In the ever-changing world of medicine, it’s clear that a one-size-fits-all approach to drug therapy isn’t ideal. People respond differently to medicines due to various factors, including their genes. Pharmacogenomics, a field combining genetics and medicine, aims to address this challenge. It uses genetic information to customise drug treatments, making them more effective and safer. The global pharmacogenomics market was worth $15 billion in 2022 and is expected to reach approximately $35.67 billion by 2032, with an annual growth rate of 9.1 per cent during the period from 2023 to 2032.

India holds a significant position in the global pharmaceutical market. As per a report by CareEdge Ratings, the domestic pharmaceutical industry is poised to reach an impressive $57 billion by FY25, with notable improvements in operating margins. In FY23, the Indian pharmaceutical market exhibited robust growth, with a nearly five per cent yearon-year increase, reaching a substantial $49.78 billion. Despite modest export growth of three per cent, the domestic market soared with a remarkable seven per cent year-on-year rise. Even in the face of pricing pressures in the US generics market, formulation companies managed to maintain their margins at approximately 22 per cent in FY23, thanks to their focus on complex and specialty products. CareEdge Ratings predicts a continued upward trajectory for the pharmaceutical industry, projecting a growth rate of 7-8 per cent in FY24-FY25.

Understanding Pharmacogenomics

Pharmacogenomics, often referred to as pharmacogenetics, is the study of how a person’s genetic profile that influences their response to the drugs. It delves into the genetic variations that affect an individual’s drug metabolism, efficacy, and safety. By identifying these variations, pharmacogenomics aims to guide healthcare providers in customising drug regimens for each patient, ensuring that they receive the most effective and safe treatment.

The human genome, consisting of over 20,000 genes, plays a pivotal role in how the body processes drugs. Variations in these genes can lead to differences in the enzymes responsible for drug metabolism, the transporters that move drugs in and out of cells, and the drug targets themselves. Consequently, individuals may experience variations in drug absorption, distribution, metabolism, and elimination (ADME), all of which influence the drug’s overall effectiveness and side effect profile.

Advantages of Pharmacogenomics

The incorporation of pharmacogenomics into clinical practice offers several compelling advantages. Perhaps the most significant benefit of pharmacogenomics is its ability to inform healthcare providers about the most appropriate drug for an individual based on their genetic profile. This can greatly improve the chances of a successful treatment outcome while minimising the risk of adverse effects. Pharmacogenomic data allows for the adjustment of drug dosages to ensure they are both effective and safe for a specific patient. This is particularly crucial for drugs with a narrow therapeutic window, where small dosage variations can lead to either ineffectiveness or toxicity. By identifying genetic factors contributing to adverse drug reactions, pharmacogenomics can help healthcare providers anticipate and mitigate potential side effects, enhancing patient safety. Tailoring drug treatments can reduce the financial burden on healthcare systems by minimising ineffective treatments and reducing hospital admissions due to adverse drug reactions. Additionally, pharmacogenomics speeds up drug development by identifying patient groups more likely to respond positively to specific drugs, streamlining clinical trials, and making drug discovery more efficient.

Pharmacogenomics in India: The Current Landscape

According to the Pharmacogenomics Global Market Report 2023 report, in 2022, North America held the top position as the largest market region in pharmacogenomics. It is anticipated that Asia-Pacific will emerge as the swiftest growing region. In recent years, India has made significant strides in the field of pharmacogenomics. Researchers are actively exploring the genetic diversity within the Indian population to identify unique genetic variations that may impact drug responses. This is crucial because genetic differences among populations can significantly influence drug metabolism and efficacy.

To fully harness the potential of pharmacogenomics in India, it is essential to comprehensively study the genetic landscape unique to the country. They are conducting studies to identify genetic variations in the Indian population that influence drug responses, with a particular focus on conditions such as cancer, cardiovascular diseases, and diabetes. Some healthcare institutions in India have initiated the incorporation of pharmacogenomics into their clinical practices. This involves genotyping patients to guide drug selection and dosing decisions for various medical conditions.

Furthermore, India’s regulatory authorities have recognised the importance of pharmacogenomics and are working towards developing guidelines and regulations to ensure the responsible implementation of pharmacogenomic testing in healthcare. Educational programs and workshops are helping healthcare providers and patients understand the potential of personalised medicine.

Challenges and Barriers in India

Despite progress, there are challenges hindering the widespread adoption of pharmacogenomics in India. The cost of pharmacogenomic testing remains a significant barrier for many patients. Efforts to make these tests more affordable and accessible must be a priority. Many healthcare providers and patients in India are still unaware of the benefits of pharmacogenomics and how it can improve treatment outcomes. To build a comprehensive understanding of the Indian genetic landscape, data sharing among research institutions and healthcare providers needs to be encouraged and facilitated. Ethical considerations related to privacy and consent regarding genetic testing must be addressed through clear guidelines and regulations. Widespread implementation of pharmacogenomics into routine healthcare practices requires significant investment in infrastructure and training for healthcare providers.

Global Impact and Collaborations

While India is making progress in the field of pharmacogenomics, global collaboration is essential to fully unlock its potential. Genetic variations that affect drug responses can differ significantly among populations. Partnering with other countries can provide access to a broader range of genetic data, facilitating the identification of rare and population-specific genetic variations.

significantly among populations. Partnering with other countries can provide access to a broader range of genetic data, facilSimilarly, the integration of global technologies and techniques takes on paramount significance. By teaming up with leading countries in genetic research and technology, India not only gains access to a diverse genetic dataset but also accelerates progress in pharmacogenomics research. This collaborative approach allows research institutions across the globe to exchange their expertise, tools, and knowledge, leading to swifter advancements in this field.tating the identification of rare and population-specific genetic variations.

Furthermore, such associations can help align pharmacogenomic testing guidelines and regulations across countries, promoting consistency in practice. Moreover, they hasten the creation of medicines designed for particular genetic groups. This focused method holds the promise of producing treatments that are not only more effective but also tailored to individual genetic profiles, marking a significant step towards personalised medicine.

The Road Ahead: Towards Personalised Medicine

Pharmacogenomics represents a paradigm shift in healthcare. India, with its diverse genetic landscape, holds a pivotal position in propelling this field forward and enhancing healthcare outcomes for its people. As we find ourselves at the crossroads of genetics and medicine, the journey towards a more personalised, efficient, and secure approach to drug therapy is firmly underway.

Views expressed by Sanjeev Jain, Jt. Managing Director, Akums Drugs & Pharmaceuticals

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