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Pharmacogenetics - Testing before Rx

3/27/2023

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​Getting the word out ... could well be the Achilles heel preventing Pharmacogenetics from being the first stop on most providers path when considering what medications to prescribe. It is certainly proving to be effective at improving care, reducing ARs (adverse reactions) and driving down the cost of care. 
​
NHS in the UK took the barriers down before they got in the way of providers.  In this article posted on LinkedIn by 
Ron H.N. van Schaik, Full Professor Pharmacogenetics / Head Dept Clinical Chemistry / Past-President European Society Pharmacogenomics & Personalised Therapy (ESPT),  van Schaik applauds the 'First-ever NHS pilot of routine pharmacogenetic testing to guide drug choice in primary care [which] will begin in early 2023 in north-west England, with plans for it to become a national programme if successful. Drugs include antidepressants, statins and proton pump inhibitors (PPIs). 

The program will expand to Scotland and is sure to find its way onward.  PGx testing is gaining momentum across the globe, yet there still appears to be lack of adoption despite statistics that support its benefits. 

When I've discussed the topic with colleagues and providers - I am met with mixed responses. Typically it is one of three reactions: 
Patients -"I need that and it is super cool, how do I get the test?'
Provider Response 1 - "I've heard of that, it's great but I don't have time to log-in to another system to order it for my patients or go look at the results"
Provider Response 2 - "That's very interesting, I look forward to hearing about it on our next visit"

Will it take a significant shift like the NHS's push to test before prescribing?  Or the engagement of EHR vendors, who like Epic, are incorporating PGx related fields into their systems for prescribing tests and capturing the discrete data points for inclusion in the patient record? Or perhaps, it is patients who are tired of being human guinea pigs taking medications only to end up with a mysterious interaction that might have been avoided? 

Big players like Microsoft, Google, NIH and many others have been behind the movement toward precision medicine and for good reasons.  Treating individuals has the promise of far greater outcomes in medical care and with it the future of medicine. 

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    With a decade plus of experience as a brand ambassador and chief sloganista, I am fascinated with customers and their customers. Ever curious, I love to analyze data, talk to people and seek to know "Why?" 

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