OnCo
ideasIdea

A public fund that pays for phase 3 trials of cheap, off-patent drugs against cancer

Old drugs like aspirin, statins and beta-blockers show hints of fighting cancer, but no company will pay to prove it. A dedicated public fund should.

The ReDO project (Anticancer Fund) catalogues hundreds of off-patent drugs with anticancer signals; almost none have reached a definitive trial. Public funders have run a few (Add-Aspirin, ALASCCA, MA.32 metformin), and the UK, Belgium and the EU have discussed repurposing frameworks. The proposal is a dedicated international fund (order of $200-300 million a year, from NIHR, NCI, EU and philanthropy) with an independent prioritisation panel, a standing trial network, and a requirement that funded trials be designed to support regulatory label updates and guideline inclusion.

Hypothesis
The fund completes at least ten definitive repurposing trials in its first decade, of which at least two produce practice-changing survival benefits at a cost per life-year gained under $5,000.
Rationale
Repurposed generics have no sponsor because the returns cannot be captured; the expected value to health systems is enormous even at a low hit rate because the drugs cost almost nothing to deliver once proven.
What would test it
Capitalise the fund, select the first five trials through open prioritisation, and report time to enrolment, cost per trial and results against a pre-registered portfolio plan.
Maturity
early clinical
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
6
Bottlenecks it attacks

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