Genetics and Health

Navigenics #7 - “The barriers to success”

by Elaine on April 11th, 2008

Concluding G&H’s exclusive interview with Navigenics’ Medical Director Dr Michael Nierenberg, we explore the challenges faced by Navigenics to integrate its genomic services into mainstream medicine … 

When founding my old company Opaldia, probably the single most challenging aspect of early adoption of genetic testing was physician barriers.  Mostly this was borne out of a genuine lack of understanding about the field of genetics but also concerns that testing was too much in its infancy and tests had not been subject to rigorous clinical evaluation.  Time and again the phrase ‘not undergone prospective trials’ was used as a defense against bringing genetic testing into mainstream medical practice. 

I was interested to learn how Navigenics proposed to overcome this barrier.  Dr Nierenberg explained that Navigenics has developed a physician education program. He says: 

“We’re developing our own on-line material but we’re working with Medscape to develop a CME program for physicians to access.  The educational material will cover a large range of information from basic to complex”. 

Dr Nierenberg describes the word genetics as a ‘hot button’, guaranteed to evoke the strongest of reactions.  He is philosophical about the fact that genetics research and genetic advances are still at a relatively embryonic stage but made the analogy with the completeness of research into the effects of smoking. 

“Everyone is aware that smoking is not good for health. Would it be of benefit to continue smoking until all the research evidence to prove smoking is bad for you is complete?  … This is the same for genetics…. If there is a means to identify an individual’s increased risk of developing a disease then isn’t it is everyone’s best interests to use this?” 

There have been a number of recent articles on the state of play of personalized genomics, some of which have been less than complimentary to industry players.  The term ‘recreational genomics’ has been used to describe these services.  I asked Dr Nierenberg whether he considered any damage had been done to this embryonic field by these articles.  Dr Nierenberg again took a philosophical view on these articles: 

“Navigenics is no way a ‘recreational’ genomics company and does not wish to contemplate entering any ‘recreational’ field. It is a company focusing on the wellness and prevention aspects of health.  Our service focuses on actionable entities and things of substance such as cardiac disease, not eye colour or such like. We welcome regulation and make heavy use of genetic counseling.  We follow all NHGC latest guidelines and best practice and more …” 

Dr Nierenberg and his team believe that the company is ‘… ahead of the curve and when you are leading a new field there is always a level of scepticism about your service and an expectation that you will be challenged every step of the way’. 

He cited the example of the C-Reactive Protein (CRP) test and its use in diagnosing cardiac inflammation.  Initially the test was ridiculed but now it is established as a routine diagnostic test used alongside CT heart scanning – another modality which initially received poor press.   

Navigenics firmly believes that through educating both clinicians and the public, it will only be a matter of time before genomic screening become part of routine health and wellness programs.  By focusing its services around a serious health delivery model rather than a ‘recreational’ model, Navigenics anticipates achieving its company vision to transform medicine from a ‘sick care’ model of ‘wait and see’ to the emergence of early risk detection and prevention of disease development.

I hope you enjoyed this series of articles about Navigenics’ Wellness Services.  I am most thankful to Dr Michael Nierenberg and the Navigenics’ team for the opportunity to discuss in-depth the issues surrounding the whole field of personal genomics services, wellness and health management.

Elaine Warburton  www.geneticsandhealth.com

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POSTED IN: General Genetics and Health, Genetic Ethics, Genetic Testing, Genetic information and education, Genetics Interviews, Navigenics, Personal Genomics Services, Personalized Medicine