What will the crowd fund? Preferences of prospective donors for drug development fundraising campaigns

An overview of Fintech applications to solve the puzzle of health care funding: state-of-the-art in medical crowdfunding

Crowdfunding is emerging as an alternative form of funding for medical purposes, with capital being raised directly from a broader and more diverse audience of investors. In this paper, we have systematically researched and reviewed the literature on medical crowdfunding to determine how crowdfunding connects with the health care industry. The health care industry has been struggling to develop sustainable research and business models for economic systems and investors alike, especially in pharmaceuticals. The research results have revealed a wealth of evidence concerning the way crowdfunding is applied in real life. Patients and caregivers utilize web platform-based campaigns all over the world to fund their medical expenses, generally on a spot basis, using donation-based or even reward-based schemes, regardless of the health care system archetype (public, private insurance-based or hybrid). Academics have also focused on funding campaigns and the predictors of success (which range from social behaviour and environment to the basic demographics of the campaigners and their diseases) and on social and regulatory concerns, including heightened social inequality and stigma. While equity crowdfunding is disrupting the way many ventures/businesses seek capital in the market, our research indicates that there are no relevant or consistent data on the practice of medical equity crowdfunding in health care, apart from a few anecdotal cases.

Crowdfunding for health research: a qualitative evidence synthesis and a pilot programme

Background

Many low-income and middle-income country (LMIC) researchers have disadvantages when applying for research grants. Crowdfunding may help LMIC researchers to fund their research. Crowdfunding organises large groups of people to make small contributions to support a research study. This manuscript synthesises global qualitative evidence and describes a Special Programme for Research and Training in Tropical Diseases (TDR) crowdfunding pilot for LMIC researchers.

Methods

Our global systematic review and qualitative evidence synthesis searched six databases for qualitative data. We used a thematic synthesis approach and assessed our findings using the GRADE-CERQual approach. Building on the review findings, we organised a crowdfunding pilot to support LMIC researchers and use crowdfunding. The pilot provided an opportunity to assess the feasibility of crowdfunding for infectious diseases of poverty research in resource-constrained settings.

Results

Nine studies were included in the qualitative evidence synthesis. We identified seven findings which we organised into three broad domains: public engagement strategies, correlates of crowdfunding success and risks and mitigation strategies. Our pilot data suggest that crowdfunding is feasible in diverse LMIC settings. Three researchers launched crowdfunding campaigns, met their goals and received substantial monetary (raising a total of US$26 546 across all three campaigns) and non-monetary contributions. Two researchers are still preparing for the campaign launch due to COVID-19-related difficulties.

Conclusion

Public engagement provides a foundation for effective crowdfunding for health research. Our evidence synthesis and pilot data provide practical strategies for LMIC researchers to engage the public and use crowdfunding. A practical guide was created to facilitate these activities across multiple settings.

Factors Influencing Donation Intention to Personal Medical Crowdfunding Projects Appearing on MSNS

This purpose of this study is to develop a research model by extending the theory of planned behavior in a new application context, and applies it to investigate the extrinsic factors influencing people’s attitude towards donating to medical crowdfunding projects appearing on mobile social networking sites (MSNS) and their intention to donate. A survey of 356 Chinese users was conducted and structural equation modeling was used to validate the proposed model and hypotheses. The results indicate that project information, retweeter information and MSNS information all have the significant effect on the general attitude towards donating to medical crowdfunding projects, and general attitude positively affects people’s donation intention. In addition, perceived behavioral control also has positive effect on people’s donation intention, while experienced donating to medical crowdfunding projects has negative effect on people’s donation intention. The research findings provide important theoretical and practical implications.

Exploring new uses for existing drugs: innovative mechanisms to fund independent clinical research

BACKGROUND

Finding new therapeutic uses for existing medicines could lead to safe, affordable and timely new treatment options for patients with high medical needs. However, due to a lack of economic incentives, pharmaceutical developers are rarely interested to invest in research with approved medicines, especially when they are out of basic patent or regulatory protection. Consequently, potential new uses for these medicines are mainly studied in independent clinical trials initiated and led by researchers from academia, research institutes, or collaborative groups. Yet, additional financial support is needed to conduct expensive phase III clinical trials to confirm the results from exploratory research.

METHODS

In this study, scientific and grey literature was searched to identify and evaluate new mechanisms for funding clinical trials with repurposed medicines. Semi-structured interviews were conducted with 16 European stakeholders with expertise in clinical research, funding mechanisms and/or drug repurposing between November 2018 and February 2019 to consider the future perspectives of applying new funding mechanisms.

RESULTS

Traditional grant funding awarded by government and philanthropic organisations or companies is well known and widely implemented in all research fields. In contrast, only little research has focused on the application potential of newer mechanisms to fund independent clinical research, such as social impact bonds, crowdfunding or public-private partnerships. Interviewees stated that there is a substantial need for additional financial support in health research, especially in areas where there is limited commercial interest. However, the implementation of new funding mechanisms is facing several practical and financial challenges, such as a lack of expertise and guidelines, high transaction costs and difficulties to measure health outcomes. Furthermore, interviewees highlighted the need for increased collaboration and centralisation at a European and international level to make clinical research more efficient and reduce the need for additional funding.

CONCLUSIONS

New funding mechanisms to support clinical research may become more important in the future but the unresolved issues identified in the current study warrant further exploration.

Working the crowd for forensic research: A review of contributor motivation and recruitment strategies used in crowdsourcing and crowdfunding for scientific research

Crowdsourcing and crowdfunding have been successfully used in a range of scientific disciplines and present opportunities for forensic researchers to draw on the power of large numbers of people to contribute to research projects through participation or by providing an alternative source of funding. This review aimed to examine whether contributors to crowd science and crowdfunding for scientific research are motivated to participate or provide financial support by the same factors, and to examine recruitment strategies in an attempt to identify a potential crowd for forensic researchers to approach. There was found to be limited research into crowdfunding for scientific research that addressed the motivations of contributors or recruitment strategies used, and no conclusions could be made. There is a need to overcome low response rates and high attrition over the lifetime of a crowd science project or crowdfunding appeal. It is necessary to target a large number of people who are interested in the subject studied and who want to make a difference in some way and contribute to science. True crime podcast audiences are proposed as they present large numbers of listeners who are interested in forensic science, criminal investigation or law enforcement. These audiences have been targeted for successful fundraising efforts and invitations to participate in crowd activities previously. They should be considered by forensic researchers who are looking to venture into crowdsourcing or crowdfunding for research projects.

Success factors of crowdfunding campaigns in medical research: perceptions and reality

Crowdfunding in medical research is becoming more popular owing to increasing competition for the shrinking amount of government funding. To inform researchers applying for this complementary source of research funding, we investigate the determinants of successful crowdfunding campaigns in medical research. We find that establishing and maintaining professional contacts through social media is of major importance for successful crowdfunding campaigns; an additional tweet or retweet significantly increases the success of crowdfunding campaigns. In contrast to the stated preferences of prospective donors, we document that crowdfunding campaigns can achieve their fundraising goal regardless of the disease characteristics. Scientists could therefore request funding for any kind of project, including therapies for rare diseases and diseases with lower mortality rates.

Medical crowdfunding for organ transplantation

An increasing number of patients and families are utilizing online crowdfunding to support their medical expenses related to organ transplantation. The factors influencing the success of crowdfunding campaigns are poorly understood. Crowdfunding campaigns were abstracted from a popular crowdfunding web site. Campaigns were included if they were actively accepting donations to fund medical expenses related to transplantation of selected organs. The primary outcome measure was total amount raised among successful campaigns receiving at least one donation. Bivariate and multivariate analyses were performed on various campaign characteristics. A total of 850 campaigns were analyzed. Kidney transplant campaigns were most common (40.5%), followed by liver (33.3%), lung (12.2%), heart (11.3%), and multiorgan (2.7%). 69.1% of campaigns received any donation, and among these, the mean amount raised was $3664 (median $1175). The following factors were significantly associated with amount raised: more positive emotional sentiment in the campaign description (+2.6% per AFINN unit, P < .001), longer campaign description length (+2.4% per 100 characters, P = .001), higher goal amount (+0.6% per $1000 of goal amount, P = .004), and third-person description perspective (+131% vs first person, P < .001). Physicians will likely encounter medical crowdfunding with increasing frequency as it continues to grow in popularity among their patients.

Affordable orphan drugs: a role for not-for-profit organizations

AIMS

The success of the Regulation on Orphan Medicinal Products in the European Union is evidenced by the 127 orphan drugs that have had market authorization since 2000. However, the incentives aimed at stimulating research and development have had the unintended consequence of increasing drug cost, resulting in many orphan drugs not being cost-effective. Orphan drugs command an increasing share of the pharmaceutical market and account for a disproportionate amount of healthcare expenditure. Orphan drug ownership by socially motivated, not-for-profit organizations may facilitate access to more affordable orphan drugs, for the benefit of patients and healthcare systems alike. This study aims to describe opportunities for such organizations to become orphan drug Market Authorization Holders.

METHODS

We reviewed data on the ownership of EMA designated and approved orphan drugs, identified funding opportunities and business models for not-for-profit organizations, and summarised relevant legal and policy documents concerning intellectual property rights and drug regulation.

RESULTS

Using repurposed drugs as a paradigm, this narrative review navigates the regulatory hurdles, describes the legal context and identifies funding opportunities, in a bid to facilitate and encourage not-for-profit organizations to lead on the development of affordable orphan drugs.

CONCLUSIONS

Although the regulatory steps required to obtain an MA for an orphan drug are numerous and challenging, they are not insurmountable and can be achieved by not-for-profit organizations that are socially motivated to reduce the costs of orphan drugs to the payers of healthcare. Opportunities for orphan drug development resulting in affordable products lie mainly with repurposed drugs.