The intersection of pharmacists and biotechnology—particularly in gene therapy and pharmacogenomics—is transforming health care. These advancements enable pharmacists to increasingly customize treatments based on genetic profiles, enhancing drug efficacy and safety. However, challenges persist, particularly the high costs associated with gene therapies and the ethical dilemmas surrounding pharmacogenomics. As health care evolves, pharmacists must navigate these obstacles to realize the benefits of these innovations while addressing the financial and ethical complexities of this emerging field.
Gene therapy is an innovative medical approach that involves modifying or replacing defective genes to treat or prevent genetic disorders.1 A significant advancement in this field is the development of CRISPR (clustered regularly interspaced short palindromic repeats)-Cas9, a gene-editing technology that allows for precise alterations in a patient’s DNA sequence. CRISPR-Cas9 has shown promise in correcting mutations responsible for various genetic conditions, including sickle cell disease (SCD) and transfusion-dependent β-thalassemia (TDT). Notably, the first CRISPR-based medicine, exagamglogene autotemcel (exa-cel; Casgevy; Vertex Pharmaceuticals Incorporated) was approved in 2023 for treating SCD and TDT, marking a milestone in gene therapy applications.2
As gene therapies become more integrated into clinical practice, pharmacists will be crucial in managing these protocols. Their responsibilities include ensuring the proper storage, preparation, and administration of gene therapy products. Pharmacists are also essential for providing education to health care providers and patients as well as monitoring for potential adverse effects (AEs).
Although gene therapy has the potential to cure diseases, the high cost of treatment makes access extremely difficult.3 Pharmacists play an impactful role in spreading awareness about potential therapeutic options and preventing barriers to patient access.
The limited accessibility for patients is a significant challenge associated with gene therapy.4 The high costs arise from the significant development and research required to create these technologies. Additionally, gene therapy is often associated with being a treatment option for rare or ultrarare diseases, imposing a high cost for individual treatment as there is a reduced population of patients who would receive the treatment.
Gene therapies come with expensive prices for patients, and many health plans either do not cover the already-approved gene therapies on the market or place restrictions on the number of patients who may be treated with the therapy per year.5
Pharmacists have a duty to balance these promising therapies with the financial burden on patients and health care systems. Because formulary decisions incorporate the clinical benefits and long-term impacts of these high-cost treatments, it is important for pharmacists to be involved in helping health care centers weigh the benefits and financial feasibility of gene therapies.