4.4 Review

Advancing Pharmacogenomics from Single-Gene to Preemptive Testing

Journal

ANNUAL REVIEW OF GENOMICS AND HUMAN GENETICS
Volume 23, Issue -, Pages 449-473

Publisher

ANNUAL REVIEWS
DOI: 10.1146/annurev-genom-111621-102737

Keywords

pharmacogenetics; pharmacogenomics; precision medicine; individualized medicine; personalized medicine; clinical decision support; genomic medicine

Funding

  1. American Lebanese Syrian Associated Charities
  2. National Institutes of Health [U24HG010135]

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Pharmacogenomic testing is effective in enhancing medication safety and efficacy. However, preemptive testing poses logistical concerns, such as reimbursement, result reporting, and portability. Lessons can be learned from institutions that have implemented preemptive testing.
Pharmacogenomic testing can be an effective tool to enhance medication safety and efficacy. Pharmacogenomically actionable medications are widely used, and approximately 90-95% of individuals have an actionable genotype for at least one pharmacogene. For pharmacogenomic testing to have the greatest impact on medication safety and clinical care, genetic information should be made available at the time of prescribing (preemptive testing). However, the use of preemptive pharmacogenomic testing is associated with some logistical concerns, such as consistent reimbursement, processes for reporting preemptive results over an individual's lifetime, and result portability. Lessons can be learned from institutions that have implemented preemptive pharmacogenomic testing. In this review, we discuss the rationale and best practices for implementing pharmacogenomics preemptively.

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