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This article presents BioFRAM PGx, a multicentre implementation framework that defines the methodological and operational basis for subsequent observational validation in cardiovascular and mental-health care settings. Methods: The framework was developed by healthcare centres from eight Spanish Autonomous Communities through a structured review of PharmGKB\/ClinPGx clinical annotations, CPIC and DPWG guidelines, and national regulatory resources. Gene\u2013drug pairs were prioritized according to clinical actionability, therapeutic relevance, applicability to the Spanish population, and analytical feasibility. BioFRAM PGx defines a panel of seven pharmacogenes and 35 drugs, standardized genotyping and phenotype-assignment procedures, pharmacovigilance and clinical variables, healthcare-resource measures, and centralized data management. The proposed non-interventional validation phase includes adults receiving at least one selected drug in hospital or primary-care settings, with a minimum six-month follow-up. PGx results are not returned to clinicians and do not modify treatment. Its primary objective is to assess the predictive value of PGx genotyping for adverse drug reactions (ADRs); secondary objectives include ADR incidence and implementation feasibility. Results: The main outputs are the proposed multicentre observational design, the prioritized gene\u2013drug panel, harmonized analytical and pharmacovigilance workflows, standardized data domains, and a centralized data-management strategy. No patient-level clinical, implementation, or economic outcomes are presented. Conclusions: BioFRAM PGx provides a structured multicentre framework for harmonizing pharmacogenetic procedures across the Spanish NHS. Its clinical effectiveness, influence on prescribing, scalability, and economic outcomes remain to be assessed in subsequent studies.<\/jats:p>","DOI":"10.3390\/ph19081305","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T12:09:32Z","timestamp":1787054972000},"page":"1305","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["BioFRAM PGx, an Implementation Proposal for Pharmacogenetics in the Spanish National Health System"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6394-0193","authenticated-orcid":false,"given":"Francisco","family":"Arias-Arag\u00f3n","sequence":"first","affiliation":[{"name":"Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), 06080 Badajoz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1849-1093","authenticated-orcid":false,"given":"Carmen","family":"Mata-Mart\u00edn","sequence":"additional","affiliation":[{"name":"Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), 06080 Badajoz, Spain"},{"name":"Pharmacogenetic and Personalised Medicine Unit, Extremadura Health Service, Badajoz University Hospital, Extremadura University, 06080 Badajoz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"S\u00e1nchez-Redondo","sequence":"additional","affiliation":[{"name":"Instituto Universitario de Investigaci\u00f3n Biosanitaria de Extremadura (INUBE), 06080 Badajoz, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5384-4512","authenticated-orcid":false,"given":"Jes\u00fas","family":"Novalbos","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, Hospital Universitario de La Princesa, Pharmacology Department, Faculty of Medicine, Instituto de Investigaci\u00f3n Sanitaria la Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel \u00c1ngel","family":"Seguido","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, Hospital Universitario de La Princesa, Pharmacology Department, Faculty of Medicine, Instituto de Investigaci\u00f3n Sanitaria la Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6519-8885","authenticated-orcid":false,"given":"Francisco","family":"Abad-Santos","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Department, Hospital Universitario de La Princesa, Pharmacology Department, Faculty of Medicine, Instituto de Investigaci\u00f3n Sanitaria la Princesa (IIS-Princesa), Universidad Aut\u00f3noma de Madrid, 28006 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5352-3462","authenticated-orcid":false,"given":"Mar","family":"Hernaez","sequence":"additional","affiliation":[{"name":"Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, University of Barcelona, Fundaci\u00f3 Cl\u00ednic per a la Recerca Biom\u00e8dica (FCRB), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"Brunet","sequence":"additional","affiliation":[{"name":"Pharmacology and Toxicology Laboratory, Biochemistry and Molecular Genetics Department, Biomedical Diagnostic Center, Hospital Clinic of Barcelona, University of Barcelona, Fundaci\u00f3 de Recerca Cl\u00ednic Barcelona-Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (FCRB-IDIBAPS), Centro de Investigaci\u00f3n Biom\u00e9dica en Red Enfermedades Hep\u00e1ticas y Digestivas (CIBERehd), 08036 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6631-9319","authenticated-orcid":false,"given":"David Hansoe","family":"Heredero-Jung","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain"},{"name":"Department of Clinical Laboratory, Salamanca University Hospital (HUS), 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alejandro de la","family":"Sota-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda","family":"Isidoro-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Institute of Biomedical Research of Salamanca (IBSAL), 37007 Salamanca, Spain"},{"name":"Department of Clinical Laboratory, Salamanca University Hospital (HUS), 37007 Salamanca, Spain"},{"name":"Department of Medicine, University of Salamanca, 37007 Salamanca, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7637-6915","authenticated-orcid":false,"given":"Almudena","family":"Gil-Rodriguez","sequence":"additional","affiliation":[{"name":"Pharmacogenomics and Drug Discovery Group (GenDeM), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"},{"name":"Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Barral-Ra\u00f1a","sequence":"additional","affiliation":[{"name":"Pharmacogenomics and Drug Discovery Group (GenDeM), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"},{"name":"Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olalla","family":"Maro\u00f1as","sequence":"additional","affiliation":[{"name":"Pharmacogenomics and Drug Discovery Group (GenDeM), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain"},{"name":"Genomics and Bioinformatics Group, Centre for Research in Molecular Medicine and Chronic Diseases (CiMUS), University of Santiago de Compostela, 15782 Santiago de Compostela, Spain"},{"name":"Galician Public Foundation of Genomic Medicine (FPGMX), Galician Health Service (SERGAS), 15706 Santiago de Compostela, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys Guadalupe Olivera","family":"Pasquini","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Universitat de Val\u00e8ncia, 46100 Valencia, Spain"},{"name":"Pharmacogenetics and Gene Therapy Unit, Instituto Investigaci\u00f3n Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-2542-1776","authenticated-orcid":false,"given":"Enrique G.","family":"Zucchet","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Universitat de Val\u00e8ncia, 46100 Valencia, Spain"},{"name":"Pharmacogenetics and Gene Therapy Unit, Instituto Investigaci\u00f3n Sanitaria La Fe (IIS La Fe), 46026 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6042-4185","authenticated-orcid":false,"given":"Mar\u00eda Jos\u00e9","family":"Herrero","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Universitat de 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