NEW INDICATIONS FOR EXISTING DRUGS - IMPLICATIONS FOR DRUG DEVELOPMENT AND CLINICAL-PRACTICE

Optimization of the use of available resources for health is a necessity for both the developing and developed world because both are faced with a significant disparity between needs and resources. Better use of existing therapeutic agents, which are cost-effective, readily available and easy to use represents a critical element in the overall effort. Using the unusual case of the drug phenytoin as an example, this paper explores the value of new indications for existing drugs and describes a system for evaluating such indications and expanding the appropriate use of these agents. Emphasis is placed on the leadership role of developing countries in this process and on crucial elements of any such program such as knowledge of local / national needs and priorities; innovative approaches to clinical research in a range of clinical settings from rural primary health care clinics to tertiary care centers; and the establishment of national and multinational teamwork and more effective two-way communication.