Choose pharmacogenomic testing deliberately, not blindly

A clinical pharmacology position piece highlights that commercial pharmacogenomic laboratories differ widely in how they test and report germline variants affecting drug response, and proposes standards for which practices laboratories should adopt or abandon, plus criteria clinicians can use when choosing one.

The practical consequence for prescribers is that a pharmacogenomic result is only as good as the laboratory and the panel behind it: an incomplete allele set or non-standard reporting can give false reassurance or miss an actionable variant. When ordering testing, prefer laboratories that follow recognised standards, check which genes and alleles the panel actually covers, and interpret results against established guidance such as CPIC rather than the report's own prescribing suggestions.

This is guidance rather than trial evidence, but it changes a concrete habit: treat the choice of pharmacogenomic laboratory and the scope of its panel as part of the clinical decision, not an afterthought.

• Pharmacogenomic laboratories vary widely in testing methods and reporting.
• An incomplete allele panel can falsely reassure or miss an actionable variant.
• Prefer laboratories that follow recognised pharmacogenomic standards.
• Check which genes and alleles a panel covers before relying on it.
• Interpret results against established guidance such as CPIC, not the vendor's own advice.

Why it matters

A pharmacogenomic result drives prescribing, so an unreliable or incomplete test can mislead the very decision it is meant to inform.

Don't overread it

This is a standards and opinion piece, not new outcome evidence; it guides how to order and interpret testing, not whether to test.

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