Anne Wojcicki is co-founder and CEO of 23andMe, one of the world's largest personal genomics companies.
GeneWatch: Where do you see consumer genomics in 20 years?
Anne Wojcicki: Twenty years is an eternity in this business. I feel like it would be sci-fi even if we were talking three to five years, so twenty ... I've never thought that far ahead in this business. I can barely keep track of the next six months. We started 2012 thinking maybe we would try to do something in sequencing, but it was still kind of expensive; and by the second week of January, it's cheap! It's cheap, it's fast, and it's here. It's moving so fast.
Twenty years is so exciting. I get chills just thinking about it. For one, the cost of sequencing is going down so much-everything is going to be sequenced, and you're going to see sequencing being used all the time. What I'm most excited about is that in 20 years, we'll really understand your genome: your health risks, why you are the way you are, the environmental factors, the underlying causes of disease. It's not just personalized medicine, but personalized health.
What does the business model look like in the future for a company like 23andMe? Correct me if I'm wrong, but it seems to me like most people are only going to buy the genetic tests once.
In our model, we've always pushed the envelope in driving down cost. We don't look at just getting access to your genome as a high margin business for us, or even any significant margin. We want to enable access. What we've realized-and I think what everyone has realized-is that this ongoing interpretation is where we have to spend a pretty large amount of resources. That's why we've really transitioned into a service business rather than just a testing business.
It won't necessarily just be 23andMe where you go and get your genome sequence. You might get it from your physician, you might get it from a clinical trial ... you can get it a number of different ways, so getting access to it is no longer going to be the bottleneck. Interpreting it is going to be the challenge.
I think that's where we are as a business: making sure that anyone who wants to get access to their genome can get access, and then providing an ongoing service where we can continually keep people updated. We keep you up to date on the health side if there are new developments that are potentially relevant to your genome. Over the next 20 years, I see a spectacular amount of information coming out, so having a service that can keep you updated will be important.
Are you looking at whole genome sequencing?
We launched an exome pilot at the end of last year. We've done some whole genome sequencing, but it's just a matter of price point. It's getting so cheap, it seems unreasonable for us not to consider it.
Can you tell us about 23andMe's Neanderthal lab?
There were some discoveries about Neanderthals and being able to specifically identify the Neanderthal DNA in humans. This is one of the fun things: we created a lab tool so that you can see how much Neanderthal is in your DNA. So I can share that information with a couple hundred people, and I can look to see who has the least Neanderthal and who has the most. It makes my DNA interactive, it makes it fun. People have an image in their minds of a Neanderthal; but the person that I share with who has the most Neanderthal (and who is OK with me using the info)-the person at the very top, in the 99th percentile, is Ivanka Trump! So it's not always about health: there are a lot of fun things. Our whole human history is so interesting, and it's in our DNA.
It sounds like this is all going in the direction of social networking, but with your genes.
It is social networking. One of the things that is really important to us, also, is disease research. What we hope to do eventually is introduce a new model for understanding health and disease. So instead of having research done in the traditional models, you can actually have consumer-driven research. We have a number of different disease communities where people come together and take surveys, and we're able to do a mass amount of research on this. So it's social networking with a very specific purpose.
In terms of the disease risk aspects, do you see a line between what's appropriate in a commercial versus clinical setting, and do you see that changing in the future as technologies change?
That's something we've really approached with caution. We believe the consumer should have access to information that is fundamentally theirs. If it's about my health or about my body, there's no reason a physician should stand in between that information and me. That said, we recognize that the medical community has their concerns, and I think we've tried to be very responsible about how we're putting out information. For things like the BRCA report [for risk of breast cancer], and the APOE report [for risk of Alzheimer's Disease]-for the APOE report, we actually have a video with Robert Green talking about what you are likely to learn, what happens if you are or aren't a carrier, and we've had really positive feedback about that from physicians, genetic counselors, and consumers. As people take more control over their health, they want not just the information, but all the context around it. So you might want to talk to a genetic counselor or a physician, but we don't necessarily believe that you have to.
As we know, medicine is more of an art than a science, so being able to get multiple opinions will be really valuable for the whole field of medicine, as well as for the patient.
Is that something that could be built into 23andMe's own business? For example, are there any genetic counselors on staff at 23andMe, or might there be in the future?
We don't have any genetic counselors, but we have a partnership. We thought it was important that we're not the ones who are necessarily giving all the information to consumers, that there should be a divide. We are the ones providing the information, and there is a separate group that is actually giving the genetic counseling. So we have partnered with an external group, and that is available to people for an extra fee. I think that's something that we'll continue to pursue. We recognize that there will always be people who will want that option, and they should have that option. And we will always continue to engage with genetic counselors and the medical community to make sure we are doing things responsibly, and to make sure that customers have all the access points if they want them.
Do you have any thoughts about things that are unlikely to happen in 20 years?
There are a lot of science fiction movies that involve genetics, and I am more skeptical about some of the science fiction scenarios. One, I have faith in humanity, that we'll put in the appropriate regulations; and two, genetics is a hard problem. I think we'll be able to make a lot of really fabulous discoveries, but it won't be enough to solve everything.