Prediction from a Reader.

Ok, another sleepy day up in New Haven.......

But not with me. I received some comments from my last post which were interesting and I want to share one with all of you....

This year we will see some new genetic tests being developed and improved. We will also see 23andMe start to follow the business plan of DNA Direct.

This is a pretty insightful comment. Will we see 23andMe go for the DNADirect business? If the data behind genome scans is currently weak, how can 23andMe monetize their model? Yes, we all know about the database thing....Isn't that what landed Celera in a heap of pain?

Seriously, will 23andMe begin offering single gene tests? I am always confused by this one. DNADirect states that they do not mark up their tests, but how do they make money? I am curious about this one too. But if you look, their BRCA testing it costs 3465 USD which includes pre and post test counseling. The Cost of the Test through Myriad is 3120 USD, which is a difference of 345 USD. But the test through DNA Direct includes pre- and post- test counseling.

So 345 for counseling? I think that is an incredibly cheap amount. In fact it pushes the limits of the true value, which I think is around 1000 USD.

How do they do it? Through, telegenetics. And, if you look closely, if all you want is counselling, they only charge you 150 USD...likely per consultation, thus making 45 USD, which doubtfully can cover overhead. So I ask again, would 23andME like this model? I say yes, because if you use a genetic counselor rather than a physician you can pay them about 50-70,000 USD.

So, if we do the math 1200 consults need to be provided per year to cover the CGC salary. What if that is a physician at 150,000 USD? I think you get the picture.

So what do you get from a physician that you don't from a CGC? I think I have been over that one a few times now. Thus the higher salary. But for a business, do they care about that difference? More importantly, would 23andMe care?

Doubtful......

So I tend to agree with my reader. If 23andMe can sell medically relevant tests to consumers skipping the doctor and using the counselor instead, then this is an attractive business to them. But if you throw in physicians, then you may have a problem. So heads up Ryan, looks like you may have a healthy competition....

Now, here's the big question. Who is ordering the test? In CA like many other states a physician has to be responsible for ordering these tests, just like the Viagra Scheme.....

So, will we see more of this "creative" entrepreneurism which will likely disintegrate the trust between providers and patients? A most resounding yes. At the same time, should patients trust providers who often miss these diagnoses or fail to test?

How do we solve this? My gut tells me the responsible way to do this is out there. It doesn't include cutting corners for patient empowerment. What it does include is education for physicians and healthcare practitioners on a scale so massive that it only can be done over the television, radio and internet. It will take millions and millions of dollars.......Didn't Navigenics get 25 million? That should cover the first few years of what I propose we do.......

The Sherpa Says: I am still waiting for a press release to be drafted before I announce my news. Don't switch that dial......genomicTV will be right back!