Prospects for pharmacogenetics and ecogenetics in the new millennium

Genetics and genomics are certain to have a large impact in drug development and proper pharmaceutical treatment of subgroups of patients with many specific diseases. We should be able to increase the therapeutic margin for many agents. Genetic variation will also be important in refining estimates of risk from all kinds of environmental agents and in choosing more effective and more cost-effective risk reduction strategies. The linkage of information about genetic variation and information about environmental, nutritional, behavioral, metabolic, medical, and healthcare factors will be necessary to interpret the variation in clinical and public health terms. However, there is a great risk that present federal and state efforts to protect confidentiality and privacy of individual genetic information may make such research infeasible. In Michigan, a Governor's Commission has sought to strike an appropriate balance.