|02.18.20| Medtronic buys Digital Surgery; Nebula launches D2C whole genome sequencing product for $299

The last month has been tough going for the consumer genomics industry with frontrunners 23andMe and Ancestory.com both announcing massive layoffs, however, new kid on the block Nebula Genomics is launching a consumer product today that will offer users whole genome sequencing for $299.

“We hope to really revitalize the whole space by making whole genome sequencing affordable, providing more comprehensive, dynamic user-driven reporting and by addressing privacy concerns that many people have,” Dennis Grishin, cofounder at Nebula Genomics, told MobiHealthNews.

The Harvard Medical spinout, cofounded by geneticist George Church — made famous for among other things, his attempts to revive the woolly mammoth — differs from other popular consumer genomics companies because it will perform a 30X whole genome sequencing as opposed to genome typing. This allows for a more comprehensives insights into the genome.

Traditionally this kind of testing was expensive; however, over the years the price of whole genome sequencing has been on the decline and is trending toward a point of actual consumer affordability.

“So, we are twice as cheap as the nearest competitors. So right now, the price is about $600 or $700 if you want to buy 30X whole genome sequencing. We are doing it at $299,” Grishin said.

Of note, many D2C genetic testing offerings, like 23andMe’s $99 basic service, are not whole-genome sequencing but instead focus on only a few base pairs.

Nebula is also focused on addressing privacy concerns. The company is building a secure data management platform that will use blockchain technology and “privacy-preserving computing”.

“We have been deploying blockchain for more than a year, which has such an immutable access control layer, that really documents all access permissions you give to the data. So the consumer can say, ‘I will allow access to research for my data’ or ‘I will allow general data sharing’ or ‘I don’t allow it at all.’ So we document things like that on blockchain in a immutable fashion to really create transparency and help build trust,” Grishin said.

The product was designed so that users could get more information about their genome and traits as additional research emerges.

“One of our reporting features is called the Nebula Research Library. So, what they do is a weekly update of research studies and we apply [the research] to our users’ genetic information. The pace of research is accelerating every week, there is new research published by different associations with certain genetic variants and traits,” Grishin said. “So what we do is essentially enable our customers to stay up to date with the latest advancements and learn how they might be relevant to them.”

WHY IT MATTERS

During the last decade consumer genomics companies such as 23andMe and Helix have been on the rise. 23andMe for example, has caught the attention of pharma companies and consumers alike. In 2018 it landed $300 million in investments from GlaxoSmithKline in order for the pharma giant to gain exclusive access to the company’s DNA data base.

However, privacy has been a major concern for users and legislators. In 2017 Senator Chuck Schumer (D-New York) wrote a letter to the FCC urging the organization to investigate and ensure that privacy policies are clear, transparent and fair to consumers.

In fact, 23andMe CEO Anne Wojcicki noted privacy concerns as one of the factors that has led to declining sales.

Nebula has pitched its secure blockchain tech as a way to help remedy these concerns. Cofounders Grishin and Kamal Obbad, have also been vocal about giving the consumer or patient more control of their data. However, as news emerges about layoffs, it is clear that it's still a tough market to enter.

THE LARGER TREND

In 2018 Nebula announced a different business model, where participants could have their whole genome sequenced for no out of pocket cost, instead they could sell their data to researchers and receive Nebula tokens in exchange. A participant is able to use these coins to purchase information about their genome sequence, and what it means for their health and potential future of their child. While the coin option is no longer listed on its website, it does appear to have a sponsored sequencing feature, which follows a similar model.

In June, it made its first pharma partnership with Merck KGaA’s EMD Serono. This early partnership will come in the form of a pilot program.

ON THE RECORD

“For the past 30 years, we've been working towards making personal whole genome sequencing affordable and accurate. Today, we have a big step towards this goal, reducing the cost of 30x Whole-Genome Sequencing to less than $300 and making it available to people around the globe,”Church said in a statement.

Cindy Gaines has worn many hats over her career — she's been a nurse, a project manager, held multiple C-suite roles, and now serves as the clinical leader of population health management at Philips. She said that her experience in both the clinical and nonclinical realm has helped her in her current role of bringing the world of health IT and patient care together.

“I come with a lot of experience having done this work. I was a customer for 10 years using a lot of our population health management solutions,” Gaines said. “So I really come in as a subject matter expert in bridging the world between our technology and our innovations, and the clients and customers, and understanding their world. I serve as that connection of understanding their pain points and then translating that and vice versa.”

Today she is focusing on bringing new technologies into the quickly changing industry of population health.

What is changing in population health?

The primary care provider is seeing the bulk of the change when it comes to population health, Gaines said.

“They’ve always done a great job of taking care of the patient in front of them. The patient comes in for the appointment, they address the need for the appointment and they work with that patient,” she said. “But with population health management they became accountable for what happens to that patient when they weren’t in the office. So if you didn’t come in to get your mammogram, if you weren’t following up on your diabetes care, [PCPs] have some accountability to how are they going to stay connected with you and engage with you. That has been a big transition to population health management.”

Additionally, the consumerization of healthcare has created new challenges for the PCP as well. For one, the healthcare industry is seeing the rise in retail clinics and urgent care centers. This can mean that a patients records are often disjointed.

“Convenient care has become the demand of our consumers. It is consumer-driven. No one would like to wait. Here is the challenge of that as a PCP, I’ve become accountable for coordinating with you your care. But there are a lot of ways for you to get your care that aren’t connected to your primary care. I think our challenge is to use technology to drive information back to the primary care provider so they can really help to be that partner with that patient.”

Another rising conversation emerging in the world of population health is the role social determinants of health, in caring for patients.

“I think it’s this realization that the health system can’t meet the patient needs and so it is really going to force us to partner with our community resources to better meet our patient needs,” she said. “I can tell you to go to the food pantry to help you with your food, but did you follow through on that and did you get what you needed? We need technology to start connecting us with resources, so not only do I say you should go but I can actually refer you. Then we can get information back on how that went. That is really helping the patient.”

However, tech has already done some work supporting population health, she said. In particular she said there is an emergence of predictive analytics that can help prevent a health emergency before it happens.

Advice to the next generation of population health hopefuls

Gaines said there is a lot of opportunities in the field for individuals from both the tech world and the clinical world.

“What is exciting about population health is, it is bringing together the clinical and nonclinical. It is a space that, if you want to make a difference, it feels a little unlimited,” Gaines said. “Even if you are not a clinician it’s a great space to be in. That’s what population health is about. It’s bringing together the community resources with the health system and the technology [world]. It’s just a great environment if you want to be that person who can be part of something bigger than themselves where we can partner and bring your skill set to it. We need all of those skillsets.”

For women in particular, Gaines stressed the importance of taking risks.

“What I would say to women is to be courageous. Don't be defined by boundaries,” she said.

Gaines explained that she graduated from college as a nurse, which has a set career path. However, she started branching out of that traditional path.

“When you are faced with opportunities, they scare you a little bit, but be courageous and take a chance,” she said. “Don’t let your fears stop you.”