From new molecules to leads for innovation : studies on the post-innovation learning cycle for pharmaceuticals

The pharmaceutical arena is evolving constantly: new drugs enter the market while older ones are discontinued, clinical practice changes, health care budgets rise and fall, and public health needs are redefined. To assist in thinking about the usage environment of drugs in a comprehensive manner that includes regulation, clinical outcomes, and incentives for innovation, we propose a conceptual post-innovation learning cycle for pharmaceuticals. A primary objective of this thesis is to develop a set of analytical tools to study the post-innovation learning cycle of pharmaceuticals. With these tools we aim to provide an evidence base for the formulation of policies that want to achieve a sustainable balance between providing good quality health care, stimulating the optimal allocation of scarce resources, and fostering an environment where innovation is adjusted to real public health needs. Finally, we want to identify directions for future research. In this thesis we shown that epidemiological methods provide opportunities for studying the links between various aspects of the post-innovation learning cycle of medicinal products. At the same time, we have identified critical issues that need to be addressed for these tools to fulfil their promise.