The Native American/First Nation tribal groups of North America are treated from medication formularies that are constructed using little or no local data. PGENI is using DNA variation in drug metabolism, transporters, or drug targets from an individual tribal/nation group as a way to select medicines with the greatest chance of benefit and least chance of risk for the specific tribal partner. From this information Tribal/Nation Formulary Recommendations will be built and provided to the Health Authority for each tribal partner. These recommendations will be in the form of prioritization – highlighting clinically relevant polymorphisms of high frequency for each tribe/nation that should be targeted for pharmacogenetics assessment in individuals where possible, and surveillance – suggesting closer monitoring for reduced drug response and/or increased toxicity based on high population risk. This public health pharmacogenetics approach will provide an overarching mechanism for individualization of the medication formulary for the tribe/nation. PGENI will also help interested tribes/nations implement individual patient pharmacogenetics testing, in situations where this is deemed of priority by the health authority.