Tests to determine how a patient’s genetic profile will affect their response to commonly prescribed medicines should be offered across the NHS, a landmark report concludes.
The British Pharmacological Society and Royal College of Physicians’ report on personalised prescribing said pharmacogenomic testing was currently used for a small number of drugs in the UK, for example human leukocyte antigen (HLA) testing was mandated before starting abacavir to treat HIV.
However, the groups said there was evidence that a patient’s genetic profile can account for a varied response to many commonly prescribed medications, including painkillers, beta-blockers, and anti-depressants.
For example, about 8% of the UK population lacked the gene which allowed codeine to work properly, meaning those patients would not receive any analgesic effect from the drug.
The report noted pharmacogenomic testing could also target prescribing to reduce unwanted side effects from medications, something which currently costs the NHS £530 million annually in hospital admissions.
Professor Sir Munir Pirmohamed, David Weatherall Chair of Medicine at the University of Liverpool, and chair of the report’s working party, said pharmacogenomic testing would mean medicines were more likely to work and be safer.
‘In the 21st century, we need to move away from the paradigm of ‘one drug and one dose fits all’ to a more personalised approach where patients are given the right drug at the right dose to improve the effectiveness and safety of medicines,’ he said.
Ravi Sharma, Director for England at the Royal Pharmaceutical Society, who was on the working group for the report, said the report highlighted a pivotal role for pharmacists.
‘Pharmacists have the knowledge, skills and abilities to provide the precision dosing and therapeutic drug monitoring that connects genomic testing with medicines optimisation, and so will play a central part in delivering the advances in personalised medicine that are set to revolutionise patient care,’ he said.
‘Pharmacy teams across the whole system have a vital role to play in pharmacogenomics, particularly in primary care where most prescribing and dispensing takes place for patients.’
The RPS wanted to see a pharmacogenomics service in every Integrated Care System, as recommended in the report, with pharmacists having a critical leadership role in the multidisciplinary team embedded into clinical pathways across specialties, he added.
The report made a series of recommendations to implement pharmacogenomics into clinical practice, including central funding through the relevant commissioning processes in all four nations, education and training, and a pharmacogenomics advisory service for doctors. It also recommended funding further research to identify more interactions between genes and drugs.