The Theranos Kerfuffle: a setback, but is it for the best? (updated)

click to enlargeSome clarity emerges from the controversy around Theranos and last week’s Wall Street Journal exposé [TTA 16 Oct]. Last week’s rebuttal/denial released by the company said remarkably little, which disturbed Roger Parloff, the Fortune writer who profiled the company in June 2014’s high-profile cover story. He failed to reach CEO Elizabeth Holmes, who on her break from an all-day with the Harvard Medical School Board of Fellows, taped a segment with CNBC stock tout Jim Cramer (a questionable priority indeed–Ed.) Fortunately he received more specific answers via email from General Counsel Heather King. It clarifies among other things that venipuncture, not finger stick, is used in the majority of their tests in practice, and that dilution of samples is within industry practice for use in third-party analyzing machines. There also seem to be two sides to the proficiency-testing story. (Oddly, no mention of the sensational claims around British biochemist Ian Gibbons who was key to Theranos’ patent development and the alleged legal threats to his widow.)

For those who have difficulty getting through the WSJ paywall, Mr Parloff’s summary of the WSJ article’s main points is helpful. His conclusion: Theranos is wisely ‘dialing back’ its USP on drawing blood through finger stick to “Smaller samples. Smaller needles. Better experience.” (A neat pivot from what Theranos ‘made their bones’ on and still features–tiny finger-sticks.) His open-ended question (for, presumably, the next article): can it profitably run its low-cost testing business when it’s using the same analyzing machines as the big testing labs; and while cheaper, can doctors and patients trust the Theranos tests (which are a matter of health, and perhaps life and death) if they’ve flunked their first test at transparency?

Another view from Health 2.0 supremo Matthew Holt over at his Health Care Blog is that for Theranos, this blow is eminently recoverable if they play their cards right. Witness the recovery made by 23andMe, now in the good graces of FDA after having blown it badly to near-shutdown. Getting past the usual H20 promotion, Mr Holt is on the money here:

  • The lab business has been decentralizing and democratizing (lowering price) anyway–Theranos is hardly the only game in town, there have been startups for the past five years mining this vein (ahem)
  • The most important trends in health care are #1 chronic care management and #2 consumerism, not lab tests
  • Company valuations based on investment and press hype are bonkers and Stark Raving Mad, mit out a relationship to reality.

There’s a buried but tasty piece of speculation on Theranos’ real market. Because of the makeup of the corporate board, heavy on government, retired military and defense types, Theranos’ real market may not be retail and consumer-driven, but governmental entities such as the Department of Defense. You do have to slog through the usual extraneous cracks about old, white male Republicans and Rupert Murdoch to get to it, though. Not that Theranos is the first company that’s ever played this game. Your Editor will go a little farther–is Theranos betting on a change of parties?

Updated: An seemingly equivocal stance by an early investor, Steve Jurvetson of Draper Fisher Jurvetson, adds some more fog to the debate depending on your interpretation, but to this Editor it’s a proper step back. The reference to Elon Musk and Tesla also confirms that This Is Not Doom. Silicon Valley Business Journal. If you have time, you can watch the full Bloomberg News video included at the end. Hat tip to Chris Seper in MedCityNews’ Morning Read, though this Editor differs.

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