When will it start paying the bills? The science and development is somewhat fragmented like the rest of health care, and this is not to say in any way that phenomenal breakthroughs are not occurring by any means as they are. Part of the problem is having enough data, real time data for one. As this article makes reference to warfarin being a potential for genetic testing, the action has been limited and one of the big reasons is maybe because insurance companies won’t pay for the test. Supply and demand like everything else, there has to be a market. Insurance companies want more evidence.
Diagnostics are used for many different studies today than compared to years past and to put a lot of money into a product that fails is not on anyone’s priority list, thus some kind of preliminary stats are helpful if not necessary before the dollars roll in and the project continues.
Of course, oncology is the hottest research areas going for obvious reasons as we have wanted a cure for cancer forever and technology as it has evolved today might just get us there. Do physicians understand biomarkers? Ask one and find out, more than likely not all of it as it gets complicated at their level too as the markers can impact a whole range of drugs, so data mining and getting the definitive information relative to the diagnosis at hand is a challenge. Doctors don’t have time to Google in the 15 minute HMO prescribed office visit.
So now we have the science, and what’s the next area that clouds the issue, it just might be documentation, in other words including this information in an EMR/EHR. What! You bet, you can’t have one without the other. Have we hit the wall yet? 
There are not enough physicians in the US who understand personalized medicine yet and there’s a lot of training to do, so they can in turn discuss and educate patients and prescribe a treatment plan the patient understands. You think patients come in with a bunch of information now from the Internet, wait until they start doing their own DNA research and it will get even more interesting.
Now keep in mind this office visit is still limited to an average of 15 minutes, and we still have all the other administrative work that goes along with an office visit, the coding, prescriptions, etc. and have added on a genomics session, and at this point if a physician isn’t using some type of electronic medical records system, well we won’t go there for now, but it won’t be pretty.
Hedge funds and venture capitalists continue to invest as well as big pharma in selected areas. Everyone wants a return on their investments, including the patients who’s lives are potentially at stake! It might take bigger teams and groups to start bringing things together in a more organized fashion too. We might also start electing some scientists to public office too, gosh knows that couldn’t hurt to have some folks in the know at the top levels too.
The proof of concept on personalized medicine I think has been re-written almost every 
day and will probably continue on the same path for a while until the science is old enough to begin creating some standards beyond the science side of the business. It may take a while as look at how long electronic medical records has gone on and using it for a comparison, and we are still not there, partially due to the way the business grew, fragmented from the start and still in development at all times, so give this some thought too down the road as the physicians are not only faced with genomics knowledge coming down the tube, many have electronic records in their future to adapt to as well, some are already there, but as we have read, most are not. BD
Though the promise of personalized medicine has been widely touted, firms focusing on targeted therapies and companion diagnostics are not getting much bang for their buck - yet. So far, the actual impact of personalized medicine, and specifically Pharmacogenomics-based therapies that predict a patient's response to drugs based on genetic information, has been limited, he said.
That should have been a turning point for firms such as Nanosphere, whose Verigene warfarin genetic test kit was cleared in September 2007, and AutoGenomics, Nanogen, Third Wave Technologies and Luminex, who sell warfarin genetic marker reagents and are developing test kits. Unfortunately, uptake of the tests has been tepid.
http://www.medicaldevicestoday.com/2008/07/personalized-me.html
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