Genetic Future

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Nearly five months after 23andMe dropped the price of its genome scan service from $1000 to $400, personal genomics competitor Navigenics has made its own foray into the lower-cost genetic testing market.

Navigenics has always been the most expensive of the three mainstream genome-scan companies, despite offering essentially the same product as competitors 23andMe and deCODEme: a genome scan examining between 500,000 and a million sites of common genetic variation, known as SNPs. While its competitors charge a one-off fee of $400 (23andMe) or $1,000 (deCODEme), Navigenics whacks its customers with a hefty $2,500 up-front fee plus a $250 annual subscription for its flagship product, Health Compass.

It seems likely that Navigenics’ higher fees are part of its overall strategy to paint itself as the more serious and respectable member of the personal genomics industry, and to appeal to the kind of well-paid executive customer who sees higher prices as a sure sign of quality. While Navigenics does offer a genetic counselling service that undoubtedly increases its running costs, its hard to justify the extra expense on the grounds of clinical value: in essence, Navigenics provides you with less information than its competitors (because it doesn’t offer ancestry or non-disease gene testing), and the health impact of most common genetic variants is small regardless of which company you choose.

Essentially, to buy the Navigenics service, you have to be convinced that talking on the phone to Navigenics’ pet counsellors will give you $2,000 worth of value that you couldn’t gain from the detailed online information provided by 23andMe or deCODEme – and then there’s the annual $250 subscription fee on top of that.

Now, on its corporate blog the Navigator, the company announces the launch of a new lower-budget product, Annual Insight:



Navigenics’ Annual Insight service retails for $499 and analyzes an
individual’s genetic predisposition for ten common health conditions
(nine each for men and women), including breast cancer, prostate
cancer, colon cancer and heart disease. The service will be available
to consumers through participating health care providers or directly
from the Navigenics website with genetic counselor support.

In other words, they’re not following 23andMe’s lead in the sense of dropping the cost of their flagship genome scan product, which remains as laughably over-priced as ever. Instead, they’re offering a stripped-down version of their test, targeting common variants associated with just ten diseases, apparently using targeted genotyping assays rather than a genome-wide SNP chip scan.

Why is it called Annual Insight, I hear you ask? Well, that’s because it comes with a time limit – the Navigenics web-site says your $500 buys you “[a]ccess to your genetic test results for an entire year”. Wow, guys, you get to look at a tiny fraction of your own genome for an entire year before your access gets revoked! You also get a whole hour of phone conversation with Navigenics’ genetic counsellors, which should be more than enough time for them to explain to you that their results have no clinical implications (and indeed the four conditions listed above are diseases where common genetic variants typically have very low predictive power).

Moreover, using targeted genotyping means that you can’t simply check your results whenever a new region of the genome is associated with one of these diseases (as you can, in many cases, if you have genome scan data) – instead, you’d have to pay to get another test done. Alternatively, you could take advantage of Navigenics’ offer to “upgrade to the comprehensive Navigenics Health Compass package” – yay!

I just don’t understand how anyone could possibly see this as an attractive alternative to 23andMe’s ($100 cheaper) full genome scan – but I suppose it will be interesting to see what proportion of their target audience disagrees with me.

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Comments

  1. #1 Blaine Bettinger
    January 28, 2009

    Daniel – I was just about to sit down and write this very post! I still can’t believe they used the sentence “Access to your genetic test results for an entire year.” Anything would have been better than that (like “Access to your genetic test results for one year” or “Access to your genetic test results while enrolled in Annual Insight.”) It seems that they are unaware of the discussion/criticism surrounding their service or aren’t concerned with it.

    This leaves me with another question – If I sign up for Annual Insight, can I extend my Annual Insight service for a subscription fee, or am I forced to upgrade to the Health Compass?

  2. #2 Anonymous
    January 28, 2009

    This post seems lame too.

    “Well, that’s because it comes with a time limit – the Navigenics web-site says your $500 buys you “[a]ccess to your genetic test results for an entire year. Wow, guys, you get to look at a tiny fraction of your own genome for an entire year before your access gets revoked!”

    I don’t understand your issue with this. The time limit is really irrelevant since once you get your test results in your account, you can save that info in your computer/print it out. Its not going to change with time.

  3. #3 Steven Murphy MD
    January 29, 2009

    Daniel,
    This is precisely the market they should have been targeting from the beginning…..

    No one, I mean no one is willing to pay 2500 for software and a “test”

    I have no clue what KPBC was smoking when they told them that was the right price point…..

    Besides, unless you move into the novelty testing area or medically in PgX, this sort of commercial application will be dead and the punchline to a cocktail party joke in about a year…

    The true winners in this genome space will be those who have a distribution platform for medical tests OR a platform for Novelty tests…..the 2 shall never meet…..which is why I predict 23andMe will go straight to novelty this year….

    If not, the fed is likely to put the squeeze on them…..regardless of Schmidt and the inauguration gifts….

    -Steve
    http://www.thegenesherpa.blogspot.com

  4. #4 Daniel MacArthur
    January 29, 2009

    Anonymous,

    As Blaine notes, the issue is mainly with the wording – it makes it sound as though Navigenics thinks it is generous to offer access for “an entire year”. This is of course absurd given that its competitors offer unlimited access.

    As for downloading your data off-line: sure, you can do it, but it’s worth noting that Navigenics actively discourages this (at least for their SNP chip package). Their view seems to be that too much knowledge could be scary or dangerous for ignorant consumers; well, that, and they don’t want you taking your raw data off to be analysed by a third party. It’s a deeply regressive, paternalistic approach compared to the “knowledge is power” perspective advocated by both 23andMe and deCODEme.

  5. #5 Tera Eerkes
    January 29, 2009

    I agree with many comments here…
    But I don’t agree that Navigenics has got it all wrong.

    The marketplace for genetic testing is basically an uneducated one (with the exception of people who are really excited about it).

    Add to that, Navigenics also wanted to offer disease related testing (I’m leaving the question of clinical utility aside here since the only people who have thought usefully about that are the deCode folks, and apparently not the Navis, 23s, etc.)

    So, they realized that to keep an uneducated customer happy while contemplating medically related information, they were going to need to make it easy for that person to pick up the phone and talk to an “expert”.

    That’s what they got right. Personalized genetic testing is not about the test, which is a commodity, or the “report” which is useless to most doctors, mothers, etc., but the information, which is currently best conveyed through a person who can answer questions. And people cost a lot of money, thus the ridiculously high price.

    Personalized genetic testing is about people getting attention they feel they need or want enough to pay for it, because they can’t get it from their PCP anymore on their insurance co.’s dime.

    Any company that can capitalize on that (regardless of whether the test is clinically useful or just hand waving) will have a market.

    Navigenics hit much closer to this mark than the other big 3.

  6. #6 BOBBY
    September 11, 2009

    An interesting article appeared several years ago in one of the general interest magazines, such as Wired, entitled “200 Pills A Day:”

    The writer traced the experiences of a new Silicone Valley millionaire who had sold his interest for a few million. This fellow had contracted with a physician in Denver who was also a research scientist in dietetics and longevity.

    The MD took the guy’s DNA info and made a prescriptive supplement program plus a killer 4 hour per day exercise regimen. The doc mentioned something about a guarantee his patient would live to be a hundred! He didn’t say who would be the beneficiary.

    Interesting.