During internationalisation, international new ventures in the life sciences industry face distinct challenges. For example, high product development costs push companies into early internationalisation to increase sales turnover and recover investments. At the same time, financial and managerial resource limitations and the demand to adjust to local regulations render internationalisation difficult. To date, relatively little is known about how different industry contexts influence new venture internationalisation processes. This paper presents an in-depth case study of the internationalisation process of a Swedish new venture from the life sciences industry to fill this gap. The findings outline factors in the industry context that affect the internationalisation process, with specific emphasis on entrepreneurs and their networks, leading to several propositions and a model of life sciences new venture internationalisation.

Purpose: This paper explores how different cross-country institutional healthcare settings affect an international new venture’s selling strategies and internationalization processes when commercializing a medical technology innovation.

Design/methodology/approach: The study is based on a longitudinal indepth case study approach with a comparative healthcare analysis in Sweden, the United Kingdom, Germany and the United States.

Findings: An institutional framework helps elucidate the regulative, normative and cultural-cognitive dimensions in different healthcare settings. National markets differ when operating in a healthcare setting and thus affectboth sales patterns and the internationalization process. In this study, four different sales patterns emerged from the countries’ and even regions’ distinctive institutional differences. This complexity and diversity led to a focused and slow internationalization process, which contradicts the assumption of rapid internationalization proposed in international entrepreneurship literature.

Practical implications: Every nation has its own unique healthcare structure, indicating the importance of choosing markets that facilitate a swift uptake of a specific breakthrough innovation. It is a lengthy, complex and costly process to commercialize a breakthrough innovation in cross-country healthcare settings, especially if new behaviors and routines need to be created.

Originality/value: The paper contributes to international entrepreneurship literature by developing a contextualized internationalization model and by advancing six propositions related to the role of institutional healthcare settings and their impact on international new ventures’ sales patterns and internationalization processes.

The importance of networks for firm internationalization has been pointed out for several decades. Especially for small and new firms, networks have been found to be an important tool to gain access to resources and to overcome liabilities of newness, smallness and foreignness. Yet, there is a lack of understanding regarding which types of capabilities are developed through networking and how and when networks are used for growth purposes overtime. The aim of this article is to explore how and when the individual key actors’ competence bases and networking activities create, develop and deploy critical capabilities during different phases of an international new venture’s early development. The article is based on a longitudinal, in-depth case study ofa Swedish international new venture from the medical-technology industry. We find that the development process is greatly affected by the key individual actors’ various competences, existing network ties and their leveraging of different indirect ties during the pre-founding, start-up and establishment of production phases. During the commercialization and sales growth phases, however, many new network ties are developed. The heterogeneity of the individual actors’ backgrounds plays an important role during the different developmental phases. We conclude by advancing a number of propositions inrelation to how critical capabilities are created, developed and deployed through networking during different developmental phases.

Purpose – The purpose of this paper is to explore how and why an international new venture co-creates value with different types of network actors during its process of gaining international market acceptance and commercializing a medical technology innovation.

Design/methodology/approach – The study is based on a longitudinal indepth case study approach.

Findings – Five different groupings of actors were identified as playing critical roles in the international new venture’s commercialization process.These groupings were related to the actors’ overall roles and drivers and the ways in which they both give and receive value to each other through different activities and resources. The five groupings are as follows: (1) actors related to improving health; (2) actors related to ensuring healthcare safety; (3) actors related to reducing healthcare costs; (4) actors related to creating opinion and enhancing legitimacy; and (5) actors related to business.

Practical implications – This research reveals the roles of different actors in a healthcare value chain context in which institutional and scientific network actors are specifically important. Moreover, networks that are related to creating positive opinions and legitimacy for the international new venture and its medical technology innovation are also paramount (e.g., media and different non-profit organizations). Finally, business networks are important to achieve competitiveness and to find international distributors.

Originality/value – This study contributes to the international entrepreneurship literature by proposing an extended network model that relates to both non-market-based and market-based networks, including scientific, institutional, opinion creating and business networks.

This study combines a network with a practice view to understand the interactions that take place among different actors when commercializing a medical-technology innovation on international congresses/trade fairs. It takes an integrative stance to identify different kinds of networks, both commercial/non-commercial and academic ones which are important in the process of gaining international market acceptance. This study has identified what different types of tools/material are used in trade fair booths with the purpose of underpinning different arguments to various actors. For example, it reveals how crucial it is for the focal firm to have an impact on treatment guidelines and to become a first-hand collaborative actor with key opinion leaders and clinicians. It subsequently becomes important to understand how this is done through the creation of mutual values for the actors and by understanding and defining the incentives for their collaboration. The main findings of this paper illustrate how the different actors, activities and tools/material reinforce each other in order to create mutual value aiming at an international market acceptance for and adoption of the innovation. The study has also established that the focal firm has to think globally when it comes to science, but that there are many different country-specific circumstances to consider when it comes to value creation through the choice of different tools/material and activities. This study contributes to the international entrepreneurship literature by extending the view on internationalization by acknowledging tools and material that are co-created with different actors and through different activities. The study also highlights the need to extend the concept of business networks to uncover further dimensions such as academic and institutional ones in an international context.