John Dobak had learned about genomic testing in the 1990s and been tracking the evolution of this new approach to detecting cancer, and other diseases. Yet few had been able to turn it into an easy to use diagnostic tool. In 2011, Dobak decided he would take the risk, focusing on genomic testing for melanoma, a cancer that is expected to affect about 100,000 Americans this year.
For more than 5 years, Dobak worked with researchers to create an adhesive that would eliminate the need for painful biopsies–the traditional approach to testing for skin cancer. In 2017, with the help of a friends and family round, he introduced DermTech, a California-based startup, using small adhesive stickers to collect samples for melanoma testing.
“Before this, no one was really looking at the root cause of melanoma and why these cells were turning cancerous. But, with decades of research, through the work done in genomic testing, we now know that changes in the genome are occurring, and if we can see that, we can see if it’s cancerous or not.”
However, early on, dermatologists were a bit skeptical and hesitant to adopt DermTech’s approach. Dobak says that more than consumers, it was the dermatologists and the insurance companies that they had to convince.
“Payers operate from a place of fear. They worry that any new technology is going to be over utilized. That’s why it’s very hard for new technology to thrive because of our third-party payer system. Payers are actually more resistant than practitioners. Patients who want to use this tech should push for insurance companies to cover it.”
DermTech is covered under some private insurance plans and by Medicare. But, Dobak says there’s still a lot more work to be done in the US, getting it as widely available as possible. In fact, if someone wants their insurance to cover a DermTech test (and it currently doesn’t fall under his/her coverage), the company has created a letter that they will send out on behalf of the patient to the insurance provider, urging them to reconsider. Patients just have to go to the DermTech website and request it.
Dobak argues that DermTech could actually be beneficial for the healthcare system beyond just better diagnoses. He breaks it down with stats: There are approximately 200,000 cases of melanoma diagnosed each year. And yet, there are more than 4 million diagnostic procedures performed on possible melanoma cases. “Doctors don’t want to miss it. So they’ll test, even if there’s any hesitation.”
That means patients are enduring countless biopsies regularly, which are not only uncomfortable, but expensive for the healthcare system. Where it would cost $1,200 to $1,400 for each test to go through the conventional route, DermTech’s sticker is less than $100 for patients, typically.
“We could essentially eliminate all those biopsies. Because we know that the genes are not turned on, which would be indicative of melanoma.”
DermTech’s adhesive captures enough epidermal cells to perform the genomic testing required, while refraining from cutting altogether. And if caught early, melanoma is one of the more treatable cancers: in fact 99% cases are curable.
Dobak started this company because he saw this process first-hand when a family member was diagnosed with melanoma, but a bit too late. The spot that had developed into cancer was determined after countless biopsies that came back negative, so much so that the doctor ruled out melanoma entirely because he couldn’t find a problematic spot. Turns out, the doctor should have kept testing.
This experience made him witness the gaps in the system, he says, and go on this quest to find a better solution. “For the last thirty years, we’ve been looking at how we can find better ways of testing, shining lights on moles, and whatnot. But now after years of research and development, we’ve found something that actually works.”
For those patients who cannot find a local dermatologist using DermTech, they can turn to the company’s online platform: DermTech Connect. With the help of a nurse, the patient can collect the same on her own, and send it for testing. It comes to about $75. “That’s pretty affordable,” he says.
But Dobak hopes that one day they’ll be able to work with primary care physicians to do melanoma testing, making it even easier, and more accessible.
“There’s been an epidemic of melanoma for the past 15 to 20 years with cases continuing to rise. The only dip we saw was through COVID and that probably has to do with a reduction in testing. But melanoma continues to be a huge challenge for the healthcare industry.”
A culture of sunbathing (particularly after staying indoors for long periods of time), Dobak says, can lead to burns and it’s those burns, he says, that are damaging.
While Dobak feels optimistic about the future as DermTech continues to grow, he’s not shy to acknowledge the difficulties he faced along the way: “There were periods in our business that we were struggling to have enough capital, to keep the doors open, and ensure that we’d be able to pay everyone for the next three to six months.”
Although the venture started with friends and family, DermTech went public, in an effort to raise more funding.
Currently the company’s offering is applicable to about 90 million covered Americans. Dobak wants to double that. “People are tired of being cut. This is the way forward.”