Bringing pharmacy to the forefront of pharmacogenetics

Around four million patients annually in the UK could benefit from genetic testing before they are prescribed common medicines. This is according to new research led by researchers at the University of East Anglia (UEA), England, in collaboration with academics at Boots UK and Leiden University, Netherlands. 

Researchers looked through 2019 National Health Service (NHS) dispensing data across the UK to see how many patients are started on new prescriptions each year. They found that, for the 56 medicines, including antidepressants, antibiotics, stomach ulcer treatments and painkillers where there are known drug-gene interactions, there was the potential for a doctor or pharmacist to take action under international guidelines in more than one in five occasions (21.1%). If this screening was applied to all new prescriptions, an estimated one in 11 (9.1%) would lead to a change of drug or dose, affecting over five million dispensed items. 

Depending on the results of individual pharmacogenetic tests, they might either receive a higher or lower starting dose than normal, or be more closely monitored during the early stages of treatment. 

Pharmacogenomic testing services already working in the Netherlands show that specially-trained GPs and pharmacists can carry out pre-prescribing tests and use the results to give advice on safer and more effective prescribing, delivering better patient outcomes.

“We strongly believe that pharmacy has a key role to play supporting the wider accessibility and use of pharmacogenomics,” says Marc Donovan, chief pharmacist, Boots UK. “Our work shows the benefits that patients and the NHS could get from rolling out a national screening programme as part of their plans to embed pharmacogenomics in clinical practice by 2025, and that this testing could be effectively delivered by community pharmacists.” 

Essra Youssef, research pharmacist, School of Pharmacy, UEA, commented: “Better selection of medicines based on a patient’s genetic information could mean less side-effects and better treatment outcomes.”

“This not only benefits the patient but also the NHS, as patients may not need to return to their GP so often to change their medication. It could also reduce hospital visits related to side effects of medicines. The testing process is quite simple in most cases, with a cheek swab sample collected and DNA analysed for genes related to medicines. As the cost of this testing continues to drop, the technology is more likely to represent good value for the NHS.”