National Pharmacogenomics Pilot in England Triggers Medication Changes for One in Four Patients
One in ten patients across England carries a genetic variation that triggers a red flag warning to switch prescribed medicines, according to findings from a national NHS pharmacogenomics pilot. The primary care initiative also resulted in medication changes for one in four participating patients overall.
The findings were presented on October 2, 2026, at the British Oncology Pharmacy Association annual conference in London by Vicky Chaplin, senior clinical lead for the genomics unit at NHS England. The data stems from the PROGRESS pilot scheme, which evaluates pharmacogenomic-guided prescribing in routine primary care settings.
Rollout and Patient Cohort of the PROGRESS Scheme
The PROGRESS trial launched in June 2023 across ten general practices in north-west England before expanding nationwide in February 2025. By the time of the October 2026 presentation, the scheme had evaluated more than 1,325 patients who were started on a new medicine. Statins and selective serotonin reuptake inhibitors accounted for the majority of these prescriptions.
Genetic testing identified a clinically relevant variation in one of four key study genes—CYP2C19, CYP2D6, SLCO1B1, or CYP2C9—in 91% of pilot participants. Specifically, 9.8% of patients possessed a genetic profile warranting a red flag warning to switch medications entirely.
Clinical Response Rates to Genomic Flag Recommendations
In addition to red flags, three in ten patients, or 30.5%, received an orange flag recommendation advising a potential dose or titration switch. Healthcare professionals acted on this pharmacogenomic guidance 90% of the time, leading directly to a medication adjustment for one in every four study participants.
Chaplin told delegates at the conference that ongoing clinical training in genomics must be built into future medical practice to help providers keep pace with rapid advancements. She emphasized that expanding the genomic medicine service into a broader population health service requires accessible testing infrastructure closer to patients’ homes.
NHS England Targets Genomic Testing for Half of Healthcare Decisions
NHS England projects that up to 50% of healthcare decisions will involve a genomic result by 2035. Chaplin noted that genomic testing must become as routine in medicines optimization as checking a patient’s renal function.
To support this expansion, NHS England is developing a digital version of its national test directory scheduled for release in April 2027, alongside ongoing work to digitize test ordering. Chaplin stressed that research and clinical practice must run side by side to ensure innovations reach patients safely and quickly.
Frequently Asked Questions About the NHS Pharmacogenomics Pilot
Which specific genes were analyzed in the PROGRESS pilot?
The study focused on four key pharmacogenes: CYP2C19, CYP2D6, SLCO1B1, and CYP2C9, which influence how the body processes common medications.
What types of medications were most frequently prescribed to participants?
The majority of patients enrolled in the pilot were started on statins or selective serotonin reuptake inhibitors before undergoing genetic testing.
When was the PROGRESS pilot scheme initiated?
The trial began in June 2023 across ten general practices in north-west England before expanding to a national rollout in February 2025.
When is the digital version of the national test directory expected to launch?
A digital version of the national genomic test directory is scheduled to be available from April 2027.