The genomics revolution has produced a vast amount of information about genes, their functions, and their polymorphisms and has, in turn, dramatically changed the way that drugs are discovered and developed. These newly found capabilities within the pharmaceutical and biotechnology industries have created both optimism and strain for the healthcare market beneficiaries of these new products, particularly in the area of pharmacogenomics. Pharmacogenomics, the integration of pharmacogenetics with the new technologies of genomics, has created the potential for developing new drugs for genetically subdivided markets. While these new pharmacogenomic technologies are providing us with the possibility for customizing drug therapies for patients, they are also creating financial and marketing uncertainties within the healthcare industry and causing conflict between the interests of drug manufacturers, healthcare payers, healthcare providers, and healthcare consumers. Current cost-containment pressures on the healthcare system would seem to favor the adoption of pharmacogenomically targeted drugs. However, the pharmaceutical companies' concern for losing market share and the patients' concern for loss of privacy appear to be formidable stallers of the adoption process. Government intervention or even the threat of government intervention could be the trigger that accelerates the pharmacogenomics revolution. If that occurs, reallocations of financial risk-sharing between the payers, the healthcare providers, the pharmaceutical companies, and the patients are to be expected. However, the public's concerns about privacy and the healthcare system's need for more data will also have to be addressed before we will witness the new era of personalized medicine.