The DNA discount

Geoffrey Shmigelsky says the best money he ever spent on his health was a $1,000 test he took a year ago. The 41-year-old—who sold Calgary’s largest internet service provider, PSINet, for a “stupid amount of money” a decade ago—spat into a test tube and FedExed the vial to biotech start-up 23andMe in California. Eight weeks later, he sat down to find out his risk for developing everything from heart disease to Alzheimer’s, schizophrenia to prostate cancer—even how likely he was to go bald.

Most of the information was interesting, but benign. However, Shmigelsky did discover that he’s 10 times more likely than average to develop glaucoma and 50 per cent more likely to develop age-related macular degeneration of the eyes. So now he takes lutein, a dietary nutrient that significantly decreases his risk of developing the ocular disease. He’s also learned that he carries a gene putting him at “extremely high risk” for developing gallstones, so he has frequent, thorough ultrasounds to screen for them. “I can do something today to reduce my risks going forward,” he says. “It’s empowering.”

Not so long ago, predictive genetic tests were the stuff of science fiction, but DNA sequencing is rapidly becoming a new growth area in biotech. There’s no doubt that many people are interested in finding out whether they are a genetically advantaged athlete, or have a particularly high risk of developing a disease—the only question is how much they’ll pay to find out. Right now, the tests can cost as much as US$50,000, but prices are coming down quickly and the race is on to provide fast results at mass-market prices that the whole family can afford. At stake is a whole new market that could be worth billions.

Already, entrepreneurs are offering consumers enticing glimpses of what might be in their genetic cards. For US$149 and a cheek swab, Atlas Sports Genetics can tell parents whether to steer their toddler toward power sports like football or endurance sports like distance running. For US$995, ScientificMatch.com promises to pair clients with DNA-friendly mates who will give them more orgasms and produce healthier children. Two months ago, Icelandic start-up deCODEme began offering a $195 test analyzing your risk for six common cardio conditions including heart attack, stroke and aneurysm.

Such tests are essentially the Coles Notes of DNA decoding, giving you just a hint of what’s inside. But at the pricier end of the field are companies that can completely unravel your DNA, and prices are coming down here too. Illumina, a San Diego biotechnology company, can now deliver a complete genetic decoding for US$48,000. That may sound like a lot, but consider that just seven years ago, when the first complete human genome was decoded, the procedure cost $2.7 billion. Since then the price has dropped from $1 million two years ago, to $350,000 a year ago, to $100,000 a few months ago, to $48,000 today. Complete Genomics, a Silicon Valley biotech start-up, now has plans to sequence human genomes for $5,000. Some scientists predict that within a decade, the sequencing technologies used by Illumina will be cheap enough to be integrated into widely available health care programs.

There are still a few hurdles to jump before we see DNA kits at the drugstore, however. For starters, some big names are still questioning the science behind the tests. Muin Khoury, director of public health genomics at the U.S. Centers for Disease Control and Prevention, says genes are not destiny, and mutations that put us at risk for a disease certainly don’t guarantee that we will develop it. Most diseases result from an interaction between genes and environment, he says, and you need to understand both parts of the puzzle to gauge the risk.

Perhaps the main barrier to widespread genetic testing, however, will be convincing people that this is a service they need. After all, sometimes the tests deliver bad news that doesn’t help you at all. Google co-founder Sergei Brin, whose wife Anne Wojcicki helped found 23andMe, discovered that he has a genetic mutation that sharply raises his risk for developing Parkinson’s disease. The 35-year-old billionaire, who gives himself “50-50 odds” of developing the neurological disorder, has announced funding for a major new study of its genetic underpinnings, but there’s little else he can do.

Such diseases are rare, however, and if you find out you have a higher-than-average risk for ailments such as diabetes or heart disease, there’s plenty you can do to improve your odds. That’s why boosters like Shmigelsky suggest the coming decade will be the “decade of genomics,” and that eventually all children will have their genomes sequenced at birth. The “genie is out of the bottle,” says Khoury. And as the price continues to drop, that genie will only grow stronger.