Myriad Genetics: Oncology Demand Is Up 13%, but Cash Collection Still Lags

Myriad has demand, but not yet clean monetization

Myriad's immediate problem is not demand. It is converting that demand into cash quickly enough to matter this year. In Q1, Cancer Care Continuum test volume grew 13% and average revenue per test rose 2%, but the company still reported adjusted EBITDA was $(4.5) million. Orders can move ahead even if the cash picture lags.

Why bulls still have a case

Bulls have a real business case. Myriad entered the year with a busy oncology launch schedule, and the recent test-growth data suggests clinicians and patients are engaging with the platform. If those tests gain traction, the market could start rewarding that demand quickly.

Why bears focus on collection friction

Bears are focused on the gap between demand and realized economics. Just as Myriad tries to monetize its oncology launches, the reimbursement backdrop remains uneven. Earlier this year, radiation oncology payment changes were still sowing confusion, lower pay, and speed bumps, and practices were reporting reimbursement declines. That does not kill the bull case, but it does make the path from order to collected revenue rougher.

Why stronger oncology demand has not yet improved the economics

The core issue is that Myriad was not only benefiting from stronger oncology demand in Q1. It was also absorbing a decline elsewhere, while the broader care environment grew tougher on pricing and workflow.

Oncology growth is real, but total revenue growth is not

Myriad's first-quarter revenue rose only 2% year-over-year despite 13% test-volume growth in the Cancer Care Continuum. That happened because Prenatal Health volume fell 12% and offset part of the oncology gain. In other words, the oncology engine is running better, but it has not fully made up for the loss elsewhere.

That distinction matters. Investors do not just need activity to rise in one segment; they need net activity to rise fast enough to change expectations for the year. Myriad entered 2026 with a busy oncology launch schedule, and Q1 showed progress within that strategy. But progress is not the same as stronger overall economics.

Better volume is not the same as better capture

Myriad reported gross margin up 20 basis points, which suggests the core testing model is at least holding up. That argues against the idea that growth is coming at the expense of a collapsing product economics.

But gross margin is only the first check. It does not fully capture reimbursement friction, billing complexity, or payer pressure downstream. That is why the broader provider backdrop matters. Radiation oncology payment changes were sowing confusion, lower pay, and speed bumps, and 2026 practice economics are being squeezed by payer complexity, staffing strain, and administrative load. If partners feel that pressure, they may still order a valuable test, but adoption can still be slower and monetization less immediate.

Why Q1 matters

The takeaway is straightforward: test volume can improve before economics do, because the new oncology demand first has to offset the prenatal decline and then pass through a tougher reimbursement environment. Q1 was an early check on whether the Cancer Care Continuum strategy is gaining enough traction to outrun those headwinds.