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A call for more patient value in the Dutch healthcare system: pharmaceutical innovation opportunities towards diabetes mellitus type 2 care group board needs.

By L.M.E. van der Staay


Driven by more demanding customers and global competition, many industrial organisations search for new ways to achieve and retain a competitive advantage. Past attempts have largely focused on innovative improvements within organisations. The next source for competitive advantage will presumably come from a more outward orientation towards customers, as indicated by the many calls for organisations to compete on superior customer value delivery (Woodruff, 1997). \ud \ud Nowadays, pharmaceutical organisations, that focus on diabetes mellitus type 2 (DM) drugs, have a hard time to obtain competitive advantage. In the pharmaceutical industry the R&D of DM drug pipelines are becoming more empty, which pressures pharmaceutical organisations to innovate (Gassmann et al., 2004; Buurma et al., 1996). As from January 2010, patient value needs of care group boards in the Dutch integrated DM care funding structure, regarding DM drugs and services, are increasing (RVZ, 2008). This increasing patient value need pressures pharmaceutical organisations to innovate even more. Consequently, pharmaceutical organisations presumably can take up patient value care group board needs as innovation opportunities to innovate and obtain competitive advantage. So, this research examines the central research question: “To what extent are pharmaceutical innovation opportunities needed by Dutch diabetes mellitus type 2 care group boards, in order to increase patient value?” \ud \ud In order to answer the central research question, the following three sub questions are answered beforehand; (1) Which pharmaceutical innovation opportunities can be discerned theoretically? (2) What are specific characteristics of diabetes mellitus 2 compared to diabetes mellitus type 1, and how are these characteristics related to patient value? (3) Which pharmaceutical innovation opportunities do Dutch diabetes mellitus type 2 care group boards need, with regard to patient value?\ud \ud This research aims to get insight in the pharmaceutical innovation opportunities that increase patient value, which are currently needed by Dutch DM care group boards. This research also aims to understand to what extent these opportunities are needed by the care group boards. \ud \ud The innovation theory of Porter and Teisberg (2006) is used to answer sub question 1. According to Porter and Teisberg (2006), pharmaceutical organisations can obtain competitive advantage by creating innovation opportunities, besides supply-driven R&D of DM drugs, that specifically increase DM patient value in a healthcare system. Consequently, this research discerns five pharmaceutical innovation opportunities as independent variables in the conceptual model by means of Porter and Teisberg (2006); demonstrated value of drug, personalised drug, embedding of drug, marketing campaign of drug, and support service. The dependent variable is called ‘patient value need of Dutch DM care group boards’. The latter measures to what extent pharmaceutical innovation opportunities are needed by Dutch care group boards, with regard to DM patient value. \ud \ud Next, this research combines an exploratory and explanatory research design. First, it explores the existing DM needs of Dutch care group boards. Second, it explains in a causal way to what extent pharmaceutical innovation opportunities are needed by Dutch care group boards. Furthermore, the unit of analysis in this research is a board member, being also a physician, of each currently existing Dutch care group board, in the field of DM.\ud \ud Moreover, different methods are used for data gathering. These methods are; a literature study, five (qualitative) explorative semi-structured interviews, and a (quantitative) questionnaire. \ud \ud The methods that are used for data analysis are the following; innovation literature discerns five theoretical pharmaceutical innovation opportunities, that increase patient value, in order to answer sub question 1. Next, a literature study examines all different characteristics between diabetes mellitus type 1 and 2 with regard to patient value and relates these characteristics to patient value to answer sub question 2. This literature study collects necessary background information, which is needed to do latter research steps accurately. Subsequently, five (qualitative) explorative semi-structured interviews with Dutch care group boards verify the five theoretically discerned pharmaceutical innovation opportunities and explore additional pharmaceutical innovation opportunities to refine the model, consequently, sub question 3 could be answered. The five care group boards are selected on their care group size and geographical location. The interviews reveal four additional pharmaceutical innovation opportunities; self management of patients, research regarding disease complications, research regarding treatment of foreign patients, and research objectivity. At last, a (quantitative) questionnaire makes it possible to examine the nine pharmaceutical innovation opportunities of the refined model among the whole population of Dutch care group boards by means of descriptive statistics in Excel and a multiple linear regression analysis in SPSS. Consequently, an answer can be give on the central research question. \ud \ud The answer to the central research question is that three pharmaceutical innovation opportunities increase DM patient value need of Dutch care group boards to the following extent; research regarding disease complications (¬i value = 0.932), personalised drug (¬i value = 0.767), and support service (¬i value = 0.657). The ¬i values determine to what extent these three pharmaceutical innovation opportunities are needed by Dutch care group boards, because, the p-values of all three significant pharmaceutical innovation opportunities are extremely close to each other (0.070 ≤ p-values ≤ 0.077). The pharmaceutical innovation opportunity ‘research regarding disease complications’ should focus on performing research regarding the relation between this new diabetes mellitus type 2 healthcare structure and the frequency of complications by DM patients. Furthermore, the pharmaceutical innovation opportunity ‘personalised drug’ should focus on performing research regarding DM overtreatment and DM undertreatment. At last, the pharmaceutical innovation opportunity support service should focus on providing a well working transmural ICT system and offering a service that helps Dutch DM care group boards to obtain financial capital. \ud \ud Next, this research implicates that, besides these three pharmaceutical innovation opportunities, care group boards are rather skeptical about the idea that specifically the actor ‘pharmaceutical industry’ should satisfy care group board patient value needs. Another research implication is that an individual pharmaceutical organisation can obtain short-term profitability only by focusing on pharmaceutical innovation opportunitity ‘support service’ (selling support services that focus on providing a well working transmural ICT system or help Dutch DM care group boards to obtain financial capital). So, from a national Dutch DM healthcare system perspective it is recommended that the remaining two pharmaceutical innovation opportunities ‘research regarding disease complications’ (performing research regarding the relation between this new diabetes mellitus type 2 healthcare structure and frequency of complications by DM patients) and ‘personalised drug’ (performing research regarding DM under-/ overtreatment) would be executed by an actor e.g. consultant or Dutch government, other than the pharmaceutical industry

Topics: Geowetenschappen, Pharmaceutical innovation opportunities, patient value, care group board, diabetes mellitus type 2, needs, Netherlands
Year: 2010
OAI identifier: oai:dspace.library.uu.nl:1874/179630
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