The impact of pharmacogenomics on a pharmacy and therapeutic committee's formulary system management: An opinion of the pharmacokinetics/pharmacodynamics/pharmacogenomics practice and Research Network for the American College of Clinical Pharmacy

Pharmacogenomic (PGx) considerations are increasingly influencing health system formularies, prompting Pharmacy and Therapeutics (P&T) committees to integrate genetic insights into their decision-making processes. This can be the case in several clinical scenarios, including (1) Prioritizing the use of lower-cost drugs, where PGx testing is applied to guide the use of lower-cost medications when appropriate, (2) Rescuing medications that are effective in the majority of individuals but were removed from the formulary because of harm in a subset of individuals with a specific phenotype, (3) Improving medication safety by utilizing PGx testing/results to guide initiation of reduced drug doses or use of alternative therapy in patients with at-risk genotypes, and (4) Restricting use of high-cost drugs to individuals most likely to respond based on genotype. The primary objective of this PRN opinion piece is to describe how PGx impacts formulary management, including the challenges and opportunities that arise from precision medicine approaches to prescribing.