In this episode of the JACCP Podcast, hosts Robbie Parker and Stuart T. Haines discuss the impact of pharmacogenomics on formulary decision-making with Dr. Jacob Brown and Dr. Larisa Cavallari. The conversation highlights how genetic testing should influence a Pharmacy & Therapeutics (P&T) committee’s work to optimize medication safety and effectiveness. The guests discuss the variability in pharmacogenomic adoption across institutions, barriers such as clinician education, cost, and reimbursement challenges, and the importance of physician-pharmacist collaboration. They also described gene-drug pairs where the evidence is compelling, like clopidogrel, fluoropyrimidines and codeine, demonstrating the value of pharmacogenetic-guided prescribing. Finally, they offer guidance for smaller institutions looking to implement pharmacogenomic strategies, emphasizing a stepwise approach and leveraging available resources. Read The impact of pharmacogenomics on a pharmacy and therapeutic committee's formulary system management: An opinion of the pharmacokinetics/pharmacodynamics/pharmacogenomics practice and Research Network for the American College of Clinical Pharmacy in JACCP.