certain protein markers of inflammation, fat and carbohydrate metabolism, and cell death. Tethys hopes that by looking at those markers in combination, it can predict whether a person is likely to get diabetes in the next five years. The level of risk is communicated through a scale of 1 to 10, with 10 being the highest risk.
There are plenty of skeptics out there. The company’s first clinical trials focused on large groups of patients in Denmark, and then Sweden. That made people wonder if the results were generalizable to more diverse populations in the U.S. “It was a question everyone had,” Urdea says. “If it works on Europeans, does it work on Hispanics, African Americans, and other Caucasians? The answer is yes. No differences in race classes. With all the clinical data in hand, we’ve been selling to physicians and seeing quite an impact.”
But exactly where do you start selling a product like this? Primary care physicians would be a natural place, but such a big and fragmented customer base is too much for a small company like Tethys. So it has focused geographically on certain states with the highest rates of diabetes and obesity—a belt of states that starts in the east in New Jersey, dips down into the south through Georgia, Alabama and across to Texas, then up into the Midwest.
Doctors in those states see so many people with warning signs of diabetes that there is growing interest among doctors who are essentially becoming “prevention specialists,” Urdea says. “They don’t call themselves that, but that’s what they are,” he says.
One doctor in Iowa is a particularly enthusiastic early adopter of the Tethys test—he even likes to call his patients at lunchtime and ask them what they are eating, Urdea says.
While that might be a fun anecdote to tell investors and the occasional journalist, I can’t imagine most doctors would take that much interest in their patients’ overall well-being, especially when it’s something they don’t get paid to do. If Tethys is going to gain wider usage of its test, it needs to advance from the early adopters like the Iowa doctor to larger group physician practices, which have multiple specialists who work together.
Doctors in settings like this really want to know more than just the Tethys risk score—they want to know whether it will motivate patients to reduce their risk, and if so, what the best medical interventions are.
“People who get the risk score are going to ask, ‘what do I do about it?’ Urdea says. “It’s about risk identification, and also risk mitigation.”
Actually, it’s about more than that, too. Tethys, with a test that lists at $585, will need to show that an ounce of its form of prevention is worth its weight in gold—by saving people from going down the long, expensive road of chronic diabetes treatment. If Tethys can really make a persuasive case that this test scares people straight, and they end up avoiding the cost of diabetes, it could save people a lot of heartache, and the healthcare system a lot of money. It might even set an example for other entrepreneurs wondering if there’s any way to make money in healthcare through prevention.
“The economics of this are critical,” Urdea says. “We can’t burden the economy with lots of more expensive tests.”
