Intended for healthcare professionals


New uses for old drugs

BMJ 2018; 361 doi: (Published 26 June 2018) Cite this as: BMJ 2018;361:k2701
  1. Pan Pantziarka, programme director12,
  2. Munir Pirmohamed, David Weatherall chair of medicine3,
  3. Nasir Mirza, locum consultant neurologist3
  1. 1Anticancer Fund, Brussels, 1853 Strombeek-Bever, Belgium
  2. 2George Pantziarka, TP53 Trust, London, UK
  3. 3University of Liverpool, Liverpool, UK
  1. Correspondence to: P Pantziarka{at}

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 ( 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 …

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