Could personalized prescriptions revolutionize the UK healthcare system?

Here, Rich Quelch from Origin explores the potential benefits of attributing a prescription to pharmacogenomics data and how moving to such a system could impact the UK’s National Health Service.

pharmacogenomics and personal prescription idea - set of DNA shaped prescription capsules and tablets running diagonally across a light green background

The call for personalized prescribing is growing thanks to advances in pharmacogenomics – our understanding of how a person’s unique genetic makeup influences their response to medication.

Today, even 6.5 percent Hospital admissions in the UK are the result of an adverse reaction to a prescribed or over-the-counter medication. Moreover, up to half of people do not respond as intended.

in recent report By the British Pharmaceutical Society and the Royal College of Physicians, the adoption of the pharmacogenomics model has been hailed as a way to modernize the UK healthcare system, reduce costs and improve health outcomes across the board.

So, could we see personalized prescriptions become fully, fairly and quickly integrated into the UK’s National Health Service (NHS) in the near future?

Old form of medical prescriptions

Each person has different genetic information stored in the genes that they inherited from their parents. This is the unique data that pharmacogenomics uses to understand and adapt your response to different drugs, and since your genes rarely change throughout your life, only one blood test is needed to guide drug selection and dosage at any age or life stage. .

However, the way the NHS prescribes medicines today is much the same as it was when it started more than 70 years ago, despite huge leaps forward in the way patients are diagnosed and treated.

The idea of ​​prescription drugs - cartons of various shapes and sizes for pharmaceutical packages and their packaging

The status quo remains a one-size-fits-all approach to prescribing based on a global understanding of its benefits for patients. But this ignores the (significant) minority of patients who do not respond well to some medications.

Instead, move towards personal description The model, which depends on a patient’s genetic makeup and how it responds uniquely to different drugs and treatments, can allow health care providers to deliver the right treatments, at the right time, at the right doses.

From common medications like antibiotics and anti-inflammatory drugs, to advanced treatments like chemotherapy, a person’s genes can mean they experience negative and even life-threatening side effects. In the UK alone, there Hundreds of deaths every year due to adverse drug interactions.

For others, they lack the gene that makes some medications, such as the pain reliever codeine, effective which means they see no improvement. This not only wastes money and products, but leaves the patient with untreated pain.

Pharmacogenomics research has also revealed a rare variation in a single gene that can cause an excessive immune reaction when exposed to a variety of common medications, resulting in liver damage.

So, with the NHS at affordability limits and waiting lists at an all-time high, can pharmacogenomics provide the answer?

Making pharmacogenetic testing a reality

The wider use of pharmacogenetic testing within the NHS has the potential to keep more people healthy for longer, as well as save money and resources.

But achieving this will not be easy. The required tests are not currently widely available and there is a knowledge gap between patients, prescribers and health practitioners, which means that adoption remains low.

While the report’s authors are calling for NHS funds to move toward a pharmacogenomics model of prescribing, it is not as simple as testing patients when they arrive at a doctor’s office or hospital.

As set out by the British Pharmaceutical Society and the Royal College of Physicians, there are several recommendations that will help make drug genetic testing a reality across NHS trusts.

3D helix DNA annotation - the idea of ​​gene therapies / ATMPs

They suggest that the step should be a gradual and iterative process to achieve a comprehensive service that is available in both primary and secondary care settings, as well as in specialist centers. In addition, the body of knowledge surrounding gene-drug pairs must be improved and built upon, with newly discovered pairs added to the NHS National Genetic Testing Handbook.

To avoid the postcode care lottery and thus exacerbate inequality, the roll-out of the NHS pharma-genetic services across the UK should be mandated and funded through the relevant pathways in the four countries rather than being directed locally. Data collected across the four countries must also be standardized, reported, stored, and shared to accelerate its usefulness and success.

The knowledge gap about personal prescribing must be filled with a comprehensive education and training package targeting all healthcare sectors, as well as pharmacogenomics being included in the training curricula of the future workforce.

To achieve a multidisciplinary pharmacogenetics service, clinicians, general practitioners, and pharmacists need to be supported with clearly defined roles, counseling services within each integrated care system, and strategically planned service delivery models to integrate workforce planning from the start. This will ensure that there are enough healthcare professionals to provide the service within budget and of high quality.

Finally, to be truly patient-centered, the application of pharmacogenomics must be accompanied by clear and open lines of communication with patient representative bodies, the public, and the media.

Consent and Ethics

For any standard medical procedure, consent must be obtained from each patient prior to pharmacogenetic testing. The patient should be able, appropriately informed, and free from compulsion.

But for some, genetic data is thought of as “private,” very personal, and different from other types of health or medical data. This belief may mean that physicians, physicians, and pharmacists encounter strong resistance among some patients, making it difficult to obtain approval.

Based on the National Genomic Testing Handbook, pharmacogenomics has the potential to be a daily prescribing fact across the UK, but it may be a long time before we see this available to everyone.”

Implementation must also take into account the diversity of our population and the fact that most genetic research up to this point has been based on patient groups of European ancestry. If diversity and differences in biological risk factors are overlooked, the initiation of pharmacogenetic testing and the development of a national framework could exacerbate existing health and racial disparities with severe consequences. As the data grows, so will our understanding of how biological factors affect our response to medications, and ultimately outcomes.

Finally, any genetic data collected by the NHS as part of clinical care must be securely stored and kept confidential in line with the UK’s General Data Protection Regulation (GDPR). Any deviations or irregularities must be reported quickly and transparently as required by legislation to avoid losing public confidence and reducing participation.

We have an exciting road ahead

It is clear that there are many barriers, as well as opportunities, presented by the increase in pharmacogenetic testing across the NHS.

The UK is at the forefront of the genome revolution, having first implemented the 100,000 Genomes Project, which now aims to expand to five million genomes. Based on evidence of national genomic testing, informed pharmaceutical prescriptions have the potential to be a daily prescribing fact across the UK, but it may be a long time before we see this available to everyone.

In the meantime, we can look forward to a time when the traditional model of care is fundamentally and irreversibly changing for the better, leading to a customized and age-appropriate system.

About the author

Rich QuelchHead of Global Marketing at Origin, a global marketer with experience in the healthcare and pharmaceutical sector. He has led the development of the Origin brand, making it a leading global supplier of innovative and ground-breaking drug packaging devices, as well as delivering a unique supply chain model that is disrupting the pharmaceutical industry.

For more than 55 years, Origin has been offering customers an impressive range of versatile packaging solutions that respond to the unique needs of the global pharmaceutical market. Origin engages in the design, manufacture and supply of pharmaceutical packaging materials in partnership with licensees and collective management entities.