa's leadership and of our women's health group and a lot of opportunities still there.

Matthew Sykes

analyst
#30

Got it. And you've been clear in the past and today, and you're focused on profitable growth and are waiting to release the Foresight Universal Plus...

Paul Diaz

executive
#31

[indiscernible] last week.

Matthew Sykes

analyst
#32

Yes, okay. I'm sorry. Certainly not, as we were preparing for the conference. But you had mentioned the strong path to payment via guideline inclusion. And so maybe just talk about [Technical Difficulty] there.

Paul Diaz

executive
#33

I lost this one. I was -- I wanted to launch a Foresight Universal Plus until we actually had a cut [Audio Gap] our competitors like to kind of use anything that they can [Technical Difficulty] differentiate with. So I became convinced that we needed to demonstrate to our existing customers and new customers that we were going to be right there when guidelines are expanded. . And so yes, we're excited. It's a soft launch of Foresight Universal Plus, but it's out there. It's available. It's got all the genes that we expect ACOG to ultimately adopt that are all in ACMG. And we wanted to run it -- start running it commercially through the labs as well. So once ACOG guidelines expand, we're going to be right there, and nobody can make the claim that we're not where we need to be.

Matthew Sykes

analyst
#34

What is your expectation for ACOG guideline inclusion at this point? I know you've been very conservative about how you've thought about that...

Paul Diaz

executive
#35

I mean it's a great lift for the sector. This is again is one of the tide that lifts all the boats. It is rumored to be in final review and it could be over the next 60 to 90 days. And the real key here, Matt, I think, is coverage. And we recently hired Dr. Gina Moore, who's an MD, OB/GYN, who's spent the last 15 years at Elevance and United and other payers. She's running point on making sure that the minute ACOG guidelines come out that were in front of the payers to expand coverage and make sure that they [Audio Gap] that's a little bit of again, how we're changing our go to [Audio Gap] payers at the same time we're going to market with the docs. And so Dr. Moore is going to be a great asset to Chris and the team there. Just an illustration of both. But the coverage will take longer. It's not like ACOG is going to issue guidance and the players are going to all jump up and say, I can't wait to cover that. That's not exactly how this works. So -- but I do think we can shrink what used to be 12 to 18 months to hopefully 6. So maybe early next year, we get the $10 million to $20 million bump that this could be.

Matthew Sykes

analyst
#36

Got it. We talked about the sales force incentives, and I think a lot of that trend is probably going to have an impact on no pays at some point over time. And you've also talked about not really trying for sales force additions in 2024. Maybe just talk about how you're driving increased productivity with the existing sales force that you have and certainly as you prepare for additional product launches.

Paul Diaz

executive
#37

It's something I get very excited about, but we'll let Scott take this one.

Scott Leffler

executive
#38

Well, I mean, the tools that we've implemented in terms of the CRM capabilities for the team in order to make sure that we have the most efficient deployment of the sales team, really, I think, is the #1 driver of efficiency over time. The leadership in terms of span of control across the organization that I know that Mark and Paul have been working on over time does result in the right structure in terms of delivering the optimal return on that investment.

Paul Diaz

executive
#39

It's not lost on you, but lost on some folks on the sell side. We grew 9% in '22. We grew 11% in '23, and we're going to do 12% plus this year. That's the trajectory that we're on, and we've done that with no additions to the sales force. So productivity is way up. We're using digital tools. We're actually using Salesforce the way it was intended to be used. As we launch new products, we'll probably have more medical affairs support to help people understand the products and guide people through that, but very committed and Mark has just done a phenomenal job on getting productivity up in our sales force. So that's the leverage in this model that needs to happen for everybody, quite frankly.

Matthew Sykes

analyst
#40

Yes. I mean it brings up an interesting topic of operating leverage in the diagnostics business model. I think given that there's just so few folks with actual operating margins is difficult to see, but I think the great fear is that $1 of sales and marketing spend equals just $1 in revenue and you can grow if you spend, but you guys have shown so far that there is [Technical Difficulty] operating. What do you think it is that you guys are doing to create that operating leverage that has sort of been a challenge for the sector overall?

Paul Diaz

executive
#41

Well, I may not be the innovator that some of my peers are, but I know how to drive a P&L. The P&L starts with how do you grow efficiently as we just discussed. ASP can drive a lot of gross margin expansion. And then Sam, who's been a great addition to the team, and our Lab of the Future operations really makes a difference. If you look at our cost of goods sold, they continue to kind of trend down even in an inflationary environment. And then you go further down the P&L, we've made important investments in technology and important investments in R&D, but we have found other places to find efficiencies to pay for it. So you're seeing tech and R&D investments grow 10% or 15% per year. But that means to hold the line at around 6% OpEx increase that we're saving money elsewhere, which is what you should be doing if you're a disciplined organization. So yes. I'm just excited about the discipline we brought across the P&L to the whole company and the opportunity that affords us to invest in our new product pipeline and continue to grow going forward.

Matthew Sykes

analyst
#42

Got it.

Scott Leffler

executive
#43

I would add to that, that we did add to our guidance for 2024 for the first time, guiding to an adjusted EBITDA range. We guided to an adjusted EBITDA range of $20 million to $30 million for the year. And I think in doing that, it really emphasizes, first of all, how far we come overall in terms of the profitability journey over the last couple of years. But in particular, it will make it that much more clear to our stakeholder is exactly how we're able to extract the type of leverage that we're talking about here.

Matthew Sykes

analyst
#44

And we spent a lot of time on one part of the gross margin equation in the ASPs. But which is what's discussed the last sort of the reduction in cost per test. And I think you guys have reduced these costs by about 8% last year. And so any more progress on that front? And how much room to grow is there on that in terms of further cost per test leverage?

Paul Diaz

executive
#45

I mean I caution absolutely, we think that over time, the automation and Lab of the Future our unified order management system that's going to begin to get rolled out this year means that we don't have to have sort of this linear growth of customer service and billing people, for example, or lab techs. And these are great folks and do great work. But right now, sustaining our volume growth means we've had to add more. That's the only place where we're adding physicians in the company right now, quite frankly, those areas. But the automation that we're putting in place, some of the AI tools that we're working on, we continue to partner with Bain and PwC and just being smarter about stuff, and those are great dollars. I think we're getting great returns on that investment. But we're also absorbing inflationary increases. There's a reason why 86% of our teammates just recently said we're a great place to work. Churn over is down [ 9% ] because we're trying to make sure we're paying people fairly. And health insurance costs were up 12%, wage rates 4%. So we got to cover those things. Even while we work with our suppliers and Sam is leading a great effort with Julia to -- for the first time, we're taking an enterprise approach to sourcing $200 million worth of spend. Who would have thought this would be like table stakes. But again, as some of the immaturity of these companies, things that you would think are routine like FedEx charges and reagents and all of the other things it's $200 million spend. And so Sam and the team are all over trying to up-level that and figure out how we can engage with our suppliers in a more systematic way. Those are all the things that hopefully can get us beyond 70%. But at this point, I don't think -- I think that's a pretty good margin if we can sustain a 70% margin. So we're going to hang on to that for right now.

Matthew Sykes

analyst
#46

And what benefit do you think you'll ultimately see from the investments you made in San Francisco and Salt Lake City in those labs automation? I know that's a long-tailed kind of investment to play out, but what do you kind of envision?

Paul Diaz

executive
#47

We're already seeing it. So the integration of Intermountain Precision Genomics that we just completed, we've already knocked 4 days of turnaround times off a Precise Tumor. Precise Tumor right now is growing at 184%. That's the number I saw this morning. And that's a small number that is going up, but it's pretty exciting. We had a big customer at ASCO tell us that they are ready to pair myRisk our hereditary cancer test, which they love and myChoice are HRD with Precise Tumor. And so we're really starting to make inroads on getting the comprehensive set of tests in the hands of folks. And part of the reason is they don't want to deal with multiple labs and have to reconcile discord in some own reports and outcomes. And so that's part of our value proposition. And I was just really excited coming out at ASCO that some new customers and some existing customers are starting to order Precise Tumor. And I think that bodes well for liquid and certainly bodes well for a precise MRD as we continue to march that forward. And I think we've got some good energy at ASCO around that part of our deal.

Matthew Sykes

analyst
#48

And just continuing on the margin piece, you just talked a little bit about investing a little bit more into R&D through the rest of 2024. Where are these dollars going? And what progress are you seeing there?

Paul Diaz

executive
#49

So we don't buy into that it's an arm's race about how many studies you have. I don't know how compelling it is to have a study with 50 patients in it. But I do think it's compelling to have the studies that we're talking about with Memorial Sloan Kettering and MD Anderson and others. So that notwithstanding, as I said before, we're playing catch-up in tech, the underinvestment in tech that happened in this company for over a decade. And we're -- we've made great progress. We went to ASCO with 7 posters and abstracts. But across every one of our products, we need to continue to invest in the clinical evidence base. And particularly, I think the industry [Audio Gap] and MRD is a perfect example of that. If we don't figure out how clinicians are going to use this in clinic and give rise to how a payer should pay for it over the course of treatment we're not going to get the full benefit of MRD. And so we are ramping up our studies across the portfolio, whether it's Prolaris or whether it's MRD, Firstgene. And so that's part of the investment. And the rest of the investment has a higher and quicker return the tech stuff, EMR integrations or the gift that gives back really quickly. So this customer that I mentioned, that's a very large oncology group basically said that we could see a significant increase in Precise Tumor testing if we built the tech lift in her EMR to do this. And so we committed to doing that by year-end, and that should bode well for Precise Tumor next year because they want that ease of use to be able to push the button on myChoice, push the button on myRisk and push the button on Precise Tumor.

Matthew Sykes

analyst
#50

Just in general, where are you, you think, on the EMR integration front? I mean are you kind of doing it project by project? Or is it more broad-based and kind of where are you?

Paul Diaz

executive
#51

It's definitely more broad-based. We've engaged PwC to help accelerate that. But we're still in the third inning of this, quite frankly. And I don't see how these folks in the synergy who are not investing in Epic, Flatiron integrations, Athena integrations are going to be able to do business. And it's millions of dollars of investment there. Just like it's millions of dollars of clinical studies. And again, I think you're seeing the companies that have made those investments like Natera and us start pulling away from folks, and I think that will continue.

Matthew Sykes

analyst
#52

Got it.

Paul Diaz

executive
#53

And exact as well because Kevin has done a lot of those investments.

Matthew Sykes

analyst
#54

You recently kind of reorganized European assets to allow you to focus on kind of more strategic initiatives. Are there kind of any other areas of the business that you still see opportunities for streamlining optimization?

Paul Diaz

executive
#55

None that are readily apparent. We really like the portfolio of products we have right now. Do we need to do more work to get Prolaris into a more competitive position with the Cipher? Absolutely. But we've got a great path there. EndoPredict is a good product and we've sat back and let Oncotype sort of take the market well. So I think we have opportunities there. So as we look at the portfolio, and you know we've divested a lot of stuff in the early years of the transformation. We kind of like the ability to organically grow. And it's a lot -- in my view, it's a lot better return on invested capital to figure out how we can get all of our products to their full potential than going out to try to buy stuff that's not fully tested and fully [ vetted and stuff ]. So bolt-on acquisitions may be part of our future. But right now, getting all of our existing products to their full potential, I think it creates the most value for patients and shareholders right now.

Matthew Sykes

analyst
#56

Got it. And then just digging into the pipeline a bit. Just talk a little bit about why your whole genome MRD product is potentially differentiated from the competition and kind of where you fit into that market ultimately?

Paul Diaz

executive
#57

Yes. I think if you're a clinician and a family and a patient and talking about deescalating care, whatever word choice you want to use, you're going to want to have a high level of sensitivity and specificity in terms of the results. You're going to want to have very low failure rates. And I think what we heard at ASCO from many, many clinicians and from our pharma partners where I think you're going to see more of our pharma arrangements. We put out on press release on our recent deal, but there will be more to follow that MRD is a big market, but I think a highly sensitive test is going to matter. And particularly, when you're talking about deescalation of care and one of your competitors did a KOL meeting not too long ago that us and personnels are really kind of called out as differentiated in the marketplace in terms of everybody else is thinking about MRD. We need to continue to make -- put out proof points of that. I think you'll see some readouts this fall from some of our studies. So it's not just the analytical validation work that we are doing but it is the work with others that is also validating the MRD test that we built on our platform. And again, we built -- Dale built MRD on the prequel circulating DNA platform with amplified that's highly differentiated and IP that dates back to 2016 in terms of that. And what we do with myChoice in terms of the FDA-approved tumor. And building on that platform and we look at the unit economics there, we think we're going to be highly competitive and what's going to be a big market and a great opportunity for patients. So we're really excited about MRD.

Matthew Sykes

analyst
#58

Can you talk a little bit about just to the extent the unit economics, I think people hear whole genome, I think it's more expensive cost to run when in fact, it might not be that case. Maybe the -- can you talk about the unit economics potentially?

Paul Diaz

executive
#59

Yes. I think at our next Investor Day, we were just going through these numbers. The incremental cost of the run is not as expensive. Dale was kind of taking us through that a couple of weeks ago in the way that we are running it right now and seeing it. So is it more expensive than [Audio Gap] but if you think about the industrialization of our whole platform and what I just talked about, putting this on an existing platform, that is FDA approved, and we're not outsourcing any of this to anybody. I think our prospects of the unit economics here are quite -- going to be quite compelling.

Matthew Sykes

analyst
#60

And can you ultimately leverage sort of the expertise of the existing commercial team to sell the MRD. And so therefore, the commercial spend is just not going to be near what it needs to be would have just before others?

Paul Diaz

executive
#61

We're really excited to have to Dr. George Daneker hey, incredibly experienced oncologists running our oncology business. And we think the commercial team that we have right now that is being -- that's successful with myRisk, myChoice, Precise Tumor can lead this. We'll make more investments in the medical affairs people that need to hold people's hands as I think about more novel technologies, but for the most part, I think our commercial infrastructure is quite scalable in terms of liquid as well as MRD as we look -- think about our oncology business. And same thing in women's health. I mean we're -- I think we're built to scale at this point.

Matthew Sykes

analyst
#62

Operating leverage.

Paul Diaz

executive
#63

Operating levering. Serving more patients will increase the value of the shareholders and we had a way to make a living.

Matthew Sykes

analyst
#64

In the minute we have left, just any kind of what do you want investors to kind of take away from about Myriad? What do you think is underappreciated?

Paul Diaz

executive
#65

I think the fundamental science as this company was built on the operations that this company was built on and the fact that we are growing at 12%, and we're going to build on that, that I see one of your Goldman partners here who showed me a slide the other day that most people think we're only growing 7% or 8%. This is not true. We grew 11% last year, 9% the year before. I know I said those numbers. We're off to a great start this year at 12%. We're going to build on that. And so -- and profitability. So I guess that's the final takeaway in our last 3 second.

Matthew Sykes

analyst
#66

Sounds great. Paul, Scott, thank you very much. Appreciate it.

Paul Diaz

executive
#67

Thanks, Matt.

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