A Letter From Our CEO: Reinventing Allergy Care

Lessons I’ve learned from taking AncestryDNA to the masses

I gravitate toward opportunities to transform large categories with massive consumer pain points.

Allergy care is one such category. Allergies impact over 120 million Americans - more than hypertension, mood disorders, and diabetes. Allergy care has a staggeringly low Net Promoter Score of -69, making even other lousy experiences, like going to the pharmacy, seem pleasant. Why is allergy care such a massive consumer pain point? Because allergy care is a highly fragmented industry of small physician practices and big pharma companies that lack the incentive to innovate. In other words, allergy care desperately needs a category leader that is an advocate for the consumer and brings together cutting-edge scientific research, modern customer technology, and a delightful customer experience. So, I founded @Nectar Allergy @Nectar Life Sciences.

As I embark on this journey, I reflect on my time as the former EVP at Ancestry.com and founding executive of AncestryDNA. I went back to the old playbook and tried to identify the catalyzing lessons that transformed a niche opportunity, with a total addressable market of $10M, into a mainstream category worth over $2B today.

Overall, we accomplished this by developing strategies that delivered exceptional service to the masses without compromising on the quality of the science. Today, I’m leading with the same guiding principle at Nectar. But if I had to get more specific on how we actually accomplished all of this and more, I would say there are three lessons learned from AncestryDNA that I’m applying to Nectar.


Lesson #1: Marry great science with an exceptional customer experience

In 2010, DNA sequencing costs were plummeting and approaching the magical price point of $99, which drove massive scale. That scale allowed scientists to use AI to transform an experience that, at the time, could only tell consumers if they were predominantly African, Asian, or European, to one that could locate their ancestors in Cameroon, Northern Spain, or even County Kerry, Ireland. Once the AI flywheel got going, AncestryDNA continued to differentiate the product experience and created a massive barrier to entry that endured.

An allergy is the immune system overreacting to a substance or allergen (e.g., pollen, cats, peanuts, etc.) that is otherwise harmless. We’ve known for over 100 years that you can train or desensitize a human’s immune system by exposing them to increased amounts of the allergen over time. Allergy shots, as they are commonly known, are effective but inconvenient since they require multiple doctor visits per week over the course of years. Over 88% of customers that are recommended allergy shots either refuse treatment or quit.

Nectar’s breakthrough technology is a daily drop, administered under the tongue, of personalized allergen extracts. Allergy drops use the same FDA-approved allergens to accomplish the same result safely and from the convenience of home. The drops are stable at room temperature and are under the TSA limit for liquids, so you can even take them with you on your travels. Recently, allergy drops have shown great promise as a safe and effective treatment for food allergies in children. I predict that this breakthrough technology will expand the market from the niche 2M customers that currently take allergy shots and make immunotherapy a mainstream allergy treatment for tens of millions.

Lesson #2: Build the product for the mainstream market, not the early adopters

The AncestryDNA early adopters were vocal about how they wanted the product to evolve. They wanted tools that allowed them to go deeper into the data, like a chromosome browser to analyze the raw DNA results. Sounds fun, right? Instead of making the product more technical, we stripped out the jargon, introduced a map, and used beautiful graphics to visually show them where their ancestors originated from. This path took us longer as it required us to educate the market, but had we not made this hard choice in the face of fierce criticism from some of our most loyal and early customers, the product would not have gone mainstream and been sold to nearly 10% of all Americans.

Less than half of all allergy sufferers have been to an allergist. Even those that have been recommended allergy shots don’t understand immunotherapy and the potential for long-term relief of their allergies. Therefore, the Nectar journey starts by educating consumers about the underlying causes of their allergies. We even show you, for example, a picture of ragweed (a common allergen), where it's found, and when it pollinates. From there we educate consumers about their personalized therapy, how it was selected, and the long-term benefits. This approach will take longer, but we believe educating consumers and building lasting brand trust will pay off and ultimately unlock the mainstream market with the promise of massive economic returns.

Lesson #3: Trust the data, even when it goes against your gut

Why would Ancestry, a family history company, launch a DNA test? The obvious and completely rational hypothesis is that you can find distant relatives to collaborate with in order to fill out your family tree. After all, our loyal customers knew their ethnic background based on their extensive knowledge of their family history. The data, however, suggested that consumers were primarily interested in finding their ethnic origins. Internally, this was quite controversial and there was a lot of pressure to go against the data. The right approach is to take your opinions (and ego) out of the equation and either disprove the data or follow it; ignoring it is not an option. In the end, the data was right and even today, ethnic origin is the leading marketing message that drives AncestryDNA.

At Nectar, we are gathering consumer feedback and taking a disciplined approach to data. Those learnings have led to numerous iterations of the underlying technology and product experience. With every iteration, we are seeing not only improvements in NPS and CSAT but also in unit economics.

The lessons from AncestryDNA are proving to be timeless. In a little over a year, the team has made exceptional progress in translating rigorous science into a delightful product experience and becoming a trusted partner in comprehensive allergy care. We’ve launched a beta product, are well on our way to launching our first physical clinic in New York City, and are preparing to conduct our first clinical study. Above all, we are having a lot of fun cracking this $450B market and fulfilling our vision of putting an end to allergies.