Meet the California start-up reimagining prenatal screening

Born out of a need to address the problems within the US prenatal healthcare system, Juno Diagnostics is on a mission to shake up the landscape of traditional prenatal care. We speak to co-founder and chief medical officer, Dr Mathias Ehrich, and director of genetic counselling, Katie Sagaser, to find out more.

Tell us a bit more about the story behind Juno.

Mathias Ehrich: Our aim has always been to create equitable access to high-quality prenatal care. We want all women to have the opportunity to learn about their pregnancy and feel empowered to make informed decisions.

In launching the world’s first capillary-based cfDNA non-invasive prenatal screening test, we looked to create an affordable test that met our goals of accessibility and transparency.

So in 2011, the Juno co-founders and I were working together at a life sciences company to pioneer the development and commercialisation of the first cell-free DNA-based non-invasive prenatal screen (NIPS) in the United States.

There, we drove a lot of innovation in pregnancy care and prenatal care up until the company was acquired in 2016. At the time, only about 800,000 women had true access to NIPS.

So when we looked at the problem again, we found a couple of things in the market that were not working. 

First of all, most NIPS tests were too expensive, and second of all, they were difficult to access. In almost 50 percent of all US counties, women don’t even have access to an OB/GYN, let alone a phlebotomy service.

So women really had a problem with getting access to NIPS technology.

That’s when we realised that we needed to develop something that we could send in the mail and that could be shipped in a box, in a cheaper and a lot more accessible way. We needed to meet women where they are.

Katie Sagaser: From my experience as a genetic counsellor, I was able to see the ways in which a new type of test is introduced, especially in the genetic testing world.

There’s a lot of ‘healthy fear’ at first, but sometimes that ends up paralysing patients in a way that if we, as folks in industry, don’t equip them with the right resources, it prevents them from being able to utilise technology that can be extremely empowering, in this case, for their pregnancy.

NIPS is not novel anymore. Yet, there are still OB-GYN providers out there who are reticent to incorporate it into their routine screening programmes for whatever reasons.

So one of the things that we have really wanted to do at Juno is work together with our providers, colleagues and partners, to try to equip them with the resources that they need to help their patients get the information that’s right for them and to ultimately, make an informed decision.

How does your approach help women access pre-natal screening tests at home?

KS: We’ve designed an extremely personalised approach because we really want to be meeting people right where they are.

At present, for the non-invasive prenatal screening test, there are two different pathways that people can follow.

They can either request the test themselves and a physician will review the order request and approve it, or their provider can order the test for them.

Once the order is placed, the patient is prompted to set up a Zoom call for a sample collection. This is going to be the same whether they’re doing the non-invasive prenatal screening test or the foetal gender test.

After the actual sample collection, patients are equipped with everything they need to return the kits. They just have to send them to the lab.

After we analyse the sample, they can access their results in their myJuno account.

What’s really unique is that our platform keeps them informed every step of the way, similar to how they might be used to tracking an order.

ME: We always wanted to empower women and encourage them to do things at their own pace. They have all the information they need on the platform and if something isn’t clear, they can get in touch with a genetic counsellor at any time of the process.

However, the platform is not a replacement for their OB-GYN provider. It’s something that’s intended to complement those services and make everybody’s life easier.

A lot of people were introduced to at-home testing during the pandemic. Do you think Covid has changed the way people view digital health?

KS: I think that prior to 2020, especially in the genetic counselling space, the whole concept of telemedicine was still intriguing. Covid has definitely changed that.

However, I think there are still challenges in the United States pertaining to our maternal health crisis and our OB-GYN access that telehealth on its own is not going to instantly fix.

ME: I think the pandemic did bring about a pretty big shift in the minds of the providers and they started to become more open to things like telehealth and taking care of patients remotely.

You’ve launched three products in 2022. What feedback have you received so far?

KS: The feedback has been exceptionally positive. I have been helping out with some of the Zoom calls on the collection side and people really appreciate the kind of support that we offer.

First of all, they like the fact that they’re talking with a real person in real time, but they also like that when they have questions, they don’t feel like a burden, and they can seek help and express their concerns.

Currently, the tests are only available in the US. Are you considering expanding your services globally?

ME: We’re extremely proud of all the work that we did in 2022. Yes, as we continue to grow, we’re considering expanding beyond the US when the time is right and in a way that is most appropriate.

It’s not Europe! I think Europe will be on our list at some point as well, but it is a little bit more difficult since most European countries have very particular healthcare systems to navigate. We promise it’s something exciting, though!

For more info, visit junodx.com.