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For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

South Africa’s primary health outcomes do not correspond to the country’s spending on public health, with South Africa ranking among the worst globally in the incidence of tuberculosis, HIV prevalence, infant mortality and life expectancy. In part, this poor outcome can be explained by high inequality in access to healthcare, which reflects South Africa’s grossly skewed income and wealth distributions, with the bulk of the country’s population reliant upon an underfunded, inefficient and poorly managed public health system. This substandard service for the working poor in South Africa’s townships with high population densities offered a profitable entrepreneurial opportunity to provide affordable and effective primary care with vast gains in quality and outcomes improved dignity for patients. After receiving her MBA, physician and entrepreneur Dr Nthabiseng Legoete self-funded the launch of Quali Health in 2017. The business model set out to disrupt healthcare delivery for South Africa’s poorest citizens. Drawing patients from the working poor in Diepsloot, Quali Health’s inaugural site was cash flow positive within five months when the facility hit only 30% of installed service capacity. With quick success, Dr Legoete faced the strategic question of how fast to scale and finance the expansion. She also considered a new micro-insurance product for her clientele.

For discussion of social entrepreneurship in middle-income economies, emerging markets generally and Africa, specifically, Quali Health presents interesting questions about entrepreneurial funding, scaling and the interplay between social entrepreneurial activities and the informal sector.

Teaching notes are available for educators only.

CSS: 3 Entrepreneurship.

This descriptive case study applies economic concepts to an issue of public policy, and helps build students’ critical thinking, analytical and quantitative skills. The case addresses a variety of topics typically taught in microeconomics and public economics courses. Topics most prominently represented in the case include elasticity of demand and supply, tax policy, tax incidence and negative externalities. Theoretical basis for each topic is laid out in the discussion section of the instructors’ manual, along with insights from student responses. The core nature of the concepts covered in this case study allows it to be integrated with common economics textbooks.

This descriptive case is based on critical economic analysis of secondary sources.

This case study focuses on the imposition of the controversial “soda tax” on sweetened beverages in the City of Philadelphia in 2017 and considers the economic lessons that can be learned from Philadelphia’s experience with the tax. The tax was proposed as a way to raise the city’s revenue while reducing obesity. After the tax was enacted, the sales of sweetened beverages declined in the city, but increased outside the city’s borders. The receipts from the tax have been below projections.

Learning outcomes covered by the case are typical for a microeconomics, public economics or managerial economics course. The appropriate course levels range from the principles to the MBA level of the economics and business curriculum. Discussion questions may be selected to fit a specific course focus and level. The instructors’ manual outlines question sets suitable for various types of economics courses.

The central lesson to be learned from studying the case is to understand the challenges and constraints posed by contextual conditions in designing contracts in public–private partnerships (PPP) for financing and delivering health care in emerging economies such as India.

Perverse incentives, along with contextual conditions, led to extensive opportunistic behaviors among involved agencies, limiting the effectiveness of otherwise highly regarded innovative design of the program.

India’s “Rashtriya Swasthya Bima Yojana” or National Health Insurance Program, launched in 2007 provided free health insurance coverage to protect millions of low-income families from getting pushed into poverty due to catastrophic health-care expenditure. The program was implemented through a PPP using standardized contracts between multiple stakeholders from the public and private sector – insurance companies, hospitals, intermediaries, the provincial and federal government.

Teaching Notes are available for educators only.

CSS: 10 Public Sector Management.

This teaching case aims to stimulate the debate over the issue of arsenic in rice and prepares students to make a decision by evaluating trade-offs and aligning moral values in a business context.

Rice feeds people in many parts of the world. This teaching case focuses on an entrepreneurial food producer who has strong sustainability values built into his business model. The CEO, Johan Henriksson, of Vegoganic faces a dilemma when a press release by the Swedish National Food Agency potentially threatens the core existence of the business. It challenges the CEO to take a stand on food safety and food security, as well as personal and societal values.

It is a discussion case, developed with undergraduate students in mind, but could be taken to a graduate level by including more advanced literature and questions.

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 8: Marketing

The assignment is to design a plan that aligns patient satisfaction scores with quality care metrics. The instructor’s manual (IM) introduces models for designing and implementing a strategic plan to approach the quality improvement process.

This is a field research case. The author(s) had access to the Chief Operating Officer (COO) and other members of the management team, meeting with them on numerous occasions. Cleveland Clinic Florida (CCF) provided the data included in the appendices. Additionally, relevant hospital data, also included in the appendices, is required to be made public on Centers for Medicare and Medicaid Services (CMS) databases. Accordingly, all data and information are provided by original sources.

Osmel “Ozzie” Delgado, MBA and COO of CCF was faced with a dilemma. Under the new CMS reimbursement formula, patient satisfaction survey scores directly impacted hospital reimbursement. However, the CCF patient satisfaction surveys revealed some very unhappy patients. Delgado pondered these results that really made no sense to him because CCF received the highest national and state rankings for its clinical quality at the same time. Clearly, patients were receiving the best medical care, but they were still unhappy. Leaning back in his chair, Delgado shook his head and wondered incredulously how one of the most famous hospitals in the world could deliver such great care but receive negative patient feedback on CMS surveys. What was going wrong and how was the hospital going to fix it?

This case is designed for graduate Master’s in Business Administration (MBA), Master’s in Health Sciences Administration (MHSA) and/or Public Health (PA) audiences. While a healthcare concentration is useful, the case raises the generic business problems of satisfying the customer to increase brand recognition in the marketplace and displacing competition to increase annual revenues. Indeed, the same analysis can be applied in other heavily regulated industries also suffering from a change in liquidity and growth occasioned by regulatory change.

This case describes how eight entrepreneurs discover different opportunities for new businesses to exploit a single technological invention. The case focuses on the process of entrepreneurial discovery and its implications for the creation of new firms. Many of the teaching materials on entrepreneurship assume that entrepreneurs have already discovered an opportunity. While these materials provide useful information about the process of creating new enterprises, they miss the crucial first step in the entrepreneurial process: identifying an opportunity. The case illustrates the theoretical concept of the role of information in the discovery of entrepreneurial opportunities. It can be used in a class on entrepreneurship or management of technology.

The case study offers a unique teaching tool to the instructor and learners. Very few cases offer a product and segmentation dilemma in a single problem. The discussion would enable learners to:

– conduct a situational analysis by using frameworks such as the 5C and SWOT;

– understand different kinds of segmentation options that a firm can consider;

– understand the nuances of making a viable and actionable new product launch decision;

– analyze the pros and cons of a segmentation decision and comprehend how the decision will impact the firm’s marketing and/or business strategy.

Sirona Hygiene Private Limited was a young startup founded in 2015 by Deep Bajaj. The firm had three brands under its umbrella, namely, female hygiene (Peebuddy), menstrual hygiene (Sirona) and protection and wellness (BodyGuard). Though the firm was recognized for feminine hygiene products, the pandemic boosted the sale of BodyGuard face masks and hand sanitizers.

The sanitizer market was growing, and protection and sanitization products were now part of every consumer’s daily ritual. As BodyGuard now had some brand recognition, Sirona could consider expanding the sanitizer line with a natural new product formulation. However, the expansion decision could have short- and long-term impacts on BodyGuard and Sirona Hygiene. The decision could be two-pronged, involving a product line expansion and revisiting the BodyGuard segmentation strategy. Currently, the BodyGuard range was focused on business-to-consumer (B2C) users, but volumes were higher in business-to-business (B2B). Second, BodyGuard was a forced fit brand amongst the Sirona family of feminine products

Thus, as Sirona considered a new product opportunity, assessing the viability of a possible move to the B2B segment may be prudent. However, the BodyGuard range also had mosquito repellents and baby products, which were essentially a B2C option, so was it more practical to stay as a B2C brand? Furthermore, if BodyGuard stayed a B2C brand, should it consider a demographic segmentation, or was a psychographic approach more beneficial in a cluttered commoditized space such as sanitizers? Which approach would build a consumer–brand connection? Or should the brand straddle both segments? Finally, the firm would also need to assess the BodyGuard segmentation strategy from the overarching Sirona business strategy.

The case can be used for a foundation course in Marketing and/or an advanced elective on Product Management or Marketing Strategy.

Teaching notes are available for educators only.

CSS 8: Marketing.

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 begins with newly appointed chairman and interim CEO Garo Armen dwelling on the significant issues that Elan Corporation, an Irish pharmaceutical company, faces. Its share price has plummeted 96% after accusations of accounting fraud and the discontinuation of an important clinical trial due to the drug's severe side effects. As a result, Elan faces insolvency. About $2 billion in debt that could no longer be satisfied in stock will soon mature, and there are questions regarding the company's structure and various operating concerns. Armen is also concerned about the ethical consequences of the company's failing and thus not being able to develop potentially life-saving medicines. Armen must decide what the nature of Elan should be moving forward and what strategy it should adopt. The operational and financial issues discussed in the case are complicated by Elan's status as an Irish company with significant international operations. The case closes with Armen reflecting on the decisions he has made—which students should critique and suggest alternatives to—as well as an open decision on choosing a successor CEO.

1. Crafting a vision and strategy for a newly streamlined organization and implementation 2. Balancing the complexities of an international corporation in a turnaround situation 3. Quantitatively identifying the probability, advantages, and disadvantages of bankruptcy 4. Succession planning decision making 5. Responding to fraud accusations 6. Managing a distressed workforce and retaining key employees

This case was developed from the author’s personal experience as a participant in one of the health taskforce subcommittees. The author also sought the inputs of the Vice President of Health and Medical Education, the Dean of the Health Sciences College, the Student Affairs Assistant Dean of the Pharmacy College and the previous Vice President of Health and Medical Education. Moreover, secondary data were obtained from the office of the Vice President of Health and Medical Education at Qatar University (QU).

The government of Qatar has consistently provided generous funding for QU over the years. However, recent economic challenges, such as drops in oil prices, have had a negative impact on the country’s GDP and export revenue. In response, QU began to implement a new organizational structure. Specifically, the university proposed merging the three health-related colleges (health sciences, medicine and pharmacy) into a single cluster called the health education cluster. This decision was supported by a broad benchmark of approximately 40 universities worldwide, as well as input from various stakeholders within the university. Forming a cluster was expected to benefit the organization as a whole. However, the decision faced resistance and challenges that required investigation by top management. Would the new organizational structure be accepted by all? Was it feasible to have a single cluster that encompassed three distinct departments within the organization? These are examples of the questions that this case study addresses.

This compact case is suitable for a case study in basic undergraduate, postgraduate and advanced courses in Strategic Management at a business school. The case highlights the need to restructure an organization and the use of strategy formulation and implementation in the framework of management.