Published: 18 June 2026 /Medscape/
AMSTERDAM — Thanks to the drop in the cost of genetic sequencing over the last two decades, genomics is becoming ever more present in medicine. Yet, translating that raw scientific capability into routine clinical practice has remained an uphill battle so far. “We’ve been at the bottom of a hill, pushing boulders up,” said Josh Wittner, the president of Gene by Gene, a commercial genetic testing company and laboratory based in Houston, Texas, at a panel at the HLTH Europe 2026 conference. Today, however, the momentum is shifting as those operational challenges begin to clear. “The boulders have become smaller, and we are now at the hill ready to tip over.”
Beyond One Size Fits All
The first diagnostic tool discussed by the panel was pharmacogenomics. This is the study of how a person’s unique DNA influences their response to medications; it aims to eliminate the traditional trial-and-error approach to prescribing, said Sandosh Padmanabhan, MD, PhD, a consultant at the Queen Elizabeth University Hospital and Pontecorvo Chair of Pharmacogenomics at the University of Glasgow. “Each of us responds to medicines differently,” he said. “If you take 10 people with the same condition and give them the same drug, same dose, [then] some of them will respond promptly, for some of them the drug will do nothing, and for some it may cause harm.”
Because these differences are largely written into our DNA, a single pharmacogenomic test could read that genetic code once, providing lifelong utility to guide physicians on which treatments will work and which could cause side effects.
The second diagnostic defined was the polygenic risk score (PRS). Rather than searching for single, rare genetic variants responsible for conditions like cystic fibrosis, a PRS analyzes hundreds of thousands to millions of minor genetic variations across a person’s entire genome. By compiling these variants, the score provides a highly accurate risk assessment for common, complex chronic conditions, including cardiovascular disease, type 2 diabetes, prostate cancer, and breast cancer.
The clinical value of deploying these two tools lies in shifting medicine from purely reactive treatment to true preventive engagement, the panel agreed.
For private insurers such as Bupa, which covers millions of customers across insurance and clinics globally, investing in genomics is seen as a necessity to manage rising healthcare costs and demand. “The key unlock was around us wanting to move from being the fire engine in a reactive system of care to being a fire alarm,” said Rebecca Rohrer, MD, the clinical innovation and genomics director at Bupa, based in London. The goal is to integrate these insights into practical care pathways, enabling doctors to diagnose risks earlier and implement lifestyle changes or preventative therapies long before a clinical disease manifests.
The Obstacles to Mainstream Adoption
If the science is proven and the benefits clear, what is stopping genetics from becoming a routine part of a GP consult? The panelists outlined several challenges.
The first is systemic wiring and workflow: “Policy ambitions are easy,” Padmanabhan said, referencing the UK National Health Service (NHS) 10-year plan, which commits to embedding genomics into patient records. “The difficult bet is the machinery to get genomics to work in a busy hospital on an afternoon on Tuesday. It should not interfere. It's those bits that are the blockers.”
Second are trust issues and fears that a high-risk genetic result could negatively impact health insurance premiums or underwriting guidelines. To counter this, Rohrer said that Bupa offers these tests on a voluntary basis and ensures that genetic testing data is kept separate from insurance underwriting and will never be used to alter premiums.
Third, scaling means ensuring that cutting-edge diagnostics do not inadvertently widen health inequities. While private health consumers can easily buy or opt into clinical testing, public health systems must figure out how to capture underserved, excluded, or marginalized populations who do not proactively seek out healthcare innovation. “It must be for everyone,” Rohrer said.
What the Future Holds
Looking ahead over the next 5-10 years, the panel agreed that success means genomics completely loses its status as an innovation.
Success looks like a healthcare ecosystem in which an individual's genetic profile is seamlessly integrated into their electronic health record from day one. It should no longer be handled as a specialized, rare order, but rather viewed as a baseline vital sign — as standard and routine as checking a patient's blood pressure or cholesterol level, said Padmanabhan.
For the patient, this means receiving highly tailored, evidence-based care without any added friction. For the clinician, it means moving away from clinical guesswork to ensure that the very first drug prescribed delivers maximum efficacy and minimizes the risk for toxicity, he said.
Manuela Callari is a freelance science journalist specializing in human and planetary health. Her work has been published in The Medical Republic, Rare Disease Advisor, The Guardian, MIT Technology Review, and others.
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