Existing medicines and new uses

Across the health and care system, there is continued interest in how to make the best use of existing medicines. One area attracting increasing attention is drug repurposing – using established medicines to treat conditions other than those for which they were originally licensed.

The concept is not new, and it continues to be discussed in the context of efforts to improve outcomes and make effective use of NHS resources.

In this blog, we explore the role of repurposed medicines within the wider landscape of innovation and system efficiency. We consider how actuarial analysis can support decision-making in this space.

The current landscape

Discussions have focused on how repurposed medicines might contribute to improved patient outcomes and better value for the NHS. This interest is consistent with the intention set out in the government’s 10‑Year Health Plan for England. Its aim is to “put the NHS on a sustainable footing by adopting a new value‑based approach, that aligns resources to achieve better health outcomes”.

Alongside academic and clinical interest, there has been wider discussion of the practical considerations involved in bringing repurposed medicines into routine use.

National Institute for Health and Care Excellence appraisal and guidance processes apply to both new and existing treatments. They place evidential standards at the centre of NHS treatment adoption decisions.

Repurposed medicines can offer advantages such as improved cost-effectiveness. (Credit: Unsplash)

In April 2025, NHS England concluded that a central programme was not the most effective mechanism for supporting medicines repurposing. It therefore decided to suspend its national medicines repurposing programme.

The reasons cited were primarily that:

a limited number of medicines had evidence strong enough to support a licence variation many opportunities can progress without the need for a formal programme NHS England would be integrated into the Department of Health and Social Care

That decision does not remove the wider interest in repurposing, or the potential value of considering where existing medicines might improve outcomes or support better use of NHS resources.

Opportunities for repurposing can still be identified and taken forward through other routes, such as clinical off-label use, research projects and NHS commissioning decisions. Research funders, including the Medical Research Council, also support repurposing projects through established funding routes.

Regulatory considerations shape how repurposed medicines are used in practice. In some cases, use falls outside a medicine’s licence, meaning prescribing decisions rest with clinicians and liability shifts accordingly. This can influence the pace and extent of adoption.

Why repurposing matters

Repurposed medicines can offer advantages:

potential for lower cost – off-patent or widely available medicines may offer opportunities for improved cost-effectiveness evidence of safety – these medicines typically have established safety profiles from use in other conditions faster development timelines – where early-stage uncertainties are reduced, research can sometimes progress more quickly than for novel treatments

Realising these benefits depends on several factors. These include the strength of the clinical evidence base, regulatory pathways, and the feasibility of generating sufficient evidence to support adoption at scale. For generic medicines, incentives to generate this evidence may be limited, as the costs of further research may not be matched by sufficient commercial returns.

Addressing these factors could help unlock benefits that align with broader ambitions to support innovation, improve population health outcomes, and build system resilience.

Discussions focus on how repurposed medicines might contribute to improved patient outcomes. (Credit: iStock Photo). An actuarial perspective

Actuaries have long been involved in helping public bodies make long-term decisions under uncertainty. This is particularly relevant where costs, risks and outcomes interact across complex systems. Repurposed medicines present an opportunity to apply this lens in several ways:

1. Exploring uncertainty

Actuaries can support decision makers by analysing clinical, behavioural and financial uncertainties – for example, around effectiveness, the strength of available evidence, uptake rates, duration of benefit and potential system impacts. They can also structure alternative scenarios and test the sensitivity of conclusions to different assumptions.

2. Quantifying potential system impacts

Repurposed medicines may, in some scenarios, reduce avoidable morbidity or death. Where appropriate data is available, actuarial modelling can help quantify these potential pathways, drawing on published studies, routinely collected health information or emerging research. When evidence is limited, scenario analysis can still support informed discussion.

3. Understanding population-level effects

Well-established public health research demonstrates that even modest improvements in individual outcomes can lead to meaningful population-level benefits over time. Examples include reductions in blood pressure or improved management of chronic conditions. Actuarial approaches help assess how such effects may accumulate across different groups.

4. Supporting value-for-money assessments

By bringing together costs, health outcomes and wider system implications, actuarial analysis can complement economic approaches. It can help decision-makers understand a range of possible outcomes across different scenarios.

Looking ahead

As interest in the potential role of repurposed medicines continues, careful assessment of evidence, uncertainty and system impacts will remain central to decision-making.

Analytical approaches can help place repurposing alongside other options, supporting more consistent prioritisation within a complex and resource-constrained system.

Actuarial analysis can support a structured, objective approach to understanding where repurposed medicines may add value. By modelling long-term outcomes, analysing uncertainty, and considering cross-system impacts, GAD can help public bodies assess opportunities within a robust and evidence-informed framework.

Disclaimer

The views expressed are the author’s own and the opinions in this blog post are not intended to provide specific advice. For our full disclaimer, please see the About this blog page.

https://actuaries.blog.gov.uk/2026/07/21/existing-medicines-and-new-uses/

seen at 11:50, 21 July in Actuaries in government.