Abstract
While pharmacogenomics (PGx) presented to many as the poster child of personalized medicine, in the context of moving away from the “one size fits all” model of pharmacological therapy of diseases to a more tailored approach addressing the individuality of each person, the application of PGx has been hindered by numerous challenges. These challenges range from issues with study designs in scientific research, both clinical and for discovery, policy and regulatory hurdles affecting insurance coverage, to the very fundamental need for adequate training for laboratorians, physicians, and pharmacists. Moreover, access to services and addressing health disparities in personalized medicine generally and PGx specifically remain a complicated endeavor. PGx-related ethical, legal, and social issues continue to be a point of concern for those looking to implement PGx in clinical practice. Additionally on the technical side, the speed with which next generation sequencing (NGS) technologies have evolved, generating tens of thousands of rare PGx variants adds a new layer of challenges requiring accurate interpretation and assessment of functional role of novel variants to determine their impacts on drug response and possible toxicities. Without consensus and standardized approaches to testing and interpretation, integration of PGx into routine clinical care becomes an unattainable task. In this article we aim to address some of the challenges that impede broad adoption of clinical PGx testing, and to shed the light on needed steps towards a successful implementation of PGx, with the goal of improving health outcomes individually and for the general population.