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探索现有药物的新用途:为独立临床研究提供资金的创新机制。

Exploring new uses for existing drugs: innovative mechanisms to fund independent clinical research.

机构信息

Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, Belgium.

Anticancer Fund, Strombeek-Bever, Belgium.

出版信息

Trials. 2021 May 4;22(1):322. doi: 10.1186/s13063-021-05273-x.

Abstract

BACKGROUND

Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs. However, due to a lack of economic incentives, pharmaceutical developers are rarely interested to invest in research with approved medicines, especially when they are out of basic patent or regulatory protection. Consequently, potential new uses for these medicines are mainly studied in independent clinical trials initiated and led by researchers from academia, research institutes, or collaborative groups. Yet, additional financial support is needed to conduct expensive phase III clinical trials to confirm the results from exploratory research.

METHODS

In this study, scientific and grey literature was searched to identify and evaluate new mechanisms for funding clinical trials with repurposed medicines. Semi-structured interviews were conducted with 16 European stakeholders with expertise in clinical research, funding mechanisms and/or drug repurposing between November 2018 and February 2019 to consider the future perspectives of applying new funding mechanisms.

RESULTS

Traditional grant funding awarded by government and philanthropic organisations or companies is well known and widely implemented in all research fields. In contrast, only little research has focused on the application potential of newer mechanisms to fund independent clinical research, such as social impact bonds, crowdfunding or public-private partnerships. Interviewees stated that there is a substantial need for additional financial support in health research, especially in areas where there is limited commercial interest. However, the implementation of new funding mechanisms is facing several practical and financial challenges, such as a lack of expertise and guidelines, high transaction costs and difficulties to measure health outcomes. Furthermore, interviewees highlighted the need for increased collaboration and centralisation at a European and international level to make clinical research more efficient and reduce the need for additional funding.

CONCLUSIONS

New funding mechanisms to support clinical research may become more important in the future but the unresolved issues identified in the current study warrant further exploration.

摘要

背景

为现有药物寻找新的治疗用途可能会为高医疗需求患者带来安全、负担得起且及时的新治疗选择。然而,由于缺乏经济激励,制药开发商很少有兴趣投资于已批准药物的研究,尤其是当这些药物已过基本专利或监管保护期时。因此,这些药物的潜在新用途主要在由学术界、研究机构或合作团体的研究人员发起和主导的独立临床试验中进行研究。然而,需要额外的财政支持来进行昂贵的 III 期临床试验,以确认探索性研究的结果。

方法

本研究通过检索科学和灰色文献,以确定和评估重新利用药物进行临床试验的新的资金机制。2018 年 11 月至 2019 年 2 月,对 16 名具有临床研究、资金机制和/或药物再利用专业知识的欧洲利益相关者进行了半结构式访谈,以考虑应用新资金机制的未来前景。

结果

传统的政府和慈善组织或公司拨款资助在所有研究领域都广为人知且广泛实施。相比之下,只有很少的研究关注应用更新的机制来资助独立的临床研究,如社会影响债券、众筹或公私合作伙伴关系。受访者表示,健康研究,特别是在商业利益有限的领域,需要额外的财政支持。然而,新资金机制的实施面临着一些实际和财务方面的挑战,如缺乏专业知识和指导方针、高交易成本以及难以衡量健康结果。此外,受访者强调需要在欧洲和国际层面加强合作和集中化,以提高临床研究的效率并减少对额外资金的需求。

结论

新的资金机制来支持临床研究可能在未来变得更加重要,但当前研究中未解决的问题需要进一步探讨。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f06c/8094543/675a8d6aa61e/13063_2021_5273_Fig1_HTML.jpg

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