Genetic Future

Added in edit: for superb analysis of the announcement from multiple angles, you should also check out Dan Vorhaus’ three incisive articles on Genomics Law Report.

Personal genomics company 23andMe announced yesterday on its blog (and in an email to customers) of impending changes to its product line. Until now 23andMe has offered only two products: its $399 full scan, and a $99 Research Revolution product that offers limited functionality and a focus on common disease risk prediction.

There are two major components of the altered product line. Firstly, customers will now be able to purchase separate products focusing on health and ancestry: the Ancestry Edition ($399) will focus on ancestry and genealogy analyses, while the Health Edition ($429) will provide risk predictions for common diseases and provide an updated line of carrier testing for rare, severe, recessive mutations relevant to reproductive decisions. It sounds as though 23andMe plans to move more extensively into the carrier testing market:

We are expanding our cystic fibrosis panel report to cover the full panel of mutations recommended by the American College of Medical Genetics, as well as several additional mutations. We will also be providing data for most of the mutations routinely screened for in the Ashkenazi Jewish population, including those associated with Tay-Sachs disease, Canavan disease and Bloom’s syndrome.

Finally, the company will still be offering its full scan to customers, but at an increased price of $499. If you want to get the full scan at the current price of $399 you have only a few days to order: the price hike comes into effect on November 19th.

The separation of products comes as no great surprise: this is a route already adopted by new personal genomics provider Pathway Genomics, and is a recognition that personal genomics customers occupy a variety of niches. In particular, there is a hefty contingent of genetic genealogists who are keen on the ancestry and family-tracing potential of genome scans but have much less interest in the health aspects. Other customers see genetic information as a way to inform health decisions and see ancestry genetics as a frivolous distraction (this is the market that Navigenics has targeted since launching with its no-nonsense health-only approach).
The increase in the price of the full scan, however, is a shock to those of us expecting a consistent decrease in the cost of personal genomics products, and suggests that the two rounds of lay-offs from the company this year were indeed driven by cash flow problems rather than mere restructuring.
23andMe is certainly not the first company to diversify its product line. I’ve already mentioned Pathway Genomics above; deCODEme has long offered separate products using specific panels of markers to target particular sets of diseases (e.g. its Cancer Scan), while Navigenics offers a pretty horrible discount product to attract customers who can then upgrade to their full version.
However, until now 23andMe has been steadfast in its insistence that personal genomics customers should see everything that their genome yields, not just fragments of it – the consistent subtext being that the whole raison d’etre of personal genomics should be the pursuit of broad intellectual curiosity and self-exploration rather than a desire to look purely for information relevant to health or some other specific interest. That ideal now appears to yielding to market forces.

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Comments

  1. #1 Jonathan
    November 15, 2009

    I do hope I’m not going to have to hear them claim they’re not in the medical testing business anymore following this decision…

  2. #2 Steven Murphy MD
    November 15, 2009

    Daniel,
    The “intent” is clear. They use a CLIA accredited lab and do clinical testing that is advocated by the American College of “medical” Genetics. This is Direct to Consumer medical testing. Now depending on the state or country you are in, you either need to work with a licensed health professional to obtain testing or you do not. We will see what each state/country does in response to this clearly clinical action. Frankly, I am frustrated with you and Dan’s whitewashing of what this is. It is almost a if your desires are clouding you impressions…..

    This IS medical and nonmedical testing, just like Pathway. When the CEO of pathway had to respond to my comments via Muin Khoury at the IOM meeting, he could not explain why this obtaining of human biological samples for the purpose of diagnosing a state/condition was not medicine.

    Because, It IS medicine.

    Steve

  3. #3 James Larry Vick
    November 15, 2009

    If Navigenics “no nonsense” approach doesn’t include ancestry information, then it is missing a huge potential marker of people who are interested in genealogy. The last time I checked, genealogy was the number two reason for going to the internet.

    Having customers with family trees would seem to be a valuable addition to the genome information.

  4. #4 asdf
    November 15, 2009

    A price hike is a sign of serious problems. This glassdoor account (with a rating for Senior Management of 1.0/5.0) looks more and more prescient by the day.

    http://www.glassdoor.com/Reviews/23andMe-Reviews-E145899.htm

    By 23andMe Anonymous (Current Employee) on Oct 1 2009

    Work/Life Balance 4.5
    Senior Leadership 1.0
    Fairness & Respect 3.0
    Recognition & Feedback 2.0
    Career Opportunities 1.5
    Compensation & Benefits 2.0
    Employee Morale 2.5
    Communication 3.0

    “23andMe is a fox in a world where hedgehogs succeed.”

    Pros

    * Unique synthesis of Web 2.0, social networking, and genetics.
    * Non-traditional, outside-the-box problem-solving.
    * Cooperative attitude among employees and in approach to external parties.
    * Novel space: personalized medicine.
    * Company’s efforts have influenced policy and dialogue at an international level.
    * Excellent networking connections with key opinion leaders and academic researchers.
    * Fun, intelligent co-workers.
    * Casual work environment.
    * Flexible work schedules.

    Cons

    * The scientists have little or no corporate experience.
    * People with corporate experience (management, BD) have little or no biotech/research experience.
    * No medical knowledge/experience in company.
    * Peer feedback, review process, and career advancement paths unclear.
    * Lack of focus in company direction and in how projects connect to company goals.

    Advice to Senior Management

    23andMe’s non-traditional approach is a strength in building new and interesting products and in attracting a very savvy group of customers. 23andMe has done a lot for genetics–making a complex topic accessible and fun, bringing genetics to a wide audience, and also influencing important discussions at very high levels.

    The non-traditional approach is also a weakness, because the company’s lack of corporate biotech experience at nearly all levels of the company has created major blind spots. As a result, 23andMe has stumbled into barriers that a more experienced company would have been aware of and taken the necessary steps to mitigate–which can require major commitments in resources and incorporation into the long-term business plan.

    23andMe also made an early choice to pursue several different, non-overlapping goals at once, and although it has achieved some success–excellent content, unique website, novel research platform, recognition in the space–continued growth will start to cause these functions to overlap less and less, potentially creating resource conflict and mission creep in the future.

    The lack of biotech and research experience in the executive management and BD teams also creates an attitude of taking research for granted. Biology is hard; finding discoveries that can provide a foundation for profitability is by no means guaranteed. Improving the chance of medically useful discoveries means thoroughly understanding a clinical question and conducting the best research possible–which may directly conflict with making the web service as customer-friendly as possible. But the lack of direct research knowledge and experience has led 23andMe to avoid focusing on specific areas, which means that specific expertise has never been brought on board and that research quality continually compromises with (and is compromised by) the needs of the web-based service.

    My advice is to build a company that focuses on doing one thing very well. If that thing is a web portal for genetics content, then set aside the research goal. If that thing is research, then set aside the web portal. If it is a genome-wide diagnostics company, then do whatever it takes to succeed in the increasingly difficult diagnostics world. In terms of both science and profitability, quality scientific research requires a much larger commitment of time, resources, and discipline than management has been able to show thus far. Hiring people with clinical knowledge and with experience at running a successful biotech or molecular diagnostics company will keep 23andMe from having to constantly reinvent the wheel.

  5. #5 Blaine Bettinger
    November 15, 2009

    A “frivolous distraction”? What kind of person would think such a thing?

  6. #6 Daniel MacArthur
    November 15, 2009

    James (#3) – I completely agree, and have criticised Navigenics for this in the past. Their depiction of non-medical testing as frivolous is particularly galling given that non-medical predictions from genome scans (e.g. for non-disease traits or ancestry) are substantially more accurate than risk predictions for common diseases, often by orders of magnitude.

  7. #7 Russell
    November 17, 2009

    Hmmmm. Navigenics does seem much more focused on health, and it, unlike 23andme, reports on your ApoE alleles. I wonder what the IRS says to using HSA funds to pay for Navigenics services?

  8. #8 Joe Average
    November 17, 2009

    Mr. Murphy, MD, no one cares about your definition of what is or is not a “medical test”. You have lost the battle. Most people want access to their test results without having to go through doctors ($$$, delay, bureaucracy). The more powerful and cheap these tests get, the more your position will become untenable.