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PERSONALIZED MEDICINE
Emerging trends, players, and business models
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TABLE OF CONTENTS
9 Macro Trends Enabling The Genomics Revolution
18 Investment Trends, Exits, And Active Investors In
Private Markets
29 The Role Of Corporates
40 Business Models And Approaches + 23andMe analysis
57 The Role Of Government
64 Genomics Looking Ahead
#cbigenomics www.cbinsights.com 7
WHAT IS GENOMICS (AS WE DEFINE IT)?
#cbigenomics www.cbinsights.com 8
Macro Trends
The key factors that are enabling the wave of genomics developments today
#cbigenomics www.cbinsights.com 9
GENETICS CAN HELP
US BETTER
UNDERSTAND OUR
HEALTH
Thanks to technological
advances, the cost of
sequencing has dropped
dramatically since the
days of the Human
Genome Project. It now
costs closer to $1000
compared to $10M+ a
decade ago.
#cbigenomics www.cbinsights.com 13
TESTING HAS STILL
ONLY HIT A SMALL
PART OF THE MARKET
Identifying chronic
diseases is a main area
of interest in genomics,
particularly for diseases
that drive up health
expenditure drastically
and that may be
manageable through
lifestyle changes.
J. Craig Venter
CEO, Human Longevity
#cbigenomics www.cbinsights.com 18
Global equity funding since 2013:
$6.5 BILLION
across
473 DEALS
#cbigenomics www.cbinsights.com 19
GENOMICS ANNUAL GLOBAL FINANCING HISTORY GENOMICS DEALS HIT
2013 - 2017 YTD (7/19/17) HIGH IN 2015, 2016
121
SEES MEGAROUNDS
114
(Full-Year Run Rate)
112 Funding into genomics in
$3251 2017 has already
94 (Full-Year Run Rate)
surpassed the
81 cumulative funding of the
previous year due to
65 mega deals in cancer
detection companies like
GRAIL and Freenome.
Deals have remained
stagnant, with 2017 on
track to hit 115 by the
year end.
$568 $1,168 $1,237 $1,703 $1,852
McKesson Ventures,
$914M/Series B Q1'17
Amazon, Merck & Co.
The largest genomics
deals are starting to get
bigger, with GRAIL
Softbank Group,
$360M/Series E Q2'17 Orbimed Advisors, leading with more than
Sequoia Capital $1B in total financing.
Recent large deals in the
Sequoia Capital space have been focused
$320M/Unattributed Q2'14 China, Shenzhen
Capital
on specific applications
for genomics (fertility,
cancer detection, etc.) as
Celgene, Draper
$220M/Series B Q2'16 Fisher Jurvetson, opposed to only
Illumina sequencing or building a
genetic database.
Lee Equity Partners,
$200M/Series B Q4'16 Reproductive Biology
Associates
$1.8B Valuation
$1B Valuation
IPO
$872M
$415M Acquisition Valuation
REVERSE
$410M Acquisition
MERGER
$619M
Valuation
#cbigenomics www.cbinsights.com 24
GENOMICS GLOBAL DEAL COUNT GENOMICS DEALS
2013 - 2017 YTD (7/19/17) SHIFT FROM EARLY TO
LATE STAGE
63
60 Interest in genomics in
the last couple of years
50 led to many new early
stage financings,
jumping in 2015 and
35 2016. This trend has
32
27 slowed however, and
25
23 23 instead 2017 has seen
22
18 17 more deals happening in
15
11 12 the mid and late stage
8 8 8 areas as companies
10 6
mature.
2013 2014 2015 2016 2017 YTD
Because genomics is
both a cutting edge
technology/software
issue as well as a
biological one, the field
sees a wide array of
investors from both sides
and all types. Genomics
companies business
models are also both
enterprise and direct-to-
consumer, attracting
investors that specialize
in either.
#cbigenomics www.cbinsights.com 29
CORPORATE PARTICIPATION IN GENOMICS DEALS CORPORATES SLOW
2013 - 2017 YTD (7/19/17)
THEIR INVESTMENT
ACTIVITY
17% 20%
22% 23% 24% Corporates increased
their participation in
genomics deals through
2016, taking part in
nearly 25% of all
genomics deals. This
year however, corporates
83% 80%
78% 77% 76% have slowed down.
1 51
Veritas
GRAIL Genetics Baebies
ReadCoor Singlera
Kallyope Human Desktop Oxford Nanopore 23andMe
The most active
corporates in the
GRAIL Baebies Kallyope Human Desktop Oxford Nanopore 23andMe
Longevity Genetics Technologies Genomics Longevity Genetics Technologies
Illumina Illumina
Lilly Asia Ventures
2 52
genomics space run the
Freenome 23andMe GRAIL Genomics
Medicine Ireland
Cambridge
Epigenetix
DNAnexus Freenome
GRAIL
23andMe
Inivata
GRAIL
Atlas Genetics
Genomics
Medicine Ireland
Cambridge
Epigenetix
DNAnexus
3
Vitagene Encoded Trace Genomics Biome Makers Urology
53
Vitagene
Human
Encoded Trace Genomics Biome Makers
Veracyte RainDance
Urology
also several tech
companies (Google, GE)
Genomics Diagnostics Genomics Diagnostics
Longevity Technologies
#cbigenomics www.cbinsights.com 34
ILLUMINA INCREASES
THEIR PRIVATE
Jan 2010 July 2012 Jan 2015 July 2017 MARKET ACTIVITY
In addition to raising
significant amounts of
money, GRAIL is also
recruiting for several
large scale clinical trials
in partnership with
notable collaborators like
the Mayo Clinic and
Cleveland clinic to test its
technology. The
company suggests it will
have a product by 2019,
depending on trials.
#cbigenomics www.cbinsights.com 40
COMPANIES ARE
INVOLVED IN AT LEAST
SAMPLE SEQUENCE SOFTWARE ONE PART OF THE
CHAIN
Companies generally
focus on one specific
part of the data capture
chain, but can also
verticalize into one
specific area and
integrate the entire
process.
#cbigenomics www.cbinsights.com 41
MOST GENOMICS
COMPANIES CHOOSE
BETWEEN WELLNESS
AND MEDICAL
RELEVANCE
Most genomics
companies base their
business model and
CURIOSITY/WELLNESS MEDICAL RELEVANCE
market approach through
the lens of wellness
(customer curiosity,
actionable lifestyle
recommendations)
and/or medical relevance
(disease risk, lab
analysis, etc.) each with
pros and cons.
#cbigenomics www.cbinsights.com 42
WELLNESS HAS LESS
REGULATION, BUT
TOUGHER BUSINESS
Genetics companies
targeting wellness can
typically go straight to
consumers with less FDA
CURIOSITY/WELLNESS stringency (for now) and
do not provide
diagnoses. The
consumer typically pays
for these tests
themselves, which also
means they have to be at
a cheaper price point and
have less actionability
with the data.
#cbigenomics www.cbinsights.com 43
MEDICAL RELEVANCE
HAS LONGER
REGULATORY AND
SALES CYCLES
#cbigenomics www.cbinsights.com 44
THE MIDDLE IS A
NASCENT AREA
Combining medical-
grade interpretations and
a patient-driven approach
GENOTYPE yields preventive
GUIDED medicine thats
MEDICINE & potentially reimbursable
WELLNESS by insurance.
#cbigenomics www.cbinsights.com 45
ANALYTICS SOFTWARE SOFTWARE FOCUSED
ON GENOMICS
Analytics software
provides tools that help
providers and
researchers make sense
of their data by
aggregating multiple
data streams.
Gene screening
companies are analyzing
samples from patients to
determine their carrier
status and other
potential predispositions
to help people better plan
for their health.
#cbigenomics www.cbinsights.com 51
FDA COMPLIANCE
PROVES TO BE A BIG
HURDLE
FDA APPROVAL FOR
FDA CRACKDOWN
10 MORE DISEASES
Providing analysis
directly to consumers
about disease
23ANDME RAISES predispositions based on
FDA APPROVAL
TO TEST BLOOM SYNDROME genetic data requires the
regulatory oversight of
the FDA. 23andMe was a
pioneer here, first getting
approval for their Bloom
Syndrome test and more
recently receiving
approval for 10 more
tests, including
Parkinsons, Gaucher
disease type 1, and more.
Post-FDA approval,
23andMe saw a massive
VALUATION valuation jump, and the
JUMP OF 194% scope of the company
POST FDA
also broadened.
23andMe also received a
grant from the NIH to
open their de-identified
data to partners and a
recent grant from the
National Human Genome
Research Institute. The
company is poised to
raise another round
soon.
#cbigenomics www.cbinsights.com 55
23ANDME CAN GET
INTO SERVICES
#cbigenomics www.cbinsights.com 57
GENOMICS AS PART OF THE PRECISION
MEDICINE INITIATIVE
And just like analyzing our DNA teaches us more
about who we are than ever before, analyzing data
from one of the largest research populations ever
assembled will teach us more about the connections
between us than ever before. And this new
information will help doctors discover the causes,
and one day the cures, of some of the most deadly
diseases that we face.
Barack Obama
Former President Of The United States
#cbigenomics www.cbinsights.com 59
59
GRANTS PLAY A BIG
ROLE FOR GENOMICS
COMPANIES
Multiple regulatory
bodies govern different
steps in the genetic
analysis process, from
sequencing to
interpretation to
marketing.
Genomics companies
are affected by multiple
laws, including GiNA,
CLIA, etc.
Source: http://www.mlo-online.com/the-push-to-reconcile-the-gap-in-ldt-regulations,
#cbigenomics www.cbinsights.com 62
http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm509814.htm
HOW GENETIC DATA CAN BE USED IS STILL UP IN
THE AIR
Employees given Potentially no limit on
< 30% insurance employee wellness
Does not apply to discount for sharing program incentives
life insurance. medical information offered for access to
with employer genetic data.
#cbigenomics 63
Genomics:
LOOKING AHEAD
#cbigenomics www.cbinsights.com 64
GENE-BASED DNA-BASED
GENETIC COUNSELING GENE EDITING THE APPLICATION
THERAPIES AND DRUGS DRUGS AND THERAPIES
LAYER IS BEING BUILT
#cbigenomics www.cbinsights.com 65
CRISPR COMPANIES ARE MATURING GENE EDITING IS
BECOMING A REALITY
#cbigenomics www.cbinsights.com 66
HOW MUCH SHOULD
WE RELY ON GENETIC
DATA?
nkrishnan@cbinsights.com
#cbigenomics