Abstract
Current cancer treatments are characterized by a low response rate, on average one out of four patients has a positive response on a chemotherapeutic drug. The cause of this low response rate is that the cause of cancer was not fully understood and therefore anti-cancer drugs were based on a
... read more
‘one-size-fits-all’ approach. However over the last years the underlying mechanisms that cause cancer are unraveled and gave the insight that each cancer has a unique genetic profile. Therefore a personalized approach is required to optimize the treatment, also called personalized cancer treatment. However, until now the use of these personalized cancer treatments is uneven distributed between European countries and thus not all patients had access to this new treatment. This leads to the main research question of this study: What are the hampering and promoting factors on the system level that influence the development and diffusion process of personalized cancer treatments in the Netherlands? A technological innovation system (TIS) approach is used because this approach describes technological change as the interaction between multiple actors which together contribute to the development and diffusion of this technological development. The development of two emerging personalized cancer treatments systems are analyzed to provide insights in the dynamics of personalized cancer treatments in the Netherlands. These cases are Herceptin for breast cancer and Tarceva for lung cancer. Herceptin is selected as a case study because Herceptin is regarded as one of the first personalized medicines. Tarceva is selected as a second case study because it entered the Dutch market 5 years later, therefore it was expected that the scene for personalized cancer treatments has changed. Furthermore a comparison is made between the Herceptin system in the Netherlands and the Herceptin system in England in order to validate the results found for the Dutch situation. First a structural analysis of personalized cancer treatments in the Netherlands is made to identify the main actors. Second a functional analysis is made to give insights into the dynamics of the innovation system. The results show that most of the promoting and hampering factors of the emerging Herceptin and Tarceva innovation systems in the Netherlands are overlapping. The main difference between the systems was the reimbursement principle, which led to unequal healthcare in the Herceptin system. The comparison with the Herceptin system in England shows that interactions around market formation are important for establishing reimbursement principles for Herceptin. In both systems lobbying activities were an essential factor for the establishments of these reimbursement principles.
The TIS approach is a well-known tool in for analyzing emerging innovation systems in the energy sector, but is rather new for analyzing emerging innovation systems in the life sciences & health field. This study shows that the TIS approach can be a valuable tool in analyzing the dynamics in emerging innovation systems in the life-science field. Further research should verify whether the observed patterns in the development of the innovation system of personalized cancer treatments can be generalized to the field of life science & health.
show less