Pharmacogentics in Transition: Overcoming Barriers to Pre-Emptive Pharmacogenetic Testing Implementation for Enhanced Healthcare in the Netherlands

Abstract

Pharmacogenetics is a rapidly evolving field that aims to personalize drug therapy based on an individual's genetic profile. Pharmacogenetic testing (PGt) can be performed in two ways: single-gene testing or panel-based testing, also known as pre-emptive pharmacogenetic testing (PGt). Panel-based testing involves screening multiple high-risk pharmacogenetic genes at once, making it a more efficient approach. This study investigates the potential implementation of pre-emptive pharmacogenetic testing (PPGt) in the Dutch healthcare system and the associated challenges and opportunities. A mixed-methods approach, combining a scoping literature review with qualitative interviews of Dutch professional stakeholders in pharmacogenetics was employed. The findings underscore the need for structural improvements to enable PPGt implementation, including enhancing education for healthcare professionals, developing clinical guidelines, and setting up a data infrastructure for genetic information exchange. This study also highlights the importance of collaboration among various stakeholders, such as pharmacies, medical associations, insurers, patient groups, and governmental agencies. This paper suggests that a consortium for PPGt implementation could help develop an action plan. The scaling up of implementation can be guided by evidence generated from pilot projects that assess factors including patient and clinician perceptions, cost-effectiveness, and clinical utility.