The current clinical practice of pharmacogenetic testing in Europe: TPMT and HER2 as case studies

The clinical use of pharmacogenetics has so far been overestimated with only a few practical applications currently available. To explore the reasons of this so far limited access to the clinical practice, we have undertaken a survey on the use of tests for the Human Epidermal Growth Factor Receptor 2 (HER2)-overexpression and Thiopurine Methyltransferase (TPMT)-activity in four European countries (UK, Ireland, Netherlands and Germany). The objective of this survey was twofold: to gain insight into the current clinical practice of pharmacogenetics in Europe, and to reveal the factors that influence the implementation of pharmacogenetics in healthcare. From the results it is clear that none of the tests are fully implemented, though HER2 testing is far more widely used than TPMT-activity testing. Barriers to implementation have been identified in the complexity of sample handling and storage, high costs, unclear clinical utility and lack of specialized education, as well as difficult reimbursement. No negative patient response was perceived for either test.JRC.J.5-Agriculture and Life Sciences in the Econom