Myriad Genetics Inc (MYGN) 2024 Q3 法說會逐字稿

Good afternoon and welcome to the Myriad Genetics third-quarter 2024 financial earnings. I am Franz and I'll be the operator assisting you today. (Operator Instructions)

下午好，歡迎觀看 Myriad Genetics 2024 年第三季財務收益報告。我是弗朗茲，今天將擔任協助您的接線生。（操作員指令）

And I would like to turn the call over to Matt Scallo. Please go ahead. Thank you.

我想將電話轉給馬特·斯卡洛 (Matt Scallo)。請繼續。謝謝。

Thank you, Franz, and good afternoon and welcome to the Myriad Genetics third-quarter 2024 earnings call. During the call, we will review financial results we released today, and afterwards we will host a question-and-answer session. Our quarterly earnings release was issued this afternoon on Form 8-K and can be found on our website at investor.myriad.com.

謝謝你，弗朗茲，下午好，歡迎參加 Myriad Genetics 2024 年第三季財報電話會議。在電話會議中，我們將回顧今天發布的財務結果，然後我們將舉辦問答環節。我們的季度收益報告於今天下午以 8-K 表形式發布，可在我們的網站 investor.myriad.com 上查閱。

I'm Matt Scalo, Senior Vice President of Investor Relations, and on the call with me today are Paul Diaz, President and Chief Executive Officer; Scott Leffler, our Chief Financial Officer; Sam Raha, our Chief Operating Officer; and Mark Veratti, our Chief Commercial Officer. This call can be heard live via webcast at investor.myriad.com, and a recording will be archived in the Investors section of our website, along with the slide presentation.

我是投資人關係資深副總裁 Matt Scalo，今天與我一起參加電話會議的還有總裁兼執行長 Paul Diaz；萊弗勒 (Scott Leffler)，我們的財務長；我們的營運長 Sam Raha；以及我們的首席商務官馬克·維拉蒂（Mark Veratti）。您可以透過 investor.myriad.com 上的網路直播收聽本次電話會議，錄音將與幻燈片簡報一起存檔在我們網站的「投資者」部分。

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 those expectations for a variety of reasons.

請注意，今天提供的一些資訊包含有關未來事件或公司未來財務表現的預測或其他前瞻性陳述。這些聲明是基於管理層目前的預期，而實際事件或結果可能由於各種原因與這些預期有重大不利差異。

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 the actual results to differ materially from those contained in our projections or forward-looking statements. I will now turn the call over to Paul.

我們請您參閱本公司不時向美國證券交易委員會提交的文件，特別是公司的 10-K 表年度報告、10-Q 表季度報告以及 8-K 表當前報告。這些文件確定了可能導致實際結果與我們的預測或前瞻性陳述有重大差異的重要風險因素。現在我將電話轉給保羅。

Thanks, Matt. Good afternoon, everyone, and thank you for joining us. On today's call, we will discuss the highlights from our strong third-quarter performance and provide an update on the progress we continue to make accelerating profitable revenue growth.

謝謝，馬特。大家下午好，感謝大家的參與。在今天的電話會議上，我們將討論第三季強勁業績的亮點，並介紹我們在繼續加速獲利收入成長方面取得的進展。

We will also address how we are actively engaging with UnitedHealthcare regarding the importance of maintaining access to our gene site tests for those UnitedHealthcare enrollees struggling with the medication management challenges associated with depression, anxiety, and ADHD.

我們還將討論如何積極與 UnitedHealthcare 合作，強調為那些在與憂鬱、焦慮和注意力不足過動症相關的藥物管理方面遇到困難的 UnitedHealthcare 受益人保持基因位點測試訪問權限的重要性。

First, I want to thank my Myriad teammates and our provider partners for their continued support and commitment to advancing our mission and vision to make genetic testing and precision medicine more accessible to help people take more control of their health.

首先，我要感謝我的 Myriad 隊友和我們的供應商合作夥伴，感謝他們對我們的使命和願景的持續支持和承諾，使基因檢測和精準醫療更加普及，幫助人們更好地掌控自己的健康。

We continue to deliver on our commitment to shareholders as we achieve 11% revenue growth in the third quarter compared to last year, reflecting both volume and revenue for test improvements across the portfolio. Our focus on profitable growth continues as we generated approximately $150 million in gross profits, $14 million of adjusted EPA, positive adjusted EPS of $0.06. and maintain approximately $149 million in liquidity in the third quarter.

我們繼續履行對股東的承諾，第三季度我們的收入與去年相比增長了 11%，這反映了整個產品組合的測試改進的數量和收入。我們繼續專注於獲利成長，我們創造了約 1.5 億美元的毛利、1,400 萬美元的調整後 EPA 和 0.06 美元的正調整後 EPS。並在第三季保持約1.49億美元的流動性。

At our Investor event in October, we laid out the commercial growth strategy supporting our long-term financial target and provided updates on our product portfolio, including first gene, precise liquid, and precise MRD. We encourage investors to view our Investor Day presentation on the Investor section of our website for a deep dive into our product enhancements, new product pipeline, and initiatives to better serve our customers and improve efficiencies.

在十月份的投資者活動中，我們制定了支持長期財務目標的商業成長策略，並提供了我們的產品組合的最新信息，包括第一個基因、精準液體和精準 MRD。我們鼓勵投資者查看我們網站投資者部分的投資者日演示文稿，深入了解我們的產品增強功能、新產品線和計劃，以更好地服務我們的客戶並提高效率。

Despite a return to more typical seasonal ordering patterns and heavy storms and flooding in the Southeast that prevented patients and providers from testing, our teams delivered a strong third quarter. With this positive momentum in mind, and the strong pickup in volumes we have experienced over the last four weeks, we are tightening our 2024 revenue range target around the midpoint of $840 million. And we are increasing our 2024 adjusted EPS target to between $0.12 and $0.14.

儘管恢復了更典型的季節性訂購模式且東南部遭遇了暴風雨和洪水，導致患者和醫療服務提供者無法進行檢測，但我們的團隊在第三季度仍取得了強勁的業績。考慮到這一積極勢頭以及過去四周銷量的強勁增長，我們將 2024 年收入目標範圍收緊至 8.4 億美元的中點左右。我們將 2024 年調整後每股盈餘目標上調至 0.12 美元至 0.14 美元之間。

Last week, UnitedHealthcare updated its medical policy restricting access to multi-gene panel PGx testing. We believe that the existing body of clinical evidence for gene sites, including peer-reviewed research studies, supports the clinical validity and utility of the gene site test. We were surprised by United's policy update because this topic never came up during our contract negotiations at the end of 2023, nor in subsequent meetings just three weeks ago. Additionally, the American Psychiatric Association updated its recommendations on PGx testing earlier this year, which should not change their long-held stance on this type of testing.

上週，聯合健康保險更新了其醫療政策，限制多基因組 PGx 檢測的取得。我們相信，現有的基因位點臨床證據，包括同行評審的研究，支持基因位點測試的臨床有效性和實用性。我們對美聯航的政策更新感到驚訝，因為這個主題在我們 2023 年底的合約談判中從未出現過，而且在三週前的後續會議上也沒有出現過。此外，美國精神醫學會今年稍早更新了有關 PGx 測試的建議，但這不會改變他們對此類測試的長期立場。

GeneSight has a strong value proposition, which Mark Roddy will address further on today's call. And with approximately 3 million tests to date, we believe that primary care providers see the value in GeneSight as an important tool that helps reduce the costly and potentially harmful trial and error when working with patients to get them on the right medications for depression, anxiety, and ADHD. We are engaging with United and Optin to try to find a resolution to this policy change and hope for an outcome in the next few months.

GeneSight 具有強大的價值主張，Mark Roddy 將在今天的電話會議中進一步闡述這一點。到目前為止，我們已經進行了大約 300 萬次測試，我們相信，初級保健提供者認為 GeneSight 是一種重要工具，在與患者合作以幫助他們獲得治療抑鬱、焦慮和注意力缺陷多動症的正確藥物時，它有助於減少昂貴且可能有害的反複試驗。我們正在與 United 和 Optin 合作，試圖找到解決這項政策變化的辦法，並希望在未來幾個月內得到結果。

GeneSight revenue associated with the United commercial business was approximately $40 million for the 12 months period, ending the third quarter of 2024. We want to reinforce that this policy change, if implemented, is effective January 1, 2025, and does not affect United's Medicare Advantage or managed Medicaid business. Nor do we have any reason to believe that other payers are likely to adjust their medical policies, especially as biomarker laws in a growing number of states require state-regulated plans to expand coverage of PGx testing pursuant to national and local coverage determinations.

截至 2024 年第三季的 12 個月期間，與聯合商業業務相關的 GeneSight 收入約為 4,000 萬美元。我們要強調的是，這項政策變更一旦實施，將於 2025 年 1 月 1 日生效，並且不會影響 United 的 Medicare Advantage 或管理的 Medicaid 業務。我們也沒有任何理由相信其他付款人可能會調整他們的醫療政策，特別是隨著越來越多的州的生物標誌物法律要求州監管計劃根據國家和地方的覆蓋範圍決定擴大 PGx 測試的覆蓋範圍。

And with that, I'll turn the call over to Mark.

說完這些，我會把電話轉給馬克。

Thanks, Paul. I would like to start with the product group. Myriad continues to lead the market with differentiated scientific insights offered by our MyRisk with RiskScore test. Last 12 months, year-over-year revenue growth through Q3 of 11% demonstrates the continued growth of our category and our commercial capabilities during the period of continued dislocation in our sector.

謝謝，保羅。我想從產品組開始。Myriad 繼續以其 MyRisk 與 RiskScore 測試所提供的差異化科學見解引領市場。過去 12 個月，截至第三季度，我們的營收年增 11%，這表明在我們行業持續混亂的時期，我們的產品類別和商業能力仍在持續增長。

Despite a strong end to the third quarter, typical seasonal softness in July and August, as well as our ongoing focus on possible growth, which inhibits some of the volume growth in Q3. Investors should note that our hereditary cancer testing business includes both MyRisk and BRAC analysis CDX. While we continue to see some strong growth in MyRisk with increased adoption and strong payer coverage, hereditary cancer testing growth was partially impacted by slower growth of our BRAC analysis CDX business in the US and internationally.

儘管第三季收官強勁，但 7 月和 8 月出現了典型的季節性疲軟，我們持續關注可能的成長，這抑制了第三季的部分銷售成長。投資人應注意，我們的遺傳性癌症檢測業務包括 MyRisk 和 BRAC 分析 CDX。儘管我們繼續看到 MyRisk 隨著採用率的提高和付款人覆蓋率的提高而實現強勁增長，但遺傳性癌症檢測的增長部分受到了我們在美國和國際上的 BRAC 分析 CDX 業務增長放緩的影響。

MyRisk is expected to continue its strong growth as it benefits from expanded guidelines, as well as an acceleration of EMR integrations, which play an important role in overall customer experience and revenue cycle management. We are on track to transition several large accounts, including several multi-state health systems. And we continue to expect to achieve double-digit growth in hereditary cancer testing volumes with stable average revenue per test in '25.

MyRisk 預計將繼續保持強勁成長勢頭，因為它受益於擴大的指導方針以及 EMR 整合的加速，這在整體客戶體驗和收入週期管理中發揮著重要作用。我們目前正在轉換幾個大型帳戶，其中包括幾個跨州醫療系統。我們繼續預計，2025年遺傳性癌症檢測量將達到兩位數成長，且每次檢測的平均收入將保持穩定。

Next slide. In the third quarter, our women's health teams delivered 10% prenatal revenue growth year over year and 24% for the trailing 12-month period, excluding SNP. While volume growth in Q3 was softened by typical seasonality, we continue to see growth from both current and new accounts. We believe the market is becoming more rational regarding market pricing for these services and continue to see strong growth opportunities with new customers as we move into year end.

下一張投影片。第三季度，我們的女性健康團隊的產前收入年增 10%，過去 12 個月（不包括 SNP）成長 24%。儘管第三季的交易量成長受到典型季節性因素的影響，但我們仍看到現有帳戶和新帳戶均實現成長。我們相信，市場對這些服務的市場定價變得更加理性，隨著年底的到來，新客戶將繼續帶來強勁的成長機會。

Next slide. In the third quarter, gene site revenues increased 34% year over year, as we reported volume growth of 10%, GeneSight revenue protests improved both year over year and quarter over quarter in the third quarter, reflecting a combination of strong provider demand, commercial pull through, and improving payer coverage driven in part by the growing list of states that have enacted biomarker laws and positive contribution from prior periods.

下一張投影片。第三季度，基因位點收入同比增長 34%，正如我們報告的 10% 銷量增長一樣，GeneSight 收入抗議在第三季度同比和環比都有所改善，這反映了強勁的供應商需求、商業拉動和付款人覆蓋範圍不斷改善的綜合作用，部分原因是越來越多的州法頒布了生物標誌物貢獻，以及前期的積極貢獻。

Next slide. The critical need in mental health treatment is demonstrated by the fact that 96% of counties in the United States have an unmet need for specialty mental healthcare. This leaves the burden on primary care to provide over 70% of antidepressants. Far too often, this results in trial and error to find the right medication. GeneSight is an easy to use tool backed by strong clinical evidence, including the largest randomized controlled trial in this space conducted by the VA.

下一張投影片。美國 96% 的縣對專業心理健康護理的需求尚未得到滿足，這一事實表明心理健康治療的需求很迫切。這使得初級保健機構承擔起提供 70% 以上抗憂鬱藥物的負擔。很多時候，這會導致人們不斷反覆試驗才能找到正確的藥物。GeneSight 是一種易於使用的工具，有強有力的臨床證據支持，包括 VA 在該領域進行的最大規模隨機對照試驗。

In that trial published in JAMA, both primary endpoints were met, including the GeneSight group achieving greater remission rates over the 24-week period. The clinical utility and ease of use of GeneSight has driven an overall satisfaction to over 93% among its current providers.

在 JAMA 上發表的試驗中，兩個主要終點均得到滿足，其中 GeneSight 組在 24 週內實現了更高的緩解率。GeneSight 的臨床實用性和易用性使其目前提供者的整體滿意度達到 93% 以上。

Next slide. We continue to see positive momentum with our precise tumor test, which we acquired in early 2024 and launched from our Salt Lake City facility this quarter. We're also excited to have launched Foresight Universal Plus in June and await ACOG guideline updates that could potentially expand this market opportunity.

下一張投影片。我們的精準腫瘤檢測持續保持積極勢頭，該檢測是我們於 2024 年初收購的，並於本季在鹽湖城工廠推出。我們也很高興在 6 月推出了 Foresight Universal Plus，並期待可能擴大這一市場機會的 ACOG 指南更新。

At our Investor event in October, we spoke about Precise Liquid and MRD, as these new products will provide tremendous value for our providers and support our long-term growth ambitions.

在十月的投資者活動中，我們談到了 Precise Liquid 和 MRD，因為這些新產品將為我們的供應商提供巨大的價值並支持我們的長期成長目標。

Now I will turn the call over to our Chief Operating Officer, Sam Raha.

現在我將電話轉給我們的營運長 Sam Raha。

Thanks, Mark. As Paul mentioned, we hosted investors in New York this past October to provide a deep dive into our growth strategy and the enterprise initiatives that support our longer term goals. Therefore, on this call, I'll keep my comments brief.

謝謝，馬克。正如保羅所提到的，去年 10 月，我們在紐約接待了投資者，深入探討了我們的成長策略和支持我們長期目標的企業計畫。因此，在這次電話會議上，我將簡短地發表我的評論。

Let me start on slide 13 with an update of our Labs of the Future program. The overall objective of our Labs of the Future program is to drive innovation and operational excellence at scale, to continue delivering high quality testing results that meet regulatory requirements while shortening turnaround times and reducing our cost per test. The work we're doing on this program supports our ongoing focus to improve the overall patient and provider experience and also support continued strong gross margins.

讓我從第 13 張投影片開始介紹我們的未來實驗室計畫的最新情況。我們未來實驗室計劃的總體目標是推動大規模創新和卓越運營，繼續提供符合監管要求的高品質測試結果，同時縮短週轉時間並降低每次測試的成本。我們在該計劃上所做的工作支持我們持續專注於改善整體患者和提供者的體驗，並支持持續強勁的毛利率。

Over the last three years, we've invested over $75 million in state-of-the-art labs, standard-based technologies, and digital capabilities. In 2023, we completed the construction of our new lab facilities, both in Salt Lake City and South San Francisco.

在過去三年中，我們已經投資超過 7500 萬美元用於最先進的實驗室、基於標準的技術和數位化能力。2023 年，我們在鹽湖城和南舊金山完成了新實驗室設施的建造。

This year, in 2024, we made important progress at both sites, including with permitting, lab moves, lab validation, and operational scale up. In Salt Lake City, we continue to ramp up volume of samples process for both Polaris, as well as Precise MRD for clinical validation research projects.

今年，也就是 2024 年，我們在兩個地點都取得了重要進展，包括許可、實驗室遷移、實驗室驗證和營運擴展。在鹽湖城，我們繼續增加 Polaris 和 Precise MRD 的樣本處理量，以用於臨床驗證研究項目。

A Precise tumor, which is our therapy selection test that we acquired from Intermountain Precision Genomics, I'm pleased to report that we have completed validation of started processing samples in Salt Lake City as of last week. We continue to see monthly volume growth and expect this trend to continue accelerating as we head into 2025.

精準腫瘤是我們從 Intermountain Precision Genomics 獲得的治療選擇測試，我很高興地報告，截至上週，我們已經完成驗證並開始在鹽湖城處理樣本。我們繼續看到月度交易量成長，並預計進入 2025 年這一趨勢將繼續加速。

In South San Francisco, we have completed validation and are ramping up sample volume for both prequel, our NIPs test, and foresight, our expanded carrier screening test in our new lab. Based on our continued progress, we're on track with our plan to complete the South San Francisco move in early 2025 and Salt Lake City move by the end of 2025.

在南舊金山，我們已經完成了驗證，並且正在新實驗室中增加前傳（NIPs 測試）和預見（擴展的攜帶者篩檢測試）的樣本量。根據我們不斷取得的進展，我們正在按計劃在 2025 年初完成南舊金山的搬遷，並在 2025 年底完成鹽湖城的搬遷。

Next slide. Digital capabilities continue to be a key focus area of investment across our enterprise. To both improve customer experience and increase internal efficiency and productivity. Our efforts with EMR systems are making a difference in the way we're engaging with our customers and will be an important driver of future volume growth. It's clear that providers seeking to integrate genomic and genetic information into the care of their patients. And to provide the ease of use, this increasingly requires our products to be natively ordered and resulted in EMR systems.

下一張投影片。數位化能力仍然是我們整個企業投資的重點領域。既改善客戶體驗，又提高內部效率和生產力。我們在電子病歷系統方面的努力正在改變我們與客戶的互動方式，並將成為未來銷售成長的重要驅動力。顯然，醫療服務提供者正在尋求將基因組和遺傳資訊整合到患者的照護中。為了提供易用性，這越來越要求我們的產品能夠在本地訂購並產生 EMR 系統。

Over the past two years, we've doubled our investment in EMR programs, including in engineering, integration, commercial pull through, have seen an almost 10x increase in the pace of newly integrated clinical sites. In fact, we're tracking to integrate about 4,000 new provider sites this year. We have system integrations across more than 15 different vendors, including strategic partnerships with EMR providers, including Athena, Epic, Flatiron for oncology, and Lumia for urology.

在過去的兩年裡，我們對 EMR 專案的投資增加了一倍，包括工程、整合、商業拉動等方面，新整合臨床站點的速度幾乎增加了 10 倍。事實上，我們計劃今年整合約 4,000 個新的供應商網站。我們與 15 多家不同的供應商進行了系統集成，包括與 EMR 提供者建立策略合作夥伴關係，其中包括用於腫瘤學的 Athena、Epic、Flatiron 和用於泌尿學的 Lumia。

As we look at the first half of 2025, we expect to add iNomed and LKEMR systems to enable for the first time healthcare providers and systems to be able to order the continuum of our oncology products from Journal Line to Symatic.

展望 2025 年上半年，我們預計將添加 iNomed 和 LKEMR 系統，使醫療保健提供者和系統首次能夠訂購從 Journal Line 到 Symatic 的一系列腫瘤產品。

Next slide. As we share during our recent Investor Day, we see a meaningful opportunity for Myriad to serve community oncologists and healthcare systems who trust Myriad's gold standard hereditary cancer and HRD tests with precise tumor now and precise MRD a differentiated highly sensitive MRD assay in the future.

下一張投影片。正如我們在最近的投資者日上所分享的那樣，我們看到了 Myriad 為社區腫瘤學家和醫療保健系統提供服務的重要機會，他們現在信任 Myriad 的黃金標準遺傳性癌症和 HRD 測試，可以精確檢測腫瘤，未來可以精確檢測 MRD，這是一種差異化的高度敏感的 MRD 檢測。

We continue to strengthen our freedom to operate, an ability to deliver tumor-informed, high-definition MRD assays with the issuance of a third foundational method patent from the USPTO, a personalized method for detecting circulating tumor DNA. In addition, our agreement with personalists to cross-license patent estates, cover tumor-informed approaches to MRD, fortifies our IP position.

隨著美國專利商標局頒發第三項基礎方法專利（一種檢測循環腫瘤 DNA 的個人化方法），我們繼續加強我們的營運自由以及提供腫瘤知情、高清 MRD 檢測的能力。此外，我們與個人專家達成的協議，對專利資產進行交叉許可，涵蓋針對腫瘤的 MRD 方法，鞏固了我們的智慧財產權地位。

We plan to launch our first MRD commercial offering for breast cancer. first half of 2026. Last month, we announced five ongoing research collaborations to study the use of MRD testing in breast cancer using Myriad's precise MRD test.

我們計劃推出首個針對乳癌的 MRD 商業產品。 2026 年上半年。上個月，我們宣布了五項正在進行的研究合作，利用 Myriad 的精確 MRD 測試研究 MRD 測試在乳癌中的應用。

This includes a study to determine whether circulating tumor DNA level may predict the magnitude of response to Pembrolizumab and hormonal therapy in patients with HR-positive inflammatory breast cancer who did not achieve pathological complete response at the time of surgery. This is being led by Dr. Bora Lin at the University of Texas MD Anderson Cancer Center.

這包括一項研究，以確定循環腫瘤 DNA 水平是否可以預測手術時未達到病理完全緩解的 HR 陽性炎性乳癌患者對 Pembrolizumab 和荷爾蒙療法的反應程度。該計畫由德克薩斯大學 MD 安德森癌症中心的 Bora Lin 博士領導。

Another study is to evaluate whether CPDNA levels correlate with nodal involvement in patients who have newly diagnosed HR-positive breast cancer, and if so, how the correspondence may be used to aid in surgical decision making. Led by Dr. Anna Weiss at the University of Rochester Medical Center, as well as a multi-center prospective study to evaluate the maintenance of complete response to Trastuzumab, Dexitocan, and HER2-positive advanced or metastatic breast cancer patients, and whether CPDNA can be used to optimally guide therapy, being led by Dr. Yoichi Neito of National Cancer Center Hospital East in Japan.

另一項研究旨在評估 CPDNA 水平是否與新診斷的 HR 陽性乳癌患者的淋巴結受累相關，如果相關，如何利用這種對應關係來輔助手術決策。由羅徹斯特大學醫學中心的Anna Weiss博士牽頭，以及由日本國立癌症中心東醫院的Yoichi Neito博士牽頭的一項多中心前瞻性研究，旨在評估曲妥珠單抗、Dexitocan與HER2陽性晚期或轉移性乳腺癌患者完全緩解的維持情況，以及是否可以使用CPDNA來最佳地指導治療。

Across our studies, we have more than 4,000 patients receiving precise MRD tests. And with each patient having multiple draws, this will result in more than 30,000 time points, which will be an important part of the clinical evidence for our MRD test. We look forward to sharing data from our ongoing studies in the first half of 2025 and submitting data to MoLDEX in the second half of 2025 for reimbursement.

在我們的研究中，我們有超過 4,000 名患者接受了精確的 MRD 測試。並且由於每個患者都有多次抽樣，因此將產生超過 30,000 個時間點，這將成為我們 MRD 測試臨床證據的重要組成部分。我們期待在 2025 年上半年分享我們正在進行的研究的數據，並在 2025 年下半年向 MoLDEX 提交數據以獲得報銷。

We're also engaging biopharma companies that are currently running their MRD samples in our new Salt Lake City lab, where we bring together the power of high performance MRD assay with our efficient lab workflows and cutting edge infrastructure. We're excited about the sizable opportunity for myriad to serve this market with our MRD assay as part of our precise oncology solution portfolio, enabling thousands of providers and healthcare systems that count on us to serve their patients through the continuum of cancer care. I look forward to updating you on our progress.

我們也與目前正在我們新的鹽湖城實驗室運行其 MRD 樣本的生物製藥公司合作，在這裡我們將高性能 MRD 檢測的強大功能與我們高效的實驗室工作流程和尖端基礎設施結合在一起。我們很高興看到 Myriad 有巨大的機會透過我們的 MRD 檢測為這個市場提供服務，作為我們精準腫瘤解決方案組合的一部分，使依賴我們在整個癌症治療過程中為患者提供服務的數千家供應商和醫療保健系統能夠受益。我期待向您通報我們的進展。

Moving on to our key performance indicators on the next slide. We continue to see a high level of teammate engagement across the company. The work we've been doing over the last couple of years to increase internal efficiency and productivity is paying off.

下一張投影片將繼續討論我們的關鍵績效指標。我們持續看到公司全體員工的積極參與。過去幾年來我們為提高內部效率和生產力所做的努力正在取得成效。

Compared to 2021, we're seeing a 75% increase in the revenue per commission sales rep and a 70% increase in the number of cases processed per customer service rep. Our ongoing focus on revenue cycle management is also continuing to pay off. It's evidenced by a 5% increase in revenue per test. We continue providing industry leading test turnaround times to support providers making treatment decisions.

與 2021 年相比，我們發現每位佣金銷售代表的收入增加了 75%，每位客戶服務代表處理的案件數量增加了 70%。我們對收入周期管理的持續關注也持續獲得回報。證據是每次測試的收入增加了 5%。我們將繼續提供業界領先的測試週轉時間，以支持供應商做出治療決策。

Our turnaround times, along with the focus we're putting to improving customer experience and supporting our strong net promoter score of 72. With that, let me turn the call over to our Chief Financial Officer, Scott Leffler.

我們的周轉時間，以及我們對改善客戶體驗和支援我們 72 的強勁淨推薦值的關注。說完這些，請允許我將電話轉給我們的財務長 Scott Leffler。

Thanks, Sam. I'll start on slide 18. As you've already heard from Paul and Mark, we're pleased with our continued progress in Q3 highlighted by our 11% revenue growth. Increase in our adjusted EBITDA to $14.1 million, and adjusted EPS improvement to $0.06 per share. While hereditary cancer testing revenues grew by only 5%, we were encouraged by 11% growth in my risk for the affected population, which is the area most likely to benefit from disruptions in the competitive landscape.

謝謝，山姆。我將從第 18 張投影片開始。正如您從保羅和馬克那裡聽說的那樣，我們對第三季度的持續進展感到滿意，其中收入增長了 11%。我們的調整後 EBITDA 增加至 1,410 萬美元，調整後 EPS 改善至每股 0.06 美元。雖然遺傳性癌症檢測收入僅增加了 5%，但受此影響人群的風險成長了 11%，這讓我們感到鼓舞，而這個領域最有可能從競爭格局的顛覆中受益。

We did benefit from a favorable change of estimates from prior periods in Q3 of 24, primarily impacting gene sites. As a reminder, we disclosed the meaningful benefit in Q3 of last year from change of estimates as well. This year's change of estimate benefit was similar to last year's benefit on a consolidated total company basis, making it easier to compare consolidated year-over-year revenue. On a year-to-date basis, revenues across our three major product categories were even more impressive, with growth ranging from 13% for hereditary cancer testing up to 26% for GeneSight.

我們確實受益於 24 年第三季前期估計值的有利變化，這主要影響了基因位點。提醒一下，我們也揭露了去年第三季估計變更帶來的顯著收益。今年的估計變更收益與去年合併總公司收益相似，因此更容易比較合併年收入。從年初至今，我們三大產品類別的收入更加令人印象深刻，成長率從遺傳性癌症檢測的 13% 到 GeneSight 的 26% 不等。

Next slide. As a reminder, we went into some detail at our recent Investor event regarding some of the key drivers for sustainable progress in average revenue per test, including various investments and initiatives by both our revenue cycle and payer markets team. In Q3, we saw stability in underlying rates across the portfolio, which represents another proof point for the great work being done by our revenue cycle and payer markets team, along with others throughout the company.

下一張投影片。提醒一下，我們在最近的投資者活動中詳細介紹了推動每次測試平均收入可持續發展的一些關鍵驅動因素，包括我們的收入週期和付款人市場團隊的各種投資和舉措。在第三季度，我們看到整個投資組合的基礎利率保持穩定，這再次證明了我們的收入週期和付款人市場團隊以及公司其他團隊所做的出色工作。

On the next slide, I'll highlight some of the wins from these efforts. On slide 20, we continue to see positive traction from these ongoing investments in revenue cycle workflows and from our ongoing payer engagement activities. These include, among other things, working with health plans to encourage their implementation of medical policies that conform to state biomarker legislation.

在下一張投影片中，我將重點放在這些努力所取得的一些成果。在投影片 20 上，我們繼續看到對收入週期工作流程的持續投資以及我們正在進行的付款人參與活動的正面影響。其中包括與健康計劃合作，鼓勵他們實施符合國家生物標記立法的醫療政策。

As discussed on prior earnings calls, there's a growing list of states that have passed biomarker legislation that lends itself to ensuring access to precision medicine and advanced diagnostics. As we have mentioned, we recently received expanded commercial and managed Medicaid coverage for GeneSight with Blue Shield of California, and Peach State Health Plan under the Centene umbrella. And there are several other payers with which we have had positive discussions regarding GeneSight coverage.

正如在先前的收益電話會議上所討論的那樣，越來越多的州通過了生物標誌物立法，這有助於確保獲得精準醫療和先進的診斷技術。正如我們所提到的，我們最近獲得了加州藍盾和 Centene 旗下的 Peach State Health Plan 的擴大商業和管理醫療補助覆蓋。我們也與其他幾位付款人就 GeneSight 覆蓋範圍進行了積極的討論。

In total, our team won 10 new product coverage or medical policy expansions from payers and executed seven contracts with new payers as we seek to bridge gaps in coverage across our no-pay universe during the third quarter. Those Q3 results bring us to 18 new contracts and 29 new coverage wins on a year-to-date basis.

總體而言，我們的團隊從付款人那裡贏得了 10 項新的產品保險或醫療政策擴展，並與新付款人簽訂了 7 份合同，以期在第三季度彌補我們無付款領域的保險空白。第三季的業績使我們今年迄今已獲得 18 份新合約和 29 項新承保。

As I've said in the past, no one of these wins will generally meaningfully move the revenue needle. But we certainly expect the accumulation of many small and medium-sized wins over time to contribute to the maturing and more stable rate environment for our products.

正如我過去所說的那樣，這些勝利通常不會對收入產生重大影響。但我們確實期望，隨著時間的推移，許多中小型勝利的累積將有助於我們產品的成熟和更穩定的利率環境。

Next slide. As a reminder, we closed the sale of our European EndoPredict business during the third quarter. There was a one-time non-cash charge, as well as minimal cash restructuring costs associated with the transaction. But it's important to note that the transaction removes about $11 million of annual run rate revenue.

下一張投影片。提醒一下，我們在第三季完成了歐洲 EndoPredict 業務的出售。此次交易涉及一次性非現金費用以及最低限度的現金重組成本。但值得注意的是，這筆交易將減少約 1,100 萬美元的年運行收入。

Importantly, it will be accretive by more than $4 million per year to our go-forward adjusted operating income by streamlining our cost structure. We had about two months of this impact in our Q3 results. Despite the impact of the transaction, we nonetheless delivered a solid 11% revenue growth on a consolidated basis and maintained healthy margins above 70%, contributed to a solid bottom line performance with six cents of adjusted EPS.

重要的是，透過精簡我們的成本結構，我們的未來調整後營業收入將每年增加 400 萬美元以上。我們的第三季業績受到了大約兩個月的影響。儘管受到交易的影響，但我們仍然實現了 11% 的綜合收入增長，並保持了 70% 以上的健康利潤率，並以 6 美分的調整後每股收益為基準，實現了穩健的盈利表現。

Next slide. Our 11% revenue growth in Q3 also translated to 11% year-over-year growth in gross profit dollars. On a year-to-date basis, we've generated 14% growth in gross profit dollars. Our adjusted EBITDA for the quarter was $14 million and is now $48 million on a trailing 12-month basis as of Q3.

下一張投影片。我們第三季的營收成長了 11%，這也意味著毛利年增了 11%。從年初至今，我們的毛利成長了 14%。我們本季的調整後 EBITDA 為 1,400 萬美元，截至第三季度，以過去 12 個月計算，目前為 4,800 萬美元。

The combination of our generous gross profit base and increasing levels of adjusted EBITDA profitability demonstrate the profit and cash generating potential of the business, especially as we generate more operating leverage over our operating expenses. We also finished Q3 in a strong liquidity position, with $149 million of total liquidity from a combination of cash and cash equivalents and availability under our revolver. We saw sequential increases in cash and cash equivalent balances from Q2 to Q3 and expect to be free cash flow positive in Q4 as well.

我們豐厚的毛利基礎和不斷提高的調整後 EBITDA 獲利水準相結合，證明了業務的利潤和現金創造潛力，特別是當我們在營運費用上產生更多的營運槓桿時。我們在第三季也維持了強勁的流動性狀況，現金、現金等價物和循環信貸下的可用流動性總計達 1.49 億美元。我們看到現金和現金等價物餘額從第二季到第三季連續增加，預計第四季的自由現金流也將為正值。

Next slide, please. Finally, before handing it back to Paul, I wanted to update our guidance for full-year 2024. As a reminder, we began the year with a revenue guidance range of $820 million to $840 million.

請看下一張投影片。最後，在將其交還給保羅之前，我想更新我們對 2024 年全年的指導。提醒一下，我們今年年初的營收預期範圍是 8.2 億至 8.4 億美元。

On our last earnings call, we updated that range to $835 million to $845 million. In light of our Q3 performance and continued execution, we're narrowing our full year revenue range to $837 million to $843 million. Our updated gross margin expectation is 69.8% to 70.3% and our optics is now expected to be $565 million to $570 million.

在我們上次的收益電話會議上，我們將範圍更新為 8.35 億美元至 8.45 億美元。鑑於我們第三季的業績和持續執行，我們將全年營收範圍縮小至 8.37 億美元至 8.43 億美元。我們最新的毛利率預期為 69.8% 至 70.3%，目前預計光學產品銷售額為 5.65 億美元至 5.7 億美元。

The net impact of these updates is a more favorable bottom line performance, with adjusted EBITDA of $34 million to $39 million, and an increase in adjusted EPS of $0.12 to $0.14. We have been pleased to have delivered solid performance proof points throughout the year and are also proud of these expected full year results.

這些更新的淨影響是更有利的底線表現，調整後的 EBITDA 為 3,400 萬美元至 3,900 萬美元，調整後的 EPS 增加 0.12 美元至 0.14 美元。我們很高興能夠在全年提供堅實的業績證明，也為這些預期的全年業績感到自豪。

Now, let me turn the call back to Paul.

現在，讓我把電話轉回給保羅。

Thanks, Scott. We continue to build on the pillars of long-term growth and profitability that delivered our strong results in the third quarter. The momentum we continue to see across the enterprise supports our decision to update our 2024 financial guidance.

謝謝，斯科特。我們繼續鞏固長期成長和獲利的支柱，並在第三季取得了強勁的業績。我們在整個企業中持續看到的勢頭支持我們更新 2024 年財務指導的決定。

While the GeneSight medical policy changed by UnitedHealthcare's disappointing, we remain encouraged about our future. As I mentioned earlier, revenue related to patients under UnitedHealthcare's commercial policies represent about $40 million in the most recent 12-month period.

儘管 GeneSight 的醫療政策因 UnitedHealthcare 的失望而改變，但我們對未來仍充滿信心。正如我之前提到的，最近 12 個月，聯合健康保險商業保險下的患者相關收入約為 4000 萬美元。

If the policy change goes into effect in January, we would expect a loss of about $40 million of revenue. That would translate to approximately $30 million of lost gross profits. Our preliminary view is that we can mitigate at least $10 million of that bottom line impact. In addition, we continue to believe that we can grow our remaining business at double digit pace, even after adjusting our budget, our projected 2024 revenue for the loss of the UnitedHealthcare commercial revenue.

如果該政策變更於一月份生效，我們預計收入損失約為 4000 萬美元。這意味著大約3000萬美元的毛利損失。我們的初步看法是，我們可以減輕至少 1000 萬美元的底線影響。此外，我們仍然相信，即使在調整預算、預計 2024 年收入將彌補 UnitedHealthcare 商業收入的損失後，我們剩餘的業務仍可以以兩位數的速度成長。

Our clinically differentiated products supported by technology deliver value in real world clinical settings and enable early detection and better treatment decisions for providers and their patients. Our modernized labs and commercial engines are examples of where investments in automation and advanced technology are yielding improved workflows, faster turnaround times, and reduced operating costs. All of this is reinforcing our position as a trusted and reliable lab with specialized expertise committed to quality and service excellence. We continue to energize the enterprise around our shared mission and vision to make genetic testing and precision medicine more accessible, helping people take more control of their health, and to enable providers to better treat and prevent disease.

我們在技術的支援下具有臨床差異化的產品在現實世界的臨床環境中提供了價值，並為醫療服務提供者及其患者提供了早期發現和更好的治療決策。我們的現代化實驗室和商用引擎就是對自動化和先進技術的投資帶來工作流程改善、週轉時間加快和營運成本降低的典範。所有這些都鞏固了我們作為值得信賴和可靠的實驗室的地位，我們擁有致力於卓越品質和服務的專業知識。我們將繼續圍繞共同的使命和願景為企業注入活力，使基因檢測和精準醫療更加普及，幫助人們更好地掌控自己的健康，並使服務提供者能夠更好地治療和預防疾病。

I'll now pass the call back over to Matt for Q&A.

我現在將把電話轉回給馬特進行問答。

Thanks, Paul. And as a reminder, during today's call, we use certain non-GAAP financial measures. A reconciliation of the GAAP to non-GAAP financial results can be found in our earnings release and under the investor relations section of our website.

謝謝，保羅。提醒一下，在今天的電話會議中，我們使用了某些非 GAAP 財務指標。在我們的收益報告和我們網站的投資者關係部分中可以找到 GAAP 與非 GAAP 財務結果的對帳表。

Now we're ready to begin the Q&A session to ensure broad participation. We're asking participants to please to please ask only one question and one follow-up. Franz, we are now ready for the Q&A portion of the call.

現在我們準備開始問答環節，以確保廣泛參與。我們要求參與者只問一個問題和一個後續問題。弗朗茲，我們現在準備好進行電話會議的問答部分。

(Operator Instructions) Doug Shendel, Wolfe Research.

（操作員指示）Doug Shendel，Wolfe Research。

Good afternoon, guys. Thanks for taking my questions. So I'm going to, probably no surprise, start on Genesight. And I wanna start with a couple math questions, and then I wanna kind of get into a philosophical question for you, Paul.

大家下午好。感謝您回答我的問題。因此，我將從 Genesight 開始，這可能並不令人驚訝。我想先問幾個數學問題，然後我想問你一個哲學問題，保羅。

So United accounts for, I think, roughly a quarter of GeneSight revenue. Presumably volume is about 15% to 20%. And you know, as we think about updating our models for next year, assuming this holds. I believe gene site gross margin is, you know, 75% to 80%, so I just wanna make sure those are right from a math standpoint. And, well, why don't I pause there, and then I'll come back with a follow-up on the philosophical question.

所以我認為 United 大約佔 GeneSight 收入的四分之一。推測成交量大概在15%到20%左右。你知道，當我們考慮更新明年的模型時，假設這種情況成立。我相信基因站點的毛利率是 75% 到 80%，所以我只是想確保從數學角度來看這些是正確的。好吧，我為什麼不在這裡暫停一下，然後再回來繼續探討這個哲學問題。

Yeah, so Doug, try to be real clear about the math. Of our $840 million of revenue that we expect this year, approximately $40 million of it is United commercial. And we expect to be able to grow in double digits on that sort of pro forma base. We are still aiming for 12% growth rate next year and beyond.

是的，所以 Doug，請盡量清楚地理解數學知識。我們今年預計的收入為 8.4 億美元，其中約 4,000 萬美元來自聯合商業收入。我們預計在此基礎上能夠實現兩位數的成長。我們明年及以後的目標仍然是12%的成長率。

We've said that that's our long-term growth rate. We are four days into evaluating this, and most importantly, engaging with United on some additional data that we think they failed to take into account. And frankly, some interpretation of some of the information out there.

我們說過這是我們的長期成長率。我們花了四天時間對此進行評估，最重要的是，與美聯航討論一些我們認為他們未能考慮到的額外數據。坦白說，對一些資訊進行了一些解釋。

So we're looking forward to continuing that discussion. We have a really great working relationship with United. This clearly kind of caught us out of the blue. And quite frankly, it's inconsistent with typically how policy is made. Typically, some study would be issued that would say that the test is dangerous or problematic. And so we're not really sure what gave rise to this policy change, but we're looking forward to those continued discussions and quite frankly, continuing to share with them the differentiating nature of chainsight that I think sets it apart to some extent from other PGx tests. So that's the math that I would anchor you on.

因此我們期待繼續討論。我們與美聯航保持著良好的合作關係。這顯然讓我們感到有些意外。坦白說，這與通常的政策制定方式不一致。通常，會有一些研究表明該測試是危險的或有問題的。因此，我們不太確定是什麼導致了這一政策變化，但我們期待繼續進行討論，並且坦率地說，繼續與他們分享 Chainsight 的差異化，我認為這在某種程度上使它有別於其他 PGx 測試。這就是我要告訴你的數學。

And we -- again, I wanted to give you a sense of the gross profits there of around $30 million and that we've already sort of putting our arms around, you know, at least $10 million of mitigation with respect to that. And that's again, assuming four days into what we can do. So I hope that guides you on your modeling and gives you a baseline from which to think about 2025.

而且我們 — — 我再次向您介紹那裡的毛利約為 3,000 萬美元，而且我們已經就此籌集了至少 1,000 萬美元的緩解資金。再假設我們能用四天完成這些事情。所以我希望這能引導你的建模並為你思考 2025 年提供一個基準。

No, that's super helpful. And that's pretty impressive in four days. We'll see what you do next week. On the philosophical question, so I understand the unmet need associated with GeneSight. That being said, going back to the time of the [Assurax] deal, which of course predates you, this has been a pretty consistently controversial area of focus for the company, at least in the minds of Wall Street, and I think to an extent in even the clinical community.

不，這非常有幫助。四天內取得這樣的成績真是令人印象深刻。我們將看看你下週會做什麼。關於哲學問題，我理解與 GeneSight 相關的未滿足的需求。話雖如此，回顧 [Assurax] 交易的時間，當然這比你們早，這一直是公司關注的一個相當有爭議的領域，至少在華爾街人士的心目中是如此，我認為甚至在臨床界也在一定程度上如此。

The motivation behind the deal, again, which -- it's not you, Paul, but it was questionable from the start, in my opinion. The way your predecessors cut data wasn't straightforward. All that said, I bring this up because in your three-plus years with the company, you've done a commendable job of not doing these types of things. You've stopped the lawsuits. You're really good with disclosure. You haven't been adversarial with payers. You've worked with them.

再次強調，這筆交易背後的動機——這不是你，保羅，但在我看來，它從一開始就是值得懷疑的。您的前任削減數據的方式並不簡單。儘管如此，我之所以提起這件事，是因為您在公司工作的三年多時間裡，一直沒有犯下此類錯誤，您做得非常出色。你已經停止了訴訟。您確實很善於揭露資訊。您並未與付款人發生過對抗。你曾經和他們合作過。

You know, simply put, you've worked hard to optimize the good at Myriad and reduce the drama and increase the predictability. Let me put aside clinical need and maybe be the jerky Wall Street guy for a second, but recognizing this is a quarterly financial call, GeneSight kind of remains the last bastion of drama at Myriad in the eyes of the investment community. Again, I think to a certain extent, the clinical community.

你知道，簡單地說，你已經努力優化 Myriad 的優點並減少戲劇性並提高可預測性。讓我暫時把臨床需求放在一邊，也許可以當一下華爾街人，但認識到這是一個季度財務電話會議，在投資界眼中，GeneSight 仍然是 Myriad 的最後一個戲劇堡壘。再次，我認為在某種程度上，臨床界是這樣的。

What's the criteria you decide, you use to decide if any asset keeping Genesight very much in mind, should be part of Myriad 2.0, should be part of your business? Thank you.

您決定的標準是什麼？謝謝。

Yeah, thanks, Doug. Well, first of all, let's underscore a big we here. The last four and a half years have been a real team effort, including our Board of D irectors. And we have continued to deliver double digit growth and now profitable growth for the last five, six quarters. And we're committed to continue to do that.

是的，謝謝，道格。嗯，首先，讓我們在這裡強調一下「我們」。過去四年半是真正的團隊努力的結果，包括我們的董事會。過去五、六個季度，我們持續保持兩位數的成長，並實現獲利成長。我們致力於繼續這樣做。

And I appreciate your kind words. We have divested those non-strategic assets. We've just completed -- it was a little noisy in Q3, our international restructuring. And despite that, we delivered on the 11% growth and quite frankly, a nice beat on the EPS line too.

我也很感激您的善意言辭。我們已經剝離了那些非戰略資產。我們剛剛完成——第三季有點混亂，我們的國際重組。儘管如此，我們仍然實現了 11% 的成長率，而且坦白說，每股盈餘也超出預期。

Look, I will tell you there are thousands of patients, three million patients out there, including a number of personal stories that I can get into offline of people whose life has really changed because of the gene site test. There is nothing more painful than watching your teenage daughter struggle with depression and anxiety and going through the trial and error of three or four drugs over the course of 18 months and the weight gain and the loss productivity.

你看，我會告訴你，有成千上萬的患者，有三百萬患者，其中包括很多我可以線下了解到的個人故事，這些人的生活因為基因位點測試而發生了真正的改變。沒有什麼比看著你的十幾歲的女兒與憂鬱和焦慮作鬥爭，在 18 個月的時間裡嘗試三到四種藥物，體重增加，生產力下降更痛苦的了。

And so we're looking forward to sharing more of that data and clinical utility with United, including the work that we've done with Optum, and try to better understand this policy change. But I can tell you that our Genesight team and the 500,000 patients this year that are gonna benefit from getting on the right medication faster, we're not gonna abandon them anytime soon.

因此，我們期待與 United 分享更多數據和臨床實用性，包括我們與 Optum 合作完成的工作，並嘗試更好地理解這項政策變革。但我可以告訴你，我們的 Genesight 團隊和今年的 50 萬名患者都將從更快獲得正確的藥物治療中受益，我們不會很快拋棄他們。

(inadible), Morgan Stanley.

（不可置信），摩根士丹利。

Hi, this is Madison on for Cages. Thanks for taking the question. I guess. I wanted to start off, I guess, in light of the body of evidence for use of multi gene panels and mental health disorders being relatively less mature than say for like, oncology. Do you think that there is a risk that payers who are facing growing headwinds on the cost structure will view the field as kind of like low hanging fruit to deny claims or raise the bar for prior off?

大家好，我是麥迪遜，為凱奇斯報道。感謝您回答這個問題。我想是的。我想首先考慮到，使用多基因組和精神健康障礙的證據相對不太成熟，例如腫瘤學。您是否認為，面臨成本結構日益增大的阻力的付款人，會將該領域視為拒絕索賠或提高優先賠償標準的唾手可得的手段？

Well, I think that we acknowledge that the payers, it's their turn in the cycle here and they're facing on their enormous profit base, by the way, a fair amount of pressure. And that there's a drown stream effect on that and there's a great deal of scrutiny, bipartisan scrutiny on prior authorizations and a number of their practices.

嗯，我認為我們承認，現在輪到付款人進入這個週期了，順便說一句，他們在巨大的利潤基礎上面臨著相當大的壓力。這會產生淹沒效應，並且需要進行大量審查，兩黨需要對事先授權和一些做法進行審查。

Again, we've worked really hard with United and others to be transparent, to work through coding changes. And we're gonna continue to do that, because I think that goes to the underlying integrity of our revenues and our business model. But there's no question that their pressure gets extended like everybody else in the healthcare ecosystem.

再次強調，我們與美聯航和其他公司進行了非常艱苦的合作，保持透明度，並努力完成編碼變更。我們將繼續這樣做，因為我認為這關係到我們的收入和商業模式的根本完整性。但毫無疑問，他們的壓力與醫療保健生態系統中的其他人一樣大。

It is also true that we've had a disciplined approach to managing our costs, which is important here as well in terms of improving the value proposition. The data and the evidence that we see for GeneSight, quite frankly, is that it improves the MLR. That when you look at the other costs associated with patients, whether it's their primary diagnosis or secondary, is that whether you're talking about the elderly or a person in their working years or a teenager, that depression, anxiety, ADHD have enormous personal and financial costs to the system, and so again, we're gonna continue to build that body of evidence.

事實上，我們在管理成本方面也採取了嚴謹的方法，這對於提高價值主張也很重要。坦白說，我們看到的 GeneSight 數據和證據表明，它改善了 MLR。當你考慮與病人相關的其他費用時，無論是他們的主要診斷還是次要診斷，無論你談論的是老年人、工作年齡的人還是青少年，憂鬱、焦慮、過動症都會給系統帶來巨大的個人和經濟成本，所以，我們將繼續累積這方面的證據。

But we think in the context, and I have a fair amount of experience in this, in terms of looking at the total cost of care and the MLR of a payer, that people would be short-sighted to not use the GeneSight tool as part of the process to get people on the right drugs faster and improve their overall treatment process.

但我們認為，在這種背景下，而且我在這方面有相當多的經驗，從總護理成本和付款人的 MLR 的角度來看，如果人們不將 GeneSight 工具作為流程的一部分來讓人們更快地使用正確的藥物並改善他們的整體治療過程，那將是目光短淺的。

Got it, okay, that makes sense. Then maybe one other one. I know you kind of touched on this before, but just wondering if you've had any in-bounds from other payers following the Unites decision, and then more specifically, what had your revised long-term targets assumed by way of improvement in the gene site no-pay rate over the next couple years?

明白了，好的，這很有道理。然後也許還有另外一個。我知道您之前提到過這個問題，但我只是想問，在 Unites 做出決定之後，您是否收到過其他付款人的任何限制，然後更具體地說，您修改後的長期目標是什麼，假設未來幾年內基因位點免付費率有所改善？

Well, no inbound. And again, we continue to, as Scott pointed out and I've talked about over the last couple of years, we view reducing our no pay as a lot of ground game. You know, the small wins that are adding up, most of those wins have just been in the last couple of quarters. So you're not even seeing that yet.

嗯，沒有入站。正如斯科特指出的以及我在過去幾年中談到的，我們將繼續把減少無薪工資視為一項艱鉅的任務。您知道，這些小勝利不斷累積，其中大部分都是在最近幾季取得的。所以你現在甚至還沒有看到這一點。

Many of these state biomarker laws just went into effect in July, some are just going to affect in January, and it takes months if not a year to make it into medical policy and to make it into contracts. So it is, as we've articulated before, a slow process. The biomarker laws are not tied to United's medical policy. They are tied to national coverage determinations and LCDs specifically.

許多州的生物標記法律剛剛在 7 月生效，有些將於 1 月生效，而將其納入醫療政策和合約則需要數月甚至一年的時間。因此，正如我們之前所闡述的，這是一個緩慢的過程。生物標誌物法律與聯合航空的醫療政策無關。它們與國家覆蓋範圍決定和 LCD 有具體的關聯。

And so again, we don't expect that to impact our ability to continue to reduce no pays for gene site and quite frankly, continue to grow gene site. And again, we'll look forward to hopefully affecting this policy change at United. In terms of our long-term growth, I think I've sort of spoken to that.

因此，我們再次強調，我們不希望這會影響我們繼續減少基因位點費用的能力，坦白說，也不會影響我們繼續發展基因位點的能力。我們再次希望能夠影響美聯航的這項政策改變。就我們的長期發展而言，我想我已經談過這個問題了。

Certainly that we will continue to revisit that, but we are confident in our ability to continue to grow our revenue base, our pro forma revenue base on a double digit basis, and continue to grow profitably as we continue to get the productivity gains of our lab of the future and see the rest of the leverage in our P&L that you really saw this quarter and the drop through that is happening across our P&L.

當然，我們將繼續重新審視這一點，但我們有信心我們能夠繼續以兩位數的速度增加我們的收入基礎、我們的預期收入基礎，並且隨著我們未來實驗室的生產力不斷提高，我們將繼續實現盈利增長，並看到我們本季度真正看到的損益表中其餘的槓桿率以及損益表中正在發生的下降。

Got it. Okay, very helpful. Thanks for the time guys. Thank you.

知道了。好的，很有幫助。謝謝大家的時間。謝謝。

Puneet Souda, Leerink Partners.

Puneet Souda，Leerink Partners。

Hi, Paul. So just wanted to clarify on GeneSight. Could you please confirm the Medicare rate there? And as you pointed out, that would become the larger portion of the mix, and as a result only about half of the impact on the bottom line. So I just wanted to confirm that.

你好，保羅。所以只是想澄清一下 GeneSight。您能確認那裡的醫療保險費率嗎？正如你所指出的，這將成為組合中較大的一部分，因此對底線的影響僅佔約一半。所以我只是想確認這一點。

And then on the payer side, why would we not expect to continue to see more pressure from the payers because they themselves are experiencing pressure in other areas? So why wouldn't we expect that on other parts of the portfolio or any conversations that you have had on that end?

那麼從付款人方面來看，為什麼我們不會期望繼續看到來自付款人的壓力更大，因為他們自己在其他領域也面臨壓力？那麼，為什麼我們不期望在投資組合的其他部分或您在這方面進行的任何對話中也出現這種情況呢？

Yeah, let me start with the last one, Puneet. Thank you. As I said a few minutes ago, the whole healthcare system is gonna see continued pressure. I think our sector is in a little different position because adoption rates are still pretty low, and we have significant no-pays across our portfolio, whether it's in prenatal or for hereditary cancer, and you've seen progress across the board there. There are many payers that only cover, you know, a BRAC in terms of hereditary cancer, for example.

是的，讓我從最後一個開始，Puneet。謝謝。正如我幾分鐘前所說，整個醫療保健系統將面臨持續的壓力。我認為我們的行業處於略有不同的境地，因為採用率仍然很低，而且我們的投資組合中存在大量未付款項，無論是產前還是遺傳性癌症，您都看到了全面進展。例如，許多付款人僅承保遺傳性癌症的 BRAC。

So I think there's more than enough upside to improving our ASP, notwithstanding the global pressures. And we're not seeing -- and we talked about this year to date, we haven't seen any contract pressure, pricing pressure in any of our discourse with payers. That has not come up.

因此我認為，儘管面臨全球壓力，但提高我們的平均售價仍然具有足夠的上升空間。我們沒有看到——而且就今年迄今為止的情況而言，我們在與付款人的任何討論中都沒有看到任何合約壓力和定價壓力。但那還沒有發生。

Our Medicare rate is 13.56 for GeneSight. And again, while -- again, this is disappointing and we're working through this again four days in. We don't see this having an overall impact on our ASP opportunity over the next few years. We think that across our portfolio, we have three or four to five more years of opportunity to expand medical policy, to improve rev cycle, and reduce no pay.

我們的 GeneSight 醫療保險費率為 13.56。再次，然而 — — 再次，這令人失望，我們仍在四天後再次處理這個問題。我們認為這不會對未來幾年的 ASP 機會產生整體影響。我們認為，在我們的投資組合中，我們還有三到四到五年的機會來擴大醫療政策，改善收入週期，並減少無薪假。

Got it. That's helpful. And then let me switch away from GeneSight. There was an acquisition in the space on the GeneSight side. Just wondering how are you thinking about the competitive landscape? You obviously taking some share with the disruption in the marketplace. Now with this acquisition, just wondering how you are thinking about Myriad's position and potentially maybe even ability to take share.

知道了。這很有幫助。然後讓我離開 GeneSight。GeneSight 領域有一項收購。只是想知道您如何看待競爭格局？您顯然對市場混亂負有一定責任。現在有了這次收購，我只是想知道您如何看待 Myriad 的地位以及潛在的甚至奪取市場份額的能力。

Yeah, thank you. I'll start and then turn it over to Mark. I think you probably all have heard enough from me already.

是的，謝謝。我先開始，然後交給馬克。我想你們可能已經聽夠我說過的話了。

But the recent changes in the marketplace and [VTA, Semaphore], and now the transaction of the Ambre, all create opportunities for us to gain share as a respected and quite frankly, the leading provider for hereditary cancer tests. This is both for affected patients in oncology and particularly for unaffected patients principally in our women's health channel.

但最近市場和 [VTA、Semaphore] 的變化，以及現在的 Ambre 交易，都為我們創造了機會，讓我們能夠作為受人尊敬的、坦率地說是領先的遺傳性癌症檢測提供者獲得市場份額。這既適用於腫瘤科受影響的患者，也適用於主要在我們的女性健康管道中未受影響的患者。

So as I've said throughout the year, these changes take time, even with respect to the most recent change in VTA and LabCorp, the policy changes are just taking us into effect now. The integration is just going to happen here in January, as I understand from some of our field people. So I think 2025 is going to be a great year for us to win share, particularly as we land these large accounts, continue to advance our EMR integrations, continue to expand our MyRisk panel that we've talked about at the investor day.

因此，正如我全年所說的那樣，這些變化需要時間，即使就 VTA 和 LabCorp 的最新變化而言，政策變化也才剛開始生效。根據我從我們一些實地人員那裡了解到的情況，整合將於明年 1 月完成。因此，我認為 2025 年將是我們贏得份額的好年份，特別是當我們獲得這些大帳戶、繼續推進我們的 EMR 整合、繼續擴大我們在投資者日討論的 MyRisk 面板時。

So we're quite bullish on our opportunity to grow MyRisk, our hereditary cancer tests across all of our channels in 2025.

因此，我們非常看好 2025 年在所有通路拓展 MyRisk 遺傳癌症測試的機會。

Mark?

標記？

Yeah, the only thing I would add to that, just echo Paul's comments, on the unaffected side are our women's health channel. Myriad is by far the market leader, and we don't see much competition there. I think on the unaffected side, clearly MyRisk is considered the gold standard test. And anytime we've seen this dislocation, that opens up different providers and health systems to now have to make a choice because they have to remove a product. So that means it opens up a choice for Myriad to get into that account.

是的，我唯一想補充的是，只是回應保羅的評論，不受影響的是我們的女性健康頻道。Myriad 是迄今為止的市場領導者，我們在該市場沒有看到太多競爭。我認為從不受影響的角度來看，MyRisk 顯然被視為黃金標準測試。每當我們看到這種混亂，不同的供應商和醫療系統就必須做出選擇，因為他們必須刪除某種產品。所以這意味著 Myriad 可以選擇進入該帳戶。

In addition, it takes a long time for these integrations as we sort of talked about, right? We would expect those to be a lot quicker, but unfortunately when you're trying to integrate a test like hereditary cancer test, it does take a long time. So that move from one competitor to another doesn't happen overnight, but it really does open up a lot of opportunities for Myriad to be back in there, selling the best in class test.

此外，正如我們所討論的，這些整合需要很長時間，對嗎？我們希望這些會更快，但不幸的是，當您嘗試整合像遺傳性癌症測試這樣的測試時，它確實需要很長時間。因此，從一個競爭對手轉向另一個競爭對手並非一朝一夕就能實現的，但它確實為 Myriad 重返市場並銷售同類最佳測試產品帶來許多機會。

And so similar to what we've seen with the previous dislocation, we're going to take this opportunity to really focus and to get back in there and win share.

與先前的混亂情況類似，我們將藉此機會集中精力，重新回到市場並贏得份額。

There's a warm room already set up on in VT and Ambry, I promise you.

我向你保證，VT 和 Ambry 已經設立了一個溫暖的房間。

All right. Thanks, Paul. I'll leave it at that.

好的。謝謝，保羅。我就不說了。

Chan Coda, Goldman Sachs.

高盛的 Chan Coda。

Hey, guys. This is Prashad on for Matt. Congrats on the quarter. Sad to hear about the GeneSight development, but I was wondering how you're thinking about the timeline of further dilution of no pay rate from the addition of new products.

嘿，大家好。這是 Prashad 代替 Matt 上場的。恭喜本季取得佳績。很遺憾聽到有關 GeneSight 開發的消息，但我想知道您如何看待增加新產品後免費費率進一步降低的時間表。

For example, would you ever consider staggering the launch of certain products to avoid dilution of the no pay rate all at once, which could potentially affect margins? And then I have another question on MRT, but I want to start with that first.

例如，您是否會考慮分階段推出某些產品，以避免一次降低免付費率，這可能會影響利潤率？然後我還有另一個關於 MRT 的問題，但我想先從這個開始。

Yeah, that's a really great question. I actually spoke about this at a panel recently with our friend Doug, who was on the line earlier. The industry's great opportunity here is to close the gap between science and technology and the great innovations happening in our labs and medical policy. But in between there are guidelines and whether we're talking about prenatal tests or guidelines for oncology products, we gotta close those gaps.

是的，這是一個非常好的問題。事實上，我最近在一次小組討論中與我們的朋友 Doug 討論過這個問題，他之前也在線上。該行業的巨大機會是縮小科學技術與我們實驗室和醫療政策中發生的偉大創新之間的差距。但在這兩者之間都有指導方針，無論我們談論的是產前檢查還是腫瘤產品指南，我們都必須彌補這些差距。

Now I think we're, as part of our product management here, really trying to be thoughtful about how we go to market with products like First Gene. In fact, our discussions with United around MRD are right around this topic that we will expect to continue. And so we certainly expect that as we launch new products like everyone has experienced, some no pay, some even margin degradation. We have plenty of other ways to continue to maintain margins, but ultimately we want to close the gap between launch and payment.

現在我認為，作為我們產品管理的一部分，我們正在認真考慮如何將 First Gene 等產品推向市場。事實上，我們與 United 圍繞 MRD 的討論正是圍繞這個主題進行的，我們希望這個討論能夠繼續下去。因此，我們當然預料到，當我們推出新產品時，就像每個人都經歷過的那樣，有的沒有報酬，有的甚至利潤率下降。我們有很多其他方法來繼續保持利潤率，但最終我們希望縮小發布和付款之間的差距。

But you will see that in First Gene, you will see that with precise liquid. And we've been pretty open about those things. The strength of myriad genetics though, is the diversity of our portfolio. And the many different levers we have to pull here to grow profitability.

但您會看到，在 First Gene 中，您會看到精確的液體。我們對這些事情一直都非常開放。然而，無數遺傳學的優勢在於我們產品組合的多樣性。我們必須利用多種不同的手段來提高獲利能力。

Sam, I don't know if you'd add anything to that.

山姆，我不知道你還有什麼要補充。

I think you said that very well, Paul. Yeah.

我認為你說得很好，保羅。是的。

That's helpful. And then just playing devil's advocate, what if the revenue contribution from MRD for some reason takes longer than expected? Do you still feel confident in achieving that 12% plus long-term guide for top line growth?

這很有幫助。然後，只是扮演魔鬼代言人，如果由於某種原因 MRD 的收入貢獻比預期需要更長的時間怎麼辦？您是否仍有信心達到 12% 以上的長期營收成長目標？

Yeah, we have said consistently, I'll underscore this, that our long-term growth target is based on our core portfolio products, including the enhancements we're making to those products across the portfolio. We don't expect contributions for first gene to get us there. We don't expect contributions from precise tumor, precise liquid to get us there and we certainly don't expect MRD.

是的，我們一直說，我要強調的是，我們的長期成長目標是基於我們的核心產品組合，包括我們對整個產品組合中這些產品所做的改進。我們不指望對第一個基因的貢獻能幫助我們實現這一目標。我們不期望精準的腫瘤、精準的液體能幫助我們實現這一目標，當然也不期望 MRD。

Those products we hope and expect as we think about 26 and 27, start pointing us to growth in the mid-team. And again, with many different levels, levers to maintain our 70% gross margins.

當我們想到 26 年和 27 年時，我們所希望和期待的那些產品開始指引我們走向中階團隊的成長。再一次，我們利用多個不同層面的槓桿來維持 70% 的毛利率。

Subodh Ambhi, Guggenheim Partners.

古根漢合夥人公司的 Subodh Ambhi。

Hey guys, thank you for taking my question. Clearly the United Health decision was a surprise. One of the things that made it all the more surprising is that a United affiliate, Optum Health, was a key group that generated health economic data supporting gene-side use. Does this relationship actually help you as you engage with United on this or does this make the decision all the more challenging, given how close your data should be to how this data was generated?

嘿夥計們，謝謝你們回答我的問題。顯然，聯合健康集團的決定令人意外。更令人驚訝的是，聯合公司的附屬機構 Optum Health 是產生支持基因側使用的健康經濟數據的關鍵組織。當您與 United 就此事進行交涉時，這種關係是否真的對您有幫助？

Well, you know, I think United is a big complex organization and that's been incredibly successful, one of the more successful healthcare companies in America. But it is quite a big complex organization and I'm not really sure if they took that health economics data into account. But I assure you when we sit down with them in the next couple of weeks that that data is going to be shared.

嗯，你知道，我認為聯合醫療是一個龐大而複雜的組織，它取得了巨大的成功，是美國最成功的醫療保健公司之一。但它是一個相當龐大和複雜的組織，我不確定他們是否考慮了健康經濟數據。但我向你們保證，當我們在接下來的幾週與他們坐下來談話時，這些數據將會被分享。

As we said previously, there is no doubt that GeneSight contributed to some of those savings. That's clear from the Phase I study. So we'll be reviewing that data along with the additional GeneSight-specific meta-analysis that was recently completed.

正如我們之前所說，毫無疑問 GeneSight 對其中的一些節省做出了貢獻。從第一階段的研究中可以清楚看出這一點。因此，我們將對該數據以及最近完成的附加 GeneSight 特定薈萃分析進行審查。

And again, part of what I think we're going to discuss with United is the difference between GeneSight and some of the other PGx tests out in the marketplace and that differentiation, both in terms of clinical utility and clinical validity. So we can't tell you exactly what ended it. We've read the policy just like you have, but there's more to talk about, and we're looking forward to those conversations and having a more holistic conversation. And that's probably what's disappointed here, that the position of other stakeholders wasn't taken into account.

再次強調，我認為我們將與 United 討論的部分內容是 GeneSight 與市場上其他一些 PGx 測試之間的差異，以及這種差異，包括臨床實用性和臨床有效性方面。所以我們無法確切地告訴你它是如何結束的。我們和您一樣閱讀了該政策，但還有更多內容需要討論，我們期待這些對話並進行更全面的對話。這可能就是令人失望的地方，因為其他利害關係人的立場沒有被考慮在內。

And again, that there wasn't some big study that was recently released that would give rise to this policy change. So we're really scratching our heads about this, but we'll know more in the weeks to come once we sit down.

而且，最近並沒有發布什麼大型研究成果來推動這項政策改變。所以我們真的對此感到困惑，但只要我們坐下來，未來幾週我們就會知道更多。

Thank you for that, Paul. And just to address the elephant in the room, what gives you the confidence that other payers won't pull their coverage for GeneSight? Especially payers are always looking for an excuse to not pay for tests, especially diagnostic tests. So just anything, any sign I know you said about the personal stories and the data that's out there, but these were all out there even when United took that decision. So just trying to see how are you planning to navigate that?

謝謝你，保羅。只是為了解決這個顯而易見的問題，是什麼讓您有信心其他付款人不會取消對 GeneSight 的承保？尤其是付款人總是找藉口不支付測試費用，特別是診斷測試。所以，我知道您所說的任何跡像都與個人故事和數據有關，但即使在美聯航做出這項決定時，這些都已經存在。所以只是想看看您打算如何解決這個問題？

We're not offering a guarantee here. You know, what we are saying is those other coverage determinations were not based on United's policy. They're based on local coverage determinations. And we are, you know, obviously, we've talked about this before. We are always trying to build the clinical evidence across all our products.

我們在此不提供保證。你知道，我們要說的是，其他保險範圍的決定並非基於美聯航的政策。它們是基於當地的覆蓋範圍決定的。你知道，顯然我們之前已經談過這個問題。我們始終致力於為所有產品提供臨床證明。

And while the company fell behind on those research and those clinical studies, there's been a great deal of work over the last three years and you've seen this at various conferences to bring forth more clinical evidence to support our test as an ongoing obligation and commitment that we have. But we have no reason to believe that there will be changes in other payers' coverage determinations or policies. That's not to say as you and others have pointed out, that payers might not look to this and attempt to do that. It's just inconsistent with how medical policies have been underwritten to date, and it would be a big departure from their contractual obligations to look to this policy to make a change here. And four days in, that's the best we can tell you.

儘管公司在這些研究和臨床研究方面落後了，但過去三年來我們已經做了大量工作，您可以在各種會議上看到這一點，以提供更多的臨床證據來支持我們的測試，這是我們持續的義務和承諾。但我們沒有理由相信其他付款人的核保決定或保單會改變。正如您和其他人指出的那樣，這並不是說付款人可能不會考慮這一點並嘗試這樣做。這與迄今為止醫療保險政策的承保方式不一致，並且期望該政策做出改變將大大背離他們的合約義務。四天過去了，這就是我們能告訴您的最好的訊息了。

Thank you, thank you for that, Paul.

謝謝你，保羅。

Sure, no thank you.

當然，不用了，謝謝。

Sung Nam, Scotiabank.

加拿大豐業銀行的 Sung Nam。

Paul, I may have misunderstood your comments earlier, but do you have a sense of what additional data they're looking for at this point, or if they provided any kind of specific endpoints or metrics or, you know, size of patient cohorts they're looking for, just trying to better understand kind of what's missing from their perspective?

保羅，我之前可能誤解了你的評論，但你是否知道他們此時正在尋找什麼額外數據，或者他們是否提供了任何特定的終點或指標，或者他們正在尋找的患者群體規模，只是想更好地了解他們的角度來看缺少了什麼？

We're not quite clear on what's missing, quite frankly. But again, we have a good working relationship with the team at United, and we are scratching our heads about how policy change was affected without some study being released that pointed to the negative aspects of these tests, and including from different societies and others.

坦白說，我們不太清楚缺少了什麼。但是，我們與 United 的團隊保持著良好的工作關係，我們正在絞盡腦汁思考政策變化會如何受到影響，因為還沒有發布一些研究指出這些測試的負面影響，包括來自不同社會團體和其他機構的研究。

So again, we're looking forward to sitting down with United and understanding what gave rise to this policy change, because again, we don't see the trigger for it, but I can't speak for them. So again, we'll look forward to having that conversation and presenting the additional data that was not presented in the policy statement that we think should have been taken into account. So that's the clarifying point. We do have additional data, and we think that the input of stakeholders is gonna be important here.

因此，我們再次期待與美聯航坐下來談談，了解導致這項政策變化的原因，因為我們再次沒有看到導致這一變化的觸發因素，但我不能代表他們發言。因此，我們再次期待進行這次對話，並提供我們認為應該考慮到的政策聲明中未提供的額外數據。這就是需要澄清的一點。我們確實有額外的數據，我們認為利害關係人的投入在這裡很重要。

We don't think that this policy change allowed for getting the stakeholder input from providers and patient advocate groups about gene side or the other test. So we'll have more to share after we sit down with United, but I don't want to prejudice those conversations. I want to go into them listening and learning, and hopefully they will respond in kind to be open to the data that we want to provide and the additional input from other stakeholders.

我們認為，這項政策的改變不允許從供應商和患者權益團體獲得有關基因方面或其他測試的利害關係人的意見。因此，在與美聯航坐下來談判後，我們會有更多資訊可以分享，但我不想影響這些對話。我希望深入地傾聽和學習他們的意見，希望他們也能以開放的態度對待我們提供的數據和其他利害關係人的額外意見。

Got yo. And then just curious on that note, trying to assess the best-case scenario, worst-case scenario, maybe the worst-case scenario is more obvious, but best-case scenario, do you think something like this, you know, after presenting additional data, something like this could be resolved within the next year, or would be kind of the earliest? We might know is kind of the next decision cycle for United from their coverage perspective. And then also just curious if the United Health portion of your GeneSight business has been going at kind of roughly the same rate as the rest of the business or has it been growing faster over the last few years?

明白了。然後只是好奇地嘗試評估最佳情況和最壞情況，也許最壞情況更明顯，但最好的情況是，您是否認為在提供更多數據後，這樣的事情可以在明年內解決，或者最早是在明年？從他們的報道角度，我們或許可以知道這是美聯航的下一個決策週期。然後我也很好奇，GeneSight 業務中的 United Health 部分是否一直以與其他業務大致相同的速度成長，或者在過去幾年中是否成長得更快？

Thank you. Sure, Mark, you want to take the last one and I'll take the first one?

謝謝。當然，馬克，你想拿最後一個，我拿第一個嗎？

Yeah, so the latter part, yeah, sure, correct. The United business has been growing at a very similar rate as the rest of our business actually maybe a little bit more just because of the focus that we've had on profitable volume versus the no pay reductions that we've talked about earlier. You know, with respect to our hope that United might modify this most recent policy, we can't speak to the timeframes around that.

是的，所以後半部分，是的，當然正確。聯合航空的業務一直以與我們其他業務非常相似的速度增長，實際上可能略快一點，這是因為我們專注於盈利量，而不是我們之前談到的不減薪。您知道，儘管我們希望美聯航能夠修改這項最新政策，但我們無法透露具體時間範圍。

But we do think that there is enough here for them to revisit the policy, potentially suspend it while they evaluate more data and more stakeholder input. So the best case scenario here is that they put a pause button on the January 1 effective date and take another year to evaluate the data and stakeholder input.

但我們確實認為，有足夠的理由讓他們重新審視這項政策，甚至可能在評估更多數據和更多利害關係人的意見時暫停政策。因此，最好的情況是，他們在 1 月 1 日的生效日期上按下暫停按鈕，並再花一年時間來評估資料和利害關係人的意見。

And I think we've given you the worst case. We believe we can mitigate a lot of this, not all of it. And we're certainly gonna come to work every day beginning January 1 to address this policy and grow through it. But I think we wanted to give you sort of a pro forma view of what we think is the worst case and how we approach it.

我認為我們已經給出了最壞的情況。我們相信我們可以緩解很多這類問題，但不是全部。從 1 月 1 日起，我們每天都會上班，以解決這項政策並在其基礎上發展。但我認為我們想給你一個形式上的觀點，即我們認為最壞的情況是什麼，以及我們如何處理它。

And despite this, we're gonna grow next year. And so I think that's the part that I would underscore for investors about our ability to continue what we've done the last four years, which is discipline, transparent, you know, execution, and delivering on the commitments that we make to you all. So, unfortunately, we've had to reset that pro forma base, and we'll go from there.

儘管如此，明年我們仍會成長。因此，我認為這就是我要向投資人強調的，我們有能力繼續做過去四年來所做的事情，即紀律、透明、執行，以及兌現我們對大家所做的承諾。因此，不幸的是，我們必須重置該形式基礎，然後從那裡開始。

Great. Thank you so much.

偉大的。太感謝了。

(Operator Isntructions) Rachel Watzendahl, JPMorgan.

(操作員指示) Rachel Watzendahl，摩根大通。

Great. Thanks so much for taking the question. Hi, Rachel. Hi, guys. So, we wanted to dig in a little bit more on gene site again, you know, specifically just on the actual market size for pharmacogenomics. So your Analyst day a few weeks ago, you talked about how the market size is $2 billion. You said that was based on the most updated data that you had at the time. If we look at the year before, you guys had really pointed us towards that $5 billion actionable market. I know you talked about how some of the underlying data, you were just working with the best you had at the time. But can you break down for us what really changed in that underlying market data?

偉大的。非常感謝您回答這個問題。你好，Rachel。嗨，大家好。因此，我們想再次深入挖掘基因位點，特別是藥物基因組學的實際市場規模。幾週前的分析師日上，您談到了市場規模是 20 億美元。您說這是基於您當時掌握的最新數據。如果我們回顧前一年，你們確實為我們指明了那個 50 億美元的可操作市場。我知道您談到如何使用當時所掌握的最佳數據。但您能為我們分析一下底層市場數據到底發生了哪些變化嗎？

And then appreciate that you're working with United to try to reverse the decision. But as it stands today, does that give you a further change in terms of your current view of the $2 billion TAM that you provided a few weeks ago?

然後感謝您與美聯航合作試圖扭轉這一決定。但就目前的情況來看，這是否會讓您對幾週前提供的 20 億美元 TAM 的當前看法進一步改變？

You know, I'm sorry, we will sit down with you and Ramiah who is our market expert. And Matt, you know, I'll commit to you that they will sit down with you and go through the TAM data that we have. And as we said, our investor data, that's the best data that we have.

你知道，很抱歉，我們會和你以及我們的市場專家 Ramiah 坐下來談談。馬特，你知道，我向你保證，他們會和你坐下來，仔細研究我們擁有的 TAM 數據。正如我們所說，我們的投資者數據是我們擁有的最好的數據。

Look, I would just say more importantly, generally, that there's a tremendous amount of interest in pharmacogenomic testing. The medication errors in America are pronounced across many different indications. You know, tough flooding right here, being the early leader in PGX testing, but we get calls from physicians all the time across a number of indications of the need they have for further guidance on medication administration.

我只想說，更重要的是，總體而言，人們對藥物基因組學測試有著極大的興趣。美國的用藥錯誤在許多不同的病症中都有明顯表現。您知道，這裡洪水氾濫，作為 PGX 測試的早期領導者，我們經常接到醫生的電話，他們表示需要進一步指導藥物管理。

And in my prior life, I will tell you that so many of hospital readmissions were being driven by improper medication administration particularly among seniors. So, you know, we, this goes back to the first question from Doug, you know, long-term, we think this is really important for American healthcare and for myriad genetics.

在我過去的生活中，我會告訴你，很多再次入院的病例都是因為藥物管理不當造成的，尤其是老年人。所以，你知道，這又回到了 Doug 提出的第一個問題，你知道，從長遠來看，我們認為這對美國醫療保健和無數遺傳學來說確實非常重要。

And there is a long-term opportunity here to continue to look at other indications, build a better body of evidence, work with other stakeholders, how we can be part of the solution to do better medication administration. And you look at the rise in specialty drug costs and across the MLRs of payers, it's a problem, it's an issue.

這是一個長期的機會，我們可以繼續研究其他適應症，建立更好的證據體系，與其他利害關係人合作，共同尋求解決方案，實現更好的藥物管理。你看看特種藥品成本的上漲，以及付款人的 MLR，這是一個問題，是一個麻煩。

So, you know, whether TAM is three billion or five billion, we'll get back to you on that. I think the bigger thing is there's a real need to bring more science to medication administration, and that's part of what we are committed to here, and we think there's a real long-term opportunity for us and for our patients here at MuroGeneX in this regard.

所以，您知道，無論 TAM 是 30 億還是 50 億，我們都會回覆您。我認為更重要的是，我們確實需要為藥物管理帶來更多的科學，這也是我們所致力於的部分工作，我們認為，在這方面，對我們和 MuroGeneX 的患者來說，這是一個真正的長期機會。

Fair enough. Maybe just then shifting over to the women's health side. So you've talked about how there's some dislocation in the market given current competitive dynamics there. So can you just give us an update where we are in terms of [Invitae] exiting the market there, how much more Greenfield opportunity is for you to kind of compete on some of that share and any shift expectations you expect going forward?

很公平。也許就此轉向婦女健康方面。您談到，鑑於當前的競爭態勢，市場中存在一些混亂。那麼，您能否向我們介紹 Invitae 退出該市場的最新情況，Greenfield 能為您提供多少機會來競爭該市場份額，以及您對未來有何轉變預期？

Yeah, I don't know if I could put a number on it, but I would still say that there is still a lot of disruption, right? I think when you think about, as I mentioned earlier, accounts are still making choices, and in some cases accounts made choices because they were forced to move quickly, and so they may have chosen another lab, and now they're evaluating that lab and they're not happy with that particular service. And so we are still continuing, as I commented on, winning new accounts, and in many cases in the women's health space.

是的，我不知道是否可以給出一個數字，但我仍然會說仍然存在很多混亂，對嗎？我認為，正如我之前提到的，帳戶仍在做出選擇，在某些情況下，帳戶做出選擇是因為他們被迫快速行動，因此他們可能選擇了另一個實驗室，現在他們正在評估實驗室，並且他們對那項特定的服務不滿意。正如我所說，我們仍在繼續贏得新客戶，而且在許多情況下是在女性健康領域。

It is about stealing share. It is about providers making choices. And so I still think there's a lot of green space for us to win back in VJ share, as well as other competitors that are in the space. Because as we continue to improve our products, as we continue to improve our ease of use, customers do believe that Myriad has had some of the best in class tests.

這是關於竊取份額。這是關於提供者做出的選擇。因此，我仍然認為，我們在 VJ 市場份額以及該領域的其他競爭對手方面還有很大的贏回空間。因為隨著我們不斷改進產品，隨著我們不斷提高易用性，客戶確實相信 Myriad 已經擁有同類產品中最好的測試。

In some cases, it was because of ease of use. And now that we're doing EMR integrations and we're doing other investments, we are in a very strong position to continue to win back share from other competitors. Yeah, look, I'm going to just actually get -- yeah, I mean, the opportunity in prenatal, for prequel, for example, our I&I PS test that we're going to be launching at eight weeks to station, that's big.

在某些情況下，這是因為易於使用。現在我們正在進行 EMR 集成，並進行其他投資，我們處於非常有利的地位，可以繼續從其他競爭對手那裡贏回市場份額。是的，看，我實際上會得到——是的，我的意思是，產前的機會，例如，我們將在八週後啟動的 I&I PS 測試，這很重要。

Having an answer at eight weeks and not having the failure rates that many of our competitors have at nine or 10, that's big. That gives our folks a differentiated experience and prequel is more accurate with Amplify and we have less failure rates at first pass in terms of blood draws. So that's an opportunity moving to average risk has moved, has lifted all the boats in terms of prenatal testing. And that's even before we get the carrier screening and a potential ACOG guideline expansion and our pre-launch of foresight universal plus.

我們在八週內就能給出答复，而且不會像我們的許多競爭對手那樣在九週或十年內出現失敗率，這一點意義重大。這為我們的人們提供了差異化的體驗，並且使用 Amplify 進行前傳檢測更加準確，而且在抽血方面，我們第一次的失敗率更低。因此，這是一個向平均風險轉變的機會，在產前檢測方面，它已經帶來了所有好處。這甚至是在我們進行攜帶者篩選、潛在的 ACOG 指南擴充和預先推出 Foresight Universal Plus 之前。

So in the prenatal space, it's narrowed, you know, to three, four, five different providers. We have a lot of white space to gain share, but also participate in the expansion of guidelines and adoption, particularly in a lot of underserved communities. The real secret sauce there though, as Mark pointed out, is the ability to bring my risk with Risk Score and our newly recently launched Breast Cancer Risk Assessment Program into that channel. And so I'll tell you that one of the things that we're most excited about, not only is the prenatal in women's health, but doing more, particularly with, you know,

因此，在產前領域，服務範圍縮小到三、四、五種不同的服務提供者。我們擁有大量的空白空間來獲得份額，同時也參與指導方針的擴展和採用，特別是在許多服務不足的社區。然而，正如馬克所指出的那樣，真正的秘密在於能夠將我的風險與風險評分以及我們最近推出的乳癌風險評估計劃帶入該管道。所以我要告訴你，我們最興奮的事情之一，不僅是產前婦女健康，而且還有更多的事情要做，特別是，你知道，

Breast density being at issue and FDA guidelines expansion, bringing more of our myRIST test with RISC score that is not available for anybody else, for patients of all ancestry, into that women's health channel. Lots of opportunity in green space for us there.

乳房密度成為問題所在，FDA 指南也隨之擴展，將更多帶有 RISC 評分的 myRIST 測試帶入女性健康頻道，這些測試和測試對其他任何人都無法使用，適用於所有血統的患者。那裡的綠地為我們提供了大量的機會。

Brian Quillard, Wells Fargo.

富國銀行的 Brian Quillard。

A couple of questions for you. This is part of the program. You know, hurricane impact, where you alluded to volumes coming back pretty strong in the last few weeks. Just wanted to make sure there's no hurricane effect. And is the prior period revenue benefit in the third quarter, is that seven million? I think that's about what it was last year.

我想問您幾個問題。這是該計劃的一部分。您知道，颶風的影響，您提到過去幾週交易量回升得相當強勁。只是想確保沒有受到颶風的影響。第三季的上期營收收益是 700 萬美元嗎？我認為，這與去年的情況差不多。

Thanks. Hey, Brian, I'm sorry, I might need to ask you to repeat the first part of your question, but yeah. So I mentioned in my prepared comments that our prior period impact benefit was similar to last year's. Last year's was around $7 million. This year it was a little over $8 million. But if you could repeat the first part of your question.

謝謝。嘿，布萊恩，很抱歉，我可能需要請你重複問題的第一部分，但是是的。因此，我在準備好的評論中提到，我們前期的影響效益與去年相似。去年的金額約為700萬美元。今年這數字略高於800萬美元。但如果你能夠重複問題的第一部分。

Yeah, I was asking if just the implied fourth quarter guide embeds any headwind from the hurricane disruption. I think Paul talked about volumes coming back strong in the last few weeks, but wanted to make sure there's fantastic case.

是的，我想問的是，隱含的第四季指引是否反映了颶風造成的不利影響。我認為保羅談到了過去幾週交易量強勢回升的情況，但他想確保這是一個非常好的情況。

Yeah, you know, I think we're pleased to see a normalization and volume, but and so, no, the Q4 guide doesn't assume any kind of particular weather related headwind coming at us.

是的，你知道，我們很高興看到正常化和數量，但是，第四季度指南並沒有假設任何特定的天氣相關的逆風向我們襲來。

Okay, last question. You've got -- it looks like, a number of EMR site integrations planned for the fourth quarter. Can you just remind us how quickly you start to pull through when those new sites come online and whether we should maybe be thinking about the first quarter perhaps having less, you know, a step down, less seasonality in light of those integrations? Thanks.

好的，最後一個問題。看起來，第四季度計劃進行一些 EMR 站點整合。您能否提醒我們，當這些新網站上線時，你們開始恢復的速度有多快，以及考慮到這些整合，我們是否應該考慮第一季的業務下滑幅度和季節性因素減少？謝謝。

Yeah, I think the way I would think about the integration, similar to the comment that Scott made about some of our pair contract wins, which is We have multiple integrations going on. I think Scott mentioned we're connecting over 4,000 different sites. And so some of those sites. We see, you know, immediate adoption and you know, just because of the Just because of the individual connections and others. Yes, I would think when you think about larger health systems.

是的，我認為我對整合的看法類似於斯科特對我們贏得的一些配對合約所發表的評論，即我們正在進行多項整合。我記得斯科特提到我們正在連接超過 4,000 個不同的站點。還有一些這樣的網站。我們看到，你知道，立即採用，你知道，只是因為個人聯繫和其他人的聯繫。是的，當你考慮更大的健康系統時我會這麼想。

This is going to continue through Q4 and Q1 of next year and throughout all of 25.

這一趨勢將持續到明年第四季和第一季以及整個 25 個季度。

Tycho Peterson, Jefferies.

傑富瑞 (Jefferies) 的 Tycho Peterson。

Hey, thanks. I'm not going to ask you about United. I'm curious about some nuances around guidance. You lowered gross margin guidance 20 bips. You took the top end of the range down. Maybe just touch on that.

嘿，謝謝。我不會問你關於美聯航的事情。我對指導的一些細微差別感到好奇。你們將毛利率預期下調了 20 個基點。您已將範圍的頂端降低。也許只是觸及這一點。

Yeah, there's no change in the underlying fundamentals of the business. It's just, you know, there is some variability from product product in terms of the gross margin profile, and that's just updating the blended average. But overall, the underlying gross margin profile remains just as healthy as before the individual product model.

是的，業務的基本面沒有改變。您知道，就毛利率狀況而言，不同產品的毛利率存在一些差異，這只是更新了混合平均值。但總體而言，基礎毛利率狀況與單一產品型號之前一樣健康。

Okay, Paul, I want to stress test -- and yes, what up psycho. I mean, you know, we are, we are dropping through the growth. I want to stress test your comments around the Ambri deal because Invitae went through bankruptcy, Semaphore exited reproductive health. You did have some other factors there that accelerated share gains. It does seem like Ambri could be a different setup. Why would the share gain opportunity there be similar, I guess, to the other deal?

好的，保羅，我想做壓力測試——是的，你怎麼了，神經病。我的意思是，你知道，我們的成長正在放緩。我想對你對 Ambri 交易的評論進行壓力測試，因為 Invitae 已破產，Semaphore 退出了生殖健康領域。確實有一些其他因素加速了股價上漲。看起來 Ambri 可能是一個不同的設定。我猜想，為什麼那裡的股份收益機會與其他交易類似？

No, I think the Semaphore situation is different, just like the Invitae LabCorp situation is different. Each one of these are different, you know, and the Tempest guys do a good job. Just a question of, you know, when you go through these changes, whether it's in VT to LabCorp, and you know, some of the policy changes, we understand they're gonna go into effect in January.

不，我認為 Semaphore 的情況不同，就像 Invitae LabCorp 的情況不同一樣。您知道，這些都是不同的，而 Tempest 的人做得很好。只是一個問題，你知道，當你經歷這些變化時，無論是在 VT 還是 LabCorp，你知道，一些政策變化，我們知道它們將於 1 月生效。

And people wait and see what the integration of Ambry does. You know, you gotta harmonize products, you have to harmonize Salesforce, you have to harmonize, you know, RevCycle contracting.

人們拭目以待Ambry的整合將帶來什麼。你知道，你必須協調產品，你必須協調 Salesforce，你必須協調 RevCycle 承包。

This is complicated work and it always takes time, Tycho. What I've said and have experienced is, you know, you go through an integration, most customers, this is not on the top of their list. This is like number 30 of the things that a provider is worried about. But if they see changes, and more importantly, if their frontline staff, their office workers, their nurses start seeing changes in service level, turnaround times and start comparing products in terms of quality, you know, that just enables our sales force to go in and talk about the differentiation of our products and our experiences.

這是一項複雜的工作，而且總是需要時間，Tycho。我說過並且經歷過的是，你知道，當你經歷一個整合過程時，對大多數客戶來說，這並不是他們最關心的問題。這就像是供應商擔心的第 30 件事。但如果他們看到變化，更重要的是，如果他們的第一線員工、辦公室工作人員、護士開始看到服務水平和周轉時間的變化，並開始在質量方面比較產品，你知道，這就使我們的銷售人員能夠深入討論我們的產品和體驗的差異化。

So I can't -- I wouldn't call out any specifics, but I think all of these disruptions, what we hear from genetic counselors and others, begins to set us apart as a more reliable, trusted, stable, provider that isn't going through the turn that we are seeing within VT, Ambry, and Semaphore.

所以我不能——我不會說出任何具體細節，但我認為所有這些中斷，我們從遺傳諮詢師和其他人那裡聽到的，開始讓我們成為更可靠、更值得信賴、更穩定的提供商，並且不會經歷我們在 VT、Ambry 和 Semaphore 中看到的轉折。

Okay, thank you. Sure.

好的，謝謝。當然。

Dan Brennan, TD Cowen.

丹布倫南（Dan Brennan），TD Cowen 公司。

Hey, good afternoon, guys. This is Kyle and for Dan. Thanks for taking the questions. I'll just ask one here, non-gene site related. Moving over to hereditary cancer, you talked about this category, I guess, as a whole growing volume, sort of low double digits and stable pricing in the future. I think if we look at year to date, year over year in the last 12 months on volume, volume's sort of grown half this rate, call it 6%, both year to date, year over year in the last 12 months.

嘿，大家下午好。這是凱爾 (Kyle)，也是丹 (Dan)。感謝您回答這些問題。我只在這裡問一個與基因位點無關的問題。談到遺傳性癌症，您談到了這個類別，我想，作為一個整體，其數量正在增長，未來將處於低兩位數水平，價格也將保持穩定。我認為，如果我們查看年初至今和過去 12 個月同比銷量，銷量增長率大約是這個數字的一半，也就是 6%，年初至今和過去 12 個月同比銷量都是如此。

Given these volume trends, how confident are you that hereditary cancer can accelerate and grow at the corporate average next year? And I guess what are the drivers?

有鑑於這些數量趨勢，您是否有信心明年遺傳性癌症的發生率會加速成長至企業平均值？我猜想驅動因素是什麼？

Yeah, I think I'll take that. I think what we try to do is sort of split out because when we think about what's baked into our hereditary cancer number, as we've mentioned, there is my risk on the affected and on the unaffected side.

是的，我想我會接受。我認為我們嘗試做的是將其分開，因為當我們考慮到我們的遺傳性癌症數量中包含的因素時，正如我們所提到的，受影響的一方和不受影響的一方都存在風險。

There's also the BRAC CDX component. And so I think what we've seen pulling down the overall average that you just talked about is some of that BRAC CDX business, not only domestically, but also internationally, that is going to continue to be a lesser drag on the overall my risk growth that I think we're talking about. So we feel confident and that's why we stated that we see the double digit growth going into next year of total monetary because of the MyRisk Adoption that we see I think on the unaffected side Paul referenced breast cancer risk assessment.

還有 BRAC CDX 組件。因此，我認為，我們看到的拉低整體平均水平的因素是，BRAC CDX 業務的部分原因，不僅在國內，而且在國際上，這將繼續對我們正在談論的整體風險增長產生較小的拖累。因此我們充滿信心，這就是為什麼我們說我們看到明年的總貨幣支出將實現兩位數增長，因為我們看到 MyRisk 的採用，我認為在未受影響的方面，保羅提到了乳腺癌風險評估。

There's a huge under penetrated market And we have a highly differentiated product there and we're seeing growth there and we're integrating more Breast risk assessment program especially coming out of the October breast cancer risk awareness month

有一個巨大的未被充分滲透的市場，我們在那裡有高度差異化的產品，我們看到了那裡的增長，我們正在整合更多的乳房風險評估計劃，特別是在十月乳癌風險宣傳月

On the affected side, as we've mentioned, we are seeing double digit growth there now. Now we have the embryo dislocation. So there's just a lot of headroom for us here. And there's been guidelines changed, by the way, that have also recommended that, you know, any affected cancer patients should get a hereditary cancer test. So, you know, all of those things added, Paul.

就受影響的方面而言，正如我們所提到的，我們現在看到那裡出現了兩位數的增長。現在我們遇到了胚胎錯位。因此，這裡對我們來說有很大的發展空間。順便說一句，指南已經改變，它還建議任何受癌症影響的患者都應該進行遺傳性癌症測試。所以，您知道，所有這些都是添加的東西，保羅。

Paul, I'll just underscore one thing. And there's been a lot of change we've talked about organizationally in our go-to-market and we've clearly given up some volume for net revenue. And I mean, so we have been much more careful about our targeting with Salesforce and trying to move the model from you can have any hereditary cancer test for 249 to you can have the clinically differentiated my risk test with risk score, but we need to work through your payer, we need to work through prior off, and we've moved our whole sales force this year to a revenue-based model.

保羅，我只想強調一件事。我們在行銷組織方面已經討論過很多變革，並且我們明確放棄了一些銷售來換取淨收入。我的意思是，我們對 Salesforce 的目標定位更加謹慎，並試圖將模型從可以進行 249 種遺傳性癌症測試轉變為可以進行臨床區分風險測試和風險評分，但我們需要透過您的付款人來開展工作，我們需要先完成工作，今年我們已將整個銷售團隊轉移到基於收入的模式。

The net effect has been, yeah, we've consciously given up a couple of percentage points of volume, but we're getting it back in spades on the ASP. And so I think that's -- you know, that's where the model needs to go for this industry. Not withstanding the fact that, as we said, throughout the year, we didn't expect to see the upswing of share shifts for hereditary cancer to even start until Q4 and accelerate next year. As they said, LabCorp -- and Adam, those guys do a great job, but they're just starting to integrate. Some of their practices and policies, as I understand it from the field, are just going to affect on January.

最終的效果是，是的，我們有意識地放棄了幾個百分點的銷量，但我們在 ASP 上將其大幅收回。所以我認為這就是這個行業模式所需要的。儘管如此，正如我們全年所說的那樣，我們預計遺傳性癌症的份額變化要到第四季度才會開始上升，並在明年加速。正如他們所說，LabCorp——和亞當，那些人做得很好，但他們才剛開始整合。據我從實地了解，他們的一些做法和政策將會影響到一月。

So I would expect that the share shifts for hereditary are, as we've said before, really gonna be more of a 25 issue. The large accounts are just being onboarded now in Q4. Net to start moving ASP and hereditary and lower our no pay, which is like 36% for hereditary. You know, that's a big number. So knocking that back, you know, that's why you've seen the bottom line improve here and so it's profitable growth that we're focused on.

因此我預計，遺傳的份額變化正如我們之前所說的那樣，實際上將是一個 25 個問題。大型帳戶現在才剛在第四季加入。淨開始轉移 ASP 和世襲並降低我們的無薪假期，這對世襲來說是 36%。你知道，這是一個很大的數字。因此，你知道，這就是為什麼你看到這裡的底線有所改善，所以我們關注的是獲利成長。

Got it. Thanks, guys.

知道了。謝謝大家。

Michael Reisten, Bank of America.

美國銀行的麥可‧賴斯滕 (Michael Reisten)。

Hello, this is John Kim on for Michael. I'll also skip ahead of the Gensight. We can talk about Gensight. No need to apologize, it's okay. You guys have talked extensively about it, and yeah, I understand the uncertainty but you guys are doing everything you can. But, and it's great to hear that, you know, so everybody knows what they're in. Thank you.

大家好，我是 John Kim，代表 Michael。我也會跳過 Gensight。我們可以討論 Gensight。沒必要道歉，沒關係。你們已經就此進行了廣泛的討論，是的，我理解這種不確定性，但你們正在盡一切努力。但是，聽到這個消息真是太好了，這樣每個人都知道自己在做什麼。謝謝。

But you mentioned the 2% reduction in no pay rate from your RCM efforts. Could you size what sort of progress has been made versus what sort of opportunity remains? And how much of that, could you quantify how much of that we can see, we might see in 2025?

但您提到，由於您的 RCM 努力，無薪率降低了 2%。您能否衡量一下已經取得了哪些進展以及還剩下哪些機會？您能量化一下我們能夠看到多少，到 2025 年可能會看到多少嗎？

So we're certainly not at this point going to be projecting or committing to a 2025 improvement. And just for for everyone else on the call, I think what you're referencing is back at our investor event. We had referenced an improvement so far this year in no pay rate from 46% down to 44%. And that is, as you can see from the robustness of the average revenue protests in our Q3 results, that is a -- you know, forward progress that we continue to see even into Q3.

因此，我們現在當然不會預測或承諾 2025 年的改善。對於電話會議中的其他所有人來說，我認為你們提到的內容與我們投資者活動有關。我們提到，今年迄今為止，無薪休假率有所改善，從 46% 下降到 44%。也就是說，正如您從我們第三季業績中平均收入抗議的強勁程度所看到的那樣，這是一個向前的進步，我們甚至在進入第三季後仍能繼續看到這一進步。

And so certainly we are anticipating that would continue into Q4 as well. You know, I had gotten the question at the investor event around what might be a reasonable target for annual benefit from continued no pay improvement. And we talked and again, I'm not committing by any means to something for 2025 specifically. But we talked about certainly being able to achieve that 2% at a minimum that we've seen so far this year and a typical year. And certainly in a good year, we could expect to do better than that potentially go for 3% or 4% as well. I'll keep it to one.

因此我們當然預計這種情況也會持續到第四季。你知道，我在投資人活動上被問到的一個問題是，在薪資持續沒有提高的情況下，年度福利的合理目標是什麼。我們談過了，我再說一遍，我絕對不會承諾 2025 年的具體目標。但我們討論過，肯定能夠至少實現今年迄今為止和典型年份所見的 2% 的增幅。當然，在好年景，我們預期會做得更好，可能達到 3% 或 4%。我會保留一個。

Mason Carrico, Stephens.

梅森·卡里科，史蒂芬斯。

Hi, this is Nathan on for Mason. Thanks for taking the question today. I'm going to circle back to GeneSight here, but more from a strategic standpoint. Was hoping you'd be able to sort of lie out. There's obviously a profitability gap that you pointed to as a result of this decision here. So just kind of curious if you could give any color on sort of where the resources are going to be coming from to really address this decision with UNH, the additional interactions, touch points that you're going to have with the provider.

大家好，我是 Nathan，代表 Mason 發言。感謝您今天回答這個問題。我將在這裡回到 GeneSight，但更多的是從戰略角度來談論。希望你能夠躺下。您所指出的這個決定顯然導致了獲利能力的差距。所以我有點好奇，您是否可以透露將從哪裡獲得資源來真正解決 UNH 的這個決定，以及您將與提供者進行的額外互動和接觸點。

And then just as a quick follow up there, as you think about investing sort of across your business and you remain very committed to GeneSight, of course, and as well as your future offerings.

然後作為一個快速的跟進，當您考慮對整個業務進行投資時，您當然仍然非常致力於 GeneSight，以及您未來的產品。

So just kind of curious if you could help us think about investing across those different growth initiatives moving forward. That's a really good question. You know, again, in terms of mitigation strategy, that's early and you're right in terms of the underlying question, strategy is all about choices and where we make investments.

我只是好奇您是否可以幫助我們考慮未來對這些不同成長計劃進行投資。這真是一個好問題。您知道，就緩解策略而言，這還為時過早，就根本問題而言，您說得對，策略就是選擇以及我們在哪裡進行投資。

What we try to highlight at the investor day is having rationalized our portfolio. It positions us to try to invest in clinical evidence across all of our products. So that is a commitment to continue to look at all of our products and continue to position them to get to their full potential. And Genesight is included in that. And clearly we need to continue to invest in building that body of clinical evidence to continue to support GeneSight coverage and adoption.

我們在投資者日試圖強調的是合理化我們的投資組合。它使我們能夠嘗試在所有產品上投資臨床證據。因此，我們承諾將繼續關注我們的所有產品，並繼續定位它們，以充分發揮它們的潛力。其中包括 Genesight。顯然，我們需要繼續投入建立臨床證據體系，以繼續支持 GeneSight 的覆蓋和採用。

There are opportunities as we spoke to in women's health, as we said, that are not in our 12% growth target. We've already made those investments in Foresight Universal Plus. We have made investments in Prequel to move to eight weeks to Stational to have Amplify make it the most accurate test and continue to do studies there. So if you go back to our Investor Day presentation, there was a lot of studies that Katie and the team and Dale have advanced.

正如我們所說，女性健康領域存在著機遇，但不在我們 12% 的成長目標之內。我們已經對 Foresight Universal Plus 進行了投資。我們已經對 Prequel 進行了投資，將其轉移到 Stational 進行為期八週的測試，讓 Amplify 使其成為最準確的測試，並繼續在那裡進行研究。因此，如果你回顧我們的投資者日演示，你會發現凱蒂和她的團隊以及戴爾已經推進了許多研究。

There are more studies in the hopper. This is coming from a place where four years ago, quite frankly, the cover was pretty empty in terms of this. But certainly the biggest area of opportunity to push this company into mid-teens growth rates is in oncology. And the work that Dr. Daniker's doing, our medical affairs group, the opportunities we have to pair MyRisk with precise tumor and in the future liquid.

料斗還有更多研究。坦白說，四年前，封面上關於這方面的內容還很空白。但可以肯定的是，推動該公司實現十五中期成長率的最大機會領域是腫瘤學。Daniker 博士所做的工作，我們的醫療事務小組，我們將 MyRisk 與精準腫瘤和未來液體結合的機會。

And obviously with a highly sensitive MRD assay that we think for certain indications is gonna be incredibly important if people are thinking about deescalating care. But as our friends at United pointed out at this conference that we both attended here recently, there's a lot of work that needs to be done in terms of the clinical utility around MRD and there's a long runway there.

顯然，我們認為，如果人們正在考慮降低治療級別，那麼對於某些適應症來說，高度敏感的 MRD 檢測將非常重要。但正如我們聯合航空的朋友在我們最近參加的這次會議上指出的那樣，在 MRD 的臨床實用性方面還有很多工作要做，而且還有很長的路要走。

So I would just underscore for investors, for long-term investors in Myriad and X, we have a lot of different levers to pull here and we are building a company for the next 10 years, not for the next 10 quarters. And whether it's the ASP opportunities that Scott pointed to or continued investment across the portfolio, they all give us different ways to achieve all the great work that Sam and the two team is doing in Lab of the Future. None of that has come into play yet.

因此，我只想向投資者強調，對於 Myriad 和 X 的長期投資者來說，我們有很多不同的槓桿可以利用，我們正在為未來 10 年而不是未來 10 個季度建立一家公司。無論是史考特指出的 ASP 機會還是對整個投資組合的持續投資，它們都為我們提供了不同的方式來實現薩姆和兩個團隊在未來實驗室中所做的所有偉大工作。但這些都還未發生作用。

This year has been about multiple lab moves, multiple validations. And so our best days are really ahead of us, but it's a really good question and we'll continue to look at investing capital wisely, where the biggest returns are for our patients and for our investors.

今年發生了多次實驗室遷移、多次驗證。因此，我們最好的日子還在前方，但這是一個很好的問題，我們將繼續明智地投資資本，為我們的患者和投資者帶來最大的回報。

Thank you. I'll keep it to one. Appreciate the update today.

謝謝。我會保留一個。感謝今天的更新。

Thank you.

謝謝。

If there are no further questions at this time, I would like to turn the call back over to Matt Scalo for the closing remarks. Please go ahead.

如果現在沒有其他問題，我想將電話轉回給馬特·斯卡洛 (Matt Scalo) 做結束語。請繼續。

Okay. Thanks, Frans, and thanks everyone for your participation. This concludes our earnings call. A replay will be available via webcast on our website for one week. Thank you again for joining us this evening, and have a good night. Thanks, everybody. Thank you.

好的。謝謝，弗蘭斯，謝謝大家的參與。我們的收益電話會議到此結束。重播將透過網路直播在我們的網站上提供一週。再次感謝您今晚加入我們，祝您晚安。謝謝大家。謝謝。