Myriad Genetics, Inc.

Good day, and thank you for standing by. Welcome to the Myriad Genetics fourth quarter and full year 2025 earnings call. At this time, all participants are in a listen-only mode. After the speaker's presentation, there will be a question and answer session. To ask a question during the session, you will need to press star 11 on your telephone. You will then hear an automated message advising your hand is raised. To withdraw your question, please press star 11 again. please be advised that today's conference is being recorded. I would now like to hand the conference over to your first speaker today, Matt Scalo, Senior Vice President of Investor Relations. Please go ahead.

Good afternoon, and welcome to Myriad Genetics' fourth quarter and full year 2025 earnings call. During the call, we will review the financial results we released today, and afterwards, we will host a Q&A session. Our earnings release was issued this afternoon on Form 8K and can be found on our website at investor.myriad.com. I'm Matt Scalo, Senior Vice President of Investor Relations. On the call with me today are Sam Raha, our President and Chief Executive Officer, Ben Wheeler, our Chief Financial Officer, and Mark Verratti, our Chief Operating Officer. Also joining us for Q&A will be Brian Donnelly, our Chief Commercial Officer. This call can be heard live via webcast at investor.myriad.com, and a recording will be archived in the investor section of our website along with this slide presentation. Please note that some of the information presented today contains projections or other forward-looking statements regarding future events or the future financial performance of the company. These statements are based on management's current expectations, and the actual events or results may differ materially and adversely from these expectations for a variety of reasons. We refer you to the documents the company files from time to time with the SEC, specifically the company's annual report on Form 10-K, its quarterly reports on Form 10-Q, and its current reports on Form 8-K. These documents identify important risk factors that could cause actual results to differ materially from those contained in our projections or forward-looking statements. I will now turn the call over to Sam.

Thanks, Matt. Good afternoon, everyone, and thank you for joining us. As we head into the new year, I'm pleased with the progress we're making as the new Myriad to live up to our significant potential by focusing on high growth market segments, advancing our plans for multiple timely product launches, including leveraging strategic partnerships, and by executing with stepped up urgency and strengthened execution rigor. I'm happy with how we ended 2025 with fourth quarter revenue of $210 million, coming in above the high end of the pre-announced range we provided in January. When you exclude the headwind from UnitedHealthcare's decision on GeneSight, our business grew approximately 4% over Q4 of 2024. In terms of testing volume, we delivered 382,000 test results in the fourth quarter. Our financial results were supported by continued strong volume growth for MyRisk in oncology at 14% over the year-ago quarter and MyRisk for unaffected at 11% over the year-ago quarter. These results reflect our ongoing efforts to enhance the customer workflow, including EMR functionality. Mark will provide additional color in his section, but certainly we continue to see positive demand for our MI-RISC regulatory cancer test, and this supports our accelerated profitable growth journey ahead. I'm also pleased to call out the acceleration in Prolaris test volume growth in the fourth quarter, where the combination of actions over the last two quarters, including incremental investments in the commercial team focused on urologists, have helped drive 12% test volume growth year over year. Fourth quarter prenatal volume declined year over year, primarily stemming from Q2 order management disruption. With this issue resolved, we're now in an active rebuild phase, reactivating accounts, expanding access, and driving new customer wins. We expect these actions to support a return to positive growth in 2026. Moving to our mental health business, GeneSight volume grew 9% year-over-year and continued to accelerate from the first half of 2025 as our commercial organization maintained strong execution with new and existing customers. For the full year of 2025, revenue was $824.5 million and we delivered over 1.5 million test reports by serving over 55,000 healthcare providers. Turning now to profitability. In the fourth quarter, we reported strong adjusted gross margin of 70% and closely managed our discretionary spend as reflected in our adjusted OpEx line. Ultimately, we reported healthy adjusted EBITDA of $14.3 million and adjusted EPS of 4 cents. We're also making great progress on our cancer care continuum strategy to maintain leadership, regulatory cancer testing, while expanding into other attractive cancer testing applications. This includes launching the expanded MIRIS panel in Q4, which has been well received in the market. We're also sharing results from an increasing number of studies and precise MRD with positive clinical data presented in major clinical conferences. and we're in final preparation mode to start commercial testing of Precise MRD for breast cancer for a select set of customers in what we call an alpha launch starting next week. Overall, we're making good progress towards our goal of expanding our portfolio of differentiated testing solutions that provide actionable insights across the cancer care continuum. From a new product pipeline perspective, 2026 is shaping up to be a banner year. Throughout the year, there are a number of important catalysts that we will be tracking that supports this year's growth. But even more, these are leading indicators of key growth drivers for 2027 and beyond. We're making significant progress on a number of catalysts outlined in this slide. Our strong fourth quarter test volume growth for MI-RISC reflects ongoing traction of our breast cancer risk assessment programs and the launch of our expanded MI-RISC test. We plan to launch disease-specific panels for MyRisks in Q2 and expect our market activation programs and product extensions to support increased MyRisks growth. Building on Prolaris' strong fourth quarter performance, we're on track to launch our first AI-enhanced Prolaris prostate cancer test in Q2 that combines the power of molecular and AI analysis. And this is based on our partnership with Pathomic. On Precise MRD, as I noted earlier, we're on track to commence commercial testing for a select set of customers next week, and I'll provide additional color on the next slide. At JPMorgan Healthcare Conference in January, we reconfirmed that our first Precise MRD test will be for breast cancer and announced additional indications that will follow. We plan to submit for Moldex and expand commercial testing for early access customers for both renal and colorectal cancer in the second half of the year, with commercial launch of breast, renal, and colorectal plan for 2027. All of these precise MRD tests have a growing body of clinical validation, some of which has been shared recently in venues, including presentations at the San Antonio Breast Cancer Symposium in December, ASCO GI Symposium in January. where a first look at precise MRD data related to colorectal cancer was presented by collaborators from National Cancer Center Hospital East in Japan, showing how the ultra-sensitive detection of precise MRD can have additional benefits compared to first-gen MRD tests. and to round out the robust 2026 pipeline. We're on track to launch first gene multiple prenatal screen tests in the second half of this year. The timing of this launch dovetails nicely the deployment of a focused prenatal health sales team next quarter and the expected early results of the connector study in the next few months. As we prepare to achieve the important milestone of commencing commercial testing for select set of customers with precise MRD for breast cancer patients next week, I want to help frame expectations at this stage. This slide highlights our three objectives. First, we're looking to further showcase Precise MRD's clinical performance while continuing to build a body of real-world evidence. Data shows Precise MRD's high sensitivity and ability to detect disease down to one part per million. We believe our MRD platform can help guide clinical decision making for patients in their journey in cancer care and has the ability to detect presence and recurrence meaningfully earlier than the standard of care with imaging and therefore can positively impact patient outcomes. Second, nearly 85% of cancer care in the US happens in the community. That's where Myriad has a strong, established presence where we served nearly 3,500 oncologists in 2025. We've seen strong interest from our community oncologist base to participate in the alpha and early access stages of our commercial rollout. Clearly, this is an encouraging sign, but we also remain disciplined regarding the overall number of participating centers in these early stages of launch to ensure good customer experience and manage our profitability. We will look to expand the number of centers as we move through 2026. And the third objective is to track and learn from specific metrics appropriate for this early stage. After all, you get what you measure, and we'll look to provide an appropriate level of visibility into these metrics moving forward, starting with the Q1 earnings call. While we're excited and busy preparing for multiple launches this year, I want to reiterate that there is little to no contribution from these MRD tests in our 2026 revenue guidance. Going into 2026, we're taking a number of actions to accelerate growth. This includes our plan to invest over $35 million over the next few years to support a number of initiatives to accelerate organizational efficiency, agility, and growth. These initiatives include strengthening our commercial capabilities, particularly in the cancer care continuum. Specifically, we're adding a meaningful number of sales and medical headcount ahead of multiple new product launches this year. Many of these new additions come from advanced diagnostics sector and bring strong domain knowledge and experience in molecular profiling and cancer diagnostics along with relationships across the oncology healthcare community. In addition, we're strengthening the tools critical to our sales team. while implementing a comprehensive plan to drive awareness, excitement, and demand for our products. I attended our commercial kickoff meeting last month, hosted by Brian Donlier, Chief Commercial Officer, and I can say our teams are energized and highly motivated to win in the market. Now, let me hand it over to our COO, Mark Verratti. Mark.

Thanks, Sam. Turning to fourth quarter oncology. Total oncology revenue was $84.7 million. Growth of 2% over the fourth quarter of 2024. I would like to highlight our MIRIS test continues to gain share with fourth quarter 2025 year-over-year volume growth of 14% in the affected market and 11% in the unaffected market. Shifting to prostate cancer. Polaris revenue growth in the fourth quarter accelerated to 16% year-over-year, up from 3% year-over-year revenue growth in our third quarter. Fourth quarter Polaris revenue growth was driven by 12% volume growth, reflecting a continued improvement year to date. As mentioned on previous calls, we are investing in the commercial channel and other programs to grow and regain share in this market. Adding to what Sam mentioned in previous calls, Myriad is on track to be the only company that will offer AI, biomarker, germline, and tumor profile testing when we launch our first AI-enabled Polaris test in the second quarter of 2026. In January, we issued a press release outlining our MRD commercialization timelines and clinical evidence presented at recent clinical conferences. Our ultra-sensitive precise MRD test continues to demonstrate strong clinical value in these studies, which now includes data on colorectal cancer patients, where we saw 100% baseline ctDNA detection across all patients. Approximately 20% of samples were detected at levels in the ultra-sensitive range that may have gone undetected on first-generation assays. This supports strong performance of precise MRD. As Sam mentioned, we're excited to begin offering our ultra-sensitive precise MRD test next week. Initially, this launch will be limited to a number of oncology centers, ones we believe best reflect a variety of needs across the community oncology setting and breast cancer patient. This early launch provides the opportunity to engage these providers and incorporate their feedback about a host of topics, including the ease of use and overall utility and actionability of the test. As we move ahead, we'll plan to expand the number of centers in a controlled manner until full commercial launch. Now moving to our women's health business. In the fourth quarter, women's health delivered revenue of $88.5 million, an increase of 2% over prior year period. We're pleased to see another consecutive quarter of incremental growth in hereditary cancer testing in the unaffected market, with revenue growth of 3% and volume growth of 11% year over year. This improving volume growth trend is particularly important as it reflects EMR-related workflow improvements put in place. such as the September integration of our MyGene history assessment into Epic as a way to better identify patients that qualify for hereditary testing and improve the provider experience. So we continue to be optimistic about the potential for continued momentum. We also remain confident about our ongoing progress from breast cancer risk assessment programs that enable providers to rapidly identify patients who qualify for additional screening. We continue to see positive momentum at these sites and expect to make further investments in our commercial capabilities to accelerate this program through 2026 to fuel growth in MI-RISC volume. As for prenatal testing in the fourth quarter, we saw a modest pullback in volume growth from previous quarters as we continue to work with accounts affected by friction created by the second quarter implementation of a new test ordering system. While we are optimistic on our ongoing engagement will win back share and drive overall growth in 2026, prenatal volume growth in the first quarter of 2026 will face a difficult year-over-year comparison, likely leading to a decline in year-over-year volume growth. As for our new multiple prenatal screen, Firstgene, last week we published the analytical validation of Firstgene in clinical chemistry. Firstgene is an integrated solution for multiple pillars of prenatal testing, and our paper shows excellent accuracy and reliability for each pillar. We continue early access clinical testing with our connector study seeing positive enrollment momentum, and we are pleased with our turnaround times, assay performance, and early customer feedback. We are reaffirming our full commercial launch in the second half of 2026 and are investing appropriately ahead of this launch as Firstgene provides added insight and has the potential to expand the overall addressable prenatal testing market. Turning now to mental health. In the fourth quarter, the team generated gene site revenues of $36.6 million on volume growth of 9% year over year. We continue to drive expansion of the ordering provider base, achieving a record number of ordering clinicians to over 38,000 in the fourth quarter. This strong fourth quarter volume performance is worth highlighting as MIRI remains disciplined and focused on capital efficiency in this group. While quarterly revenue continues to be impacted by UnitedHealthcare's coverage policy change in January of 2025, we are proud of our clinical development and payer market teams for securing positive coverage policies across 12 payers for Genesight in 2025 related to biomarker laws. including the California Medicaid program, Medi-Cal. In addition, we are seeing benefit from optimizing revenue cycle workflows to maximize reimbursement. I will now turn the call over to our CFO, Ben Wheeler.

Thanks, Mark. As Sam and Mark highlighted, we're seeing clear momentum from the operational and commercial progress made throughout 2025. Let me start with a recap of our fourth quarter growth drivers. We generated another quarter of strong test volume growth in hereditary cancer testing, achieving 9% year-over-year growth in the fourth quarter and 7% year-over-year growth for the full year 2025. This acceleration in the fourth quarter reflects continued double-digit growth in our unaffected market. Likewise, GeneSight finished the year with strong momentum, generating test volume growth of 9% year-over-year in the fourth quarter and 6% for the full year 2025. This progress reflects commercial discipline and effectiveness of the actions taken in early 2025 in response to UnitedHealthcare's coverage decision. The re-acceleration in both unaffected hereditary cancer volumes and gene site volumes is a clear proof point that our commercial performance is strengthening and that the actions that we've taken to enhance focus, accountability, and effectiveness are translating into tangible momentum. Moving to the consolidated financial results. For the fourth quarter, we reported revenue of $209.8 million, above the high end of the range preannounced on January 12th, and consistent with the year-ago period. Overall, test volumes grew 2% year-over-year, while average revenue per test declined 2% year-over-year. The headwind in fourth quarter average revenue per test reflects the impact from UnitedHealthcare's policy change with respect to gene site coverage. Despite the average revenue per test headwind, underlying demand continues to be strong. Excluding UnitedHealthcare's net impact on Genesight of $8.1 million, our underlying fourth quarter 2025 revenue growth rate was 4% year-over-year. We generated 70% gross margins in fourth quarter, in line with our third quarter, but down approximately 190 basis points year-over-year. This decline was driven by the revenue headwind I just mentioned that affected Genesight average revenue per test. Fourth quarter adjusted operating expenses decreased by $7 million year over year, reflecting disciplined cost management and the timing of investment as resources were deliberately redirected towards commercial and R&D initiatives that will ramp and be reflected in first quarter spending. We remain committed to balancing strategic investment to support our long-term growth with continued progress toward improving profitability, while ensuring capital is allocated to our highest impact priorities. Taking all of that into account, we generated adjusted EPS of 4 cents, or one penny above the year-ago period. Next, I'll speak to Myriad's profitability and liquidity. We generated $14.3 million of adjusted EBITDA and $17.9 million in adjusted operating cash flow in the fourth quarter. These results reflect the strength of our gross profit base, the operating leverage inherent in our business model, and the meaningful earnings and cash flow potential of the business as we continue to execute. We also maintain a solid balance sheet with access to $225 million in capital. As a note, we intend to file a universal shelf registration to replace our existing shelf. We view maintaining an effective shelf registration as a prudent corporate housekeeping measure. Next, I'll address financial guidance. We're reaffirming our full year 2026 financial guidance, which we issued on January 12th. including a revenue range of $860 to $880 million, an adjusted gross margin range of between 68% and 69%, as well as an adjusted EBITDA guidance range of between $37 and $49 million. In order to support investor modeling for 2026 by quarter, we provided additional commentary in the earnings release, and I would like to highlight a few key points. First quarter revenue is expected to be between $200 and $203 million. representing 2% to 4% growth over the year-ago period. As happens in most years, first quarter average revenue per test tends to be lower than fourth quarter due to items such as the resetting of insurance deductibles. In addition, as Mark mentioned, prenatal volume and revenue are expected to face unfavorable year-over-year comparisons in the first quarter, leading to a year-over-year decline in this portfolio. We anticipate prenatals to demonstrate year-over-year progress likely beginning in Q2. Also consistent with recent years, revenue in the second half of the year is typically stronger than the first half. We expect this pattern to repeat to a similar degree in 2026. This outlook is supported by current business trends, an anticipated improvement in prenatal portfolio, and early contributions from recent commercial investments. As a result, we expect quarterly revenue to grow sequentially from first quarter through the remaining quarters of the year. I also want to make investors aware that beginning in first quarter, we plan to simplify how we present and discuss our business to better align with our refreshed strategy and how we're operating the company. Going forward, we'll organize our reporting around our strategic areas of focus, with the first group being the cancer care continuum. This group will incorporate all hereditary cancer testing, including both affected and unaffected populations, and all tumor profile testing. This will be followed by prenatal health, which will include our NIPS and carrier screen lines, as well as sneak peek. And lastly, we'll continue to report mental health as a distinct category. We are making these changes because it provides clear visibility into the core drivers of the business and better aligns our external reporting with how we operate and allocate resources to our strategic priorities. We're confident in our full year outlook in the team's execution as we enter 2026. Now let me turn the call back to Sam.

Thanks, Ben. Let me conclude by saying this is an energizing time for the new myriad. We are at an inflection point where we have the absolute clarity and conviction for our go-forward strategy with a particular focus on the cancer care continuum. We have a robust pipeline of new products and enhancements for attractive market opportunities mostly developed internally but also complemented with ones enabled through strategic partnerships. Yes, we are the hereditary cancer company, but we are more than that, and many of these new products will strengthen our position across cancer care testing. Along with that, we're going to leverage our operational strengths for sample processing and reporting while expanding our commercial capabilities and customer reach. We have a stronger leadership team now, both for my direct staff and the next level, the needed blend of diagnostics, cancer, and genomics domain knowledge combined with proven experience for delivering results. Along with all this, we're taking steps programmatically and culturally to strengthen execution excellence. Put it all together, we have the substance and confidence to positively impact an increasing number of patient lives and to accelerate profitable growth. I now pass the call over to Matt for Q&A. Matt.

Thanks, Sam. As a reminder, during today's call, we used certain non-GAAP financial measures. The reconciliation of the GAAP to non-GAAP financial results and our reconciliation of GAAP to non-GAAP financial guidance can be found in our earnings release and under the investor relations section of our website. Now we're ready to begin the Q&A session to ensure broad participation. We're asking participants to please ask only one question and one follow-up. Operator, we're now ready for the Q&A portion of the call.

Thank you. As a reminder, to ask a question, please press star 11 on your telephone and wait for your name to be announced. To withdraw your question, please press star 11 again. Please stand by while we compile the Q&A roster. And our first question comes from Puneet Sudha of Learing Partners. Your line is open.

Hi, guys. Thanks for my questions here. First one, maybe, Sam, just given the momentum or the recovery that you're focused on for the full year, do you So, you know, I was trying to understand what gives you confidence that we can continue with this sort of high single-digit long-term growth rate, you know, that you had before. And what you're projecting for the year is that how should we, you know, should we think about, you know, sort of 2027? Or can we return back to that high single-digit growth rate? Let me pause there and I'll come back with another question to follow up.

Yeah, Puneet, thanks for the question. Well, first let me start with 2026. And the drivers of our growth this year, again, it's the number of products that we have already launched coming into the year, be it the expanded MyRisk panel in Q4 of last year. It's improvement that we're seeing across the board, both in commercial and other parts of our organization and execution, so we're getting better at that. We are also, you know, as we get along the year, we're adding headcount to go along with new products that we're launching and so forth. So, you know, based on what we have, the recovery of the prenatal business that we anticipate that we've spoken to happening over the next several months and quarters, we feel confident being right there in our guidance range, right? That's what we feel for this year. Listen, when you look at 2027 and beyond, as I've said recently at the JPM conference in January, we believe that we have a number of levers in place. I'll again point you to the Catalyst slide, which talks about a number of new products. We have three major launches this year, starting with Precise MRD for breast and other indications as well, AI-enabled Prolaris for prostate cancer, as well as first gene, right? All of these things I think will be important that we're timely in our launch, but truly these become even more growth drivers for 2027 and beyond. So I would summarize the second part of your question in that we have confidence that, you know, as we exit this year, go into 27, 28, that we will be on path for high single digit to low double digit sustained profitable growth.

Got it. That's helpful. And then on the MRD launch, I appreciate the details you provided, but just wanted to get, you know, sort of how do you plan on holding back? I mean, is it certain indications just given the, you know, sort of the competitiveness of the market and competition in the market and also the fact that, you know, currently the products are not reimbursed, but you're on... a path towards that. So maybe just talk to us as to sort of how you plan to throttle it back and then accelerate in, you know, sort of into the second half of the year and beyond. And then on prenatal, if I could just to squeeze in, how should we think about the growth rate in the first quarter? I know it's down, but just wanted to make sure there's a finer point on that and then the recovery through the rest of the year.

Yeah, let me take the MRD question, and then if you can answer the prenatal question here. Yeah, from an MRD standpoint, we are excited again. As I said, it's next week. We're going live. We're going to start commercial testing, and it is for what we're calling our alpha phase of the launch select number. So we are being selective, Puneet. It is a little bit challenging in a good way that we've seen a lot of interest to have access to precise MRD, but I believe we can do it. in a balanced way. I mean, again, in this phase, what we're looking for is input on the user experience all the way from ordering to the reporting, the number of repeat orders, the operational efficiency that we have, and ultimately the order volume that we have. And as we noted, our Moldex submission is planned for early H2, so you can call it Q3 for breast. and then later in 26 for renal and colorectal cancer. So until we have submitted for Moldex, we're going to be a little bit more careful on the volume we take on, but we have a path and listen, it'll be something we will carefully consider as the year goes by of are there merits to increase the volume? What do we think on the timing of Moldex? As we sit right now, we're pleased, particularly with the start of alpha for precise MRD in breasts next week. Ben, over to you on prenatal.

Thanks, Sam. So as it relates to prenatal pre-need, you know, as a policy, we don't generally offer product-level revenue guidance, but we did call out the prenatal Q1 growth in the unfavorable year-over-year comparison because we had noticed that that the street revenue models had a pretty wide range as it related to our prenatal product. And so we thought it was important to be able to make sure that folks understood that appropriately reflecting our expectations as it relates to the recovery in 2026 is really the only major change needed to get Q1 revenue in line with our updated revenue range of $203 million. Got it.

All right. Thanks, guys.

Thank you. Our next question comes from Sue Bunambi of Guggenheim. Your line is open.

Hey, guys. Thank you for taking my question. At JPM, you laid out an ambitious MRD launch roadmap that you reiterated today. As you think about the puts and takes in that roadmap, where is there the most risk or the most factors out of your control that could delay your roadmap? And conversely, are there things that wouldn't go faster than what you planned?

Yeah, thank you, Subbu, for the question. In fact, when we think about this year, one of the biggest challenges, if you will, and I think it could be a positive thing, is exactly how many samples in advance of Moldex approval for precise MRD that we run. You know, some of the things that are, as you're asking, out of our complete control are just how long and how many cycles it might take Moldex to do the review, provide us input, and ultimately for us to get approval. What we can control, and I think we've been doing a really nice job of, is preparing the data and for the submission for the publication. I think I've shared before we have more than 15 active studies in MRD underway. The MONITOR study is the one which will inform and provide the publication for breast cancer MRD, and that is on track for us to be able to do that in Q3. Now, for the colorectal cancer submission to Moldex, that's tied. That's part of the pan-cancer study. It's part of the MONSTAR study that we're doing with our collaborators in Japan. We believe that's on track for the second half, which will be the submission to colorectal. Now, in renal, the good news is in September of last year, we already had a publication in Lancet for renal cell carcinoma. So those things on submissions, that's just to speak to kind of our level of confidence. We have, I think, a decent level of control. It's really about the Moldex timing. And as you know, Suzu, we'll kind of walk that road together and we'll see how that goes.

Thank you so much for that. One follow-up. Last week, you published a paper of performance data for first gene in a prospectively collected set of patient samples. You reiterated the timing for connector study in second half of this year, which will be based on real-world samples. Is there any reason to expect the real-world data set to have meaningful difference in performance of the test and the prospectively collected samples?

Oh, thank you. Thank you for the great question. So first, yeah, we were very pleased with the results, both on selectivity and sensitivity from, you know, about 500 samples that we noted in the press release last week. And we you know, until the data is fully there from a broader set of Connector individuals who are enrolled in Connector, we can't conclusively say, but there is, we see no reason to believe that the data shouldn't be as robust and compelling in terms of, you know, the performance for first-gen.

Perfect. Thank you so much, guys.

Thank you.

And our next question comes from Tycho Peterson of Jefferies. Your line is open.

Hey, thanks. A couple on margin. So if we look at, you know, HCT volumes and oncology, you grew 9%. Revenue obviously only increased 3%. Maybe just talk about what specific ASP or pair-mix dynamics, you know, are driving this gap, and how do we think about this kind of dynamic in 26 as you launch disease-specific panels?

So, Tycho, this is Ben. Thanks for the question. Yeah, as we talked about ASP in Q3, we talked about that kind of the launching point for Q4 and then moving forward into 2026, I think it's important for folks to take into account that we anticipate a modest headwind relative to ASP when we look at the portfolio in 2026 when you're thinking about what the year will look like. As you mentioned, from a payer mix standpoint, as we focus on selling the extended panel and then also the MyRisk more broadly across our sales channels, We've talked about this before where we have about a 10% lighter ASP in the unaffected channel relative to the affected channel. And I think that we saw that headwind across the portfolio from an ASP standpoint when you look at 2025. really driven by the different mix of payers. Part of it was biopharma revenue that we talked about in Q3 with the new baseline moving forward. And then another part of it is you just see a shift in the different payer mix from one payer group from a Blue Cross Blue Shield group to another group or something along those lines.

Okay. And then on precise, appreciate, you know, the color on kind of the alpha rollout. Maybe just talk a little bit about how you think about scaling up on the sales and commercial channel there. Obviously more of a, you know, 27 driver overall. But just talk a little bit about how you're thinking about, you know, hiring for the various indications.

Yeah, sure. Maybe I'll start and then I'll allow Brian Donnelly, who's here with us. to join in. I'll just say that the scale up and the preparation for the launch has been underway for some time, and it includes training the existing team, making sure we're hiring people with the right profile, understanding of molecular, and beyond just the sales team, it's also our medical folks, MSLs, and a lot of that's already happening.

But Brian, please. Yeah, thanks, Sam. Hey, this is Brian. So just building on what Sam has said, we're really focused on making sure we have the right level of reach and frequency to priority targets, which you won't be surprised to hear us say. So we're just taking a consistent view at the market, making sure that we are hiring the right level of folks in the right territories, and we're training them, which is a really important piece of the puzzle. We want to get them ready to go as quickly as possible to make an impact.

Yeah, and Tycho, I'll just add to that. I mentioned again earlier in my prepared remarks that we're spending over $35 million over the next couple of years, and a very big part of that is to augment our sales team. And those additions are underway as we speak. In fact, we had our commercial meeting kick off just a couple of months ago, and there's a lot of new faces in the room. They're coming from places where they've done this already, so they're not just going to be learning on the job.

Okay, that's helpful. And then maybe just along those lines, and lastly, just on the alpha launch, can you just provide any more color? You talked a little bit about how you're thinking about number of tests you need to run, but maybe the customer profiles you're going to be targeting.

Sorry, I didn't know if you got cut off. Did you just say, can I provide any more color? Is that what you just mentioned there?

Yeah, on the alpha launch, I mean, you talked about number of tests you may target.

Okay, I'm going to go with that.

Hey, listen, we are...

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