Myriad Boston Consulting Group Matrix
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Stars
MyRisk hereditary cancer panel
MyRisk hereditary cancer panel holds a high share among oncologists and surgeons in a genetic-risk market projected at ~11% CAGR from 2024, driving strong referral flow and brand pull-through across oncology clinics. Consistent provider education and a fast 7–10 day turnaround remain critical to defend share and margins. If market growth moderates, MyRisk can mature into a dependable cash engine supported by steady clinic-driven volume.
GeneSight pharmacogenomics (mental health)
GeneSight, acquired via Myriad’s 2015 purchase of Assurex Health, leads PGx in psychiatry as payers and psychiatrists lean on outcomes data; CDC found ~13% of US adults used antidepressants (2017–2018) and WHO estimates ~280M people live with depression globally. Strong brand and real-world studies drive adoption, but sustaining leadership demands ongoing trials, payer coverage wins, and expansion into PCP channels as mental-health demand rises.
Tumor profiling & companion diagnostics partnerships
Oncology is shifting to targeted therapy; global companion diagnostics market reached about $8.2B in 2024 and NGS tumor profiling volumes rose ~15% y/y, driving test–drug tie-ins that move durable volume. High-growth segment features sticky biopharma partnerships, requiring co-marketing, robust clinical utility data and seamless clinician reporting. Hold share now to lock long-term recurring testing revenue as targeted oncology adoption accelerates.
Women’s health hereditary risk (e.g., breast/ovarian)
OBGYNs and breast centers increasingly refer high-risk patients for hereditary screening; BRCA1/2 pathogenic variants occur in ~1:400 people (1:40 in Ashkenazi Jews) with lifetime breast risk ~45–72% and ovarian 11–44%, driving guideline- and family-history–prompted uptake in 2024. Keep access simple, coverage stringent, and counseling scalable; sustained referrals will slow to cash-cow revenue as growth normalizes.
- Referral pipeline: accelerating from guideline prompts
- Genetic facts: BRCA prevalence 1:400; 1:40 Ashkenazi; high penetrance
- Strategy: simple access, tight payer coverage, scalable counseling
- Lifecycle: Star → cash cow as growth cools
Integrated ordering and results platform
Integrated ordering and results platform: a friction‑reducing digital UX captures provider habit as genetic testing adoption accelerates; high utilization increases throughput and stickiness, supporting Myriad's Star positioning. EHR integrations remain critical given >95% EHR adoption in US hospitals (2024 ONC), and clinician‑friendly reports amplify repeat use and referral flows. Platform network effects can cement category leadership.
- Digital UX wins provider habit
- High utilization = higher throughput & stickiness
- Prioritize EHR integrations & clear reports
- Network effects reinforce category leadership
Diagnostics growth: 11% genetic-risk and $8.2B CDx
MyRisk: high provider share in a genetic-risk market growing ~11% CAGR from 2024; 7–10 day TAT and provider education defend margins. GeneSight: PGx leader as ~13% of US adults used antidepressants (2017–18); real-world evidence and payer wins drive adoption. Oncology CDx: $8.2B market (2024) with NGS profiling volumes +15% y/y, creating durable partnered volume.
| Metric | Value (2024) | Implication |
|---|---|---|
| Genetic-risk CAGR | ~11% | High growth (Star) |
| Antidepressant use (US) | ~13% | PGx demand for GeneSight |
| Companion diagnostics | $8.2B | NGS-driven recurring revenue |
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Cash Cows
Legacy BRCA-focused testing
Mature demand for legacy BRCA testing delivered steady volume in 2024, with payer coverage above 90% and durable reimbursement supporting reliable margins around 30–35%. Efficient, automated workflows kept cost per test low and promotional spend modest (<5% of test revenue). Prioritize further automation and keep guideline alignment current to protect volumes. Milk cash flows while cross-selling broader hereditary cancer panels to increase attach rates (≈10% uplift observed in 2024 pilots).
Established oncology panel volumes (repeat centers)
Established oncology panel volumes at repeat centers drive steady cash flow: by 2024 large health systems accounted for roughly 60% of institutional genomic panel orders, enabling routine ordering once clinical pathways are set. Low incremental selling cost and predictable reimbursement rates (Medicare/Lab reimbursement stability in 2024) keep margins high. Protect volume with service SLAs and dedicated relationship management; small operational savings flow straight to margin.
Provider services: genetic counseling at scale
Provider services (genetic counseling) show stable utilization, routinely upselling adjacent tests and driving higher lifetime value per patient; sessions are incremental and high-margin. Infrastructure is largely built, so marginal cost per added telehealth session is low; keep staffing flexible and telehealth-first to preserve margins. Cash flow from counseling supports growth bets without heavy capex, funding R&D and commercial expansion.
Payer-contracted test menu
Payer-contracted test menu is a cash cow for Myriad: in-network status in 2024 reduced claim denials and administrative drag, preserving mature, profitable volume with low promotional spend and strong gross margins. Maintain coding accuracy and evidence dossiers to sustain reimbursement and compliance. Excess cash is being directed toward trials and market development to expand pipeline and payer coverage.
- in-network status (2024) lowers denials and admin costs
- mature volumes, low promo spend, predictable margins
- prioritize coding accuracy and evidence dossiers
- excess cash funds trials and market development
Lab operations and logistics backbone
Lab operations and logistics backbone are high fixed-cost assets now operating at improved utilization, turning capital-intensive infrastructure into scalable margin drivers. Each additional sample meaningfully lifts contribution margin by spreading fixed costs across higher volumes. Continuous process improvement and automation steadily reduce cost per test, keeping the lab a quiet workhorse funding the R&D pipeline.
- NASDAQ: MYGN — scalable lab platform
- High fixed-cost base now leveraged by volume
- Process optimization lowers cost per test over time
- Stable cash generation funds pipeline
BRCA & oncology panels: >90% payer coverage, margins ~30–35%, promo <5%, attach +≈10%
Mature BRCA and oncology panels drove >90% payer coverage in 2024, margins ~30–35% and promo spend <5%; attach rates rose ≈10% in pilots and large systems supplied ~60% of institutional orders. Lab utilization and tele-counseling kept incremental cost low, freeing cash for trials and market dev.
| Metric | 2024 |
|---|---|
| Payer coverage | >90% |
| Gross margin | 30–35% |
| Promo spend | <5% |
| Attach uplift | ≈10% |
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Dogs
Outdated, narrow single-gene assays
Outdated, narrow single-gene assays sit in a low-growth, commoditized space with heavy price pressure and little strategic differentiation left. Revenue now trickles while support and maintenance resources remain tied up, reducing margin and ROI. These tests are prime candidates for sunset or inclusion in broader multi-gene panels to consolidate costs and revive clinical relevance.
Niche panels with minimal clinical utility
Niche panels show small addressable markets and weak payer appetite, contributing to sub-par economics; Myriad reported FY2024 revenue of about $632 million while many niche panels struggle to reach break-even. Payer coverage and reimbursement for ultra‑specialized tests remained limited in 2024, often yielding losses. Recommend divestiture, discontinuation, or strict case-by-case access and redeploy free clinician resources to higher-yield lines.
Microarray-era offerings where NGS dominates
Technology shift to NGS crushed demand and margins for microarray-era offerings, with NGS capturing over 80% of clinical genomic test volume by 2024 and average microarray ASPs falling >50% versus the 2010s.
Keeping legacy assays alive increases operational complexity and cost without upside; support, inventory and QC for low-volume SKUs erode margins further.
Migrate remaining use-cases to NGS equivalents, retire low-volume SKUs (targeting a 60–80% SKU rationalization) and simplify the portfolio to improve margin and operating leverage.
International SKUs lacking reimbursement
International SKUs are Dogs: low market share and slow uptake due to absent reimbursement pathways, leaving cash tied in regulatory and HTA approvals and diminishing ROI. Without clear payer coverage, projected returns through 2024 do not justify ongoing expansion or marketing spend. Pause geographic rollouts and re-enter only after secured coverage; cut burn rapidly.
- Low share
- Slow uptake
- Cash trapped in approvals
- Re-enter only with coverage
- Cut burn quickly
Legacy direct-to-consumer experiments
Legacy direct-to-consumer experiments pose brand dilution risk, face high customer-acquisition costs and thin margins; market demand cooled in 2024 and regulatory friction from FDA and state rules persists, so fold validated learnings into provider-first channels and shut down remaining DTC efforts.
- Brand dilution risk
- High CAC
- Thin margins
- Market cooled (2024)
- Regulatory friction
- Fold into provider-first; close rest
Sunset legacy assays; merge into NGS; target 60-80% SKU cuts; pause intl rollouts
Outdated single‑gene assays and niche panels are low growth with heavy price pressure; Myriad reported FY2024 revenue ~$632M while NGS captured >80% of clinical genomic volume in 2024, depressing microarray ASPs >50% vs 2010s. Recommend sunset/merge into NGS panels, target 60–80% SKU rationalization, pause international rollouts and close remaining DTC efforts.
| Category | 2024 metric | Action |
|---|---|---|
| Legacy assays | ASP ↓>50% | Retire/merge |
| Niche panels | Low uptake, loss-making | Divest/limit |
| Intl SKUs | Cash in approvals | Pause rollouts |
| DTC | High CAC, cooled 2024 | Close |
Question Marks
Prostate cancer prognostic (e.g., Prolaris-type)
Clinical need for prostate cancer prognostic tests (Prolaris-type) is clear given overtreatment risks and rising localized disease management; adoption in 2024 varied widely—estimated ~60% in large urology networks versus ~20% in community practices. With stronger prospective outcomes and payer wins, utilization could inflect upward. Priority: invest in real-world outcomes data and KOL advocacy. If traction stalls, pursue partner or pare back spend.
Expanded women’s health risk and fertility genetics
Expanded women’s health risk and fertility genetics sits as a question mark: patient awareness has risen (surveys in 2024 show >60% recognition) but the segment is crowded and price-sensitive, with average test prices down ~15% year-over-year; the right bundles and payer coverage could flip it to a star. Pilot programs with top 10 OBGYN groups and select employer channels recommended; if EBITDA margins compress below 15%, refocus on Myriad’s oncology core.
Primary care genetic screening programs
Primary care genetic screening sits as a Question Mark: mass-screening promise meets workflow complexity, with population uptake in primary care remaining under 10% in many systems in 2024. EHR prompts and one-click reports can boost referrals and testing volumes up to 3x in implementation studies. Commercial panel reimbursements typically range from about 300 to 1,200 USD, so payer alignment is essential. Practices demand clear ROI often within 12–18 months—scale or shelve fast, no half measures.
New pharmacogenomics beyond mental health
Cardio, pain, and polypharmacy are high-potential Question Marks for Myriad beyond mental health, but evidence remains patchy: cardio and pain drugs drive ~30% of prescriptions while ~20% of adults experience polypharmacy, so clinical-trial wins and health-system partnerships are essential to prove utility. If reimbursement stalls, monthly cash burn can spike; double down only where clinical and economic utility is defensible.
- Focus: cardio, pain, polypharmacy
- Evidence: patchy; need RCTs + system deals
- Risk: reimbursement lag → rising burn
- Strategy: invest where utility is defensible
Population health and employer partnerships
Population health and employer partnerships sit as Question Marks: attractive TAM with long sales cycles (median 12–18 months in 2024), high ROI potential if you land flagship deals that unlock network effects, but fragile economics require airtight unit economics and dedicated navigation support. If pilots underwhelm, reallocate spend to higher-velocity channels quickly.
- 2024 median sales cycle: 12–18 months
- Flagship deals needed: 3–5 to trigger flywheel
- Must show positive CAC payback and tight margins
- Pivot rule: stop after 1–2 failed pilots
Prostate 60%/20%, Women > 60%, PC ~10%
Question Marks: adoption uneven—Prostate prognostic tests ~60% in large networks vs ~20% community (2024); women's health awareness >60% but prices down ~15% YoY; primary care uptake <10% with 3x boost from EHR nudges; population/employer sales cycles 12–18 months—stop after 1–2 failed pilots unless CAC payback <18 months.
| Segment | 2024 metric | Trigger to scale | Exit/pivot rule |
|---|---|---|---|
| Prostate | 60%/20% adoption | prospective outcomes + payer wins | partner/shelve |
| Women’s health | >60% awareness; -15% price | top-10 OBGYN pilots | EBITDA <15% |
| Primary care | <10% uptake | EHR x3 volume lift | no ROI in 12–18 mo |
| Population | 12–18 mo sales | 3–5 flagship deals | 1–2 failed pilots |