Tell us about the fundamental changes the diagnostics sector has witnessed in the last decade.
In India, diagnostics mostly comprises of pathology and radiology which are usually run by private players. Driven by demand and ability to pay, this sector has seen growth not only in metros or urban cities but also in tier 2 and 3 cities. Today, due to increasing awareness amongst the population, the focus now has shifted towards early diagnosis. The acceptance of newer technologies like gene-based testing has resulted in precision diagnostics and medicine gain visibility across the globe. This approach unlike the conventional treatment doesn’t follow the ‘one size fits for all’ but emphasises on tailor made treatment for an individual. Though precision medicine has more traction in oncology space, it is slowly spreading to other specialities as well. Off late, there are companies which have come up in this space and are offering genetic tests and precision care, given the demand and implication in clinical practice. MedGenome’s goal is to build a legacy of precision medicine in India and are working towards realising that dream.
Is genomic diagnostics business an opportunity or a challenge in India?
Genomic diagnostics industry is still at a nascent stage in India given that we are riddled with many complex diseases and fewer organisations addressing or catering to these issues. Given the size of our country, there is enormous potential to address various diseases through genomics-based diagnostics and research. Also, with celebrities like Angelina Jolie opting for hereditary cancer genetic test and Twinkle Khanna checking genetic compatibility with her husband before marriage, there is more curiosity, interest and awareness generated regarding genetic testing. Further, today with late pregnancies and other health factors, there is a huge demand for NIPT (Non-invasive prenatal test), preimplantation genetic screening (PGS) etc. where you can screen your fetus and embryo for any chromosomal and genetic abnormality respectively to take an informed decision about your pregnancy and childbirth. We are only scratching the surface as the awareness and acceptance of gene-based diagnostics is low and requires more time to pick up, which would eventually reduce the cost of treatment and benefit larger population. Since we, Indians, represent a population of untapped genetic knowledge, hence there is a huge scope to study and develop drugs on the basis of our genetic code.
What role does technological development play in transforming/ supporting your business? And what is the scope in future?
In our industry, technology like Next Generation sequencing (NGS) has facilitated in reducing the cost, processing more samples in less turn around time while giving accurate results. We are firm believers that technology can aid in precise diagnosis and allow the patients to make an informed decision, thereby, reducing the diagnostic odyssey which a patient undergoes. Over the past 5-6 years, we have witnessed advance technologies like DNA sequencing technology, which has reduced the cost of genetic testing manifold. Most importantly, the turnaround time for completing the test has reduced from several months to less than 4-5 weeks. A decade ago, for a genetic test to be conducted, DNA sample had to be sent to the US and Europe, with clinicians and patients waiting for 6-7 months to get the result while spending around a lakh on these tests. Today at MedGenome’ s lab, the most complex test is done in just 4 weeks’ time.
How will the current and anticipated developments through genomic testing affect the future of currently accepted laboratory medicine?
Today genomics has become an integral part of medicine. For many disorders, clinicians recommend genetic test and based on the report, they chart the treatment or management regimen for the patient. In fact, in cancer, the treatment is tailor-made to the individual based on the mutation they harbour. Many large pharma companies are taking the genomics route to test if their drugs will work for people with specific mutations. As genomic testing gains ground, research and development will also expand leading to development of drugs or medicine which will be tailor-made for the entire population. As more and more clinicians understand the value of precision medicine, genetic testing will gain momentum, thus, revolutionising our healthcare system. For example: Today for most high-risk pregnancies, clinicians suggest Non-invasive prenatal test (NIPT) and for recurrent pregnancy loss, they suggest carrier screening to understand the cause and thus, precautions can be taken accordingly. An early bird in this segment, when MedGenome launched NIPT in 2016, the clinicians initially weren’t ready to embrace it. However, once they understood the value of these tests, they have opened up to prescribing it to their patients. Today, NIPT market has grown in India with many players entering this segment.
What should laboratories focus while preparing themselves for the future? (with respect to genomics)
Healthcare is moving towards precision diagnosis and targeted therapy. It is about treating each patient as unique and customising the treatment for them. Hence, laboratories should prepare themselves for precision medicine which is ought to revolutionise healthcare sector in the coming years. Furthermore, labs should try to educate and create awareness about genetic tests among clinicians and public. Setting up genetic counselling services and workshops would increase the visibility and clarity about these tests. Accessibility to all should be focused on with respect to financial support and insurance policies. In India, insurance is privatised and not availed by all, hence government should initiate public private partnership model (PPP) in order to make genetic test affordable for all. Its only by increasing the accessibility and acceptance on larger scale that one can work on the cost effectiveness and affordability of these tests.
How will genetic testing help in reducing the financial burden in future?
Genetic testing is based on a person’s DNA; hence, it reduces the trial and error of a clinician to diagnose the disease as genetic tests specifically highlights the disease causing defect or mutation and thus allowing a very targeted treatment. This would help the patient to take an informed decision about their health and treatment, thereby saving time, energy and money.