Search results

Dr. Juan Caicedo was educated in general medicine and surgery at Universidad Nacional de Colombia and practiced transplant medicine in Bogota. He determined that he would need to go to the United States to advance his training, and ultimately was awarded a fellowship in transplant surgery at Northwestern Memorial Hospital.

During his three years as a fellow, Caicedo was struck by the number of Hispanic patients on the kidney transplant waiting list. Not only were Hispanics the highest growth group on the transplant waiting list, they also waited longer for transplants and died while waiting at higher rates than non-Hispanic whites or African-Americans. Caicedo also was alarmed by Hispanic patients' lower utilization of living donors for transplantation they were underrepresented not only as live donor transplant patients, but also as donors.

As he neared the end of his fellowship in 2006, Caicedo wondered if the Hispanic population encountered unique barriers to transplantation and living donor usage, and began to think about creating a program to address these barriers.

A midsize community hospital must choose a strategy to compete with an expanding regional rival. The strategy, focused on acquiring patient volume, includes expanding investment into integrated care, setting the reimbursement structure for revenue collection, and moving to a capitation-based payment system. The case presents an evaluation of revenue models to select that which best supports a given business strategy.

This case is designed to introduce a health care audience to financial analysis. It provides a straightforward introduction to hospital financial-statement ratio analysis and hospital operating statistics, so it can also serve to introduce any audience with a business or medical background to hospital finance.

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.

The learning outcomes are as follows: what tasks are to be done by medical representatives in pharmaceutical industry? This study also highlights various competencies required to do effective selling in this industry; analyzes and discusses different unethical practices going on in the market; explains why ethical norms are necessary in sales context when sales targets are already achievable with unethical means; and develops and comments on strategies Flori Pharmaceutical can make to overcome on these unethical issues. What should be the response of Dahar to the email of Naveed khan? What course of action should be taken by Dahar in the deceitful reporting case of Mohsin Ali?

Flori is considered a leading and growing multinational organization in the highly competitive environment of Pakistan pharmaceutical industry with over 40 years of experience. The company aims to command a leading position in developing new health-care products as it offers a wide range of diabetic, cardiovascular, respiratory and vitamin products based on quality as a result of high research and examination. Recently, an email to Bilal Dahar on March 2017 from Flori’s star sales person Naveed Khan has forced management to take some strong decisions regarding ethical norms and values to be adopted by medical representatives of Flori pharmaceuticals. The email highlighted the issues related to sales pressure which are leading toward unethical sales practices. Dahar just not have to maintain Flori’s ethical code of conduct but he and his team also has to work hard to achieve more than 26% growth rate in sales revenue as compared to last year. Dahar knew that the highly competitive environment of pharmaceutical industry has led most of the stake holders to indulge in unethical behavior to achieve their individual targets. He knew that this is dangerous in long term for the multinational organizations such as Flori pharmaceuticals as if the similar behavior continues, the sales culture and values of the organization would be on stake. He also has to decide what decision to be taken against deceitful reporting issue of one of the top-performer territory managers, who was key person in helping Flori to close the sales year 2016 with the revenue of Rs. 6.4bn, a 26% growth over the last year. The case is rich enough to provide a platform regarding management of several ethical challenges in pharmaceutical selling and developing strategies based on them.

BBA, MBA final year.

Teaching Notes are available for educators only.

CSS 8: Marketing.

The purpose of this case study is to illustrate how Dianne Savastano, founder and CEO of Healthassist, Inc., a US-based health-care advocacy firm, successfully led her clients and team through the COVID-19 pandemic of 2020. To gather the data for this case study, the authors interviewed the protagonists, the members of her team and two clients. The authors read Healthassist Newsletters and the firm’s documents; and in fact, they included one Newsletter and several documents in the Exhibits of the case study. The authors conducted a literature review for articles in newspapers and journals about the newly developing field of “health-care advocacy,” a field which Savastano helped to create.

The authors illustrate how Savastano, using the five practices of exemplary leadership by Kouzes and Posner, in The Leadership Challenge, led her team through the pandemic of 2020. This is a story of a woman leader, using traits such as warmth, empathy, analysis and decisiveness, keeps her small business afloat when so many other firms collapsed in 2020.

The authors conducted seven interviews and literature searches on the topics of health-care advocacy; women leaders; leading through a crisis; and COVID-19.

The case study illustrates how a woman founder and CEO can lead her firm through a crisis.

This is an example of how a woman leader managed through the 2020 pandemic.

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

This case was based on both primary and secondary data. In-depth semidirected interviews were conducted in 2021–2022 after receiving the institutional research board approval. The interviews took an approximate time ranging from 90 to 120 min. They were recorded and transcribed. A thematic analysis was undertaken to identify the most relevant themes for the case. The secondary sources used included various websites, scholarly and trade journals, as well as specific databases, such as Statista.

The case exposes students in multiple disciplines to the challenges created by the COVID-19 crisis at Yale School of Medicine (YSM). It describes its remarkable effects on organizational and community members as they struggled to reimagine more inclusive and supportive spaces. As one of the most severe crises humanity has ever witnessed, COVID-19 exacerbated the existing struggles of the underrepresented communities, creating a double pandemic. It has also amplified inequities among marginalized groups including black, indigenous and people of color; women; immigrants; lesbian, gay, bisexual, transgender, queer/questioning; people with different abilities; working parents; single parents; religious minorities; and people with low income. When COVID-19 hit in 2020, Yale University School of Medicine (YSM), like other pioneering schools in the field of health care, doubled their efforts to face both the public health crisis and the substantial social turmoil (racial tensions after the death of George Floyd, food insecurity, vaccine resistance, social inequalities, etc.). Professor Marietta Vazquez, MD, who was the first Latina to be named Associate Dean for Medical Students Diversity at YSM, launched with Dr Latimore (Chief Diversity Officer) and her other colleagues many strategic initiatives aiming at improving the diversity, equity and inclusion of organizational and community members.

The case is an invitation to graduate students and students in executive education programs to reflect on the grand challenges leaders faced at YSM as well as in other institutions across the nation and the globe. It is also a call to reimagine ways leaders can accelerate the pace of change in their organizational ecosystems.

This case was written for use in graduate-level courses, including executive education dealing with Diversity, Equity, Inclusion and Belonging, Leadership and Change, Health-Care Equity/Policy, Health Sciences, Human Resource Management, Organizational Behavior, Crisis Management, Sustainability, Business and Society, Social Issues in Management, Strategy, etc. Faculty members can easily adapt the case to fit the content of the course they teach, the students’ context as well as the specific learning outcomes to be achieved.

Richard Alpert, senior partner at Evergreen Investments, must decide which of his two best employees to promote to the position of managing VP. He had initially preferred Charlie Pace over Daniel Faraday, but that decision had become less clear-cut when Alpert inadvertently overheard an office conversation and learned that Pace was taking Adderall, a stimulant primarily prescribed for people suffering from attention deficit/hyperactivity disorder (ADHD). Pace did not have ADHD and apparently obtained the medication by deceiving a physician. Alpert is faced with a number of questions, including whether it was fair to Faraday—or any other high-performing employee—to be passed over for promotion in favor of someone who illicitly boosted his performance with a substance he did not medically need.

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.

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.