{"id":2434,"date":"2015-11-22T14:32:10","date_gmt":"2015-11-22T19:32:10","guid":{"rendered":"https:\/\/digital.hbs.edu\/platform-digit\/submission\/23andme-dna-analytics-and-the-future-of-personalized-medicine\/"},"modified":"2015-11-22T23:26:39","modified_gmt":"2015-11-23T04:26:39","slug":"23andme-dna-analytics-and-the-future-of-personalized-medicine","status":"publish","type":"hck-submission","link":"https:\/\/d3.harvard.edu\/platform-digit\/submission\/23andme-dna-analytics-and-the-future-of-personalized-medicine\/","title":{"rendered":"23andMe \u2013 DNA analytics and the future of personalized medicine"},"content":{"rendered":"<p>WORD COUNT: 750<\/p>\n<p>One of the most important areas to be transformed by our ability to generate larger than life data sets, and our capacity to analyze them, is medicine. 23andMe\u2019s ability to analyze anyone\u2019s DNA quickly and cost effectively, paired with its success in getting\u00a0<strong>800,000<\/strong> people (an impressive 90% of its customers)<a href=\"#_ftn1\" name=\"_ftnref1\">[1]<\/a> to provide their genetic data as part of an anonymized database, foreshadows a future where personalized medicine becomes possible.<\/p>\n<p>23andMe was founded in 2006 with the mission of (1) providing genetic testing and interpretation to individual consumers, and (2) through these tests, creating a vast genomic database which may be used in advancing medicine.<\/p>\n<ol>\n<li><strong><u> How the test works<\/u><\/strong><\/li>\n<\/ol>\n<p><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/23e.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-2624\" src=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/23e-1024x641.jpg\" alt=\"23e\" width=\"640\" height=\"401\" srcset=\"https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/23e-1024x641.jpg 1024w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/23e-300x188.jpg 300w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/23e-600x375.jpg 600w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/23e.jpg 2023w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<figure id=\"attachment_2630\" aria-describedby=\"caption-attachment-2630\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/3steps.png\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-2630 size-large\" src=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/3steps-1024x554.png\" alt=\"3steps\" width=\"640\" height=\"346\" srcset=\"https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/3steps-1024x554.png 1024w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/3steps-300x162.png 300w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/3steps-600x325.png 600w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/3steps.png 1330w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><figcaption id=\"caption-attachment-2630\" class=\"wp-caption-text\">Three quick steps to get your report &#8211; (1) order a kit, (2) send in saliva sample, (3) logon online to view your report<\/figcaption><\/figure>\n<p><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/REPORTS.jpg\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-2655\" src=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/REPORTS-624x1024.jpg\" alt=\"REPORTS\" width=\"624\" height=\"1024\" srcset=\"https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/REPORTS-624x1024.jpg 624w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/REPORTS-183x300.jpg 183w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/REPORTS-366x600.jpg 366w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/REPORTS.jpg 980w\" sizes=\"auto, (max-width: 624px) 100vw, 624px\" \/><\/a><\/p>\n<ol start=\"2\">\n<li><u> <\/u><strong><u>How 23andMe differs from other genetic testing services<\/u><\/strong><\/li>\n<\/ol>\n<ul>\n<li>Faster and cheaper testing (Ease of data collection)<\/li>\n<\/ul>\n<p>Rather than <em>sequencing a full genome<\/em> (which costs $10,000<a href=\"#_ftn2\" name=\"_ftnref2\">[2]<\/a>), 23andMe employs single nucleotide polymorphisms (SNP) chip technology, which sequences less than 0.1% of the genome but offers genetic results for 260 factors.<a href=\"#_ftn3\" name=\"_ftnref3\">[3]<\/a> This enables 23andMe to provide fast results, at an affordable price \u2013 today, kits cost $199.<\/p>\n<ul>\n<li>Accessing a larger population (Scale of collection)<\/li>\n<\/ul>\n<p>23andMe fundamentally differs from others in the genetic testing space in terms of its underlying \u201cDirect-to-Consumer\u201d (DTC) approach to collecting data \u2013 <em>it is the first and only company to receive FDA authorization to market a direct-to-consumer genetic test.<\/em><a href=\"#_ftn4\" name=\"_ftnref4\"><em><strong>[4]<\/strong><\/em><\/a> The vast majority of genetic tests come through a doctor, and are requested for testing one, or a very specific set, of genes. Navigenics, for example, a 23andMe competitor, makes its tests available only through healthcare professionals, whereas 23andMe launched its genetic test as a DTC product. According to founder Anne Wojcicki, \u201cWe\u2019re DTC\u00a0not because it\u2019s easy, but because that\u2019s how you create a revolution.\u201d<a href=\"#_ftn5\" name=\"_ftnref5\">[5]<\/a>\u00a0A key to this &#8216;revolution&#8217; is being able to <em>aggregate genomic data from far more people<\/em>, thanks to a $199 price tag and DTC marketing.<\/p>\n<ol start=\"3\">\n<li><strong><u> Value Creation &amp; Value Capture<\/u><\/strong><\/li>\n<\/ol>\n<p><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/valuecap.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-2662\" src=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/valuecap-1024x528.png\" alt=\"valuecap\" width=\"640\" height=\"330\" srcset=\"https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/valuecap-1024x528.png 1024w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/valuecap-300x155.png 300w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/valuecap-600x310.png 600w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/valuecap.png 1758w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><\/p>\n<p>23andMe\u00a0<strong>creates value for consumers<\/strong> by (1) generating quick and affordable insights which may help them better plan their healthcare, and (2) ancestral information which may help find relatives, or be of pure entertainment value. It <strong>captures value from consumers<\/strong> through its $199 kit fee.<\/p>\n<p>While this consumer facing value creation\/value capture mechanism has generated 23andMe\u2019s revenue so far, building its large, unprecedented genomic database has laid the foundation for 23andMe to capture value in much bigger ways \u2013 by <strong>selling data and related services<\/strong>, and down the line, even\u00a0<strong>developing its own personalized drugs<\/strong>.\u00a023andMe\u2019s Personal Genome Service isn\u2019t primarily intended to be a consumer device, but a \u201cfront-end for a massive information-gathering operation\u201d,<a href=\"#_ftn1\" name=\"_ftnref1\">[8]<\/a> where its true value creation and capture lie &#8211; analogous to the search engine&#8217;s role in Google&#8217;s ultimate value creation\/capture.\u00a0In February,\u201c23andMe announced the first of ten deals\u00a0with big biotech: Genentech will pay $60M to access 23andMe&#8217;s data to study Parkinson&#8217;s.\u201d <a href=\"#_ftn1\" name=\"_ftnref1\">[6]<\/a>\u00a0The potential to uncover genetic causes of hereditary diseases through pattern matching in its massive data set could pave the way for 23andMe to develop its own billion-dollar blockbuster drugs; and in March, 23andMe announced plans to start inventing medicines itself.<a href=\"#_ftn2\" name=\"_ftnref2\">[7]<\/a><\/p>\n<ol start=\"4\">\n<li><strong><u> Avoiding the big pitfalls in the data<\/u><\/strong><\/li>\n<\/ol>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\"><\/a><\/p>\n<p>(<em>SNP) technology<\/em><\/p>\n<p>SNP is used to sample the genome at thousands of points, rather than fully sequencing it; to then <em>correlate genomic variants commonly found in the \u2018average\u2019 population with diseases and traits.\u00a0<\/em><\/p>\n<ul>\n<li>Using genomic <em>variants<\/em> means results of these reports are not nearly as predictive as looking at family history or <em>specific<\/em> genes (such as the BRCA breast cancer gene) &#8211; geneticists call their clinical validity into question.<\/li>\n<li>Companies doing\u00a0SNP-based testing don\u2019t define<em>\u00a0\u2018average\u2019<\/em>\u00a0population risks or <em>select sets of single nucleotide polymorphisms<\/em> in the same way, \u00a0as evidenced by <a href=\"http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3883880\/\">published research<\/a>\u00a0(Tables 1) on taking tests across different providers, which produced vastly different results.<\/li>\n<\/ul>\n<figure id=\"attachment_2759\" aria-describedby=\"caption-attachment-2759\" style=\"width: 640px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/t11.png\"><img loading=\"lazy\" decoding=\"async\" class=\"size-large wp-image-2759\" src=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/t11-1024x567.png\" alt=\"Source: Variations in predicted risks in personal genome testing for common complex diseases Rachel R.J. Kalf, MSc,1 Raluca Mihaescu, MD,1 Suman Kundu, MSc,1 Peter de Knijff, PhD,2 Robert C. Green, MD, MPH,3 and A. Cecile J.W. Janssens, PhD1,4\" width=\"640\" height=\"354\" srcset=\"https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/t11-1024x567.png 1024w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/t11-300x166.png 300w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/t11-600x332.png 600w, https:\/\/d3.harvard.edu\/platform-digit\/wp-content\/uploads\/sites\/2\/2015\/11\/t11.png 1828w\" sizes=\"auto, (max-width: 640px) 100vw, 640px\" \/><\/a><figcaption id=\"caption-attachment-2759\" class=\"wp-caption-text\">Source: Variations in predicted risks in personal genome testing for common complex diseases<br \/>Rachel R.J. Kalf, MSc,1 Raluca Mihaescu, MD,1 Suman Kundu, MSc,1 Peter de Knijff, PhD,2 Robert C. Green, MD, MPH,3 and A. Cecile J.W. Janssens, PhD1,4<\/figcaption><\/figure>\n<ul>\n<li class=\"p1\"><span class=\"s1\"><span class=\"s1\">These tests assume genes are always &#8216;acting&#8217;\u00a0<em>independently of one another &#8211; <\/em>they\u00a0only &#8220;consider marginal effects of each SNP and fail to accommodate epistatic effects&#8221;<a href=\"#_ftnref1\" name=\"_ftn1\">[9]<\/a>\u00a0(genes having different effects in combination than individually)<\/span><\/span><\/li>\n<\/ul>\n<p><em>Bias in sample population<\/em><\/p>\n<ul>\n<li>There may be inherent selection bias in the populations that opt to take DTC tests \u2013 (1) young, more tech savvy early adopters keen to get a glimpse of their genetic information for more recreational value, or (2) people who have a family history of a serious disease, to cite a few examples. This means the average test taker will not be representative of the average population.<\/li>\n<\/ul>\n<p><em>Incorrect interpretation of results<\/em><\/p>\n<ul>\n<li>Beyond the above-mentioned risks, there is that of consumers incorrectly interpreting their results.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[1]<\/a> http:\/\/www.forbes.com\/sites\/matthewherper\/2015\/03\/12\/23andme-enters-the-drug-business-just-as-apple-changes-it\/<\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\">[2]<\/a> Source: Illumina<\/p>\n<p><a href=\"#_ftnref3\" name=\"_ftn3\">[3]<\/a> Murphy, \u201cInside 23andMe.\u201d<\/p>\n<p><a href=\"#_ftnref4\" name=\"_ftn4\">[4]<\/a> http:\/\/mediacenter.23andme.com\/blog\/2015\/10\/21\/new-23andme\/<\/p>\n<p><a href=\"#_ftnref5\" name=\"_ftn5\">[5]<\/a> http:\/\/www.fastcompany.com\/3022208\/fda-tells-23andme-founder-anne-wojcicki-to-stop-marketing-99-genetic-test-or-face-penalties<\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[6]<\/a> http:\/\/www.forbes.com\/sites\/matthewherper\/2015\/01\/06\/surprise-with-60-million-genentech-deal-23andme-has-a-business-plan\/<\/p>\n<p><a href=\"#_ftnref2\" name=\"_ftn2\">[7]<\/a> http:\/\/www.forbes.com\/sites\/matthewherper\/2015\/03\/12\/23andme-enters-the-drug-business-just-as-apple-changes-it\/<\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[8]<\/a><a href=\"http:\/\/19squx2sqzlk2w3lh726rs88.wpengine.netdna-cdn.com\/wp-content\/uploads\/2015\/11\/REPORTS.jpg\"> http:\/\/www.scientificamerican.com\/article\/23andme-is-terrifying-but-not-for-reasons-fda\/<br \/>\n<\/a><\/p>\n<p><a href=\"#_ftnref1\" name=\"_ftn1\">[9]<\/a>\u00a0http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3032061\/<\/p>\n<p>http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3327518\/<\/p>\n<p>http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2238676\/<\/p>\n<p>http:\/\/www.biomedcentral.com\/1755-8794\/8\/33<\/p>\n<p>http:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC3883880\/<\/p>\n<p><em>Variations in predicted risks in personal genome testing for common complex diseases,\u00a0<\/em>Rachel R.J. Kalf, MSc,1 Raluca Mihaescu, MD,1 Suman Kundu, MSc,1 Peter de Knijff, PhD,2 Robert C. Green, MD, MPH,3 and A. Cecile J.W. Janssens, PhD1,4<\/p>\n","protected":false},"excerpt":{"rendered":"<p>DNA analytics and the future of personalized medicine<\/p>\n","protected":false},"author":80,"featured_media":2436,"comment_status":"open","ping_status":"closed","template":"","categories":[927,926,851,946],"class_list":["post-2434","hck-submission","type-hck-submission","status-publish","has-post-thumbnail","hentry","category-dna","category-genetics","category-medicine","category-parkinsons"],"connected_submission_link":"https:\/\/d3.harvard.edu\/platform-digit\/assignment\/data-driven-value-creation-value-capture-and-operating-models\/","yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>23andMe \u2013 DNA analytics and the future of personalized medicine - Digital Innovation and Transformation<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/d3.harvard.edu\/platform-digit\/submission\/23andme-dna-analytics-and-the-future-of-personalized-medicine\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"23andMe \u2013 DNA analytics and the future of personalized medicine - 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