The Rise of Direct-to-Consumer Blood Testing

Several companies now offer individuals the ability to order their own laboratory work without a physician's order. Medical professionals cite both potential benefits, such as early detection, and concerns, including patient anxiety and the risk of unnecessary follow-up procedures.

Industry Overview and Service Models

Several companies have entered the direct-to-consumer blood testing market. Oura, known for its smart rings, has begun offering a blood test for $99 through a partnership with Quest Diagnostics. The company reports it has sold approximately 5.5 million smart rings.

Other prominent services include:

• Function Health: Offers a membership with twice-yearly testing of over 160 biomarkers for $365 per year. The company recently received a $2.5 billion valuation after a funding round.
• Hims & Hers: Offers a similar service testing over 130 biomarkers for $499 per year, currently discounted to $349.
• Superpower: Advertises access to over 100 tests for $199.

Major laboratory networks Quest Diagnostics and Labcorp also offer direct-to-consumer testing through services like Labcorp OnDemand. According to Function Health, 40% of its members come from ZIP codes with median household incomes below $95,000.

The Patient Experience: A Case Study

Lana McDonald, a 34-year-old teacher, ordered a $99 blood test through Oura. Her results indicated eight values outside standard ranges, including high cholesterol and low hemoglobin. The results did not include clinical explanations.

McDonald researched her results online and ordered an additional ferritin test directly, which was also low. She then shared her findings with her primary care physician via a patient portal and waited two months for an appointment. Her doctor ordered repeat tests through his own lab, which were covered by her insurance and showed similar results.

The doctor diagnosed anemia, prescribed iron supplements, and suggested lifestyle interventions for cholesterol, which he was not concerned about. McDonald stated she would not recommend the Oura test to others, noting that similar tests can often be obtained through health insurance.

Medical and Industry Perspectives

Proponents of direct-to-consumer testing argue it provides greater access to health information. Dr. Anna Wexler, an assistant professor at the University of Pennsylvania, stated the appeal is based on an idea that more health information leads to empowerment, particularly for individuals interested in longevity and biohacking.

Dr. Wexler also suggested the growth of these services is a response to frustrations with the traditional healthcare system, including lack of cost transparency and difficulty scheduling appointments.

Dr. Mark Hyman, co-founder of Function Health, stated this kind of testing is valuable for catching early signs of disease and creating predictive health models, calling it the future of medicine.

Medical professionals have raised several concerns. Dr. Jeffrey Linder, chief of general internal medicine at Northwestern University, noted that patients increasingly bring outside test results to appointments for interpretation.

He stated this model may raise unnecessary fears, as indeterminate results are common and can cause anxiety without improving health.

Dr. Linder also cautioned against the normalization of frequent blood testing, stating that annual "routine blood work" is not a standard medical recommendation for healthy individuals. He follows guidelines recommending cholesterol screening every five years and one-time screening for HIV and hepatitis C for most adults, aligning with recommendations from the United States Preventive Services Task Force.

A specific risk identified is a "medical misadventure," where an abnormal result triggers a cascade of further, potentially unnecessary testing. A cited study found that in 33% of cases, the initial test leading to such a cascade was clinically inappropriate.

Company Protocols and Liability Questions

Companies offering these services state they incorporate clinical oversight. Both Oura and Function Health report using third-party clinician partners to interpret tests and contact patients with critical results.

Dr. Ricky Bloomfield, chief medical officer at Oura, stated their blood test product is intended "to complement—not replace" an ongoing relationship with a healthcare provider. Oura stated it has been intentional about starting with a small set of evidence-based labs.

To help explain lab results, Function Health has integrated with OpenAI's ChatGPT Health. A press release from OpenAI emphasized that ChatGPT Health is not designed to replace medical care.

Dr. Anna Wexler raised questions about liability and accountability in this space, noting that companies may contract with physician groups and position themselves as a connecting platform rather than assuming direct responsibility.