We must move away from the current “one drug and one dose fits all” model to make treatments safer and more effective
Genetic testing to predict how patients respond to a range of common drugs should be made available as soon as possible, according to a report by the Royal College of Physicians and the British Pharmacological Society.
There can be a huge variation in how people respond to drugs due to differences in their genes. The tests that the experts are calling for are known as pharmacogenomic tests, and can be used to check how safe, effective and side-effect-free more than 40 drugs are in each individual patient by identifying variations in their genes. The authors say that 99 per cent of patients carry at least one of these variations.
While some pharmacogenomic tests – such as one for the chemotherapy drug fluorouracil – are currently available on the NHS, they are not available for most of the drugs on the list, which includes commonly prescribed painkillers, as well as beta blockers and antidepressants.
One striking example is codeine, a commonly prescribed painkiller. Around 8 per cent of people in the UK lack the gene that codeine acts on and so don’t experience any pain relief from taking it.
“The UK is a world leader in genomic medicine, and the implementation of a wider range of pharmacogenomic tests would further demonstrate UK leadership,” said Prof Sir Munir Pirmohamed, David Weatherall Chair of Medicine at the University of Liverpool, and Chair of the report’s working party.
“Today we are calling on the government and the health service to ensure that patients across the UK are offered these tests where there is evidence to show their utility. For patients, this will mean the medicines they take are more likely to work and will 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 added.