By Andreas Scherer, PhD, Founder and CEO, Salto Partners
Pharmacogenomics has crossed from promising science to clinical necessity. The guidelines are mature, testing is inexpensive, and most patients carry at least one actionable variant. Yet adoption is still fragmented, concentrated in a few centers of excellence and often triggered only after something has gone wrong.
The core argument
- Medication risk is a genomic problem. Variation in genes such as CYP2D6, CYP2C19, DPYD, TPMT and SLCO1B1 affects drugs prescribed in almost every specialty, from antidepressants and statins to opioids and chemotherapy.
- A genotype is for life. The value of a PGx result grows with every prescription that follows. Test once, store it, and make it available at the point of prescribing in every care setting.
- System-wide deployment changes the economics. Fewer adverse drug reactions, less trial-and-error prescribing and more equitable access only materialize when PGx is treated as shared infrastructure.
- It paves the way. PGx is often the first genomic data used in routine care. The pipelines, knowledge bases, clinician education and oversight built for it become the foundation for broader genomic medicine.
What it means for leaders
The bottleneck is not the science, it is operationalization: curated knowledge, transparent interpretation, decision support inside the prescribing workflow, and quality oversight. Spreadsheets and one-off panels do not scale.
Health systems should build the business case on reuse across many encounters and start with cohorts where the payoff is fastest, such as oncology, polypharmacy and older patients. Companies selling into this market should sell outcomes and workflow integration, not genotypes.
Read the full perspective: Pharmacogenomics at Scale: Why System-Wide Implementation Is the Next Frontier of Precision Medicine, published in GenomeWeb.
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