Elechi Kelechi W, Adeoye Adekunle F, Olaniyi Aliyu O, Akanbi Olukunle O, Olumeko Isaiah, Udensi Chukwuma G, Kolapo Toluwanimi J, Barrah Vincent U
Integrated Biomedical Sciences, University of Texas Health Science Center at San Antonio, San Antonio, USA.
Mathematics and Statistics, Georgia State University, Atlanta, USA.
Cureus. 2025 May 29;17(5):e85033. doi: 10.7759/cureus.85033. eCollection 2025 May.
The COVID-19 pandemic spurred an unprecedented wave of drug repurposing as scientists and clinicians raced to find immediate treatment options for a novel disease. This narrative review examines how those crisis-driven repurposing efforts fared. It highlights key successes and failures in translating research into practice and assessing their pharmacoeconomic implications in high-income health systems. It also distills lessons to guide future pandemic preparedness and improve equitable global access to effective treatments. We performed a broad literature search across major databases (2020-2025) to identify studies and reports on repurposed COVID-19 therapies and health economic outcomes. While repurposing accelerated the delivery of treatments, results were mixed: a handful of existing drugs, such as the widely available steroid dexamethasone, that reduced mortality, emerged as life-saving interventions, but many other initially promising drugs ultimately showed limited or no efficacy. Agile translational research frameworks like large adaptive trials proved critical, separating truly effective therapies from many speculative candidates. From a pharmacoeconomic perspective, repurposed therapies yielded cost-effective breakthroughs and costly disappointments. High-income countries invested substantial resources in repurposed drugs. In some cases, this approach provided rapid access to evidence-based care but also led to significant spending on unproven interventions, underscoring the importance of timely evidence generation and prudent resource allocation. Disparities in access to effective therapies between wealthy and low-resource settings highlight a persistent global equity challenge. The collective experience of pandemic drug repurposing provides a pragmatic blueprint for balancing urgency with scientific rigor, economic prudence, and equity. This will ultimately guide how we might better pivot from crisis to cure in future global health emergencies.
新冠疫情引发了前所未有的药物重新利用浪潮，科学家和临床医生竞相为这种新型疾病寻找即时治疗方案。这篇叙述性综述考察了这些由危机驱动的重新利用努力的成效。它突出了将研究转化为实践过程中的关键成功与失败之处，并评估了它们在高收入卫生系统中的药物经济学影响。它还提炼了经验教训，以指导未来的大流行防范工作，并改善全球有效治疗的公平可及性。我们在主要数据库（2020 - 2025年）中进行了广泛的文献检索以识别关于重新利用的新冠治疗方法及卫生经济结果的研究和报告。虽然重新利用加速了治疗的提供，但结果好坏参半：一些现有的药物，如广泛可得的类固醇地塞米松，降低了死亡率，成为挽救生命的干预措施，但许多其他最初有前景的药物最终显示出有限的疗效或无效。像大型适应性试验这样灵活的转化研究框架被证明至关重要，它将真正有效的疗法与许多推测性的候选药物区分开来。从药物经济学的角度来看，重新利用的疗法带来了具有成本效益的突破和代价高昂的失望结果。高收入国家在重新利用的药物上投入了大量资源。在某些情况下，这种方法提供了快速获得循证护理的途径，但也导致了在未经证实的干预措施上的大量支出，凸显了及时生成证据和审慎资源分配的重要性。富裕地区和资源匮乏地区在获得有效疗法方面的差距凸显了一个持续存在的全球公平挑战。大流行期间药物重新利用的集体经验为在紧迫性与科学严谨性、经济审慎性和公平性之间取得平衡提供了一个务实的蓝图。这最终将指导我们在未来全球卫生紧急情况中如何更好地从危机转向治愈。
