Dr Surendra K Chikara, Founder & CEO, Bione highlights the role of genetic testing for personalised wellness
A World Economic Forum study estimates that the global economic impact of cancer, diabetes, mental illness, heart disease, and respiratory disease could reach USD 47 trillion over the next 20 years. According to a UN report, these non-communicable diseases could cost the Indian economy a whopping USD 6.2 trillion during the 2012-2030 period. The increased demand on healthcare systems due to chronic disease in terms of cost and resources has turned into a serious concern.
The answer to this problem could lie in the significant advances that have been made recently in the area of genetic testing. These advances mark a significant breakthrough in the way we can tackle disease. They make it possible to prevent disease. At the very least, its onset can be delayed and its effect mitigated with the right knowledge and guidance. Targeted genetic testing can help identify people who have the highest risk of developing a chronic condition.
A simple test that costs Rs 15000 rupees today could potentially save you lakhs on long hospital stays, medicines, surgeries as well as a whole lot of mental stress for you and your loved ones a few years down the line. An added bonus is much better quality of life over a longer lifespan.
The results of a DNA test can motivate people in the high-risk category to make lifestyle changes that can help prevent or control their chronic conditions. Even small lifestyle changes like reducing sugar intake and adding fibre could help prevent serious diseases like diabetes or cancer. If taking a DNA test helps you identify disease risks and take proactive action, it just could be the smartest investment you ever make.
The fitness aspect is also of great interest. A DNA test can be used to evaluate which exercises work best for you based on your DNA profile. This helps to optimise workouts and reduce the risk of injuries to achieve a higher level of fitness. More injuries and lower fitness levels also mean more spending on healthcare. Hence, enhancing fitness in general can reduce the economic burden of chronic diseases.
In addition to reducing the risk of disease, genetics testing can serve as a source of data. This data can help medical researchers to get a better understanding of chronic diseases and thus improve prevention, diagnosis, and treatment in the long term. This could significantly bring down treatment costs which now run into billions of dollars on a global basis.
When it comes to treatment, genetic testing can reveal genetic variations that can affect a person’s response to specific medications, thus paving the way for precision healthcare. This helps to save time and money that might be wasted on experimenting with different medications. A 2018 ProPublica article (“Unnecessary Medical Care Is More Common Than You Think”) reported that unnecessary tests and procedures contribute to about 25 per cent of health care costs. More precise treatment with regard to the medicines used and the treatment protocol can help reduce treatment costs at the global, national and individual levels.
Genetic testing can be done either in a clinical setting or in a home setting. Clinical genetic testing is generally for people affected by rare genetic disorders and their family members at a hospital or a clinic. A clinician or genetics expert would identify a suitable test after a detailed discussion to understand the complete family history and the particular genetic disorder. The nature of the sample taken is blood, amniotic fluid, POC- tissues, biopsy, etc. The tests are conducted in a laboratory setting and the results are discussed with a clinician or genetic expert for management of the condition and or further family planning.
In contrast, Direct-to-consumer (DTC) genetic testing is generally for healthy people who want to take a proactive approach to achieving optimal wellness. Consumers learn about genetic testing from social media, websites, and TV commercials. They then take the process further by connecting to a specific company for a detailed discussion on the pros and cons of the test. They buy the test online for getting health insights that would help recognize the risk of serious diseases. Such information obtained through a highly affordable test would help them make changes to achieve optimal health.
In the case of such genetic tests, the sample is either saliva or cheek swab. This makes the test convenient and practical in a home or office setting. The sample is then sent to the company, which extracts the DNA from the sample for testing in a laboratory. In some cases, blood samples may be also required. The test results are analysed through proprietary in-house programs using AI technology, databases, and a detailed report is provided to the consumer. The parameters covered in the test report may vary depending on the test selected and the company. Each test has different reportable parameters related to nutrition, fitness, and lifestyle disorders. The cost of the test can vary depending on the parameters covered, the technology used for analysis, and the cost of any additional services provided to the consumer. But it would still be a lot more affordable than the treatment costs related to chronic disease in the long term.
Therefore, clinical genetic testing has a clinician-centric framework for the identification of rare genetic disorders. DTC genetic testing, on the other hand, is consumer-centric and is essentially a wellness check that covers parameters related to nutrition, exercise, fitness, and common lifestyle disorders. Such tests are carried out for preventive purposes rather than diagnosis and or treatment of diseases. Pre and post-test counselling by a genetic expert are essential for the successful implementation of the test findings. This will help the consumer to transform his health with the suggested lifestyle modifications.
This is what led me to set up Bione. We use DNA sequencing and AI-based technology for Microbiome and DNA tests. Bione’s tests help tackle diseases at its root, providing consumers with the opportunity to learn about both their genetic and microbiome profiles. They benefit from better health and quality of life while reducing the heavy costs related to illness.
The emphasis is now shifting from the treatment of diseases to preventive health solutions. It has become increasingly clear in recent years that genetic testing and precision medicine is the wave of the future. They will soon become essential components of affordable treatment models. Genetic testing is generally not covered by insurance companies in India. Thanks to the benefits the technology offers, it is fast catching on in the developed world. Insurance companies there now understand that it could significantly cut costs in the long run and are now partnering with DTC test companies. Just like health insurance has now become commonplace in India, genetic testing would soon become the first line of defense against chronic disease. It is only a matter of time before genetics testing and thus precision medicine enters the mainstream of healthcare in India as well.