Repurposing medicines in the NHS in England

Did you know?

Repurposed medicines have been used as effective treatments for COVID-19. An example of this is tocilizumab, originally an arthritis drug, that has been shown to support recovery from COVID-19 pneumonia in hospitalised patients and to cut the relative risk of death from the virus by 14%. It is typically used in addition to dexamethasone, another repurposed drug with significant life-saving benefits in the treatment of COVID-19.

Medicines Repurposing programme

The Medicines Repurposing programme identifies and progresses opportunities to use existing medicines in new ways.

The programme aims to:

  • identify and develop opportunities to repurpose prioritised medicines to improve outcomes, patient experience and value for money
  • support and advance innovative research into medicines that might be repurposed and adopted into the NHS.
  • facilitate and encourage the licensing of repurposed medicines to support clinical decision making and improve equity of access.

This multi-agency initiative is supported by the Department of Health and Social Care (DHSC), the Medicines and Healthcare products Regulatory Agency (MHRA), the National Institute for Health and Care Excellence (NICE), the National Institute for Health and Care Research (NIHR) and NHS England and NHS Improvement. The programme team is hosted by NHS England and NHS Improvement.

A steering group oversees the work of the programme. The group includes representatives from the national agencies listed above, a representative of the Association of Medical Research Charities (AMRC), and two patient and public voice partners.

What is medicines repurposing?

Medicines repurposing identifies new uses for medicines that are outside of the scope of the existing licence for the medicine. This typically involves taking an existing medicine that already has a marketing authorisation or licence for human use for a particular condition, and then using it to treat another condition. Alternatively, a repurposed medicine may be used in a different dose, or form, than its original licence (for example an inhaled product, rather than a tablet).

Origins of the programme

In 2017 the Association of Medical Research Charities (AMRC) released the report, Facilitating adoption of off-patent, repurposed medicines into NHS clinical practice. The report focused on opportunities for the repurposing of medicines, through further research and by facilitating the licensing of medicines that were already commonly prescribed off-label. It was identified in the report that whilst it was likely that there were high levels of off-label prescribing happening within the NHS, more consideration was required to address the potential to repurpose medicines more systematically.

NHS England and NHS Improvement, in partnership with other organisations, subsequently prepared a report on how those national agencies would collectively address and action key repurposing opportunities.

Working in collaboration with these other organisations in managing the rapid consideration and adoption of repurposed medicines as treatments for COVID-19 has provided the opportunity to test, refine and streamline our approach, as well as identifying further promising repurposing opportunities.

Identifying repurposing opportunities

The following organisations and individuals are eligible to put forward candidate medicines for potential inclusion within the programme:

  • voluntary-sector organisations with a focus on patients, medical research, clinical condition(s) or disease(s)
  • registered healthcare professionals working in the NHS in a clinical role (for example, doctors, pharmacists, nurses)
  • pharmaceutical companies.

The programme does not accept proposals from individual patients or members of the public.

Medicines are assessed against interim eligibility criteria and then prioritised by the Steering Group for inclusion in the programme. The interim eligibility criteria and proposal form are available online, for additional guidance on completing the form please email england.repurposing@nhs.net

Progressing repurposing opportunities

The Medicines Repurposing Programme works in partnership with multiple stakeholders including patient groups, research organisations, the pharmaceutical industry and generic manufacturers. Dedicated Working Groups will be established to provide tailored support for each medicine in the programme. The activity of a Working Group could include working with external partners to support evidence generation, applying for a licensing variation, or liaising with commissioners. Working Groups normally include patient representatives, clinicians and programme staff; industry representatives are included when appropriate.

Contact

Please contact england.repurposing@nhs.net for any general enquiries.