Hospitals and universities are repurposing drugs through late-stage trials at funded costs up to 90 per cent lower than industry studies.
The findings point to a “hidden” research system outside the patent system, which could help provide more affordable treatments.
Examples include using a cancer drug to treat a leading cause of blindness, changing a breast cancer drug so it can help prevent the disease, and using an older anti-inflammatory drug to treat Covid.
The research, led by King’s College London, explores a parallel drug innovation system taking place outside pharmaceutical companies.
It found that hospitals and universities are running substantial numbers of late-stage clinical trials funded at less than 10 per cent of pharmaceutical companies’ reported costs.
Late-stage clinical trials are studies carried out later in the research process to test whether a treatment is safe and works in a larger group of patients.
The lower cost is partly because universities and hospitals can carry out these trials with fewer resources than industry.
In drug research and development, the three main barriers to innovation are expertise, risk and capital.
These barriers are high for organisations developing new medicines, but lower when repurposing generic drugs.
Drug repurposing means finding new uses for medicines that have already been authorised. Generic drugs are medicines no longer protected by patent, meaning they can usually be made and sold by more than one company at lower cost.
The research found that less expertise is needed when repurposing drugs because the medicine is already well studied and manufactured, projects are selected based on investigators’ expertise, and trials are approved by grant and ethics bodies.
It said risk is also lower because no organisation’s financial viability depends on the authorisation and sales of the drug.
The study also found that clinicians and scientists may be motivated by different incentives from those offered by the patent system, including helping patients recover more quickly and publishing research to support career progression.
Dr Johnathon Liddicoat, reader in law at King’s College London, said: “This alternative research system offers enormous potential to help patients at a fraction of the cost, and governments around the world are starting programmes to formally recognise the research in the system. The drugs are already cheap because they are generic and the programmes will ensure patients have access.”
Early in a drug’s lifecycle, pharmaceutical companies are interested in repurposing. The researchers said recent data indicates that companies obtain regulatory authorisations for 32 new uses a year on average.
These approvals allow the medicines to be marketed for new uses as well as their original purpose.
However, once generic versions enter the market, companies lose interest in repurposing because of competition, according to the research.
The researchers said this is when the alternative system becomes more active, with hospitals and universities using cheaper generic versions of medicines in their studies.
