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The case is designed to be used with the digital business model framework developed by Peter Weill and Stephanie Woerner of Massachusetts Institute of Technology (MIT) (Weill and Woerner, 2015) and is referred to as the W & W framework. This approach provides a useful structure for thinking through the strategic options facing environments ripe for digital transformation.

Research for this case was conducted through face-to-face interviews with the protagonist, as well as through a review of their business planning documents and other data and documentation provided by the founder. Some of the market and industry data were obtained using secondary research and industry reports. Interviews were digitally recorded and transcribed to ensure accuracy.

The case follows the story of Kurt Waltenbaugh, a Minnesota entrepreneur who shared the dream of using data analytics to reduce costs within the US health-care system. In early 2014, Waltenbaugh and a physician colleague founded Carrot Health to bring together their personal experience and expertise in both consumer data analytics and health care. From the beginning, they focused on how to use data analytics to help identify high-risk/high-cost patients who had not yet sought medical treatment. They believed that they could use these insights to encourage early medical interventions and, as a result, lower the long-term cost of care.

Carrot’s initial success found them in a consultative role, working on behalf of insurance companies. Through this work, they honed their capabilities by helping their clients combine existing claims data with external consumer behavioral data to identify new potential customers. These initial consulting contracts gave Carrot the opportunity to develop its analytic tools, business model and, importantly, to earn some much-needed cash flow during the start-up phase. However, they also learned that, while insurance companies were willing to purchase data insights for one-off market expansion projects, it was much more difficult to motivate them to use data proactively to eliminate costs on an ongoing basis. Waltenbaugh believed that Carrot’s greatest potential lay in their ability to develop predictive models of health outcomes, and this case explores Carrot’s journey through strategic decisions and company transformation.

This case is intended for either an undergraduate or graduate course on entrepreneurial strategy. It provides an effective introduction to the unique structure and constraints which apply to an innovative start-up within the health-care industry. The case also serves as a platform to explore the critical criteria to be considered when developing a digital transformation strategy and exposing students to the digital business model developed by Weill and Woerner (2015) at MIT (referred to in this instructor’s manual as the W&W framework). The case was written to be used in an advanced strategy Master of Business Administration (MBA) class, an undergraduate specialty health-care course or as part of a health-care concentration in a regular MBA, Master of Health Care Administration (MHA) or Master of Public Health (MPH). It may be taught toward the end of a course on business strategy when students are building on generic strategy frameworks and adapting their strategic thinking to the characteristics of specific industries or sectors. However, the case can also be taught as part of a course on health-care innovation in which case it also serves well as an introduction to the health-care payments and insurance system in the USA. Finally, the case can be used in a specialized course on digital transformation strategy in which case it serves as an introduction to the MIT W&W framework.

The case is particularly well-suited to students who are familiar with traditional frameworks for business strategy and business models. The analysis builds on this knowledge and introduces students interested in learning about the opportunities and challenges of digital strategy. Equally, the case works well for students with clinical backgrounds, who are interested in how business strategy can influence changes within the health-care sphere. Finally, an important aspect of the case design was to develop students’ analytical confidence by encouraging them to “get their hands dirty” and to carry out some basic exploratory data analytics themselves. As such, the case requires students to combine and correlate data and to experience the potentially powerful combination of clinical and consumer data. Instructors should find that the insights from these activities give students unique insights into the potential for of data analytics to move health care from a reactive/treatment ethos to a proactive/intervention ethos. This experience can be particularly revealing for students with clinical backgrounds who may initially be resistant to the use of clinical data by commercial organizations.

The learning objectives have been prepared following Bloom’s taxonomy (Bloom et al., 1956). After completing the case study, the students will be able to identify and recall the prerequisites necessary for establishing a pathology laboratory. (knowledge); analyze the micro- and macroenvironmental factors considered by Mr Sabihul Haque in the development of the strategic plan for Healthcare Laboratories (HCL) (knowledge and application); explain the key components of the Porter’s value chain and their significance in the operation of HCL (comprehension and evaluation); use the TOWS analysis to map the internal strengths, weaknesses, opportunities and threats of HCL (application and synthesis); and analyze the challenges faced by protagonist in managing HCL and generate suggestions for addressing the challenges (analysis and synthesis).

HCL, an enterprise established in 2018 in Sahdeo Khap, Gaya, Bihar, India, aims to provide high-quality pathological diagnostic services in semi-urban and rural areas. This health-care initiative is pioneering, offering pathology services to make high-quality, low-cost diagnostic services accessible in rural India. In rural settings, numerous health-care hurdles make it challenging for individuals to access the care they need. Since its inception, HCL has expanded its reach to connect more areas, facilitating diagnostic services for people in remote regions. The establishment of laboratories in semi-urban areas aims to reduce patient travel time, costs and health risks by bringing services directly to their doorstep. Haque, the chief executive officer of the lab, grappled with multiple challenges, including selecting an appropriate location for the lab, recruiting and retaining skilled workforce, managing logistics supply, collaborating with local health-care providers, dispelling the stigma among the population that superior services are only available in cities and enhancing health literacy in rural communities. Following numerous meetings with Ms Ummati Naiyyer, head of operations, they worked collaboratively to address these challenges, developing a blueprint and future plan to operate services in rural areas. This case study provides insights into the obstacles faced by HCL striving for success in rural areas. It elucidates the beneficial application of the Porter’s value chain, along with an analysis of macro- and microenvironmental factors. Unique challenges such as societal stigma and mistrust are specifically emphasized. Students engaging with this case study will enhance their problem-solving skills through brainstorming and providing recommendations, contributing to potential solutions for HCL’s difficulties.

The teaching notes for the HCL case is designed to enhance the learning experience of undergraduate and graduate students within the context of the course. This case study serves as a valuable teaching tool, allowing students to apply theoretical knowledge to real-world scenarios in the health-care industry. The notes provide a framework for instructors to facilitate discussions, encourage critical thinking and promote a deeper understanding of key concepts related to establishing diagnostic laboratories in rural areas.

Teaching notes are available for educators only.

CSS3: Entrepreneurship.

Pharmaceutical marketing, brand protection.

It could be used with the pharmaceutical marketing students and MBA students for analysing counterfeit medicines' menace in developing countries and positioning of a disruptive technology. The case could be used for marketing consultants, Brand managers and executive development programmes to explore issues such as protecting brands through technology, pharmaceutical packaging marketing, competitiveness of counterfeit drugs, global harmonisation.

Against the backdrop of rising menace of counterfeit drugs in developing countries, the case talks in particular about an innovative pharmaceutical packaging company. The company has developed a unique security technology called non-ClonableID™ which can enable products to be authenticated throughout the supply chain, thus protecting brands and preventing misuse. Despite a promising technology, it poses challenges regarding its adoption and commercial success.

Counterfeiting as an inevitable result of Globalization has become a global nuisance and has to be dealt at global level. Brand protection could be one of the lowest cost tools for pharmaceutical companies to restore public confidence in their products and themselves. While all methods for anti-counterfeiting are known to have short lives the menace still must be dealt with. For this, companies need to deploy anti-counterfeiting strategies that set up various layers of security.

Teaching note.

Learning outcomes (objectives and outcomes) are as follows: to understand the brand positioning, brand building and category extension decisions of a pharmaceutical brand (operative in one of the most competitive and regulated industries in a developing country); to analyze the outcomes of decisions pertaining strategic sales, branding, marketing and strategic restructuring to overcome the challenges of growth; and to design strategic solutions for developing brand equity.

This case explores the strategy of launching and establishing a pharmaceutical brand in an industry that tends to be a highly technical and the most regulated industry. It depicts market research data, industry analysis, stiff competition and regulatory affairs, and elaborates various strategic decisions taken by the company. The primary data for the case is accumulated through in-depth interviews from six industry experts on pharma marketing who were well acquainted with Maple Pharma and secondary data is gleaned from substantive literature. Maple Pharmaceuticals launched Starpram, a high-growth, high-potential generic antidepressant brand (in the central nervous system category) containing Escitalopram molecule/chemical. It had expertise cum competitive advantage in cardiovascular and anti-diabetic streams, but such initiative appeared category extension, with the intention to diversify risk and expand the company to achieve greater economies of scale. The first year sales revenue for Starpram appeared too bleak to spur further product inaugurations. Consequently, strategic overhaul transpired to establish the brand in the highly fragmented pharmaceutical industry. The firm lacked experience in anti-depressants category, coupled with poor sales, marketing mix and overall marketing strategy. Eventually, the management exercised strategic restructuring to establish brand equity and observed growth.

Study levels/Applicability graduate (MBA), MS, PhD (management sciences).

Teaching Notes are available for educators only. Please contact your library to gain login details or e-mail support@emeraldinsight.com to request teaching notes.

CSS 8: Marketing.

In January 2005 Dr. Mean Chhi Vun, director of the Cambodian National Center for HIV/AIDS, Dermatology and STDs (NCHADS), needed to decide how to control the spread of HIV/AIDS and save the lives of thousands of Cambodians who were dying from it each year. In the seven years since Dr. Vun had been appointed director, NCHADS had built an organization that was transparent and efficient, had implemented a nationwide 100 percent Condom Use Program, had established a system that allowed individuals to voluntarily seek confidential counseling and testing, and had instituted a set of guidelines and procedures for staff at health facilities to refer HIV-positive patients to treatment clinics and link them with NGOs providing financial and psychosocial support. Now, however, Dr. Vun faced decisions about three initiatives that were critical to expanding care and treatment programs in his country. First, he needed to decide how to quickly and cost-effectively improve the national HIV/AIDS laboratory support infrastructure. Second, Dr. Vun needed to improve logistics and supply management in order to get the best prices and ensure patients had access to life-saving medicines. Finally, he needed to figure out how to provide sustainable care and treatment to the thousands of Cambodian children living with HIV/AIDS.

Create innovative solutions for large-scale, socially relevant challenges. Understand how to start, scale, and lead cross-sector public health initiatives, or any initiative requiring behavior change by a range of players on a large scale over the long term. Discover and implement operating models that balance the needs of for-profit, non-profit, and government organizations. More effectively manage situations where required resources are not under one's direct control.

In January 2013, small biotechnology firm Orexigen was in the final stages of testing Contrave, a promising new pharmaceutical product for the treatment of obesity. At the time, Orexigen had no products in the market, so all its hopes of financial success rested on this new treatment. Contrave had proven to be highly effective in clinical trials, and Orexigen executives were confident it would receive FDA approval.

At the same time, a much larger pharmaceutical company was considering acquiring Orexigen. Because the decision to acquire would ultimately be a financial one, the project team from the large company had to complete a valuation for Orexigen's only significant product in its pipeline, Contrave. What was the new product actually worth?

Business, management.

This case is suitable for undergraduate and postgraduate students studying topics related to human resources, decision making, managing in multinational companies and crisis management. In addition, the case is useful study for practitioners in non-governmental organizations (NGO).

Dr Manal Taryam, the Chief Executive Officer, was discussing with Ms Shurooq Al Banna, Marketing Specialist, the achievements and challenges faced at Noor Dubai over the past three years. Noor Dubai is an international charity for the prevention and treatment of blindness. The problem facing these decision makers is the prioritization of their resources to support logistics management, operations, human resources, funding and educational issues. In addition, to meet the needs of the visually impaired, a long-term mission is to establish permanent eye centers in areas of most need.

Students will be able to:

• Describe the problems facing Noor Dubai in relation to logistics management, operations, human resources, funding and educational issues.

• Explain how the management strategies of Noor Dubai prioritize logistics management, operations, human resources, funding and education.

Describe the problems facing Noor Dubai in relation to logistics management, operations, human resources, funding and educational issues.

Explain how the management strategies of Noor Dubai prioritize logistics management, operations, human resources, funding and education.

Teaching notes.

In March 2015, Amgen is preparing for the launch of Repatha, a new molecule that has demonstrated a remarkable ability to treat high cholesterol. Through a series of clinical trials, Amgen has proven that the molecule is both safe and effective for patients with high cholesterol. It also is effective for patients with familial hypercholesterolemia, a difficult-to-treat population that has exceptionally high levels of cholesterol. Amgen expects the FDA to approve the molecule before the end of the year. Now, the Repatha team has to develop a revenue forecast.

Executives at biotechnology firm Genzyme are debating funding a clinical trial for a new version of a medical device called Synvisc. The trial is expensive and the odds of success are not high, but the upside is substantial. The case presents a common business question: invest or not? The case forces students to think about customer insights, wrestle with a number of complex issues, and evaluate the financials of the decision.

The case is ideal for teaching financial analysis and decision making. It can also be used to teach marketing, new product strategy, and healthcare industry management.

Describes how four independent, community-based nonmedical centers that offered professional services and programs to cancer patients on a voluntary non-fee basis in the 1990s came together to form the Cancer Health Alliance in 2003-2004 as a separate nonprofit to help achieve more of their mission and be more sustainable.

To understand why it is so difficult for small independent nonprofits with similar missions, activities, programs, and funding to collaborate to achieve more mission. To examine how less complex nonprofit alliances begin, how they progress along an alliance continuum, and what the options are for future growth.