Bloomberg Businessweek (May 20, 2024)

Год выпуска: May 20, 2024

Автор: Bloomberg Businessweek

Жанр: Бизнес

Издательство: «Bloomberg Businessweek»

Формат: PDF (журнал на английском языке)

Качество: OCR

Количество страниц: 68

THE DNA DELUSION

MASS-MARKET GENETIC TESTING HAS LITTLE TO OFFER MOST PEOPLE THAT’S AN EXISTENTIAL THREAT TO 23ANDME

Answers to our greatest questions, we were told about a decade ago, could be ours if we just spat in a tube. Celebrities were using DNA tests to trace their ancestry on the hit TV show Finding Your Roots. A “Who’s Your Daddy” truck rumbled through the streets of New York City, offering paternity tests on the go. Angelina Jolie sent droves of women scrambling to get their DNA tested when she wrote a 2013 op-ed in the New York Times. Jolie, whose mother was diagnosed with breast and ovarian cancer and died at 56, credited a DNA screening with identifying a mutation in her BRCA1 gene that meant she had an elevated risk for cancer, too. In detailing her choice to get a double mastectomy, she helped cement the popular understanding that a single gene could mean the difference between life and death.

A few months after the op-ed ran, during an appearance on CBS This Morning, 23andMe Chief Executive Officer Anne Wojcicki said she was bringing the power of these sorts of DNA tests to everyone. Her startup would make testing affordable, she said, so it could build a massive repository of genetic data, one big enough to speed research and create a road map for living to age 100. Wojcicki cited her own DNA as proof of concept: She’d quit drinking after finding that she also carried a gene that heightened her risk of breast cancer. When co-host Gayle King said she’d heard some doctors were skeptical, Wojcicki brushed it off. “Anytime there’s a new technology for physicians, it’s a challenge,” she said. Then the conversation moved in a different direction, as co-host Norah O’Donnell asked whether 23andMe planned to usher in a future of designer babies.

Around the time of that morning show appearance, Wojcicki’s team brought 1,000 of their DNA-testing spit kits to 23andMe’s first medical conference and managed to give away maybe five. Physicians breezed past her team to line up for Dippin’ Dots instead. In late 2013 the US Food and Drug Administration ordered 23andMe to stop selling its health tests until the company could prove they were safe and effective.

In a recent interview with Bloomberg Businessweek, Wojcicki looked back on that period with good humor. She says the early rejections only made her more determined. It was just a matter of time, she believed, until the medical community added genetic testing to its standard operating procedures. “When you start, you’re just naive about everything,” she says. “We thought, at some point, physicians would adopt it.”

Given more evidence, of course, the FDA later authorized the tests, and 23andMe became a household name. The problem, for Wojcicki and the rest of the DNA testing industry, is that all these years and millions of spit kits later, the doctors still don’t care. Mass-market genetic screenings remain well apart from the medical mainstream, and 23andMe has never made a profit. And unfortunately for Wojcicki and her peers, the reasons for that seem to be less about the stuffiness of the doctors than about the limits of genetic testing.

When researchers unveiled a working draft of the human genome in the early years of the 21st century, it was billed as a panacea. Within our DNA, the project’s boosters said, lay the keys to victory over almost everything that ails us. Drugs tailored to a person’s particular genetic code had the potential to cure diseases instead of merely treating them. Genetic risk assessments would drive people to eat and exercise in the ways they needed to avoid getting sick in the first place. Today, however, the biggest insight most people have gained from DNA testing is trivia about their ancestors’ countries of origin. Most doctors remain untrained in genetics, when to order a DNA test or what to do if a patient brings one in. Therapies targeting the human genome are few and far between, and they’re often too expensive for most people to afford.

We’re still waiting, in other words, for health care’s great DNA revolution. And a growing contingent is starting to question whether genetic data simply isn’t of much use to the average person. “Everyone now is getting their genetic reports back and realizing that it’s not actually making a damn bit of difference when it comes to their health,” says James Tabery, a professor of philosophy and bioethics at the University of Utah and author of Tyranny of the Gene: Personalized Medicine and Its Threat to Public Health.

“I’m more confident than ever,” Wojcicki says. “But I think there’s also that reality that it’s not like gold dripping from trees.” Few have more riding on the next phase of applications from DNA testing than 23andMe. Over the past decade, it’s tried a lot of strategies to make personalized genetics profitable. It partnered with Big Pharma to develop drugs from DNA insights. It acquired a telehealth company. Most recently it rolled out a $999 yearlong testing subscription that includes full sequencing of the genome’s protein coding regions, two rounds of blood tests and analysis from a clinician. Still, it has yet to graduate from stocking stuffer to health care. As kit sales have slowed, investors have soured on the company’s longer-term bets, and its stock is on the verge of being delisted from the Nasdaq. (On May 10, the company said it had received an extension of 180 days to bring its share price back above $1, according to a filing with the US Securities and Exchange Commission.) 23andMe needs to find a way to increase sales, raise capital or slash spending, even as it struggles to close the gap between the practical uses of DNA testing and the hype.

Wojcicki acknowledges things aren’t going exactly according to plan. “We’re in an industry that is definitely figuring out what is that application of genetics in the clinical space,” she says. “It’s a little bit of a sector in crisis.”

Code has proven an imperfect genetic metaphor. DNA’s double helix structure, first revealed to the world in the 1950s, is made up of billions of base pairs of A’s, C’s, G’s and T’s. Each one of a person’s roughly 20,000 genes amounts to a stretch of those letters, and the ACGT makeup of individual genes can make the difference between brown eyes and blue ones, or attached earlobes and the free-swinging kind. In the 1980s and ’90s, a string of research breakthroughs began to pinpoint the location of individual genes for conditions such as Huntington’s disease and cystic fibrosis. The prospect of a full-length genetic code, then, seemed to promise that we could reverse-engineer the eradication of diseases by treating DNA as something akin to a programming language. If we could decrypt the code, we’d just have to figure out how to intervene in the disease genes—to switch the 1s to 0s, the ons to offs.

As a team of international researchers drew close to finishing the Human Genome Project, the first full sequence of a person’s code, its backers made grand promises about the data’s potential. In 2000, President Bill Clinton said it would lead to cures for Alzheimer’s, Parkinson’s, diabetes and cancer. In 2003, at a celebration of the project’s completion at the National Museum of Natural History in Washington, Francis Collins, the scientist who led the endeavor, predicted that researchers would identify the genes responsible for those diseases within a decade, and that by 2020 “we will have a genebased designer drug available for almost any disease that you can name.” Collins, who went on to run the National Institutes of Health, capped his remarks with a DNA-themed song to the tune of Del Shannon’s Runaway. He played guitar, and the audience clapped along to the chorus: “I wonder / wo-wo-wo-wo-wonder / Why / why why why why why / you’ve got an A / I’ve got a C there, what does that say? / Amazing DNA.”

Within a few years of Collins’ performance, new technology made it much easier to suss out teeny variations in DNA that can turn a healthy gene into a disease-causing one. Keeping up with the pace of discovery, the New England Journal of Medicine wrote in 2007, was like “drinking from a fire hose.” That same year, 23andMe shipped its first product, a $999 DNA test, with the help of $4 million in funding from Google. (At the time, Wojcicki was married to Google co-founder Sergey Brin.) Wojcicki and her co-founders said they planned to take the genetics revolution out of the lab and put it in people’s hands. “That any consumer with $1,000 can now capitalize on this project is a rare case of groundbreaking science overlapping with an eager marketplace,” Wired magazine wrote at the time...

A Big Test for 23andMe

• The company faces delisting as the health benefits of genetic data fall short

Inside an MLM for Day Trading

• IM Academy promised its young members riches. Many lost everything

America’s Captive Labor Market

• A suit says US inmates are being kept in prison to provide a cheap workforce

IN BRIEF

• US inflation cools
• BNP gets greener
• Mining moves

OPINION

• One likely outcome of a Trump victory: Higher prices

AGENDA

• Mexican elections
• US GDP growth
• World Bee Day

REMARKS

• Startups try to find their place in the future of AI

BUSINESS

• Addiction lawsuits are coming for video game makers
• Drugstores seek a treatment for falling profits

TECHNOLOGY

• The first patient with a brain implant from Elon Musk’s Neuralink describes how the device changed his life

FINANCE

• For Europe’s banks, breaking up with Russia is hard to do
• Homeowners insurance is through the roof in California

ECONOMICS

• A shift in Asian exports gives East Coast ports a boost
• Argentina’s Milei versus pro-labor hiring and firing rules

PURSUITS

• Building a Napa for beer lovers in the Hudson Valley
• The Venice Biennale’s must-see exhibitions
• New fans fast-forward demand for cassette tapes
• Aston Martin’s updated Vantage still trails its competitors
• Keep the windows to your soul open with lighter shades

LAST THING

• Mall landlords are hungry for more restaurants

скачать журнал: Bloomberg Businessweek (May 20, 2024)