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Prayas is a unique healthcare initiative, launched in India by Sanofi-Aventis, a French multinational pharmaceutical company, with the objectives of updating the medical knowledge of doctors in semi-urban and rural areas, bridging the gap between diagnosis and treatment, and making available quality medicines at affordable prices. This case discusses the evolution of the Prayas model from its inception to its current state, and the company's business strategies around it. Cognizant of the success of Prayas, many competitors of Sanofi-Aventis are actively developing and implementing similar models. The company's top management team has to respond to the competitive threat.

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.

GE Healthcare was on a continuous lookout for investing into new and innovative super value products for the Bottom of the Pyramid markets in India. After launching its first successful super value ECG machine Mac 400, GE had recently launched its twenty-fifth super value product a PET CT machine. Serving the BOP markets has its own unique challenges that may be different for each product that is placed in the market. However, GE has so far successfully sailed through all the challenges and developed a steep learning curve about BOP markets. However, it is now facing the challenge of ensuring sustainability of product pipeline. The company is also keen to exploit the opportunities for reverse innovation that super value products have provided. The company also wants to assess the disruptive impact of these products in domestic medical device markets as well as markets outside India.

The case documents the evolution of an eye care hospital promoted by a not-for profit organization located in Mandvi, Surat, close to the tribal community of Gujarat state, India. In a short span of five years (as of 2016), the trust has evolved as a community hospital. The value proposition of the trust is a portfolio of activities, which includes awareness by education, prevention of eye care diseases through eye screening camps, treatment, and rehabilitation on need basis and addressing direct and indirect healthcare needs of the community. The managerial challenge before the board of trustees is to carefully balance (a) The purpose for which the trust was created, (b) the gap between the ground realities and the need in the relevant tribal community (c) the accomplishments of the eye hospital so far.

The Global Health Initiative (GHI) is a tripartite collaboration among Northwestern University, non-profit donors, and commercial diagnostics companies. GHI attempts to bridge the gap between the market for sophisticated medical diagnostics equipment in wealthy nations and the need for point-of-care diagnostics in resource limited settings. In 2006 GHI narrowed its focus to HIV diagnostics for underserved nations. The case examines the accuracy-access tradeoff related to the roll-out of infant HIV diagnostics in Tanzania. Tanzania has a prevalent HIV/AIDS problem, particularly in children. As of 2007, Tanzania had an estimated 140,000 children infected with HIV. Existing lab-based diagnostic equipment was either inaccurate for use in infants or required highly skilled health workers. Tanzania's limited infrastructure also forced healthcare providers to choose between providing advanced care to a minority of the population and offering minimal care to the majority with poor access. A Kellogg MBA student research team performed more than thirty in-country interviews to collect data on stakeholder perceptions of three infant test concepts: the strip test, the squeeze test, and the filter paper test. Across the three tests, access decreased as accuracy increased---rural labs could not find or afford health workers skilled enough to conduct the test. In general, interviewees closely affiliated with the government preferred accuracy over access. In contrast, private health facilities had to follow fewer regulations and preferred access over accuracy. The case focuses on the decisions facing Kara Palamountain, the executive director of GHI, in her roll-out recommendations for infant HIV tests in Tanzania. It examines key factors of working in a developing country, including the need to operate in the absence of sufficient market research, balance the competing agendas of different stakeholders, and mitigate external risks such as major international funding.

This case was written to be used as a teaching case for students unfamiliar with how to approach and analyze a typical business school case. Unlike many cases used in specific classroom settings, this case is intended to be broad enough that any single student will not have a significant advantage because of his or her background. Moreover, the case is designed to guide students' thinking in a certain direction, using open-ended and more focused discussion questions provided at the case's end.

The Global Health Initiative (GHI) is a tripartite collaboration among Northwestern University, non-profit donors, and commercial diagnostics companies. GHI attempts to bridge the gap between the market for sophisticated medical diagnostics equipment in wealthy nations and the need for point-of-care diagnostics in resource limited settings. In 2006 GHI narrowed its focus to HIV diagnostics for underserved nations. The case examines the accuracy-access tradeoff related to the roll-out of infant HIV diagnostics in Tanzania. Tanzania has a prevalent HIV/AIDS problem, particularly in children. As of 2007, Tanzania had an estimated 140,000 children infected with HIV. Existing lab-based diagnostic equipment was either inaccurate for use in infants or required highly skilled health workers. Tanzania's limited infrastructure also forced healthcare providers to choose between providing advanced care to a minority of the population and offering minimal care to the majority with poor access. A Kellogg MBA student research team performed more than thirty in-country interviews to collect data on stakeholder perceptions of three infant test concepts: the strip test, the squeeze test, and the filter paper test. Across the three tests, access decreased as accuracy increased---rural labs could not find or afford health workers skilled enough to conduct the test. In general, interviewees closely affiliated with the government preferred accuracy over access. In contrast, private health facilities had to follow fewer regulations and preferred access over accuracy. The case focuses on the decisions facing Kara Palamountain, the executive director of GHI, in her roll-out recommendations for infant HIV tests in Tanzania. It examines key factors of working in a developing country, including the need to operate in the absence of sufficient market research, balance the competing agendas of different stakeholders, and mitigate external risks such as major international funding dry

This case was written to be used as a teaching case for students unfamiliar with how to approach and analyze a typical business school case. Unlike many cases used in specific classroom settings, this case is intended to be broad enough that any single student will not have a significant advantage because of his or her background. Moreover, the case is designed to guide students' thinking in a certain direction, using open-ended and more focused discussion questions provided at the case's end.

This case study is designed to enable students to analyze the competitive landscape of a business impacted by technological disruption; evaluate the viability of an organic growth strategy using stakeholder analysis; evaluate the revenue and cost structure of Apollo 24/7 and decide on the future investment strategy; and analyze funding strategies of traditional hospitals versus pure digital players.

To extend its reach, Apollo Hospitals Enterprise (Apollo Hospitals), a leading private sector brick-and-mortar hospital chain in India known for using state-of-the-art technology, launched a unified virtual mobile platform Apollo 24/7 in February 2020, 45 days into the COVID-19 pandemic. The management believed that the digital platform had a unique ecosystem that could not be replicated. The analysts were optimistic about the impact of the decision on the future performance of Apollo Hospitals, as it was expected to lead to higher penetration and increased revenue. They also anticipated the unlocking of value, as and when the venture capitalist (VC) would invest in Apollo Hospitals. However, with increasing operating expenses on account of burgeoning technological and marketing expenses, things did not seem to go going as planned. Three years later, in February 2022 after the Q3 of financial year 2023 results. Suneeta Reddy, the company’s managing director found herself pondering whether the digital platform could boost Apollo Hospitals’ profitability in addition to expanding its reach and increasing affordability when the company missed the analyst estimates. In India, which was then the second most populous country, “incremental access” and “affordability” were what mattered to the patients, However, for the investors and analysts, it was quarter-on-quarter performance. The change in the macroeconomic environment stalled the company’s plan of raising money from VCs.

Furthermore, the financing dilemma also plagued Reddy. She knew there was a difference between financing for conventional businesses that for digital businesses. She also had to take decide between short-term profitability with which investors were obsessed versus long-term sustainability, which involved taking care of stakeholders’ interests.

This case study is basically aimed at postgraduate courses and executive management courses.

Teaching notes are available for educators only.

CSS11: Strategy.

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 learning outcomes are to sensitise with the cause of sport development in India; to familiarize with the concepts of SDGs and sport development continuum in context of the Tata Trusts work in sports (Sports Portfolio); to relate strategy concepts of resources, SWOT analysis, cooperative implications, Carroll's CSR pyramid and Porter-Kramer strategic corporate social performance and shared value framework of inside-out and outside-in linkages with the Sports Portfolio strategy at the Tata Trusts; and to link sport development concepts like sport and development, sports development continuum and capacity building with the Sports Portfolio work at the Tata Trusts.

The case explores the sport and development issues faced by Ms Neelam Babardesai, Head of Sports Portfolio, Tata Trusts in Mumbai, India. The Trusts had a long history of contributing to the development of sport in India and looked forward to aligning their work in the sport with the United Nations (UN) sustainable development goals (SDGs). They started Sports Portfolio in 2016–2017 intending to complement their work in education and generate positive socio-economic change at the grassroots (local community) level in India. They also had the resources to implement the programmes. However, they were faced with issues like the deficiency of physical literacy in schools resulting in the disinterest of children and parents in sport and physical activity, which also might lead to health issues, later in life, minimal cooperation between entities involved with sport and development, lack of structured sports programmes and skilled human resources and the national sports policy needing better details and implementation and follow-up plans in India. Their strategic response was based on the use of a “sports development pyramid”, capacity building, alignment with the SDGs and complementary partnerships and collaborations. What were the outcomes? Should they continue with the same strategic approach? What should be their future course of action for sport and development? How should they respond to the COVID-19 crisis? Ms Babardesai reflected upon the above questions while concluding that India needed a long-term strategy for the development of sport.

The case is intended to be taught in the class of strategic management for postgraduate or master's level participants of business administration for concepts like resources, SWOT analysis, cooperative implications, corporate social responsibility (CSR), shared value and introducing the concept of the UN SDGs (SDGs), capacity building and sports development continuum (sports development domain) in context of the Indian sports scenario. The case should be equally useful in teaching relevant courses related to sports management and development. It may also be used for courses related to development studies and sustainability at the master’s level. The case may also be used by practitioners and researchers associated with sport and development/sports development and SDGs.

Teaching Notes are available for educators only.

CSS 11: Strategy

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.