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Strategy.

MBA.

On 20 May 2016, the Management team at Patanjali Ayurved Limited (PAL), an Indian fast-moving consumer goods (FMCG) company, had assembled in their Haridwar office, India, to discuss their future growth plans. The team was in a celebratory mood, as their internal reports suggested the annual revenue forecasts for the year 2016-2017 to be INR 10bn, an increase of 100 per cent as compared to the previous fiscal year 2015-2016 that recorded annual revenues of INR 5bn. PAL incorporated in 2006 and co-founded by Acharya Balkrishna operated in four business segments of foods, personal care, home care and Ayurved products. The products sold under the brand name Patanjali were single-handedly promoted by Swami Ramdev (hereafter referred as Ramdev), a popular Yoga practitioner and preacher amongst the Indian masses, as well as PAL’s co-founder. Ramdev recommended PAL’s products in his yoga sessions on television and yoga shibirs which had led to huge positive “word-of-mouth” publicity for their brand Patanjali. Their fast-paced growth in less than a decade had generated a disruption in the Indian FMCG sector, resulting in a negative impact on the sales of established multinational corporations (MNCs) such as Colgate-Palmolive, Hindustan Unilever Limited (HUL), ITC Limited (ITC), besides the domestic players such as Dabur India Ltd. and Emami Ltd. This had led their FMCG competitors to launch plans to strengthen their product portfolios so as to provide a tough competition to PAL. The management team at PAL, though confident of achieving their annual revenue targets, were apprehensive of this new competition from the big players of the FMCG sector. Were they capable of continuing their success story? Going forward what strategic steps would ensure them a sustainable growth and a market leader position? The mood turned reflective as the team pondered on some of these questions.

The case is structured to enable discussion on: conducting and understanding a general environment analysis and industry and competitive analysis and critically evaluating the firm’s strategic positioning and scope in a competitive environment.

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

CSS 11: Strategy.

Non-profit management and corporate strategy.

The case is appropriate for teaching undergraduate students, executive MBAs and graduate students. The case is useful for an overview of hospice and palliative care in the developed and developing world, and for class room discussions of external analysis of non-profit organizations' ecosystems, funding needs and industry analysis.

Hospice care in the developed parts of the world is well established but in most developing countries, there are no organized hospice care facilities. This case focuses on a charitable organization, Brthya – Add Value to Life (Brthya – AVTL), that established and operates hospice care in Chennai, India. The Indian context for hospice care, and the ecosystem needed to sustain ongoing operations, are described along with a summary of four different models of hospice care used in other parts of the world.

The case will help students to understand: what hospice care is and its various forms; management issues related to funding and operating hospice care in particular and a non-profit in general; ecosystems that make non-profits sustainable in emerging economies; and managing expansion and growth in non-profit organizations, in emerging economies and globally.

Teaching notes are available; please consult your librarian for access.

The learning outcomes are as follows: identify and evaluate the impact of risk factors for health-care organizations during crisis; evaluate the role of different organizational factors in building resilient health-care organizations; define organizational resilience in a health-care context; and apply the effect-strategy-impact resilience framework.

September 2022 found Ranjan Thakur, the Hospital Director at Manipal Hospital, Jaipur (MHJ) reflecting on MHJ’s resilience toward future health-care crises. MHJ was established in the capital city Jaipur of the Indian state of Rajasthan in 2014, as a 225-bed multispecialty unit of the nationally renowned Manipal Health Enterprises Ltd. As the Hospital Director, Thakur had been responsible for navigating his team and the hospital through the multiple health-care related challenges exacerbated by the multiple waves of the Covid-19 pandemic in a large Indian state with a sizable rural and semiurban population. Though Thakur and his team of doctors had worked through the vulnerabilities of their health-care ecosystem, mapping the risks and mitigating the same, Thakur asked himself if they had done enough. He wondered how a health-care institution such as theirs could sustain effective health-care delivery during future crises situations to deliver high-quality health care to the vulnerable communities. Had they effectively mapped MHJ’s vulnerabilities and built resilience into the hospital’s functioning? The backdrop of the case is public health in the state of Rajasthan (Jaipur), and the case is rich in detailing social factors such as behavior issues of patients, doctors and nurses; operational factors such as standardization of treatment and standard operating procedures, availability of resources, clinical concerns; leadership and management of the hospital through the pandemic. This case can be used by instructors to teach organizational resilience building in the health-care context.

Graduate- and executive-level courses in managing change during crisis in health-care context; health-care management/leadership.

Teaching notes are available for educators only.

CSS 7: Management Science.

Describes Myriad Genetics and its struggle to develop a genetic testing service while facing challenges from competitors and activist organizations. After Myriad's discovery of the BRCA gene, capable of genetic testing for breast cancer in women, Myriad needed to choose a strategy to provide this service to the public. With several major competitors offering similar services, intense media scrutiny, and a charged activist and political climate, a poor Myriad decision could have major repercussions.

Competitive strategy.

Post-Graduate (MBA/Doctoral) level courses.

This paper aims to examine the evolution of Himalaya Drug Company (hereinafter referred to as Himalaya), an Ayurveda-based pharmaceutical-wellness company. Over the eight decades of its history, Himalaya has built a reputation for Ayurveda-based formulations that conform to allopathic standards and are accepted globally. In the recent years, Himalaya dramatically strengthened its competitive position of “scientific Ayurvedic products” through its entry into fast-moving consumer goods (or consumer-packaged goods), categories of wellness products as well as over-the-counter (non-prescription) drugs. This case describes the focused differentiation strategy of Himalaya and sets out the challenges it faced/would face in sustaining its focused differentiation strategy, as it enters into highly penetrated categories such as toothpastes and soaps (that were traditionally dominated by broad differentiators and broad cost leaders).

The outcomes are as follows: to exemplify the logic of focused differentiation, where a competitor commands a higher willingness to pay than its average competitors, by narrowing its target segments; to illustrate how the firm’s entire set of activities are tailored to meet the specific needs of a set of carefully chosen products, narrow customer segments, of defined geographic markets; to highlight how a combination of tradeoffs and fit helps protect the firm’s competitive position from its potential imitators; and to demonstrate the limits of a focused strategy, specifically relating to growth, and how a company such as Himalaya can overcome such limits.

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

CSS 11: Strategy.

Innovation, information technology, e-marketing and sales, strategy and entrepreneurship.

The case is intended for use in advanced graduate and executive education level management and technical programs of study. The case is high inter-disciplinary appropriate for all courses dealing in use of innovation, information technology, entrepreneurship, marketing and sales and strategy.

Practo Technologies Pvt Ltd is a company established in 2008 by entrepreneurs Shashank, N.D. along with Abhinav Lal. At Practo Technologies engineers practice to create technology that supports healthcare industry. In India, there is not enough assistance given to the patients in terms of searching for appropriate doctors and fixing an appointment with them easily. The patient's data lie scattered in reports and the patient's medical history goes unrecorded. Practo provides a robust platform for doctors and patients to collaborate together under one umbrella. It provides patients with open basket of doctor profiles and special search based on doctor's specialty. The case showcases the journey of transformation healthcare sector in India has gone through. The change was resisted, it never came that easy! The case explores issues in implementing information technology for clinics and hospitals in India. This case illustrates interesting facts Indian healthcare and the preparation they need to equip with to manage global technology tide.

The case can be used for teaching service innovation. Managing innovative practices and low-cost online business models is illustrated. In particular, it deals with how the early start up employs innovation to set up new working ideas. The case is designed to stimulate discussions of broad array of issues regarding deployment of IT services specifically in the hospitals and clinics across India. Evaluate the advantages and liabilities of expanding globally at a very early start up stage. The case focuses on Practo early development with only concept in hand and transforming it into a profit generating business. Evaluate the advantages and challenges of innovation, technology development, deployment and training of manpower to use it. The case offers students opportunity to understand and take view of strategically building early start up and management of concerns with no prior experience. To identify business opportunities and explore various possibilities of expansion into IT healthcare business. The students are given base to explore sales and marketing strategies for online model. The students get overview of cutting edge business offerings and surviving the dynamic competition in the era of globalization.

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

The subject area is entrepreneurship.

Graduate and executive education level in leadership, entrepreneurship and strategic management are used to discuss leadership, entrepreneurship and strategy in health services.

This case talks about the passionate journey of a pediatrician practicing in the Mumbai city of India, who as an individual private practitioner is contributing to the fulfilment of the global health agenda and the fourth Millennium Development Goal (MDG) – “reduce child mortality”. His vision is to make quality and affordable expert pediatric care accessible to all the individuals, right from pre-birth to adulthood. Surya Mother and Child Care Hospital (SMCH) is being strengthened as a nation-wide network of mother and child hospital offering patient/consumer-centric integrated collaborative quality care, and it needs to be seen how this model can be made sustainable as it enlarges in scale for the future.

The case is structured to achieve the following learning outcomes: to understand about effectuation as a logic for entrepreneurial success through the lens of Dr Avasthi and his venture SMCH; To understand and apply Porter’s Principles of value transformation that essentially focus on outcome-driven cost-efficient work practices in a collaborative integrative fashion, where transformation must come from within (some practices suggested can be applied to the Indian Healthcare Services Delivery systems); to critically analyze the overall strategic position of SMCH as an organization and its competitive environment; to discuss the factors influencing health-care delivery capacity build up, given the MDGs 2015, Every Newborn Action Plan and Indian Newborn Action Plan framework, as applicable to India; and to discuss and analyze mechanisms for future sustainable service delivery options for SMCH. Although each of these principles is important, possibly, the instructor could emphasize and encourage more discussions on potential models of shared partnerships that can help quality health-care services reach the unreached and the incorporation of technology in achieving this. The learning process can also facilitate discussions about leadership qualities in the creation of health-care entrepreneurs, for the “Change That They Would Want To See”.

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

CSS:3 Entrepreneurship.

The case tells the story of Synthroid from its development in 1958 as the first synthetic thyroxine molecule to its competition against generic equivalents in 2004. The case introduces students to the pharmaceutical industry, its practices, and some of the complexities of pricing and drug choice, with drug manufacturers, insurance companies, physicians, pharmacists, and patients all playing a role. It also provides a primer on hypothyroidism, its symptoms, and its treatment.

Because Synthroid was developed and introduced before FDA regulations and drug standards of identity were fully established, it was difficult for competitors to get their drugs certified as identical to Synthroid. Through a series of efforts with physicians, especially endocrinologists, Synthroid's owners were able to maintain the perception for forty-six years that Synthroid was uniquely effective. In 2004, however, the FDA declared several competitive products to be bioequivalent to Synthroid, which posed a significant challenge to its owner, Abbott Laboratories. Students are challenged to consider options to maintain the drug's unit volume, revenue, and/or profit in these difficult circumstances.

The case is written in two parts. The (A) case provides background on the history of the drug, the pharmaceutical industry and its marketing practices, and hypothyroidism and its treatment, and it concludes in 2004 as Abbott's marketers face the impending challenge of defending the Synthroid business against generic competition. The (B) case describes what Abbott actually did to maintain its share in the United States and outlines its strategy in India, a market without patent protection for pharmaceuticals.

After analyzing the case students should be able to:

• Describe strategies that branded competitors can use to defend their business from lower-priced competition

• Understand the basics of pharmaceutical marketing and pricing, including the global challenge of defending branded drugs against generic equivalents

• Discuss ethical issues in the marketing of high-margin branded products that have lower-priced alternatives, especially in the healthcare industry

Describe strategies that branded competitors can use to defend their business from lower-priced competition

Understand the basics of pharmaceutical marketing and pricing, including the global challenge of defending branded drugs against generic equivalents

Discuss ethical issues in the marketing of high-margin branded products that have lower-priced alternatives, especially in the healthcare industry

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.

This case describes the innovations of a medical practitioner over six decades of practice. It provides an opportunity to the participants to analyse the motivation, processes, constraints and outcomes or innovating efforts of individuals as opposed to corporates. During his career Dr. Shah has experimented with novel methods of treatment, applications of known solutions and new product formulations. At the fag end of his career Dr. Shah is wondering whether the innovating efforts were worth their white.