FIGURE 1.

Proposed framework for pharmacogenomics (PGx) implementation in practice. PGx implementation in practice involves several stakeholders. See Box 1 for details. Briefly, after test authorization or requirements for testing by drug regulators, the hospital leadership supports the process and communicates with payers, while the pharmacy and therapeutics committee leads the process in collaboration with the hospital laboratory and information technology department. Healthcare providers order the test, make the appropriate therapeutic decisions, and explain them to the patient whom reports to the healthcare provider and payer. Steps for the design of the clinical PGx are highlighted in grey and detailed in Figure 2.