Public awareness, attitudes, and concerns regarding pharmacogenomics in the Kingdom of Saudi Arabia: an exploratory online cross-sectional survey.

BACKGROUND: Pharmacogenomics (PGx) is a cornerstone of precision medicine, enabling tailored drug therapy based on an individual's genetic profile. However, public awareness, attitudes, and concerns regarding PGx testing in Saudi Arabia remain largely unexplored. This study aimed to evaluate these aspects among Saudi adults and to identify associated sociodemographic and health-related factors. METHODS: An exploratory, cross-sectional online survey was conducted between August and October 2025 using convenience and snowball sampling. A total of 391 eligible adults (≥18 years, non-healthcare providers) completed an anonymous questionnaire adapted from previously published instruments. Multivariable logistic and ordered logistic regression analyses were performed to examine factors associated with PGx familiarity, attitudes, concerns, willingness to undergo testing, and consent preferences. RESULTS: Attitudes toward PGx testing were strongly positive. Between 70 and 72% of respondents expressed comfort with PGx testing to predict medication efficacy, appropriate dosing, or side effects, and 68% were comfortable when it was recommended by a healthcare provider. The most prominent concerns were privacy breaches (34% high concern) and testing cost (44% high concern). While 71% expressed concern about paying out of pocket for the test, 83% indicated greater willingness if it were free or covered by insurance. Most participants (93%) expected prior notification by their provider, and 85% favored obtaining specific consent for PGx testing. In adjusted models, good/excellent self-rated health was associated with lower odds for high privacy concern (aOR 0.26, 95% CI 0.11-0.64; p = 0.004) and high cost concern (aOR 0.25, 0.10-0.62; p = 0.003). Doctoral education was associated with a more favorable overall attitude toward pharmacogenomic testing (aOR 3.92, 1.16-13.28; p = 0.028), and residence in Mecca (vs Riyadh) was associated with greater willingness if covered by insurance (aOR 4.24, 1.44-12.50; p = 0.009). CONCLUSION: Acceptance of and interest in PGx testing were high in this online volunteer sample, with privacy and cost as the main barriers. Robust privacy protective measures and integration into healthcare coverage could accelerate the adoption of precision medicine in Saudi Arabia. Findings should be interpreted with caution, given the convenience sampling design and limited generalizability to the broader population.