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      • October 2022 (Revised August 2024)
      • Case

      Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?

      By: Leemore Dafny
      In Fall 2019, Cigna Corporation – a global health services company with a significant presence in the U.S. employer-sponsored health insurance market - was digesting its $54 billion acquisition of Express Scripts, Inc. (ESI), a pharmacy benefit manager (PBM)... View Details
      Keywords: Mergers and Acquisitions; Business Model; Vertical Integration; Insurance Industry
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      Dafny, Leemore. "Cigna-Express Scripts: Can a Vertical Merger Rescue an Industry Under Attack?" Harvard Business School Case 323-038, October 2022. (Revised August 2024.)
      • October 2022
      • Case

      Weapons of Self Destruction: Zak Pym Williams and the Cultivation of Mental Wellness

      By: Lauren Cohen, Ronnie Stangler and Grace Headinger
      Zak Pym Williams, mental health advocate, grappled with the question of how to create a proactive mental health family environment for his children. Having witnessed how mental health challenges such as addiction and depression had impacted the past four generations of... View Details
      Keywords: Family; U.S.; Mental Health; Family Business; Entertainment; Values and Beliefs; Ethics; Leading Change; Family and Family Relationships; Well-being; Social Issues; Entertainment and Recreation Industry; United States; California
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      Cohen, Lauren, Ronnie Stangler, and Grace Headinger. "Weapons of Self Destruction: Zak Pym Williams and the Cultivation of Mental Wellness." Harvard Business School Case 223-033, October 2022.
      • October 2022
      • Background Note

      Note on Cyberattacks and Regulatory Regimes

      By: Frank Nagle, George A. Riedel, William R. Kerr and David Lane
      Describes common types of cyberattacks on enterprises and their costs, as well as the fragmentary regulatory regimes through which U.S. states and regulatory agencies at the start of 2021 attempted to encourage disclosure of cyberattacks and to pursue enforcement... View Details
      Keywords: Regulations; Regulatory Agencies; Cyberattacks; Governance; Corporate Disclosure; Cybersecurity; Information Industry; Information Industry; Information Industry; Information Industry; United States
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      Nagle, Frank, George A. Riedel, William R. Kerr, and David Lane. "Note on Cyberattacks and Regulatory Regimes." Harvard Business School Background Note 723-392, October 2022.
      • 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
      Keywords: Africa; Pharmaceutical Companies; Pharmacy Benefit Manager; Health Care; Health Care And Treatment; Health Care Costs; Health Care Delivery; Health Care Entrepreneurship; Telehealth; Health Equity; Corporate Strategy; Social Entrepreneurship; Equity; Growth and Development Strategy; Expansion; Product Launch; Customer Value and Value Chain; Social Enterprise; Multinational Firms and Management; Pharmaceutical Industry; Pharmaceutical Industry; Africa
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      Herzlinger, Regina E., and Ben Creo. "mPharma: Scaling Access to Affordable Primary Care in Africa." Harvard Business School Case 323-033, October 2022. (Revised September 2024.)
      • June 2022
      • Article

      A New Initiative to Track HIV Resource Allocation and Costs

      By: Ryan McBain, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi and Robert S. Kaplan
      In early 2020, several global health institutions – including the Global Fund to Fight AIDS, Tuberculosis and Malaria; Joint United Nations Program on HIV/AIDS (UNAIDS); United States Agency for International Development; and Office of the Global AIDS Coordinator at... View Details
      Keywords: Activity Based Costing; HIV; Cost; Health Care; Healthcare; Health Care and Treatment; Activity Based Costing and Management; Resource Allocation; Health Industry; Africa
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      McBain, Ryan, AK Nandakumar, Michael Ruffner, Carlyn Mann, Mai Hijazi, Susanna Baker, Linden Morrison, Kalipso Chalkidou, Shufang Zhang, Iris Semini, Fern Terris-Prestholt, Steven Forsythe, Sarah Byakika, Joshua Musinguzi, and Robert S. Kaplan. "A New Initiative to Track HIV Resource Allocation and Costs." Bulletin of the World Health Organization 100, no. 6 (June 2022): 358–358A.
      • 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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      Nurok, Michael, Vin Pellegrino, Marc Pineton de Chambrun, Jonathan Warsh, Meredith Young, Erik Dong, Neil Parrish, Syed Shehab, Alain Combes, and Robert S. Kaplan. "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." Anesthesia & Analgesia 135, no. 4 (October 2022): 711–718.
      • 29 Sep 2022
      • Talk

      Lessons from U.S. COVID Hospital Crisis

      By: Regina E. Herzlinger
      Keywords: COVID-19 Pandemic; Hospital Capacity; Health Care and Treatment; Health Pandemics; Health Industry; United States
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      Herzlinger, Regina E. "Lessons from U.S. COVID Hospital Crisis." Henry Stewart Talks Ltd., September 29, 2022.
      • September 2022
      • Technical Note

      Addressing Social Determinants of Health in the American Landscape

      By: Susanna Gallani and Jacob Riegler
      Social determinants of health (SDOH) have gained significant attention in recent years. A growing body of research shows that a person’s health is influenced by a large number of non-genetic factors, most of which operate outside the realm of health care and are... View Details
      Keywords: Socioeconomic Determinants Of Health; Social Determinants Of Health; Population Health; Health; Health Care and Treatment; Social Issues; Health Industry; Health Industry; Health Industry; United States
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      Gallani, Susanna, and Jacob Riegler. "Addressing Social Determinants of Health in the American Landscape." Harvard Business School Technical Note 123-023, September 2022.
      • September 2022
      • Case

      Proactive for Her

      By: Rembrand Koning and Kairavi Dey
      Proactive for Her began amid the COVID-19 pandemic, in August 2020 as a digital platform to provide accessible, evidence-based, primary, preventive non-judgmental healthcare services for Indian women, who were often dissuaded from seeking help as premarital sex and... View Details
      Keywords: Women's Health; Healthcare; India; Start-up; Telehealth; Digital Platforms; Health Care and Treatment; Customer Focus and Relationships; Business Startups; Health Industry; Asia; South Asia; India
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      Koning, Rembrand, and Kairavi Dey. "Proactive for Her." Harvard Business School Case 723-351, September 2022.
      • September 2022
      • Case

      HPP: Tapping the Netherlands’ Potential

      By: Brian Trelstad and Idelès Kaandorp
      Stichting Het Potentieel Pakken (HPP) was launched to solve a systemic problem in the Dutch Labor Market: gender inequity that was leading to a large number of women to work part-time in fields that were in desperately short supply of labor, like health care, child... View Details
      Keywords: COVID-19 Pandemic; Grants; Scaling And Growth; Nonprofit Organizations; Opportunities; Gender; Income; Employment; Health Care and Treatment; Human Capital; Mission and Purpose; Motivation and Incentives; Growth and Development Strategy; Employment Industry; Employment Industry; Employment Industry; Employment Industry; Europe; Netherlands
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      Trelstad, Brian, and Idelès Kaandorp. "HPP: Tapping the Netherlands’ Potential." Harvard Business School Case 323-024, September 2022.
      • 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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      Wei, Chen, Michelle Boeck, Pierre C. Qian, Todd Vivenzio, Zoe Elizee, Jeremy S. Bredfeldt, Robert S. Kaplan, Usha Tedrow, Raymond Mak, and Paul C. Zei. "Cost of Cardiac Stereotactic Body Radioablation Therapy versus Catheter Ablation for Treatment of Ventricular Tachycardia." Pacing and Clinical Electrophysiology 45, no. 9 (September 2022): 1005–1179.
      • September 2022
      • Article

      Drivers of Philanthropic Foundations in Emerging Markets: Family, Values and Spirituality

      By: Valeria Giacomin and Geoffrey Jones
      This article discusses the ethics and drivers of philanthropic foundations in emerging markets. A foundation organizes assets to invest in philanthropic initiatives. Previous scholarship has largely focused on developed countries, especially the United States, and has... View Details
      Keywords: Philanthropy; Foundations; Spirituality; Philanthropy and Charitable Giving; Social Enterprise; Emerging Markets; Values and Beliefs; Africa; Asia; Latin America; Middle East
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      Giacomin, Valeria, and Geoffrey Jones. "Drivers of Philanthropic Foundations in Emerging Markets: Family, Values and Spirituality." Journal of Business Ethics 180, no. 1 (September 2022): 263–282. (https://doi.org/10.1007/s10551-021-04875-4.)
      • 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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      Krieger, Joshua L., Xuelin Li, and Richard T. Thakor. "Find and Replace: R&D Investment Following the Erosion of Existing Products." Management Science 68, no. 9 (September 2022): 6552–6571.
      • 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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      Dafny, Leemore, Christopher Ody, and Teresa Rokos. "Giving a Buck or Making a Buck? Donations by Pharmaceutical Manufacturers to Independent Patient Assistance Charities." Health Affairs 41, no. 9 (September 2022).
      • September 2022
      • Article

      The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente

      By: Alyce S. Adams, Raymond Kluender, Neale Mahoney, Jinglin Wang, Francis Wong and Wesley Yin
      Most hospitals have financial assistance programs for low-income patients. We use administrative data from Kaiser Permanente to study the effects of financial assistance on health care utilization. Using a regression discontinuity design based on an income threshold... View Details
      Keywords: Healthcare; Utilization; Financial Assistance; Health Care and Treatment; Social Issues; Poverty; Health Industry
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      Adams, Alyce S., Raymond Kluender, Neale Mahoney, Jinglin Wang, Francis Wong, and Wesley Yin. "The Impact of Financial Assistance Programs on Health Care Utilization: Evidence from Kaiser Permanente." American Economic Review: Insights 4, no. 3 (September 2022): 389–407.
      • 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
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      McComb, Emily R., Mel Martin, and Amy Klopfenstein. "Sweet Teez Bakery: Projecting the Dough’s Rise Financial Supplement." Harvard Business School Spreadsheet Supplement 223-702, August 2022.
      • August 2022 (Revised November 2024)
      • 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
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      McComb, Emily R., Mel Martin, and Amy Klopfenstein. "Sweet Teez Bakery: Projecting the Dough's Rise." Harvard Business School Case 223-004, August 2022. (Revised November 2024.)
      • 2022
      • Other Unpublished Work

      Got 'Critical Minerals'? Hooray! But Be Careful

      By: Louis T. Wells
      When a country has “critical minerals,” certain issues require special attention in the country’s mining legislation or while negotiating contracts with potential mining investors. As well, to obtain maximum benefit the government should prepare for negotiations with... View Details
      Keywords: Critical Minerals; Foreign Direct Investment; International Relations; Mining Industry
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      Wells, Louis T. "Got 'Critical Minerals'? Hooray! But Be Careful." Columbia FDI Perspectives, No. 338, August 2022.
      • August 13, 2022
      • Article

      A Historic Opportunity for Universal Health Coverage in India

      By: Vikram Patel, Shubhangi Bhadada, Kiran Mazumdar-Shaw, Arnab Mukherji, Tarun Khanna and Gagandeep Kang
      The milestone of India's 75th anniversary of independence on Aug 15, 2022, offers an opportunity to reassert the country's commitment to realising universal health coverage (UHC). The first such effort predates independence, with the 1946 Bhore Committee report.... View Details
      Keywords: Universal Health Coverage; COVID-19 Pandemic; Health Care and Treatment; Gender; Prejudice and Bias; Health Industry; India
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      Patel, Vikram, Shubhangi Bhadada, Kiran Mazumdar-Shaw, Arnab Mukherji, Tarun Khanna, and Gagandeep Kang. "A Historic Opportunity for Universal Health Coverage in India." Lancet 400, no. 10351 (August 13, 2022): 475–477.
      • August 2022 (Revised January 2025)
      • 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
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      Riedel, George A., Amy Klopfenstein, and Mel Martin. "NOW PT (A): Should We Invest?" Harvard Business School Case 323-009, August 2022. (Revised January 2025.)
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