Disruptive innovation in rheumatology: new networks of global public–private partnerships are needed to take advantage of scientific progress

Patterns of innovation can be sustained (continuous) or rapid, sometimes even ‘disruptive’. A major difference is that in order to support disruptive innovation the support networks and its infrastructure often need to be changed dynamically to accommodate a rapidly evolving landscape to establish the disruptive approach. For example, introducing electric cars disrupts the support network for gasoline cars (network of gas and service stations), and at the same time requires an entirely new system of charging stations. Such disruptions occur in science, and a wonderful example was the creation of monoclonal antibody technologies. The discovery of the principle for production of monoclonal antibodies by Cesar Milstein and Georg Kohler fueled a rapid adoption of new antibody-based technologies in all areas of medicine. This transformation was strongly supported by the open workshops that catalogued antibodies from many laboratories into distinct ‘clusters of differentiation’, thereby providing a new ‘support network’ for the global use of well validated and standardised monoclonal antibodies. This new support network helped the pharmaceutical industry transition from a major focus on small chemical molecules (screened for effects in vitro) to a new targeted approach, first with recombinant proteins, later with monoclonal antibodies with the introduction of anti-tumour necrosis factor (TNF) antibodies as an example. During the last two decades, in both the USA and Europe, the need to develop public–private partnership support networks has been recognised as a means to accelerate innovation and enable translation of the rapidly expanding cellular and molecular understanding of disease pathogenesis into the development of new therapeutic agents. In Europe, the Innovative Medicine Initiative (IMI) was formed to enhance public–private partnerships, and in the USA the Accelerating Medicines Partnership (AMP).1 Identifying, validating and testing new targets based on enhanced understanding are at the core of both AMP and IMI. To facilitate continuous …