What Viagra tells us about sustainability and repurposing

The story of Pfizer's billion-dollar drug Viagra is well known. Initially, the drug was supposed to be a treatment against angina pectoris (chest pain), but its side effects led to its commercially very successful repurposing into a treatment against erectile dysfunction.

Finding new uses for existing solutions to address unsolved problems and customer needs is the key characteristic of repurposing. The potential of repurposing is rather evident in the biopharmaceutical industry: think of the multiple attempts to use existing medications as treatments against Covid-19. But it's worth remembering that the creative arts and crafts toy Play-Doh was originally used as a wallpaper cleaner or that opportunities for interaction among the players of the popular Fortnite game were repurposed to host a concert series in the virtual space?

Looking at these and other examples, you may be surprised that repurposing has a massive potential for addressing unmet needs and for making our economy and society more sustainable. Therefore, sustainability is not restricted to responsible, environmentally friendly production and consumption. The United Nations' Sustainable Development Goals emphasise economic aspects in addition to environmental and other aspects, such as access to (affordable) medications and health care services.

With respect to sustainable patterns of production and consumption, repurposing helps us to make the production and use of products more environmentally friendly by giving the products a second life. For instance, think of the pedestrian bridge in Co Cork made with used wind turbine blades, or how batteries from Nissan’s LEAF electric vehicle that reach the end of their life cycle in a car and are then repurposed as emergency power supplies for railroad crossings.

In addition to environmental aspects, repurposing leads to economic benefits because it reduces development times and costs. Car manufacturer Stellantis was able to release its Officer Protection Package in its Dodge Charger Pursuit police cars almost instantly and with only minor amendments to the car’s dashboard. The Officer Protection Package repurposes the preinstalled parking sensors and the rear camera to detect movements behind the car, thereby alerting officers of a possible ambush. This example highlights the potential gains for speeding up the development process. In addition, researchers estimate that repurposing could save more than 80% of development costs.

The latter aspect is particularly important if we think of sustainability from a health perspective. The potential cost savings associated with the repurposing of existing medications make it possible to develop medications for rare diseases and for unmet therapeutic needs across the globe and to make medications more accessible. Examples of the benefits of repurposing in this context include zidovudine, the first HIV drug approved by the US Food and Drug Administration, which was originally developed as a cancer treatment.

But the success of repurposing existing solutions is not guaranteed. To increase the odds of successful repurposing, collaboration is imperative. Collaborative partnerships can provide additional revenue for one partner while providing access to essential resources and expertise for the other partner. An example of this type of collaboration is BMW's partnership with Off Grid Energy, a UK-based provider of electricity supply for locations not connected to the grid, to find new applications for used electric vehicle batteries.

Until very recently, most examples of repurposing have not been the outcome of systematic research efforts. As in the case of Viagra, repurposing occurred when promising yet often unintended effects were discovered in the development process. To make repurposing more successful and less reliant on serendipity, digitalisation is also important.

In many cases, the search for solutions that may be repurposed is just too vast to be performed manually. For example, the pharma giant GSK screened more than 2 million compounds to search for a new malaria treatment. Artificial intelligence can handle massive search tasks such as this and can help to predict the effectiveness of existing solutions in a different context.

Specialised companies such as IQVIA use artificial intelligence and machine learning to find the most promising repurposing candidates. In addition, technical and managerial expertise is required to assess the expected cost, development time, and market potential of solutions proposed for repurposing.

To realise its full potential, we must reflect upon the economic incentives that society provides for repurposing. Even though cost savings are likely, substantial efforts may still be required to demonstrate feasibility, efficacy, or safety and to obtain regulatory approval for repurposed solutions. This is relevant not only for health care industries but also for software and many manufacturing industries. Airbus recently stated that hundreds of test hours will be required to secure Type Certification for its A321XLR aircraft, a repurposed long-range version of its successful A320neo single-aisle family of aircraft.

Additionally, repurposed solutions are often on the market or at least known for several years before they are applied in a new context. For instance, it took 3M multiple years to repurpose a new adhesive in its Post-it notes. Against this background, regulatory changes may be needed, and policymakers need to reflect upon how innovators can avoid immediate imitation and secure value through repurposing when patent protection is not an option.

The examples above show that repurposing tends to be more frequent than we normally assume and that it has the potential to boost sustainability across various dimensions. However, to realise its benefits, more systematic search efforts and better incentives are needed.

This article orginally appeared on RTE Brainstorm