Driving forces of technological change in medicine: Radical innovations induced by side effects and their impact on society and healthcare

Technological change in medicine has complex interactions driven by demand- and supply side determinants. The epistemological position of this paper is that scientific research generates in medicine vital radical innovations (new drugs/therapies) that are associated, a posteriori, to moderate and/or severe side effects. These side effects spur feedback mechanisms, which support a co-evolution of innovation in parallel technological pathways: 1) incremental innovations with lower side effects and higher efficacy; 2) emergence of new radical innovations induced from severe side effects. Empiricist-positivist arguments support this stance and show the main role of society and healthcare in the patterns of technological innovation in medicine. Critical evidences are the foundation to state main inductive theoretical implications between observed facts.