Modern Software Experience

2011-10-18

Objects in the crystal ball are closer than they appear

The cost of genetic testing is already less than the cost of not doing it.

costs of genetic testing

The prices for DNA tests continue to go down, and our ability to take legal or medical advantage of the results continues to increase. So, we are moving towards and then past the point where the cost of DNA testing is less than the cost of not doing it.
Well, that is what some people might say, but objects in the crystal are closer than they appear.
I say we already passed that point. The cost of genetic testing is already less than the cost of not doing it.

Paternity tests are cheaper than paternity lawyers.

paternity testing

Many genealogists are familiar with Y-DNA test and mtDNA tests, used for paternity and maternity testing respectively. FamilyTreeDNA currently sells 37-marker Y-DNA tests for US$ 169, and mtDNA tests for as little US$ 159. Sure, the more reliable 67-marker Y-DNA test is US$ 268, and their complete mtDNA test is US$ 299. You also have to test at least two subjects to make a comparison, but have you checked what a lawyer charges per hour recently?
Paternity tests are cheaper than paternity lawyers.

Genotyping costs less than a hospital bed for one day.

genotyping

Genotyping provides valuable information about diseases and afflictions you are susceptible to. Right now, 23andMe offers to genotype your DNA using an Illumina OmniExpress chip for US$ 99 when you sign up for at least one year of their US$ 9 per month Personal Genome Service. That is US$ 207 for the test and one year of service, about € 150 in total. That is less than the cost of many one-year drug prescriptions, and insignificant compared to the cost of complex medical procedures.
Genotyping costs less than a hospital bed for one day.

Cost Per Genome

full-genome sequencing

The cost of full-genome sequencing is coming down rapidly. A study the National Human Genome Research Institute published in February of this year contains the dramatic table reproduced here.
Notice that the scale is logarithmic.

This graph shows the cost of genome sequencing going down, and going down faster than Moore's Law. If the trend shown in that graph holds, the cost of full-genome sequencing cost will be marginal within a few years.

€ 999 exome

The € 999 genome may still be in the future, but the € 999 exome is here now. On 2011 September 27, at the Health 2.0 conference in San Francisco, 23andMe announced the limited availability of their new US$ 999 Exome 80x personal exome sequencing programme, and US$ 999 is less than € 750. It is only available to current customers, it costs at least US$ 207 to become a customer, and it does not come with any anything like their Personal Genome Service, but even so, you can have your exome sequenced for less than € 999. The € 999 exome is here, now.

insurance cost

To put € 1000 in medical context: € 1000 is approximately how much each Dutch citizen pays per year for their mandatory medical insurance. The costs of that insurance is likely to go up, while the costs of exome and genome sequencing is expected to go down.

hamburger

Heck, the price of hamburgers continues to go up, while the price of genome sequencing continues to go down. If both trends hold, then it's only a matter of time before full-genome sequencing will cost less than a hamburger.

Ridiculous? Yes. Genome testing is likely become free to consumers before it costs less than a hamburger.
Have a good look at 23andMe's business model. They're not making money from the tests, they're making money from their Personal Genome Service, the analysis and interpretation of your data. To execute that business model, they need to get your data first, they need to get you as a client first - and offering free tests will be cheaper and more effective than running full-colour advertising in the medical journals your doctor reads.

Some sperm bank children will decide to found a new lineage society, one that does not outlaw, but demand genetic testing to get in.

brave new world

As the costs of testing continues to go down, and the benefits of testing increase, consumers will start suggesting and demanding these tests from their doctors. Medical insurers will provide incentives for clients to get tested. Genetic tests will be covered under the standard medical package.

Governments will encourage testing, regulate testing and mandate testing.
Medical insurers and hospitals will make multi-million deals with genetic testing and analysis companies. Consumer organisations will perform comparative tests of genetic testing products and services.

Laws will be adapted to match the real-world implications of cheap genetic testing. Doctors, psychologists and lawyers will recommend men to get a paternity test at the birth of children. Paternity leave will largely become dependent on the results of those tests. Insurance companies will start including legal services to deal with all the possible consequences of such a tests in their basic package.

Sperm bank children will discover how many half-siblings they have. There will be public debates, and sperm bank laws will get stricter. Some sperm bank children will decide to found a new lineage society, one that does not outlaw, but demand genetic testing to get in.

Governments will regulate who has access to your data. Some commercial companies will find creative ways to get around those regulations. There will be several high-profile genetic data breaches, exposing customer data to the world, followed by compensation claims and calls for more stringent regulation and oversight.

Eventually, hospital baby wards will routinely perform full genome sequencing for every newborn. Welcome to a brave new world.

Hospital baby wards will routinely perform paternity and maternity tests. Eventually, hospital baby wards will routinely perform full genome sequencing for every newborn.
Welcome to a brave new world.

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