Pharmacogenetics in Community Pharmacy Faces Systemic Implementation Barriers

Despite evidence supporting community pharmacists’ roles in managing pharmacogenetics (PGx) services, limited reimbursement, insufficient training, and restricted access to patient data hinder the transition toward personalized medicine in pharmacy practice.

According to authors of a study published in the Journal of Clinical Medicine, a coordinated approach forward involving policy support, education, and clinical integration is necessary to improve community pharmacy-based PGx services.¹

“If [pharmacogenetic] testing was performed for all patients with a new prescription for one of 56 commonly prescribed medicines, then one in 5 of these patients could potentially benefit from either better drug or dose selection,” David Wright, PhD, professor of health services research at the University of Leicester, told The Pharmaceutical Journal.² “With a need to counsel patients on the use of any genetic test and provide treatment guidance once the results are obtained, the pharmacist is the most appropriate health care professional to undertake this role.”

The push toward precision medicine is part of a broader “4P” medicine paradigm—personalized, preventive, predictive, and participatory—which seeks to move away from the traditional one-size-fits-all approach to pharmacotherapy.

Despite this vision, the reality in community pharmacies often involves navigating a fragmented data landscape. Research into the implementation of a pharmacogenetic passport revealed that inadequate data infrastructure is a primary bottleneck.^1,3

READ MORE: Why Pharmacy Schools Are Urged to Partner with Community Pharmacies

Currently, according to Pharmacogenomics, there is a lack of automatic data exchange between laboratory systems and electronic health records, which forces pharmacists into a cycle of manual labor to exchange vital patient information. This technical friction is compounded by a lack of international standardization for recording and exchanging genomic data, leaving many pharmacists without the user-friendly tools necessary to integrate PGx services into their daily workflow.³

Beyond the software, the financial architecture of health care systems presents its own set of roadblocks. Although the cost of genomic sequencing is decreasing, systematic reimbursement for pharmacist-led PGx consultations remains elusive.¹

In the US, for example, adoption is often localized within academic centers because commercial insurers remain reluctant to cover testing costs. Even in Europe, where initiatives like the UK’s Genomic Medicine Service and the European PREPARE (NCT03093818) study have demonstrated that preemptive testing can reduce clinically significant adverse drug reactions by 30%, funding mechanisms have not fully caught up to the science.

Pharmacists are frequently expected to perform complex interpretations and provide patient counseling without a clear billing structure for these services, which undermines the long-term sustainability of the practice.¹

Educational disparities also create friction between health care providers. Although pharmacists often possess a strong foundation in how genetic variants affect drug-metabolizing enzymes, many of their physician colleagues report feeling under-informed and uncomfortable applying PGx results to clinical decisions.^1,3,4

This uneven playing field can lead to inconsistent integration of pharmacist recommendations by prescribers. Without standardized education programs that span the entire health care workforce, the clinical utility of PGx is often restricted by professional gatekeeping and an unclear division of responsibilities regarding who should order, interpret, and communicate results.^1,3,5

The clinical stakes of overcoming these barriers are high, as genetic factors are estimated to account for up to 30% of the variability in drug response. Testing for variants in common genes like CYP2D6, CYP2C19, and SLCO1B1 can identify patients at risk of toxicity or treatment failure with high-volume medications such as statins, antidepressants, and antiplatelet agents.^1,5,6

As genomic data remains valid for a patient's entire life, preemptive testing offers a high-value, long-term tool for preventing adverse reactions that currently drive 5% to 10% of hospital admissions. Organizations like Genomind and clinical platforms like the Dutch Pharmacogenetics Working Group have established clear, evidence-based guidelines for translating these results into action. But without system-level innovation, these insights remain underutilized.^1,4

Realizing the full potential of PGx will require a concerted shift in policy that treats pharmacogenetics as a health system innovation rather than just a technological advancement. For the community pharmacist, this transition depends on a future where regulatory frameworks, interactive communication protocols, and interoperable data systems finally align with the scientific readiness of the field.^1,5

Only through such a coordinated, system-level approach can precision medicine move from a specialized research interest into routine pharmacy-based patient care. Acknowledging that genetic makeup is just one factor alongside environment and lifestyle is critical, but securing the infrastructure to manage that genetic data is the first step toward a safer, more efficient health care future.^1,6

“Despite growing international experience, the integration of PGx into community pharmacy practice remains uneven and faces systemic barriers, including limited reimbursement, insufficient training, and restricted access to patient data,” concluded the authors of the study.¹ “A coordinated, system-level approach that combines policy support, education, and clinical integration is essential to fully realize the potential of PGx in community pharmacy and to translate precision medicine into routine patient care.”

READ MORE: Q&A: Value-Based Care is Reshaping Pharmacy’s Clinical, Financial Future

REFERENCES

1. Rutkowska K, Chełstowska B, Religioni U, et al. Pharmacogenetics in community pharmacy: global perspectives and implementation. J Clin Med. 2026;15(9):3280. https://doi.org/10.3390/jcm15093280

2. Robinson J. Pharmacogenetic testing in community pharmacy could improve drug selection and cut adverse reactions, study finds. The Pharmaceutical Journal. January 22, 2021. Accessed May 18, 2026. https://pharmaceutical-journal.com/article/news/pharmacogenetic-testing-in-community-pharmacy-could-improve-drug-selection-and-cut-adverse-reactions-study-finds

3. Roelofsen AHA, Kreeftenberg LL, van El CG, et al. Barriers and facilitators for implementing a pharmacogenetic passport: lessons learned from reusing sequencing data. Pharmacogenomics. 2025 Apr-Apr;26(5-6):143-156. doi: 10.1080/14622416.2025.2504862.

4. What is pharmacogenetics testing and who should get it? Genomind. January 22, 2021. Accessed May 18, 2026. https://genomind.com/patients/what-is-pharmacogenetics-testing-and-who-should-get-it/

5. Coumau A, Coumau C, Csajka C. Implementing pharmacogenetic testing in community pharmacy practice: a scoping review. Front Pharmacol. 2025 Sep 22;16:1659875. doi: 10.3389/fphar.2025.1659875.

6. Pharmacogenomics. Cleveland Clinic. October 4, 2023. Accessed May 18, 2026. https://my.clevelandclinic.org/health/articles/pharmacogenomics