2007). Until recently, policy-level discussions about the promotion of health intervention selleck inhibitor development work in RGFP966 cost biomedicine have often revolved specifically around these measures (Pisano 2006; Martin et al. 2009; Lander

and Atkinson-Grosjean 2011). The emergence of a discussion around TR model has brought to the foreground a different set of issues in the search to improve the productivity of biomedical innovation systems then those discussed in the paragraph above. There has been a multitude of claims and propositions for reform made using the TR label. In this section, we present three core claims that have recurrently been put forward in editorials, commentaries but also policies about TR. Using these categories, we aim to capture the type of scientific and institutional changes advocated in discussions about TR. Together, they form the basis for what we would here call the “TR model”. We will refer Vactosertib in vivo to the “TR movement” to refer to this large and unorganised group of actors that have actively advocated the TR model as a means to improve biomedical innovation systems. Experimental platforms and research practices Proponents of the TR model maintain that biomedical innovation should make a central place to experimental

practices conducted in clinical contexts. Some representations of biomedical innovation have had a tendency to treat clinical research as simply a means to validate therapeutic hypotheses that originate in laboratory experiments using animal models, cell cultures or collections of biospecimen, for for example (Nightingale and Martin 2004; Keating and Cambrosio 2012). Instead TR advocates maintain that clinical research and clinical care are practices productive of experimental knowledge in their own right, that they are an important source of hypotheses and data, and that they need to be put at the foreground of biomedical innovation to improve productivity (Nathan 2002; Coller 2008;

Wehling 2008; CIHR 2011; Marincola 2011). The experimental fecundity of clinical research is argued to be especially well visible in areas such as therapeutic research into targeted anti-cancer agents. There, new developments in “biology-led clinical trials”, for example, transform early clinical studies into complex experimental platforms that combine simultaneous and interdependent clinical and laboratory areas (Hoelder et al. 2012). Analysts of biomedical policy themselves have indeed commented that hospitals and clinics were “hidden innovation systems”, because these sites of knowledge production have often been left out of the dominant representations of innovation in the field (Lander and Atkinson-Grosjean 2011). As such, academic medicine centres and university clinics have been argued to form central institutions in TR initiatives (Zerhouni 2005; FitzGerald 2009).