Can Cheap Old Drugs Cure Cancer? The Truth About Clinical Trials and Cancer Treatment

So today, I want to talk about something sort of as a prelude because I've got two different news stories coming up that I want to let you know about, and they both have to do with repurposing drugs and clinical trials.

So a lot of people think that every clinical trial costs a huge amount of money, and it's true that many clinical trials do, but there's a lot of different flavors of clinical trials, and only a fraction of them are for licensing new drugs.

Licensing a new drug, that's what we call an interventional trial, though that term is used for more than just that.

So for drug registration, getting a drug on the market, you have to do phase one, phase two, phase three clinical trials.

Those are insanely expensive, upwards of half a billion dollars per drug.

Insanely expensive, very risky, and the government doesn't pay for that.

If a company wants to sell a drug, of course, you're going to make them pay the half a billion dollars to do the clinical trials.

So for drug approvals, that fraction of interventional trials, it makes sense for the pharma companies to pay for them.

No one else is going to pay for that.

But there are other kinds of clinical trials.

There are other interventional trials, which are much cheaper, much smaller, and are government-funded or university-funded or even sometimes just individual investigator-funded.

If a drug is already on the market, you can give it to people.

If you have a doctor willing to write prescriptions for off-label use, you can just give it to a bunch of people and see what happens.

Those kinds of repurposing trials are often not done by pharmaceutical companies, at least not at the beginning, because you can get efficacy data really fast, really cheap.

The fact that they haven't been done with things like ivermectin is a really big sign that there's nothing there to look for.

But they do happen.

They've happened with hydralazine.

They've happened with everolimus.

They've happened with other drugs, and we'll talk about some of those.

Those clinical trials, they're still interventional trials because you're testing a drug.

You're intervening in the disease.

Those are much smaller, much cheaper, usually not done by the pharma companies.

Now, if those work, then we know that the drug works for this new disease.

It works for this new indication.

But that doesn't mean that insurance will cover it because it's not licensed for that use.