August 31, 2012

Looking for some autumn reading?

For someone like me it's easy to forget that personalised medicine isn't just about genomics.

Eric Topol's The  Creative Destruction of Medicine is a book for genomicists who want to know what's going on in health care innovation outside of genomics. It's also a book for everyone else working in a health-related field who wants to understand the changes that are happening in medicine right now outside of their specialisation.

The central thesis of the book is that there are several areas of innovation in medicine - genomics, wireless sensors, health IT, social networking, and novel ways of assessing drug efficacy - that could each have a large impact, but that together they could change medicine beyond recognition.

There are many parts of The Creative Destruction of Medicine that are excellent. The section on large clinical trials as an out-dated way of assessing drug efficacy and safety is one of them. Topol thinks that conditional approval would be a better alternative: Drugs that can reasonably be assumed to be safe are initially tested on a small group of patients under strictl regulation. The regulatory agency has the right to withdraw the conditional approval at any time, and only once a reasonably large dataset has been collected does the drug gain full approval.

Topol clearly loves his medical gadgets. I was amazed by some of the ones he describes, like a pocketable ultrasound device that allows imaging the heart in real time and that may soon replace that symbol of the medical profession, the stethoscope. My biggest complaint is that parts of the book are not entirely relevant to its central topic and have probably only been included because they are of interest to the author. For example, Topol is clearly passionate about the dangers posed by the ionising radiation that come with excessive use of medical imaging technology such as CT scans, but two chapters on this are too much.

If you wonder whether The Creative Destruction of Medicine is for you, here are the most important facts:

Areas covered: The convergence of wireless sensors, genomics, information systems, mobile connectivity, internet, social networking, and computing power. Basically anything that has to do with personalised medicine

Who it is for: Doctors and anyone else working in healthcare, including researchers. As someone working in genomics, I felt that the book did an excellent job of putting genomics into perspective

Who it is not for: This book is not a guide for patients to personalised medicine. Some of topics, such as the challenges of compatibility between different proprietary Health IT systems, will be less applicable to Europe than to the United States

How much it costs: The recommended retail price for the hardcover is $27.99, but online the book is available for $15.58. The Kindle edition is a bit more expensive and costs $15.73.

If you think you're going to buy this book, do so sooner rather than later: The rate of progress in medicine means that it'll be out-dated in a year.

Again, thanks to the Sanger Institute Library for ordering this book following my suggestion.

August 23, 2012

Who is the most attractive?

According to a report by Ernst & Young, the professional services firm, and EuropaBio, an industry association, American biotech companies attracted four times as much venture capital than European ones. Does this pattern hold for genomics as well?

Click on the figure to enlarge. Number of investments in genomics companies, average genomics investment, and total genomics investment in California, Massachusetts, the rest of the USA, Europe, and Canada for the period 2005-2012

When I analysed data from Crunchbase, an online database, it became clear that the imbalance in biotech investment between the old and the new world is even more pronounced when it comes to genomics: In the period between 2005 and 2012, the United States attracted $1.7bn in funding, whilst Europe attracted only $213m.

Within the United States, it is striking that the money goes to the two states where most of the research is done: California and Massachusetts. The dominance of California is particularly remarkable: It's not just IT startups that rule in the Golden State.

These figures should be taken with a pinch of salt. Crunchbase may be biased towards listing more Silicon Valley and American companies (Genomics companies from outside of North America and Europe don't figure at all). Even so, the average genomics investment figure is still likely to be representative, and that is also much lower in Europe than in the United States or in Canada.

August 16, 2012

Could 2012 be the best year ever for genomics investments?

Funding for biotech startups is hard to get right now. And if biotech funding is down, surely genomics funding must be down as well? After all, genomics is just a subcategory of biotech.

To get a better understanding of this, I downloaded data on investment in genomics firms between 2006 and 2012 from Crunchbase and did some data crunching of my own.

Click on the figure to enlarge. Number of investments in genomics companies, average investment value, and total genomics investments, 2006-12. Bright green in 2012 bars for numbers extrapolated to the end of the year.

Whilst it is true that the number of investments in genomics companies for 2012 is probably going to be the lowest since 2008, the average amount invested is higher than in any previous year. Overall, it seems likely that there will be more than $400m in new genomics investments this year, which would be the highest on record.

For genomics startups this means that it may be harder to get funding, but that once you get it, it will be generous.


I used Crunchbase to compile a list of 73 genomics companies and the funding they have received since 2006. I only included companies that did receive venture capital, private equity funding, or similar. This means that my sample set does not represent all genomics companies, but I am confident that it is representative at least for US companies. Estimates for 2012 totals are based on the assumption that funding will be similar September-December to what it was January-August.

Coming up next week: Funding of genomics companies in Europe versus the United States.

Update (24 August 2012)

As I already mentioned, the possibility that 2012 could be a good year for genomics investment is in contradiction with other reports, which paint a bleaker picture. A good overview and links to further sources are provided by Genomeweb in A Banner Year.

August 10, 2012

Are the stakes too high in genomics?

If you want people to be creative, putting pressure on them is counterproductive. The threat to fire someone unless they have some brilliant ideas is unlikely to motivate them in the desired way.

When it comes to the commercialisation of genomics, there is a lot of pressure to come up with new things. Those working in the field feel that genomics has enormous potential. For those observing genomics from the outside, there is often a vague sense that so far it has failed to deliver.

For both those within the field and outside of it there seems to be a consensus that if genomics is to become an ubiquitous technology, it will be because of its widespread adoption in healthcare.

I would like to suggest that most progress in the commercialisation of genomics may come from somewhere else entirely. Possibly from somewhere unexpected where there is less pressure to deliver and less competition, allowing for more creativity. Besides that, healthcare is one of the most strictly regulated industries, making innovation even less likely.

There are several applications of genomics outside of healthcare that show great promise. One of them, forensics, I reviewed in a blog post two week ago.

An even more harmless area is what could be called the genomics of irrelevance: There are plenty of genetic variants that predict things that no-one cares about. Examples include whether your pee smells differently after you eat asparagus, whether you earwax is runny, or whether you feel the urge to sneeze when looking into the sun. The website of 23andMe lists dozens more.

Could it be that for most people, including potential hobbyists, exploring the genomics of such harmless traits holds more appeal than learning about their risk for Alzheimer's?

August 3, 2012

Looking for some summer reading?

I like reading popular science books, and go through quite a lot of them. However, recently I have become increasingly picky. Due to overconsumption, I now tend to avoid books on cognitive biases, behavioural economics and such like. I am probably victim of an inverse mere exposure effect.

Another area that I avoid due to overexposure is genomics. As I spend my days working in the field, I prefer to spend my nights reading about other things. This means that I have not read a popular science book on genomics since Matt Ridley's fantastic Genome.

For Elizabeth Finkel's The Genome Generation I made an exception, and I do not regret it. Finkel writes beautifully, knows the subject, and is never boring - in other words, she is a good science writer.

Where she really excels is at covering the areas of genomics less explored by others, such as agrigenomics and immunogenomics

Finkel is clearly and unapologetically enthusiastic about genomics. There is not a lot of mention in The Genome Generation of the ethical questions that a lot of science journalists seem to be obsessed with. If this is what you are looking for, then this is not the right book for you. However, if you are interested in the science itself, then it may be.

My only complaint are the figures: Although they are clear and get the message across, they are also ugly and look a lot like clip art.

If you wonder whether The Genome Generation is for you, here are the most important facts:

Areas covered: Epigenetics, Personal Genomics, Immunogenomics (especially AIDS), Agrigenomics, Ancestral Genomes.

Who it is for: If you want a clear primer to genomics and its diverse applications. If you want something more readable than an academic textbook.

Who it is not for: If you have had recent training in biology or biochemistry, you will already be familiar with most of the material. If you are looking mainly for entertainment, and if you are interested only in Personal Genomics, you will be better served with My Beautiful Genome by Lone Frank.

How much it costs: For reasons I do not understand, Finkel chose Melbourne University Press as her publisher, and they are not cheap. They recommended retail price is $32.95, but online the book is available for $21.75.

Thanks to the Sanger Institute Library for ordering this book following my suggestion.