Biomedical Engineering Reference
In-Depth Information
Remaining gains were due to income improvements and better education (World
Health Organization, 1999).
Given the importance of innovations to sustained improvements in health, gov-
ernments should create a favourable environment for innovation. Creation of such
an environment depends on a sound understanding of the innovation process, fac-
tors which encourage or hinder innovation, but also the goals and objectives of
health systems. Partial understanding of the innovation process, the factors which
influence the uptake and diffusion of innovations, and the goals and objectives of
health systems may lead to development of policies and regulations which hinder
the innovation process as well as the uptake and diffusion of innovations.
This paper provides an overview of innovation models, how these have evolved
over time and the consequences of partial understanding of the innovation process.
We describe health systems goals and objectives and argue why it is important to
understand these when formulating regulatory interventions. We present a sum-
mary of a systematic review of empirical studies which explore how broad- and
health-system-specific regulations influence the adoption and diffusion of innova-
tive technologies (in this case innovative medicines) in health systems. The paper
concludes with a discussion of the findings and policy implications of these.
Innovation Models
In his review of innovation models, Tidd (2000) notes the shortcomings of early
models of innovation which consider the innovation process to be linear: driven
by “technology push” (a sequence of related R&D initiatives which led to devel-
opment of a new product or process and eventual adoption in the market place)
or “market pull” (when solutions are generated in response a market signal that a
new intervention is needed to address a problem). However, these linear “pull” and
“push” models do not adequately capture the nature of the innovation process and
the innovation ecosystems within which these innovations occur.
However, more recent models of innovation look at the innovation process as a
whole and identify that the innovation process is dynamic, discontinuous, incremen-
tal, inter-dependent and highly influenced by a number of factors—such as network
of actors, availability of resources, incentive systems and constraints. Using these
more recent models and viewing innovation from a more holistic lens, it is possible
to see how policies based on a partial view of the innovation process can adversely
effect innovation. For example, a partial view that focuses on “technology push”
alone may encourage investments in R&D that lead to outputs not valued (or needed)
by users. On the other hand, a partial view that focuses on the “demand pull” alone
may lead to development of products or services that the market wants but risks
detachment from technological development, with consequent risks of erosion of
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