Like a Lamborghini on a regular street, one kind of company stood out in more than 60 direct-to-consumer genetic services that were reviewed (here). These companies offer even greater sophistication than whole-genome sequencing by including non-genetic assessments, some of which might seem extravagant – such as an MRI scan. But if $7500 isn’t all that much, a premium version also adds a CT scan, cardiac monitoring, and blood tests. The product in question is Health Nucleus, the company offering it is Human Longevity, and one of the people behind the company is Craig Venter, the inventor of PCR (which for molecular biology is as important as having a word processor on a computer). And maybe you’d have to be like Craig Venter or at least in the top 1% economically to afford Health Nucleus.
In the same class as Human Longevity, but affordable for the top 10%, Arivale is another company that packages personalized medicine as concierge medicine. Along with whole-genome sequencing, the service includes blood analysis, saliva analysis, gut microbiome analysis, FitBit tracking, and personal coaching, all priced at $3,499 for one year. (Update: Arivale reduced the price and features beginning around August 2017)
Arivale and Human Longevity differ in three aspects. As already suggested, Human Longevity requires greater disposable income than Arivale. And the price difference can be explained by how they diverge in data collection; though they overlap on the full-genome sequencing and blood analysis, one hooks you up with an MRI and the other a FitBit. Nevertheless, what may be the most important difference is how they engage with clients. Human Longevity does one snapshot and consultation while Arivale does repeated testing and personal coaching for an entire year.
Yet Arivale and Human Longevity share certain features that distinguish them from other direct-to-consumer genetic services. In a way, they’re both overachievers. They already go deeper than most other direct-to-consumer companies by offering whole-genome sequencing, but to also try integrating and leveraging non-genomic data is trying a lot. It requires more bioinformatics brainpower as well as human translation to make the data meaningful. Both companies appear to be more idealistic than other companies with regard to what can be achieved with genetic technology, and both seem more obsessive about optimizing health than any other genetic service. Arivale, especially, seems to care about follow-through given the remarkably long one-year program.
But who can spend so much on this approach to optimizing health? In a society where even basic healthcare is a commodity, genomics is a luxury good. A wealthy and educated minority takes most advantage of whole genome sequencing, though there might be a “trickle-down” effect in the sense that individuals getting whole genome sequencing do indirectly benefit others by contributing their money and data to science research.
Fortunately, history shows that many things considered exclusive to a privileged group can become standard as a society evolves. One example is access to higher education (in developed countries), and it may similarly transpire that everyone will have the same level of access to the knowledge of their personal genomes.