NOTE: This is a duplicate of an on chain proposal from prior to VitaDAO's using snapshot, and is present here for completeness on snapshot. No snapshot vote occurred.
Crowd Funded Cures' mission is to implement pay-for-success smart contracts (an on-chain version of Social Impact Bonds or SIBs) to incentivise repurposing of generic drugs. The SIB mechanism incentivises impact investors (such as VitaDAO token holders) to fund IPNFTs holding encrypted Phase II/III randomised controlled trial (RCT) data to sell to payers in exchange for outcome payments or a subsidized price for the newly labelled generic from a generic drug repurposing fund if the RCT is successful and/or the repurposed generic obtains regulatory approval. The fund can also be crowdfunded from the public using disease-specific NFTs or backed by payers such as governments, health insurers, or large philanthropy. We propose VitaDAO provide $40,000 of funding to Crowd Funded Cures to commission a feasibility study from Guidehouse or another leading consulting firm on this new model of research funding ("generic drug and nutraceutical repurposing pay-for-success contracts") to kickstart potential future mechanisms that VitaDAO could support in the future.
There are over 20,000 generic drugs with FDA approval and even more nutraceuticals which lack private incentives for repurposing because it is impossible to enforce a monopoly price if the drug is available for a large off-patent indication, which means it is not possible to prevent off-label competition. In essence, dosing information about which generic drugs work for new indications, in which patients, and at which stage of a disease, is a non-rivalrous and non-excludable public good which causes a “tragedy of the commons”.
Most known longevity drugs are also generic or off-patent (e.g. metformin, rapamycin, resveratrol, NMN etc), without evidence from large RCTs to determine optimal safety and efficacy due to this market failure. Public and philanthropic grant funding for generic drug repurposing suffers from many disadvantages, including centralisation, inefficiency, lack of innovation, exposure to risk of RCT failure and risk of cronyism and nepotism.
By contrast, pay-for-success does not suffer from these disadvantages. In particular, it is decentralised / meritocratic, transfers risk of RCT failure from payers to impact investors who are willing to bear this risk, and leverages market forces, with impact investors most likely to fund successful RCTs - forming syndicates and/or aggregating VITA tokens - which increases their value.
Establishing the world’s first pilot pay-for-success (PFS) smart contract using IPNFTs to incentivise repurposing of generic drugs to treat a specific disease (e.g. Covid, longevity, pancreatic cancer) and raise impact investor funds of $1-10m to conduct Phase 2 or 3 RCT data encrypted as a trade secret in the IPNFT until unlocked by payers. Launch to wider community to obtain syndicate of payers or crowdfund outcome payment fund or advance market commitments $10-50m. After the pilot PFS / IPNFT smart contract validates the concept, expand into new use cases/diseases and raise larger fund from payers (e.g. health insurers, govts, philanthropy, community - $10-100m).
Team Members
For the full proposal with more details, see the discussion on Discourse here.