7 comments

  • jawns 1 hour ago
    I have been a supporter of Cures Within Reach, a nonprofit that focuses on repurposing drugs, especially for rare diseases. https://www.cureswithinreach.org

    They have funded some important repurposed-drug studies for Huntingtons Disease, which runs in my family. For a disease like this, it's never going to make sense for major pharmaceutical companies to invest the effort to develop entirely new drugs, but by repurposing existing drugs, it gives people living with rare diseases a chance to ease symptoms.

  • functionmouse 5 minutes ago
    Related, one of my all time favorite articles: https://www.propublica.org/article/revlimid-price-cancer-cel...
  • turtleyacht 2 hours ago
    How do people needing (and willing to risk) treatment hear about repurposing studies?
    • astura 2 hours ago
      Big medical systems will post their clinical trails quarterly or so. If you have a big medical system near you you can sign up for emails. I imagine universities would have a mailing list too, if they regularly did clinical trials.

      You can also search here: https://clinicaltrials.gov/

      I was a clinical trial participant once and it was a positive experience for me.

    • giuliomagnifico 2 hours ago
      I think in the same way they participate in other clinical trials.
    • bell-cot 1 hour ago
      Communities (on-line or off-line) of people who share your disorder, and maybe health care professionals who see many patients with your disorder.
  • oezi 2 hours ago
    Such studies are great but there is no regulatory pathway to extend the use of existing drugs for new indications of use without the consent of the manufacturer (or becoming a manufacturer yourself).

    This means such studies can give more clarity on which off-label use is beneficial but it can't be an officially allowed usage.

    • intrasight 1 hour ago
      There tens of millions of people being treated off-label.
      • oezi 37 minutes ago
        The doctors are assuming liability or let the patient sign waivers, which I guess is fine. But the lack of a pathway prevents a lot of commercial possibilities. For instance it is almost impossible to build a business around supporting off-label use cases (for instance selling necessary accessories).
        • Aurornis 0 minutes ago
          Off label prescribing is extremely common.

          This isn’t a new or novel concept. Doctors manage patients with off-label prescriptions all day long.

        • forgetfreeman 16 minutes ago
          The business is already built given the drug in question is already being manufactured and available on the market.
      • uberex 38 minutes ago
        Can confirm. LDN user here.
        • cjbgkagh 26 minutes ago
          Also a LDN user, that drug saved my life. I bought it from a shady dude online, the initial effect was so strong that I thought they shipped me meth instead - that wore off after a week but the lifting of the brain fog persisted.
          • jnovek 13 minutes ago
            It didn’t have that sort of immediate, intense effect for me (though yours isn’t the only account like this that I’ve seen) but I’m still happy with the outcome; it dropped my average 1-to-10 pain score by about two points at three months.
    • vidarh 1 hour ago
      The article points out that it is typically after patent expiry that the universities and hospitals start looking at repurposing.
      • oezi 36 minutes ago
        The patents aren't hindering off-label use. The hinder commercial exploitation by others.
        • vidarh 23 minutes ago
          Yes, but that isn't relevant to what happens after the type of trials described in the article, which tends to happen when the patents are no longer relevant. As the article points out, while the drugs are patented, the manufacturers themselves are generally very interested in repurposing because it broadens their market. The article is discussing trials that mostly happens once the patents have expired.
    • ktallett 2 hours ago
      This isn't completely true at least in the UK. It is simply that the manufacturer is no longer responsible legally. The GMC allow prescibing of unlicensed meds. However the change needs to be made to the pathway. So many issues in the NHS has been due to pathway problems.
    • boxed 2 hours ago
      That seems wild. Do you have a citation to back that up? And in what country/countries?
      • amanaplanacanal 1 hour ago
        I'm in the US, and there are a couple of wrinkles to this: insurance typically won't cover off label use, so patients end up paying the full cost of the medication, and if there is a big enough market, I believe companies can patent the new use even if the patents for the original use have run out.

        Doctors here are allowed to prescribe them though.

  • ck2 1 hour ago
    the thing is while something is better than nothing, new drug development is critical

    there is absolutely no cure for certain types of long-covid and me-cfs right now

    no repurposing any drug is going to cure it, they've tried everything after six years

    it will take a decade to have anything even in the pipeline and won't emerge from the USA because all medical and science research investment by the government has been destroyed by Russell Vought and Heritage Foundation

    JAK-STAT inhibitors will be a big treatment, not a cure, but they cost thousands per month in the USA because generics aren't allowed

  • xenophenes 1 hour ago
    fascinating! I'm sure there's quite a bit that can be learned through appropriate research - pathways to solve problems that haven't been thought of before
  • shevy-java 34 minutes ago
    The prices of drugs in the USA are especially high. This is interesting because the USA claims to pursue a maximum capitalistic society - but if this were the case, you'd have competition in a free market. But you don't have that. You have a cartel (or rather more than one).

    A pure capitalistic society works on assumptions that are not real. People are often cheaters. This would have to be taken into account. But when you have an orange Al Capone in charge, it is pillage day. Even before the orange King you had heavily overcharged prices in the health care system. You need to realise that you have a mafia in charge that does not want to change this system. Why kill the cow that you can milk for free?

    • wk_end 25 minutes ago
      > This is interesting because the USA claims to pursue a maximum capitalistic society

      No it doesn't. This is silly.

      Drug prices in the US are high for non-generic drugs because patent law gives the patent holder an artificial government-granted monopoly, which is blatantly not "pure" or "maximum capitalistic".

      Generic drugs - where the free market does apply - in the US are as cheap or cheaper than in other countries. See [0]:

        U.S. prices for brand-name originator drugs were 422 percent of prices in
        comparison countries, while U.S. unbranded generics, which we found account for 90
        percent of U.S. prescription volume, were on average cheaper at 67 percent of
        prices in comparison countries, where on average only 41 percent of prescription
        volume is for unbranded generics.
      
      [0] https://pmc.ncbi.nlm.nih.gov/articles/PMC11147645/
    • bluGill 24 minutes ago
      The US is not a capitalist society, it is a liberal society. Capitalism is a consequence of that but it isn't the reason.
    • MrBuddyCasino 30 minutes ago
      Look at the development of price and quality of something that is outside the regulated medical system, like eg Lasik, and everything within that system. Its like night and day.

      If we had proper competition and price discovery, things would be much better.

      • Geeek 26 minutes ago
        On the other hand, dental work, especially anything above basic filings, are prohibitively expensive. I'd say Lasik is the exception, not the rule.