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ORIGINAL RESEARCH article

Front. Pharmacol.

Sec. Drugs Outcomes Research and Policies

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1670845

Overcoming Barriers to Off-Patent Drug Repurposing: A Lifecycle-Based Policy Solutions

Provisionally accepted
  • 1Escuela Andaluza de Salud Publica, Granada, Spain
  • 2Universidad de Granada Facultad de Ciencias Economicas y Empresariales, Granada, Spain
  • 3Universidad de Granada Departamento de Economia Aplicada, Granada, Spain
  • 4Instituto de Investigacion Biosanitaria de Granada, Granada, Spain
  • 5Centro de Investigacion Biomedica en Red, Madrid, Spain

The final, formatted version of the article will be published soon.

Introduction: Drug repurposing leverages existing medicines to reduce time and costs for exploring new therapeutic indications. However, off-patent medicines do not provide enough private incentives for investment, and prescribing by active ingredient can be a major barrier. Academics and non-profit sponsors also face regulatory barriers. Methods: This study combined a structured literature review with a questionnaire completed by 25 drug repurposing experts to identify key challenges and policy solutions across the full lifecycle of off-patent drug repurposing. Results: Public funding is generally available for the early-stage research, where opportunities often arise from off-label uses and real-world evidence. However, limited support for confirmatory clinical trials, combined with the predominance of academics and non-profit sponsors lacking regulatory objectives, reduces the likelihood of successful authorisation to below 30%. Policy solutions include prioritising research into rare diseases and other conditions with unmet health needs, and call for a more prominent role of governments in public investment and in reinforcement of public–private partnerships. Substitution in community pharmacies remains a major challenge, which may be addressed through indication-based differentiation and enhanced dispensing controls. Some innovative public intervention mechanisms, such as Social Impact Bonds and the InterVentional PharmacoEconomics proposal, offer potential, although real-world experience is still limited. Conclusion: Off-patent drug repurposing faces persistent financial and regulatory barriers that require a central role from academics and non-profit sponsors, supported by governmental engagement throughout the lifecycle. Although steps have been taken in recent years, efforts remain insufficient, and structural and political barriers continue to hinder broader implementation.

Keywords: Drug repurposing1, Off-patent medicines2, Policy solutions3, Barriers4, Lifecycle5, Public Funding6, Academic research7, Non-profit organisations8

Received: 22 Jul 2025; Accepted: 08 Oct 2025.

Copyright: © 2025 García Díaz, Epstein and Espin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mario García Díaz, mario.99.mgd@gmail.com

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.