Demand articulation in intermediary organisations: The case of orphan drugs in the Netherlands

Several aspects of a technology are uncertain when it is in its emerging phase, e.g. the demand for a technology. Demand articulation processes are regarded as important, but till now it is often treated as a black box. We present a conceptual framework for the analysis of demand articulation processes inside intermediary organisations, and in interaction with other stakeholders. The empirical basis of this framework is provided by a case study involving an event history analysis, in which the occurrence and the contents of demands are followed over time. We studied the processes within the ‘Dutch Steering Committee Orphan Drugs’, an intermediary organisation that supports new and emerging technologies in the context of orphan drugs. Our results show that due to the activity of the intermediary organisation demand articulation occurred, that interactions exist between the demands and the organisation's underlying values, and that in interaction with other actors a debate on the reimbursement of new drugs is settled. The major contribution of this paper lies in the design of a framework for studying demand articulation processes in intermediary organisations and the resulting impacts on the development of emerging technologies. In addition, the paper provides insights in the possibilities to reinforce the role of the intermediary organisation studied.