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Influencers with Andy Serwer: Anne Wojcicki

In this episode of Influencers, Andy is joined by 23andMe co-founder & CEO, Anne Wojcicki, as they discuss the benefits of DNA testing, concerns over privacy in the healthcare industry, and the future of medicine.

Video Transcript

[MUSIC PLAYING]

ANDY SERWER: 23andMe is one of the buzziest companies to hit the stock market lately in what's been a blockbuster year for IPOs, not just because of the company's home DNA tests, but for how they could shake up health care, something on all of our minds these days. Anne Wojcicki, the co-founder and CEO of 23andMe, envisions a new model of personalized care that determines the treatment we get and the drugs we take, based on our specific genetic code. On this episode of "Influencers," Anne joins me to talk about the company's shift toward drug development, how it's addressing privacy concerns, and what its research can teach us about fighting this pandemic.

Hello, everyone. I'm Andy Serwer and welcome to "Influencers." Welcome to our guest, Anne Wojcicki, co-founder and CEO of 23andMe. Anne, nice to see you.

ANNE WOJCICKI: Good to see you.

ANDY SERWER: So let's talk about 23andMe. A lot of people have heard about the company by now, of course, but you do DNA home testing, you have a subscription service, you do some drug development. Why don't you talk about the business in the company, writ large.

ANNE WOJCICKI: Well, the idea around 23andMe was always this idea of personalized care and the power of data. So in 2003, I remember being very touched by Francis Collins, who's the head of NIH today, and he had come out and he said, genetics is going to transform how we predict, prevent, and treat all human disease. And it was an incredible statement, and I think that there's an absolute opportunity and potential with having DNA to have, essentially, this code that tells you what your risk factors are, and how you might be susceptible to certain kind of conditions, how you might respond to certain kind of conditions.

And we don't fully understand the genome. So there is a huge opportunity to say, I'm going to deliver true personalized care, being like, I'm going to help you understand what your risks are, and then potentially help you manage how to prevent. And then there's this opportunity for us to all come together and crowdsource what does the human genome actually mean. And so that really is our therapeutic side. So 23andMe is all about how people access, understand, and benefit from the human genome, easily get access to your genetic information, understand what it means for you, and now benefit, which is really going to be about helping people prevent disease, and then treat it when they cannot prevent.

ANDY SERWER: OK, so then break it down for us in terms of the business lines and what your guys are doing there.

ANNE WOJCICKI: It's a direct-to-consumer company, still, so one of the things that is unusual about us is that we sell straight to customers. And we do not go through employers, we don't go through physicians. There's two offerings-- there's an ancestry only, and then there's the health and ancestry. And we found that some people really just want to explore their ancestry before they got into health, but that health really is this much bigger opportunity.

What we also found that taps into the health side, is that our customers were telling us that they were looking for more. They were looking for more information, they were looking for more ways that they could take this information and do something meaningful with it. And so we responded to that request by saying we're going to have a subscription offering, and the subscription offering today is really about additional content, and so more reports. So for instance, we have a whole section about heart health and the risk factors might have there, and then a whole section also on pharmacogenetics, how your DNA might impact how you respond to medications. And so those are examples of reports that are now part of the subscription service.

We have another whole side of the company, which is really about the data. And over 80% of our customers elect to opt into research, and they answer questions about themselves. And with that information that people have given, we are able to then do analysis and research on disease areas, like depression, or Parkinson's, or cancer. And we can look at all of this information, and we look to see, are there genetic insights that potentially help us have a unique insight into developing a drug. So we now have a big therapeutics division, as well, saying, can we leverage genetic information to develop therapies?

ANDY SERWER: Also really cool stuff.

ANNE WOJCICKI: It is [INAUDIBLE].

ANDY SERWER: Yeah. So there are other companies doing this now, but you guys have this tremendous brand equity in the space, I would say, and what makes you guys different from competitors? And then tell me what you were about to say, as well.

ANNE WOJCICKI: Well, I question this thing. There's people who all compete in very specific spots.

ANDY SERWER: Got it.

ANNE WOJCICKI: So ancestry.com has an ancestry-related test, but they've actually now pulled out of health. There's companies that you could go to that will give you a health report, but they are through a physician and it's not necessarily a fun experience. I wouldn't say that getting your CBC done at LabCorp is a fun experience. No one brags about those reports or takes them home to show their friends.

ANDY SERWER: Right.

ANNE WOJCICKI: So there's absolutely companies that do very specific aspects of what we do, but there's no one else that looks at your whole genome holistically, that looks to have a fun and engaging experience, and that's truly direct to consumer. It's one of those things that's interesting-- when we had this the regulatory issues with the FDA back in 2013, and after all of that work, we are still the only ones who've gone through this whole path and brought forward a direct-to-consumer product. And one of the things I am vehemently committed to and very proud of is that we have proven out that customers are, in fact, quite capable of getting information on their own. And the reason why that's so important, is it's important to show that health care actually can be scalable.

I tell my kids-- and I was like, in the old day, when mom wanted to book a trip to a country, I had to call a travel agent, and there was a person. It wasn't automated. Imagine if, for all of your trips, you had to still talk to a person to get that hotel room. But now it's obviously all scalable.

Health care is still in that world, where it's all predicated upon a one to one interaction with an individual. And one of the things that's so important to do is figure out, how can health care more and more scale? And how is it that you can actually say a lot of information can go direct to consumer, you can structure information in a way that people can, in fact, absorb it on their own, and that there's a select number of cases, like you're a carrier for a BRCA mutation and we highly encourage you follow up with your physician. And we found that people do, in fact, do that.

ANDY SERWER: Now, does that suggest, Anne, that there is this incredible opportunity where you can take the company into a myriad different paths? And what might some of those be?

ANNE WOJCICKI: Exactly. So that is where I think of us as a very different company than everyone else out there, because we look at ourselves as a direct-to-consumer company that has the foundation of everyone's personalized medicine. So everyone talks about personalized medicine. There's all kinds of glossy brochures, people talk about it, it has a great name. But to me, if you don't have your DNA that's part of it, you're not starting with the foundation of personalized care.

And so what I see is this huge opportunity for 23andMe, is to really offer a service for customers to say I'm giving you personalized preventative care. So I give you your genetic information. And based on that, I'm going to help you understand what your risks are and how you potentially want to better manage, and all based on your genome, and really within a lens towards keeping you healthier. And that's, I think, a big differentiator.

So much of health care today is really about, how do you do chronic disease management. That's one of the best sectors. Everyone is getting into that, chronic disease management of all sorts. But what I think about-- I'd rather just have chronic disease prevention, you just don't want it. But the reality is, that doesn't pay for the existing health care system as it is, which again ties back into why is 23andMe a direct to consumer company, because prevention is largely in the lack in the responsibility of you, the individual.

Changing your diet, exercising, how you take care of yourself is not something your doctor is regularly checking up on you for. They might tell you, lose weight, but it's your responsibility. And so that's what I think 23andMe has this real opportunity to say-- we're giving you a very scientifically-based, looking at your genome, and we're going to help you understand where you need to focus your energy on prevention.

ANDY SERWER: Now, you mentioned that doctor relationship. Is there any consideration being given to having your product and service so that consumers could work in conjunction with their physicians?

ANNE WOJCICKI: Absolutely. Again, I have a lot of good friends who are physicians, and I feel for them. And I think one thing that was brought up to me early on in the days of 23andMe is that one doctor complained-- he said, the problem with 23andMe is you generate a lot of non-reimbursable questions, which is really true. And you can't fight with someone to say, you should do work for free. A lot of it I completely understand.

So what we have done, since those early days, is really figure out how can we support physicians best when a patient, a customer in our case, walks into the physician's office and says, I have this 23andMe report that says I have a BRCA mutation, or I have a 23andMe report and it tells me that I am higher risk for type 2 diabetes. So a lot of what we've thought about doing, is how do we actually make sure that we're creating this content so that you can walk into a physician's office, and that physician is prepared, and how is it that we can work with companies, like Osmosis and others, and really train physicians so that they feel comfortable talking about genetic information.

ANDY SERWER: So is it the case, though, that, say, just the core DNA home testing part, maybe, has slowed down the growth there as it gets more saturated? And of course, that's, in part, why you're looking to grow in these areas you just discussed, right?

ANNE WOJCICKI: Well, it's interesting. There was a time period where it was absolutely raining ancestry kits, and there was an explosion of everyone. It was on Saturday Night Live, celebrities were dressing up like 23andMe kits. We really hit a cultural moment where people started talking about-- it was a whole new way of thinking about identity. And one thing I look at is, even in this recent census-- and there was some of the reports out there about how there's this radical jump in the number of people who identifies as being multiracial. And a lot of that was attributed to coming from genetic testing, so I think there was absolutely an explosion there.

I think, at the same time, we did get hit by things, like Cambridge Analytica and the questions on privacy. And there were all kinds of reports out-- oh, and Golden State Killer. There was all kinds of questions about, just exactly where is your data going. And I think that there was a very natural slowdown, just across the board, of everyone taking a step back and saying, I want to understand.

That said, we've seen a lot of recovery. Frankly, things like COVID have really reignited people's interest in health. And one thing that we have always done research on-- the health market is far larger than the ancestry testing market.

Again, thinking back, also, just what I started talking about with what Francis Collins said, that statement about the opportunity for really changing all of care, all the ways that you predict, prevent, and treat human disease, all that opportunity is there. And it's just a matter of time before that becomes a reality. I think if you ask any medical professional, everyone says there's absolutely a world where everyone is sequenced at birth. But the path to get from today to that moment in time is undefined. And frankly, that's one of the things that 23andMe is doing, is we are actually the ones defining that path.

ANDY SERWER: Well, I think that ancestry thing is always a hot topic. You'll be happy to know-- and I was walking behind two little boys going to the beach a couple of weeks ago. And they were going, well, I'm part Irish, Spanish, and Japanese. And another kid was going, well, I'm part Portuguese. And they were talking like there were seven years old and they were into it, but that's a natural curiosity we have.

ANNE WOJCICKI: Well, I love it when I hear kids who don't look alike, who say, oh, maybe we have DNA in common.

ANDY SERWER: Right.

ANNE WOJCICKI: There's a sense of you're connected to everything in the world, and ultimately, that's true. DNA is the ultimate connector of humanity. We all have DNA in common, we all have common roots. I look at it and I look at each mutation tells a phenomenal story of our survival. And we're all unique, and different, and optimized to survive in different types of environments, and that's amazing.

ANDY SERWER: You mentioned data and the concerns people have about that, naturally. And so what have you done-- I think you said 80% of your customers' consent.

ANNE WOJCICKI: Opt in, yes.

ANDY SERWER: Yeah. And not opt out, but opt in.

ANNE WOJCICKI: Opt in, right.

ANDY SERWER: Right. And so how have you thought about using this? How are you, and what are you thinking, going forward?

ANNE WOJCICKI: I have really strong opinions about how data is used in health care, and I think a lot of this comes from the fact that I wish my health care providers followed what we do at 23andMe and I wish that my health care providers had the same level of transparency and choice. So 23andMe is 100% predicated on this idea that people should have choice about what their data-- where it's going and they should have transparency about how it's being used.

And one thing that agitates me in health care is that, oftentimes, my data is circulating around to places I'm not aware of, and then the insult on top is that I don't have the choice about how it's shared. Try to get your medical record and say you want to send it to another facility or send it to somebody else. They use all kinds of privacy laws to say you're not allowed to share it. So I find it the ultimate insult that I cannot control my health information. And my days as an investor and chatting with companies about it, it was remarkable how pervasive that is in the system.

So 23andMe to me is built to have an entirely different system. I believe people should have the transparency and choice with their information. And at any time a customer wants to opt in to research, they should be able to. And at any time you want to opt out of research, you should be able to, and it should be easy.

So for instance, when you're a 23andMe customer, if you are taking a survey, it says at the top, you are opted into research. Click here if you don't want to be. When we did our first partnership with GSK, we actually emailed all of our customers to say, do you want to participate? Or do you want to opt out?

And it's amazing-- I think that people really are eager, actually, to participate in research. You see that enthusiasm from things like Susan G Komen and the Livestrong walks-- there's an enthusiasm to help each other-- even the bone marrow drives. People want to fundamentally help each other, and they understand that we are actually all connected. But nobody likes to feel like they're being taken advantage of, and that's why choice and transparency have to become the foundations of health care.

ANDY SERWER: Yeah, the paradoxical opacity that you just talked about drives me crazy. It's a heads, they win, tails, you lose, and it's just unbelievable. So I hear you, loud and clear, on that one.

ANNE WOJCICKI: I love encouraging people. Next time you go to the doctor, and they try to get you to sign the forms, and they don't even give you the forms anymore because it's so automatic, say, no. And I love it, I love when the receptionist is like, what do you mean? I'm like, no I'm going to mark it up, no, it's a legal document why would I just sign it? Why am I going to sign the rights for you to be able to do whatever you want with my data? So I just think there needs to be almost an uprising of people just saying, no. The same way there's California Privacy Act and others-- why is health care exempt?

ANDY SERWER: Right. And you mentioned Wall Street, Anne. I know you worked there when you were younger, and you guys went public-- it's a segue, is it? You guys went public, via SPAC, in June. Talk to us about that. Why did you decide to go that route? And I know was with Richard Branson's Virgin Group, so you had that relationship.

ANNE WOJCICKI: I always told my team that we would go public when the time is right, and then, part, because you have it's a level of maturity of the company-- do you know, essentially, who you are when you're grown up? And 23andMe me, at this point in time, was at the stage where we're really well solidified, what we stand for. And it was important for me to always have that sense of, we are an activist brand, we're out to drive real change.

People sometimes talk about, oh, you got into drug discovery and it's a pivot. No, it was there from the very beginning. We're out to do something radical and really transformative, and I only want to be a public company when we have the maturity to withstand the public pressures.

So at the same time, it was a phenomenal time to be public, because I have two driving factors-- one, my therapeutics team is mature enough that they have real cash needs, so we need the capital. Second, COVID ushered in a whole world of suddenly having-- remote care was obvious. Suddenly, getting blood at home, prescriptions at home, telemedicine, all these things that we want to do to potentially usher in a world of personalized care became a reality. And so we said this is a phenomenal time for us to actually have a public currency and look at the world of doing acquisitions.

ANDY SERWER: Right, interesting about COVID and you talk about how that's changed the business. Shifting gears a little bit, I have to ask you about Elizabeth Mahomes who was on trial for fraud allegations related to a home testing kit. Do you think the attention that she's garnered has had any impact on consumer trust or products like yours?

ANNE WOJCICKI: I get that question quite a bit, and I would say no. And people will ask me how we're different, and I'd say, look, well, we have hundreds of papers. I have a culture of transparent science, going back to my thesis on choice and transparency. We are an incredibly science driven company, and Theranos was never transparent.

And to be honest, Theranos was a-- because, again, you had a woman who was running it. But there's other companies out there that are also not transparent, that don't get the same kind of publicity. So I think, again, it's good for everyone to push on, especially in that world of science. You need publications, you need transparency, you need to be able to really understand how something is working.

Again, I think the heightened scrutiny of all companies, I think, is fabulous and I would encourage this even more to make sure that people are understanding what exactly is this product that's out there. And I think this is where FDA has a real responsibility and a real opportunity to make sure that they're setting standards.

ANDY SERWER: Interesting. Of course, there are some companies that are actually directly following what she wanted to accomplish, and must be tougher for them to maybe gain trust, because you guys aren't in the same business. I want to ask you about politics a little bit, because science has seemingly become more politicized than ever. And I'm wondering if that makes it harder for you to market your product to a broad consumer base?

ANNE WOJCICKI: In an interesting way now, I think what's happened in the last with COVID. And we just had a call with Andy Slavitt, and we were talking about this, and it reminded me about when there was H1N1. And again, I remember rushing to get that vaccine, and everyone rushed to get the vaccine. There was no politicization of-- everyone wanted it.

And obviously, this is wildly political. So I think what that has done is it's opened up a door for additional leadership. Obviously, I'm incredibly supportive of the agencies out there, the CDC and FDA, and it's a really hard to be a scientific leader right now. But I do look at that public is hungry for other people that they can relate to.

One company that we've always pointed to is why do people follow Goop and Gwyneth Paltrow. So Gwyneth, she's definitely up to her game more with the science, but she's not known as a scientific leader, but people follow. And I think that one thing that I do think that the science world has missed is that people are looking more and more to relate to their physician and to the science and make the information something that they can actually understand. And I think that the scientific medical world is still stuck into a world of white coats, call me by my title, and I use names that you can't understand, and I include a package insert that no one can read.

And I think that there has to be some of that consumerization of health care. And so I think of that whereas I think there's actually an opportunity for 23andMe. And we try to do this, have more of a role in scientific leadership. And when we put out publications around COVID, we tried to do that very mindfully of how can we actually help people understand the science of what's really going on here, because I do think that people are looking for what to believe.

ANDY SERWER: Let me ask you about TAM, total addressable market, one of those favorite buzzwords in business these days. So you guys are available in the US, Canada, and the UK, I think. But you have aspirations, I'm sure, to expand further internationally, and then there's China out there in India. What do you see in terms of the potential for the company to go into those kinds of markets?

ANNE WOJCICKI: I think people should be mindful. Each one of those countries is highly regulated in a different way. So we definitely think about international expansion. But I would not say it's top of my mind to think about right now. I think that there's a lot more work we can do in all the countries where we have an authorization.

And I am-- I continue to be very excited about our subscription product and very excited about the therapeutic side. So I would say we're really focused on the opportunities that we outlined here, especially in this back, outline subscriptions priority. And the idea of getting more and more into the world of true personalized care and do we actually start to do acquisitions .

ANDY SERWER: Right. You are one of the few women CEOs in your field. Talk to us about that. Was that an advantage? Was that a disadvantage? Or it just is what it is?

ANNE WOJCICKI: I was lucky to grow up in an environment where I think there is a lot of strong women. And-- and I look at again the circle of groups. We're one of many families of three girls.

And I also happen to have my sister around. So-- so there's a normalization of like yeah, there's just like-- there's a lot of lactating CEOs that I know. I was put that way.

And-- and I think it's-- it's like I said, to me, what-- what was most beneficial is I had a supportive community. And I had a community where it was normal. And I think that one of the biggest responsibilities for women in positions of leadership is to reach out and mentor other women.

And one of the things I am really proud of is the number of female CEOs that have left 23andMe and gone on to become against CEOs at their own companies. So there's at least three off the top of my head.

I don't know if there's actually maybe 4. And I'm really proud because I think that's one thing that I can do is instill the normalization like women can be in charge and I can believe in them.

And so for all of those women, I'm really proud. Like you-- what you do, you act locally influence globally like the culture that we've created the company I think is going to have an influence. So again, I'm really lucky to have come from that kind of environment. And the best thing I can do is support other women to-- to just take it take that initiative on their own.

ANDY SERWER: Yeah, just to be clear about that environment. I mean, your sister Susan would just be CEO of YouTube. I mean, I've got to ask you. What was in the water at the Whiskey family growing up and you had two CEOs come out of there?

ANNE WOJCICKI: We-- we joke. We had a lot of independence. I think what my parents did that-- that I do think is good for everyone, there was a lot of-- there was a lot of belief that we would find our own passions, and there was a lot of flexibility to-- to take on risk and to explore what you are passionate about. And there wasn't that pressure that I had to go and do a specific job.

So I try to encourage my kids now take on risk and have independence. There's nothing better in life than being independent.

ANDY SERWER: Right. And we mentioned that you worked on Wall Street as a health care analyst and you almost went to medical school I understand. So what is it about the intersection of business and health care that you find so interesting? Yeah.

ANNE WOJCICKI: I-- you know, the reality for me is what I just like to do, I think in some way some of the most successful companies are-- are started by people who see a specific need that fits their own desires. And I personally when I was five years old, I first heard about the intersection between genes and environment.

And it captured me. It captured me that there is something within me that I couldn't see, and that all the behaviors and all the actions I had were potentially-- there's potentially a formula there to stay healthy as long as possible. And I just want to know what that formula was.

So what I love-- I'm in a really ideal dream position because I feel like I'm accomplishing what is sort of like a lifelong curiosity. And I'm surrounded by people who are incredible scientists, and I love the osmosis of being able to learn from all of them. And then I also love that I'm creating a service that impacts millions of lives like nothing better.

ANDY SERWER: And last question. And what do you see down the road for yourself and for 23 in May? And maybe they're the same answer and maybe they're separate.

ANNE WOJCICKI: I think-- look, I think the hardest challenge before us is how do you actually introduce a type of health care that isn't supported by the existing health care system.

And-- and it is. Like I am-- it's I'm very much tied into with the company. I'm like one in the same of what I am passionate about. Like I-- I really it's what we talked about before.

Like there's chronic disease management out there. But there's chronic disease prevention I really think about. Like how do you help people avoid really the pain and suffering of being sick?

And I spent enough time in hospitals to know. Like you-- you want to do everything you can to not get there. And so the actions that you take earlier, like I think about that with things like sunscreen. Like you really want to emphasize to your kids under like you really have to like you really want to prevent those early childhood burns.

So like how do you actually really help people? Because it saves so much suffering down the road and having been front row seat to some of that suffering. Like I said, I really think about that.

And so when I think about what I want for the company with 23andMe is we say internally like I want to be healthy at 100. And the most rewarding aspect of 23 is when I do get like customer testimonials or customers who ride in who say we've had a significant impact on their life. And that could be from ancestry or identity. But there's nothing like that experience of health and whether you've really had an impact and really change someone's life with that.

ANDY SERWER: When the company is 100 or when you're 100?

ANNE WOJCICKI: Oh, good question. I mean, I think I want to be healthy at 100. But the reality is like let's start thinking about, what should we do for the 23AndME 100th anniversary. It's a great question. I'll get back to you on that one.

ANDY SERWER: Excellent. Anne Wojcicki co-founder and CEO 23andMe. Thank you so much for your time.

ANNE WOJCICKI: Thank you, Andy.

ANDY SERWER: You've been watching "Influencers." I'm Andy Serwer. We'll see you next time.

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