Topol Discusses Personalized Medicine with 23andme CEO Wojcicki

Medscape Editor-in-Chief and digital health champion Eric J. Topol, MD, spoke with Anne E. Wojcicki, co-founder and CEO of 23andMe, about her desire to shake up the practice of medicine by using patients' genetic data to enhance preventive care and disease treatment. Although FDA ordered 23andMe to stop marketing its $99 genetic screening tests to consumers last November, Wojcicki, a Yale-educated biologist, says her company is pressing on with its mission and has already genetically screened some 650,000 people, including Dr. Topol. (The full interview is available on Medscape.)

On the founding of 23andme, Wojcicki said, "I put together this community to help people access their genetic data and make it really fun for them. We wanted to do research that involved everyone, [allowing them to contribute their own] information."

In the interview, Topol noted that the idea behind the company was solid: "You wanted to advance science and do research."

The company published in several peer-reviewed journals on topics including Parkinson's, the photic reflex of sneezing when looking at the sun, and the BRCA gene, and the experience of women who find out that they have BRCA-positive mutations.

The relevance of genomics is tantamount to a whole host of health conditions. "It was obvious to all of us [at 23andMe] why you should want your genetic information," Wojcicki says. "What we learned is that it's not obvious to the consumer why they should want their genetic information."

Still, the company has managed to amass an impressive database of people interested in their genetic blueprint. "[We have] 650,000 [people in our database] now. We are by far the largest [consumer genomics firm]," Wojcicki observes. "When you look at some of our papers, and we say that we had 40,000 people with asthma, and 150,000 controls, our numbers are genuinely huge."

Despite the amount of data, it is difficult for 23andMe to make good on its mission to share genomic data with patients considering the recent setback they faced from FDA and the fact that they influential medical bodies like the American Medical Association also don't back the idea of sharing genomic information with patients unless it is mediated by a physician.

"We find that a lot of physicians are not educated yet about genetics," Wojcicki opines. "We are at a true inflection point in this. What is unusual about 23andMe is that it is one test and it gives you a ton of data...."

"That clearly represents a challenge to the current system - the hundreds of thousands of genotypes and hundreds of actual results for an individual," Topol resonds.

Part of 23andMe's original mission was to get the genomic information from a million people. "[A] million people walking around the country and into their physicians' offices becomes disruptive in the right way, she says. "That was our goal. I don't want to wait around for 10 years for personalized medicine. I want to see it ushered in sooner."