BM Manifesto has teamed up with the US-based Cures Within Reach to help develop the concept of social investment for rediscovery research for fundamental diseases. Dr Bruce Bloom of Cures Within Reach explains how this works:

Rediscovery research improves lives by taking drugs approved for one disease and repurposing them to create a new treatment in a different disease. When the repurposed drug is generic and able to be taken in the current dosage and formulation, there is often little or no profit to be gained, so industry does not fund these repurposing projects. Currently, philanthropy funds them, and that funding is hard to get.

One potential way to create a huge incentive for investors to finance these life-saving rediscovery research projects is through a social impact bond (SIB). A SIB is an arrangement between one or more government agencies and an external organisation, called a social impact bonding organisation (SIBO), where the government specifies an outcome and promises to pay the external organisation a pre-agreed sum if it is able to accomplish the outcome.

A rediscovery research SIB could be used to further the government’s dual mission to improve the health of its citizens and reduce healthcare costs by creating life-saving treatments for diseases with no current effective therapy by repurposing safe generic drugs.

The SIB investors would provide the initial resources to fund these projects, and could see significant returns on investment from receiving a percentage of the healthcare cost savings realised by the government within 2-4 years. The remaining funds paid by the government would be used to fund additional rediscovery research projects, creating a self-sustaining system that lowers costs and saves lives.

A Generic SIB Model:
SIB Model

The average cost of a rediscovery research project is under $250,000, the average time for initiation of the project to patient availability is 36 months, and almost all successful rediscovery research projects save significant healthcare dollars. This compares favorably to the costs ($1.5B+) and timeline (12-19 years) for new discovery research, which almost always increases healthcare costs.

An example of a rediscovery research success is a Cures Within Reach project repurposing the generic drug sirolimus for the deadly childhood disease Autoimmune Lymphoproliferative Syndrome (ALPS.) There are about 600 children in the US with this disease, too small a patient population for industry to create a brand new treatment.

Cures Within Reach funded a physician researcher at Children’s Hospital of Philadelphia who, in less than 30 months and for less than $200,000, created a mouse model of the disease, cured the mice, and then conducted a pilot human clinical trial that proved that this drug significantly reduced or eliminated symptoms of ALPS in more than 85% of the test subjects. Within 90 days of publication of the results, over 200 physicians from around the globe had contacted the researcher for dosing instructions. A few years later, this drug regimen is the off-label standard of care for patients with ALPS.

BM Manifesto and Cures Within Reach are seeking to set up a social investment bond in the UK, which is leading the way in this area. Discussions are afoot. Keep an eye on this blog to find out about progress.