Farmacogenetische tests in de Belgische zorg: (hoe) beginnen we eraan?

Abstract

Pharmacogenetic tests in Belgian care: (how) do we get started? Personalized medicine attempts to take all the information about an individual into account, and this also includes characteristics that differ from the presumed ‘average patient’. This approach includes pharmacogenetics, where the influence of genetic variation in various biomolecules on drug response is studied. By performing preemptive pharmacogenetic testing, drug therapies can be optimized, and serious side effects can be avoided. In order to implement pharmacogenetic testing in practice, some hurdles still need to be overcome. For example, scientific information needs to be translated into practical clinical guidelines that are applicable in the local context and reimbursement issues also need to be resolved. In this paper, a current list of gene-drug interactions is presented that could be prioritized during the implementation process in Belgium. The list only contains clinically relevant interactions for which there is sufficient scientific evidence. In addition, a tool is described that takes into account the drug consumption in a specific healthcare environment, to prioritize the most interesting gene-drug interactions. International implementation initiatives show that the obstacles are surmountable. It is therefore time to start a dialogue on accelerating the implementation of pharmacogenetic testing in Belgium. We hope that this prioritized list, together with a discussion of some hurdles that need to be overcome, can inform this debate.