Related Experiment Video
Updated: Feb 9, 2026

Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
Pharmacogenetic testing in the Veterans Health Administration (VHA): policy recommendations from the VHA Clinical
Jason L Vassy1,2,3, Annjanette Stone4, John T Callaghan5,6
1Section of General Internal Medicine, VA Boston Healthcare System, Boston, Massachusetts, USA. jvassy@partners.org.
Purpose:
The Veterans Health Administration (VHA) Clinical Pharmacogenetics Subcommittee is charged with making recommendations about whether specific pharmacogenetic tests should be used in healthcare at VHA facilities. We describe a process to inform VHA pharmacogenetic testing policy.
Methods:
After developing consensus definitions of clinical validity and utility, the Subcommittee identified salient drug-gene pairs with potential clinical application in VHA. Members met monthly to discuss each drug-gene pair, the evidence of clinical utility for the associated pharmacogenetic test, and any VHA-specific testing considerations. The Subcommittee classified each test as strongly recommended, recommended, or not routinely recommended before drug initiation.
Results:
Of 30 drug-gene pair tests reviewed, the Subcommittee classified 4 (13%) as strongly recommended, including HLA-B*15:02 for carbamazepine-associated Stevens-Johnston syndrome and G6PD for rasburicase-associated hemolytic anemia; 12 (40%) as recommended, including CYP2D6 for codeine toxicity; and 14 (47%) as not routinely recommended, such as CYP2C19 for clopidogrel dosing.
Conclusion:
Only half of drug-gene pairs with high clinical validity received Subcommittee support for policy promoting their widespread use across VHA. The Subcommittee generally found insufficient evidence of clinical utility or available, effective alternative strategies for the remainders. Continual evidence review and rigorous outcomes research will help promote the translation of pharmacogenetic discovery to healthcare.
Related Concept Videos
Myocarditis II: Clinical Features and Diagnostic Tests
Pericarditis II: Clinical Features and Diagnostic Tests
Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
Mitral Stenosis II: Clinical features and Diagnostic Tests
Aortic Regurgitation II: Clinical Features and Diagnostic Tests
Mitral Regurgitation II: Clinical Features and Diagnostic Tests

