Implementation of innovative pharmacogenetic tests into practice in Taiwan: An institutional perspective

Pharmacogenetic tests are proposed as a means of targeting therapy to patients such that ineffective medicine prescription and adverse events are reduced and overall benefit in terms of improved health outcomes is maximized. However, the true impact of introducing pharmacogenetic tests into clinical practice remains to be confirmed. This commentary presents some of the key requirements in developing a pharmacogenetic clinical practice model in a hospital setting. The analysis considers the need to select carefully which pharmacogenetic tests are best offered, while balancing the cost to the institution given the potential benefits to the patient population base. Drawing on our experience in Taiwan, we recommend that developing a hospital task force for pharmacogenetic testing is a recommended approach to: (1) set quality standards on how best to conduct the test, (2) provide a pro forma for interpreting results, (3) prescribe treatment appropriately according to results, and (4) design an educational program for all relevant health care team members. To further support the implementation of pharmacogenetic testing in the hospital setting, it is necessary to promote audit of clinical practice by building hospital-based registries to facilitate the collection of health care resource use and outcome data that records the clinical uptake of testing. We suggest that well-conducted economic evaluations, relevant to local practice, are essential pieces of information to guide institutional decision making on how best to develop the appropriate use of pharmacogenetic tests in clinical practice.