Helix Health’s Steve Murphy rather breathlessly announces the launch of the Coriell Personalized Medicine Collaborative website (for the uninitiated: you can tell Steve is really excited when he uses five exclamation marks at the end of a sentence rather than four.)
To be fair, it is big news. Coriell is offering a free service – a full genome scan, plus a genetic health report and genetic counselling – that would cost you at least $500 from Navigenics. The pay-off to them is a massive database to mine for new gene-disease associations and information about patient responses to genetic testing; the pay-off for you is free genetic disease risk predictions.
There are catches, of course. Firstly, you have to be able to physically travel to an enrolment session – all of which appear to be in New Jersey for at least the next few months – as opposed to simply spitting in a cup in the privacy of your own home for a commercial genome scan.
Secondly, Coriell takes an old-school and rather patronising approach to personal genomics: although the organisation will scan your genome looking at somewhere in the vicinity of a million genetic markers, you will only be allowed to look at the markers that Coriell thinks you’re ready for. These are the markers associated with diseases that Coriell’s Oversight Board regard as “potentially medically actionable”. If you’re interested in using your own genetic data for other purposes (e.g. exploring genetic ancestry), or if you just genuinely want to know if you carry markers associated with “non-actionable” diseases (e.g. Alzheimer’s) – well, it seems you’ll have to go elsewhere.
So, will this free service have a major impact on the market for commercial personal genomics companies? I doubt it will have any real effect on 23andMe or deCODEme, who both offer a wider range of applications than disease risk analysis (such as genetic ancestry and family member comparisons), and at least in 23andMe’s case have a vastly superior PR engine. Perhaps most importantly, these two companies (and especially 23andMe) have managed to make genomics genuinely entertaining – that’s a hard act for a non-profit, academic outfit like Coriell to follow.
However, the story is quite different for Navigenics, which has spent the last year carefully attempting to carve out the “serious, responsible genomics for sensible people” niche for itself, only to now watch Coriell effortlessly seize the moral high ground. Navigenics has explicitly avoided “frivolous” products such as ancestry or non-disease trait genetics (e.g. eye colour) to focus on disease risk prediction; having now backed itself into this corner, it will be much harder for this company can compete with Coriell’s offering.
- Breast cancer
- Celiac disease
- Colon cancer
- Crohn’s disease
- Diabetes, type 2
- Heart attack
- Macular degeneration
- Prostate cancer
I’d be pretty surprised if Coriell didn’t add breast cancer and celiac disease to its list of conditions in the near future: both are actionable, and both have fairly convincing (albeit only weakly predictive) associations with common variants.
So Navigenics’ product, which focuses only on these diseases, offers a negligible advantage over the Coriell scan in terms of clinical utility but costs $500 more. From most places in the US, it would be cheaper to travel to New Jersey and get Coriell’s test than to fork out for Navigenics’ product – and assuming that Coriell will eventually take its show on the road, the travel costs and inconvenience barrier are likely to drop even further at some point.
I’ll be interested to see how Navigenics responds to this threat – can it do so without destroying its carefully constructed facade of sombre, medically-focused responsibility? Resorting to a move into non-disease genetics and ancestry would break this spell, and put the company up against the well-entrenched 23andMe; expanding the list of tested conditions would mean moving into less well-established associations, undermining its claims of conservatism. It’s a tricky dilemma.
As for Coriell – well, if I was living anywhere near the New Jersey area I’d be signing up at the next enrollment session. I deeply dislike the patronising “need to know” attitude, but Coriell’s study will answer important questions about the response of consumers to responsible genetic testing, and maybe even find some new associations – and at the end of the day, free genetic information is free genetic information.