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Pharmacogenomics is referred to as the scientific field that studies the influence of genetic variation on drug response by correlating gene expression or single nucleotide polymorphisms (SNPs) with a drug’s efficacy or toxicity. Pharmacogenomics aims to develop the rationale for individualising drug therapy, based on a patient’s genetic profile, to maximise drug efficacy and/or minimise adverse drug reactions (ADRs). Such innovative approaches, where drugs or drugs and food combinations are optimised against an individual’s unique genetic profile, would constitute ‘personalised medicine’. This notion stems from ancient times, when Hippocrates first said that ‘. . .it is more important to know which kind of person suffers from a certain disease than knowing from which disease somebody suffers’. The recent technological revolution that led to the various high-throughput methods for determining an individual’s genetic make-up — namely, next-generation sequencing and microarray-based technologies — has brought the prospect of personalised medicine even closer to fruition, but, at the same time, has posed some dilemmas and has serious ethical implications that have to be overcome and addressed properly. The first important issue is the choice of the genotyping platform, which is directly dependent on the cost of the pharmacogenomic test that is being offered. Despite the fact that there are numerous mutation detection and screening methods, there is no single platform or methodology that prevails for pharmacogenetic testing. Genotyping can be done using different approaches with respect to the throughput, amplification-based and separation technologies and labelling. The variety of detection approaches makes it not only difficult, but also challenging to determine which is better suited to a laboratory setting, although DNA sequencing is considered to be the gold standard for the identification of DNA sequence variants, particularly with the advent of the next-generation sequencing technologies. The initial investment costs and the expected test volumes are some of the factors that need to be taken into consideration prior to choosing the genotyping technique, including hardware and software, testing reagents, and kits. The choice of genotyping platform goes hand in hand with the training of the personnel — not only of those performing, but also those interpreting the pharmacogenomic test. The continuing education of personnel in the diagnostic laboratory is crucial for the accuracy of the results obtained (see also below). Alongside this, and closely related to it, healthcare costs represent an important parameter. Generally, the cheaper the pharmacogenomic test, the more likely it is to be undertaken by a patient or prescribed by the physician. Unfortunately, economic barriers to the adoption of genomic data for individualising medical practice exist and mostly depend on the nature of the technology used. Different reimbursement policies from different insurance companies can also pose an obstacle to the rapid dissemination of pharmacogenomics. In EDITORIAL

General considerations for integrating pharmacogenomics into mainstream medical practice