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Medicines improve and save lives, but taking several medications simultaneously can also increase the risk of harmful interactions and adverse drug reactions (ADRs). This is particularly relevant for people with comorbidities and older patients. HORIZON-HLTH-2027-01-CARE-02: “Personalised approaches to reduce risks from Adverse Drug Reactions due to administration of multiple medications” aims to make medication management safer by combining personalised medicine, biomarkers and better clinical decision-making. Following the recently published official Horizon Europe Cluster 1 Health Work Programme 2026-2027, applicants should plan for the 17 February 2027 single-stage deadline. Below, we outline the main requirements from the call topic and how to address those in the proposal.

Biomarkers should guide safer medication decisions

HORIZON-HLTH-2027-01-CARE-02 is more than a biomarker or pharmacogenomics call. The EC is looking for integrated approaches that can identify ADR risks and translate personalised information into safer medication decisions.

A central element of HORIZON-HLTH-2027-01-CARE-02 is using personalised medicine to better predict and prevent adverse drug reactions. Projects should leverage pharmacogenomics, pharmacokinetics and pharmacodynamics to understand individual responses when three or more medicines are administered simultaneously. Biomarkers should support better patient stratification and help identify drug-response patterns in well-defined patient groups. The goal is not simply to identify associations. Projects should translate this information into personalised approaches that improve medication safety.

The scope allows for different biomedical approaches, including:

• genetic and other relevant biomarkers;
• in-vitro or in-silico ADR models;
• imaging biomarkers;
• drug-drug, drug-gene and drug-food interactions;
• therapeutic dose reduction;
• pharmaco-exposomics;
• environmental and lifestyle factors;
• de-escalation studies to improve multiple drug management.

Tip: Connect your biomarker directly to a clinical decision. Explain what information it provides, when clinicians would use it and how it could change prescribing, dose adjustment, deprescribing or patient monitoring.

All six aspects need to come together

The Work Programme specifies six aspects that funded proposals should address. Together, they show that the EC expects projects to go beyond biomarker discovery.

Proposals should:

• Use pharmacogenomics, pharmacokinetics and pharmacodynamics to predict and prevent ADRs and develop personalised medicine approaches.
• Maximise technology use, including electronic health records (EHRs), artificial intelligence and clinical decision support systems.
• Address ethical, regulatory and implementation challenges associated with bringing personalised approaches into clinical practice.
• Generate evidence on clinical utility and cost-effectiveness of pharmacogenomics and other biomarker-guided approaches for individual medicines and drug combinations.
• Develop strategies for implementation, including regulatory science approaches, so that project results can enter routine healthcare.
• Align with relevant EU initiatives, particularly the European Partnership for Personalised Medicine and the European Partnership on Transforming Health and Care Systems, while avoiding duplication.

Tip: Do not organise these as six disconnected tasks. Build a pathway from risk prediction and personalised treatment decisions through clinical validation and health-economic evidence to implementation in everyday healthcare.

Clinical evidence needs to lead to implementation

The expected outcomes make clear that scientific performance alone is insufficient. The EC wants evidence that can ultimately influence healthcare practice, guidelines and policies. The Work Programme also asks proposals to be sufficiently robust to examine differences across populations and to consider sex differences in drug reactions. Results should be shared with relevant stakeholders and the European Medicines Agency (EMA) to support possible uptake into deprescribing or adjusted-prescribing guidelines.

Projects should generate evidence supporting:

• safer and more effective medication use;
• fewer ADRs and related hospital admissions;
• clinical utility of biomarker-guided treatment;
• cost-effectiveness;
• improved prescribing or deprescribing;
• revision of clinical and regulatory guidelines;
• better education of healthcare professionals and patients.

Tip: Plan for guideline and clinical uptake from the start. Identify which evidence healthcare professionals, regulators and guideline developers will require, then make sure your clinical studies and implementation activities generate it.