Razzle Dazzle 'Em Part Deux

I was reading Daniel's Blog and this person's comments caught my eye...

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

I think she is right. To do the education to get someone to use this test will ultimately make them not use this test...because once you can understand the implications, you could understand that these tests are of limited value.......unlike Pgx testing...

Caveat: I like the people at Navigenics. I think they have great scientists. BUT, I am extremely skeptical of any physician who is working for this company to promote tests which are not clinically validated.....

To continue...

She then goes further....


"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". "


Spot on......too bad the expert is a genetic counselor who has no medical training in explaining heart disease, multiple sclerosis or anything other than cancer, prenatal issues "Family planning" or monogenic disease.......the model that they were trained for.... What would you do with a woman who had a systolic BP of 136 Elissa? Could you suggest anything?...Wouldn't it be smarter if they actually talked to doctors who understood what these tests meant and who had cared for people with these diseases???? And even with clinical utility aside, deCode has failed to prove clinical utility of their tests.....

The commenter is wrong again down here........but in an extremely correct way......

"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."


Exactly, the cobbler issue.....but I doubt,


1. That the genetic counselor is getting paid 2000 per consult. If you subtract the costs of the test from the charge, that is what you get.....


2. That the counselor is even close to a replacement for a physician....not even close when it comes to adult disease management.......

But she is absolutely correct. It costs a lot to speak with someone, which is why VC always hated Helix Health of Connecticut's model of healthcare...Too bad for them. Patients are using it.....

Just then, she had an absolutely correct point, which is exactly what Navigenics hit square on the head......they were so right in this one way!

"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."

This my dear is called concierge medicine and it is why Navigenics has partnered with the Internists and Family Practitioners of MDVIP........If not to bolster the impression that their unvalidated test IS Clinically valid (Very sneaky, guys)

But I wonder how MDVIP is doing, using these tests and charging patients for it.......since after all


1) In Navigenics Terms of Service, you can't use it for healthcare

2) Most Internists and FPs need about 6 months of genetics training to understand genetics

3) Most of the info in that report gives us no advantage clinically.


And then she nails the point home:

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

Have any of you watched Chicago? This is exactly what I call Razzle Dazzle 'Em.......baffle the people with bull$h!+ and they will think you are worth something.......Hell, it is how these companies were sold the Venture Capital in the first place.....

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

I agree, hand waving and bull$h!+, precisely what this company is offering........otherwise they would have hired physicians to go over the reports with patients rather than genetic counselors....

That to me is the proof of what they feel is important........

For the millions they spent in NYC (there is no shop in SoHo) they could have had Geneticists and Internists who actually get this stuff. They could have them hired at 130k per year.....what's that? 10 Doctors who know what they're doing for a year or 20 counselors who won't tell the patients that they wasted their time on clinically useless testing?

Oh wait.......last time I checked, Navi didn't even have more than 3 counselors doing the clinical work. So if Navi is so into the clinical side, why didn't they hire enough people for the job......Nor did decode or 23andMe..

Oh wait, maybe they have? All 3 have an extensive marketing team and web development team.............. deCode , Navigenics , 23andMe
All are looking for more......

As for the commenter? She works for a company who provides services around bead technology.......


The Sherpa Says: All 3 of these companies are struggling to find themselves......as I have said before, no one knows the true value of these tests yet. Which is why they should be studied......in a rigorous, IRB approved fashion, not anecdotally........Dietrich, you should have had your team listen to me about a year ago when we spoke......I could have gotten you there quicker.........One test is called a one hit wonder....a platform.....is worth so much more.