Genetic testing: The challenges
The promise is that genetic testing coupled to other forms of diagnostics and artificial intelligence will create 4P medicine – a new form of healthcare which is predictive, personalised, preventative, and participative.
But huge barriers remain. For starters, there is the challenge of educating two generations of clinicians worldwide who are broadly ignorant of genetic medicine in all its forms. One source said: “Even newly graduated doctors have barely covered genetics in their training. The main issue is that doctors simply don’t know what tests can achieve, or how to order them.” In many countries, genetics is not yet recognised as a medical specialisation within the profession.
Classically, this education need would be met by the shock troops of big pharma, with medical specialists calling on doctors one-on-one to persuade them of the merits of new drugs. But the lack of intellectual property means the genetic testing business won’t be like that. Fielding a huge salesforce is only possible when in high margin industries. Genetic testing will likely a low margin, high volume service business.
And then there are the payors. Often almost as ignorant as the medical profession, they do not want to pay for expensive genetic tests that they don’t understand. A US source told us that in many sectors only around 35% of genetic tests taken in the US are actually paid for. “The patient or the doctor orders it, the payor refuses to pay and the individual patient refuses to cough up. Labs are spending an inordinate amount of time chasing money.”
The private sector is often competing with large public sector hospitals, although the players we’ve talked to are generally confident that the public sector won’t be able to compete as test volumes grow. “Speed of results is essential. We used to take 2-3 weeks to do analysis, now demand is for four-day turnaround. I don’t see how the public sector will be able to compete there.”
If you really want to wind up anyone running a genetics lab, ask them about recruitment and retention. There is, quite simply, an aching void to be filled in bioinformatics.
And the upside? The tests are getting better and cheaper all the time. There is a clear parallel to the microcomputer industry in the 1980s and 1990s. First, they moved from the data processing centre to the office desktop and then they moved into every home. But it was a cut-throat business.
We would welcome your thoughts on this story. Email your views to Max Hotopf or call 0207 183 3779.
