University of Groningen
Access to innovative medicines in a middle-income country
Moye Holz, Daniela Denisse
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Publication date: 2019
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Moye Holz, D. D. (2019). Access to innovative medicines in a middle-income country: The case of Mexico and cancer medicines. Rijksuniversiteit Groningen.
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As another stage and milestone in my life come to an end, I dedicate all my sweat and tears, my joy and all the work I have put into my Ph.D. to my family: Sandra Holz, Arturo Moye, and Sandra Moye. I would have not been able to achieve this without the strong base and support that my family has given me.
I dedicate this book to the memory of my beloved mother: Sandra. As I write this, I cannot help but cry and remember her dearly. She left too early and it saddens me to remember our plans to celebrate this occasion together. I’m sure she would’ve been crying happy, excitement, proud tears (she cried for everything and anything that would excite her). She will be forever my biggest role model. I am the woman I am largely because of her. She taught me how to love and be loved; she taught me to work hard, give my best, and the value of work well done; she taught how to be brave while being polite, and that it is never too late to accomplish your dreams and be what you always wanted to be.
To my dad, Arturo, another primal pillar and love of my life. For your unconditional love, support, and generosity. I will forever be grateful for your (very) loud and cheerful voice that always expresses joy, excitement, pride, and love. Thank you for always showing off how great we are. You make us feel like peacocks. Daddy, thank you so much for being there with such strong support and a big smile. Thanks to you and mom for all that you have given me (us). Because of both of you, we have been able to realize all our dreams. All my dreams and all my successes go to you.
To my sister, Nany (Sandra), the third love of my life and best friend: because it’s you and me against the world. You know that your opinion will always matter the most and you will be forever my “go-to” person whenever I need advice, a scold, a laugh or comfort. This last year (a bit more than that) has been so much and so tough for both of us – especially for you. But we are making it through. Our relationship has grown so much stronger and has shown that together we can overcome anything. Thank you for your continuous support – particularly 2018 – as I had to come back and finish this work, and leave you back in Mexico with a big amount of things to deal with. I am sorry I had to come back and leave you with such a burden. You have no idea how much I admire how loving and caring you are, your positivity, your kindness, your devotion, your courage, your bravery, and your resilience. I only hope I can repay you with as much help, support, and love
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A as I can. I am certain that in no time we will be reading your thesis and attending your graduation as well. Just think about it: by 2020 we will both be Dr. Moye Holz.
This project and final result – my thesis – wouldn’t have been possible without the support, mentoring, and supervision of my promotors: Hans Hogerzeil, Menno Reijneveld, and Jitse van Dijk. Thank you, Hans, for responding and following up with those initial emails back in 2014. Those emails led me to Groningen and to the realization of my Ph.D., which provided me with many of the skills, expertise, and experiences that I was looking for. Thank you for believing in me and supporting me to get this project through the end. Thank you Menno and Jitse for supporting this project, which was perhaps a bit outside your fields and scope. I appreciate all the time you have spent reading, commenting and supervising my work; but mostly, I thank you also for believing in me and in this project. I have enjoyed working and learning from all of you. I realize that 2018 brought some doubts regarding the completion of my Ph.D., but I am glad to say that we were able to complete this project with 5 manuscripts and a research stay.
I want to thank all those that contributed to this Ph.D. with their assistance, feedback, input, support, mentorship, and encouragement: Anahi Dreser, Marg Ewen, Sergio Bautista, and René Soria. I really appreciate all the time and effort you have put into this research. I have learned so much from all of you and I have enjoyed working and collaborating with all of you. I also thank my two interns: Eva Abbing and Leon Franzky. I greatly appreciate your work, efforts, and contributions to our projects. I hope you have learned from this experience as much as I learned from you. I wish you tons of success during your studies and your career.
I want to express my appreciation to the University of Groningen, the University Medical Center Groningen/Graduate School of Medical Sciences and the Research Institute SHARE for hosting and supporting my research, making this Ph.D. degree possible. I acknowledge and thank the support that my country, Mexico, has given me since this Ph.D. was largely financed and supported with a scholarship from the Consejo Nacional de Ciencia y Tecnología (CONACYT). I also thank the National Institute of Public Health (INSP) in Mexico for collaborating with us and approving this project to carry out data collection and thus make some of the chapters possible. In addition, I thank Dr. Alejandro Mohar for his feedback and interest
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Miguel, and Els for helping me get this book through by proofreading, providing feedback, and translating some sections into Dutch. I also want to thank Veronika Wirtz, as my co-author, and Sabine Vogler, as my research-stay supervisor, for their support, encouragement and mentoring during the last months of my Ph.D.
I extend my gratitude to my assessment committee, Prof. Rob Henning, Prof. Bert Leufkens, and Prof. Albert Figueras for assessing this thesis. I also extend my appreciation to the other members of my opposition including Prof. Maarten Postma, Prof. Brigit Toebes and Dr. Marg Ewen.
I have to admit that the first time I came to Groningen, I did not get the best impression. I arrived in late November – gloomy, grey, cold November. Despite my continuous complaints on the (bad) weather and (bland) food, and despite some hard times, I have been very happy in Groningen and I have had some of the best years of my life here. This is because I have met the best friends here. My friends have made me feel that I belong here and that I was at home, despite being very far away from Mexico. In the worst moment of my life, they welcomed me back home with big arms to hug and support me, and with the most heartwarming messages (accompanied by a wonderful gift). I wouldn’t have been able to complete this Ph.D. with a good face without the support, laughter, cheering and encouragement of my friends. My friends: you have been a true blessing.
To Lucía, Charlotte, Sandra, Sarah, and Eric Cezne – thank you for our get-togethers in (very long) brunches, (very long) drinks + food evenings, and lunch during weekdays. For me, these moments with you were the highlights of many of my weekends and weekdays. Just meeting with you was a guarantee of a nice time, of interesting conversations, and mostly fun and good times. These moments with you helped me survive 2018 particularly. I am very grateful for your presence, your care, your patience, your encouragement, your support and understanding, your affection and for making me laugh very often.
When I arrived in Groningen, I decided to get involved as much as I could. So, I decided to join Gopher. That has been one of the best decisions I made in Groningen. Joining Gopher gave me 4 wonderful friends: Antonija, Els, Eric de Vries, and Simon. I thank you all for giving me the opportunity to get to know you, to learn from you, to work, and have fun with you. I am so grateful for your support during
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A hard times, and your cheers during good times. Gopher memories will be forever in my heart because of all the fun and laughter we had together.
I have to say that being new in a city where you don’t even speak the language has its challenges. At the beginning and for most of my Ph.D., I found myself in a work environment with no (or extremely few) international colleagues. It was interesting and also challenging to work in such an environment. However, Sander, Jorieke, Lisette, Ellen, and Katrina made it easier as the good officemates, colleagues, and friends they are. Still, I had to go outside and come up with stuff to make new friends. Organizing events in and outside Gopher gave me some of these great friends, and these friends introduced me to other friends – a true snowball effect. Estefania, Agnieszka, Sarah, and Dionisio: even when some of you have moved away from Groningen, I thank you all for staying in my life, for inviting me over, for your feedback, your cheers, for being so supportive, loving and caring. Aga and Sarah: I still miss our wine + Disney movie evenings – those were a nice break during the week.
During my last year in Groningen (2018), I got to meet great new friends: Miguel, Valentina, Adriana García, and Fabio. I really love the unusual group we have become. I cherish all our moments together in parties, dancing, our adventures and trips, or just hanging out and having great conversations. You have also made the last period of my Ph.D. so much easier and enjoyable. Time with you is always cheerful, chilled and full of laughter. Thank you for becoming such dear, close and loving friends. Thank you guys for your friendship and your spirits, despite the odds of meeting me during a difficult time in my life.
To all my other friends that have shared a piece of their time and their journey with me: Adriana Pérez and Reyer, Desiree, Steven, Nadia, and Marty. It has been a pleasure to meet you and share with you special moments – even if it was a conversation, a drink, a dance, or a laugh. You have all contributed to my wonderful time in Groningen and my Ph.D. journey.
To my friends in Germany: Erika, Jamila, Peter, Nandita, Yan, Magus, and Irma, you have no idea how much I miss all of you and being close to you. However, despite distance and time, I feel close to all of you and I thank you for your support during
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been a contributing factor to the realization of this stage in my life. As I enter a new stage, I hope to meet you much more often and stay close to all of you.
To my friends and family back in Mexico: Glaus, Tía Lupita, Tíos Beto y Cata, Tía Cata, Ceci, Katia, Fam. Moye, Aileen, Laura, Marimar, Paloma, Pili, Mary, Maritali, Mónica (Carolina), Caro, Silvia (Chuy), Alan, Iliana, Susi, Polola, and Fer. Thank you all for cheering for me, for supporting my decisions, following up on my progress, celebrating my small and big successes, and mainly being there for me despite the distance. I will always be glad to go home, meet you, and celebrate with you our successes. You have all, to different extents, contributed to the realization of my dreams. I love and miss you all.
To Lucía, Katrina, and Antonija – my (honorary) paranymphs: you girls have given me so much these last 4 years. It has been a true blessing getting to know you. I only hope I can repay all your love, care, consideration and support during this period of my life. I am glad that no matter what happens next I can always count on you, and I hope you know you can always count on me. Thank you all for being so supportive and for being so attentive to what I needed or how I felt. Lulu, I have learned so much from you. I love your intensity, passion, and good humor even through hard times. Thank you for your hugs and comfort, your laughs, your attention and considerations, your cheers, and presence. Kat, thank you so much for being my brain when I felt overwhelmed and lost my head. Thank you for being such a great colleague and enthusiastic friend, for all your recommendations, your encouragement, your input and feedback, and for helping me get through this Ph.D. (particularly the last year). Antonija, dear, I hope to be as supportive as you have been with me during the end of my Ph.D. I’m sure that in no time we will be celebrating your defense. I will always cherish your kindness and sweetness as the great friend you are. Thank you and Eric for your warm welcome last February (2018). Thank you for your hugs, kind shoulders, and ears to comfort me. I love you, girls, very much.
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