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n search of genomic incentives Medical innovation involves a peculiar mix of seemingly contradictory motivations. We need to strike the right balance, says Jonathan Kimmelman. [Jonathan Kimmelman is a genetics researcher and bioethicist at McGill University] In a renewed quest for medical breakthroughs, the Canadian government recently committed $67.5-million for research into "personalized medicine." This bold initiative promises faster, smarter and cheaper drug development by uncovering new targets, identifying patients likely to benefit from experimental therapies, and using molecular markers of disease to predict drug response. Yet, personalized medicine follows on decades of efforts at plying molecular genetics toward drug development. To be sure, these approaches have borne fruit. But the process of developing cures remains painfully slow, error prone and costly. Despite steady increases in industry and public investment in research, the number of new drugs approved each year continues to decline.

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