Applying the Genome to National Drug Formulary Policy in the Developing World

With pharmacogenetics comes the promise of individualized therapy selection for many common diseases where multiple treatment options are available. Recent advances including the Human Genome Project, the International HapMap project, advances in throughput technology and reduction in cost of genetic testing, and the inclusion of genotype-related dosing recommendations into package inserts all point to the integration of pharmacogenetics into clinical practice. However, many countries will not have access to pharmacogenetics resources to individualize patient therapy for decades to come. The PharmacoGenetics for Every Nation Initiative (PGENI) is a first step to making pharmacogenetics applicable on a global level. Generation of genotype profiles for 'common' population groups within a country will provide a useful, but not perfect resource for incorporating pharmacogenetics into national drug formularies in the form of prioritization or tailored surveillance recommendations for a country's population. Targeted educational efforts will also prepare the Ministry of Health staff from participating countries to better integrate genetic information into many areas of healthcare, including disease management and therapeutic development. The goal should always be optimizing therapy for each individual patient, but pharmacogenetics can be useful now and essential in the future for the developing world.