Repurposing existing drugs, especially when combined with systems medicine, offers a significant opportunity to deliver safe, effective, and affordable therapies to patients with unmet medical needs in a timely manner. However, to ensure long-term impact and accessibility, fair pricing and reimbursement strategies are essential to transform scientific discoveries into market-ready products and tangible patient benefits. Despite the potential of generic, out-of-patent drugs to address new indications—whether through novel combinations, adjusted dosages, or innovative formulations—there is often resistance to increasing their prices for these new uses. This resistance creates a critical barrier, making returns on investment unlikely, discouraging necessary funding, and ultimately depriving patients of potentially transformative treatments.

We must act to overcome this challenge and pave the way for safe, effective, and cost-efficient innovations to reach the patients who need them most. This requires collaboration among policymakers, healthcare providers, and industry stakeholders to establish sustainable models that incentivize innovation without compromising affordability. The REPO4EU initiative is driving this transformative approach. We are a Euro-Global Platform for Mechanism-Based Drug Repurposing that transitions from imprecise drug therapies to AI-powered precision medicine. By fostering innovative methodologies, REPO4EU is set to revolutionize medicine, offering timely solutions to pressing medical challenges while emphasizing long-term sustainability.

To fully unlock the potential of drug repurposing, a coordinated European strategy for innovation, reimbursement, and sustainable implementation is essential. The creation of a Special Interest Group (SIG) under the REPO4EU platform aims to advocate for the establishment of a European Commission Guideline that promotes best practices for health-technology agencies. This will ensure the successful scaling of repurposed therapies through equitable collaboration, sustainable investment models, and streamlined regulatory pathways. By focusing on innovation, sustainability, and reimbursement, this SIG will enable drug repurposing to evolve from an underutilized opportunity into a cornerstone of modern medicine, benefiting patients, healthcare systems, and the environment alike.