The Impact of Small Molecules R&D Decisions on the Health System in the Context of Pandemic Preparedness and Outbreak Response

Antiviral drugs are a vital component in the treatment of viral infections. Treatment response time is of particular importance when administering antiviral drugs and this is particularly relevant for coronavirus, because of how easily and fast it spreads. The current Covid-19 pandemic presents the need for accelerated delivery of antiviral treatments which prompts the need for accelerated development of antiviral drugs and fast evaluation and approval of these newly developed drugs. This motivates the need to model the entirety of the drug development system, to create the overarching insights into efficiency gains. This research applies a systems approach to small molecule research and development decisions for the development of antiviral drugs to treat Covid-19 patients. By creating a dynamic systems model of the drug development process from end to end, we will evaluate the downstream impact of these research and development decisions on the health system and on patient outcomes. This is done for the current emergency context with forward looking goal of preparedness for future outbreaks. We draw insights based on a broad interdisciplinary literature review of the end-to-end process of antiviral drugs, from drug discovery, drug development, pre-clinical testing, clinical evaluation, to safe and timely delivery of treatment. Following this, in collaboration with various experts across different fields, we build a dynamic systems model encompassing each stage of the process, from initial conception to the patients discharge from hospital. This model can be used to create systemwide insights to address both the current outbreak and future outbreaks. The aim is to produce a model that captures every stage of the drug development process in order to optimise the overall process for future use. This can be used to develop a preparedness strategy to safely speed up the treatment of novel coronavirus outbreaks with antivirals.