John Dobak had learned about genomic testing in the 1990s and followed the evolution of this new approach to detecting cancer and other diseases. But few had managed to make it an easy-to-use diagnostic tool. In 2011, Dobak decided he would take the risk and focus on genomic testing for melanoma, a cancer expected to affect about 100,000 Americans this year.
For over 5 years, Dobak worked with researchers to create an adhesive that would eliminate the need for painful biopsies — the traditional approach to skin cancer testing. In 2017, with the help of a friends and family round, he introduced DermTecha California-based startup, which uses small adhesive stickers to collect samples for melanoma testing.
“Before, nobody really looked at the cause of melanoma and why these cells became cancerous. But with decades of research, through the work that’s been done in genomic testing, we now know that changes are happening in the genome, and if we can see, we can tell if it’s cancer or not.”
At first, however, dermatologists were a little skeptical and hesitant to adopt DermTech’s approach. Dobak says that more than consumers, it was the dermatologists and insurance companies they had to convince.
“Payers operate out of fear. They fear that new technology will be overused. Therefore, it is very difficult 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 technology should push for insurance companies to cover it.”
DermTech is covered by a number of private insurance plans as well as Medicare. But, Dobak says, there’s a lot more work to be done in the US to make it as widely available as possible. If someone wants their insurance to cover a DermTech test (and it’s not currently covered by their coverage), the company has created a letter that they will send to the insurance company on behalf of the patient, asking them to reconsider. Patients just need to go to the DermTech website and apply.
Dobak argues that DermTech may even be beneficial to the healthcare system, beyond just better diagnoses. He breaks it down with statistics: About 200,000 cases of melanoma are diagnosed each year. And yet more than 4 million diagnostic procedures have been performed on possible cases of melanoma. “Doctors don’t want to miss it. So they will test even if there is some hesitation.”
That means patients regularly undergo numerous biopsies, which are not only uncomfortable, but also expensive for healthcare. Where it would cost $1,200 to $1,400 for each test to go the conventional route, DermTech’s sticker is typically less than $100 for patients.
“We could essentially eliminate all those biopsies. Because we know that the genes are not turned on, which would indicate melanoma.”
DermTech’s glue captures enough epidermal cells to perform the required genomic testing while not cutting at all. And when detected early, melanoma is one of the more treatable cancers: in fact, 99% of cases are curable.
Dobak started this company because he experienced this process firsthand when a family member was diagnosed with melanoma, but a little too late. The spot that had developed into cancer was determined after numerous biopsies that were negative, so much so that the doctor ruled out melanoma completely because he couldn’t find a problematic spot. Turns out the doctor should have kept testing.
Through this experience, he witnessed the gaps in the system, he says, and set out to find a better solution. “For the past 30 years, we’ve been looking at how we can find better ways to test, shine light on moles, and so on. But now, after years of research and development, we have found something that really works.”
For 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 it herself and send it for examination. It comes in at about $75. “That’s pretty affordable,” he says.
But Dobak hopes that one day they will be able to partner with primary care physicians to conduct melanoma testing, making it even easier and more accessible.
“There has been an epidemic of melanoma for the past 15 to 20 years and the number of cases continues to rise. The only dip we saw was from COVID and that probably has to do with a reduction in testing. But melanoma remains a huge challenge for the healthcare.”
A culture of sunbathing (especially after being indoors for a long time), Dobak says, can lead to burns, and it’s those burns, he says, that are harmful.
While Dobak is optimistic about the future as DermTech continues to grow, he is not shy to acknowledge the difficulties he encountered along the way: “There were periods in our business when we struggled to have enough capital, to keep the doors open and to make sure we could pay everyone for the next three to six months.”
Although the company started with friends and family, DermTech went public in an attempt to raise more money.
Currently, the company’s offering applies to approximately 90 million covered Americans. Dobak wants to double that. “People are tired of being circumcised. This is the way forward.”