Date：2021-04-13

Our understanding of the impact of genetics on drug response has come a long way. Through various technological advances over the years we are in a position now to identify using genetics the likelihood of response, positive or negative, to various medications in an individual. While for many drugs we have known that genetic impacts treatment and selection, we did not know until recently the prevalence of these genetic attributes in self-identified ethnic Chinese people of Hong Kong. However, a recent scientific publication has helped to fill this gap.

A February 2021 scientific publication conducted by researchers from Hong Kong to establish in ethnically Chinese the prevalence of genetic attributes that can impact medication response, identified an astounding proportion of individuals, 99.6% of 1,116, in their sample had at least one attribute in their gene that could impact selection of a medication for them. In order to assess the impact of this observation, they extracted medications data from the Hong Kong public health system prescribed in 2019. Using this information, they identified that 13.4% of the people in Hong Kong were prescribed a medication for which we know genetic information impacts response. The top 5 medications commonly prescribed were the cholesterol lowering medication simvastatin (146,167 patients), blood thinner clopidogrel (26,304 patients), pain medication ibuprofen (12,000 patients), uric acid reducer allopurinol (10,438 patients) and blood thinner warfarin (10,280 patients). Furthermore, it was estimated that over $8 million USD, approximately 25% of all money spent on buying medications in 2019, was for purchasing these medications that had genetic guidelines indicating. It is important to note that all these numbers are focused on 36 medications. There are currently well over 70 medications that have clinically important recommendations based on genetics and so the reported positive benefits could clearly be an underestimate.

Based on this report, there is clear evidence that the use of genetics can have clinical and financial benefits in prescribing medications for people in Hong Kong.

Importantly, the research results mentioned in this article can be used as a reference for promoting the wider use of drug-gene testing for use in prescribing medications in people of Hong Kong.

Lastly, although the Hong Kong health system does not provide all patients with drug-gene screening prior to medical prescriptions, fortunately people in Hong Kong can still receive such tests to personalize their own care. Patients can present their report to their doctors or pharmacists before being provided prescriptions, aiding in the formulation of the most appropriate personalized medication plan to improve medication effectiveness and reduce drug side effects.

Reference material:

Yu MHC, Chan MCY, Chung CCY, Li AWT, Yip CYM, Mak CCY, et al. (2021) Actionable pharmacogenetic variants in Hong Kong Chinese exome sequencing data and projected prescription impact in the Hong Kong population. PLoS Genet. 17(2): e1009323. https://doi.org/10.1371/journal.pgen.1009323