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Director, Tardive Dyskinesia Assessment Clinic, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN; Assistant Professor of Psychiatry, Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis
Reprints: Dr. Dean, Department 116A, One Veterans Dr., Minneapolis, MN 55417, fax 612/725-2292, charles.dean{at}med.va.gov
Abstract
While the development of personalized or molecular medicine is a laudable goal, there remain multiple barriers to its implementation. For example, little is known about the functions of noncoding regions of DNA, as well as the interplay of drug response, environmental factors, and the patient's genetic profile. In addition, there is a constant influx of new information on genetic factors such as epigenetic variation that could further complicate the development of medications based on the genetic profile, as well as the cost of profiling. However, assuming that clinically relevant genetic factors will be discovered and that drugs can be developed based on the molecular changes induced by those genetic factors, I suggest that the costs involved may substantially exceed the savings brought about by abandoning our current "one drug fits all" approach. While there is no doubt that our current approach is inefficient and expensive, remarkably little attention has been paid to the potential costs of molecular medicine. Given the current economic crisis, the time is ripe for a debate on this issue.
Key Words: personalized medicine, pharmacoeconomics, pharmacogenomics
Published Online, May 5, 2009. www.theannals.com, DOI 10.1345/aph.1L563
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  J S. Leeder and S. P Spielberg Personalized Medicine: Reality and Reality Checks Ann. Pharmacother., May 1, 2009; 43(5): 963 - 966. [Abstract] [Full Text] [PDF]
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