Pharmacogenomic testing pilot to start in general practice from June 2023

An NHS pilot to test the feasibility of rolling out pharmacogenomic testing for patients taking statins, antidepressants and proton pump inhibitors (PPIs) will start in June 2023.

The ‘Progress programme’, which is being led by the University of Manchester, is the first in the UK to introduce genetic testing before prescribing in primary care and will initially involve four GP surgeries in the north west of England.

In October 2022, The Pharmaceutical Journal exclusively reported that the pilot would start in early 2023; however, William Newman, professor of translational genomic medicine at the University of Manchester, told The Pharmaceutical Journal on 11 May 2023 that there have been delays with ethics approval, which pushed back the start date.

“[Approval is] all in place now. Site visits with four GP practices have taken place and [we] plan to start in June [2023],” he said.

The pilot will test patients when they start a new statin, certain antidepressants or PPIs, or have a change of medication, to ensure they are receiving the right drug and are not being put at risk of side effects.

Newman previously told The Pharmaceutical Journal in October 2022 that, if successful, there are plans to expand the initial pilot to early adopter GP practices in the other six Genomic Medicine Service Alliance regions in England, with the aim of it becoming a national programme within a year.

The launch of the pilot programme follows results from the ‘PREPARE’ (Preemptive Pharmacogenomic Testing for Preventing Adverse Drug Reactions) trial in February 2023, which confirmed that adverse drug reactions to commonly prescribed medicines can be reduced by 30% using a 12-gene pharmacogenomic panel to tailor treatment.

Speaking about the pilot at the Clinical Pharmacy Congress in London on 13 May 2023, Vicky Chaplin, pharmacy genomics lead at NHS England, told delegates: “They’re at the stage now where they’re going to start delivering this service to patients as part of a research programme next month and then, building on that, they’ll do further evidence-gathering and then look to expand this pilot nationally.

“We’ll use the evidence from that to look at utility, outcomes and cost effectiveness.”

Chaplin added that the pilot is looking at potentially having a panel of tests, “so you can look at all the results across various medications and tailor a patient’s treatment throughout their lifetime”.

She also said that an IT system will be used for storing and sharing test results during the pilot but that the long-term vision is that results and related guidance will become part of clinical decision support systems.

The NHS England five-year plan on genomic medicine, published on 12 October 2022, said that, over the following three years, it will review the evidence for “real-time” decisions informed by pharmacogenomics to form “part of routine clinical care”.