This talk will focus on genomic strategies applied in academia to identify subsets of patients who, based on their genetic make-up, are predicted to have a favorable response profile to drugs that modify specific pathways and gene networks. Examples will be given on attention deficit hyperactivity disorder and autism, where a subset of patients were identified with copy number deletion in the metabotropic glutamate receptor signaling pathway, where a drug candidate, already developed through phase III for a different indication was repurposed for these new indications. Another genetically stratified patient cohort with inflammatory bowel disease is also being studied for intervention at a novel site in the TNF alpha pathway observed through genetic associations where functionally active rare variants are being implicated in the disease pathogenesis with potential extension to other autoimmune diseases. A few rare disease examples will be discussed where new discoveries have led to repurposing opportunities based on state-of-the-art genomic approaches.