Challanges Faced in Pharmacogenetics

¶ … ethical, financial, and legal challenges to "personalized medicine"? There are a number of challenges associated with personalized medicine, including ethical, financial and legal challenges. Ethical challenges; A main challenge is the way the information gained from testing for pharmacogenetics is used. The information may belong to the patient, but who should have the right to it, especially if a third party, such as an insurance company pays for the tests (Vogenberg, Barash, & Pursel, 2010).

Knowing which treatments may be effective may aid health insurance firms as well as physicians in gaining effective treatment, this could lead insurance firms seeking to coerce patients into tests they do not want to have, for example, fears over additional findings of genetic weaknesses being found. There may be understandable fears that insurance firms may use the information to disclose and refuse insurance to those who may have genetic weaknesses, or be resistant to lower cost treatment options.

Therefore, the ethical issue is who should be given control over the information, and how should be allowed to use it (Vogenberg, Barash, & Pursel, 2010). This issue may be exacerbated where there is treatment for a minor, as there are additional stakeholder and sociality consideration, especially if parents refuse tests (Wilcockson, 2008).

Financial Challenges; A major cost associated with pharmacogenetics is the cost of implementation, not only the tests to identify the patients personal biological characteristics, but the costs associated with personalising treatments and drugs to suit the individual needs of each patient to maximise efficacy while minimising toxicity (Ross et al., 2012). This is costly as it will require greater resources compared to the standardised pharmacological treatments which currently dominate medicine.

In the long-term there may be financial advantages for patients and insurance companies; limited research has indicated lower potential levels of subsequent hospitalization where pharmacogenetics, as well as potentially reducing long drug costs (Epstein et al., 2010). However, the cost of testing and assessment may currently outweigh the potential benefits. Legal Challenges; New treatments and technology are often ahead of legislation. The legal issue may center on the way information is used, and who has access to it, especially with reference to privacy and insurance firms and the potential for discrimination.

It is possible that medical insurance will seek to discriminate against those where genetic testing indicates the need for more costly or personalized drugs, even withdrawing after discovery. The use of these tests may also increase knowledge, which may also result in legal demands for disclosures about drug risks to the public, rather the current position where disclosure is only required for physicians (Wertz, 2003). How would you overcome each challenge? Each of these challenges may be difficult to overcome, but these are some suggestions on how they may be mitigated.

Ethical challenges; Clear development of an ethical code of conduct, clarifying who owns the information and can use it. As insurance firms cannot force treatment on an individual, they should not be able to force tests. Furthermore, the default position should be that the resulting data should belong to the patient, with declarations made to payers with reference to the required and received treatment only. The continued use of ethical committees will also help to overcome these issues.

Addressing legislation to declare priorities will also reduce the pressure in the ethical considerations. Financial Challenges; The relative cost per patient is likely to decrease as the technology develops and becomes more efficient and the practice expands. If more patients and insurance companies use the services it is likely that there will be increased economies of scale; the overhead costs will be spread over more patients, reducing the overall costs. Importantly, pharmacogenetics may also reduce potential exposure and liabilities for inappropriate drug treatments (Ross et al., 2012).

Knowledge of reduced long-term costs and exposure may encourage increased.