Can 8.8 Million DNA Spit Tests Add Up to a Cancer Breakthrough, Or Just a Privacy Nightmare?
Bloomberg Businessweek|November 08, 2021
23andMe is using its customers’ genetic data to try to become a new kind of pharma company
Kristen V. Brown

A few months ago, on the morning 23andMe Holding Co. was about to go public, Chief Executive Officer Anne Wojcicki received a framed sheet of paper she hadn’t seen in 15 years. As she was preparing to ring in the Nasdaq bell remotely from the courtyard of her company’s Silicon Valley headquarters, Patrick Chung, one of its earliest investors, presented her with the pitch document she’d shown him when she was first asking for money, reproduced on two pieces of paper so she could see both sides. The one-sheet outlined a radical transformation in the field of DNA testing.

Wojcicki’s plan back then was to turn genetics from the rarefied work of high-end labs into mainstream health and quasi entertainment products. First she’d sell tastemakers on her mail-in spit kits as a way to learn sort-of- interesting things about their DNA makeup, such as its likely ancestral origins and the chance it would lead to certain health conditions. Eventually she’d be able to lower prices enough to make the kits broadly accessible, allowing 23andMe to build a database big enough to identify new links between diseases and particular genes. Later, this research would fuel the creation of drugs the company could tailor to different genetic profiles. 23andMe would become a new kind of health-care business, sitting somewhere between a Big Pharma lab, a Big Tech company, and a trusted neighborhood doctor.

Some of this still sounds as far off now as it did during the Bush years. Improbably, though, 23andMe has rounded second base and is heading for third. Wojcicki did sell millions of people on DNA test kits—11 million and counting—and bring such tests to the mainstream, with some help from Oprah’s holiday gift guide. An estimated 1 in 5 Americans have turned over their genetic material to 23andMe or one of its competitors. Now that she’s got the data, Wojcicki is working on the drugs. Her company is collaborating on clinical trials for one compound (and nearing trials for another) that could be used for what’s known as immuno-oncology, treatments that attempt to harness the body’s complex immune system to beat cancer. 23andMe says it’s also exploring drugs with potential use in treatments for neurological, cardiovascular, and other conditions, though it declined to specify them. Last month the company bought Lemonaid Health, a telehealth and drug delivery startup that offers treatment and prescriptions for a select group of conditions, including depression, anxiety, and STDs.

Chung, now a co-founder and general partner at the venture capital firm Xfund, says his framed gift to Wojcicki was meant to emphasize how exceptionally closely she stuck to her original vision for 23andMe over the past decade and a half. Most young tech companies in search of their initial venture funding have little hope of identifying their eventual path to great wealth and instead focus their energies on some sort of “dancing startup laser light show,” he says. “The rule, not the exception, is that whatever the founders are pitching at the very earliest stages is simply never the thing that is successful.” 23andMe went public in June at a market value of $3.5 billion, is now closer to $5 billion, and is expected to report about $56 million in revenue in its latest quarter, though it’s unlikely to turn a profit.

Of course, Wojcicki, a former Wall Street research analyst with a focus on biotech, did have some experience with outstanding startups. Soon after she closed that round of venture funding, she married longtime boyfriend Sergey Brin, who co-founded Google in her sister Susan’s garage. (Wojcicki and Brin divorced in 2015.) It’s easy to see the Google influence in 23andMe’s strategy—collect all the data, derive whatever insights you can, and find an adjacent line of business with the potential to yield much bigger profits. Even today, Wojcicki’s conversations tend to be shot through with an older strain of Web 2.0 techno-optimism about ways to better connect people with, in this case, how their medicines get made, and to cut through the randomness and waste that suffuses the science of drug making. “One of our core values is, like, we’re all in this together,” she says. “One thing I always think is a tragedy is that you develop a drug and then people hate you. I’m really interested in, can we actually be the first drug development group that is loved by people?”

The next phase of her master plan might sorely test that question. While it’s difficult to imagine anyone saying they love their pharmaceutical company, it wouldn’t be crazy for the 8.8 million 23andMe customers who once absently checked a box saying yeah, sure, use my data for whatever, to feel like they’ve been bait-and-switched now that their genes are laying the groundwork for potential cancer cures.

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