Wednesday, October 19, 2016
How Arivale Is Harnessing Genomics To Optimize Human Health and Wellness
Story by Benjamin F. Kuo
There's been a revolution in the amount of information that can be gathered about our genetics—driven by automated gene sequencing equipment and advancement. However, all of that data, although useful, has not yet been used in a way that directly impacts personal health and wellness most effectively. Arivale (www.arivale.com), a startup founded by Dr. Leroy Hood, the well known DNA and genomics pioneer—which combines gene sequencing with clinical labs, lifestyle, nutrition and activity levels, and ties that with personalized counselors and health and wellness recommendations, recently launched an expansion into California, starting in Los Angeles. We caught up with Clayton Lewis, the company's CEO (and also a General Partner at Maveron), here in Los Angeles last week as it launched into this market. Arivale is based in Seattle.
What is Arivale?
Clayton Lewis: What Arivale does, is we help our participants optimize their wellness. It's not just about wellness in the short term, but it's about wellness for decades. How we do that, is for each of our participants, we create a dense, dynamic data cloud. We'll talk more about that, but what we do is bring the data cloud to life through licensed professional coaches, who understand the incentives of behavior change, and meet participants where they are, through three or four occasional recommendations each month. Our participants take an initial journey of one year, and we hope to keep them for a lifetime.
Explain what a dense, dynamic cloud is?
Clayton Lewis: We look at four quadrants of data. My co-founder, Lee Hood, was the first to map the human genome. The four quadrants are first, whole genome sequencing; the second is clinical labs, where we analyze over 94 different things, twice as many measurements, twice as often as an annual physical. Quandrant three is discovery of your gut microbiome, which, although nascent in actual recommendations, offers a rich amount of data. The fourth is the quantified self, the quantity and quality of your sleep, your exercise pattern, your heart rate. It's a system approach that analyzes all of that data to make recommendations to you, based on your genetic predispositions and the decisions of your life to date. We use all of this to recommend ways to optimize your wellness.
How is this different from other DNA testing startups and services out there today?
Clayton Lewis: What is interesting, is if you can find companies in any of the four sectors, it's rare to find those who look at the human product as you are, which is a system. We take this data, and organize those into dimensions—your diabetes range, your cardiovascular system, optimal aging, nutrition, stress. So, for example, if you and your family have heart health issues, that might be the first dimension where you have interesting opportunities to optimize your health. You can click open your dashboard, see how the different genetic variants have challenges and advantages for hearth health. Genes are not your destiny, they are just indications of your predispositions. The clinical labs related to your life choices, how they affect heart health. For a number ofyears, as a venture capitalists, I looked and led Maveron's investments in health and wellness. We figured out it's pretty much a failed category. Why is that? There are three reasons it doesn't work. The first, is that people don't want to be healthy today. They'll take the risk of chocolate cake over the risk of diabetes in five years. What we want to do, is ground that experience today with the future. What makes us different from other companies, is we take a systems approach, and assign you a coach, backed up by a clinical team, external, third party physicians, and analyze the data, and understand what are the most important experiences in your life, and translate that into actual recommendations every month. The second thing I learned as a VC, is that data paralyzes people. If you look at a lot of companies, they give you a lot of data, but after people have looked and saw they took 10,00 steps in the last week, they don't know where to go. The second thing, which is different from other companies, is we have translated that into bite-sized recommendations, and we give you a coach. The final headline, is if you look at the sector for the last seven years, is they have eliminated any human interaction. It's all about the app, or the computer screen, or the data. In today's world, people are lonely, and they are really looking for someone to mentor them, to guide them, to hold them accountable. Behavior change is hard, and frankly this is why the category of wellness struggles.
Genome sequencing and testing, although it's dropped a lot in costs, is still very expensive—where is that now?
Clayton Lewis: We say we're launching a new industry, called Scientific Wellness. Lee and I were recently at the Exponential Conference, and Lee got up in front of the whole group, primarily healthcare providers. He said, the market cap of the scientific wellness industry will dwarf the current cap of the wellness industry in as soon as a decade. You are correct that right now, whole genomic sequencing is the most expensive part of this. Though, if you look at the cost of whole genome sequencing, it's blowing way Moore's Law in terms of how quickly the cost is going down. If you are an individual, you can come to our website, and sig up for a year, and you get all of the assays for a year, really detailed coaching, clinical labs twice, at the start and in six months, and it's $3500 for the first year, and $1000 for the second year. That's because we'll already have made the investment in your baseline data. What is even more interesting, is we have enterprise and corporate partners—three partners now—who are subsidizing, to various degrees, all of their employees. One of those partners is covering 100 percent, one is doing 75 percent, and the other we are talking to is talking about an 80 percent subsidy.
There's a big debate in healthcare industry about raising consumer alarms over DNA testing and their possible health risks – your thoughts?
Clayton Lewis: Because we are a wellness company, and not a healthcare company, even though we're doing whole genome sequencing, we're only looking at genetic variances related to wellness. There's a lot of debate about BRCA1, however our objective at Arivale is to give you your genetic dispositions and wellness state, to help you understand how to optimize wellness and so you stay healthy, not to diagnose disease. That's the primary reason we're not sharing the information with people on those genetic variants which might predispose them to chronic or very serious diseases.
What made you decide to go from a full time GP at Maveron to the hard work of running a company?Clayton Lewis: That's a great question. VC is definitely a dream job. At Maveron, we focus on people we want to back, ahead of any business idea. Lee Hood had been on the top of my list for six years, and I'd built a great relationship with Lee. He has such extraordinary respect, and not only has he received the the National Medical of Science from President Obama, he's one of only fifteen people who has been a member of all three National Acadamies. He's founded 15 companies representing over $150 billion over his career. Back in October, Lee invited me to go to dinner, and told me—Clay, I want to launch a new industry, scientific wellness, and create the largest company of my career, and I want you and Maveron to partner with me on this. As an early stage investor, I typically will drop in on a 30 to 40 percent basis to help launch our companies. In 2014, we did an IRB approved study when I was doing this for 30 to 40 percent of my time, where I learned three things. For cohorts who are actively engaged in healthcare, and who were healthy, how many of this group could we identify transitions, where they might not understand their healthcare trajectory; second, what was our ability to change that path; and third, how could we start to get insights into scientifically validated metrics. We had 108 individuals in the study, and we found that 90 percent of them had meaningul, nutritional deficiencies or toxin levels, 70 percent had chronic problems like heart disease or diabetes, and 5 percent were already living with disease.
My own story, is I have been participating in Ironman triathalons, and had been on the board of Trustees of Harborview Medical Center, and I'd been the CEO of a health and wellness company. I have a passion for health and wellness. I entered into this study, and thought—since I'd been training for the Ironman—I'd be the healthiest person in the study. I was shocked to learn I was prediabetec. It turns out, I had been experimenting with the Paleo diet, because I thought people on that diet were thg e folks who were faster. It turned out, because of my genetics, I had issues with protein and fat, and on the flip side process carbohydrates really well. The Paleo diet was actually causing material damage to my body. By switching back to putting rich, complex carbohydrates back into my diet, it moved my markers back to the normal range. So, to answer the question of why I'd leave full time venture capital and become a CEO, it's because I saw that we can take people, and in the scope of a year, really help them how to optimize their health. Our company is now over a year old, and we find we have over 90 percent engagement. Third, there's ultimately the real opportunity to develop scientific, validated metrics for wellness. My partners at Maveron, and our LPs, love extraordinary, big, audacious, bold ideas, which this is—and that the best use of m time was spending 90 percent of my time doing it. I'm still a General Partner at Maveron, but literally 95 percent of every waking moment is focused on bringing Lee's vision to life. So really, it's, A, it's my passion, and B it's an extraordinary chance to launch a new industry, and change the world.
Finally, why the expansion into California?
Clayton Lewis: When we look at the state of California, it's the sixth largest economy in the world, and it's very big and important in terms of market size. Plus, the predisposition of residents of California is to think about their wellness. Third, after we launched in Seattle, we got some nationwide press, although we really tried to focus on Seattle—but we started to put together people on a waiting list. We literally had hundreds of people on the waiting list in California, asking us when we've be available in this market. Two weeks ago, we launched into California at the Health 2.0 conference, and Lee gave the keynote at Exponential in San Diego, reaching out to individuals to join the program there.