Genetics could improve drug treatments

A report from the Nuffield Council for Bioethics says that the tests should be viewed as no more threatening than any other blood test.

There are concerns that any move towards this use of gene testing could actually hinder the creation of drugs that benefit everyone.

The council's Professor Peter Lipton said that drug firms should be given incentives to ensure this did not happen.

At the moment, there are few gene tests which can actually help doctors alter a treatment so that it works better in an individual patients.

Scientists are finding that the genetic make-up of each person is so complex that interpreting such information is very difficult - but they predict such tests will become more common in the future.

Reduced risk

Not only would tests hopefully ensure the right patients were given the drugs most effective for them, they would also allow a safe dose to be dispensed.

This would cut the risk of adverse drug reactions, a major cause of death and injury in hospitals.

It is important to encourage discussion of ethical and policy issues raised by the introduction of pharmacogenetics Professor Peter Lipton, Nuffield Council on Bioethics

The Nuffield report highlights "legitimate concerns" which it says should be addressed before the technology advances any further.

Professor Lipton said: "Claims of 'the right medicine, for the right patients, at the right dose' may be overstated.

"But it is important to encourage discussion of ethical and policy issues raised by the introduction of pharmacogenetics."

GPs and other doctors should be trained to deal with difficult situations that might arise in the future - such as when a patient wants a prescription for a gene-related medicine, but refuses to take the test needed to confirm their suitability.

Our concern is that people with the 'wrong' genetic profile might be excluded from drugs trials Dr Helen Wallace, Genewatch UK

The report also warns that if patients are divided into groups based on their genetic test results, some groups might be so small that it is not financially worthwhile for a drug company to spend money creating and testing a new drug just for them.

"We recommend that incentives might be necessary to encourage pharmaceutical companies to develop medicines that would provide real benefit to only a small number of patients," said Professor Lipton.

Concerns

Genewatch UK, an expert group which investigates the use of genetic technology, still has deep reservations about the side-effects of attempts to personalise medicines based on the DNA of the patient.

Dr Helen Wallace said: "We feel that addressing other issues, such as drug packaging, might have more impact on the number of adverse drug reactions.

"Our concern is that people with the 'wrong' genetic profile might be excluded from drugs trials - when this would be the best way to learn more about such reactions, and improve safety as a result."