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    • All HBS Web  (358)
      • Faculty Publications  (51)

      Prescription Drug PolicyRemove Prescription Drug Policy →

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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
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      Chandra, Amitabh, Evan Flack, and Ziad Obermeyer. "The Health Costs of Cost Sharing." Quarterly Journal of Economics 139, no. 4 (November 2024): 2037–2082.
      • October 2024
      • Article

      Medicare Part D Protected-Class Policy Is Associated with Lower Drug Rebates

      By: Pragya Kakani, Michael Anne Kyle, Amitabh Chandra and Luca Maini
      Medicare Part D does not allow plans to exclude drugs in six protected classes from their formularies, which may limit plans’ ability to negotiate rebates and lead to higher spending. We estimated the association between protected-class status, US-level estimated... View Details
      Keywords: Insurance; Health Care and Treatment; Governing Rules, Regulations, and Reforms; United States
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      Kakani, Pragya, Michael Anne Kyle, Amitabh Chandra, and Luca Maini. "Medicare Part D Protected-Class Policy Is Associated with Lower Drug Rebates." Health Affairs 43, no. 10 (October 2024): 1420–1427.
      • 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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      Dafny, Leemore S., Kate Ho, and Edward Kong. "How Do Copayment Coupons Affect Branded Drug Prices and Quantities Purchased?" American Economic Journal: Economic Policy 16, no. 3 (August 2024): 314–346.
      • 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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      Vogel, Matthew, Pragya Kakani, Amitabh Chandra, and Rena M. Conti. "Medicare Price Negotiation and Pharmaceutical Innovation Following the Inflation Reduction Act." Nature Biotechnology 42, no. 3 (March 2024): 406–412.
      • 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
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      Sahlman, William, and Nicole Tempest Keller. "Vida Health: Transforming Chronic Disease Treatment." Harvard Business School Case 824-001, October 2023.
      • 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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      Chandra, Amitabh, and Benedic Ippolito. "What Does the Inflation Reduction Act Mean for Patients and Physicians?" NEJM Catalyst Innovations in Care Delivery 4, no. 10 (October 2023).
      • 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
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      Casadesus-Masanell, Ramon, Claudio Feser, Karolin Frankenberger, and David Redaschi. "Novartis (A): Reimagining Medicine." Harvard Business School Case 723-443, May 2023. (Revised June 2023.)
      • 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
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      Casadesus-Masanell, Ramon, Claudio Feser, Karolin Frankenberger, and David Redaschi. "Novartis (B): Reimagining Medicine." Harvard Business School Supplement 723-444, May 2023. (Revised June 2023.)
      • 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
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      Casadesus-Masanell, Ramon, Claudio Feser, Karolin Frankenberger, and David Redaschi. "Novartis (C): Reimagining Medicine." Harvard Business School Supplement 723-445, May 2023. (Revised June 2023.)
      • 2023
      • Article

      Experimental Evaluation of Individualized Treatment Rules

      By: Kosuke Imai and Michael Lingzhi Li
      The increasing availability of individual-level data has led to numerous applications of individualized (or personalized) treatment rules (ITRs). Policy makers often wish to empirically evaluate ITRs and compare their relative performance before implementing them in a... View Details
      Keywords: Causal Inference; Heterogeneous Treatment Effects; Precision Medicine; Uplift Modeling; Analytics and Data Science; AI and Machine Learning
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      Imai, Kosuke, and Michael Lingzhi Li. "Experimental Evaluation of Individualized Treatment Rules." Journal of the American Statistical Association 118, no. 541 (2023): 242–256.
      • 2022
      • Working Paper

      Regulatory Incentives for Innovation: The FDA's Breakthrough Therapy Designation

      By: Amitabh Chandra, Jennifer Kao, Kathleen Miller and Ariel D. Stern
      Regulators of new products confront a tradeoff between speeding a new product to market and collecting additional product quality information. The FDA’s Breakthrough Therapy Designation (BTD) provides an opportunity to understand if a regulator can use new policy to... View Details
      Keywords: Research and Development; Governing Rules, Regulations, and Reforms; Product Development
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      Chandra, Amitabh, Jennifer Kao, Kathleen Miller, and Ariel D. Stern. "Regulatory Incentives for Innovation: The FDA's Breakthrough Therapy Designation." NBER Working Paper Series, No. 30712, December 2022.
      • 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.
      • 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).
      • 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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      McFowland III, Edward, Sandeep Gangarapu, Ravi Bapna, and Tianshu Sun. "A Prescriptive Analytics Framework for Optimal Policy Deployment Using Heterogeneous Treatment Effects." MIS Quarterly 45, no. 4 (December 2021): 1807–1832.
      • 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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      Jachimowicz, Jon M., Joe J. Gladstone, Dan Berry, Charlotte L. Kirkdale, Tracey Thornley, and Adam D. Galinsky. "Making Medications Stick: Improving Medication Adherence by Highlighting the Personal Health Costs of Non-compliance." Behavioural Public Policy 5, no. 3 (July 2021): 396–416.
      • 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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      Chandra, Amitabh, Evan Flack, and Ziad Obermeyer. "The Health Costs of Cost-Sharing." NBER Working Paper Series, No. 28439, February 2021.
      • January 2021 (Revised June 2021)
      • Case

      Hester Pharmaceuticals (A): A Pricing Dilemma

      By: Dante Roscini and John Masko
      In August 2019, the leadership of Hester Pharmaceuticals (Hester) had a problem. Italy promised to be a key market for their new breakthrough oncology drug Akrozumab, but for almost two years, its single-payer healthcare system had been unable to agree with Hester on a... View Details
      Keywords: Macroeconomics; Trade; Price; Global Range; Global Strategy; Globalized Markets and Industries; Health Care and Treatment; Patents; Monopoly; Negotiation; Business and Government Relations; Risk and Uncertainty; Human Needs; Business Strategy; Commercialization; Pharmaceutical Industry; Italy
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      Roscini, Dante, and John Masko. "Hester Pharmaceuticals (A): A Pricing Dilemma." Harvard Business School Case 721-001, January 2021. (Revised June 2021.)
      • January 2021
      • Case

      mPharma (A)

      By: Rembrand Koning, John D. Macomber, Pippa Tubman Armerding and Wale Lawal
      mPharma pioneered electronic prescriptions in Ghana, and aimed to increase drug affordability and accessibility in Africa, but the company remained unprofitable. Following investor concerns about mPharma's business, CEO Gregory Rockson considered alternative business... View Details
      Keywords: Strategy; Entrepreneurship; Acquisition; Health; Business Model; Health Industry; Technology Industry; Ghana
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      Koning, Rembrand, John D. Macomber, Pippa Tubman Armerding, and Wale Lawal. "mPharma (A)." Harvard Business School Case 721-428, January 2021.
      • January 2021
      • Supplement

      mPharma (B)

      By: Rembrand Koning, John D. Macomber, Pippa Tubman Armerding and Wale Lawal
      mPharma pioneered electronic prescriptions in Ghana, and aimed to increase drug affordability and accessibility in Africa, but the company remained unprofitable. Following investor concerns about mPharma's business, CEO Gregory Rockson considered alternative business... View Details
      Keywords: Strategy; Health; Entrepreneurship; Business Model; Health Industry; Technology Industry; Ghana
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      Koning, Rembrand, John D. Macomber, Pippa Tubman Armerding, and Wale Lawal. "mPharma (B)." Harvard Business School Supplement 721-429, January 2021.
      • June 2021
      • Article

      From Predictions to Prescriptions: A Data-driven Response to COVID-19

      By: Dimitris Bertsimas, Léonard Boussioux, Ryan Cory-Wright, Arthur Delarue, Vassilis Digalakis Jr, Alexander Jacquillat, Driss Lahlou Kitane, Galit Lukin, Michael Lingzhi Li, Luca Mingardi, Omid Nohadani, Agni Orfanoudaki, Theodore Papalexopoulos, Ivan Paskov, Jean Pauphilet, Omar Skali Lami, Bartolomeo Stellato, Hamza Tazi Bouardi, Kimberly Villalobos Carballo, Holly Wiberg and Cynthia Zeng
      The COVID-19 pandemic has created unprecedented challenges worldwide. Strained healthcare providers make difficult decisions on patient triage, treatment and care management on a daily basis. Policy makers have imposed social distancing measures to slow the disease, at... View Details
      Keywords: COVID-19; Health Pandemics; AI and Machine Learning; Forecasting and Prediction; Analytics and Data Science
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      Bertsimas, Dimitris, Léonard Boussioux, Ryan Cory-Wright, Arthur Delarue, Vassilis Digalakis Jr, Alexander Jacquillat, Driss Lahlou Kitane, Galit Lukin, Michael Lingzhi Li, Luca Mingardi, Omid Nohadani, Agni Orfanoudaki, Theodore Papalexopoulos, Ivan Paskov, Jean Pauphilet, Omar Skali Lami, Bartolomeo Stellato, Hamza Tazi Bouardi, Kimberly Villalobos Carballo, Holly Wiberg, and Cynthia Zeng. "From Predictions to Prescriptions: A Data-driven Response to COVID-19." Health Care Management Science 24, no. 2 (June 2021): 253–272.
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