CardioDx: Bringing Molecular Diagnostics Into the Cardiovascular Arena

Article preview from IN VIVO -  February/March, 2010

Buoyed by their success with Genomic Health, a trio of West Coast VCs have expanded their portfolios of molecular diagnostic companies, with many following similar themes. CardioDx has developed a test to distinguish between patients who should move on to cardiac imaging and those they are comfortable managing otherwise. Such a rule-out test is a challenging proposition. But if adopted, and more broadly, as molecular diagnostics move into new and broad markets like cardiology and metabolic disease, pharma could use this opportunity to its advantage in many settings, including co-marketing arrangements.

CardioDx: Bringing Molecular Diagnostics Into the Cardiovascular Arena

Article preview from IN VIVO -  February/March, 2010

CardioDx is one of several molecular diagnostics companies founded by a well-known trio of West Coast VCs to be fast finding itself in the spotlight.

Buoyed by the success of Genomic Health, venture capital firms Kleiner Perkins, Mohr Davidow, and TPG have expanded their portfolio of molecular diagnostics companies, with many following similar themes.

** One company, CardioDx, has developed Corus CAD, a test cardiologists can use to distinguish between patients who should move on to imaging and the cath lab, and those they are comfortable managing without moving them on the diagnostic pathway.

** That's a challenging proposition, but initial clinician feedback for the product, which launched last year, appears good, especially among primary care physicians – somewhat to the surprise of the company.

** A confluence of issues around the use of diagnostic imaging could serve CardioDx well as it drives adoption of Corus CAD.

In the early part of the decade now ending, three West Coast venture capital firms – Kleiner Perkins Caufield & Byers (KPCB), Mohr Davidow Ventures (MDV), and TPG – had already established themselves as pioneer investors in molecular diagnostics. KPCB and TPG had invested early in Genomic Health Inc., whose Oncotype Dx gene expression test has become the exemplar of a rationally based diagnostic test that can command a premium price. And the VCs were now turning their attention to other therapy areas around which to start new diagnostics companies.

"It looked like oncology was going to work," recalls Fred Cohen, MD, of TPG, "Brook and Michael [Brook Byers of KPCB and Michael Goldberg, now of MDV] and I were on the board of Genomic Health at that time and we said 'Ok, we don't want to start companies that would compete with Genomic Health because that's bad for business. [An earlier version of this article incorrectly stated that MDV was also an early investor in Genomic Health. Michael Goldberg had been on the board of Genomic Health since 2001 but did not join MDV until 2005.] So what other markets should we go after?'" They ended up focusing on several, among them Tethys Bioscience Inc. in diabetes, XDx Inc. in transplant rejection, and later, CardioDx Inc. in cardiovascular disease.

The VCs had also formulated two rules of the road along the way for these new investments, based partly on their experience with Genomic Health. "We always start with the pharmacoeconomics," says Cohen: focusing on a decision that's expensive and poorly made. Otherwise, he says, "it's not a good place to work. Because ultimately, we believed then and we believe more firmly now, you have to bend the cost curve." Every one of their companies is designed to help doctors make better decisions, he says, adding that obviously, the more expensive the decision, and the more it looks like the flip of a coin, the better a setting it is for a new diagnostic modality.

Mark L. Ratner

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Companies mentioned in this article

Abbott Laboratories Inc.

Abbott Vascular Devices

Bristol-Myers Squibb Co.

CardioDx Inc.

Columbia University

Duke University

Genomic Health Inc.

Gilead Sciences Inc.

CV Therapeutics Inc.

Intermountain Health Care Inc.

On-Q-ity Inc.

Tethys Bioscience Inc.

XDx Inc.

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