The driver for Orchid Biosciences' acquisition of UK-based Cellmark Diagnostics from AstraZeneca was not the revenue potential of the existing business--providing DNA forensics test services and genetic disease testing--as much as to get a facility to use as a European beachhead for its SNP scoring business and, eventually, pharmacogenomics tests. The D2C component of those businesses are nascent, as evidenced by the current limited utility of Orchid's website, bonemarrowtest.com, and the fact that it has yet to revive its other sites, SNPs.com and geneshield.com.

A number of genomics firms, attempting to capitalize on both the consumer movement and the power of genetics to create a personalized approach to health care, are trying to create consumer businesses. The two nearest-term opportunities are in aggregating pre-stratified, genotyped patients for clinical trials, often by teaming up with consumer health web sites; and providing pharmacogenetic tests of certain well-known drug metabolism variants. But the players face major hurdles not merely in coming up with proprietary tests, but in getting around ethical, privacy, and reimbursement issues specifically related to genetics, as well as in the potential problem of alienating physicians. At the same time, paradoxically, the consumer may offer the best route to preparing a market for genomic testing, which is likely to be resisted by much of the medical establishment.