Genetic Test for Medications

The Genetic Medicines Test is a convenient at-home pharmacogenetic test that looks for gene variations affecting how your body processes certain medications. Once you receive your results, a licensed pharmacogenetics clinician will review them with you in a live video consultation. Your results can then help your doctor determine whether you metabolise a medication quickly, slowly, or at a typical rate — and whether your dosage or medication needs to be adjusted.

In areas such as psychiatry, choosing the right antidepressant or antipsychotic often involves a period of trial and error. These medications can have limited effectiveness for some patients and may cause unwanted side effects, meaning a treatment may not work as well as it should. The Genetic Medicines Test helps your doctor personalise your treatment by adjusting the medication or dose based on your genetic makeup, improving both safety, effectiveness, and treatment outcomes.

Yes. This is the first private service of its kind in the UK and is also available to users in the United States. UK and US users access separate, accredited laboratory services, each meeting the relevant national standards.

The Genetic Medicines Test is currently a private, paid-for service. In the UK, NHS funding may become available in the future. In the US, coverage through your health insurance plan may be possible; however, this depends on your specific plan. Please check with your insurer.

Yes. Your genetic results are lifelong. You will not need to retest your genetics for the same panel unless new genes are researched and added to the available tests. As testing evolves, you may be asked or wish to perform further Genetic Medicines Tests in the future. The laboratory reference sheet at the end of your report will be your best resource for determining whether additional testing could provide further benefits.

The test analyses genes that process over 30% of all commonly prescribed medications, including many antidepressants and antipsychotics. Because some genes such as CYP2D6 and CYP2C19 are relevant to multiple drug classes, your results may also provide useful information about opioid pain medications, antipsychotics, proton pump inhibitors, and nerve pain medications — beyond the medication for which you were initially tested.

NowPatient currently offers two gene panel tests. Our laboratory screens for genetic variations with a validated sensitivity of over 99%. The two gene panels we test are:

• CYP2C19

• CYP2D6

These enzymes play a key role in processing more than 30% of commonly prescribed medications, including many antidepressants and antipsychotics.

CYP2C19 is an enzyme involved in breaking down 5–10% of commonly prescribed medications. It is controlled by the CYP2C19 gene, and variations in this gene can affect how well the enzyme works. Around 3–6% of people of European and African ancestry, and 13–23% of Asian populations, have a slower-acting form of the enzyme, making them poor metabolisers. Testing for CYP2C19 gene variants tells your doctor whether the standard dose of a medication is appropriate for you, or whether it needs to be adjusted or replaced.

CYP2D6 is an important enzyme responsible for metabolising about 25% of all prescription medications. This enzyme is regulated by the CYP2D6 gene, and genetic differences can significantly affect how well it functions. Testing for CYP2D6 gene variants tells your doctor whether the usual dosage is appropriate for you, or whether it needs to be adjusted or changed.

Your rate of drug metabolism influences how your body processes medication. There are five metaboliser statuses: poor, intermediate, normal, rapid, and ultra-rapid.

• Fast metabolisers break down drugs too quickly, which can reduce effectiveness.

• Slow metabolisers process drugs too slowly, increasing the risk of side effects or toxicity at standard doses.

By identifying your metaboliser status, your doctor can decide whether the standard dose of a medication is appropriate, or whether it needs to be adjusted or switched to a more suitable option.

Yes. If your medication is sensitive to both CYP2D6 and CYP2C19, NowPatient recommends you have both panels tested. Both genes can influence how your body metabolises antidepressants, for example. Testing only one gene panel would not give you conclusive information about how your body processes your medication, because the other panel's influence would remain unknown.

Our laboratory screens for genetic variations with a validated sensitivity of over 99%.

The Genetic Medicines Test Service Card is located in the ‘Private Care’ section of your account homepage. From the Options Menu on the card, select ‘Check Eligibility’. You can then check whether your medication is influenced by your genes in one of two ways:

• Eligibility Checker: Complete a quick screening assessment to check whether your medication is covered by the test(s).

• Automatic AI eligibility check: If you have given NowPatient access to your medication records, an automatic AI eligibility check will run. If you qualify, you will receive a notification.

If you qualify, you can select ‘View Test’ to learn more, or ‘Add to Cart’ to proceed directly.

Once you have confirmed eligibility, complete your purchase by following these checkout steps:

1. Go to your Cart using the account navigation

2. Select ‘Checkout’

3. Select your delivery address

4. Select your delivery method

5. Confirm your billing address

6. Review your order

7. Submit payment

8. Order confirmed

9. Return to your account homepage

Once your order is confirmed, the journey from kit delivery to results follows these steps:

• Kit delivery: Your Genetic Medicines Test Kit will be delivered to your home or preferred delivery address.

• Collect your sample at home: Follow the step-by-step instructions included in the kit to collect your sample.

• Return your sample: Place your sample in the prepaid return packaging provided and post it back to our laboratory. All samples are fully tracked.

• Results are processed: Once your sample is received and analysed, you will receive a notification when your results are ready. Results can take up to 10 working days to process from the day the laboratory receives your sample. Your results will appear in your Documents Folder but will remain locked until after your consultation.

• Book your consultation: When you receive your results notification, a ‘Book Consultation’ button will appear within the notification, allowing you to schedule your live video consultation.

• View your results: After your consultation, your results and any referral letter issued will be available in the ‘Reports & Letters’ section of your account homepage to view, download, and share with any healthcare provider.

A prepaid return packaging system is included with every kit. Place your collected sample inside and send it from any Royal Mail post box (UK customers) or USPS collection point (US customers). All samples are fully tracked.

Results can take up to 10 working days to process from the day the laboratory receives your sample. Once your results are ready, you will receive a notification prompting you to book your clinician consultation.

Once you receive notification that your results are ready, follow these seven steps to book your live video consultation:

1. Initiate booking: Select ‘Book Consultation’ from within the results notification.

2. Choose a date: Select your preferred consultation date and add any notes that might assist the clinician. Click ‘Continue’.

3. Choose a time: Select your preferred consultation time from the available slots and click ‘Continue’.

4. Choose a clinician: View available genetics clinicians and select the one you prefer. You can filter by gender and spoken languages. Click ‘Continue’.

5. Review your booking: Check your booking summary and read the ‘Pre-consultation Requirements’ advisory for guidance on how to prepare. Click ‘Continue’.

6. Safety information and reminders: Provide your consultation address and emergency contact details. You can opt in to receive an SMS reminder 30 minutes before your appointment.

7. Confirm your booking: Click ‘Confirm Booking’. A confirmation pop-up will appear and you will be redirected to your account homepage. You will also receive in-app and push notifications confirming the appointment.

Your live video consultation with a licensed specialist genetics clinician is structured around five stages:

• Introduction and identity verification: The clinician introduces themselves and confirms your identity to ensure privacy and confidentiality. They explain what the Genetic Medicines Test is designed to do: identifying genetic variations that can affect how you metabolise or respond to specific medications.

• Review of your test results: The clinician walks you through your results in clear, non-technical language, covering your metaboliser status (poor, intermediate, normal, rapid, or ultra-rapid), which genes were tested (CYP2D6, CYP2C19), and how your gene variants may affect your response to your medications.

• Personalised interpretation and recommendations: The clinician reviews what your results mean in relation to the medications you are currently taking. If the results suggest that a medication or dosage may not be suitable for your genetic profile, the clinician may recommend that your doctor reviews your prescription. A referral letter including your test results will be sent to your doctor if this is the case.

• Your questions answered: You will have dedicated time to ask questions and discuss any concerns. The goal is to ensure you fully understand your gene and medication status and what your next steps are.

• Post-consultation summary: After the consultation, you will receive a notification summarising the key outcomes and confirming whether a referral letter to your GP was issued. If a referral was made, a copy of the letter will be available in the Documents Folder. Your test results will also be unlocked for you to view, download, and share. If your current medications are unaffected by your genetic profile, the consultation will conclude without the need for changes or further action.

After your consultation, your results and any referral letter issued will be available in the ‘Reports & Letters’ section of your account homepage. You can view, download, and share them with any healthcare provider. Before your consultation, your results will appear in the Documents Folder but remain locked.

Yes. NowPatient follows strict General Data Protection Regulations (GDPR), which came into force in May 2018, placing legal requirements on us to manage your personal data securely and with the utmost confidentiality. Records are maintained of all processing carried out, and any regulatory breaches are reported as required. Our platform is also HIPAA-compliant, meaning Protected Health Information (PHI) for US customers is handled securely.

NowPatient’s testing is based on evidence from the CPIC (Clinical Pharmacogenetics Implementation Consortium) at https://cpicpgx.org/.

The medications available for testing have a PharmGKB (https://www.pharmgkb.org/) Clinical Annotation Level of evidence of 1A, 1B, 2A, or 2B, and a CPIC level status of ‘final’. CPIC level A and level B gene/drug pairs have sufficient evidence for at least one prescribing action to be recommended. Only those gene/drug pairs that have been the subject of sufficient in-depth review of evidence are given the CPIC assignment level of ‘final’.

Yes. For UK users, our German laboratory complies with the fundamental guidelines for quality assurance in clinical laboratory testing set out by the German Medical Association (Bundesärztekammer). The laboratory meets all requirements of DIN EN ISO 15189:2014, established within an integrated quality management system based on certification according to DIN EN ISO 9001:2015 and the requirements of the Rili-BAK (2019). All consumables used for sample collection are procured in the UK and certified with conformance standards bodies.

Yes. For US users, our American laboratory is CLIA-certified and registered with the Pennsylvania Department of Health.

Both the UK and US services utilise Clinical Decision Support (CDS) software based on the evidence base of the Clinical Pharmacogenetics Implementation Consortium (CPIC).

The Genetic Medicines Test is a powerful tool for personalising your care, but it is important to understand its limitations:

• Not all medications are covered: The test is designed to identify specific gene–drug interactions primarily involving CYP2D6 and CYP2C19. Many medications are broken down through other biological pathways and will not be covered. You can check whether your medication is eligible using the eligibility checker.

• Negative Predictive Test (NPT): It is possible that the results will not help you and your doctor in managing your care. Even if the results narrow down medication choices, this does not guarantee that those medicines will work for you. There may still be some trial and error involved in finding the most effective treatment.

• Only one part of the medication selection process: Genetics is one of many factors taken into consideration when selecting a medication. Drug–drug interactions, kidney and liver function, age, weight, and diet can all also play a role.

• May not catch rare variations: Genetic Medicines testing does not evaluate the entire gene. We look for changes known to affect how you respond to a drug. You may have a gene change that is not tested for, which could mean a normal test result despite differences in how you respond to medications. As more research is completed, different tests may become available.

• Genes with limited evidence: The test gives results for many genes, but our clinicians will only make recommendations for genes with sufficient research to support medication selection guidance. Genes not currently discussed may become clinically important in the future as more evidence emerges.

If you have concerns about the risks of genetic testing with respect to insurance coverage, NowPatient refers you to the UK Code on Genetic Testing and Insurance at https://www.gov.uk/government/publications/code-on-genetic-testing-and-insurance. This code bars employers and health insurers from discrimination based on genetic testing results.