Objective: Individualized, or personalized, therapy is highlighted as the declared goal of pharmacogenetics. In this paper, the content and significance of the individualization concept are analyzed. Method: Our analysis is based on a systematic reading of the current literature pertinent to pharmacogenetics. Results: This analysis reveals that the pharmacogenetic understanding of individualization is based on a biomechanistic paradigm. In contrast to a notion of individualized therapy based on a biopsychosocial paradigm, this biomechanistic concept does not provide for individualization in psychosocial terms, but instead leads to the stratification and classification of patient populations. This finding does not necessarily cast doubt on the efficacy of pharmacogenetics, but does call its underlying ideology into question. Conclusion: The term ‘individualization of therapy’ does not reflect the real potential of pharmacogenetics, but instead represents a widely used and theoretically unjustified publicity slogan.

1.
Lazarou J, Pomeranz BH, Corey PN: Incidence of adverse drug reactions in hospitalized patients. A meta-analysis of prospective studies. JAMA 1998;279:1200–1205.
2.
Kurth JH: Pharmacogenomics: Future promise of a tool for identifying patients at risk. Drug Information J 2000;34:223–227.
3.
Kroner WG, Lindpaintner K: Pharmakogenomik und Pharmakogenetik zur patientengerechten Arzneimittelentwicklung. Med Genet 2001;13:239–240.
4.
The European Agency for the Evaluation of Medicinal Products, Committee for Proprietary Medicinal Products: Position Paper on Terminology in Pharmacogenetics. EMEA/CPMP/3070/01. http://www.emea.eu.int/pdfs/human/press/pp/307001en.pdf.
5.
Heiss NS, Rippmann F: Target-Gen bezogene pharmakogenetische Wirkstoffoptimierung in den präklinischen Entwicklungsphasen eines Medikamentes. Med Genet 2001;13:258–262.
6.
Foss L: The challenge to biomedicine: A foundations perspective. J Med Philos 1989;14:165–191.
7.
Siegrist J: Gibt es eine sozialwissenschaftliche Theorie der Gesundheit? Medizinsoziologie 1989;2:4–13.
8.
Marshall A: Laying the foundations for personalized medicines. Nat Biotechnol 1997;15:954–957.
9.
Brockmöller J: Pharmakogenetische und pharmakogenomische Analysen in Phasen 0 bis 4 der Arzneimittelentwicklung. Med Genet 2001;13:263–267.
10.
Sadée W: Pharmacogenomics. BMJ 1999;319:1286–1289.
11.
Weinshilboum R: Thiopurine pharmacogenetics: Clinical and molecular studies of thiopurine methyltransferase. Drug Metab Dispos 2001;29:601–605.
12.
March R: Pharmacogenomics: The genomics of drug response. Yeast 2000;17:16–21.
13.
Bottles K: A revolution in genetics: Changing medicine, changing lives. Physician Executive 2001;27:58–63.
14.
Pirmohamed M, Park BK: Genetic susceptibility to adverse drug reactions. Trends Pharmacol Sci 2001;22:298–305.
15.
Sadée W: Genomics and drugs: Finding the optimal drug for the right patient. Pharmacol Res 1998;15:959–963.
16.
Otterness D, Szumlanski C, Lennard L, Klemetsdal B, Aarbakke J, Park-Hah JO, Iven H, Schmiegelow K, Branum E, O’Brien J, Weinshilboum R: Human thiopurine methyltransferase pharmacogenetics: Gene sequence polymorphisms. Clin Pharmacol Ther 1997;62:60–73.
17.
von Uexküll T, Wesiack W: Wissenschaftstheorie: ein bio-psychosoziales Modell; in Adler RH, Herrmann JM, Köhle K, Schonecke OW, von Uexküll T, Wesiack W (eds): Psychosomatische Medizin, ed 5. München, Urban & Schwarzenberg, 1996, pp 13–52.
18.
Pauli HG: Gesundheit und Krankheit: Sozialmedizinische und medizinsoziologische Aspekte; in Adler RH, Herrmann JM, Köhle K, Schonecke OW, von Uexküll T, Wesiack W (eds): Psychosomatische Medizin, ed 5. München, Urban & Schwarzenberg, 1996, pp 63–72.
19.
Siegrist J: Soziologie des Arztes und der Arzt-Patient-Beziehung; in Siegrist J (ed): Medizinische Soziologie, ed 5. München, Urban & Schwarzenberg, 1995, pp 227–263.
20.
Antonowsky A: Unraveling the mystery of health. San Francisco, Jossey Bass, 1987.
21.
Kirchheiner J, Brøsen K, Dahl ML, Gram LF, Kasper S, Roots I, Sjöqvist F, Spina E, Brockmöller J: CYP2D6 and CYP2C19 genotype-based dose recommendations for antidepressants: A first step towards subpopulation-specific dosages. Acta Psychiatr Scand 2001;104:173–192.
22.
Roses AD: Pharmacogenetics and the practice of medicine. Nature 2000;405:857–865.
23.
Böhringer S, Epplen JT: Genetische Variabilität in Populationen: Prädiktiver Indikator und Klassifikationsinstrument für Pharmakogenomik? Medizinische Genetik 2001;13:249–251.
24.
Bristol LA: A regulatory protocol for pharmacogenomics services. Pharmacogenomics J 2002;2:83–86.
25.
Senior V, Marteau TM, Peters TJ: Will genetic testing for predisposition for disease result in fatalism? A qualitative study of parents’ responses to neonatal screening for familial hypercholesterolaemia. Soc Sci Med 1999;48:1857–1860.
26.
Marteau TM, Lerman C: Genetic risk and behavioural change. BMJ 2001;322:1056–1059.
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