Basing medicine on an individual, not the average

Listened to a pretty interesting podcast the other day on the creative destruction of medicine. He talks a lot about how the future of medicine will be tailored on the individual and their genetic structure, rather than based on the averages.

During one part of the discussion he talks about 23ANDme.com, and their scan of the genome variants. Here is the part of the discussion.

Well, if you do a scan of the common variants in a genome, which is really almost becoming not useful–so you can get that now for $99 through 23andMe.com. There aren’t many of those consumer-genomic companies still standing. That’s certainly the main one. It was $400; it’s just come down over time to now $99. That gets you a peek into the genome. It does get, by the way, going back to our discussion earlier about the drug interactions, it gets you something like 25-30 major drug interactions about you. So, just that alone is a bargain in my view. But it doesn’t get you every single letter of your genome sequence. There you are just getting hundreds of thousands rather than 6 billion. Russ: Why are they going out of business? Do you know? Guest: Oh, the other companies? Well, DeepCode, Navigenics, there’s been a few of them–they were charging a lot more, well over $400, and they could not get enough people to buy into that. And 23andMe brought the price down to $99 and that’s starting to get a lot of interest and support. Initially when Navigenics came out a few years ago it was $1500 for this limited genomic information of common variants. And that just wasn’t going to fly. They had bad expectations about how much people would pay for what was minimal information. Russ: And what do you mean by ‘drug interactions’? What’s an example? Guest: So, the 23andMe panel that anyone can get for a saliva kit sent to them, that gets interactions with drugs like Plavix, like various cancer drugs. Caffeine, even. A whole list of drugs. Warfarin, the blood thinner. I don’t remember all 27 of them offhand, but it has a lot of useful commonly used drugs with very strong data to support the variant in one’s genome. Russ: But the interactions you are talking about are not between drugs, but between the drug and you. Guest: Yes. Exactly. So, let’s say you are prescribed to take Warfarin, blood thinner. Well here you’d know the dosage you should be taking. I mean, I know that the average person takes between 5 and 7 milligrams. I know from having that that I should only take 2 milligrams. Otherwise I’d have a lot of bleeding. I don’t have to take that drug but it sure is nice to know that well in advance, if it ever was prescribed. Some people have to take 20 milligrams to get the effect of their blood thinned. That’s just the kind of example of the kind of information you get from that.

I don’t know how I feel about the whole test, but the part about the personalized interactions of the medications might be worth the $99.

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