Meyer Michelle N, Papageorge Nicholas W, Parens Erik, Regenberg Alan, Sugarman Jeremy, Thom Kevin
Department of Bioethics and Decision Sciences, Geisinger College of Health Sciences, Danville, PA, USA.
Department of Economics, Johns Hopkins University, Baltimore, MD, USA.
Am J Hum Genet. 2024 May 2;111(5):833-840. doi: 10.1016/j.ajhg.2024.03.010.
Some commercial firms currently sell polygenic indexes (PGIs) to individual consumers, despite their relatively low predictive power. It might be tempting to assume that because the predictive power of many PGIs is so modest, other sorts of firms-such as those selling insurance and financial services-will not be interested in using PGIs for their own purposes. We argue to the contrary. We build this argument in two ways. First, we offer a very simple model, rooted in economic theory, of a profit-maximizing firm that can gain information about a single consumer's genome. We use the model to show that, depending on the specific economic environment, a firm would be willing to pay for statistically noisy PGIs, even if they allow for only a small reduction in uncertainty. Second, we describe two plausible scenarios in which these different kinds of firms could conceivably use PGIs to maximize profits. Finally, we briefly discuss some of the associated ethics and policy issues. They deserve more attention, which is unlikely to be given until it is first recognized that firms whose services affect a large swath of the public will indeed have incentives to use PGIs.
目前，一些商业公司向个人消费者出售多基因风险评分（PGIs），尽管其预测能力相对较低。可能有人会认为，由于许多PGIs的预测能力很一般，其他类型的公司——比如销售保险和金融服务的公司——不会有兴趣将PGIs用于自身目的。但我们的观点恰恰相反。我们通过两种方式来阐述这一观点。首先，我们基于经济理论构建了一个非常简单的模型，该模型描述的是一个追求利润最大化的公司，它能够获取单个消费者的基因组信息。我们用这个模型表明，根据具体的经济环境，即使PGIs存在统计噪声，且只能略微降低不确定性，公司也愿意为其付费。其次，我们描述了两种合理的情景，在这些情景中，不同类型的公司可以利用PGIs来实现利润最大化。最后，我们简要讨论了一些相关的伦理和政策问题。这些问题值得更多关注，而在人们首先认识到那些服务会影响大量公众的公司确实有动机使用PGIs之前，这种关注不太可能实现。
