CERSI-PGx is the Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics, led by the University of Liverpool and funded by Innovate UK, with OHE among the collaborators.
Do Medicines Always Work as Intended?
An estimated 70% of the UK population have received prescription medication. However, a substantial proportion of these medicines do not deliver their intended therapeutic benefits for the individuals taking them—due to genetic variations. Despite the tremendous benefits that innovative medicines have brought to patients, health systems, and society, variability in patient response remains a persistent challenge.
Genetic variations can significantly influence how an individual metabolises or responds to a medicine. These differences can lead to reduced efficacy or an increased risk of adverse drug reactions (ADRs), which are both harmful to patients and costly to the health system.
What is Pharmacogenomics?
Pharmacogenomics (PGx) is the study of how genetic variation affects the efficacy and safety of medicines, enabling clinicians to tailor treatments based on an individual’s likely response to specific drugs or drug classes.
To help anticipate and prevent ADRs and treatment ineffectiveness, PGx testing can be used to inform prescribing decisions.
PGx testing guidelines exist for many commonly prescribed medicines, including blood thinners, antibiotics, and anti-cancer agents. Internationally recognised resources, such as those from the Clinical Pharmacogenetics Implementation Consortium (CPIC),
However, in the absence of UK-specific clinical guidance, only five drug-gene pairs (covering five drugs and seven genes) are routinely tested within the NHS, and there are no formal recommendations for clinicians to test beyond these.
Why the NHS Needs Broader Pharmacogenomics Implementation
Over the past 60 years, more than 1.3 million ADRs have been reported in the UK, many of which may have been preventable. Data from the UK Biobank showed that more than 99% of the population carries at least one actionable gene variant.
Hospital prescribing, in particular, presents a key opportunity. In 2023/24, hospital medicines cost the NHS £10.3 billion. Many of these are high-risk drugs that are ideal candidates for PGx testing. ADRs account for 6.5% of hospital admissions and around 4% of total hospital bed capacity—costing the NHS over £500 million annually. Crucially, between 40% and 60% of these ADR-related admissions are considered avoidable.
A recent trial showed that using a 12-gene PGx panel reduced ADRs by 30%. Further analysis suggests that implementing PGx in line with CPIC guidelines could prevent up to 10% of ADRs. With an ageing population, rising multimorbidity, and increasing polypharmacy, expanding PGx testing could play a critical role in advancing personalised care, improving the cost-effectiveness of NHS prescribing, and averting substantial clinical and economic burden.
CERSI-PGx
To realise the potential of PGx in the UK, structural challenges must be addressed, ranging from lack of national guidance and workforce training to regulatory and implementation barriers.
The Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (CERSI-PGx), funded by Innovate UK, seeks to accelerate the safe and effective integration of PGx into the NHS. Its work includes:
- Developing UK-specific clinical guidelines and regulatory pathways for PGx testing
- Creating educational platforms to upskill regulators, healthcare professionals, and industry
- Assessing the value of PGx implementation
OHE’s Chris Sampson and Bangor University’s Prof Dyfrig Hughes are leading efforts to develop economic frameworks to assess the return on investment in PGx. This work aligns with the UK government’s NHS Mandate and recently announced ‘Life Sci For Growth’ package, which includes investments in genomics and biomedical data infrastructure to drive innovation and economic growth
With the NHS increasingly shifting towards value-based and preventive care, pharmacogenomics is likely to become an essential tool in improving outcomes and efficiency.