Salt Lake City—On May 27, 1991, three scientists came together to form Myriad Genetics, Inc.

Twenty-five years later, that company has grown into a giant in its field and made scientific breakthroughs that have helped thousands gain the upper hand on ailments that were once practically death sentences. In order to make that big vision happen, its founders thought very, very small—using a person’s genes to see if they were predisposed to aggressive hereditary ailments or to target treatments for disease.

“Back in 1991, when this company was formed, this was a very visionary approach,” said Mark Capone, president and CEO of Myriad Genetics. “In 1991, the very first website was launched, so we were a very long way away from the technology we have now.”

Myraid Genetics boasts the largest clinical DNA sequencing laboratory in the world, with about 120,000 square feet of laboratory space in their Salt Lake City complex. Over the last quarter decade, scientists have been honing the process of isolating and identifying genetic markers and irregularities, giving the laborious process factory-like efficiency.

Scores of laboratory robots, each costing roughly the same as a Lamborghini rolled off the lot, perform a host of tasks—separate genetic material in patient samples, prepare the material for analysis, analyze the samples—and deliver results to their human coworkers, said Jeff Trost, senior vice president of operations for Myriad. The work the human lab technicians do is double-checked by other technicians, he said, to make sure human error doesn’t result in an incorrect diagnosis down the line.

“Computers, when they make a mistake, don’t make just one mistake—they make a whole bunch of mistakes, so we know when there’s a problem. When a person makes a mistake, they only make one or two little mistakes, but each person doesn’t usually make the same mistake,” he said.

Trost said the sheer volume of tests Myriad processes means the company can anticipate what problems might arise during normal testing operations, and guard against those to ensure efficient, accurate testing.

“We’ve seen all the things that can go wrong and know how to prevent that. When you do 10 tests a day, you don’t see everything, but when you do 1,000, you do,” he said.

Capone said while the U.S. has an excellent healthcare system, it isn’t very efficient, resulting in three times more spending than other first-world countries such as the United Kingdom, but lacking in results. Part of the problem is in the timing of diagnoses, which often come too late to treat with inexpensive means, he said, and then treatment is often a case of trial and error.

“When we look at the role Myriad can play, it’s actually in that area of helping—how do we prevent disease, how do we diagnose it more accurately and how do we decide much earlier on what are the appropriate treatments that we might be able to use to provide healthcare much more efficiently with a much better outcome,” he said. “That was the whole principle upon which [the company was founded].”

That role is most prominent as the healthcare system shifts to more personalized medicine—that is, medical treatments that use a patient’s own genetic makeup to help determine the best course of action—which is possible because of the breakthroughs in molecular biology over the last couple of decades.

Doctors have traditionally used information from family medical histories and socioeconomic circumstances and environmental factors in their quest to heal a patient, but a molecular understanding of a disease and what might have actually led to its occurrence, doctors can better prescribe treatments. Capone said only about one percent of drugs on the market today require a molecular understanding of a patient before using the drugs—generalized medicine contributes to the trial-and-error approach—but up to 60 percent of drugs in the FDA approval pipeline have some sort of molecular diagnostic component, helping doctors find the treatment most likely to help a specific patient with a specific ailment.

About three percent of healthcare spending comes from diagnostic costs, Capone said, but the decisions made from those diagnostic results lead to about 70 percent of overall costs. Better diagnostic information means doctors can prescribe just enough of the right kind of treatment, eliminating costs from treatments that don’t work or aren’t necessary, Capone said.

“I think we’ve started to make some significant process as an industry, but there’s a long, long way to go,” he said.

Myriad has been involved with many of the breakthroughs in the field, though, including the isolation of the BRCA 1 gene in 1994 and the BRCA 2 gene in 1995—genes that indicate a hereditary predisposition for breast and ovarian cancer. Myriad has also developed a test for hereditary predisposition for colon cancer. These predispositions mean a patient has more than an 80 percent chance of developing cancer, much higher than the 12 percent or 5 percent chance, respectively, the general population faces. Capone said knowing whether patients have these predispositions for cancer can allow doctors to monitor them more closely and select more targeted treatments.

In addition to those tests, Myriad has developed a test to measure the presence of rheumatoid arthritis symptoms and how effective treatment is, to prevent permanent bone damage from going without treatment for too long or the side effects that accompany overtreatment. They also have a test to see if and how fast a prostate cancer tumor is developing, so a doctor can better determine what and how much treatment is necessary. Another test can tell whether cancer cells are capable of repairing their DNA or not, which could help doctors find the most effective treatment.

“We truly think we’re entering the golden age of personal medicine,” Capone said.