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November 2024
Article

The Health Costs of Cost Sharing

By: Amitabh Chandra, Evan Flack and Ziad Obermeyer

What happens when patients suddenly stop their medications? We study the health consequences of drug interruptions caused by large, abrupt, and arbitrary changes in price. Medicare’s prescription drug benefit as-if-randomly assigns 65-year-olds a drug budget as a... View Details

Keywords: Outcome or Result; Health Care and Treatment; Budgets and Budgeting; Cost

October 2024
Case

Parexel: Scaling Up and Industry Dynamics

By: Regina E. Herzlinger and Ben Creo

Through the lens of biopharmaceutical contract research organization (CRO) PAREXEL, this case traces the evolution of the firm as it reinvents itself in response to the transformation of the CRO sector from a small, secondary cluster of firms into a major player with... View Details

Keywords: Research; Innovation and Invention; Business Model; Transformation; Globalization; Information Technology; Competitive Advantage; Pharmaceutical Industry

August 2024
Article

How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?

By: Leemore S. Dafny, Kate Ho and Edward Kong

Drug copayment coupons to reduce patient cost-sharing have become nearly ubiquitous for high-priced brand-name prescription drugs. Medicare bans such coupons on the grounds that they are kickbacks that induce utilization, but they are commonly used by... View Details

Keywords: Prescription Drugs; Coupons; Impact; Health Care and Treatment; Markets; Price; Spending; Pharmaceutical Industry; United States

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June 2024
Article

Valuing the Societal Impact of Medicines and Other Health Technologies: A User Guide to Current Best Practices

By: Jason Shafrin, Jaehong Kim, Joshua T. Cohen, Louis P. Garrison, Dana A. Goldman, Jalpa A. Doshi, Joshua Krieger, Darius N. Lakdawalla, Peter J. Neumann, Charles E. Phelps, Melanie D. Whittington and Richard Willke

This study argues that value assessment conducted from a societal perspective should rely on the Generalized Cost-Effectiveness Analysis (GCEA) framework proposed herein. Recently developed value assessment inventories—such as the Second Panel on Cost-Effectiveness’s... View Details

Keywords: Health Care and Treatment; Valuation; Cost vs Benefits; Society

April 2024 (Revised July 2024)
Case

Market Dynamics and Moral Dilemmas: Novo Nordisk’s Weight-Loss Drugs

By: Joseph L. Badaracco, Tom Quinn and John Schultz

Danish pharmaceutical company Novo Nordisk was owned by a charitable foundation, and since its founding in the 1920s had focused on producing insulin to treat diabetes. In 2017, however, it released Ozempic, a diabetes treatment with the revolutionary side effect of... View Details

March 2024
Article

Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act

By: Matthew Vogel, Pragya Kakani, Amitabh Chandra and Rena M. Conti

The Inflation Reduction Act (IRA) requires Medicare to negotiate lower prices for some medicines with high Medicare spending. Using historical data from public and proprietary sources to apply the IRA's negotiation criteria retrospectively, we identify all drugs that... View Details

Keywords: Policy; Government Legislation; Health Care and Treatment; Negotiation; Price; Pharmaceutical Industry

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January 2024
Article

Cost of Exempting Sole Orphan Drugs from Medicare Negotiation

By: Matthew Vogel, Olivia Zhao, William B. Feldman, Amitabh Chandra, Aaron S. Kesselheim and Benjamin N. Rome

Importance: The Inflation Reduction Act (IRA) requires Medicare to negotiate prices for some high-spending drugs but exempts drugs approved solely for the treatment of a single rare disease.
Objective: To estimate Medicare spending and global... View Details

Keywords: Health Care and Treatment; Insurance; Price; Health Industry

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October 2023
Case

Vida Health: Transforming Chronic Disease Treatment

By: William Sahlman and Nicole Tempest Keller

San Francisco based Vida Health, founded by Stephanie Tilenius, former vice president of Commerce and Payments at Google, was a B2B digital health startup focused on the treatment of cardiometabolic conditions, such as diabetes and obesity. Its innovative digital... View Details

Keywords: Corporate Strategy; Growth and Development Strategy; Demand and Consumers; Health Care and Treatment; Product Marketing; Risk and Uncertainty; Technological Innovation; Health Industry; Technology Industry; United States; California; San Francisco

October 2023
Article

What Does the Inflation Reduction Act Mean for Patients and Physicians?

By: Amitabh Chandra and Benedic Ippolito

The debate around prescription drug measures in the recently passed U.S. Inflation Reduction Act (IRA), which limit some patients’ out-of-pocket costs, has not fully addressed their effect on physicians and patients via their effect on payers. Reducing patients’ costs... View Details

Keywords: Government Legislation; Price; Health Care and Treatment

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May 2023 (Revised June 2023)
Case

Novartis (A): Reimagining Medicine

By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi

This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details

Keywords: Health Care and Treatment; Business Model; Leadership; Pharmaceutical Industry; Switzerland

May 2023 (Revised June 2023)
Supplement

Novartis (B): Reimagining Medicine

By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi

This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details

Keywords: Health Care and Treatment; Business Model; Production; Business Strategy; Pharmaceutical Industry

May 2023 (Revised June 2023)
Supplement

Novartis (C): Reimagining Medicine

By: Ramon Casadesus-Masanell, Claudio Feser, Karolin Frankenberger and David Redaschi

This case unfolds around the first-ever approved personalized cancer treatment, how Novartis wrapped it into a new business model design, and how Novartis scaled it. Novartis — one of the largest pharmaceutical companies in the world — is, among other ventures,... View Details

Keywords: Health Testing and Trials; Health Care and Treatment; Business Model; Problems and Challenges; Pharmaceutical Industry; Switzerland

January–February 2023
Article

Data-Driven COVID-19 Vaccine Development for Janssen

By: Dimitris Bertsimas, Michael Lingzhi Li, Xinggang Liu, Jennings Xu and Najat Khan

The COVID-19 pandemic has spurred extensive vaccine research worldwide. One crucial part of vaccine development is the phase III clinical trial that assesses the vaccine for safety and efficacy in the prevention of COVID-19. In this work, we enumerate the first... View Details

Keywords: COVID-19; Health Testing and Trials; Forecasting and Prediction; AI and Machine Learning; Research; 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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Article

A Prescriptive Analytics Framework for Optimal Policy Deployment Using Heterogeneous Treatment Effects

By: Edward McFowland III, Sandeep Gangarapu, Ravi Bapna and Tianshu Sun

We define a prescriptive analytics framework that addresses the needs of a constrained decision-maker facing, ex ante, unknown costs and benefits of multiple policy levers. The framework is general in nature and can be deployed in any utility maximizing context, public... View Details

Keywords: Prescriptive Analytics; Heterogeneous Treatment Effects; Optimization; Observed Rank Utility Condition (OUR); Between-treatment Heterogeneity; Machine Learning; Decision Making; Analysis; Mathematical Methods

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September 2021 (Revised October 2022)
Supplement

Hester Pharmaceuticals (B): Securing Supply

By: Dante Roscini and John Masko

Supplements the (A) case. In late 2020, demand for Hester Pharmaceutical’s (Hester’s) breakthrough oncology drug Akrozumab was outstripping the company’s most optimistic projections. In order to increase manufacturing capacity and meet the demand, Hester was... View Details

Keywords: COVID-19 Pandemic; Cost vs Benefits; Trade; Supply Chain; Global Strategy; Buildings and Facilities; Operations; Health Care and Treatment; Demand and Consumers; Global Range; Globalized Markets and Industries; Pharmaceutical Industry; Italy; China; United States; Germany

July 2021
Article

Making Medications Stick: Improving Medication Adherence by Highlighting the Personal Health Costs of Non-compliance

By: Jon M. Jachimowicz, Joe J. Gladstone, Dan Berry, Charlotte L. Kirkdale, Tracey Thornley and Adam D. Galinsky

Poor compliance of prescription medication is an ongoing public health crisis. Nearly half of patients do not take their medication as prescribed, harming their own health while also increasing public health care costs. Despite these detrimental consequences, prior... View Details

Keywords: Prescription Drugs; Medication Adherence; Personal Health Costs; Health; Behavior; Motivation and Incentives; Communication Strategy

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Summer 2021
Article

The Cost and Evolution of Quality at Cipla Ltd, 1935–2016

By: Muhammad H. Zaman and Tarun Khanna

This article examines the evolution of Indian pharmaceutical manufacturer Cipla towards producing drugs that met the quality standards of European and U.S. regulators. It employs new research in Cipla’s corporate archives, the Creating Emerging Markets database, and... View Details

Keywords: Cipla; Pharmaceuticals; Drug Quality; Generics; Quality; Standards; Information Technology; Cost; Organizational Culture; Business History; Pharmaceutical Industry; India

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Article

A Feasibility Study Using Time-driven Activity-based Costing as a Management Tool for Provider Cost Estimation: Lessons from the National TB Control Program in Zimbabwe in 2018

By: J. Chirenda, B. Nhlema Simwaka, C. Sandy, K. Bodnar, S. Corbin, P. Desai, T. Mapako, S. Shamu, C. Timire, E. Antonio, A. Makone, A. Birikorang, T. Mapuranga, M. Ngwenya, T. Masunda, M. Dube, E. Wandwalo, L. Morrison and R. S. Kaplan

Background: This study used process maps and time-driven activity-based costing to document TB service delivery processes. The analysis identified the resources required to sustain TB services in Zimbabwe, as well as several opportunities for more effective and... View Details

Keywords: Time-Driven Activity-Based Costing; Provider Cost; Health Care and Treatment; Cost Management; Activity Based Costing and Management; Zimbabwe

2021
Working Paper

The Health Costs of Cost-Sharing

By: Amitabh Chandra, Evan Flack and Ziad Obermeyer

We use the design of Medicare’s prescription drug benefit program to demonstrate three facts about the health consequences of cost-sharing. First, we show that an as-if-random increase of 33.6% in out-of-pocket price (11.0 percentage points (p.p.) change in... View Details

Keywords: Cost-sharing; Impact; Health Care and Treatment; Insurance; Health; Consumer Behavior

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