OnCo
ideasIdea

A non-profit company to hold marketing authorisations for repurposed cancer drugs

Someone must legally own a drug's licence to update its label and monitor safety. A non-profit could do this for old drugs proven to work in cancer that no company wants.

Regulatory systems assume a commercial marketing authorisation holder who files variations, maintains pharmacovigilance and supplies the product. For repurposed generics, no such holder has an incentive to act. Non-profit developers (Medicines Development for Global Health, DNDi, Cures Within Reach) have shown that non-profits can hold authorisations and run pharmacovigilance. The proposal is a non-profit oncology authorisation holder, funded by the repurposing fund and payers, that files new-indication applications, holds labels for repurposed generics, contracts manufacturing from generic makers, and runs the required safety monitoring.

Hypothesis
The non-profit holder secures labelled oncology indications for at least three repurposed drugs within five years and maintains supply at generic prices, with pharmacovigilance meeting regulatory standards.
Rationale
The gap is institutional rather than scientific or financial: someone must be the accountable holder. A purpose-built non-profit fills the role at low cost and removes the dependence on unwilling commercial holders.
What would test it
Incorporate the entity, take on one repurposed indication with completed phase 3 evidence, and file in two regions; report time to approval and running costs.
Maturity
speculative
Who has to act
philanthropy
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks

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