{"entity":{"id":"idea-reg-repurposing-prize","kind":"idea","name":"A $50 million prize for the first off-patent drug proven to extend cancer survival","aka":[],"tldr":"Offer a large cash prize to whoever proves, in a rigorous trial, that a cheap existing drug helps people with cancer live longer. Prizes pull effort towards neglected problems.","summary":"Inducement prizes (the Longitude Prize, XPRIZE, the Antibiotic Longitude Prize) attract effort where markets do not. For repurposing, the payoff to society is large but no single actor can capture it. The proposal is a prize, funded by philanthropy and payers, awarded to the sponsor of the first adequately powered randomised trial showing a pre-specified overall survival improvement with an off-patent drug in a defined cancer setting, with smaller prizes for definitive negative results that close a widely used off-label practice.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (No incentive to repurpose cheap drugs): Pantziarka et al., The Repurposing Drugs in Oncology (ReDO) Project (ecancer 2014)","url":"https://doi.org/10.3332/ecancer.2014.442"}],"tags":[],"related":["clinicaltrials-gov"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-generic-repurposing","b-incentive-misalignment"],"keyPapers":["paper-pantziarka-ecancermedicalscience"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"The prize announcement is followed within three years by at least five new registered phase 3 repurposing trials that would not otherwise have been funded, and a winner within eight years.","rationale":"A prize rewards results rather than proposals, does not require the funder to pick winners, and can be sized to exceed the cost of a pragmatic phase 3 trial of a cheap drug, which is often under $20 million.","test":"Announce the prize with published criteria and an independent adjudication panel; track registration of eligible trials on ClinicalTrials.gov against the prior three-year baseline.","maturity":"speculative","actor":"philanthropy","cost":"large","horizonYears":6},"route":"/ideas/idea-reg-repurposing-prize/","neighbours":{"collection":[{"id":"clinicaltrials-gov","kind":"collection","name":"ClinicalTrials.gov","route":"/collections/clinicaltrials-gov/"}],"bottleneck":[{"id":"b-incentive-misalignment","kind":"bottleneck","name":"Incentives reward me-too drugs and marginal gains","route":"/bottlenecks/b-incentive-misalignment/"},{"id":"b-generic-repurposing","kind":"bottleneck","name":"No incentive to repurpose cheap drugs","route":"/bottlenecks/b-generic-repurposing/"}],"paper":[{"id":"paper-pantziarka-ecancermedicalscience","kind":"paper","name":"The Repurposing Drugs in Oncology (ReDO) Project","route":"/key-papers/paper-pantziarka-ecancermedicalscience/"}]}}