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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.

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.

In January 1996, an investment manager of a hedge fund is considering purchasing an equity interest in a start-up biotechnology firm, Rocky Mountain Advanced Genome (RMAG). The asking price is $46 million for a 90% equity interest. Although managers of the firm are optimistic about its future performance, the investment manager is more conservative in her expectations. She asks an analyst to fashion a counterproposal for RMAG's management. The tasks for the student are to apply the concept of terminal value, interpret completed analyses and data, and derive implications of different terminal value assumptions in an effort to recommend a counterproposal. Little computation is required of the student. The main objective of the case is to survey many conceptual and practical challenges associated with estimating a firm's terminal value. Issues addressed include the concept of terminal value; the materiality of the terminal-value assumption; the varieties of terminal-value estimators and their strengths and weaknesses; taxation of terminal values; when to assume liquidation versus going-concern terminal values; choosing a forecast horizon at which to estimate a terminal value; the constant growth valuation model, its derivation, limiting assumptions of constant growth to infinity, and WACC > g; use of the Fisher Formula as a foundation for estimating growth rate to infinity; and using a variety of estimates to “triangulate” in on a terminal value.

This case, developed from a wide variety of publicly available information, presents ethical and economic issues arising from the development, marketing, and pricing of a biotech drug. Genentech developed TPA, the first genetically engineered drug that could be used in clot-dissolving therapy for heart attack, and marketed it as Activase. Public outrage focused on the disparity between the drug's $10 direct manufacturing cost and what Genentech charged for its drug. Activase/TPA was priced at $2200 a dose, raising immediate concerns about its affordability and therefore availability to those who needed it. Additional issues arise from other events, including concern over related-party relationships between the company and organizations which researched and recommended TPA, as well as aggressive marketing of TPA to physicians and the company's refusal to participate in an international drug study to compare TPA with competitor drugs.

This negotiation case is meant to be used in conjunction with “Hybritech, Incorporated (A)” (UVA-F-0792); half the class works from one case and half from the other. Lilly is considering acquiring Hybritech, but the genetic-engineering company's future cash flows are difficult to predict and value. Both companies want to effect the merger, but the cases, which provide essentially the same information in all other respects, provide widely divergent projected cash flows. The “Hybritech, Incorporated (B)” case (UVA-F-0793) is the follow-up case dealing with the payment structure of the acquisition.

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).

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CSS 8: Marketing.

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, “One Mission, Multiple Roads: Aravind Eyecare System in 2009” is a sequel to the earlier case, “Aravind Eyecare System: Giving Them the Most Precious Gift” (BP 0299). It describes the new challenges facing AECS in 2009. It presents the strategic choices facing a mission driven organization like AECS. For its future growth it had the option of several paths. Following any of these paths would not dilute its mission and yet it could not pursue all of them at the same time. It would have to prioritize them. The case encourages participants to develop criteria for this prioritization.

Family Business, Entrepreneurship, International Business and Marketing.

This case is intended for an undergraduate business student audience in courses dealing with Entrepreneurship, Family Business, International Business and Marketing.

TARA Trade, a Lebanese souvenir-item designer and distributor owned by two brothers, was facing hostile competition. The partners who operated the business from two different continents had to deal with multiple threats to maintain their market position in a region of the world riddled with political unrest, regulatory chaos and idiosyncratic (distinctive) socio-cultural business practices.

Students are challenged to identify solutions to the marketing concerns and analyse the partnership issues faced by the international ownership/management of the business.

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.