2024 Healthcare, Consumer & Wellness Magazine

Healthcare, Consumer &Wellness • 13 Decoding DNAtesting Genetic testing is on the rise, heralding an acceleration in precision medicine and greater public awareness about the impact our genes have on health and lifestyle choices. Many DNA tests now cost less than $100, making themaccessible to an ever-broader audience” $8.8billion 2030 Estimated size of global genetic testing market You have got the tracker and been monitoring your readings, so what’s the next step in making improvements? For an increasing number of people, it lies in understanding the interplay between their genetics, environment and lifestyle. Helping them is a burgeoning start- up scene using DNA analysis as the foundation for personalized advice and coaching to improve fitness, nutrition, sleep and wellbeing. It is a business model likely to prove popular among a wide cohort of consumers over the short term, potentially more so than testing that uncovers the risks of serious illnesses like breast cancer or Alzheimer’s disease. Both types of profiling are important. Indeed, understanding inherited risk factors can be lifesaving by enabling prevention through early medical intervention and lifestyle changes. But whereas many people are interested in fathoming their genetics to boost day-to-day health, not everyone wants to know if they are at risk of a serious disease, especially one like Alzheimer’s, which currently has no cure. And the data shows that about one in four people with European ancestry have double the risk, due to a single copy of the APOE4 gene, inherited from one parent. Another 2% to 3% have an eight to ten times higher risk after inheriting two copies, one from each parent. In 2023, the overall direct-to- consumer (DTC) genetic testing market was worth $1.93 billion according to Grand View Research. The US market intelligence firm forecasts it will increase to $8.8 billion by 2030. As Nauman Ansari, Global Healthcare Industry Head for Citi Commercial Bank puts it, “the industry has come a long way since the human genome was first sequenced in 2003 at a cost of $1 billion. Many DNA tests now cost less than $100, making them accessible to an ever-broader audience.” To date, many people’s first experience of DNA testing is for family trees or ethnicity. But these providers are also now including traits too. And not just physical ones like straight or wavy hair but behavioral traits including whether someone is likely to be an introvert or extrovert. Americans lead the world in DNA testing, accounting for 60.5% of revenues, while Europeans are expected to be the fastest growing geography over the next half-decade. A YouGov survey found that two in ten Americans have already taken a DNA test and a further 45% are interested in doing so. Learning about health ranked second to where family is from. A key reason stopping more from taking a test concerns privacy. Citi’s Ansari says this is not surprising. “There’s nothing more personal, nor more sensitive than health data,” he comments. “So, industry development will partly hinge on how interested players like big tech and big pharma harness DNA data constructively and securely to the benefit of all.” The future of DNA testing So how might this play out? Will we be happy to plug our DNA into wearables so tech companies can provide personalized advice? Will it become accepted practice to view a potential spouse’s health DNA markers before deciding whether to make a lifelong commitment? Likely trends include personalized vitamins based on DNA data and ongoing blood tests in place of standard multivitamins. For example, many people are deficient in the sunshine vitamin (D) and genes play a role in addition to sunlight exposure (two variants in GC, the gene that encodes the vitamin D binding protein). Many of the founders driving the burgeoning wave of DNA-driven health and fitness start-ups hail from academia. This includes UK-based FitnessGenes, which can, for example, tell its customers whether they have appetite-boosting mutations in the FTO gene, linked to obesity. Then there are companies like Australia’s myDNA whose services include testing individual responses to medications. Co-founder and associate professor Les Sheffield qualified as Australia’s first clinical geneticist in 1976. He says the company’s mission is to “provide actionable science to doctors so they can make more accurate prescribing decisions based on information about how their patient’s genes impact their metabolism of certain medications.” The stats demonstrate the potential. Many blockbuster drugs work in just a small percentage of the population. This is because clinicians typically rely on a ‘one-size-fits-all’ treatment approach based on the proper treatment for the ‘average patient.’ Changing treatment is often a process of trial and error. Precision medicine will overturn this by tailoring treatments to each individual. It is a rapidly emerging business megatrend. Intra-industry tie-ups are also growing. In 2023, for example, genetic testing company Myriad Genetics and DNA sequencing company Illumina extended their partnership to improve access, within the US, for testing of homologous recombination deficiency (HRD), a key biomarker in tumours involving DNA damage. For the general population, precision medicine using DNA testing will become a reality as part of national healthcare services. The AI revolution means this may not be far off. Ansari concludes that “medicine is moving away from a reactive to proactive approach with digitization helping healthcare professionals to use more types of data to make more informed decisions. This will progressively include genetics.” The use of online platforms by DTC DNA testing companies is accelerating digital payments at both the front-and back-end. Citi’s comprehensive suite of Treasury and Trade Solutions (TTS) provides themwith transactional efficiency, while our advisory services are helping to transform start-ups into industry leaders. 12