The genomic revolution: is the real risk under-investment rather than bankrupt health care systems?

There is an element of 'scientific determinism' in much of the discussion of the genomic revolution. Recognition of the potential for improving health is more than matched by worries about both the ability of health care systems to cope and the potential for genetic testing to lead to discrimination. There are five main uses for genomics in the development of human diagnostics and therapeutics: pharmacogenomics, gene therapy, pharmacogenetics, genetic testing of symptomatic or at risk people, and population genotyping. Although there are potential health gains, several concerns exist: health gain may increase funding pressures on health care systems; providing cost-effectiveness thresholds may mean drugs for some patient groups may not be developed; random population genetic testing will meet economic and ethical obstacles; and private sector patenting risks a loss of data and access to data, which will inhibit the development of potentially cost-effective tests and therapies.