REPO4EU’s policy event sparks conversations for EU-wide drug repurposing models
How can we build a patient-centered approach to drug repurposing? How can we find the balance between providing fair return on investments for companies backing repurposed drugs while ensuring patients can afford these treatments? How can regulators and researchers collaborate to reshape the future of medicine?
These were some of the questions tackled during the hybrid policy kick-off event that took place in Brussels (and online) on 15 January 2025. Organised by REPO4EU, in collaboration with REMEDi4All and with the support of the European Commission (EC), the goal was to facilitate an open conversation on how we can set up a coordinated European strategy to establish sustainable and innovative models for drug repurposing.
To achieve this, the REPO4EU platform framed this event as the initial step to form a Special Interest Group (SIG) to advocate for EU-wide guidelines for best practices on reimbursement policies and streamlined regulatory pathways for repurposed drugs.
Artur Olesch, renowned Berlin-based journalist and founder of about Digital Health, was in charge of moderating the half-day event and prompting the panelists to discuss the most crucial topics surrounding reimbursement, policy, research and sustainable innovation to make repurposed drugs accessible for patients.
The session gathered a multi-disciplinary group of experts to share their first-hand experiences across 4 different panels, representing the full spectrum of voices involved in drug repurposing — including clinicians, researchers, patient groups’ representatives, health technology assessors (HTAs), policy makers and reimbursement specialists.
Making the case for commercially-viable drug repurposing
Following a special welcome by EC representatives Arjon van Hengel (Unit for Health Innovations & Ecosystems) and Monica Ensini (Health & Digital Executive Agency), Harald Schmidt, Project Coordinator of REPO4EU and Chair of Pharmacology at Maastricht University, opened up the first part of the event with a keynote lecture on validated research innovations in drug repurposing.
Harald gave a brief overview on the current state of drug repurposing, stating the case for a paradigm-shift in medicine, one that draws from a precision medicine approach to move away from a system that merely treats symptoms instead of targeting the molecular root of the disease – and therefore start providing efficient treatments that cure.
“One common denominator of existing cases of drug repurposing is that they’ve been more serendipitous, based on incidental observations which have then been taken on. So far, there are no mechanism-based ways to do drug repurposing,” Harald expressed, taking the opportunity to highlight the mission behind REPO4EU in fostering validated processes for repurposing globally. “We want to offer a platform that challenges how we think research should be done, and promote clinical trials that will lead to treatments that benefit patients,” he added.
Harald passed on the microphone to David Cavalla, Founder of Numedicus, for the second guest lecture of the day, focused on stimulating commercial investment in pharmaceutical development of drug repurposing research outputs. “Drug repurposing offers a radical improvement to the declining productivity of pharmaceutical R&D. With the right regulatory incentives, it could provide downward pressure on the price of medicine, and hence benefit both payors and patients”, he stated.
David also highlighted how the development of generic medicines for a new use is rarely commercially attractive because of off-label substitutions, and presented the use of thalidomide and S-ketamine for conditions pertaining to the central nervous system as examples of how repurposing can succeed when those restrictions are overcome.
Building a patient-centered system for drug repurposing — sustainable investment models and streamlined regulatory pathways
A total of 18 experts, including members of the REPO4EU Consortium, were invited to participate in the 4 panel discussions, each dedicated to various aspects involved in drug repurposing, including patient accessibility, sustainable innovation, pricing and reimbursement.
Representatives from four different patient groups in Europe sat in the opening panel, centered around the need to prioritise treatments that improve patients’ immediate quality of life, especially of those battling against a rare disease.
Marcos Mengual Hinojosa (Syngap Elternhilfe e.V.) opened up the conversation advocating for clinicians and healthcare professionals to develop holistic approaches for drug repurposing strategies: “We need a more complete picture of the patient, which we can achieve by maintaining patient registry, and build data bases by mapping out the commonalities and differences between groups of patients, especially for rare diseases which don’t share a unified set of symptoms,” he stated.
Following up from Marcos’ comments, Anneliene Jonker (Duchenne Parent Project) added: “It’s also up to us, as patient organisations, to reiterate that we don’t need the latest technology or most novel treatment, we need treatments that are affordable and can be within patient’s reach. Researchers and companies need to think about the social return on investment. This is why having the patient’s input is truly essential, even before the clinical trial stage — we should be involved from the get-go.”
Reflecting on the lengthy processes that hinder development of new and repurposed medicines, Bernd Rosenbichler (Branewo) reminded the audience that “the last thing rare disease patients have is time.”
The second session focused on regulatory innovations facilitating drug repurposing, exploring how to achieve transparent and fair pricing mixed with streamlined reimbursement policies that can benefit investing companies as well as patients, thus balancing access with sustainability.
Matthew Fedowitz (Buchanan) spoke about using AI to identify the need and potential use for repurposed drugs, encouraging researchers and clinicians to make better use of existing data and advanced tools that can speed up repurposing processes. “There’s a lot of change happening in the medical and healthcare field right now, and these innovations bring along new opportunities, but we need to join forces across continents [Europe and America] so we can see results,” he emphasized.
Yoana Nuevo Ordóñez (AEMPS) also reflected on the need to facilitate collaboration, and highlighted the importance of following scientific advice and pursuing regulatory knowledge, a notion also shared by Anja Schiel, who launched a message for researchers trying to successfully complete their clinical trials for repurposed drugs: “The rules are the same for everyone, we cannot lower the bar. We are experts on failed developments, so please listen to us and trust us when we tell you your drug development is not complete; we are not the blockers, we want to open the doors and for you to walk through them.”
Also discussing successes and roadblocks in bringing repurposed drugs to the patient, during the third session Teun Grooters (Arega Medical) mentioned that “it’s very important” for academic groups and private companies to work together, but stressed that there needs to be “a strong business case”. Drawing from that premise, Saco de Visser (Centre for Future Affordable and Sustainable Therapy Development – FAST) said the incentives should be linked to whatever the researchers want the company to put in: “We need companies to also invest in the development of repurposing ideas, but we need a proper incentive. Now it’s a great time to introduce cost-based pricing models that match value-based driven repurposing.”
On the final session of the day, where panellists discussed how to implement innovative reimbursement approaches for drug repurposing, Sibylle Reichert (Association Internationale de la Mutualité) highlighted the need to raise awareness about fair pricing, and how these conversations can contribute to the affordability agenda proposed by the EU. “We need transparency on the R&D costs for medicines, rooted on scientific-based evidence. This is why we’ve developed the Fair Pricing Calculator, to make sure the patients get the medicines they really need at a cost they can afford,” she added.
The event closed with an open discussion among panellists and attendees. In his closing remarks, moderator Artur Olesch said: “Today’s event has made one thing clear: drug repurposing is a shared opportunity and responsibility. The insights we’ve gathered today demand action, and it’s up to all of us to ensure that repurposed drugs deliver on their promise of improving lives.”
About our policy kick-off event
Our first policy event took place last January in Brussels, and served as an open platform to discuss common goals and develop a roadmap to advocate for a EU-wide sustainable reimbursement strategy for repurposed drugs.
What's next?
The conversation will continue with RExPO25 in Barcelona on 24-26 September 2025, the 4th edition of REPO4EU’s annual conference on Systems Medicine, AI and Drug Repurposing.
