REMEDi4ALL Researchers have published new work in Health Policy OPEN identifying, shortlisting and examining perceptions of critical barriers in drug repurposing using a multi-stakeholder approach.
REMEDi4ALL driving forward policy barrier identification in drug repurposing
Drug repurposing holds great promise for delivering treatments more quickly and cost-effectively to patients in need. However, several policy-related barriers currently hinder repurposing of medicines across Europe. Previous research within REMEDi4ALL has systematically identified these barriers. To design solutions, key prioritisation of critical barriers most hindering the drug repurposing landscape is essential.
Building on REMEDi4ALL’s policy work, this study involved multiple stakeholder groups to identify and shortlist the most important barriers, and to examine differences in how stakeholders perceive their importance.
Barrier prioritisation: a multi-stakeholder approach
To begin to prioritise barriers, REMEDi4ALL researchers conducted a policy survey among experts from different stakeholder groups involved in drug repurposing including patient representatives, researchers, funders, industry, HTA and regulatory experts, payers and clinicians.
Participants rated barriers based on their impact (“Does the barrier have a strong negative effect on the development of repurposed medicines or these medicines reaching the target patient groups”) and actionability (“How easy it is to overcome this barrier in the next 5 years at EU level? (Considering resources, current legislative, or policy frameworks and current practices)”) using 5-point categorical scales. Researchers applied a weighted scoring method to create the shortlist by combining scores across domains, while ensuring that each stakeholder group’s preferences were retained in the final shortlist.
Prioritisation of 22 barriers hindering drug repurposing across Europe
The study identified a final shortlist of 22 barriers and reinforced the relevance of the policy-related barriers to drug repurposing identified in the previous systematic literature review. Specifically, this new work highlighted that the current drug repurposing landscape is characterised by multiple challenges, each varying in terms of how impactful and actionable they are as perceived by different stakeholder groups.
Based on the results of the survey the most important barriers relate to existing pricing structures, the challenges of securing patents and legal protection for off-patent innovations, and the absence of a viable business case for repurposing efforts. Crucially, the findings also confirmed that different stakeholder groups perceive the relative importance of barriers differently, meaning multi-stakeholder collaboration is essential to address major barriers across the drug repurposing community.
Looking forward: developing policy recommendations to overcome key barriers to drug repurposing
This research forms part of REMEDi4ALL’s work aimed at improving the policy environment for drug. By prioritising previously identified barriers, the study enables the development of more targeted policy recommendations, ensuring that development of future solutions focus on addressing the most critical challenges facing the entire drug repurposing landscape. Furthermore, multiple stakeholder groups were involved, this facilitates collaboration in the recommendation generation phase and supports this type of strategy moving forward.
Read the full publication here in Health Policy OPEN .
To improve the drug repurposing ecosystem, REMEDi4ALL has identified 19 facilitator mechanisms that can help overcome the major policy barriers limiting the development and uptake of repurposed medicines. These mechanisms fall into two main categories: Push incentives, which reduce the cost, time, and risk of R&D, and Pull incentives, which strengthen the financial and societal return for investors (Inotai et al., 2025). At iDR26 (12-13 May 2026), Dalma Hosszú (Syreon Research Institue) will present REMEDi4ALL’s faciltator mechanisms in the Industry session: Unlocking value: the pathway to commercializing off-patent repurposed medicines. Discover more about the conference.
This research was published as part of the REMEDi4ALL initiative, a Horizon Europe-funded project creating a platform for patient-centric drug repurposing across Europe and beyond. REMEDi4ALL drives innovation across the entire drug repurposing pipeline, providing the infrastructure and standards needed to boost translational research and deliver more effective, safe therapies to patients, faster.
- Read the paper here.
