To date, routine implementation of genomic data in healthcare has been largely confined to variants affecting drug response, using either a point-of-care or a preemptive approach.53,54 The point-of-care approach relies on genotyping at the time of drug prescription and very rapid turnaround of genomic variant data: programs using this approach have been implemented for clopidogrel55 and for warfarin.34,35 The preemptive strategy relies on identifying subjects at increased likelihood of receiving either a single drug56 or a range of drugs57,58 that have been associated with variable responses due to known pharmacogenetic factors.
