Biomedical Engineering Reference
In-Depth Information
disease segment, by country and by access to information technologies such as the
internet.
The rapid uptake in the US of new treatments for heart disease, osteoarthritis,
and Alzheimer's disease has, in part, been attributed to these new channels of com-
munication. Berndt (2003) has shown this form of communication to have increased
the overall diffusion of some product classes, though it would appear to have had
little impact on the respective market shares of individual companies. In Europe and
Japan, the pace of change is slower and the medical professions have reservations
about the implications for the “doctor-patient” relationship.
International comparisons of diffusion rates
Regardless of the sophistication of the models deployed, decades of general con-
sumer research supports Rogers' model of diffusion, in which a substantial range
of behaviours causes variable uptake rates for innovations in large populations.
Research strongly suggests that this model applies equally well to the uptake of
medicines by doctors, healthcare payers and patients, and leads to typical “S-shaped”
diffusion curves. Although in principle, modern state systems are expected to rapidly
build and communicate a consensus view on the value and appropriate use of new
products, this is not what is reflected in the results of empirical uptake studies that
have taken place over many years.
Parker (1984) demonstrated very large differences when he compared average
time-lags and mean sales for a range of modern medicines in developed countries
between 1954 and 1971. A more recent analysis (Cambridge Pharma Consulting,
2002) of a wide range of products shows that major differences persist, despite more
efficient and consistent national licensing systems and more effective marketing by
leading companies in OECD countries.
Danzon and Kim (2002) compared lifecycle revenues, volumes and prices for
a group of 196 globally available molecules in Canada, France, Germany, Italy,
Japan and the US between 1981 and 1992. The authors concluded that diffusion
was particularly rapid in France, Canada and the US, but much slower in Germany
and the UK.
In a broad ranging study addressing epidemiological data on patient access to the
best available new therapies across many disease sectors and classes of medicines,
Schoffski (2002) highlighted widespread delays in adoption across EU countries,
even for therapies which had been available for many years. A recent study of the
uptake of modern anti-cancer medicines in EU countries by Jonsson and Wilking
(2005) confirms large differences in adoption between countries.
A number of factors contribute to these observations. First, based on long stand-
ing differences in national medical cultures and traditions, evidence suggests that
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