CC BY-NC-ND 4.0Kukk, PiretPiretKukkMoors, Ellen H.M.Ellen H.M.MoorsHekkert, Marko P.Marko P.Hekkert2022-03-0513.4.20212016https://publica.fraunhofer.de/handle/publica/24689710.1016/j.respol.2016.01.016New technologies must be accompanied by institutional change. Innovative actors therefore need to do institutional work or take a role as an institutional entrepreneur in order to shape the institutions in the best interests of their technology. However, the literature on system building and on institutional entrepreneurship have little overlap. The goal of this paper is to bridge these two bodies of literature to gain additional insights into how institutional change evolves in a technological innovation system. We show how the pharmaceutical firm Roche acted as a powerful institutional entrepreneur by influencing the health-care system in England to create a market for the personalized cancer drug Herceptin®. We demonstrate that institutional change can be preceded by a range of innovation system-building activities that are not directly intended to bring about institutional change but are required in order for institutional change to take place.eninstitutional changepersonalized medicinesystem buildingtechnological innovation systems600journal article