University of Nottingham: Personalised testing for safety and effectiveness of common medicines must be offered throughout the NHS, says new report

Testing patients for genetic variations that affect how their body will respond to common medicines must be integrated fully, fairly and swiftly into the NHS, according to a report published the British Pharmacological Society and the Royal College of Physicians.

Guruprasad Aithal, Professor of Hepatology in the School of Medicine at the University of Nottingham, presented to the working party responsible for the report– ‘Personalised prescribing: using pharmacogenomics to improve patient outcomes’.

The report explains how a type of testing, known as pharmacogenomic testing, should be deployed across the NHS to ensure all patients have an equal chance of being prescribed a medicine at a dose that is likely to be safe and effective for them, with minimal side effects.

There can be enormous variation from person to person in whether a medicine works, whether it causes serious side effects and what dose is needed. Scientists have established a genetic cause for such variation for over 40 medicines.

Some pharmacogenomic tests are already available in the NHS, for example for a drug called abacavir used to treat HIV, and for a drug called 5-fluorouracil used to treat certain cancers. However, for most of these 40 medicines, tests are not available in the NHS. These include commonly prescribed medicines, including painkillers, beta blockers and antidepressants.

There are inter-individual variations in the way medicines work. Considering one’s genetic make-up assists while prescribing, increasing the benefits and reducing the adverse effect of the medications. We know of genetic variations which effect over 40 medicines. We are calling for NHS to offer genetic tests to improve safe and effective prescribing.”
Guruprasad Aithal, Professor of Hepatology in the School of Medicine at the University of Nottingham
A commentary on the report, that will be published in the British Journal of Clinical Pharmacology, explains that almost 99% of people carry at least one of these genetic variations.

The report gives a series of recommendations to help deploy pharmacogenomic testing in GP surgeries, hospitals and clinics across the UK. These include: central funding through the relevant commissioning processes in all four nations to avoid a postcode lottery that could exacerbate inequalities; education and training; and a pharmacogenomics advisory service for doctors.