Preventive healthcare might be the buzzword, but a company down South is working towards a paradigm shift in personalised medicine, the next frontier. Shalini Gupta finds out more in an interview with Saleem Mohammad and Abdur Rub from Xcode Life Sciences
When did the idea to have a company of your own strike you? What was the objective? Why did you think this idea was a feasible business proposition?
Saleem: The idea of this technology was incubated while pursuing my PhD. It was during this time that Dr Watson’s genome was sequenced and made publicly available in 2007. Then, I had this epiphany. Here was an opportunity to become the largest repository of genetic and environmental information which could catapult India into cutting edge delivery of personalised nutrition and personalised medicine. Of course, we might very well be few years away before these concepts become popular, yet a laudable goal worth striving and sacrificing for.
How far has Xcode come in the last few years?
Abdur: The preventive health check up market and also the fitness and wellness market have evolved quite rapidly in the past few years. Xcode has seen a significant traction for its preventive health product, 100andLife. We started off as a single person company with an idea and now we are a company of more than 25 with four products in the Indian and internal markets and several more products and services in the pipeline.
Preventive healthcare in India is currently associated with diagnostics, where do you think we stand there, especially given that the sector is very fragmented?
Abdur: Yes, the dominant public understanding of preventive healthcare is that its a diagnostic test. Unfortunately, this is not completely accurate. Diagnostic tests only detect biomarkers that are present in blood at detectable levels, which means the disease process should have already started in the body, otherwise it would be undetectable. The only truly preventive tool which advises on the personal predisposition (likelihood) way before any symptoms show up in blood is the genetic assessment. And thats only part of the story.
A major component of preventive health approach is how we can take charge of our health through nutrition, physical activity and a healthy lifestyle. Here too, genetics play a major role in how our body processes various foods and physical activity. In other words, the scientific developments in the field of human genetics have enabled for the first time in human history, a self-mediated, truly preventive health care regime. Xcode is at the forefront of this paradigm shift, helping individuals and families achieve truly preventive and personalised health, longevity and lifelong wellness.
How has genomic sequencing and the thousand dollar genome inturn changed personalised medicine? Is India ready for it?
Abdur: Yes absolutely, the drop in the cost of sequencing is what is driving the personalised medicine revolution today and this will only accelerate in the future as the prices come down further. We at Xcode believe that India is certainly ready for it. We find that the awareness levels of preventive health among our Indian customers are on par with what we find in our international customers.
Even as sequencing has been generating lot of data, the interpretation is subject to scrutiny considering most of the genome has junk DNA, how do you respond to it.
Abdur: With cost of sequencing coming down rapidly, enormous amounts of data is being generated which leads to a deeper analysis, interpretation and understanding of the genetic landscape. What is meant by ‘junk’ DNA is that currently there is lack of an understanding of the functionality of those sections of the DNA code, which does not imply no functionality.
In Xcode’s genetic assessment only those genetic markers are used which have demonstrated strong correlation with health and nutritional aspects using scientifically validated methods. We follow stringent criteria in formulating our test panels and recommendations, which are meticulously developed by our scientific team after extensive research and approved by our scientific board.
How do you use disease genomic and nutritional genomics to predict the onset of chronic diseases? Which diseases in particular can be predicted? Can the genetic predisposition to cancer also be predicted?
Abdur: We only focus on lifestyle conditions that can be prevented through lifestyle interventions such as obesity, type II diabetes, cardiovascular conditions etc. Our product philosophy is one of preventive health, where we empower our customer with actionable recommendations which will inform and enable them to take actions that will lead to better health.
Its important to distinguish between predisposition and predetermination. Its possible to assess predisposition to cancer through genetic testing. A famous recent example is Angelina Jolie who underwent a procedure to prevent breast cancer based on a genetic test.
How many patients have been so far enrolled for these tests? What is your target audience? why do they prefer such a test over a diagnostic test?
Abdur: We have just begun our marketing efforts and we are already seeing numbers roll in. We are on track to serve 10,000 customers by mid 2015. Our target audience is wide and varied. We have products for toddlers all the way to geriatrics. Like we explained earlier, diagnostic tests only indicate what is present or not present in the blood. For example, when someone goes through a battery of heart tests, what they find out is whether they currently have a heart problem or not as indicated by higher cholesterol etc. But these numbers can change quickly depending upon the changes in the persons diet, lifestyle and activities. However, the genetic assessment does not change and indicates how likely the individual is to develop the condition, long before the condition ever occurs. This enables the individual to lead a truly preventive lifestyle and avoid development of these conditions right from the beginning.
Personalised medicine is at the intersection of lifesciences and health, how do you look at it? Given that most of pharma companies(esp in India) are working in silos from healthcare institutions?
Abdur: Though our business model is fairly independent as a direct to consumer company, we do seek out and form partnerships with strategic partners. We have both intellectual partnerships with institutions such as the prestigious CCAMP, Bangalore and commercial partnerships. Given that we have the lofty goal of changing the existing paradigm of hospital-mediated sickness care to self-mediated preventive health care, we look forward to be forefront of enabling synergistic partnerships among various entities that ultimately add significant value to consumer health
How is the funding environment for biotech startups like? Is it conducive for start-ups such as yours? How does funding help? What do biotech start ups need to do in order to get funded?
Abdur: The current funding environment is very good for startups with several national and international VCs stepping up to fund Indian startups. The angel scene is also quite vibrant.
As long as the idea and execution plan are sound with a strong team we find that funding is not a bottleneck.