In this context it becomes important whether physicians will take a role of gatekeeper for tests that may prove to be inappropriate. Furthermore, one must question whether physicians are appropriately educated to take on this role, and we must guard against physicians simply becoming tools for commercial genetic testing companies to look more legitimate and sell more tests. Moreover, it is no surprise that some companies have tried to get financial support from the

healthcare system (Brdicka and Macek 2009) or insurance companies, and are attempting to gain the support of physicians working within the health care system. DTC GT companies are also developing tools to store genomic information in electronic health files as well as to enable physicians to access the genomic information of their consenting patients (Vanier 2009). Moreover, companies are also trying to establish collaborations with MK-8669 molecular weight healthcare institutions and academic researchers. Ironically, the highly hyped DTC offer of genetic testing could vanish in this way, as it may merge into the regular healthcare system (while still, marketing tests directly to consumers and to physicians). Regulatory evolutions Next to the volume of sales, the future of the DTC market will

be highly influenced by regulations meant to govern the sales and marketing of DTC genetic testing services. Discussions about this phenomenon regularly reveal the deficiencies AZD9291 chemical structure in the current regulatory frameworks (Kaye 2008). As many companies operate from the

USA, it will be crucial to see how this country will develop regulatory oversight in the future. After the partnership announcement between Pathway Genomics and the drugstore chain Walgreens to sell DTC genetic tests, the US Food and Drug Administration (FDA) decided to investigate the activities of DTC companies more carefully (Allison 2010; Genetics and Public Policy Center 2010). Between May and July 2010, the FDA sent letters to various companies telling them that they were unable to GNA12 “identify any Food and Drug Administration clearance or approval number” (Food and Drug Administration 2010b). Moreover, in mid-July 2010, the FDA held a meeting to discuss the oversight of laboratory developed tests (LDTs) (Food and Drug Administration 2010a). The issue of (lack of) oversight of LDTs or “home brews” is closely related to that of DTC GT since many of the tests offered by DTC GT companies could be considered LDTs. Until now, the FDA did not require that most LDTs be reviewed for clinical validity (the exception being those genetic tests that produce a result “for the purpose of diagnosing, treating, or preventing disease” (e.g., breast cancer and prostate cancer)) (Genetics and Public Policy Center 2010).