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Publications

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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
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      Baicker, Katherine, Amitabh Chandra, and Mark Shepard. "Achieving Universal Health Insurance Coverage in the United States: Addressing Market Failures or Providing a Social Floor?" NBER Working Paper Series, No. 30854, January 2023.
      • 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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      da Silva Etges, Anna Paula Beck, Richard D. Urman, Anne Geubelle, Robert Kaplan, and Carisi Anne Polanczyk. "Cost Standard Set Program: Moving Forward to Standardization of Cost Assessment Based on Clinical Condition." Journal of Comparative Effectiveness Research 11, no. 17 (December 2022): 1219–1223.
      • 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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      Kakani, Pragya, Michael Chernew, and Amitabh Chandra. "The Contribution of Price Growth to Pharmaceutical Revenue Growth in the United States: Evidence from Medicines Sold in Retail Pharmacies." Journal of Health Politics, Policy and Law 47, no. 6 (December 2022): 629–648.
      • 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
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      Herzlinger, Regina E., and Ben Creo. "Ajax Health: A New Model for Medical Technology Innovation." Harvard Business School Case 323-043, November 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; Health Industry; Health 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.)
      • 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.
      • 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

      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).
      • 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.)
      • 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.)
      • 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
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      Riedel, George A., Amy Klopfenstein, and Mel Martin. "NOW PT (B): Should We Invest?" Harvard Business School Supplement 323-014, August 2022.
      • 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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      Richman, Barak D., 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 Administrative Costs: A Cross-National Analysis." Health Affairs 41, no. 8 (August, 2022): 1098–1106.
      • 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
      Keywords: Female; Female Ceo; Female Entrepreneur; Female Protagonist; Health & Wellness; Healthcare; Price Policies; Minimum Advertised Price; Differentiation; Positioning; Growth; Health; Health Care and Treatment; Price; Disruption; Distribution; Distribution Channels; Competitive Strategy; Competition; Growth Management; Mission and Purpose; Product Development; Product Marketing; Product Launch; Product Positioning; Advertising; Business Startups; Internet and the Web; Entrepreneurship; Social Entrepreneurship; Social Issues; Social Enterprise; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Health Industry; Canada; United States; United Kingdom
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      Israeli, Ayelet. "The DivaCup: Navigating Distribution and Growth." Harvard Business School Teaching Note 523-008, July 2022. (Revised February 2024.)
      • 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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      Gompers, Paul A., Steven N. Kaplan, and Vladimir Mukharlyamov. "Private Equity and COVID-19." Journal of Financial Intermediation 51 (July 2022).
      • 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
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      Trelstad, Brian, Pippa Tubman Armerding, and Wale Lawal. "Lifebank Nigeria." Harvard Business School Teaching Plan 322-090, June 2022.
      • 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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      Dafny, Leemore S. "A Radical Treatment for Insulin Pricing." New England Journal of Medicine 386, no. 23 (June 9, 2023): 2157–2159.
      • 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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      Coombs, Kyle, Arindrajit Dube, Calvin Jahnke, Raymond Kluender, Suresh Naidu, and Michael Stepner. "Early Withdrawal of Pandemic Unemployment Insurance: Effects on Earnings, Employment and Consumption." AEA Papers and Proceedings 112 (May 2022): 85–90.
      • March 31, 2022
      • Article

      Two Approaches to Capping Health Care Prices

      By: Michael E. Chernew, Maximilian J. Pany and Leemore S. Dafny
      High health care prices for the privately-insured contribute to high premiums, which put downward pressure on wages, and induce employers to reduce benefit generosity and charge employees more for coverage. As the average annual premium for family coverage currently... View Details
      Keywords: Price Caps; Health Care and Treatment; Price
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      Chernew, Michael E., Maximilian J. Pany, and Leemore S. Dafny. "Two Approaches to Capping Health Care Prices." Health Affairs Forefront (March 31, 2022).
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