The coronavirus pandemic is one of the most difficult collective challenges facing humanity since the last world war. In the midst of the turmoil, national health authorities, pharmaceutical companies, universities, and research institutes are racing to find therapies to save lives and contain the grave social and economic consequences of the pandemic. As organizations and experts scramble to innovate therapies, they are also redefining innovation.
The conventional approach to innovation in the pharmaceutical industry is to conduct a lengthy process that starts with the discovery and generation of potential drug compounds and moves through a meticulous refinement and selection phase toward gradual development, clinical testing, and market approval. Although this model will continue to be the most effective in future drug development, it is now being complemented with an ultrafast approach to innovation centered on the repurposing of readily available ideas, knowledge, and technologies. In this article, we present five core principles of repurposing and discuss the lessons they hold for managers across industries and organizations that need to rapidly innovate in the face of crises.
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The Relentless Search for Therapies
Because drug repurposing (also called drug repositioning) seeks additional therapeutic uses of existing drugs with known safety profiles, it potentially allows developers to circumvent costly and time-consuming safety trials, thus greatly reducing the time, risk, and cost compared with de novo drug discovery and development.1 Many groundbreaking drugs were initially developed for other diseases (most famously the cardiovascular drug that became Viagra), but researchers stumbled across alternative uses. In recent years, the pharmaceutical industry has honed its methods to systematically repurpose drugs. These methods prove to be highly useful today and aim to find links between a drug and a disease by applying automation technologies (such as high-throughput screening) or computational biology.
Given that a vaccine will likely take months to develop, repurposed drugs that can alleviate patient symptoms and prevent deaths are urgently needed. Today, many drug-repurposing initiatives are underway. In recent months, the World Health Organization (WHO) has launched clinical trials involving four promising candidates: remdesivir (an investigational broad-spectrum antiviral), chloroquine or hydroxychloroquine (used to prevent and treat malaria), a combination of lopinavir and ritonavir (an HIV therapy), and the lopinavir-ritonavir combination with interferon beta-1a.2 With few exceptions, most major pharmaceutical companies are currently working on repurposing projects to rapidly bring treatments to market. For example, as of early April, ruxolitinib, a Novartis drug that received Food and Drug Administration (FDA) approval in 2011 for treating myelofibrosis, was moving to clinical testing in patients with severe COVID-19 symptoms.3
Ultrafast Innovation: The Advent of Knowledge Repurposing
While repurposing is common in the pharmaceutical industry, it now constitutes the cornerstone of ultrafast innovations to cope with the pandemic crisis in other industries too. For example, rum and whiskey distilleries have started producing hand sanitizer and disinfectants. Similarly, cosmetics producers such as Nivea, L’Oréal, and LMVH also started manufacturing hand sanitizer to meet the soaring global demand. Dyson, a household appliance manufacturer, is developing ventilators using its air-compression technology. Both Jeff Bezos and Elon Musk repurposed manufacturing capacity and expertise from their respective rocket enterprises, Blue Origin and SpaceX, to 3D-print face shields for health care workers.4
The specific repurposing logic underlying these ultrafast innovation initiatives can be summarized in five principles: Grasp the innovation problem, map resources, use emerging technologies, encourage collaboration, and integrate end users.
1. Get a grasp on your innovation problem. First, managers need to quickly assess and understand the problem that the innovation should target, be it tackling the ventilator shortage, supporting health care personnel, or developing a vaccine for the coronavirus. This is key to matching the problem with existing resources, ideas, knowledge, and technology. Looking at your existing technology as a potential solution may give you a new sense of the problem too.5 If your goal is to prevent people from getting infected, you need to gain as many insights about the virus as possible — its DNA, its replication, and the process of transmission. Note that the most valuable knowledge about the problem you are facing may originate outside your organization.
2. Make a rapid inventory of your knowledge and resources. To make repurposing work, you need to rapidly develop an inventory of “useful stuff,” including existing products, facilities, databases, software, talent, and expertise. As uncertainty and urgency increase, repurposing is most successful when organizations draw on readily available resources and knowledge, some of which might be seen as unattractive side effects or by-products. For example, the off-label prescribing of marketed drugs is a common approach to treating diseases where anecdotal evidence exists about the potential efficacy of a drug developed for another indication and no other treatment options are available. Indeed, the FDA recently approved the off-label prescription of chloroquine for COVID-19 despite weak evidence of its efficacy, given the lack of better alternatives.
Other recent repurposing examples include Hospitainer — an organization that converts storage containers into mobile hospitals that can be dispatched to crisis areas for rapid health care — and L’Oréal, which repurposed its facilities to manufacture hand sanitizer. While the process for making hand sanitizer is relatively simple, scarcer resources, such as L’Oréal’s hygienic manufacturing facilities and a bottling infrastructure, offered synergies for the production of this widely needed good.
Thinking creatively about by-products can be another valuable approach to repurposing. For example, in recent years, dairy producers have increasingly targeted health-conscious consumers with new protein-rich products enhanced with milk whey — once regarded as a problematic by-product in cheese making.
In all of these examples, a product’s complexity and proximity to a new product feature play an important role in repurposing effectiveness. As the gap between existing and target knowledge domains widens, knowledge repurposing may become less effective.
3. Use emerging technologies. Cloud computing, data analytics, artificial intelligence, and other emerging technologies offer two benefits for ultrafast innovation. First, digital platforms enable key actors, such as users, experts, funders, and public and private organizations, to share information and collectively create knowledge. For example, WHO initiatives to develop a vaccine are drawing on an extensive online community of experts from many different types of organizations that plan and coordinate their work, and share protocols, insights, and research-based knowledge.
Second, machine learning coupled with big data can rapidly identify promising links between needs and solutions. Drug repurposing today benefits from computational biology and automation technology that help researchers identify existing drugs that could be efficacious in treating a specific disease. Although the use of computational biology has limitations within drug discovery, it is very effective for initially identifying feasible ideas rapidly.
When problem information and solution inventories are available digitally and shared on platforms, it takes less effort to find attractive matches. For example, Alibaba Group’s Academy for Discovery, Adventure, Momentum and Outlook developed an AI-based COVID-19 diagnostic tool that can detect the disease in 20 seconds in patients’ CT scans, using a guideline provided by a leading radiologist. The tool helped doctors in 26 hospitals rapidly review more than 30,000 cases during the outbreak in China.6
4. Encourage open and cross-disciplinary collaboration. To quickly grasp the innovation problem and identify possible solutions, it is crucial to encourage and support open and cross-disciplinary collaboration. In drug repurposing, a number of thought leaders have become very influential within their patient and treatment communities. Similar developments are unfolding in the COVID-19 crisis. For example, philanthropists Bill and Melinda Gates and the experts in their foundation are hugely beneficial to crisis response. While their financial support is important, more crucial is the expertise that such foundations bring to the table when it comes to understanding how to orchestrate global and cross-disciplinary collaboration.
Given the urgency of the situation, managers’ openness to and support of the global community of researchers and scientists in pharmaceutical companies are central success factors in identifying treatments for COVID-19. As companies open up their internal assets, repurposing opportunities for scientific communities multiply.
Crowdsourcing is a well-known way to respond to crises including the testing of contaminated drinking water to the coordination of disaster relief. The idea behind crowdsourcing is to submit problems to experts across organizational and functional boundaries and ask these experts to generate alternative solutions. Dealing with the current pandemic, organizations may increasingly launch open calls or innovation contests to discover new ways of using their existing products, services, and facilities as solutions in the coronavirus crisis.
Several “coronathons” have been set up: For example, Mobility Goes Additive, an international network of 3D printing organizations, launched weboostam.com, an online platform for 3D printing that features COVID-19-specific use cases, including face shields, masks, and hands-free door openers, that are submitted by its members.7 In the spirit of openness and collaboration, managers can use such platforms to find new ways of meeting societal needs by proposing crowdsourcing challenges that invite new solutions using the organization’s existing resources.
5. Rapidly integrate end users. To meet the urgent needs of end users through ultrafast innovation, you cannot wait for market research to tell you what these needs are. You must promote communication channels that make it easier for end users to voice these needs themselves, and managers must rapidly address them in the innovation process. Indeed, integrating patients’ knowledge is a key factor in tackling diseases, particularly ones requiring ultrafast innovation.8
Information from patients about disease symptoms, which they may share freely in the form of YouTube videos and Google searches, is a highly valuable source of knowledge about the disease and its evolution, and thus critical for achieving ultrafast innovation. Likewise, health care workers are at the forefront of medical device innovation in the current pandemic. For example, engineers from Vanderbilt University developed a prototype ventilator in collaboration with physicians from the university’s medical center. Without input from those physicians, some essential features, such as pressure sensors and alarms, might have been overlooked.9 Integrating health care workers and their patients into the innovation process in this way is crucial not only for quickly identifying needs but also for saving time in the design process.
In the midst of the current coronavirus pandemic, there is considerable uncertainty about if and when we will have a vaccine and effective treatments. Still, there are good reasons to be hopeful. Having honed the key principles of repurposing, the pharmaceutical industry and its partners already have testing well underway. Now, as managers in sectors far afield from health care grapple with the significant and likely long-lasting social and economic consequences of the pandemic, that industry’s lessons of ultrafast innovation based on repurposing can help us rapidly develop new solutions to our current challenges and those that lie ahead.
1. M.J. Barratt and D.E. Frail, eds., “Drug Repositioning: Bringing New Life to Shelved Assets and Existing Drugs” (Hoboken, New Jersey: John Wiley & Sons, 2012).
2. K. Kupferschmidt and J. Cohen, “Race to Find COVID-19 Treatments Accelerates,” Science 367, no. 6485 (March 27, 2020): 1412-1413.
3. “Novartis Announces Plan to Initiate Clinical Study of Jakavi in Severe COVID-19 Patients and Establish International Compassionate User Program,” Novartis, April 2, 2020, www.novartis.com.
4. M. Sheetz, “Jeff Bezos’ Blue Origin is 3D Printing Parts for Face Shields to Help Fight the Coronavirus Crisis,” CNBC, April 7, 2020, www.cnbc.com.
5. E. von Hippel and G. von Krogh, “Identifying Viable ‘Need-Solution Pairs’: Problem Solving Without Problem Formulation,” Organization Science 27, no. 1 (January-February 2016): 207-221.
6. “AI and Control of COVID-19 Coronavirus,” Council of Europe, accessed April 21, 2020, www.coe.int.
7. “MGA Announces: Initiative ‘3D Printing Fights Corona,’” Mobility Goes Additive, April 6, 2020, https://mobilitygoesadditive.org.
8. B. Kucukkeles, S.M. Ben-Menahem, and G. von Krogh. “Small Numbers, Big Concerns: Practices and Organizational Arrangements in Rare Disease Drug Repurposing,” Academy of Management Discoveries 5, no. 4 (December 2019): 415-437.
9. S. Turney, “VU Engineers and VUMC Doctors Team Up for Open-Source Ventilator Design,” Vanderbilt University, March 27, 2020, https://news.vanderbilt.edu.