Objectives: To ascertain attitudes of prospective patients relevant to the delivery of race-based pharmacogenomics.

Methods: Written anonymous survey and qualitative responses in two sets of reactance format focus groups over-sampled for minority groups in urban, suburban, and rural communities conducted from February through April, 2002 [N = 104] and August through November, 2002 [N = 120].

Results: Participants do not associate "races" exclusively with continental clusters. They have incomplete knowledge of their recent ancestors (39.6% do not know all their biological grandparents). They would be highly suspicious of race-labeled drugs; with 47.5% saying they would be very suspicious of their safety and 40.6% indicating they would be very suspicious of their efficacy. A substantial minority of African-American participants (13.2%) would prefer to take the drugs designated for European Americans. Effect of discussion of race-based medicine on racial attitudes is ambiguous.

Conclusions: Patient knowledge of ancestry and suspicion of race-designated drugs constitute substantial barriers that need to be incorporated in judging the likely effectiveness of race-based pharmacogenomics.