What can we learn from the COVID-19 drug and vaccine development?

COVID-19 has powerfully demonstrated the central role that new drug and vaccine development plays in combating a pandemic. The challenge is on the one hand to react quickly and on the other hand to develop a safe and effective treatment method. How have researchers met this challenge in the context of Covid-19?

In a recent study, Marvin Hanisch (University of Groningen) and Bastian Rake (Maynooth University) examine the development of drugs and vaccines in response to COVID-19 using data on 2,456 clinical trials that were conducted between December 2019 and July 2020. Some unexpected results came to light. Especially early in the pandemic, most clinical trials focused on testing already existing drugs against COVID-19 (so-called “drug repurposing”), such as the antimalarial drug hydroxychloroquine. Although its low efficacy soon became apparent, investigators around the world continued to conduct follow-on clinical trials using the same ineffective treatments. This indicates a lack of coordination and information sharing between researchers and an inefficient use of resources.

The authors also found that the vast majority of COVID-19 trials were not concerned with drug or vaccine development, but with secondary effects such as crisis management in hospitals and stress symptoms. It is particularly surprising that only two percent of the clinical trials were concerned with vaccine development, possibly spurred by the fact that many large biopharmaceutical companies did not contribute to COVID-19 clinical trials during the early phase of the pandemic. This raises the question of whether companies had adequate incentives to engage in crisis innovations at an early stage.

What can we learn from these results for the future? First, it is vital that the threat of a pandemic is taken seriously at the outset and that there are clear incentives for the development of treatments irrespective of the actual outbreak of the pandemic. This can be done, for example, through early large-volume public purchase guarantees for effective drugs and vaccines that target potential fast-spreading diseases, reducing demand uncertainties. Second, drug and vaccine development must begin even before the outbreak of a potential pandemic. In addition to coronaviruses, there are several other viruses and bacteria that can potentially evolve into a pandemic such as influenza and multi-resistant bacteria. If researchers have already evaluated the safety of an adaptable platform technology for such known diseases in Phase 1 clinical trials, Phase 2 and Phase 3 trials on the efficacy and side effects of a targeted treatment can be quickly initiated, accelerating crisis response during a pandemic. Third, coordination and communication between researchers could be improved. Our data show that many clinical trials are very similar and there is considerable redundancy. The exchange of information not only about clinical trials but also about the corresponding results could be facilitated via an easily navigable international database with standardized terms for different diseases and treatments, so that researchers can quickly see which trials are already underway and which results have already been obtained.

The full study is available here:

Hanisch, M., & Rake, B. (2021). Repurposing without Purpose? Early Innovation Responses to the COVID-19 Crisis: Evidence from Clinical Trials. R&D Management, forthcoming. https://onlinelibrary.wiley.com/doi/full/10.1111/radm.12461