Will anybody pay for genomes?

3 minute read

MSNBC reports this Reuters story about the new microbead technology for gene sequencing. Because it allows such a decrease in cost (down to $2 million per genome) opposed to earlier sequencing methods, news stories are connecting this with the goal for a $1000 genome test.

I suppose $1000 would be inexpensive enough that anyone with a persuasive medical need could get her genome:

The idea is to produce a technology that could be used to compare one person's genome, for example, to the existing human genome map and find an individual's differences.
"There are needs for personal genomic data already," [method developer George] Church said.
"If you are a cancer patient there are quite a number of therapies which can only be used if you have a specific genetic component."

The live vote on the MSNBC story has 76 percent of respondants saying "yes" to a $1000 genome test, as in "Yes, what a bargain! Just think of all the information that would be revealed."

That frankly surprised me, because I gave my students the same poll last week, with a twist: I asked them how much they would be willing to pay for their full genome sequence.

The results: only two would pay more than the price of a CD, around $16.00. Most didn't want the information at all --- they didn't see what possible use it could have for them.

Now keep in mind, this was after nearly a full semester of lectures on all the interesting things that anthropological genetics can tell you. I'm not turning people off of genetics, at least I hope not. But it does help to have some realism about what kind of useful information your genome can provide.

The fact is, for these college students, a full genome sequence just doesn't have much value right now. There are exceptions, especially if you have a family history of heart disease, cancer, diabetes, or some genetic disorder like cystic fibrosis or Huntington's disease. This story from MedPage Today discusses how home genetic testing for such disorders is already becoming a "booming business."

But most people have nothing at all to gain from knowing their genomes. Right now, we just don't know enough about the genome to direct people to the likely outcomes of their thousands of genes. In the future, lots of interesting things may become possible, but not today.

That wouldn't stop me, of course. I would pay the $1000, easily, just to compare my sequence with all that research I read. I could probably pay for it from my research funds. If you start seeing papers from me in a few years using a sample size of two, you'll know where it comes from.

Most people, of course, are not like me. Even if their genomes could be sequenced cheaply, they wouldn't want the data themselves. How would they assess it? What you really want is for some medical professional to have the data, in a form already compiled and compared to other people. When it arrives, genomics won't be sold like a book; it will be sold like a service, complete with recommendations for what to eat to maximize health.

Probably in the end, there will be computer programs like TurboTax for genomes, where you plug in your information, and they come up with recommendations cheaply. By that time, of course, computers will talk to you out of robot heads, and you can start calling them "Doctor."

There will probably come a time when knowledge of a child's genome at birth will encourage parents to pursue many small interventions as their child grows up. A few more supplements of this mineral might greatly enhance their athletic performance, cutting down on that food might help their scholastics, giving a regular dose of this drug might prevent heart attacks at age 40.

But there will probably come a point in life when this kind of medicine fails. College-age people are never going to care that much what their health at 50 is like. If it can't stop them smoking right now, how in the world is it going to get them to eat Brussels sprouts in the future?

I think most people would rather have a medicine that fixes what's wrong with them, instead of one that will prevent bad things from happening. Preventative medicine works as long as the disease is imminent and the treatment once it happens very unpleasant. That is, after all, the reason for Lipitor, Crestor, and all the other cholesterol-cutters. A drug that could prevent some cancer would probably become hugely popular even if the normal odds of that cancer were relatively low.

At least with people over 35. Good luck marketing it to college students.