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2023
Working Paper

Achieving Universal Health Insurance Coverage in the United States: Addressing Market Failures or Providing a Social Floor?

By: Katherine Baicker, Amitabh Chandra and Mark Shepard

The United States spends substantially more on health care than most developed countries, yet leaves a greater share of the population uninsured. We suggest that incremental insurance expansions focused on addressing market failures will propagate inefficiencies and... View Details

Keywords: Public Sector; Insurance; Health Care and Treatment; Policy; Innovation and Invention

December 2022
Article

Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition

By: Anna Paula Beck da Silva Etges, Richard D. Urman, Anne Geubelle, Robert Kaplan and Carisi Anne Polanczyk

This communication announces the International Cost Standard Set Program. Its goal is to establish global standardized frameworks for measuring the costs of treating specific clinical conditions. A scientific committee, including 16 international healthcare cost... View Details

Keywords: Time-Driven Activity-Based Costing; Value-based Health Care; Cost; Health Care and Treatment; Activity Based Costing and Management; Health Industry

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December 2022
Article

The Contribution of Price Growth to Pharmaceutical Revenue Growth in the United States: Evidence from Medicines Sold in Retail Pharmacies

By: Pragya Kakani, Michael Chernew and Amitabh Chandra

Context: To what extent does pharmaceutical revenue growth depend on new medicines versus increasing prices for existing medicines? Moreover, does using list prices, as is commonly done, instead of prices net of confidential rebates offered by manufacturers, which are... View Details

Keywords: Revenue; Price; Policy; Business Strategy; Pharmaceutical Industry

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November 2022
Case

Ajax Health: A New Model for Medical Technology Innovation

By: Regina E. Herzlinger and Ben Creo

This case teaches key success factors for both startup and established MedTech firms. It examines how to structure a firm to maximize innovation and financial returns with organizational structures that better align the incentives for the different skill sets... View Details

Keywords: Business Startups; Success; Innovation Strategy; Mergers and Acquisitions; Market Entry and Exit; Financial Strategy; Business Model; Partners and Partnerships; Entrepreneurship; Private Equity; Technology Industry; Medical Devices and Supplies Industry

October 2022 (Revised September 2024)
Case

mPharma: Scaling Access to Affordable Primary Care in Africa

By: Regina E. Herzlinger and Ben Creo

mPharma hopes to scale up to create the largest pan-African healthcare company ever to provide much-needed primary care in retail pharmacies; a reliable, fairly priced supply of drugs; and micro-insurance for drugs. They must prioritize launching a telemedicine... View Details

October 2022
Article

It’s Not Just the Prices: Time-Driven Activity-Based Costing for Initiation of Veno-Venous Extracorporeal Membrane Oxygenation at Three International Sites—A Case Review

By: Michael Nurok, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes and Robert S. Kaplan

The United States spends more for intensive care units (ICUs) than do other high-income countries. We used time-driven activity-based costing (TDABC) to analyze ICU costs for initiation of extracorporeal membrane oxygenation (ECMO) for respiratory failure to estimate... View Details

Keywords: Healthcare; Cost; Time-Driven ABC; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Health Industry

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September 2022
Article

Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia

By: Chen Wei, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak and Paul C. Zei

Cardiac SBRT is a novel way of treating refractory ventricular tachycardia (VT) that may be less costly than catheter ablation, owing to its noninvasive, outpatient nature. We applied time-driven activity-based costing to both procedures. The direct and total... View Details

Keywords: Health Care and Treatment; Activity Based Costing and Management; Cost; Health Industry

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September 2022
Article

Find and Replace: R&D Investment Following the Erosion of Existing Products

By: Joshua L. Krieger, Xuelin Li and Richard T. Thakor

How do innovative firms react when existing products experience negative shocks? We explore this question with detailed project-level data from drug development firms. Using FDA Public Health Advisories as idiosyncratic negative shocks to approved drugs, we first... View Details

Keywords: R＆D Investments; Drug Development; Product Shocks; M＆A; Biopharmaceutical Industry; FDA; System Shocks; Research and Development; Investment; Decision Making; Pharmaceutical Industry

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September 2022
Article

Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities

By: Leemore Dafny, Christopher Ody and Teresa Rokos

The federal Anti-Kickback Statute prohibits biopharmaceutical manufacturers from directly covering Medicare enrollees’ out-of-pocket spending for the drugs they manufacture, but manufacturers may donate to independent patient assistance charities and earmark donations... View Details

Keywords: Cost Sharing; Prescription Drugs; Drug Spending; Medicare; Dual Eligibility; Cost; Health Care and Treatment; Philanthropy and Charitable Giving; Pharmaceutical Industry

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August 2022 (Revised August 2023)
Case

Sweet Teez Bakery: Projecting the Dough’s Rise

By: Emily R. McComb, Mel Martin and Amy Klopfenstein

In 2021, the HBS Impact Investment Fund student team met with entrepreneur Teresa Maynard, who had applied for a $25,000 impact investment loan. The students thought the former Harvard Data Scientist’s bakery business, Sweet Teez Bakery, showed promise. Maynard had... View Details

Keywords: Impact Investment; Entrepreneurship; Social Entrepreneurship; Finance; Investment; Goods and Commodities; Financial Reporting; Small Business; Food and Beverage Industry; United States; Massachusetts

August 2022
Supplement

Sweet Teez Bakery: Projecting the Dough’s Rise Financial Supplement

By: Emily R. McComb, Mel Martin and Amy Klopfenstein

Abstract: In 2021, the HBS Impact Investment Fund student team met with entrepreneur Teresa Maynard, who had applied for a $25,000 impact investment loan. The students thought the former Harvard Data Scientist’s bakery business, Sweet Teez Bakery, showed promise.... View Details

Keywords: Impact Investment; Entrepreneurship; Social Entrepreneurship; Finance; Investment; Goods and Commodities; Financial Reporting; Small Business; Food and Beverage Industry; Massachusetts; United States

August 2022 (Revised August 2023)
Case

NOW PT (A): Should We Invest?

By: George A Riedel, Amy Klopfenstein and Mel Martin

In fall 2021, a team of students from the HBS Impact Investing Fund considered Neurologic Optimal Wellness Physical Therapy (NOW PT) for a potential investment. Dr. Banks, the founder of NOW PT, drove to visit patients. She sought an investment from the fund to open a... View Details

Keywords: Entrepreneurship; Social Entrepreneurship; Finance; Investment; Health; Health Care and Treatment; Medical Specialties; Buildings and Facilities; Health Industry; Health Industry; North and Central America; United States; Massachusetts

August 2022
Supplement

NOW PT (B): Should We Invest?

By: George A. Riedel, Amy Klopfenstein and Mel Martin

This (B) case examines the results of the HBS Impact Investment Fund student team’s diligence on Neurologic Optimal Wellness Physical Therapy (NOW PT). After examining Springfield’s demographics, anticipated PT demand, local competition, and NOW PT’s financial... View Details

Keywords: Entrepreneurship; Social Entrepreneurship; Finance; Investment; Health; Health Care and Treatment; Medical Specialties; Buildings and Facilities; Health Industry; Health Industry; North and Central America; United States; Massachusetts

August, 2022
Article

Billing and Insurance-Related Administrative Costs: A Cross-National Analysis

By: Barak D. Richman, Robert S. Kaplan, Japees Kohli, Dennis Purcell, Mahek Shah, Igna Bonfrer, Brian Golden, Rosemary Hannam, Will Mitchell, Daniel Cehic, Garry Crispin and Kevin A. Schulman

Billing and insurance-related costs are a significant source of wasteful health care spending in Organization for Economic Cooperation and Development nations, but these administrative burdens vary across national systems. We executed a microlevel accounting of these... View Details

Keywords: Health Care Costs; Administrative Costs; Cost; Health Care and Treatment; Health Industry

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July 2022 (Revised February 2024)
Teaching Note

The DivaCup: Navigating Distribution and Growth

By: Ayelet Israeli

Teaching Note for HBS Case No. 519-055. When the mother-daughter founders of DivaCup set out with a mission to disrupt the menstrual care industry with an innovative product form, they initially struggled to gain legitimacy and convince retailers to carry their unique... View Details

July 2022
Article

Private Equity and COVID-19

By: Paul A. Gompers, Steven N. Kaplan and Vladimir Mukharlyamov

We survey more than 200 private equity (PE) managers from firms with $1.9 trillion of assets under management (AUM) about their portfolio performance, decisionmaking and activities during the Covid-19 pandemic. Given that PE managers have significant incentives to... View Details

Keywords: COVID-19 Pandemic; Health Pandemics; Private Equity; Management; Investment Portfolio; Performance; Decision Making; Value Creation

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June 2022
Teaching Plan

Lifebank Nigeria

By: Brian Trelstad, Pippa Tubman Armerding and Wale Lawal

The aspiration of addressing maternal deaths in Nigeria, which were mostly caused by blood shortages, led Temie Giwa-Tubosun to found LifeBank in 2015. LifeBank developed an online platform that enabled hospitals to connect and purchase blood from local blood banks and... View Details

Keywords: Systems Design; Social Business; Business At The Base Of The Pyramid; Health Care; Blood; Social Enterprise; Health Care and Treatment; Growth and Development Strategy; Finance; Health Industry; Health Industry; Africa; Nigeria

June 9, 2023
Article

A Radical Treatment for Insulin Pricing

By: Leemore S. Dafny

In 2021, the Food and Drug Administration (FDA) approved the first interchangeable biosimilar for long-acting insulin, which many hoped would be substantially cheaper than the reference branded product. I explain why prices have barely changed, and argue that a... View Details

Keywords: Biosimilars; Rebates; Pharmaceuticals; Health Care and Treatment; Price; Governing Rules, Regulations, and Reforms; Pharmaceutical Industry; United States

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May 2022
Article

Strengthening Digital Infrastructure: A Policy Agenda for Free and Open Source Software

By: Frank Nagle

While there is little debate that digital forces are playing an increasingly crucial role in the economy, there is limited understanding of the importance of the digital infrastructure that underlies this role. Much of the discussion around digital infrastructure has... View Details

Keywords: Open Source; Applications and Software; Policy; Infrastructure; Open Source Distribution

Article

Early Withdrawal of Pandemic Unemployment Insurance: Effects on Earnings, Employment and Consumption

By: Kyle Coombs, Arindrajit Dube, Calvin Jahnke, Raymond Kluender, Suresh Naidu and Michael Stepner

In June 2021, 22 states ended all supplemental pandemic unemployment insurance (UI) benefits, eliminating benefits entirely for over 2 million workers and reducing benefits by $300 per week for over 1 million workers. Using anonymous bank transaction data and a... View Details

Keywords: COVID-19 Pandemic; Unemployment Insurance; Health Pandemics; Insurance; Employment; Financial Condition; Spending; Government Administration

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