Sources of Medical Technology Universities and Industry (1995) / Chapter Skim
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1 THE CHANGING NATURE OF MEDICAL TECHNOLOGY DEVELOPMENT
1 THE CHANGING NATURE OF MEDICAL TECHNOLOGY DEVELOPMENT
Pages 3-14
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From page 3... ...
In particular, discussions have focused on how changes in demandside incentives, as precipitated, for instance, by the introduction of global budgets, higher insurance co-payments, and the like, might reduce the cost-ineffective use of existing medical interventions and alter the direction of medical innovation toward the development of cost-reducing technologies. By comparison, the conditions governing the supply of new medical technologies, and their particular characteristics, have been relatively neglected.
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From page 4... ...
Indeed, what has worked well in pharmaceuticals may not work at all in the newly emerging biotechnology sector. Moreover, if we consider new clinical procedures or medical devices, the conditions for successful innovation are probably very different from other subsectors of the medical technology realm.
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From page 5... ...
In fact, medical innovation depends heavily on interactions between universities, particularly academic medical centers, and industrial firms. Over the past decade, the number and diversity of these university-industry interactions have greatly increased (Blumenthal, 1994~.
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Galileo was not the inventor of the pendulum clock, even though he did indeed formulate the scientific principles that govern the behavior of the pendulum clock. Similarly, the basic science underlying light transmission was developed by Christiaan Huygens in the seventeenth century, but it would be preposterous to regard him as the inventor of fiber optics.
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From page 7... ...
technology by Boyer and Cohen at the University of California, San Francisco, and Stanford University, for example, directly encouraged the industrial development of such biologicals as human insulin, the growth hormones, and tissue plasminogen activator (see Stern, chapter 7~. Medical device innovation, by contrast, does not depend nearly as heavily on the exploitation of basic scientific and technological capabilities generated "upstream" within medical schools as does the pharmaceutical or the emerging biotechnology sector.
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From page 8... ...
The widespread introduction of the first oral contraceptives into clinical practice during the early 1960s confirmed their high degree of effectiveness, but also revealed that their use increased the risk for thromboembolic disorders. The suspicion, based updn subsequent research, that estrogen might be responsible for such circulatory diseases stimulated manufacturers to reduce estrogen levels and develop low-dose pills, which subsequently led to a dramatic decline in side effects (Gelijns and Rosenberg, 19949.
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From page 9... ...
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From page 10... ...
In the medical device sector, for example, the composition of the industrial R&D team is undergoing significant change in that clinicians are being added to these teams. At the same time, product design engineers, as well as marketing specialists, are receiving more clinical training and are spending more time in academic medical centers.
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From page 11... ...
INTERDISCIPLINARY NATURE OF MEDICAL R&D We have emphasized the importance of crossing organizational boundaries in the innovation process. In our discussion so far, we have had in mind enterprises such as university research conducted within well-defined academic disciplines on the one hand, and research conducted by industrial firms, large or small, on the other.
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From page 12... ...
The therapeutically oriented groups tended to move faster from animal testing to the clinic and collaborated more intensively with industrial firms, whereas the experimental groups entered more slowly into licensing agreements. Blume suggests that the interdisciplinary nature of cochlear implants meant that assembling the necessary skills and competences, securing agreement as to how the value of this new intervention was to be assessed, and establishing what kind of industrial expertise provided commercial advantage was more problematic than in the case of, for example, diagnostic imaging, which is much less interdisciplinary in nature.
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From page 13... ...
Medical device innovation appears to differ considerably from innovation in the realm of pharmacology and biotechnology. Although pharmaceutical and biotechnology innovation also draw upon a number of disciplinary specialties, medical device innovation relies much more heavily upon a systematic intellectual trespassing across well-established disciplinary boundaries.
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From page 14... ...
1991. Innovation in Clinical Practice: The Dynamics of Medical Technology Development.
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