Is Personalised Prescribing the future? Why Your Prescriptions Should Be Based On Your Genetics
- Jan 12
- 2 min read
Over the last decade, medicine has become increasingly sophisticated, yet much of everyday prescribing still follows a familiar pattern: prescribe, wait, adjust, repeat. For many patients it works well. For others, it doesn’t. They experience side effects, minimal benefit, or spend months cycling through alternatives before landing on something tolerable.
Trial & Error prescribing
What’s becoming clearer is that this variation is not random.
A growing body of evidence shows that genetic differences play a major role in how individuals metabolise and respond to common medications - from statins and antidepressants to pain relief and blood thinners. These differences affect how quickly a drug is broken down, how active it becomes in the body, and how likely it is to cause adverse effects.
This is where pharmacogenomics (PGx) comes in.
PGx testing looks at specific genes involved in drug metabolism and response. The aim isn’t to replace clinical judgement, but to add another layer of precision: helping clinicians choose the right drug and right dose earlier, rather than relying solely on trial and error.
A useful example already embedded in UK practice is clopidogrel. NICE now recommends CYP2C19 genetic testing for patients being considered for clopidogrel following ischaemic stroke or TIA, because around one in three people carry variants that reduce its effectiveness. In those patients, prescribing clopidogrel without genetic insight can mean the drug simply doesn’t work as intended.
NICE guidance: https://www.nice.org.uk/guidance/dg59
What’s interesting is that clopidogrel isn’t an exception - it’s a signpost. Large population studies consistently show that the vast majority of people carry at least one actionable pharmacogenetic variant affecting commonly prescribed medicines. One of the foundational analyses underpinning modern PGx implementation demonstrates how widespread these variants are across routine prescribing pathways:
How do you know what medication is right for you?
Mantara is one of the UK companies translating this evidence into clinical practice. Their approach uses a simple saliva-based test to generate a personalised pharmacogenomic profile, which can then be used alongside standard clinical decision-making. The output isn’t a “yes or no” answer, but practical prescribing insight across a broad range of commonly used drugs.
From a clinician’s perspective, the value of PGx is not theoretical. It’s seen when a patient who struggled with side effects tolerates an alternative first time. When a medication finally works as expected. When confidence replaces uncertainty on both sides of the consultation.
This isn’t about overcomplicating care or genetic determinism. It’s about recognising that variability exists - and using available tools to reduce unnecessary friction in treatment.
Once in a lifetime test
The good news is that you only need to perform this test once to gain a lifetime of knowledge about what medication works for you - and it's available today
Personalised prescribing won’t replace good medicine. But it’s increasingly clear that it can make good medicine more efficient, safer, and more predictable. And in a healthcare system under pressure, that matters.
The question is no longer whether personalised prescribing has a role - it’s how quickly we choose to adopt it thoughtfully and responsibly.
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