OnCo
ideasIdea

A $50 million prize for the first off-patent drug proven to extend cancer survival

Offer a large cash prize to whoever proves, in a rigorous trial, that a cheap existing drug helps people with cancer live longer. Prizes pull effort towards neglected problems.

Inducement prizes (the Longitude Prize, XPRIZE, the Antibiotic Longitude Prize) attract effort where markets do not. For repurposing, the payoff to society is large but no single actor can capture it. The proposal is a prize, funded by philanthropy and payers, awarded to the sponsor of the first adequately powered randomised trial showing a pre-specified overall survival improvement with an off-patent drug in a defined cancer setting, with smaller prizes for definitive negative results that close a widely used off-label practice.

Hypothesis
The prize announcement is followed within three years by at least five new registered phase 3 repurposing trials that would not otherwise have been funded, and a winner within eight years.
Rationale
A prize rewards results rather than proposals, does not require the funder to pick winners, and can be sized to exceed the cost of a pragmatic phase 3 trial of a cheap drug, which is often under $20 million.
What would test it
Announce the prize with published criteria and an independent adjudication panel; track registration of eligible trials on ClinicalTrials.gov against the prior three-year baseline.
Maturity
speculative
Who has to act
philanthropy
Cost to try
Large (over $50M)
Years to first evidence
6
Bottlenecks it attacks

Connected

3top

Pages like this

not linked directly; found by shared links

collections

1
ClinicalTrials.gov

bottlenecks

2
Incentives reward me-too drugs and marginal gainsNo incentive to repurpose cheap drugs