Limiting factors and ethical challenges in the application of artificial intelligence in pharmacology
DOI:
https://doi.org/10.14748/x3zs0267Keywords:
regulation, artificial intelligence, pharmacology, ethics, algorithmic bias, pharmacovigilanceAbstract
Introduction: Artificial intelligence (AI) is increasingly applied in pharmacology, particularly in drug discovery, prediction of pharmacokinetic and pharmacodynamic properties, identification of adverse drug reactions, pharmacovigilance, dose optimization, and clinical decision support. Despite these promising applications, its integration into pharmacological research and clinical practice remains limited by scientific, technical, ethical, and regulatory challenges.
Aim: This review aims to summarize the main limiting factors and ethical challenges associated with the application of AI in pharmacology and to outline key requirements for its responsible and clinically meaningful implementation.
Materials and Methods: A narrative review of recent scientific literature on AI tools in pharmacological research and practice was performed. The analysis focused on limitations related to data quality, representativeness of training datasets, algorithmic bias, model interpretability, external validation, reproducibility, and performance across clinical populations. Ethical and regulatory aspects, including privacy, informed consent, fairness, accountability, transparency, and governance, were also examined.
Results: The reviewed literature indicates that AI has substantial potential to support pharmacological decision-making and accelerate innovation. However, models trained on incomplete, heterogeneous, or biased datasets may produce unreliable outputs and reinforce inequities in healthcare. Limited transparency of complex algorithms reduces clinician trust and complicates the evaluation of safety, responsibility, and clinical applicability. In addition, the lack of harmonized regulatory standards remains a major barrier to broader implementation.
Conclusion: AI should be regarded as a supportive tool that complements, rather than replaces, expert pharmacological judgment. Responsible implementation requires high-quality data, robust validation, transparent reporting, interdisciplinary collaboration, continuous monitoring, and ethically grounded regulatory frameworks.
References
[1] Nagar A, Gobburu J, Chakravarty A. Artificial intelligence in pharmacovigilance: advancing drug safety monitoring and regulatory integration. Ther Adv Drug Saf. 2025;16:20420986251361435. doi: 10.1177/20420986251361435. DOI: https://doi.org/10.1177/20420986251361435
[2] Qureshi R, Irfan M, Gondal TM, et al. AI in drug discovery and its clinical relevance. Heliyon. 2023;9(7):e17575. doi: 10.1016/j.heliyon.2023.e17575. DOI: https://doi.org/10.1016/j.heliyon.2023.e17575
[3] Panayotova GG. Software Applications in Biomedicine: A Narrative Review of Translational Pathways from Data to Decision. BioMedInformatics. 2026;6(1):9. doi: 10.3390/biomedinformatics6010009. DOI: https://doi.org/10.3390/biomedinformatics6010009
[4] Fahim YA, Hasani IW, Kabba S, et al. Artificial intelligence in healthcare and medicine: clinical applications, therapeutic advances, and future perspectives. Eur J Med Res. 2025;30(1):848. doi: 10.1186/s40001-025-03196-w. DOI: https://doi.org/10.1186/s40001-025-03196-w
[5] Norori N, Hu Q, Aellen FM, et al. Addressing bias in big data and AI for health care: A call for open science. Patterns (N Y). 2021;2(10):100347. doi: 10.1016/j.patter.2021.100347. DOI: https://doi.org/10.1016/j.patter.2021.100347
[6] Alkhanbouli R, Matar Abdulla Almadhaani H, Alhosani F, et al. The role of explainable artificial intelligence in disease prediction: a systematic literature review and future research directions. BMC Med Inform Decis Mak. 2025;25(1):110. doi: 10.1186/s12911-025-02944-6. DOI: https://doi.org/10.1186/s12911-025-02944-6
[7] Mennella C, Maniscalco U, De Pietro G, et al. Ethical and regulatory challenges of AI technologies in healthcare: A narrative review. Heliyon. 2024;10(4):e26297. doi: 10.1016/j.heliyon.2024.e26297. DOI: https://doi.org/10.1016/j.heliyon.2024.e26297
[8] Schwabe D, Becker K, Seyferth M, et al. The METRIC-framework for assessing data quality for trustworthy AI in medicine: a systematic review. NPJ Digit Med. 2024;7(1):203. doi: 10.1038/s41746-024-01196-4. DOI: https://doi.org/10.1038/s41746-024-01196-4
[9] Rudnisky E, Paudel K. Pharmacovigilance in the Era of Artificial Intelligence: Advancements, Challenges, and Considerations. Cureus. 2025;17(6):e86972. doi: 10.7759/cureus.86972. DOI: https://doi.org/10.7759/cureus.86972
[10] Jafari E, Blackman MH, Karnes JH, et al. Using electronic health records for clinical pharmacology research: Challenges and considerations. Clin Transl Sci. 2024;17(7):e13871. doi: 10.1111/cts.13871. DOI: https://doi.org/10.1111/cts.13871
[11] Wang X, Hripcsak G, Markatou M, et al. Active Computerized Pharmacovigilance Using Natural Language Processing, Statistics, and Electronic Health Records: A Feasibility Study. J Am Med Inform Assoc. 2009;16(3):328–337. doi: 10.1197/jamia.M3028. DOI: https://doi.org/10.1197/jamia.M3028
[12] Wang Y, Chen Y, Xu X, et al. What Affects the Quality of Pharmacovigilance? Insights From Qualitative Comparative Analysis. Pharmacol Res Perspect. 2025;13(3):e70102. doi: 10.1002/prp2.70102. DOI: https://doi.org/10.1002/prp2.70102
[13] Hanlon P, Butterly EW, Shah AS, et al. Treatment effect modification due to comorbidity: Individual participant data meta-analyses of 120 randomised controlled trials. PLoS Med. 2023;20(6):e1004176. doi: 10.1371/journal.pmed.1004176. DOI: https://doi.org/10.1371/journal.pmed.1004176
[14] García-Abeijon P, Costa C, Taracido M, et al. Factors Associated with Underreporting of Adverse Drug Reactions by Health Care Professionals: A Systematic Review Update. Drug Saf. 2023;46(7):625–636. doi: 10.1007/s40264-023-01302-7. DOI: https://doi.org/10.1007/s40264-023-01302-7
[15] Efthimiou O, Seo M, Chalkou K, et al. Developing clinical prediction models: a step-by-step guide. BMJ. 2024;386:e078276. doi: 10.1136/bmj-2023-078276. DOI: https://doi.org/10.1136/bmj-2023-078276
[16] Abbidi SR, Sinha D. AI/ML-based strategies for enhancing equity, diversity, and inclusion in randomized clinical trials. Trials. 2026;27(1):217. doi: 10.1186/s13063-026-09537-2. DOI: https://doi.org/10.1186/s13063-026-09537-2
[17] Rabbani SA, El-Tanani M, Sharma S, et al. Generative Artificial Intelligence in Healthcare: Applications, Implementation Challenges, and Future Directions. BioMedInformatics. 2025;5(3):37. doi: 10.3390/biomedinformatics5030037. DOI: https://doi.org/10.3390/biomedinformatics5030037
[18] Deng W, Zhang L-Y, Yue J-R, et al. The future of multimorbidity management in the older adults: transforming AI-enabled precision medicine. Front Public Health. 2026 Jan 12:13:1691682. doi: 10.3389/fpubh.2025.1691682. DOI: https://doi.org/10.3389/fpubh.2025.1691682
[19] Alomar MJ. Factors affecting the development of adverse drug reactions (Review article). Saudi Pharm J. 2014;22(2):83–94. doi: 10.1016/j.jsps.2013.02.003. DOI: https://doi.org/10.1016/j.jsps.2013.02.003
[20] Venkatesh R, Keat K, Salvatore M, et al. Importance of genetic ancestry in pharmacogenomics for precision medicine. Pharmacogenomics. 2025;26(17-18):747–762. doi: 10.1080/14622416.2026.2620360. DOI: https://doi.org/10.1080/14622416.2026.2620360
[21] Cross JL, Choma MA, Onofrey JA. Bias in medical AI: Implications for clinical decision-making. PLOS Digit Health. 2024;3(11):e0000651. doi: 10.1371/journal.pdig.0000651. DOI: https://doi.org/10.1371/journal.pdig.0000651
[22] Sarker IH. Deep Learning: A Comprehensive Overview on Techniques, Taxonomy, Applications and Research Directions. SN Comput Sci. 2021;2(6):420. doi: 10.1007/s42979-021-00815-1. DOI: https://doi.org/10.1007/s42979-021-00815-1
[23] Roberts-Nuttall J, Jones AM, Castellani M, et al. An interpretable machine learning framework for adverse drug reaction prediction from drug-target interactions. PLoS One. 2026;21(1):e0340900. doi: 10.1371/journal.pone.0340900. DOI: https://doi.org/10.1371/journal.pone.0340900
[24] Hammad TA, Davies S. Navigating Diverging Perspectives: Reasoning, Evidence, and Decision-Making in Drug Safety. Drug Saf. 2025;48(6):587–593. doi: 10.1007/s40264-025-01537-6. DOI: https://doi.org/10.1007/s40264-025-01537-6
[25] Ueda D, Kakinuma T, Fujita S, et al. Fairness of artificial intelligence in healthcare: review and recommendations. Jpn J Radiol. 2024;42(1):3–15. doi: 10.1007/s11604-023-01474-3. DOI: https://doi.org/10.1007/s11604-023-01474-3
[26] Abbas Q, Jeong W, Lee SW. Explainable AI in Clinical Decision Support Systems: A Meta-Analysis of Methods, Applications, and Usability Challenges. Healthcare (Basel). 2025;13(17):2154. doi: 10.3390/healthcare13172154. DOI: https://doi.org/10.3390/healthcare13172154
[27] Zhang K, Wang D, Lin F, et al. A comprehensive review of explainable artificial intelligence in healthcare methods, evaluation, and clinical integration. iScience. 2026;29(3):115026. doi: 10.1016/j.isci.2026.115026. DOI: https://doi.org/10.1016/j.isci.2026.115026
[28] Wilson RC, Collins AG. Ten simple rules for the computational modeling of behavioral data. eLife. 2019;8:e49547. doi: 10.7554/eLife.49547. DOI: https://doi.org/10.7554/eLife.49547
[29] Karampatea A, Kassandros K, Constantinides T, et al. Systematic review of AI-based models in pharmacoepidemiology for adverse drug event prediction and detection. Front Drug Saf Regul. 2026 Mar 17;6:1773186. doi: 10.3389/fdsfr.2026.1773186. DOI: https://doi.org/10.3389/fdsfr.2026.1773186
[30] Khairil L, Benny KHS, Jerry J, et al. AI in Drug Discovery: Clinical Failures, Regulatory Reality, and the Validation Crisis Behind the Hype. Pharmaceuticals. 2026;19(6):916. doi: 10.3390/ph19060916. DOI: https://doi.org/10.3390/ph19060916
[31] Syed R, Eden R, Makasi T, et al. Digital Health Data Quality Issues: Systematic Review. J Med Internet Res. 2023 Mar 31;25:e42615. doi: 10.2196/42615. DOI: https://doi.org/10.2196/42615
[32] Guan H, Bates D, Zhou L. Keeping Medical AI Healthy and Trustworthy: A Review of Detection and Correction Methods for System Degradation. IEEE Trans Biomed Eng. 2025;PP:10.1109/TBME.2025.3642706. doi: 10.1109/TBME.2025.3642706. DOI: https://doi.org/10.1109/TBME.2025.3642706
[33] Carrasco-Ribelles LA, Llanes-Jurado J, Gallego-Moll C, et al. Prediction models using artificial intelligence and longitudinal data from electronic health records: a systematic methodological review. J Am Med Inform Assoc. 2023;30(12):2072–2082. doi: 10.1093/jamia/ocad168. DOI: https://doi.org/10.1093/jamia/ocad168
[34] Han H. Challenges of reproducible AI in biomedical data science. BMC Med Genomics. 2025;18(Suppl 1):8. doi: 10.1186/s12920-024-02072-6. DOI: https://doi.org/10.1186/s12920-024-02072-6
[35] Olakotan O, Samuriwo R, Ismaila H, et al. Usability Challenges in Electronic Health Records: Impact on Documentation Burden and Clinical Workflow: A Scoping Review. J Eval Clin Pract. 2025;31(4):e70189. doi: 10.1111/jep.70189. DOI: https://doi.org/10.1111/jep.70189
[36] McGreevey JD, Mallozzi CP, Perkins RM, et al. Reducing Alert Burden in Electronic Health Records: State of the Art Recommendations from Four Health Systems. Appl Clin Inform. 2020;11(1):1–12. doi: 10.1055/s-0039-3402715. DOI: https://doi.org/10.1055/s-0039-3402715
[37] Serrano DR, Luciano FC, Anaya BJ, et al. Artificial Intelligence (AI) Applications in Drug Discovery and Drug Delivery: Revolutionizing Personalized Medicine. Pharmaceutics. 2024;16(10):1328. doi: 10.3390/pharmaceutics16101328. DOI: https://doi.org/10.3390/pharmaceutics16101328
[38] Srivastava N, Verma S, Singh A, et al. Advances in artificial intelligence-based technologies for increasing the quality of medical products. Daru. 2024;33(1):1. doi: 10.1007/s40199-024-00548-5. DOI: https://doi.org/10.1007/s40199-024-00548-5
[39] Witek K, Nowocien M, Gerlach J, et al. Artificial Intelligence in Healthcare: From Diagnosis to Rehabilitation. Cureus. 2026;18(1):e102286. doi: 10.7759/cureus.102286. DOI: https://doi.org/10.7759/cureus.102286
[40] Alqahtani SS, Menachery SJ, Alshahrani A, et al. Artificial intelligence in clinical pharmacy—A systematic review of current scenario and future perspectives. Digit Health. 2025;11:20552076251388145. doi: 10.1177/20552076251388145. DOI: https://doi.org/10.1177/20552076251388145
[41] Conduah AK, Ofoe S, Siaw-Marfo D. Data privacy in healthcare: Global challenges and solutions. Digit Health. 2025;11:20552076251343959. doi: 10.1177/20552076251343959. DOI: https://doi.org/10.1177/20552076251343959
[42] Pham T. Ethical and legal considerations in healthcare AI: innovation and policy for safe and fair use. R Soc Open Sci. 2025;12(5):241873. doi: 10.1098/rsos.241873. DOI: https://doi.org/10.1098/rsos.241873
[43] Rahnasto J. Genetic data are not always personal—disaggregating the identifiability and sensitivity of genetic data. J Law Biosci. 2023;10(2):lsad029. doi: 10.1093/jlb/lsad029. DOI: https://doi.org/10.1093/jlb/lsad029
[44] Park HJ. Patient perspectives on informed consent for medical AI: A web-based experiment. Digit Health. 2024;10:20552076241247938. doi: 10.1177/20552076241247938. DOI: https://doi.org/10.1177/20552076241247938
[45] McKeown A, Mourby M, Harrison P, et al. Ethical Issues in Consent for the Reuse of Data in Health Data Platforms. Sci Eng Ethics. 2021;27(1):9. doi: 10.1007/s11948-021-00282-0. DOI: https://doi.org/10.1007/s11948-021-00282-0
[46] Fu C, Chen Q. The future of pharmaceuticals: Artificial intelligence in drug discovery and development. J Pharm Anal. 2025;15(8):101248. doi: 10.1016/j.jpha.2025.101248. DOI: https://doi.org/10.1016/j.jpha.2025.101248
[47] Dankwa-Mullan I. Health Equity and Ethical Considerations in Using Artificial Intelligence in Public Health and Medicine. Prev Chronic Dis. 2024;21:E64. doi: 10.5888/pcd21.240245. DOI: https://doi.org/10.5888/pcd21.240245
[48] Bruxvoort KJ, Bahakel H, Martin JM, et al. Inclusion of Women, Children, the Elderly, and Individuals With Underlying Medical Conditions: Prioritizing Vulnerable Populations in Clinical Research. Clin Infect Dis. 2025;81(Supplement_2):S78–S88. doi: 10.1093/cid/ciaf408. DOI: https://doi.org/10.1093/cid/ciaf408
[49] Joseph J. Algorithmic bias in public health AI: a silent threat to equity in low-resource settings. Front Public Health. 2025;13:1643180. doi: 10.3389/fpubh.2025.1643180. DOI: https://doi.org/10.3389/fpubh.2025.1643180
[50] Hasanzadeh F, Josephson CB, Waters G, et al. Bias recognition and mitigation strategies in artificial intelligence healthcare applications. NPJ Digit Med. 2025;8(1):154. doi: 10.1038/s41746-025-01503-7. DOI: https://doi.org/10.1038/s41746-025-01503-7
[51] Tilson H, Hines LE, McEvoy G, et al. Recommendations for Selecting Drug-Drug Interactions for Clinical Decision Support. Am J Health Syst Pharm. 2016;73(8):576–585. doi: 10.2146/ajhp150565. DOI: https://doi.org/10.2146/ajhp150565
[52] Rosenbacke R, Melhus Å, McKee M, et al. How Explainable Artificial Intelligence Can Increase or Decrease Clinicians’ Trust in AI Applications in Health Care: Systematic Review. JMIR AI. 2024;3:e53207. doi: 10.2196/53207. DOI: https://doi.org/10.2196/53207
[53] Lesar TS. Prescribing Errors Involving Medication Dosage Forms. J Gen Intern Med. 2002;17(8):579–587. doi: 10.1046/j.1525-1497.2002.11056.x. DOI: https://doi.org/10.1046/j.1525-1497.2002.11056.x
[54] Sezgin E. Artificial intelligence in healthcare: Complementing, not replacing, doctors and healthcare providers. Digit Health. 2023;9:20552076231186520. DOI: https://doi.org/10.1177/20552076231186520
[55] Habli I, Lawton T, Porter Z. Artificial intelligence in health care: accountability and safety. Bull World Health Organ. 2020;98(4):251–256. doi: 10.2471/BLT.19.237487. DOI: https://doi.org/10.2471/BLT.19.237487
[56] Nacu AG, Constantin DA, Rogozea LM. Ethical Dilemmas and Legal Responsibilities in Patient Care: An Analysis of Hospital Safety. Healthcare (Basel). 2025;13(21):2800. doi: 10.3390/healthcare13212800. DOI: https://doi.org/10.3390/healthcare13212800
[57] Fehr J, Citro B, Malpani R, et al. A trustworthy AI reality-check: the lack of transparency of artificial intelligence products in healthcare. Front Digit Health. 2024;6:1267290. doi: 10.3389/fdgth.2024.1267290. DOI: https://doi.org/10.3389/fdgth.2024.1267290
[58] Kleebayoon A, Wiwanitkit V. Ethics for artificial intelligence use in clinical pharmacology. Indian J Pharmacol. 2024;56(3):224–225. doi: 10.4103/ijp.ijp_729_23. DOI: https://doi.org/10.4103/ijp.ijp_729_23
[59] Malheiro V, Santos B, Figueiras A, et al. The Potential of Artificial Intelligence in Pharmaceutical Innovation: From Drug Discovery to Clinical Trials. Pharmaceuticals (Basel). 2025;18(6):788. doi: 10.3390/ph18060788. DOI: https://doi.org/10.3390/ph18060788
[60] Ahmed MI, Spooner B, Isherwood J, et al. A Systematic Review of the Barriers to the Implementation of Artificial Intelligence in Healthcare. Cureus. 2023;15(10):e46454. doi: 10.7759/cureus.46454. DOI: https://doi.org/10.7759/cureus.46454
[61] Committee for Medicinal Products for Human Use (CHMP) Committee for Medicinal Products for Veterinary Use (CVMP) Reflection paper on the use of Artificial Intelligence (AI) in the medicinal product lifecycle Draft agreed by Committee for Medicinal Products for Human Use (CHMP) Methodology Working Party Reflection paper on the use of AI in the medicinal product lifecycle [Internet]. 2024 [cited 2026 June 26]. Available from: https://www.ema.europa.eu/system/files/documents/scientific-guideline/reflection-paper-use-artificial-intelligence-ai-medicinal-product-lifecycle-en.pdf
[62] FDA. Considerations for the Use of Artificial Intelligence [Internet]. U.S. Food and Drug Administration. 2025 [cited 2026 June 26]. Available from: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/considerations-use-artificial-intelligence-support-regulatory-decision-making-drug-and-biological
[63] Graux H, Garstka K, Murali N, et al. Interplay between the AI Act and the EU digital legislative framework | Think Tank | European Parliament [Internet]. Europa.eu. 2025 [cited 2026 June 26]. Available from: https://www.europarl.europa.eu/thinktank/en/document/ECTI_STU(2025)778575.
[64] Dziadkowiec O, Durbin J, Muralidharan VJ, et al. Improving the Quality and Design of Retrospective Clinical Outcome Studies that Utilize Electronic Health Records. HCA Healthc J Med. 2020;1(3):131–138. doi: 10.36518/2689-0216.1094. DOI: https://doi.org/10.36518/2689-0216.1094
[65] Kim TW, Park S, Kim M. Artificial Intelligence for Drug Safety Across the Lifecycle and Decision Type: A Scoping Review. Pharmaceuticals (Basel). 2026;19(2):334. doi: 10.3390/ph19020334. DOI: https://doi.org/10.3390/ph19020334
[66] Rizvi SAA, Einstein GP, Tulp OL, et al. Introduction to Traditional Medicine and Their Role in Prevention and Treatment of Emerging and Re-Emerging Diseases. Biomolecules. 2022;12(10):1442. doi: 10.3390/biom12101442. DOI: https://doi.org/10.3390/biom12101442
[67] Otokiti AU, Ozoude MM, Williams KS, et al. The Need to Prioritize Model-Updating Processes in Clinical Artificial Intelligence (AI) Models: Protocol for a Scoping Review. JMIR Res Protoc. 2023;12:e37685. doi: 10.2196/37685. DOI: https://doi.org/10.2196/37685
[68] Kim S, Kim S, Kim C, et al. Impact of Regulatory Post‐Market Safety Advisories on Prescribing Practices: An Interrupted Time Series Analysis. Clin Pharmacol Ther. 2025;117(6):1754–1762. doi: 10.1002/cpt.3614. DOI: https://doi.org/10.1002/cpt.3614
[69] Palaniappan K, Lin EYT, Vogel S. Global Regulatory Frameworks for the Use of Artificial Intelligence (AI) in the Healthcare Services Sector. Healthcare (Basel). 2024;12(5):562. doi: 10.3390/healthcare12050562. DOI: https://doi.org/10.3390/healthcare12050562
[70] Alelyani T. A validated framework for responsible AI in healthcare autonomous systems. Sci Rep. 2025;15(1):44432. doi: 10.1038/s41598-025-25266-z. DOI: https://doi.org/10.1038/s41598-025-25266-z
[71] Chustecki M. Benefits and Risks of AI in Health Care: Narrative Review. Interact J Med Res. 2024;13:e53616. doi: 10.2196/53616. DOI: https://doi.org/10.2196/53616
[72] Pardhan S, Sehmbi T, Wijewickrama R, et al. Barriers and facilitators for engaging underrepresented ethnic minority populations in healthcare research: an umbrella review. Int J Equity Health. 2025;24(1):70. doi: 10.1186/s12939-025-02431-4. DOI: https://doi.org/10.1186/s12939-025-02431-4
[73] Barucci A, Colcelli V, De Masi S, et al. Ethical and Regulatory Frameworks for Artificial Intelligence in Clinical Research: A European Perspective on the Artificial Intelligence Act for Ethics Committees and Researchers. Eur Cardiol. 2026;21:e01. doi: 10.15420/ecr.2025.59. DOI: https://doi.org/10.15420/ecr.2025.59
[74] Algarvio RC, Conceição J, Rodrigues PP, et al. Artificial intelligence in pharmacovigilance: a narrative review and practical experience with an expert-defined Bayesian network tool. Int J Clin Pharm. 2025;47(4):932–944. doi: 10.1007/s11096-025-01975-3. DOI: https://doi.org/10.1007/s11096-025-01975-3
[75] Xu Z, Ren F, Wang P, et al. A generative AI-discovered TNIK inhibitor for idiopathic pulmonary fibrosis: a randomized phase 2a trial. Nat Med. 2025;31(8):2602–2610. doi: 10.1038/s41591-025-03743-2. DOI: https://doi.org/10.1038/s41591-025-03743-2
Downloads
Published
Data Availability Statement
Data sharing is not applicable to this article, as no new datasets were generated or analyzed during the current narrative review. All sources used in the preparation of the manuscript are cited in the reference list.