VA expands precision medicine through pharmacogenomics

In recent years, VA has become a national leader in precision medicine, using pharmacogenomics (PGx) to personalize prescriptions and improve outcomes for Veterans. PGx testing analyzes how a Veteran's genes affect their response to medications, reducing trial-and-error prescribing and preventing dangerous side effects.

From pilot programs to national expansion

Launched in 2019 through the PHASER initiative, PGx programs have expanded steadily across VA. "PHASER's mission was clear: optimize medication safety and efficacy by giving providers genetic insights at the point of care," explained Dr. Jennifer Clark. "For Veterans-many managing complex conditions like PTSD, chronic pain, or polypharmacy-this was a game-changer."

By 2025, participating sites are moving from testing 16 genes to 22, with new screenings that can prevent life-threatening anesthesia complications and antibiotic-related hearing loss.

"Pharmacogenomics is not just a scientific advancement-it is a vital part of improving health care and ensuring that every Veteran receives the best possible treatment in a timely manner," said Marri Fryar, executive director at VA Fayetteville Coastal.

Automation is also transforming care. Innovations like FastTrack PGx now cut turnaround times from six weeks to two, integrating results directly into Veterans' electronic health records. This means providers can access genetic insights quickly, supporting safer, more effective decisions.

Impact on Veterans

For Veterans managing conditions such as depression, chronic pain or heart disease, PGx has been a breakthrough. Genetic testing has already helped Veterans switch to medications better matched to their biology, lowering side effects and improving quality of life. Surgical teams are also using PGx to identify risks before procedures, reducing emergencies in the operating room.

Dr. Victor Barnes, a PGx champion, put it simply: "We're not just prescribing, we're personalizing-and that's how we honor their service."

Looking ahead, VA aims to expand PGx nationwide, integrating artificial intelligence and broader training to bring precision medicine to even more Veterans. For those who have faced years of ineffective treatments, PGx offers not just science, but hope.