Thursday, August 1, 2019

Myriad Genesight Garners United Health Coverage; Stock Spikes Upward

On August 1, 2019, Myriad issued an SEC filing that it had garnered coverage from United Healthcare for its Genesight test.

Share price spiked from $29 to $44, with a peak market cap of $3.8B, up 50% from yesterday.

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  • Coverage at Genomeweb here.
  • Myriad's SEC filing here.
  • Actual United PDF Policy for October 2019 here.
  • Update: MedTechDive on how payers are reacting, 8/27/2019, here.
Readers are directed to the actual United Healthcare policy.   It's for treatment-resistant depression defined as one drug failure, a diagnosis of major depressive disorder (or anxiety), and for panels with "no more than 15 relevant genes."    At least on first reading, it does not appear to require prescription by a psychiatrist.  (Psychiatrist's care and test order has been a requirement for Medicare's coverage of Genesight.)

The decision is paired with some non-coverage features, such as non-coverage remarks for other Myriad Genesight panels (for ADHD, for example) and non-coverage for panels with other PGx indications like cardiovascular or polypharmacy.   

As far as I can tell on first reading, it doesn't specifically cover Genesight alone, but may be valid coverage for similar PGx panels (e.g. Althea NeuroIDgenetix, with a favorable discussion of its large RCT Bradley trial).   Some decisions regarding the various marketed alternatives in the field may be left to in- or out-of-network contracting, or other factors outside the text of the policy.


Myriad's brief SEC filing states:

UnitedHealthcare has issued a positive coverage decision for pharmacogenetic testing for multi-gene panels including the company’s GeneSight Psychotropic test.  The coverage is for patients that have a diagnosis of major depressive disorder or anxiety and have failed at least one prior medication to treat their condition. The positive coverage decision is referenced in the UnitedHealthcare August 2019 Network Bulletin.


In the first version of this blog, I misread and excluded "anxiety" in my text, although it was present in the quotation.