Pharmacogenomic testing for major depressive disorder in British Columbia, Canada: Recommendations from a public...

Pharmacogenomic (PGx) testing for major depressive disorder (MDD) can reduce healthcare spending and improve patient outcomes. However, concerns about health equity, data privacy, and secondary usage of data require deliberation. We sought recommendations from members of the general public for policymakers' consideration.

A four-day public deliberation was held in Vancouver, British Columbia (BC), from November-December 2024. Invitations were mailed to 15,000 randomly-selected households in BC. Participant selection maximized socio-demographic diversity. Participants received an information booklet and heard from expert speakers before discussing whether and how PGx testing for MDD should be implemented. Participants then generated and voted on recommendation statements. Finally, participants engaged with policy-/decision-maker panelists. Sessions were audio recorded and transcribed.

Thirty participants generated 15 recommendations. Publicly funding PGx testing for MDD was supported under certain conditions. Participants unanimously called for strict test reporting standards, in line with evidence-based prescribing guidelines. Healthcare professional (HCP) education was seen as necessary, with ongoing access to PGx experts. To enhance accessibility and acceptability, the group suggested re-naming this "PGx testing (medication compatibility testing)" and conducting a targeted awareness/education campaign. However, participants wanted additional efficacy data collected across diverse ancestry groups to ensure PGx testing benefited everyone. While they agreed test results could be shared between HCPs, they wanted further public engagement on using PGx results in research without consent.

Knowledge gained throughout the event appeared to reduce concerns around data privacy, highlighting the importance of pre-implementation education and awareness. These recommendations provide guidance to policymakers considering PGx implementation.