Pharmacogenomics: economics

The science of microbial genomics requires special attention, in part, because of its medical and economic importance. Even more so, microbial genomics provide important lessons for all of computational biology and comparative genomics, and therefore, microbial genomes are prototypes for the future of pharmacogenomics. 

This situation of escalating costs from improved survival is not new our society has traditionally spent more for incremental (sometimes minor) improvements in care. From an economic perspective, the question becomes how much more and for how long. Every additional dollar spent on health care is another dollar from the Gross Domestic Product (GDP) that cannot be used for other purposes. This opportunity cost of technological improvement will be one of the primary economic and social issues that must be addressed. Pharmacogenomics-based drug therapies will likely provide a test case. Will these new and expensive therapies be rationed if so, on what basis Will our society continue to value improvements in health care above other goods and services such as education, the environment, and Social Security ... 

Understanding the human genome should lead to improved therapies that may have a favorable impact on health care expenditure. In many cases, pharmacogenomics-based therapies will be therapeutic (and economic) substitutes for other more invasive procedures such as surgery or will reduce the need for expensive support care such as long-term assisted living or skilled nursing care. 

Pharmacogenomics represents a true paradigm shift for health care. The potential to effectively treat or cure most diseases will come at a price. These therapeutic advances will create economic and ethical dilemmas at all levels of the economy. At the individual level, there will be economic barriers to access, particularly for disadvantaged or disenfranchised populations. The costs of diagnostic tests and treatments may be prohibitive, and mechanisms (e.g., insurance, income subsidies, rationing) to distribute and pay for care must be devised. With limited health care resources, trade-offs between cost, access, and quality are inevitable. 

At the health care provider level, choices will be made among many therapeutic regimens that differ in effectiveness and cost. At the producer level, pharmaceutical companies must decide whether targeted drug development is economically feasible. Will there be a sufficient return on investment to justify the risks involved in pharmacogenomic research Will companies only pursue research and drug development for diseases for which there is... 

---