If we have evidence-based web 2.0, we need evidence-based pharmacogenomics as well. That is why I try to create a database of real clinical implications. The final report on pharmacogenomics released by US Advisory Committee is a must-read for medical professionals. Some excerpts:
PGx has drawn great attention for its potential to redirect personal care and public health paradigms in the United States and abroad. It has begun to offer powerful tools for using information about individual genetic variations and drug responses to “personalize” or “customize” health care decisions. Some early applications of PGx include HER2/neu testing of metastatic breast cancer patients to determine responsiveness to Herceptin®, the use of thiopurine 6-mercaptopurine testing to manage the treatment of children with acute lymphoblastic leukemia, and the use of CYP2C9 and VKORC1 testing of those at risk for harmful blood clots to guide warfarin dosage.
PGx has the potential to improve management of chronic diseases, which pose the greatest clinical and economic burdens in the United States and elsewhere. The current therapeutic approach for these diseases is to slow their progression and diminish their symptoms. PGx may help improve symptoms and reduce health care costs through more effective treatments and fewer avoidable ADRs. However, PGx also could increase costs if drugs for smaller markets are priced higher to recoup research and development costs or if PGx testing is added to the cost of drug treatment.