Pharmacogenomics and the evolution of healthcare : is it time for cost-effectiveness analysis at the individual level?

The efficacy and toxicity of any given drug can vary substantially from one individual to another. The heterogeneity in individual genetics contributes, in part, to this variability. Pharmacogenomics uses each patient's individual genetic information to identify the drug with the best efficacy-safety profile for that patient. However, heterogeneity is also present in individuals' preferences for alternate efficacy-safety profiles. We argue that as healthcare evolves towards individualised drug therapy, preference elicitation and cost-effectiveness analysis should also be performed at the individual level to maximise societal welfare.