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Moxidectin, for example, went untested for human diseases for decades; we now know that it can cure ~70% of whipworm infections in kids. Aspirin was used for over a century before we found it had cardiovascular benefits.

Why? The commercial incentive to test further is time-limited: once a drug goes off-patent and generics can enter, companies can get undercut by generics, so it’s no longer worth it to run expensive clinical trials to test other uses.

The problem is even worse for tropical diseases, which are often not profitable to treat in the first place. The result is that we’re missing out on knowing about a lot of additional uses of already-approved drugs! There may be more miracle drugs hiding in plain sight.