Pharmacogenetic research in the past few decades has uncovered significant differences among population groups in the metabolism, clinical effectiveness, and side effect profiles of many clinically important drugs. In addition, differences in how various populations view and respond to medicines underscores the need for an individualized approach to pharmaceutical therapy. Historically, the special needs and responses to pharmaceutical treatment of these groups have been undervalued or ignored. According to the authors, all of these factors must be taken into account in the design of cost management policies such as formulary management, therapeutic drug substitution, and step-care protocols. These programs should be broad and flexible enough to enable rational choices and individualized treatment for all patients, regardless of racial or ethnic origin.