Genomics startups tread D2C route to push for predictive healthcare

Forty-year-old Brinda had always been on top of her health; she ate healthy on most days and hit the gym regularly. A covid strike, however, left her fatigued for weeks after recovery. Routine tests couldn’t detect any underlying reason, leaving Brinda searching for answers.

A doctor-friend then recommended she take Mapmygenome's Genomepatri test. Using an at-home testing kit, she did a saliva swab and sent it to a prescribed diagnostic centre through a courier partner. Using the swab sample, along with some basic details of Brinda’s family medical history,

As Mapmygenome analysed her DNA, it identified certain regions of the genome known to be associated with cardiovascular conditions, which the findings showed ran in her family. 

This prompted Brinda to consult her physician and chalk out a plan that would entail changes in lifestyle and food habits.

“It was life-changing to have someone tell me what diseases I may get in the future,” she tells YourStory.

Like Brinda, many rely on genome sequencing analysis to identify inherited disorders, characterise the mutations that drive cancer progression, and track disease outbreaks. This is done using a complex laboratory method that analyses genomes, or a complete set of DNA or genetic material.

While the complex process would earlier be left to the interpretation of qualified scientists, today, companies like MapMyGenome are making it available directly to consumers through at-home testing kits. They also provide personalised nutrition plans and integration with fitness apps. 

This is a significant milestone and is likely to encourage many more to take proactive steps to prevent lifestyle diseases and focus on overall wellness. Moreover, it shows that companies are trying to capitalise on the diversity of the Indian population for predicting and controlling disease outbreaks.

Capturing the market

Genome sequencing gained worldwide attention in the late 1990s when the Human Genome Project, a consortium of scientific minds from across the world, came together to identify what makes a human DNA and create the first-ever sequence of the human genome. The 13-year-long project cost over $3 billion. While it could not produce complete results, it gave hope to the scientific community and governments that technology could pave the way for innovation in healthcare.

Over the next few years, companies sprouted in the US, the UK, France, Germany and Japan to scale the emerging technology. 

India started seeing corporate participation about 10 years ago with MapMyGenome and MedGenome bucking the trend. In 2022 alone, over $130 million has been invested in genomics startups in India focused on healthcare—a 120% jump from the previous year, according to data by market intelligence firm Tracxn.

Today, genome testing can be done in less than 10 days, which previously took years. India too is spearheading efforts in the space, with the establishment of the India Genome Project by Bengaluru-based Indian Institute of Science's Centre for Brain Research, funded by the Department of Biotechnology.

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According to a report by Market Data Forecast, the genetic testing market in the Asia-Pacific region is expected to grow at a CAGR of 7.65% to $15.33 billion by 2027. Geographically, the Indian genetic testing market is the fastest growing in the APAC region “owing to various diseases and developments in the healthcare sector,” the report said. 

Separately, a recent study published by Mayo Clinic Proceedings indicated that nearly one in eight people who underwent predictive genomic testing found that they had a genetic risk for a health condition and may be able to manage it better with preventive care.

It is hard to tell where India stands today when it comes to the penetration of such preventive healthcare, but companies are trying to widen the scale by reaching out to consumers directly.

The D2C way

Anu Acharya, Founder and CEO of MapMyGenome, doesn’t think of genome sequencing as complicated. She believes that directly acquainting the product with the consumers should be a natural course of action because “that’s where the market is.” MapMyGenome does exactly that.

Genomepatri, one of the firm’s many offerings, is available to consumers on the website. One needs to simply add the product to their shopping cart and wait for it to be delivered to their doorstep. The kit contains basic tools for a saliva swab and instructions on how one can take the sample by themselves. The sample is then processed in a certified laboratory and the results are dissipated within three weeks. “Imagine shopping online for a comprehensive health report,” Anu quips. 

Delhi-based Answer Genomics, through its consumer-facing brand NuGenomics, offers an at-home collection of blood samples and doorstep delivery of results. Customers can choose from four different programmes—weight loss, weight gain, holistic wellness, and diabetes management—to meet health goals. Over 500 customers have been tested so far, according to the company.

NuGenomics is working on allowing users to integrate the results with select fitness apps. “The integration will provide a one-stop platform for people to manage health concerns while keeping in mind the genetic findings,” Rahul Ranganathan, CEO of NuGenomics, underlines. Some firms also offer subscription plans for families.

Personalised health insight reports are also gaining popularity, prompting Reliance-backed Strand Life Sciences to launch such a service at the Bengaluru Tech Summit last week. The Genomic Health Insight report aims to help individuals understand how their personal genomic variations might influence their risk for a broad range of diseases with 30-100% heritability. This can enable people to work with their doctors to manage risks with proactive wellness measures.

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A long road ahead

While companies are yearning to make genome sequencing a mass offering, it comes with a set of challenges.

For one, these tests aren’t exactly affordable. MapMyGenome’s Genomepatri tests start from Rs 6,500, while NuGenomics offers a complete testing cum wellness programme at Rs 17,000. For an average consumer, the cost is the biggest hurdle. 

But affordability can only be solved with scale, says Dr Vijay Chandru, Co-founder and Director of Strand Life Sciences, predicting it will take some years for a big chunk of the population to be sequenced. 

The economics of such businesses will also take time to pin down.

“Investors are looking at the space closely but it’s too early to tell if the process will move the needle. Besides, one needs to have expertise in the area to evaluate the fundamentals of such a business, let alone one operating on such a small scale,” a healthcare investor tracking startups in the space says on the condition of anonymity. 

Moreover, genome testing cannot be a substitute for routine tests. While it can be used as a reference point for the future, routine blood work is required for present diagnostics. This may prove detrimental to the business models of genomics startups as it raises the question of repeat customers, the investor adds.

“The high-ticket size of each sale is one of the few things the firms can benefit from,” an investor adds.

Another challenge is the inadequacy of genomic data or variants used as reference points. MapMyGenome has mapped its own set of data points to help make sense of genetic information which has helped the company offer tests at a lower cost. But not all companies possess the financial muscle to conduct intensive research that can otherwise take years.

At a panel discussion at the Bengaluru Tech Summit, Dr Bratati Kahali, Associate Professor at the Centre for Brain Research, IISc, also said that increased monetary and moral support from the government is helping popularise and expand the ambit of these tests. 

It certainly is a long road ahead for genome sequencing to become a fixture in India's healthcare system, but dedicated efforts are underway. Only time will tell if a niche almost luxury-like service can penetrate the masses.