Savva Kerdemelidis

Imagine if we can treat depression with an off-patent psychedelic-assisted therapy or cancer with a ketogenic diet?&nbsp; Crowd Funded Cures is a <a href="https://register.charities.govt.nz/CharitiesRegister/ViewCharity?accountId=b5fff9b0-3541-e311-8f2f-00155d0d1916&amp;searchId=206d91f5-fb22-479a-b08d-5a20c97bc926" rel="noopener noreferrer" target="_blank">registered﻿</a> NZ charity (partnered with <a href="https://gitcoin.co/grants/7162/the-longevity-decentralized-review-tldr-by-vitada" rel="noopener noreferrer" target="_blank">VitaDAO</a>, <a href="https://molecule.to/" rel="noopener noreferrer" target="_blank">Molecule</a>, <a href="https://gitcoin.co/grants/7298/psydao-democratizing-decentralizing-psychedelic-r" rel="noopener noreferrer" target="_blank">PsyDAO</a>, &amp; <a href="https://www.labdao.xyz/" rel="noopener noreferrer" target="_blank">LabDAO</a> and receiving advisory support from <a href="https://protocol.ai/" rel="noopener noreferrer" target="_blank">Protocol Labs</a> and the <a href="https://healthimpactfund.org/" rel="noopener noreferrer" target="_blank">Health Impact Fund</a>) whose mission is to create a financially innovative Impact Market to re-align private incentives in the medical industry away from monopoly-priced patented medicines and towards low-cost, open-source therapies that can treat and potentially cure millions of patients and improve global health and well-being.&nbsp; Currently, 1000s of otherwise viable unmonopolizable therapies are ignored by the pharmaceutical industry because a monopoly price cannot be enforced. We call them public good medicines because once the treatment protocol is published, it is not possible to stop people accessing the therapy from multiple sources (non-excludable) and use of the treatment protocol does not prevent others from using it (non-rivalrous). Unfortunately, this causes a tragedy of the commons which means that pharma companies will not fund the large clinical trials needed for them to be reimbursed by health insurers or obtain regulatory approval. Governments and health insurers also do not want to take on the political risk of paying for large clinical trials in case they fail, which means these treatments will typically not be accepted by the mainstream medical establishment. They include repurposed off-patent generic drugs, supplements, plant medicines, psychedelics, diets, and non-pharmaceutical / lifestyle interventions. We can solve this tragedy of the commons and provide a high impact use case for web3 that unlocks billions of dollars in social value for relatively low cost by establishing an Impact Market that incentivises impact investors to fund IP-NFTs representing public good medicines. Successful clinical trial data that validates the safety and efficacy of such public good medicines converts the IP-NFTs into Hypercerts eligible to receive outcome payments from a crowdfunded Open Source Medical Prize Fund proportional to improved patient outcomes validated in clinical trials (see Medical Prize fund figure below). The Impact Market also de-risks the funding of clinical trials for donors / public. The result would be that investors fund new public good medicines that are off-patent, unmonopolizable, and available to the entire global community at low cost, while obtaining a standard return on investment. However, in order to bring this open source business model to pharma, we need to crowdfund a source of retroactive (and quadratic) funding of the Impact Market through our <a href="https://gitcoin.co/grants/7516/open-source-medical-prize-fund-for-retroactive-fu" rel="noopener noreferrer" target="_blank">Medical Prize Fund</a>, which is governed by our Medical Impact DAO. Together, by supporting our Medical Impact DAO, the community can usher in a new era of medicine which does not ignore otherwise viable therapies because they are not profitable under the traditional patent system. Unlike donations to traditional charities (which often receive the majority of their funding from big pharma), through this novel “pay-for-success” mechanism, you can also be sure that your donations will only fund successful clinical trials. The following research seminar for Protocol Labs by founder Savva Kerdemelidis and CTO Cyrus of Eden explains the problem of this tragedy of the commons and how to solve it using crowdfunded Medical Impact NFT, a Medical Prize fund, <a href="https://hypercerts.xyz/" rel="noopener noreferrer" target="_blank">Hypercerts</a> x <a href="https://medium.com/molecule-blog/molecules-biopharma-ipnfts-a-technical-description-4dcfc6bf77f8" rel="noopener noreferrer" target="_blank">IP-NFTs</a> to create an impact market for open source medicine: <a href="https://www.youtube.com/watch?v=IQZlAtUx728" rel="noopener noreferrer" target="_blank" class="ql-size-large">https://www.youtube.com/watch?v=IQZlAtUx728</a><h3> </h3><h3>Your Giveth donations will be used to:</h3><h3> </h3><ol><li>Build out the core infrastructure (frontend, backend and operations) for our Medical Impact DAO, which will govern our <a href="https://crowdfundedcures.org/link/gitcoin-open-source-medical-prize/" rel="noopener noreferrer" target="_blank" class="ql-size-large">Medical Prize Fund</a>, a source of retroactive funding for Phase 2 clinical trials of public good medicines.</li><li>Support the establishment of an impact market for open source longevity medicines via a <a href="https://longevityprize.com/" rel="noopener noreferrer" target="_blank" class="ql-size-large">Longevity Prize</a> pilot with VitaDAO and <a href="https://hypercerts.xyz/" rel="noopener noreferrer" target="_blank" class="ql-size-large">Hypercerts.xyz</a>, and an Open Psychedelic Medicine Prize fund for treating depression (sign up to whitelist for initial Medical Impact NFT drop for Open Psychedelic Medicines <a href="https://docs.google.com/forms/d/1Pq2Diht1zeFcqSCX-qEPHlIf47Q0e_GueATUTAHl3mo/edit" rel="noopener noreferrer" target="_blank" class="ql-size-large">here</a>). </li></ol> <h3>Go-To-Market Plan &amp; Business Model</h3> Stage 1: Medical Impact DAO crowdfunds Medical “De-Risking” Prize Fund for Retrospective Funding of Phase 2 RCTs (see Figure 1 below) Step 1. The <a href="https://gitcoin.co/grants/7516/open-source-medical-prize-fund-for-retroactive-fu" rel="noopener noreferrer" target="_blank">Medical Prize Fund</a> will be crowdfunded via sales of Medical Impact NFTs (e.g. Open Psychedelic Medicine NFTs or Open Longevity NFTs for Longevity Prize pilot, noted above), with 5% platform fee to support DAO infrastructure &amp; operations, 5% royalty to support NFT artist and 90% allocated to the Medical Prize Fund. Step 2. <a href="https://www.molecule.to/blog/molecules-biopharma-ip-nfts-a-technical-description" rel="noopener noreferrer" target="_blank">IP-NFTs</a> are then minted to secure funding from impact investors for Phase 2 RCTs that generate treatment protocols with the most impact, as measured by % improved clinical outcomes vs. standard of care, which will be allocated impact points that determine the right to receive outcome payments from the Medical Impact Fund, through a flexible prize mechanism (e.g. 50% improvement in clinical outcomes vs usual care provides 50 impact points).&nbsp; The higher the impact, the more impact points and more proportion of the annual 20% outcome payment received. This incentivizes incremental improvements and medical breakthroughs and “de-risks” Phase 2 RCTs and to determine the optimal treatment protocol for a public good medicine. It also means that the Medical Prize Fund is scalable - the larger it is the more RCTs are registered before “market equilibium” is reached. This also ensures the efficient pricing and delivery of impact by the markets. Treatment protocols that are less efficacious/safe than standard of care will not be rewarded. Step 3. Successful clinical trial data validating safety and efficacy of a certain treatment protocol converts <a href="https://www.molecule.to/blog/molecules-biopharma-ip-nfts-a-technical-description" rel="noopener noreferrer" target="_blank">IP-NFTs</a> to <a href="https://protocol.ai/blog/hypercert-new-primitive/" rel="noopener noreferrer" target="_blank">Hypercerts</a> which has the rights to register to the fund and receive outcome payments for a period of time (e.g 5 years), proportional to Impact Points generated, as validated by an independent contract research organization and multisig oracle. IP-NFTs owners receive exclusivity over their treatment protocol, as long as they are actively conducting the RCT. <img src="https://cdn.discordapp.com/attachments/895209203411587082/1017111830038073394/Medical-Impact-DAO-Diagram.jpg">Figure 1. Our Medical Prize Fund acts as a retroactive (and quadratic) funding “pull” incentive to optimize treatment protocols in Phase 2 Randomized Controlled Trials (RCTs) for public good medicines that are off-patent, unmonopolizable, and potentially curative. Stage 2: Medical Impact DAO establishes Public Good Pharma Ltd to negotiate Advance Market Commitments (AMCs) for funding Phase 3 RCTs needed for Regulatory Approval of Public Good Medicines (see Figure 2 below) Once the optimal treatment protocol for Phase 2 RCTs is obtained by the Medical Impact DAO (see Stage 1 above), a Public Good Pharma company owned by the Medical Impact DAO will negotiate Advanced Market Commitments from Payers, e.g., healthcare payers - private and public - government, etc. ensure that funding the Phase 3 RCTs are rewarded with an exclusive commitment to purchase a “branded” therapy, e.g., $100m for OpenKetamine for treatment-resistant depression. The Public Good Pharma company can also leverage method of use / dosing regime patents and reformulations to strengthen its IP position although these would primarily be enforceable against payers but not against doctors and patients (hence the tragedy of the commons) - so open source is "baked-into" the model. AMCs provide financial incentives for Impact Investors to back a Phase 3 RCT which costs around $50m, and also conduct post marketing surveillance to check the therapy’s performance in real life scenarios, to study the long-term risks and benefits of using the therapy and to discover any rare side effects. The amount of the AMC will be less than the cost savings for Payers that successful treatment protocols derived from these clinical trials provide, which allows the business model to scale.&nbsp; As part of the Advanced Market Commitment, Phase 3 RCTs that fail to show efficacy/safety vs. standard of care will not receive a payout from the AMC. <img src="https://cdn.discordapp.com/attachments/895209203411587082/1015768218738114712/cfc-public-pharma-ltd-business-model.jpg">Figure 2. Our Medical Impact DAO will establish a Public Good Pharma Ltd to negotiate Advance Market Commitments for the funding of Phase 3 RCTs required for regulatory approval (e.g., FDA, EMA) of public good medicines. Explainer Video by Life Noggin showing for Advance Market Commitments or "Pay-For-Success" contracts work to incentivise generic drug repurposing <a href="https://www.youtube.com/watch?v=FwAOJc_IsVk" rel="noopener noreferrer" target="_blank" class="ql-size-large">https://www.youtube.com/watch?v=FwAOJc_IsVk</a> <h3>DAO Roadmap &amp; Milestones</h3> Over the next two quarters, our DAO building efforts will focus on the following: Building community and forming Working GroupsCommunity &amp; PartnershipsDAO Governance (Discourse / Snapshot)Ethics&nbsp;Executive Team / OperationsLegal &amp; PolicyPublic Good Medicine DealflowPayer &amp; Donor EngagementTechnology / Tokenomics OKR developmentDAO &amp; Fund Weekly town hallTo enable community members to create and contribute to proposals and have a voice in DAO governance. Onboarding a Core Partner NetworkIncluding payers, contract research organizations and other service providers, researchers, patient groups, policy makers, health care systems, generics manufacturers, healthcare practitioners, regulators, academia and non-profit, funders, health technology assessment organizations (e.g. ICER). EstablishingMedical Prize Criteria Committee&nbsp;Ethics Advisory Board WritingWhite Paper SourcingPromising research projects (e.g. generic drug and nutraceutical repurposing use cases) that will advance public good medicine development Clinical Trial “Deal Flow” (on-going, includes OpenKetamine). PreparingToken Launch (Q1 2023)

Crowd Funded Cures

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