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Myriad Genetics, Inc. (MYGN)

Q4 2017 Earnings Call· Tue, Aug 8, 2017

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Transcript

Operator

Operator

Ladies and gentlemen, thank you for standing by. Welcome to the Myriad Genetics Fourth Quarter 2017 Financial Earnings Conference Call. During the presentation, all participants will be in a listen-only mode. Afterwards, we will conduct a question-and-answer session. As a reminder, this conference is being recorded Tuesday, August 8, 2017. I will now turn the conference over to Scott Gleason, VP, Investor Relations. Please go ahead, sir.

Scott Gleason - Myriad Genetics, Inc.

Management

Thank you. And good afternoon and welcome to Myriad Genetics fiscal fourth quarter 2017 earnings call. My name is Scott Gleason. I'm the Vice President of Investor Relations. During the call, we will review the financial results we released today, after which we will host a question-and-answer session. If you've not had a chance to review the earnings release, it can be found in the Investor Relations section of our website at myriad.com. Presenting from Myriad today will be Mark Capone, President and Chief Executive Officer; and Bryan Riggsbee, our Chief Financial Officer. This call can be heard live via webcast at myriad.com. The call is being recorded and will be archived in the Investors section of our website. In addition, there is a slide presentation pertaining to today's earnings call on the Investors section of our website and which we'll be filed upon the call on Form 8-K. Please note that some of the information presented today may contain projections and other forward-looking statements regarding future events or the future financial performance of the company. These statements are based on management's current expectations and the actual events or results may differ materially and adversely from these expectations for a variety of reasons. We refer you to documents the company files from time-to-time with the Securities and Exchange Commission, 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 and forward-looking statements. With that, I'm now pleased to turn the call over to Mark.

Mark C. Capone - Myriad Genetics, Inc.

Management

Thanks, Scott. I would like to start today's call by providing key highlights from fiscal year 2017, after which Bryan will provide an overview of our fourth quarter financial results and details on our fiscal year 2018 guidance and I will finish by providing additional details pertaining to the ongoing execution of our business strategy. First, I would like to provide a summary of the fourth quarter results. We were highly encouraged with our fourth quarter performance having once again exceeded expectations on both the top and bottom line with total revenue of $200.5 million and adjusted earnings per share of $0.30. Importantly, we were able to grow volumes sequentially for all of our products, including a third straight quarter of sequential volume growth for hereditary cancer testing. In fact, this quarter, we saw the highest demand ever for hereditary cancer testing and a 6% year-over-year volume growth rate, which is a testament to the outstanding execution from all of our hereditary cancer commercial teams. Reflecting on fiscal 2017, this was one of the most transformational in our 26-year history. We're focused on five critical success factors, which we believe will allow us to achieve our long-term strategic goal. I would like to review our progress in fiscal year 2017 on each of these critical success factors, beginning with our goal to stabilize hereditary cancer revenues. It is interesting to note that our fiscal year 2017 hereditary cancer revenue of $569 million was nearly identical to the revenue in fiscal 2013, the year before the Supreme Court BRCA patent decision. After four years of intense competition, Myriad remains the world leader in hereditary cancer testing. In fact, during this four-year timeframe, we have seen hereditary cancer testing volumes increase by 15%, which was offset by a price reduction of a…

R. Bryan Riggsbee - Myriad Genetics, Inc.

Management

Thanks, Mark. I would like to start by providing a more in-depth overview of our fiscal fourth quarter financial results. Fourth quarter total revenues were $200.5 million compared to $186.5 million in the same period in the prior year, an increase of 8%. This represents our third straight quarter of delivering positive year-over-year revenue growth. Hereditary cancer revenue in the quarter was $144.6 million and was down 5% on a year-over-year basis. Looking at the components of revenue, volume was up 6% on a year-over-year basis, while pricing and the Anthem out-of-network accounting change was responsible for an 11% decline. We expect the Anthem impact to abate in the fiscal first quarter as we begin to consistently receive cash payments for Anthem claims. GeneSight revenue in the quarter was a new record at $25.5 million and grew 22% year-over-year. With this product in the early stages of adoption and a largely untapped preventive care market, we see significant opportunity for continued GeneSight growth. Vectra DA revenue in the quarter was $10.3 million, with volume increasing sequentially for the second consecutive quarter. It is important to note that Vectra DA revenue was detrimentally impacted by approximately $2 million this quarter as a result of a request from Medicare in June to temporarily delay the submission of claims as we worked on a revised LCD. We have now resumed submitting claims to Medicare and expect to recognize this $2 million in Vectra DA revenue in our first quarter results. We are continuing our discussions with Medicare regarding a final LCD. We believe the evidence supporting continued coverage for Vectra has only gotten stronger with important clinical utility data published in the fourth quarter building on top of the previous 35 publications. This quarter, we again had record Prolaris volumes and achieved greater…

Mark C. Capone - Myriad Genetics, Inc.

Management

Thanks, Bryan. I would now like to provide some additional details on important clinical data and our performance for the fourth quarter, beginning with hereditary cancer. Our strong hereditary cancer performance was attributed to multiple factors. First, our sales organization was relatively stable with turnover 40% below historical levels. This continuity led to increased productivity, with total volume per sales representative increasing 5% sequentially in the fourth quarter. Additionally, we saw continued benefits from our preferred provider agreements with US Oncology and ION, with these accounts meaningfully outpacing growth in the overall oncology segment. Also, our disease-specific panels helped us gain market share with customers in the academic and genetic segments of the business. Among customers who ordered a disease-specific panel, volume was up 40% year-over-year and we regained several large accounts and major cancer centers. Finally, as Bryan mentioned, this quarter in selected large accounts, we launched a new digital integration strategy that will simplify and deepen our integration with these customers. The first application is a digital ordering and reporting process, which has been very favorably received and likened to an Amazon-like experience. Additionally, we continue our efforts to expand indications for use for hereditary cancer testing. At ASCO this year, we presented the results of a 2,000 patient study with myRisk Hereditary Cancer where 242 of the patients had pathogenic mutations. Importantly, 50% of the patients with mutations did not meet current criteria for hereditary cancer testing and 34% had mutations in genes not indicated by family history. We believe this study adds further credence to the growing body of evidence demonstrating that current testing criteria are too restrictive to identify all patients with hereditary cancers and should be expanded. And as a final note on the hereditary cancer market, we're planning to launch an exciting new…

Scott Gleason - Myriad Genetics, Inc.

Management

Thanks, Mark. As a reminder, during today's call, we use certain non-GAAP financial measures. A reconciliation of the GAAP financial results to non-GAAP financial results and a reconciliation of GAAP to non-GAAP financial guidance can be found under the Investor Relations section of our website. Now, we are ready to begin our Q&A session. In order to ensure broad participation in today's Q&A session, we're asking participants to please ask only one question and one follow-up. Operator, we're now ready for the Q&A portion of our call.

Operator

Operator

Perfect Our first question comes from the line of Bill Quirk with Piper Jaffray. Please proceed with your question. Alexander D. Nowak - Piper Jaffray & Co.: Great. Good afternoon, everyone. This is Alex Nowak on for Bill today. So just the first question on Vectra DA. So now that you're resubmitting revenue to Medicare for payment, should we assume that the current draft LCD will be eventually deleted and that Vectra DA Medicare revenues are safe from being cut?

Mark C. Capone - Myriad Genetics, Inc.

Management

Thanks, Alex. Yes, you're correct. We have started to resubmit claims to Medicare. We're still in discussions with Medicare about what a revised LCD might look like for Vectra DA and so those discussions are ongoing. I think what I can say is we remain very confident that the data supporting Vectra DA very much supports continued coverage. We had 35 publications. We added two more very important clinical utility studies at the EULAR presentation just a few months ago and we outlined the details of that. I think what was particularly striking is the fact that it's got three times the predictive power of any other disease activity measure, which underscores why 72% of rheumatologists in this country ordered the test this past year. So that level of adoption by physicians is outstanding. It underscores just how important this is. And we know that there was a groundswell of support for continued coverage that was submitted to Medicare during the public comment period. So we're very confident in the product, in the data that supports the product and we continue to have productive conversations with Medicare about what a revised LCD might look like. Alexander D. Nowak - Piper Jaffray & Co.: Okay. That's helpful. And then does your guidance assume a change in Medicare rates under PAMA? Just because I thought PAMA would bump up BRCA payments, so that might suggest that the private payer rates are coming down a little bit more than 12% next year. If you just walk me through that that would be great.

R. Bryan Riggsbee - Myriad Genetics, Inc.

Management

Yeah. Hey, Alex. This is Bryan. We haven't said – what we would expect is that PAMA would not negatively impact our rates. We haven't said what the impact would be. We would expect to provide more information on that when the CLFS comes out later in the year. Alexander D. Nowak - Piper Jaffray & Co.: Okay. Thank you.

Operator

Operator

Our next question comes from the line of Amanda Murphy with William Blair. Please proceed with your question. Amanda L. Murphy - William Blair & Co. LLC: Hi. Thank you. So Just a quick question on the contracting for hereditary cancer. So, sounds like you've done a lot of work there sort of resetting pricing and resetting contacts. Is there a sense – can you give us a sense of how much of the business now has been renewed, if you will, so kind of what's left? And then, obviously, you talked about stability. Should we think about that in terms of a three year timeframe, like you did previously? Thanks.

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. Thanks, Amanda. Yeah. So, 86% are now under long-term fixed price contracts. Again, those are generally three year contracts to your point. That's what we've historically done and we continue to do as we renewed the – those contracts generally can only be terminated for cause. And so it gives both of us long-term visibility on what that pricing would look like for a three year timeframe. So, we think we've – the remaining 14%, as you know, in many cases, there are smaller regional payers that are not interested in going through the extensive analysis that's required in order to assess the hereditary cancer testing landscape. So, we never expected that to be 100%. In fact, we are quite pleased to get to 86%, which is as high as we've ever seen. So, our managed care team has done great work over the past quarter to drive to that level of long-term stability and reimbursement. And I think part of that was also the leverage we're able to now provide within a complete portfolio of products. And so we took the opportunity for payers that were quite interested in contracting for EndoPredict and some of our newer products to have a fulsome discussion about the entire portfolio, which is why we've been so successful now in driving that up to 86% of our hereditary cancer revenues under long-term contract. Amanda L. Murphy - William Blair & Co. LLC: Right. Okay. Yeah. So, I was going to ask you about the portfolio piece too, but just to be clear. So the 86% now has a duration in aggregate of the three years. In other words, you've renewed most of the business in this quarter. Is that the right way to think about it?

Mark C. Capone - Myriad Genetics, Inc.

Management

Well, I wouldn't say that we're going to give details on exactly when those are. Some of those contracts were already in place and we're going to extend into the future. Some obviously were renewed for full three year term. So, I think, as Bryan phrased this, this gives us a very clear visibility on what pricing will be certainly in fiscal 2018 and fiscal 2019 as we move forward. And then contracts are going to roll off at different times. So everything wasn't signed up at once, but you can tell obviously we made significant progress on a number of new contracts in the fourth quarter. Amanda L. Murphy - William Blair & Co. LLC: Right. And then on the portfolio side, just as a last question. I just wanted to get a sense, so obviously you had the United that was public in terms of the pricing that you set up for the rest of the business. So just in your conversations with these payers, I am just curious how they're thinking about the newer assays in terms of coverage. Obviously, that's a distinct decision versus the pricing. But do you get a sense of whether you might have something imminent here in terms of the portfolio and coverage with additional private payers? Obviously, you mentioned Prolaris, but just more broadly.

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah, a good question, Amanda. I think it is important. There is a distinction between coverage and contracting. So the data we've given is based on the contracting side which means we've agreed on the codes that we will use. We've agreed on the prices which is important because both steps of this have to be done to ensure reimbursement. I think on the coverage side, we continue to believe we're making very good progress. I think payers obviously were particularly impressed with EndoPredict, which is why we are anticipating with a favorable LCD that we'll see coverage to over 75% of the addressable market. So we've really made substantial progress there. Prolaris is at 50% covered and we're continuing to look to drive Vectra from 40% above. So I think for all the products, we think we've got ongoing productive dialogue on increased coverage for these. And we're encouraged that, in 2018, we're hopeful to show some additional signs of progress with coverage for some of these products. Amanda L. Murphy - William Blair & Co. LLC: Okay. Thanks very much.

Operator

Operator

Our next question comes from the line of Doug Schenkel with Cowen. Please go ahead. Doug Schenkel - Cowen & Co. LLC: Okay. Good afternoon, guys, and thank you for taking my questions. Thanks for all the detail on HCT. Just a few follow-ups. First, how much share loss is factored into your HCT guidance? We don't have a lot, but mathematically we're coming up with something like 3 points of share loss. I guess the second follow-up is kind of building off of Amanda's first question. We were thinking that the next major payer contracts come up for renewal in calendar 2019. I just want to see if we're thinking about that right. And then third, based on the pricing commentary you prepared in your prepared remarks, it seems that you're expecting HCT revenue will return to growth again in fiscal 2019. Is that also the right way to think about things?

Mark C. Capone - Myriad Genetics, Inc.

Management

Thanks, Doug. Let me tackle one or two of those and then I'll pass them on to Bryan. From a share loss standpoint, I think, we're all in a similar situation. It's really difficult to know what exactly market volumes are doing. We do have some sporadic reporting by other laboratories of volumes, but certainly not comprehensive reporting. And we also know many of those laboratories – they are actually testing patients that don't meet hereditary cancer eligibility criteria. And they oftentimes won't even breakout the volumes that meet criteria from those that don't. As we define the market, there are only patients that meet hereditary cancer criteria typically as defined by NCCN. And so, it really makes discerning what's going on in the market difficult. I think all we can say is based on the trends and what we've seen that we built in a 3% hereditary cancer volume increase in fiscal 2018. Obviously, that's coming off of a quarter with a 6% volume increase. And, in fact, as Bryan mentioned, we saw volumes strengthening throughout the fourth quarter. So, we're comfortable with our projections of 3% and how that manifests itself in market share, I think, would be difficult to say. Bryan, you want to talk about pricing fiscal 2019 and...

R. Bryan Riggsbee - Myriad Genetics, Inc.

Management

Yeah. Sure. I mean just to take those couple of questions. First, we haven't really given out specific information around what contracts come up when, so, to the question around the next set being in 2019. And then to the question around hereditary cancer in fiscal year 2019, while we're encouraged with where we ended the current year and certainly we made great progress in terms of signing up payers under long-term contracts, I don't think we'd be ready to speak to extrapolating current demand trends forward and providing any sort of outlook in terms of FY 2019. I think what we can say is that we feel good about the guidance that we've put out relative to where demand trend currently is. And I think that's all we can really comment on in terms of it's really focused on FY 2018 and the stability there. Doug Schenkel - Cowen & Co. LLC: Okay. Fair enough. And if I could ask one more. A few months ago, you noted that you completed a payer demonstration project with United for GeneSight and I think you noted you had two pending projects with Humana and Anthem at that time. Are there any updates on progress there and can we expect a publication or release of that data at some point over the next few quarters? And I guess, most importantly, are these studies in themselves combined with data that's already out there? Do they have the potential to be enough to move you into coverage and contract with more of these payers?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. Thanks, Doug. We have continued to make progress on that. And I can speak – specifically, we've already talked about the United that we've done in conjunction with Optum and mentioned that the top line results for that project were actually very favorable. They were also very much in line with the data that we published from a health economics standpoint from the Medco data. So, all the data lined up very consistently that there is significant first year savings by using GeneSight. That is in the process. The manuscripts are very close to being submitted for publication. And so, to your question, yeah, we would expect those manuscripts to be published sometime in the next two quarters, depending, of course, on reviewers and how long they take. But we're highly encouraged with that. Now we don't have to wait for those to be published to review those with United. And that's what we're in the process of doing is showing them that in their own patient population just the health economic benefit of GeneSight. We're highly encouraged with that. We're not going to wait for the results of the clinical study before we continue to have reviews with each of these payers on those demonstration projects, the others being Anthem and Humana. We're going to charge forward with the data we have because we think all the data is available and sufficient for coverage. The other thing I would note – and Amanda referenced this as well – is that, of course, we did put GeneSight in contract with United. And so we've agreed on codes and pricing with United. So, we've made that positive step forward as well. So, stay tuned and you will see that publication sometime in the next couple quarters. Doug Schenkel - Cowen & Co. LLC: Okay. Thanks again.

Operator

Operator

Our next question comes from the line of Drew Jones with Stephens. Please go ahead.

James Rutherford - Stephens, Inc.

Analyst · Stephens. Please go ahead.

Hey. Good afternoon. This is James Rutherford in for Drew. Appreciate all the color you gave around guidance assumption. So, just one question for me in the interest of time. Can you give any detail around your level of spending on GeneSight and Vectra prospective trials both in fiscal 2017 and kind of what you expect in fiscal 2018, please?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. I think, in general, we haven't commented on specific studies. But I think what's fair to say is that the cost associated with the ongoing Vectra prospective study is reflected in our fiscal year 2017 R&D spend. And we wouldn't expect any real difference in fiscal 2018. From a GeneSight perspective, we've obviously completed a very large RCT. And the spend, of course, will ramp down once we've fully wrapped up that study, which we expect to be fully completed by the end of this calendar year. And so, there will be some benefit in reduced spend from a GeneSight perspective. Now that being said, there are other studies that, of course, we're starting, Prolaris. We're doing a registry study for favorable intermediate. And then we'll look to Vectra to see if we do additional registry studies for Vectra as well. So, I think from a total R&D perspective, we would anticipate savings we might have from the GeneSight study to be invested in the reimbursement studies that are ongoing for other projects.

James Rutherford - Stephens, Inc.

Analyst · Stephens. Please go ahead.

Okay. Great. Thank you. That's helpful.

Operator

Operator

Our next question comes from the line of Joel Kaufman with Goldman Sachs. Please proceed with your question. Joel Kaufman - Goldman Sachs & Co. LLC: Hi, guys. Thanks for the question. First one on myPath, just can you help us understand the catalyst set in terms of the reimbursement signpost that you guys laid out? And then, potentially, just give us an update on what the payer mix looks like in terms of the patient population you're targeting, commercial versus Medicare. And then maybe how the reimbursement process for myPath may differ from some of the other assays that you're trying to bring through and getting reimbursement on?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. Thanks, Joel. So, obviously, we have submitted a pretty expensive dossier. We think this is one of the most complete dossiers that we were able to submit and the data looks extraordinary. I think everybody can refer back to all the publications on that, diagnostic accuracy of over 92% in a very difficult diagnostic situation. This is unique in that it's the first diagnostic that we have. Other tests we have are either answering the first question risks for cancer or prognosis or treatment decisions. So this is the first time that we'll actually be bringing a diagnostic through the reimbursement process. And we do think there are differences when you use a diagnostic. I think it's well accepted that if you don't get the diagnosis accurate, there is nothing good that can happen downstream either for the patient or for the cost in the healthcare system. So, I think it's widely accepted that accurate diagnosis is critical. And, therefore, from a clinical utility standpoint, we think the bar is going to be lower. So, we've got initial feedback from payers that looks positive. I think they've been very impressed with the data set. And, of course, we're working through the Medicare and the commercial side at the same time. We haven't factored any of that into our guidance, so that would all be upside to our guidance if we're able to secure any Medicare or private payer reimbursement. But, of course, we're pursuing it very aggressively at this point. Joel Kaufman - Goldman Sachs & Co. LLC: Great. Thanks. And then just one just back on hereditary cancer. Understand it's tough to have visibility on what the underlying market growth rate of that business is. But when we think about the outlook, I think 3% volume for your business, what are you factoring in in the market growth rate when you think about your outlook for 2018?

Mark C. Capone - Myriad Genetics, Inc.

Management

Well, I think really, as we look at it, it's really based on the volume trends that we see going on in our current business. Hard to tease out what share and what market growth would look like, but we've got, obviously, very good visibility as to what's going on in our particular physicians, what their ordering patterns are, the ability that we have to gain back share in certain accounts that we can very clearly see. And it's really the amalgamation of all of those factors that allow us to look at what we believe we're very comfortable with is a 3% volume growth for this year. Obviously, we're coming off a quarter with a volume growth significantly higher than that and trends in the quarter that were also positive. And so, that gives us comfort that 3% for our growth from a volume perspective is reasonable. The other thing I would add on is that we still are in a market that's highly under-penetrated. We've got a preventive care market, that's the rapid growing market that has less than 10% penetration. And so, you've got very large underpenetrated markets with ample opportunity for growth. And as the market leader, we think, we're well-positioned to participate in that growth. Joel Kaufman - Goldman Sachs & Co. LLC: Thanks. Very helpful.

Operator

Operator

Our next question comes from the line of Tycho Peterson with JPMorgan. Please go ahead.

Tycho W. Peterson - JPMorgan Securities LLC

Analyst · JPMorgan. Please go ahead.

Hey. Thanks. First on GeneSight, just I know you had the question on the pilot programs earlier, but if we think about the trial, the data coming out, if we see results that's similar to what we've seen in previous trials, is that enough, I think, based on your payer conversations?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. Thanks, Tycho. We most definitely believe it would be. This is a very large study. It's 1,200 patient study, which is the largest that's certainly ever been done from a diagnostic perspective and also very large even when you compare it to the size of pharmaceutical studies. So all indications are with a positive read-out from this study that we think we're very well-positioned with clinical validity, clinical utility data and very strong health economic data. We think it's a complete package. I think payers are very interested. So we've already been having quite a bit of dialogue with them already. And even in the absence of this data, there is quite a bit of interest because it's well recognized by payers that particularly for the treatment-resistant depressed patients, that it's really shooting darts at trying to figure out what is appropriate. And they know doctors are going to order additional drugs. So this isn't a question from that perspective. It's just making sure it's the right one. The other reason payers have been so interested in this is you have to look at most payers, their biggest book of business are actually self-employed or self-funded employers. And for employers, the treatment-resist depressed patients are very expensive, not only from a healthcare perspective, but from a loss productivity perspective. And so, it's very important for them to be able to go to their prospective clients and offer something unique and being able to offer this as a way to help manage what to employers is a very expensive healthcare situation is something that they find very intriguing. And so, we've gotten quite a bit of interest on how we might be able to build programs together to then allow them to offer those program to employers. So with this data, I think, we're very confident that we'll be well-positioned for broad coverage.

Tycho W. Peterson - JPMorgan Securities LLC

Analyst · JPMorgan. Please go ahead.

And then on the cost initiatives, $50 million in incremental operating profit is not an insignificant target. Obviously, you're building out the pipeline. You've got pressures on the hereditary side. I guess can you get us comfortable with the notion that this doesn't necessarily impact the revenue line with some of these cost cuts?

R. Bryan Riggsbee - Myriad Genetics, Inc.

Management

Yeah. Thanks, Tycho. This is Bryan. First of all, I think, that one of the unique opportunities that Myriad has is, given our acquisitions over the last several years, we've got a lot of opportunity for further synergies across the portfolio. So we're looking at redundant functions and contracting, as I talked about in the prepared remarks. So, I think, we have a – based on – we set the goal, I would say, based on something that we thought was achievable with some stretch in it, but we certainly think that it's possible. And the other comment I would make is that it's an operating profit improvement initiative. And so we're focused not only on things that are going to help with our cost structure, but also things that are going to help drive additional revenue. We talked about some of that with respect to our digital strategy. And so, I think, it's having that balance between cost and revenue growth that's really going to make this successful and reduce the risk that it will have a negative impact on the top line.

Tycho W. Peterson - JPMorgan Securities LLC

Analyst · JPMorgan. Please go ahead.

All right. And then just last one for Mark on Prolaris. It was down year-over-year. You've got the expansion into intermediate patients. Can you maybe just touch on those dynamics and why it was down year-over-year?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. Thanks, Tycho. As I mentioned on the comments, we actually saw record volume for Prolaris. So it was, in fact, up on a year-over-year basis and a sequential basis for volume. We did see a bit of a mix change in the fourth quarter which is why from a revenue perspective you saw a slight sequential down. I think, as we talked to physicians, they've all been made aware of the fact that favorable intermediate is going to be covered by Medicare. And so we saw quite a bit of interest from physicians at beginning to get favorable intermediate positions in the queue to be tested. And so, obviously, with the delay in the Noridian LCD until September 25, we're not able to recognize the revenue for that mix change. But that's really the dynamic that we saw. Overall, we continue to be pleased with the interest level we're seeing in our position in the market. And we know positioning for when we get reimbursement hereafter, September 25, we're going to be well-positioned to show very nice revenue growth throughout the second quarter, third quarter and fourth quarter of fiscal 2018.

Tycho W. Peterson - JPMorgan Securities LLC

Analyst · JPMorgan. Please go ahead.

All right. Thanks.

Operator

Operator

We have time for one last question. It will come from Jack Meehan with Barclays. Please go ahead.

Jack Meehan - Barclays Capital, Inc.

Analyst

Hi. Thanks. Good afternoon. I just want to make sure I understood the pricing change in the quarter the right way and what that's contributing to 2018. So, if I look at how pricing moved down 11% in the quarter versus prior quarters, how much of that was related – just the quarterly change related to some of the Anthem decisions like California? And just within the guidance, how much of a drag is that that's embedded in the down 12% for 2018?

R. Bryan Riggsbee - Myriad Genetics, Inc.

Management

Hey, Jack. This is Bryan. There are moving parts during the quarter, especially as you think about the long-term contracts that we've implemented through the year and the impact of that year-over-year as well as the Anthem accounting change. We haven't really broken those out. I think the best thing that we could do in order to help you as you start to think about next year was just to give you the numbers in terms of what we see from a volume and price perspective next year.

Jack Meehan - Barclays Capital, Inc.

Analyst

Okay. And just one follow-up on EndoPredict. I know it's early in launch, but you talked about some of the good volume metrics there. Maybe just – is there any way to quantify what you're not getting paid for yet, what's contracted but you're not generating revenue on or maybe said another way, at full reimbursement what the revenue contribution could have been in the U.S.?

Mark C. Capone - Myriad Genetics, Inc.

Management

Yeah. I think from an EndoPredict standpoint, to be clear, most of the volume is clearly coming from the international markets. And that's with our kit-based strategy. I think we're very early on in the U.S. market from an adoption perspective. And so you're not seeing a big portion of the volume coming from the U.S. yet. So, there is really not a lot of revenue per se potential in the fourth quarter. Now, as we mentioned in the prepared comments, we're seeing volumes ramp and continue to ramp. And because we are anticipating a favorable LCD, we should be at over 75% coverage for EndoPredict. So the samples that we are getting in that growing volume, over 75% of those in the U.S. are going to be reimbursed. And so that's going to, at least from a profitability standpoint, be very favorable for the volumes we generate here in the U.S.

Jack Meehan - Barclays Capital, Inc.

Analyst

Thanks, Mark.

Scott Gleason - Myriad Genetics, Inc.

Management

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 afternoon.

Operator

Operator

Ladies and gentlemen, that does conclude the conference call for today. We thank you for your participation and ask that you please disconnect your line.