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February 2019 | Published by RCPA

Issue #088

The RCPA advocates for a collaborative approach for the successful introduction of pharmacogenetics in healthcare in Australia

The RCPA advocates for a collaborative approach for the successful introduction of pharmacogenetics in healthcare in Australia

The Royal College of Pathologists of Australasia (RCPA) has released a new position statement on the significance of genetic testing to predict a patient’s response to drugs, also known as pharmacogenetics. The RCPA is advocating for a collaborative approach with medical colleges and the wider medical profession, the Government, educators, and researchers, with the aim of creating national guidelines that will facilitate the safe and appropriate introduction of pharmacogenetics in Australia.  By using pharmacogenetic testing, a clinician can align a prescription with the patient’s potential for a beneficial or adverse response to a drug.

Following the new position statement, we spoke to one of Australia’s most respected experts in the field of genetics, Professor Graeme Suthers,

“This is a rapidly growing and evolving discipline in healthcare and, when compared with other countries, Australia is under-represented in terms of pharmacogenetics education, guidelines, research, rebates, and regulatory guidance. Pharmacogenetics has potential application in many areas of healthcare. Patients metabolise medications differently, sometimes as a consequence of their genetic make-up, and this can create critical variation around whether a medication is beneficial. For patients in whom the metabolism of a drug differs from the average, the appropriate response to a pharmacogenetics test result can vary from modifying the dose of the drug to selecting a drug that is metabolised by a different genetic pathway.”

“There is clear evidence that pharmacogenetics can assist in prescribing the right drug at the right dose for a given patient. It is important to stress that it does not replace the professional responsibilities of a prescriber. Pharmacogenetics provides an additional source of information that informs the prescribing physician. A pharmacogenetic test is not required for every prescribing decision, and it is just one of the many factors to be considered by a prescribing doctor.  

“There are only two pharmacogenetics tests on the MBS: these tests identify patients at risk of severe reactions to an HIV medication or a medication used in cancer and serious immunological conditions. The main source of funding for other pharmacogenetic tests is the patient, without there being support from Governments or insurers. Medical Colleges should seek MBS funding of those pharmacogenetics tests with sufficient evidence of validity and utility.

“Australia does not have a national vision about assessing and developing pharmacogenetics in healthcare. Many clinicians are unaware of recent advances in pharmacogenetics and their impact on clinical practice. Educational resources should be developed for students and practising clinicians, and we need national guidelines on how to use pharmacogenetic testing appropriately,” said Professor Suthers.   

The College has identified a number of areas in relation to pharmacogenetics that should be addressed by the medical community, Government, educators and the public. Medications play a central role in the delivery of effective healthcare. However, medication can be costly and the benefits may be offset by side effects and risks of the medication. Pharmacogenetics provides a means of personalised prescribing, giving the right medication at the right dose to a patient. They deserve nothing less.






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