Low cost generics are an untapped source of therapeutic innovation

Cost constraint is a major concern for health systems globally. High unmet needs, increased demand because of demographic change, and the rising prices of new drugs conspire to exacerbate financial strains.1 Of these three factors, only drug pricing is amenable to influence in the short to medium term. Drug repurposing—the use of existing licensed drugs for new medical indications—has the potential to help reduce costs.2

Many candidates for repurposing are widely used low cost generics. For example, the Repurposing Drugs in Oncology project (http://www.redo-project.org) has identified more than 230 licensed non-cancer drugs with data supporting anti-cancer activity, of which over 75% are off-patent.3 As the drugs are already in routine clinical use for other purposes early phase clinical trials can be bypassed, saving time and money.

The potential for repurposing extends to all areas of medicine, with much activity in oncology, neurology, psychiatry, and infectious diseases. Several drugs are already being used for new indications, including the repurposing of propranolol for infantile haemangioma, thalidomide for multiple myeloma, and topiramate for migraine prophylaxis.