Individualized Pharmacogenetic Therapy: A Critical Analysis

Abstract

Objective: Individualized, or personalized, therapy is highlighted as the declared goal of pharmacogenetics. In this paper, the content and significance of the individualization concept are analyzed. Method: Our analysis is based on a systematic reading of the current literature pertinent to pharmacogenetics. Results: This analysis reveals that the pharmacogenetic understanding of individualization is based on a biomechanistic paradigm. In contrast to a notion of individualized therapy based on a biopsychosocial paradigm, this biomechanistic concept does not provide for individualization in psychosocial terms, but instead leads to the stratification and classification of patient populations. This finding does not necessarily cast doubt on the efficacy of pharmacogenetics, but does call its underlying ideology into question. Conclusion: The term ‘individualization of therapy’ does not reflect the real potential of pharmacogenetics, but instead represents a widely used and theoretically unjustified publicity slogan.

Pharmacogenetics, Adverse Drug Reactions and Public Health

“…Such findings are interesting because they reflect current perceptions of the potential of pharmacogenetics in the field of public policy. These perceptions, however, are often not based on rigorous evaluation of available data, but shaped by metaphors like ‘personalization’ or ‘individualization’ of therapy, which are rather publicity slogans than reflections of the actual potential of pharmacogenetics [21, 22]. …”

Putting pharmacogenetics into practice

“…Although early expectations of 'tailor-made' or 'personalized' medicines may have been inflated, and although they remain mostly unfulfilled, more modest benefits are still widely anticipated [2][3][4] . Here we present the results of a study assessing the progress in exploiting pharmacogenetics and current challenges for those attempting to apply this new knowledge.…”

Personalized medicine in context: social science perspectives

“…However, clinicians had used the term personalized medicine since the early 1950s to describe a patientcentred practice that focused on the 'art' of clinical judgement and was often hostile to technology in medicine (4). The term personalized medicine has also been controversial: some claim that it promises more than can be delivered because individualized therapy can only be truly realized in a biopsychosocial paradigm while pgmx is a biomechanistic concept that is instead concerned with the stratification of patient populations (5). Recently, certain actors have preferred other expressions such as stratified medicine as a more accurate description of how drugs are targeted at groups as opposed to individuals (6).…”