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Ancestry Shutters Health Offering, Raising Questions About Future of Consumer Genomics

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NEW YORK – Family history firm Ancestry is winding down its health and lifestyle DNA test offering to focus exclusively on the genetic genealogy market. The decision, announced last week, comes amid a general slowdown in the market, yet also showcases the continued viability of ancestry-related applications.

Ancestry first alerted customers to the change in direction in a blog post last week, saying that it had decided to stop offering its next-generation sequencing-based AncestryHealth test to focus more on family history and genetic genealogy. The Lehi, Utah-based company ceased accepting orders on Jan. 15 and said it will stop supporting existing AncestryHealth customers in July.

Ancestry initially launched an array-based AncestryHealth service in October 2019 and upgraded the service to sequencing in August 2020. The test, designed in cooperation with Quest Diagnostics and supported by PWN Health, provided AncestryHealth customers with information about their risk for developing certain health conditions, including heart disease, breast cancer, colon cancer, connective tissue disorders, and blood disorders.

As part of the service, users were also provided with steps they could take with a healthcare provider to mitigate those risks. The most recent retail price for the service was $179, though users of the AncestryDNA genetic genealogy service could upgrade to AncestryHealth at a discounted price.

It is unclear how many customers decided to use AncestryHealth. Julie Miller, an Ancestry spokesperson, declined to provide details around the business. What is clear, though, is that the company sees its main opportunity in family history and genetic genealogy. "This decision simplifies our strategy and enables us to focus our resources on our core family history subscription business and AncestryDNA, which is an important part of our family history success," said Miller.

Some of those resources will go to investing in Ancestry's reference panel of populations to improve the biogeographical analyses at the core of the AncestryDNA experience, Miller noted. "Ancestry continuously strives to have their DNA reference panel be more diverse and inclusive of people all around the world," she said.

A multitude of factors

Ancestry maintained a relationship with UpToDate, a Waltham, Massachusetts-based subsidiary of the Dutch company Wolters Kluwer that was related to its AncestryHealth business. UpToDate produces reports that support clinical decision making, and Ancestry last year awarded $1 million to UpToDate to support the development of resources that could help physicians select therapies based on consumer DNA test results. According to Miller, the firm's partnership with UpToDate ended on Dec. 31, 2020. "They used the grant from Ancestry to develop educational content about genetics for physicians," she said.

While Ancestry has decided to stop offering AncestryHealth, the test might live on under the wings of Quest. Jennifer Petrella, a spokesperson for the Secaucus, New Jersey-based diagnostic services company, said Quest is currently developing a plan to "harness this NGS platform for a range of applications, which may include through partnerships." She called the work with Ancestry "innovative" and said Quest will continue to support Ancestry's genetic genealogy work. She stressed that any potential products or services based on the platform are in development and said that Quest will share updates as they become available.

Quest has conducted the sequencing for the health test at its Advanced Diagnostic Center of Excellence laboratories in San Juan Capistrano, California, and Marlborough, Massachusetts, Petrella noted.

Ancestry's Miller said it was unclear if Ancestry would create another health-related product going forward. "It’s hard to say what the future may bring and any decision to re-engage in health in any way would depend on a multitude of factors both internally and externally," she said. "We’ve made this decision now because we have a big opportunity in family history and AncestryDNA and want to focus our resources — both people and money — on growing our core subscription business."

Ancestry, like 23andMe, has trimmed its workforce as kit sales have trailed in recent years. The cooling of the market has followed years of exponential growth that saw the company's AncestryDNA database climb to more than 18 million users since the service debuted in 2012.

Its main competitors, 23andMe and MyHeritage, continue to offer health tests in addition to genetic genealogy services, though MyHeritage no longer offers its health test as a standalone product. The Israeli online genealogy company initially rolled out its MyHeritage DNA Health+Ancestry product in 2019, providing customers with personalized health reports for diverse conditions. The array-based test retailed at $199 plus shipping, or at a discounted rate for customers who had purchased its MyHeritage DNA kit.

Rafi Mendelsohn, a MyHeritage spokesperson, confirmed that the test is still available as an upgrade to its MyHeritage DNA ancestry customers, and the firm will continue to support it. He noted the company is about to release several new polygenic risk score reports in coming months related to osteoporosis and atrial fibrillation, among others.

The future of consumer genomics for health

With Ancestry bowing out of the consumer genomics health market for now, one question on industry observers' minds is why its product failed to gain traction, especially as health has long been viewed as the next natural step beyond ancestry for the consumer market.

According to Ruby Gadelrab, CEO of MDisrupt, a San Jose, California-based company, health remains the future of the consumer genomics market, but delivering a successful product to customers is a challenge, even for companies with the resources to build such services.

"Building health products that scale is really hard, expensive, and takes time," noted Gadelrab, a former VP of commercial marketing at 23andMe. She founded MDisrupt in 2019 to offer digital health companies access to the expertise necessary to build and commercialize their products.

Such challenges facing developers of health applications include the involvement of different stakeholders in the process, regulations that might bar access for certain geographies, a greater need for evidence to support the safety and effectiveness of the product, the need to build specialized sales teams to buttress the rollout, and, to top it off, a need for reimbursement as well as acceptance by the medical community.

In Ancestry's case, Gadelrab said the company "struggled to find a product market fit with an out-of-pocket self-pay health product to upsell to their current audiences." She noted that Ancestry's customers are typically older and mainly focused on genealogy, making them less likely to take a chance on a very different kind of consumer experience.

"AncestryDNA found a killer app for consumers in ancestry testing – and it shouldn’t be assumed that their customer base, who are primarily baby boomers, would necessarily be the earliest adopters of new types of health information," said Gadelrab. She noted that given the company's success in the genetic genealogy market, it is very possible that these issues, related to selling the AncestryHealth product, really were diverting its attention from its more lucrative ancestry business.

Roberto Veronese, a former VP of product at Helix, a San Francisco-based population genomics company, similarly noted the array of challenges that Ancestry faced as it introduced its AncestryHealth product. He said that the consumer genomics market as a whole has been slowing in recent years due to market saturation, privacy concerns, and limited utility. The ongoing COVID-19 pandemic, he pointed out, has also reduced interest in making non-essential purchases.

According to Veronese, who currently advises several biotechnology firms, including Grail, the failure of AncestryHealth to gain sustainable traction in the market reveals both that ancestry testing remains the most resilient application in consumer genomics and that customers have a different set of expectations when it comes to health-related services.

"Regardless of the many scientific advancements in less than two decades from the first mapping of the human genome, genomics' applications beyond ancestry are still not ready for a large consumer market, especially under the promise of delivering actionable health insights to a broad population," said Veronese.

He noted that while at Helix, the firm observed interest in recreational genomics as a new form of entertainment, but that only a small portion of the market overall would pay if these add-on services weren't bundled together with ancestry testing. Consumers meantime continue to see health products as being covered by insurance and based on a physician's recommendation, not necessarily something they can upgrade to on a family history website. There are exceptions, of course, Veronese noted, as customers see the benefit of carrier screening testing to make family planning decisions, as well as pharmacogenomic testing related to specific drug therapies.

Population genomics projects organized by healthcare systems may be more successful ventures, he said, such as the Healthy Nevada Project, run by Renown Health, a Nevadan healthcare network, and the Desert Research Institute, which reports back both ancestry and health-related data to participants.

23andMe was the initial platform partner for the Healthy Nevada Project, and Helix became the technology provider for a second round that commenced in 2018. The project currently has more than 50,000 participants. Given its ongoing success, Veronese said the failed outcome of the AncestryHealth experiment "seems to validate the consumer preference for accessing information about their health in the context of their healthcare."

MDisrupt's Gadelrab similarly praised the Healthy Nevada Project, and also said that the direct-to-consumer health market remains the future of consumer genomics, despite some early setbacks. She cited the success of wearables as an example of the direction the market could take, while any success depends upon the utility of the health application, the overall consumer experience, and the willingness of stakeholders to pay for such new solutions.

Gadelrab also noted that timing is very important, and perhaps also influenced the tepid response to AncestryHealth. "Ancestry launched a health product to consumers just before a pandemic," said Gadelrab. "All genetics services are perceived as elective, and as the economy suffered, so did people's willingness to spend disposable income on this type of information."

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