Nebula Genomics Pharmacogenetics: How to Get a Drug Response Report From Your WGS Data

This is the overview: why your Nebula data is enough, what Gene2Rx adds, and how to get a report. Nebula Genomics gives you a VCF file: a near-complete readout of your DNA, sequenced base by base. What it does not give you is a comprehensive, guideline-based report on how those genes affect your medications. That is what Gene2Rx adds. Upload your Nebula VCF and Gene2Rx turns it into a pharmacogenetics report covering 110 medications, built on the same CPIC and FDA guidelines clinicians use. It runs in minutes, costs $5 for a starter report or $49 for the full report, plus a $15 surcharge for WGS and VCF uploads because they take more processing (so a full report is $64), needs no doctor's order, and never expires, because your DNA does not change. (For the concrete walkthrough of what the report actually shows, see the sibling drug response guide.)

Unlike genotyping chips from 23andMe or AncestryDNA, which read a few hundred thousand pre-selected positions, Nebula's whole genome sequencing reads essentially every base. That means your VCF can contain rare loss-of-function variants in genes like DPYD, TPMT, CYP2C19, and CYP2D6 that a chip was never designed to detect. This is the genuine data-quality advantage of starting from Nebula WGS: fewer blind spots on the genes that drive the most consequential prescribing decisions. One limit to know: Gene2Rx works from the variant calls in your VCF, so it does not detect copy-number changes such as CYP2D6 gene duplications or deletions (those require raw alignment files), and those particular star alleles are not part of the report.

Gene2Rx reads your VCF, calls your metabolizer phenotype for each pharmacogene (poor, intermediate, normal, rapid, or ultrarapid), and maps each phenotype to specific recommendations for 110 medications, with every recommendation traceable to its CPIC or FDA guideline. The report spans psychiatry (antidepressants, antipsychotics, ADHD medications), cardiology (clopidogrel, warfarin, statins, metoprolol), pain (codeine, tramadol), chemotherapy (capecitabine, fluorouracil), transplant, and gastrointestinal drugs. It is delivered in minutes, with no new sample and no prescriber required.

Nebula Genomics has offered optional health and trait reports, and its drug-related insights have been limited and have changed over time. What Nebula does not deliver is a comprehensive, CPIC-anchored pharmacogenetics report across your medication list. Many Nebula users end up with a rich VCF and no easy way to get a structured interpretation from it. Gene2Rx reads the full set of pharmacogenetic variants from that same VCF and reports against 110 medications using CPIC and FDA dosing guidance.

Clinical pharmacogenetic tests like GeneSight run from a few hundred to a few thousand dollars, need a new DNA sample, and require a provider order. Because you already have Nebula WGS data, none of that applies: a Gene2Rx report is $5 for the starter tier or $49 for the full report, plus the $15 WGS surcharge, with no lab work to repeat. And because your VCF already contains every position in your genome, you can re-run it against the same analysis as CPIC and FDA guidance evolves, with no new sequencing. Your pharmacogenetic profile does not change, so a single VCF is a reference you will use for decades.

These are the main genes Gene2Rx reads out of your Nebula VCF and what each one affects. The biology is the same no matter which data source you start from; what Nebula WGS provides is the most complete raw readout at these positions.

Your Nebula VCF contains the genotypes for all of these genes; the only thing standing between that and actionable guidance is interpretation. Gene2Rx translates your genotypes into metabolizer phenotypes for each gene, then maps those phenotypes to specific medication recommendations anchored to CPIC^[8] and FDA^[9] guidelines, so the output reads the same way a clinical pharmacogenetic report would. Because WGS observes more of the underlying variation directly, confidence in each phenotype assignment is typically higher than for genotyping-based reports.

If you already have Nebula WGS data, there is little reason to wait: the data exists and the starter report is $5 plus the $15 WGS surcharge. It is most valuable if you are starting or already taking a medication with pharmacogenetic guidelines, if you have had side effects or poor response in the past, or if you simply want the information on file for future prescribing. Because your genotype never changes, one report serves you for life, and you can re-run the same VCF as guidelines evolve.

• 23andMe Pharmacogenetics: How to Get a Drug Response Report From Your Existing Data
• AncestryDNA for Drug Testing: Get Pharmacogenetics From Your Ancestry Data
• MyHeritage Pharmacogenetics: Use Your MyHeritage DNA for a Drug Response Report
• How Much Does a Pharmacogenetic Test Cost? 2026 Prices and Cheaper Alternatives
• Looking for a GeneSight Alternative? Here's the Short Answer
• Looking for a Genomind Alternative? Here's What to Know

Only in a limited way. Nebula has offered optional drug-related insights through its reports over time, but these have changed and do not provide the comprehensive CPIC- and FDA-anchored interpretation that a dedicated service delivers. Gene2Rx reads the full set of pharmacogenetic variants from the same VCF and reports against 110 medications with guideline-based recommendations.

For most common pharmacogenetic variants, high-quality genotyping is very accurate, and Gene2Rx accepts those files too. WGS adds value for rare alleles that a chip does not probe. Note that Gene2Rx does not call CYP2D6 copy-number changes (gene duplications or deletions) from any file, because that needs raw alignment data we do not process.

Plain .vcf and bgzip-compressed .vcf.gz files aligned to GRCh37 or GRCh38. The pipeline auto-detects the build, so you do not need to lift over the file before uploading.

Yes. Your VCF is permanent raw data. As CPIC and FDA pharmacogenetic guidelines evolve, you can regenerate an updated report from the same file without any new sequencing.