Genetic Counseling Helps Physicians Decode Test Results

Damian McNamara

March 08, 2016

LA JOLLA, California — Companies that provide direct-to-consumer genomic testing understand that as genomic findings grow in scope and complexity, they need to provide help to physicians who already have limited time to spend with patients.

"We want patients to walk into the doctor's office and not have to hand them a 10-page report to read through," said Mirza Cifric, cofounder and chief executive officer of Veritas Genetics. The company provides next-generation whole-genome sequencing results to consumers through a smartphone app.

Embrace the technology and genomic testing to help your patients, Cifric said here at the Future of Genomic Medicine IX. "Be an early adopter. People trust their doctors and value their doctors' opinions," he told Medscape Medical News.

But "the nuances can get lost," said Elad Gil, PhD, cofounder and chief executive officer of Color Genomics, which offers 19-gene testing for breast and ovarian cancers. Patients must get physician approval to take the test and they receive the results online. Genetic counseling is included in the $249 cost of the test.

People don't want to spend $1000 on their genome just to hear that they should exercise and eat better.

Until now, Veritas whole-genome sequencing has been available only to participants in the Personal Genome Project at Harvard Medical School in Boston. But on March 3, the service became widely available. Physicians can now order sequencing for any patient in the United States. The $999 price includes interpretation and genetic counseling, the company announced at the meeting.

Veritas provides two levels of "actionable information," Cifric explained. "We're including actionable recommendations for individuals and for the healthcare providers."

Because we understand the pressures physicians are facing, including time with the patient and access to, and the varying quality of, available information, "we focus on actionable data," he said.

"We have to have healthcare providers be a part of this conversation," he pointed out. "People don't want to spend $1000 on their genome just to hear that they should exercise and eat better."

Taking the Long View

Mirza Cifric

Patients and physicians should view whole-genome sequencing as a valuable lifelong source of information, not a one-time test, Cifric said. "Your genome is a resource that can help you live a healthier and longer life."

For example, a person could consult their data in the future if a genetically driven illness occurs in the family.

Veritas has partnered with WorldCare Consortium, which provides medical second-opinion services and has access to more than 20,000 medical professionals from high-quality medical institutions, such as Boston Children's Hospital, Duke Medicine, and the Mayo Clinic. "We're incorporating them into our platform so people can get a second written opinion," Cifric reported. "This is especially important to people with less access to healthcare."

"It is an exciting time for all of these companies and for those of us at this junction of consumer health and precision medicine," said Steven Tucker, MD, a medical oncologist practicing precision cancer care in Singapore.

Whole-genome sequencing priced under $1000 "is certainly attractive, but I have concerns and thoughts about pricing across the spectrum of genome testing," he told Medscape Medical News. The focus should be on quality, interpretation, usability, portability, and provider sustainability, he said, "not price."

"The ability to create a legion of online on-demand genetic counselors is, in my opinion, more valuable than getting the actual sequencing," Dr Tucker explained. "The first company to create an engaging ecosystem around DNA will hold a lot of sway with consumers."

Mr Cifric and Dr Tucker have disclosed no relevant financial relationships.

Future of Genomic Medicine (FOGM) IX. Presented March 3, 2016.


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