Prospects for pharmacogenetics and ecogenetics in the new millennium

Genetics and genomics are certain to have a large impact in drug developmen t and proper pharmaceutical treatment of subgroups of patients with many sp ecific diseases. We should be able to increase the therapeutic margin for m any agents. Genetic variation will also be important in refining estimates of risk from all kinds of environmental agents and in choosing more effecti ve and more cost-effective risk reduction strategies. The linkage of inform ation about genetic variation and information about environmental, nutritio nal, behavioral, metabolic, medical, and healthcare factors will be necessa ry to interpret the variation in clinical and public health terms. However, there is a great risk that present federal and state efforts to protect co nfidentiality and privacy of individual genetic information may make such r esearch infeasible. In Michigan, a Governor's Commission has sought to stri ke an appropriate balance.