The growth in availability of home-use DNA tests has put tremendous power in the hands of consumers. It is now easy to get your genetic material (your “genome”) sequenced and analyzed for potential predisposition to diseases, without the involvement of a doctor or insurance company.
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Over the past several years, consumers have sought more ways to detect diseases early, gauge their risk for one day suffering from cancer or other diseases, and to simply learn more about their genetic makeup. It’s all about controlling one’s healthcare decisions and information. Patients want more say in their healthcare and more access to clinical information. The direct-to-consumer (DTC) genetic testing industry is filling that growing need.
The global market for DNA testing is expected to grow to more than $22 billion by 2024. Very strong growth is expected with direct-to-consumer Health DNA tests such as those offered by 23andMe and Futura Genetics.
Their easy-to-use test kits and expert analysis allows consumers to learn more about health risks and take steps that could lessen the likelihood of getting sick. Given differences in pricing and breadth of information in the DNA reports, these companies could end up serving different types of consumers. 23andMe has been in the business longer, pioneering the first DTC genetic tests in the United States. The company name refers to the 23 pairs of chromosomes found in human cells. Futura Genetics is an up-and-coming testing firm investing in a strong global presence. They are both leaders in the field, worthy of a head-to-head matchup.
Both 23andMe and Futura Genetics are leaders in health and lifestyle DNA testing. 23andMe was founded in 2006 to help consumers access and understand the human genome. It was the first company approved by the U.S. Food & Drug Administration (FDA) to market a direct-to-consumer DNA test in 2015. In 2018, 23andMe won FDA authorization to market direct-to-consumer tests for cancer risks and tests that examine how the body processes and absorbs medications (called pharmacogenetics). With more than 5 million genotyped customers around the world, 23andMe has a deep database from which to conduct research. The company is based in Mountain View, California. Based in Tel Aviv, Israel, Futura Genetics was founded in 2014 to help people around the world prevent illness through knowledge of their DNA. Futura also has offices in Canada.
|Testing for Conditions||☑|
|Report Contents & Presentation||☑|
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Kits from 23andMe have a regular price of $199 for health and ancestry information (the company also markets a test just for ancestry at a cost of $99). Futura Genetics test kits cost $375. Both kits have strengths, although as we will see below, the breadth and depth of information in their reports is different. Both companies sell their test kits online to a global market. 23andMe is also available at U.S. retail store locations such as Walgreens, CVS Pharmacy, Walmart and Best Buy. 23andMe runs aggressive discount campaigns, especially leading up to Christmas and the December holidays. It offers discounts for buying two or more kits, and offers a $20 “refer a friend” credit. Customers who purchase the 23andMe ancestry-only DNA test kit can upgrade to include the health reports for $125. Perhaps the standard price for the Futura kit will come down over time, or the company will implement seasonal discount offers, coupon codes or other marketing incentives.
The test kits from both companies use the “spit in a tube” approach to collecting each individual’s DNA. Test kits arrive by post or courier. In less than 30 minutes, consumers can unpack the kit, collect their saliva sample, place a barcode on the test tube, repackage the test sample and have the completed kit ready to ship in prepaid shipping boxes. It is an easy process. Futura uses collection kits manufactured by DNA Genotek. The 23andMe collection kits are manufactured in accordance with the U.S. Food & Drug Administration’s good manufacturing practice regulations. The kits secure and protect the DNA samples for the trip from home to the lab.
Scientists then extract DNA from epithelial skin cells contained in saliva. The systems used by both companies are cutting edge and follow industry standard protocols. Both companies’ laboratories are CLIA certified, based on U.S. government standards for labs that process human specimens. The 23andMe lab is in the United States, while the Futura lab is in Europe. The DNA is extracted and processed, then bound to genotyping microarray chips for computer scanning. The process looks for genetic variants that are associated with disease risk and different physical characteristics.
Futura Genetics advertises a four-week turnaround from test kit to the online report. 23andMe says customers should expect 6-8 weeks before their results are available online. Once customers register their kits online, they can track the status by logging into their accounts. Keep in mind that the above time estimates could be greatly affected at peak demand times, such as just after Christmas and the December holidays. An influx of completed test kits after the holidays a couple of years ago led to wait times of 8-12 weeks for results from some testing companies.
Winner: Futura Genetics
Testing for Conditions
Futura Genetics tests each customer’s submitted DNA for 28 diseases and conditions (access the full list here), including:
- Coronary heart disease
- Atrial fibrillation
- Alzheimer’s disease
- Multiple sclerosis
- Celiac disease
- Cancer (colorectal, lung, prostate, breast, skin, bladder and gastric)
- Peripheral vascular disease
- Many more
23andMe divides its test results into four categories (see the full lists here): genetic health risks, carrier status reports, wellness, and traits.
Genetic Health Risks
Whether a person has certain genetic variants that can affect risk for certain health conditions.
- Breast, ovarian, prostate cancer (BRCA1/BRCA2 variants)
- Celiac disease
- Parkinson’s disease
- Late-onset Alzheimer’s
- Age-related macular degeneration
Carrier Status Reports
These results indicate if a person is a carrier of certain variants associated with disease, meaning the conditions could affect their children.
- Cystic fibrosis
- Bloom syndrome
- Sickle cell anemia
- Tay-Sachs disease
- Familial dysautonomia
- GRACILE syndrome
- Mucolipidosis Type IV
- Many more
How DNA can affect the body’s response to diet, exercise and sleep.
- Caffeine consumption
- Deep sleep
- Sleep movement
- Alcohol flush reaction
- Genetic weight
- Lactose intolerance
The genetics behind appearance and the senses
- Asparagus odor detection in urine
- Back hair
- Cheek dimples
- Cilantro taste aversion
- Eye color
- Hair thickness
- Earwax type
- Skin pigmentation
- Wakeup time
- Many more
The test kits are very different in terms of what is tested and what can be learned from the information. It’s a good idea for the customer to look over the complete lists of conditions and risk reports to determine which kit has more information of interest to them. Both test kits deliver in-depth information. It’s wise to read the cautions on direct-to-consumer tests put out by some experts in genetics and medicine, in order to fully understand the issues.
WINNER: Futura Genetics
Report Contents & Presentation
The reports generated from the data are where the major differences lie between Futura Genetics and 23andMe. Futura provides a compact, tidy PDF file that contains background information on diseases and conditions, a summary and more extensive narrative on test results. The Futura report is especially valuable and unique because it provides estimates on the risk a person will develop each disease or condition over their lifetime. The report provides the average risk for each condition and the person’s individual risk. It also provides suggested action steps to reduce those risks.
This information has a real impact. For instance, the Futura Genetics sample report has an example describing someone with 14 times higher risk of macular degeneration, then suggests the person wear sunglasses and get regular vision exams. These estimates seem especially impactful for diseases such as cancer. Some experts caution that the risk claims in these kinds of reports can be subject to government review and regulation, especially in the United States. The Futura report has a section listing each genetic marker that was analyzed and the gene upon which each was found. This can be helpful if a person seeks genetic counseling.
The 23andMe reports are web-based but can easily print or made into PDF files. The reports are colorful and easy to interpret. When the customer logs into their 23andMe account, a reports home page comes up with a neatly organized sidebar with links to the more than 90 reports related to health and genetic ancestry. The main section of the page lists any new health tests or updates made to carrier status reports or ancestry estimates. Each report section has a tutorial with information to help readers get the most from the reports. The ancestry section includes five reports, the most prominent of which is ancestry composition — tracing heritage through the centuries. The results also show any DNA matches among the company’s 5 million customers. The genealogy information is certainly a bonus, although exclusively health-focused customers might view it as extraneous. A convenient button atop the health and ancestry sections prints a five-page summary of all the tests.
WINNER: Futura Genetics
Both 23andMe and Futura Genetics place security of customer information as a top priority. Both companies separate the DNA data from each customer’s personal information by use of barcoding on test kits. Computer systems are protected by the of multi-level encryption methods to guard against hacks or interception of information. 23andMe says it will not share individual-level information with any third party without a customer’s specific consent. Nor will it share information with law enforcement unless compelled by a subpoena or court order. Futura Genetics pledges it will not use a DNA sample for genetic testing except as ordered by individual customers. You can read Futura’s privacy statement here, and 23andMe’s privacy statement here to read more about how each company uses personal data in its systems.
23andMe customers have the option to participate in the company’s research projects, but it requires acceptance of a customer consent agreement. For the customer, the research involves simply filling out a health survey, then answering a few questions about health, eating habits and other subjects whenever they log in. This system has generated 1 billion data points using these self-report surveys. Since 2010, 23andMe has published 119 discoveries from its research program. In 2015, the company established a therapeutics division with an aim to use pre-clinical research to further clinical developments in oncology, skin, respiratory and cardiovascular disease.
Both companies have attractive, well-organized web sites. The 23andMe site includes a page with nearly two dozen personal-story videos that amplify how genetic testing has helped, changed and even saved lives. The professionally produced videos put a human face on the products and the customers. The web site has a Health Communities section with information and infographics on 18 common medical conditions. A family and friends section details how relatives who agree to share genetic information can compare DNA segments and tests results. A chromosome browser allows customers to select a chromosome and examine the genes and variants contained on each.
The Futura Genetics web site is somewhat plain by comparison. It has some minor quirks. Some sections, such as the blog and the press section, are sparsely populated with content. The press release page is presented in German, even when English is the selected language. We also noticed some typographical errors. The 23andMe site wasn’t immune to misfires, however. All of the “Media Coverage” links in the 23andMe Newsroom do not connect to the articles they describe. Click the headlines and you get dumped back on the main Media Center home page.
Good customer care should involve much more than taking consumer calls or fielding complaints. Customer care succeeds when it guides customers with written, graphical and multimedia content to help them get the most from the products and the web site.
The 23andMe customer care section offers dozens of articles and tutorials that show customers how to set up an online account, how to change profile information, how to print research reports, and an important article on the limitations of the data in the health reports. The tutorial section includes DNA basics and flip-chart-type tutorials explaining the ancestry, carrier status, genetic health risk, wellness and traits reports. A customer discussion forum contains a huge database of questions and answers, searchable by category or tags.
The Futura Genetics web site lacks a customer care section, although it has a convenient frequently asked questions (FAQ) section with information on registering kits, reading reports and contacting the company with other questions.
The 23andMe and Futura Genetics home health DNA tests are different enough that customers can certainly be forgiven for the temptation to try both. Futura’s test offers a clear advantage by estimating the risk of the person developing 28 of the most common diseases and disorders. 23andMe’s tests identify whether each person has variants in their DNA that are associated with disease risks. 23andMe also identifies carrier status and offers wellness reports and 30 reports on traits. Those extras make 23andMe worth the price tag.
Both companies have a depth of experience, leading-edge quality control protocols and well-defined security and privacy plans. For those who can afford it, the Futura Genetics DNA test gets the nod for delivering risk information. Consumers whose budgets are restricted could easily start with the 23andMe health kit and augment it later with the tests from Futura.
OVERALL WINNER: Futura Genetics
It is important to caution anyone purchasing home DNA health-information tests. While the science behind them is cutting edge, the reports are not intended to diagnose any disease or condition. Predisposition to a disease does not mean a person will get the disease. Many other factors — including diet, exercise, lifestyle, occupation and ethnicity — can play a role. Some doctors worry that consumers will engage in self-interpretation of test results. It’s a good idea to consult with your physician before acting on genetic information. The U.S. Centers for Disease Control and Prevention takes a rather dim view of DTC tests, saying there is no evidence for clinical validity or utility for healthy individuals. The U.S. National Library of Medicine has a comprehensive guide to DTC genetic tests.