Personalized medicine: how much can we afford? A bioethics perspective.

This article examines some major challenges to the clinical implementation of personalized medicine from a bioethics point of view. Challenges arise from the need to choose between competing scenarios in the allocation of healthcare resources. If a choice between competing scenarios must be made, the key question is what sort of medicine a society wants to have and how much its citizens are willing to pay for it. Cost-effectiveness is crucial, but not the only criterium. Pharmacogenomics-based personalized medicine is also challenged by competing concepts of 'good' medicine. However, a real dilemma for health policy arises when a trade-off between implementing public health practices and personalized medicine must be made. This paper tries to show that from a bioethics perspective these concepts are not mutually exclusive. In future, a scenario that seeks to integrate both concepts in a complementary fashion may maximize the benefit for both individuals and the community.