Abstract

BackgroundFinding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs. However, due to a lack of economic incentives, pharmaceutical developers are rarely interested to invest in research with approved medicines, especially when they are out of basic patent or regulatory protection. Consequently, potential new uses for these medicines are mainly studied in independent clinical trials initiated and led by researchers from academia, research institutes, or collaborative groups. Yet, additional financial support is needed to conduct expensive phase III clinical trials to confirm the results from exploratory research.MethodsIn this study, scientific and grey literature was searched to identify and evaluate new mechanisms for funding clinical trials with repurposed medicines. Semi-structured interviews were conducted with 16 European stakeholders with expertise in clinical research, funding mechanisms and/or drug repurposing between November 2018 and February 2019 to consider the future perspectives of applying new funding mechanisms.ResultsTraditional grant funding awarded by government and philanthropic organisations or companies is well known and widely implemented in all research fields. In contrast, only little research has focused on the application potential of newer mechanisms to fund independent clinical research, such as social impact bonds, crowdfunding or public-private partnerships. Interviewees stated that there is a substantial need for additional financial support in health research, especially in areas where there is limited commercial interest. However, the implementation of new funding mechanisms is facing several practical and financial challenges, such as a lack of expertise and guidelines, high transaction costs and difficulties to measure health outcomes. Furthermore, interviewees highlighted the need for increased collaboration and centralisation at a European and international level to make clinical research more efficient and reduce the need for additional funding.ConclusionsNew funding mechanisms to support clinical research may become more important in the future but the unresolved issues identified in the current study warrant further exploration.

Highlights

  • Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs

  • Approved medicines that have been on the market for several years are often relatively cheap compared to new medicinal products, especially if they are out of basic patent and regulatory protection and generic medicines exist

  • Stakeholders with knowledge about clinical research, research funding mechanisms and/or drug repurposing were invited to participate in a semi-structured interview to identify new funding models and explore their application potential in Europe

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Summary

Introduction

Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs. Due to a lack of economic incentives, pharmaceutical developers are rarely interested to invest in research with approved medicines, especially when they are out of basic patent or regulatory protection. Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely treatment options for patients with high medical needs [1,2,3]. Return on investment (ROI) for repurposed off-patent medicines is expected to be low or absent due to a lack of economic incentives [11, 12] Pharmaceutical developers and their shareholders are rarely interested to invest in repurposing opportunities for medicines that are out of basic patent and regulatory protection, essentially making these medicines ‘financial orphans’ [13, 14]

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