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Ethical fears over GP use of gene tests to tailor scripts

GPs could be performing genetic tests on patients as an aid to prescribing within five to 10 years, researchers predict.

Pharmacogenetics is a realistic option for many classes of drugs, including tricyclic and SSRI antidepressants, warfarin and omeprazole.

Study leader Dr Rhydian Hapgood, a GP in Nottingham and an MRC research fellow at the University of Sheffield, said the pharmaceutical industry was pouring investment into the area and it could revolutionise GPs' prescribing habits.

Drug manufacturers hope to use pharmacogenetics to tailor drugs to individual

patients to improve efficacy and reduce side-effects.

But Dr Hapgood warned of enormous ethical, financial, educational and practical dilemmas. 'The nature of the GP consultation would change completely.'

His findings, presented at this month's Society for Academic Primary Care conference in Manchester, were based on a review of 703 studies.

There was 'reasonable evidence' to suggest genetic testing could be used to tailor prescribing of tricyclics and SSRIs, warfarin, azathioprine and other purines, omeprazole and antipsychotics. There was 'some evidence' to support gene tests prior to antihypertensives, ?-agonists and codeine. And there was 'interesting but uncertain evidence' to suggest gene tests may be useful in statin prescribing.

A spokesperson for the Association of the British Pharmaceutical Industry said pharmacogenetics was still at an early stage, so the ethical and cost implications could not be predicted. 'We hope it can help. We may be able to say to certain patients that it won't work, or give this side-effect.

'Will it affect the cost of the medicine? Maybe, but with the increased cost of tailoring the drugs we will see an increased effectiveness.'

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