Does Therapeutic Repurposing in Cancer Meet the Expectations of Having Drugs at a Lower Price?

Abstract

Therapeutic repurposing emerged as an alternative to the traditional drug discovery and development model (DDD) of new molecular entities (NMEs). It was anticipated that by being faster, safer, and cheaper, the development would result in lower-cost drugs. As defined in this work, a repurposed cancer drug is one approved by a health regulatory authority against a non-cancer indication that then gains new approval for cancer. With this definition, only three drugs are repurposed for cancer: Bacillus Calmette–Guerin (BCG) vaccine (superficial bladder cancer, thalidomide [multiple myeloma], and propranolol [infantile hemangioma]). Each of these has a different history regarding price and affordability, and it is not yet possible to generalize the impact of drug repurposing on the final price to the patient. However, the development, including the price, does not differ significantly from an NME. For the end consumer, the product’s price is unrelated to whether it followed the classical development or repurposing. Economic constraints for clinical development, and drug prescription biases for repurposing drugs, are barriers yet to be overcome. The affordability of cancer drugs is a complex issue that varies from country to country. Many alternatives for having affordable drugs have been put forward, however these measures have thus far failed and are, at best, palliative. There are no immediate solutions to the problem of access to cancer drugs. It is necessary to critically analyze the impact of the current drug development model and be creative in implementing new models that genuinely benefit society.

Repurposing pantoprazole in combination with systemic therapy in advanced head and neck squamous cell carcinoma: a phase I/II randomized study

“…[21] The reported likelihood of approval of traditionally developed oncology drugs in Phase I trials was estimated to be 6.7%, [22] whereas roughly 30% of repurposing efforts have been reported to be successful. [23] Some of the best success stories of drug repurposing in oncology include arsenic, [24] thalidomide, bortezomib, [21] and raloxifene. [25] Unfortunately, we were unable to add pantoprazole to this list.…”

Drug repurposing analysis with co-expressed genes identifies novel drugs and small molecules for bladder cancer

“…Also, the proposed drug is safe as it has been approved by a health regulatory authority. For cancer treatment, there are three repurposed drugs [12,13]. Feng et al investigated metformin for BC therapy.…”