What GeneSight tests, what it costs, how it compares to Gene2Rx, and which one makes sense for your situation.
Last updated: 2026-04-22
| Feature | Gene2Rx | GeneSight |
|---|---|---|
| Price to the patient | $5 to $49 depending on report tier | Typically $330 patient max with insurance; up to about $2,000 without insurance |
| Doctor's order required | No, direct-to-consumer | Yes, a healthcare provider must order the test |
| Uses existing 23andMe, AncestryDNA, or WGS data | Yes, upload your raw data | No, requires a new cheek swab |
| Turnaround time end-to-end | Minutes after upload | 2 to 3 business days for lab results, typically 2 to 4 weeks end-to-end with appointments and sample shipping |
| Medications reported on | 103 across every major drug class | Approximately 60, primarily psychiatric |
| Genes tested | CYP2D6, CYP2C19, CYP2C9, CYP3A5, SLCO1B1, VKORC1, DPYD, TPMT, UGT1A1, HLA-B, HLA-A, CYP2B6, CYP1A2 | CYP2D6, CYP2C19, CYP2C9, CYP3A4, CYP1A2, CYP2B6, COMT, MTHFR, HTR2A, SLC6A4, HLA-A, HLA-B, UGT1A4, UGT2B15, OPRM1 |
| Primary clinical focus | Comprehensive pharmacogenetics across psychiatry, cardiology, pain, oncology, and more | Psychiatric medication selection |
| Report format | Evidence-graded per drug (Strong / Moderate / Optional) based on CPIC and FDA | Color-coded tiers: green (use as directed), yellow (moderate interaction), red (significant interaction) |
| Insurance billing | Not applicable, direct pay | Files with insurance, in-network with many plans |
| Test owner / developer | Gene2Rx, independent | Myriad Genetics |
GeneSight's list price is around $2,000. Most patients do not pay that amount. Myriad Genetics bills insurance directly, and the company publicizes a patient-responsibility cap of roughly $330 for insured patients, with financial assistance available for people who qualify. For uninsured patients or those whose insurance denies coverage, the out-of-pocket cost can still run into several hundred dollars or more.
Gene2Rx prices start at $5 for a starter report and go up to about $49 for the comprehensive report. The difference is not a lab cost difference. Both services analyze small numbers of genetic variants, and the underlying lab work is relatively inexpensive. The difference is that GeneSight's price reflects the full clinical-test infrastructure: FDA-reviewed lab processing of a new sample, insurance billing staff, sales reps who call on psychiatrists, customer support for providers, and the margin required to fund marketing and the GUIDED clinical trial.
Gene2Rx avoids those costs by analyzing genetic data you already have. If you have 23andMe, AncestryDNA, MyHeritage, or whole-genome sequencing data, the raw variant calls for most clinically relevant pharmacogenes are already in that file. Extracting and interpreting them does not require a new sample or a clinical lab workflow.
Yes. GeneSight is a provider-ordered test. Your psychiatrist, primary care doctor, or nurse practitioner must place the order through Myriad, authorize the sample collection, and receive the results. You cannot order GeneSight for yourself. For many patients this is not a barrier, because they learned about GeneSight from their psychiatrist in the first place.
For others, the provider-order requirement is a real obstacle. Finding a psychiatrist who is comfortable with pharmacogenetic testing, willing to order it, and able to interpret the results takes time. Some primary care physicians decline to order GeneSight because pharmacogenetic testing falls outside their usual scope. Patients who are trying to understand their own medication response without an active prescribing relationship often find themselves unable to access GeneSight at all.
Gene2Rx works differently. You upload genetic data you already own, pay directly, and receive a pharmacogenetic report generated from that data. No prescriber is required. You can share the resulting report with your doctor to inform prescribing decisions, and most pharmacogenetic-aware clinicians will take a Gene2Rx report as useful information alongside a clinical conversation. But getting the report does not depend on finding a willing prescriber.
Myriad markets GeneSight's lab turnaround at 2 to 3 business days after the sample arrives at their lab. In practice, the patient experience is usually 2 to 4 weeks end-to-end, because the clinical workflow has several slow steps: the visit where your doctor agrees to order the test, the sample collection kit arriving in the mail, the sample making its way to the Myriad lab, the lab producing the report, the results being sent back to your doctor, and a follow-up appointment to discuss the results.
None of those steps individually is unreasonable. Together, they mean that a patient who urgently wants to know their metabolizer status before starting a new antidepressant will usually be waiting weeks before the result changes any clinical decision.
Gene2Rx's turnaround is minutes. The slow step is having the raw genetic data in hand. If you already have your 23andMe or AncestryDNA file on your computer, uploading it and receiving the pharmacogenetic report takes a few minutes. If you have whole-genome sequencing data, uploading the VCF and receiving the report is similarly fast. Gene2Rx does not file insurance claims, does not require a new sample, and does not need a prescriber in the loop.
GeneSight focuses on psychiatry. The report covers roughly 60 medications grouped into antidepressants, antipsychotics, mood stabilizers, anxiolytics, and ADHD medications. This focus is not accidental. GeneSight's entire clinical evidence base, including the company's flagship GUIDED trial, was built around psychiatric prescribing, and the product is marketed primarily to psychiatrists.
If every medication you are trying to decide about is psychiatric, this focus is a feature, not a limitation. If you take or are considering a medication outside psychiatry, such as a statin, a blood thinner like clopidogrel or warfarin, a pain medication like codeine or tramadol, a chemotherapy drug like capecitabine or mercaptopurine, an immunosuppressant like tacrolimus or azathioprine, or a proton pump inhibitor, GeneSight will not report on it.
Gene2Rx covers 103 medications across every major therapeutic class that has CPIC or FDA pharmacogenetic guidance. That includes the psychiatric medications GeneSight reports on plus cardiology drugs, pain medications, chemotherapy agents, transplant drugs, gastrointestinal medications, antivirals, and more. For patients who want a one-time pharmacogenetic profile that will inform prescribing decisions across their lifetime of medications, the broader coverage is meaningful.
Both services test the core drug-metabolizing cytochrome P450 enzymes (CYP2D6, CYP2C19, CYP2C9, CYP3A4 and CYP3A5, CYP2B6, CYP1A2), key transporters (SLCO1B1), and disease-specific genes where pharmacogenetic evidence is strong (DPYD for fluoropyrimidines, TPMT for thiopurines, HLA-B for abacavir and carbamazepine).
GeneSight includes several genes that Gene2Rx does not: COMT, MTHFR, HTR2A, SLC6A4, OPRM1, UGT1A4, and UGT2B15. These genes have real biology but less established clinical actionability. MTHFR is the most well-known example: common clinical laboratory guidelines from CAP and ACMG explicitly recommend against MTHFR genotyping for most clinical indications, because the research does not support using MTHFR variants to guide prescribing or supplementation decisions. Similar debates surround HTR2A, SLC6A4, COMT, and OPRM1: each has supportive research, but none has reached the evidence threshold that CPIC requires for a dosing guideline.
Gene2Rx's position is that genes with actionable CPIC or FDA guidelines are worth reporting, and genes without them are worth waiting on until the evidence firms up. That is a judgment call. Reasonable people disagree. If you specifically want a report that includes MTHFR, HTR2A, or other non-guideline markers, GeneSight will cover those.
GeneSight presents results using a three-tier color system. Green means use as directed (no significant gene-drug interaction for this medication based on your genotype). Yellow means moderate gene-drug interaction (proceed with caution). Red means significant gene-drug interaction (a different medication may be a better choice). Each drug gets a colored marker, and the colored-marker display is the most recognizable feature of the GeneSight report.
This presentation is effective for prescribing workflows. A psychiatrist reviewing a GeneSight report alongside a patient can quickly identify which medications to avoid and which to prefer. The simplicity is the point. The tradeoff is that the tier assignment compresses information. A red marker on a specific drug does not distinguish between strong CPIC-graded evidence and softer evidence based on the company's internal weightings.
Gene2Rx presents results differently. Each drug's recommendation is labeled with the CPIC or FDA evidence level (Strong, Moderate, or Optional) and paired with the specific phenotype-level guidance (for example, 'CYP2C19 poor metabolizer: consider a 50 percent dose reduction'). The presentation is closer to what a pharmacogenetic clinician would want to see, and the information is traceable back to specific CPIC guidelines. It is less visually simple than GeneSight's color tiers.
Both services follow the same underlying clinical guidelines. The Clinical Pharmacogenetics Implementation Consortium (CPIC) publishes peer-reviewed, evidence-graded drug-gene recommendations, and the FDA maintains a Table of Pharmacogenetic Associations on its website. Any reputable pharmacogenetic test builds on these sources.
GeneSight has published clinical outcome studies, most notably the GUIDED trial, which compared GeneSight-guided prescribing to treatment as usual in patients with major depression. The results are often cited by Myriad as evidence that GeneSight improves outcomes. Independent meta-analyses have been more cautious: some show a modest benefit, others show no statistically significant difference versus treatment as usual, and the field generally agrees that the strength of the underlying individual gene-drug relationships (codified by CPIC) is better established than the incremental clinical benefit of any specific commercial test product.
What this means practically: the pharmacogenetic information itself, the metabolizer phenotype and its drug-specific implications, is well-supported science. How any particular commercial test packages that information does not change the underlying biology. A CYP2C19 poor metabolizer is a CYP2C19 poor metabolizer regardless of which lab produced the result.
GeneSight is a reasonable choice for a specific set of patients. If you are working with a psychiatrist who is already familiar with the GeneSight report format and integrates its color tiers into their prescribing workflow, the test will fit cleanly into your care. If you have insurance coverage that includes Myriad-contracted benefits and your out-of-pocket cost will be the patient cap (typically $330 or less), the financial case is different from the list-price case. If you specifically want a report that includes MTHFR, HTR2A, or SLC6A4 variants that CPIC does not include, GeneSight will provide that.
The situations where Gene2Rx is usually the better fit: you already have 23andMe or AncestryDNA data, you want pharmacogenetic information for non-psychiatric medications too, you do not have a prescribing psychiatrist or cannot easily access one, you are uninsured or your insurance does not cover GeneSight, or you simply want the information quickly and inexpensively with the option to discuss it with your clinician on your own timeline.
Both services are legitimate. The right choice depends on your specific constraints, not on marketing claims from either side.
For many patients, yes. Both tests cover the same core pharmacogenes using the same CPIC and FDA guidelines. The practical differences are in cost, workflow, and scope. Gene2Rx covers more medications, costs much less, and does not require a doctor's order. GeneSight reports on a narrower set of medications with a psychiatric focus and integrates into a clinical workflow through a prescriber. If you are specifically using pharmacogenetic testing to inform psychiatric prescribing with a provider who already uses GeneSight, staying with GeneSight may be simpler. If you are trying to get comprehensive pharmacogenetic information efficiently, Gene2Rx is usually the better fit.
Gene2Rx analyzes genetic data you already have from services like 23andMe or AncestryDNA rather than running a new clinical lab test. That removes the largest cost drivers of a test like GeneSight: sample collection kits, clinical lab processing, insurance billing infrastructure, and the sales organization that markets the test to psychiatrists. The underlying pharmacogenetic interpretation is similar in cost regardless of where the genotype data came from, and Gene2Rx passes the savings through.
Most of them. Both tests cover the major drug-metabolizing cytochrome P450 genes (CYP2D6, CYP2C19, CYP2C9, CYP3A4 and CYP3A5, CYP2B6, CYP1A2) and clinically actionable transporter and disease-specific genes (SLCO1B1, DPYD, TPMT, HLA-B). GeneSight also includes several genes with less established clinical actionability: MTHFR, COMT, HTR2A, SLC6A4, OPRM1, UGT1A4, and UGT2B15. Gene2Rx does not report these because CPIC has not issued clinical guidelines for them, not because they cannot be tested.
Yes, and most pharmacogenetic-aware clinicians will accept a Gene2Rx report as useful information. The results are anchored to the same CPIC and FDA guidelines that any reputable pharmacogenetic report follows, so a clinician reading a Gene2Rx report will see the same metabolizer phenotypes and recommendations they would see in other reports. Bring the report to your appointment and ask the clinician how they would incorporate the information into your prescribing.
GeneSight bills insurance directly and is in-network with many major insurers for patients with a qualifying psychiatric diagnosis. Patient out-of-pocket costs with insurance are typically capped by Myriad around $330, with further financial assistance available for patients who qualify. Without insurance, GeneSight's cost can reach several hundred or a few thousand dollars. Gene2Rx does not bill insurance. It is direct pay at $5 to $49 depending on the report tier. The out-of-pocket cost for Gene2Rx is always far less than GeneSight's cost with or without insurance.
Generally no, because both tests are reporting on the same underlying pharmacogenetic phenotype. Your CYP2D6 or CYP2C19 genotype is what it is, and a second test on the same DNA will return the same metabolizer phenotype. The one exception is if you have already taken GeneSight (or have it ordered), you want pharmacogenetic information on the non-psychiatric medications GeneSight does not report on, and you have 23andMe or AncestryDNA data available. In that case, Gene2Rx can fill the coverage gap for statins, blood thinners, pain medications, and chemotherapy drugs using the existing consumer genotyping data.
If you already have 23andMe, AncestryDNA, MyHeritage, or whole-genome data, Gene2Rx turns it into a comprehensive pharmacogenetic report in minutes. No doctor required. No waiting weeks. Starting at $5.
Get your Gene2Rx report Look up a medication firstInformational only, not medical advice. Every pharmacogenetic test has a role; the right choice depends on your situation, insurance, and the medications you're evaluating. Always discuss pharmacogenetic results with your prescribing clinician before making any medication change.