I wrote previously about what got an addiction doctor like me to open a genetics education company with a laboratory component. The question that should raise is why couldn’t I just use some other lab for the results and add the education. Good question.
When I started looking at opening a lab a bunch of knowledgeable people gave me the following scenario: spend $500K buying the top of the line high-throughput machines, hire great sales people, and then sell the hell out of the testing panel you design. It doesn’t matter if it’s what people need. They won’t know the difference. It doesn’t matter if it answers their questions. Just make your panel as big as possible, stuff a lot of fluff in there to make it look like they’re getting something. And test everyone for everything, no matter what they order. High throughput is the answer, so marketing is the way to go. Oh and take insurance because there are a bunch of companies that do nothing but resell your product to other people who then bill insurance for just one test in your big panel and make big bucks. They made it sound lucrative, very lucrative.
Nah, we went another way.
The machines today are incredible. Huge plates that multiple people’s samples can fit on. All running the same array of tests. All very fast. All very clean. All very large and expensive. But, if you run enough people through, the cost per test go way down. It sounds great, right?
Except, there are some trade offs. For this to make sense, and make a profit to pay back the huge expense of the machine, labs have to batch the samples. No one gets an answer until they get 96 people to fill the wells of the sample plate. If a lab’s economics are based on a cost per test, which is based on 96 tests at at time, why run a test for someone at 96 times the cost? That’s why everyone promises 2 to 3 week turnaround at best (and maybe slips a week or so on the long side in execution).
We figured, if someone wants the answer to a question, they should get it fast. So we don’t wait for full runs. We test every few days, and report the confirmed result as soon as we have it. We only need six samples a day to test every day. When we get that big, you’ll get answers the same day we get your sample. If there’s a problem and we have to rerun it, it will take another day, but we’ll stay in touch and people who use us will know what’s going on every step of the way.
Everyone wants to sell you a big panel. “After all, we give you 70 SNPs for the same price that other guy gives you 5. We’re a much better deal.” Sounds great if you’re buying SNPs. But you aren’t.
If you’re looking to answer a question based on your genetics, then the value is in the answer to your question. Information that gets in the way or distracts you from the answer doesn’t add value. One day, we’ll all have our complete genetic sequences on our phones, and no one will have to ask the question of “What am I at that polymorphism?” But that’s not really your question anyway. The question you have is what it all means. So rather than focus on giving you a lot of data you can’t use, we focus on the information you want.
And if you want more or different SNPs, ask us. We can add them. That’s another advantage of not doing high throughput with big panels. If a new polymorphism becomes important because of new research, we can add it in a few weeks. The big guys won’t add it at all because it means redesigning their chip at a cost of up to $50,000. We don’t have to do that because we didn’t start out to sell you something you don’t need.
Testing for Everything
Another benefit for companies running fast high throughput machines with big panels is that no matter what part of the panel you order, you get the whole thing. Now on the one hand, that’s a benefit to you. If you decide you want more data later, then they just have to go to the computer and give it to you. Very fast. But the other side of the equation is a little more nefarious.
Those people that gave me the scenario told me why these companies test for everything. It’s because they sell the data to other people. The more data, the more they can sell. We will never sell your data to anyone. It’s your data. So we’ll only test for what you order.
You’ve probably heard of some of the other fallout from testing more than the person wants to know and sharing the data. Police have started using it to track down relatives of other people who have had genetic testing. We don’t do enough tests to give anyone genealogy information, and we don’t share it, so you won’t be surprised with a call from an uncle you didn’t know you had.
If I had a dollar for every time I heard that if we didn’t take insurance we’d never make it, I’d be rich. Everyone is positive that people will refuse to pay a fair amount for a value. Everyone is positive that people will trade their privacy and safety for a few dollars. I’m not.
The biggest problem with using insurance to pay for genetic testing is that the insurance company knows you had the test. Further, they paid for it, so they can get the results. (So now how do you feel about more results in the lab’s computer than you even know about?)
But there’s nothing to worry about, right? It’s illegal to discriminate against someone for health insurance on the basis of genetic testing, right? Actually, that is right. But it is still legal for them to discriminate against you for life insurance and long term care insurance. And do you know any insurance companies that aren’t owned by or own banks? Would you give a 30 year mortgage to a guy who’s APOE showed he had 10X the normal risk of early Alzheimer’s (even if he didn’t order the test and didn’t know his own result)? Do you trust the rules those large companies put in place between their banks and insurance companies?
The GenEd Way
If normal people like you are going to use the data derived from their own genetics to help them live a better life, and they should, then there has to be a better way. It’s your question, so you get the answer. It’s your need, so you get it fast. It’s your data, so it stays private. That’s our mission. That’s our goal.
But we’re growing. We’re just staring with genetics. There’s so much more to learn and teach. Join us as we get started and see if we can’t help you answer a question or two. Come and see the GenEd difference.