Vishram Singh - Textbook of Anatomy Upper Limb and Thorax.. Volume 1 (1).pdf
Gutwiser final 2013 berkeley
1. GUTWISER
APRIL 3, 2013
PERSONALIZED NUTRITION
EMPOWERING INDIVIDUALS
TO RESHAPE THEIR BODIES
WITH SCIENCE
INTERVIEWS: 102
ADRIEN BURCH
BUBBA BROOKS
CHRISTINA CHANG
TATIANA ECOIFFIER
ANNA MAYBANK
LORIS DZAGOYAN
2. GUTWISER TEAM
Brandon Brooks Anna Maybank Tatiana Ecoiffier Adrien Burch Christina Chang Loris Dzagoyan
Ph.D MBA Ph.D Ph.D MBA M.Eng
4. CROWDSOURCING HEALTH
Research: Patient communities:
Connect to people with
Crohns around you
Map the human
microbiome with
citizen science
179K patients, 1K+ conditions
Crowd sourced clinical trials
General population People with serious diseases
5. Using cutting-edge sequencing technology, Gut Wiser is a consumer-facing• Red = self-referring, “asymptomatic” individual customers seeking personal analysis
Gut Wiser service to analyze bacterial community in the digestive system and provide •a
•
web-based platform where individuals can easily interpret and find relevant •
Green = self-referring, “symptomatic” individual customers
Blue = peer or heath practitioner referred, “symptomatic” customers
Purple = organization customers seeking aggregated individual customer data
information about their results based on published scientific data. • Black = relevant to all customer segments
1) Partners • Stool sample collection
• Partnership with • Analysis of the sample; • Maintaining 1) For testing service • Health conscious
scientific literature sequencing of the 16s rDNA • Membership individual customers
gut bacteria; creating a personal health
community through:
a. Research engines • Who is our target customer?
complete profile of the through • Retail partner/outlet
• Pay-as-you-go
with disposable income
customer gut microflora scientifically-based
(Google Scholar,
Pubmed) b. Journals
• • Quantified self?
Providing customers with a
comparison of their microflora
self-knowledge • Referral • Symptomatic
(undiagnosed illness)
(Science, Nature, • People with digestive issues?
profile with up-to-date peer-
• Do-It-Yourself non-
reviewed scientific literature 2) For data service individual customers
Journal of Intestinal
Microbiology)
•
• Doctors? diagnosis
Creating a database
aggregating customer results
clinical • Subscribers
• Pay-as-you-go • Vulnerable/dependent
• (digestive issues,
Food product
manufacturers • Research disorders,
for research purposes
mood institutions that individual customers
• Chronic-disease
• Quantified self
groups
want data?etc…)
obesity,
patients
• Easy-to-use testing kit • Prevention and/or • Consumer facing- • Health practitioners
• Patient groups
• Health providers • Operational lab monitoring existing advertising (traditional and
• Research grant- facility conditions (crohn’s • Food supplier/health alternative doctors)
• Database of disease, colitis,
making agencies stores
translated gut • Researchers:
microbiology literature
IBD) • Peer
2) Suppliers recommendation government
into plain English
• Sampling devices • Web platform for • Tool to perform • Health practitioner institutions/private
• Shipping service consumer access discovery-based referral sector/nutritional health
• Lab sequencing • Data access for science • Scientific publication supplement companies
facilities scientists
• Collection kit
• Sample handling • Product placement sales (i.e. probiotic drinks)
• Sequencing cost ($20/customer) • Subscription model (sell testing kits + results)
• Technical worker (lab, bioinformatics, statistic) • Free kits, pay for results
• Web development management • Health providers pay
• Marketing • Researchers pay for data
• Customer service
6. WE STARTED WITH SCIENCE AND
INFORMATION…
“Here’s a snapshot of your gut flora”
“High diversity is correlated with lean
people”
1
2 Symptomatic /
proactive individuals
3 • Traditional MDs:
“the science isn’t there”
• Healthy don‟t care about data/
awareness: “but if you can tell me what
4 diets actually work / how to lose weight”
• Symptomatic individuals want
solutions: “if you could tell me how to
build up my tolerance to spicy foods”
7. PIVOT TO: A COMMUNIT Y PLATFORM
Your Bacterial Diversity Results
Pain A lean person
•Can‟t lose weight or
successfully keep it off
•Too many unfounded
diet fads
YOU at week 8
MVP
Gain 1) TEST: An obese person
Gut bacteria
•A more scientific analysis
approach to
dieting
2) TRACK:
Online
results Which diets worked for
others?
3) SHARE:
Community Paleo
platform Juice cleanse
Atkins
Gluten-free
Raw food
Probiotic supplements
8. DOES THE SCIENCE MATCH THE
CUSTOMER‟S WANTS?
Hypothesis Results
Symptomatic individuals ✗ Want interventions
want info to better that the science can’t
manage their conditions (yet) offer
Weight-loss seekers want Want specific direction
info on how to maintain / + proof (sustainable
lose weight results, not fads)
9. HOW DO WE REACH WEIGHT LOSS SEEKERS?
What about people not in a
program… who are health seekers?
10. CUSTOMER ARCHET YPE:
THE FEEL-BETTER
Female, 30
years +, high
disposable
income
Comfortable Already healthy:
talking about But wants to be
poop! 100%
Comfortable Not just fitness:
with new Interested in
technology wellbeing
Highly educated
about health
12. PIVOT TO: SPECIFIC PRODUCT
RECOMMENDATIONS
1 .) ANALYSE
2.) COMPARE
3.) SUGGEST
13. HOW DO WE REACH FEEL BETTERS?
$100 NUTRITIONIST Diet
✖
$80
diagnosis
“Feel better”
• Holistic
practitioner
• Unlicensed
Behavior
change ✔
No MD approval
Product suggestions
Less expensive for client
14. COMPETITIVE SPECTRUM:
SCIENCE VS. MARKETING?
Gut Wiser
Provide Data
Metametrix
CustomVite Renew Life
FitKit
GeneMe Cust. Prob.
Vitaganic
Sell Products
15. TWO REVENUE STREAMS:
KIT SALES + PRODUCT SALES
Amazon platform
Net Revenue from Kits Probiotics sales / customer/mo. $30
x # mos./yr 12
= Annual sales /customer $360
Price per kit $80 x Gutwiser cut 15%
= Profit /customer /year $54
- Gutwiser cost per kit $60 Fully Personalized
Probiotics sales per customer/mo. $60
X # mos./yr 12
= Profit /Kit $20 = Annual sales per customer $720
x Gutwiser cut 40%
= Profit /customer /year $288
16. HOW IT WORKS
Nutritional
product vendors Consumer
15% Prob Kit
$$ spent
$$ received
Consumer‟s
$$ spent Kit Nutritionist
$80 wholesale
Kits Analysis WebSite
17. WILL WE KEEP DOING THIS? YES!
Phase 5
Phase 4 Reach out
Phase 3 Test our to a larger
Create the platform with market
Phase 2 database nutritionists
and their
Provide Begin to customers
probiotic to teach in
Phase 1 customers nutritionist
Continue and assess schools
Customer their effect
Discovery
21. LaunchPad Cent ral
KEY PARTNERS KEY ACTI VI TI ES VALUE PROPOSI TI ONS CUSTOM RELATI ONSHI PS
ER CUSTOM SEG ENTS
ER M
GETcu st o me r: h e a lt h Ma n a g in g sa mp le To o l t o p e rfo rm GET cu s t : p e e r We a lt h ie r wo me n ,
t ra ckin g a p p » co lle ct io n a n d d isco ve ry-b a se d r e co m m e n d a t io n » st ru g g lin g wit h we ig h t
a n a lysis p ro ce ss wit h scie n ce » lo ss (DIY), 2 5 + »
Nu t rit io n a n d la b su p p lie r » GET cu s t :
p ro b io t ic su p p le me n t DIY n o n -clin ica l p r o m o s t o h ig h -e n d Ph a rma »
ve n d o rs » Se q u e n cin g /a n a lysis sn a p sh o t o f yo u r g u t n u t r it io n is t s »
Pro b io t ics
o f 1 6 s rDNA g u t b a ct e ria t o co mp a re
La b se q u e n cin g KEEP cu st : ma n u fa ct u re rs »
b a ct e ria » t o t h a t o f le a n p e o p le
fa cilit ie s (o u t so u rcin g ) Disco u n t e d ,
»
» Fo o d ma n u fa ct u re rs
KEY RESOURCES CHANNELS
p u rch a sin g a d s »
Ge t
Sa mp lin g d e vice s »
r e co m m e n d a t io n s
1 . ) Pr o a ct ive life
We b p la t fo rm fo r fo r o t h e r Fo o d su p p lie r/h e a lt h
Sh ip p in g se rvice » im p r o ve r s 2 . )
co n su me r a cce ss » s u p p le m e n t s /d ie t s st o re s »
Pa s s ive n u t r it io n is t
Gyms » t o t ry ba se d on
Op e ra t io n a l la b fa cilit y Co n su me r-fa cin g a d s clie n t s »
y o u r p r o file »
We ig h t Wa t ch e rs » » »
Pe e r re co mme n d a t io n
»
COST STRUCTURE REVENUE STREAMS
Se q u e n cin g a n d a n a lysis co st ($ 6 0 /kit fo r ma t e ria ls/la b o r) » Pro d u ct p la ce me n t sa le s (i.e . p ro b io t ic d rin ks) »
Ove rh e a d (we b d e v, cu st o me r se rvice , ma rke t in g e t c) » Pa y p e r p a cka g e (3 kit s + in d ivid u a l re su lt s) »
24. LaunchPad Cent ral
KEY PARTNERS KEY ACTI VI TI ES VALUE PROPOSI TI ONS CUSTOM RELATI ONSHI PS
ER CUSTOM SEG ENTS
ER M
Pro b io t ic/su p p le me n t St o o l sa mp le Ge t re co mme n d a t io n s GET cu st : p e e r Fo o d ma n u fa ct u re rs
ma n u fa ct u re rs » co lle ct io n » fo r o t h e r re co mme n d a t io n » p u rch a sin g a d s »
su p p le me n t s/d ie t s t o
La b se q u e n cin g FDA 5 1 0 K a p p ro va l » t ry b a se d o n yo u r GET cu st : h ig h -e n d 1 .) Pro a ct ive life
fa cilit ie s (o u t so u rcin g ) p ro file » n u t rit io n ist /h e a lt h imp ro ve rs 2 .) Pa ssive
Cre a t e co mp le t e g u t
» co n su lt a n t » n u t rit io n ist clie n t s »
micro flo ra p ro file fo r
Use scie n ce , n o t
Nu t rit io n ist s (p ro d u ct cu st o me r » KEEP cu st : Nu t rit io n ist s »
t ria l/e rro r, t o b e t t e r
re fe rra l) » Me mb e rsh ip ,
u n d e rst a n d imp a ct o f
KEY RESOURCES d ie t mo d ifica t io n s o r CHANNELS
a b n o rma lit ie s »
Te st in g kit » To o ls t o Fo o d su p p lie r/h e a lt h
n u t r it io n is t t o st o re s »
We b p la t fo rm fo r
m a k e s cie n t ifica lly
co n su me r a cce ss » Co n su me r-fa cin g a d s
b a s e d p r o b io t ic
»
r e co m m e n d a t io n »
Pe e r re co mme n d a t io n
»
COST STRUCTURE REVENUE STREAMS
Ove rh e a d (we b d e v, cu st o me r se rvice , ma rke t in g e t c) » Pro d u ct p la ce me n t sa le s (i.e . p ro b io t ic d rin ks) »
Se q u e n cin g a n d a n a lysis co st ($ 6 0 /kit fo r ma t e ria ls/la b o r) » Pa y p e r p a cka g e (3 kit s + in d ivid u a l re su lt s) »
Su b scrip t io n fo r p e rso n a lize d p ro d u ct re cs a n d d isco u n t s »
Fre e a cce ss t o co mmu n it y p la t fo rm »
p r o b io t ic s a le s »
Li c e n se d fr o m b u si n e ssm o d e lg e n e r a t i o n .c o m u n d e r a Cr e a t i ve Co m m o n s At t r i b u t i o n -S h a r e Al i ke 3.0 Un p o r t e d Li c e n se
29. MOCK UP OF IDEA #3
Prebiotics
Patient Page
Probiotics
Nutritionist Nutri. Page
Kits DataBase
Analysis
30. HOW CAN WE MAKE
RECOMMENDATIONS?
1.) Profiling: 2.) Community rating: 3.) Matching:
We analyze your sample Other Gutwiser users have We look for a user that
and can see who else has rated probiotics based on looks similar to you and
a similar profile to you their personal experiences who has rated a probiotic
31. CHANNEL ARCHET YPE
Naturopathic doctor Registered Dietitian (R.D) Nutritionist / Health Coach
Licensed physician Are licensed Not credited, Unregulated
Holistic method Can work in hospital Can be certified from certain school
must meet the continuing “personalized” approach
professional education
requirements of ADA
Practitioners would:
1/ recommend our service free of charge
2/ be motivated by coupons for discounted
or free product
3/ ask for monetary compensation for
endorsing service
32. NUTRITIONIST AS CHANNEL
GET: KEEP: GROW:
Product • Community • Customer
referral results referrals
Nutritionists
• Can‟t order labs without MD
• Want to attract more clients
“Feel betters”
Wk 0 Wk 4 Wk 8 Wk 12
Baseline: Results 1: Results 2: Results 3
Test 1 Test 2 Test 3
33. WHAT DO NUTRITIONISTS WANT?
“Trial and error” Metametrix Gutwiser
Technology Intuition PCR , traditional Sanger Ultra high-throughput
sequencing Illumina-tag sequencing
Process See what happens MD approval required to No MD approval
order test
Output Client perception only • Select bacteria • Complete bacteria
snapshot profile
• Yeast and fungus • Personalized diet,
• Drug resistance supplement, and
• Parasites probiotic
• Short chain fatty recommendations
acids
• Inflammation
Cost to user Free $400 for one kit $400(?) for 3 kits
Value Limited, static bacterial Robust, dynamic
profile bacterial profile
34. SELLING THROUGH NUTRITIONISTS
Hypothesis Experiment Outcome
Sell through Too expensive to build 1. Trade shows are
nutritionists: direct sales useful for reaching
supplement retailers as
Nutritionists: partners
1.) Trade shows
$1000/booth, 400
attendees 2. Use nutritionists as
2.) Schools
only initial channel:
Supplement retailers reach them through
$5250/booth, 63000 schools. Break even
attendees and reach 1,950
grads/year
Holistic nutritionist schools: 3. Next steps:
~ 13 schools x 150 grads/year RETHINK OUR
= 1,950 grads/year CHANNELS AT SCALE!
35. SCIENCE VS MARKETING
SCIENCE
Revenue model 1: Manufacturing and selling our own probiotics
Revenue model 2: Selling data to probiotics manufacturers
Key questions:
Do people care enough about the science? No!
Do probiotics companies care about the science? No!
Nutritionists care about science and people care about what nutritionists
think
MARKETING
Revenue model: Diets and probiotics sales
Channel: Nutritionists (Avon model) vs direct to consumer via
infomercials
Science is just one part of our story
36. TWO REVENUE STREAMS:
KIT SALES + PRODUCT SALES
Net Revenue from Kits
(per customer) Overhead Expenses
Price per kit $80 # Sales employees 2
- Gutwiser cost per kit $60 + # of Technicians 1
= Profit per kit $20 + # of Web dev employees 1
x # of kits/yr 3 + # of Science Experts 1
= Kit profit per customer per year $60 = # of Employees 5
x Avg salary $50,000
= Salary expense $250,000
Net Revenue from "Amazon platform”
A Probiotics sales per customer/mo. $30
x # mos./yr 12
Travel and
Profit per Breakeven # of conference/expo expenses $3,000
= Annual sales per customer $360
customer customers: x # of conferences per
x Gutwiser cut 15%
= Gutwiser product profit per year 6
customer per year $54 $114 2,667
= Travel/conference
expenses $18,000
Fully Personalized Probiotics
B Probiotics sales per customer/mo. $60
X # mos./yr 12 Other overhead $3,000
= Annual sales per customer $720 x # of mos. 12
x Gutwiser cut 40% = Other expenses $36,000
= Gutwiser product
revenue/customer $288 $348 874
Total SG&A Expenses $304,000
37. CAN WE MAKE TRULY CUSTOMIZED
PROBIOTICS?
Revenue Model Volume constraints Time to customer
Option A: • Product price: ~ • None • 2-4 wks for analysis
$30/mo.
Kit + Amazon • Readily available
marketplace/platform • GW profit: 10- probiotics
of product reccs 25% cut of sales
Option B: • Product price: • “150K tablets” • 2-4 wks for analysis
~$60/mo. minimum order,
Kit + Fully 15k piggybacking • +4-12 wks to
personalized, custom • GW profit: 150- off existing orders develop customized
probiotics 900% markup probiotics
possible
Source: Academy of Nutrition and Dietetics
38. INTELLECTUAL PROPERTIES
Where is our value
Database
Supplement recommendation algorithm
Patentable insights on the gut microbiome
How de we want to protect it
Database: consent form the participant may be required
Algorithm: Patent vs. Trade secret?
The university in this process?
39. REGULATORY INSIGHTS FROM AN FDA
LAWYER
FDA Class I Medical Device status • Find a FDA-cleared,
marketed device to
•“As soon as you say 'test kit' it is going to be a med device" qualify for Class I
•“It would be the manufacturer‟s responsibility to get FDA exemption
approval, but your company could get in some trouble if
using an unapproved FDA test kit.”
• Cannot make
Who interprets the results? What claims can be made? claims/reccs beyond
what a non-licensed
•”If the consumer reads the results – fine to give consumer
some guidance on nutrition supplements they should be practitioner can do,
taking… but not for any disease treatment or abnormal (i.e., stay away from
condition.. You can probably say you may have symptoms of claims on disease
IBS but need to go to an internal medicine MD to find out.”
treatment/diagnosis)
Financial incentives with partners must be disclosed
• Be transparent that
•“Giving nutritionists a kickback would probably be okay but we/nutritionists are
might need a disclosure – e.g., „I understand that this recommending
practice owns the MRI ctr‟”
•“You might need to disclose on the website that all of the
products that
products offered / recommended here have a relationship we/nutritionists reap
with the company.” financial benefit from
40. SYMPTOMATIC/PROACTIVE INDIVIDUALS -
HOW BIG IS THE MARKET?
Digestive
TAM: Digestive diseases, 60 M adults 1 disease
SAM: IBS sufferers: 15.3M adults 60 M adults
% that take supplements: 50% 2
x approx monthly spend on supplements: $20 3 IBS
Target = $1.84 BN 15 M
TAM: Dieter s, 1 88 M adults 4
SAM: Women dieters: 104M 5 Dieters
“Wealthy dieters” comprise only 20% 6 188 M adults
x approx monthly spend on supplements: $ 20 7
Target = $4.98 BN
Wealthy
women
1 NIH (NIDDK), incl. Crohns, IBS, UC dieters
2 Center for Disease Control and
Prevention
20.8M
3,7 Customer interview
4,5 Gallup
6 Marketdata Enterprises
41. NUTRITIONIST MARKET SIZE
Estimated number of women aged 35-64 who get information about nutrition from a
nutritionist
35-44 45-54 55-64 Total
%age of total US pop who get
info from nutritionists 2% 3% 3%
%age of women who get info
from nutritionists 1% 2% 2%
x Number of women in US pop 20,128,000 22,459,000 19,038,000
= Est. no. of women who get
info from nutritionist 201,280 336,885 285,570 823,735
Gutwiser sells to 5% of market at $114 profit/sale = $4.7M
Source: Academy of Nutrition and Dietetics
42. SELLING THROUGH NUTRITIONIST
SCHOOLS
Cover our costs from teaching at nutrition schools
Make a small profit from future referrals of our students
Income from providing testing and teaching in nutritionist
schools Income from referrals by nutritionists
Revenue Costs Total number of students 1950
%age of students who go on to practice 50%
Wholesale price per kit 80 Curriculum development (hours) 35 = Practicing nutritionists reached 975
x Number of students 1950 x Salary per hour 50 x %age of nutritionists who refer clients to Gutwiser 50%
= Total revenue 156000 = Curriculum development cost 1750 = Number of nutritionists referring clients 488
x Clients per nutritionist 10
Salary per hour 50 = Clients using Gutwiser 4875
x Teaching hours per course 15 x Profit per client to Gutwiser 174
= Cost per course per school 750 = Profit from referrals by nutritionists via school channel 848,250
x Number of schools 13
= Cost to teach at every school 9750
Cost per kit 60
x Number of students 1950
= Cost to provide kits for students 117,000
Total revenue from teaching 156,000
- Total cost to reach 1,950 students 128,500
= Revenue from nutritionists schools 27,500
43. PROBIOTICS MARKET SIZE
• Probiotic supplements annual
North American revenue
~ $750M in 2011
• Growing 35% in 5 years
~ $1bn in 2016
• 5% of US market ~ $50M
44. NUTRACEUTICALS MARKET
Functional food, functional beverages and dietary supplements:
2011 US market for nutraceuticals = $56.4bn
2011 Global market = $142.1Bn
2017 Global market = $204.8Bn
Editor's Notes
ChristinaDieter people are educated about hos to eat and want a great level of details, however ..% we re not interested into the scienceHealthy people with not real interest for themselves actually would refer it to symptomatic friend
Christina
ChristinaCanvas changes:1.) Axed wealthier women dieters for ‘feel betters’2.) Removed any mention of us analyzing samples ourselves and replaced with outsourcing to uB or AG3.) Removed WW/gyms and replaced with high-end nutritionists/health consultants4.) Replaced value prop associated with weight loss to value prop associated with feel betters5.) Added peer recommendation to customer relationshipsWHAT SHALL WE RE-ADD RE WEIGHT LOSS? DO WE NEED TO ADD OTHER THINGS TO ACTIVITIES?
AnnaTell Kristi’s storyEnd point out that Lululemon did $1bn in revenues last year
AnnaInsights from interviews with feel betters –Not as interested in tracking results and actively learning about others’ experiences (Patients Like Me)Don’t want complete DIY ….Really want specific, personalized product recsTrust nutritionists – typically pay $100/nutritionist visit – want stamp of approvalTakeaway:Focus the community around PRODUCTS, not EXPERIENCE
1.) Analyze your gut bacteria profile2.)Compare to other people in our database3.)Recommendations for you based on what’s worked for people with similar profiles
Anna – talk about specific nutritionist we met – Tamar CohenKey points:Nutritionists type: Focused on hollistic health, unlicensedWhat they do: 1.) diet diagnosis 2.) behavior changeTo do the diet diagnosis, they like to order labs but they can’t Metametrix is the closest thing they have – needs approval, $400/kit and doesn’t give recommendations, only data – hard to interpretThey liked the idea of buying wholesale and selling to their clients
LorisDo people care enough about the science? Do probiotics companies care about the science?Nutritionists care about science: People care about nutritionists’ opinions
LorisWe envisioned 2 solutions:The 1st one was the Amazon platform were we would proposed to sell the products of probiotics manufacturersIn the 2nd one, we wanted to sell our own product, fully personalized
Loris1. Manage FDA 510K approval w/ kit supplier(6 mos.)2.Analysis + sequencing of samples(2-4 wks)3. Develop product recs platform(1K samples)4. Partner with and train nutritionists5.Partner with probiotics manuf. as platform vendors
WEEK 1
WEEK 2
WEEK 3
WEEK 4
WEEK 5
WEEK 6
WEEK 7
WEEK 8
LorisWe envisioned 2 solutions:The 1st one was the Amazon platform were we would proposed to sell the products of probiotics manufacturersIn the 2nd one, we wanted to sell our own product, fully personalized
Loris
93905790
The global market for probiotic dietary supplements generated approximately USD 2.4 billion in the consumer sector and is expected to grow 8-10% on an annual basis.For ingredient suppliers, the demand for probiotics is great. In the coming five-year period, the market is expected to grow more than 35%. The market is primarily driven by Asia today, but consumption in the US is expected to exceed demand by more than 60% during the same period""