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      • Faculty Publications  (26)

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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.
      • 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.
      • 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.)
      • 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).
      • 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.
      • Working Paper

      Rebates in the Pharmaceutical Industry: Evidence from Medicines Sold in Retail Pharmacies in the U.S.

      By: Pragya Kakani, Michael Chernew and Amitabh Chandra
      Rising list prices are often used to illustrate the burden of prescription drug spending, but payers routinely negotiate rebates from manufacturers that generate differences between list and net prices. List prices are easily available and affect patient cost-sharing,... View Details
      Keywords: Pharmaceuticals; Rebates; Health Care and Treatment; Markets; Price; Analysis; Pharmaceutical Industry
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      Kakani, Pragya, Michael Chernew, and Amitabh Chandra. "Rebates in the Pharmaceutical Industry: Evidence from Medicines Sold in Retail Pharmacies in the U.S." NBER Working Paper Series, No. 26846, March 2020.
      • January 2018 (Revised January 2019)
      • Case

      ZappRx

      By: Jeffrey J. Bussgang and Olivia Hull
      In October 2015, ZappRx founder Zoe Barry is deciding between two business models for her health technology start-up. Her product, a software application that aims to expedite the prescription fulfillment process for patients with rare diseases, has attracted interest... View Details
      Keywords: Speciality Drugs; Hub Services; Pivot; Speciality Prescriptions; Health Care and Treatment; Customization and Personalization; Internet and the Web; Business Model; Decision Choices and Conditions; Pharmaceutical Industry; Massachusetts
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      Bussgang, Jeffrey J., and Olivia Hull. "ZappRx." Harvard Business School Case 818-001, January 2018. (Revised January 2019.)
      • April 2017
      • Supplement

      Imprimis (B)

      By: Ramon Casadesus-Masanell, Karen Elterman and Marc Appel
      This case is a supplement to Imprimis (A). It describes the company’s decision to enter into the pharmaceutical compounding business in 2013–2014. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients’... View Details
      Keywords: Healthcare; Drug Compounding; Drug Development; Pharmaceuticals; Small Business; Decision-making, Business Model; Mark Baum; Imprimis; Decision Making; Strategy; Health Care and Treatment; Policy; Pharmaceutical Industry; United States
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      Casadesus-Masanell, Ramon, Karen Elterman, and Marc Appel. "Imprimis (B)." Harvard Business School Supplement 717-496, April 2017.
      • Article

      Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry

      By: Leemore S. Dafny, Christopher Ody and Matt Schmitt
      The analogy between value-based purchasing in pharmaceuticals and the new frontier of alternative payment models for health care providers is relatively straightforward. Insurers are increasingly demanding steep discounts from providers in exchange for inclusion in... View Details
      Keywords: Drug Copayment Coupons; Prescription Drug Policy; Health Care and Treatment; Insurance; Cost; Policy; Pharmaceutical Industry
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      Dafny, Leemore S., Christopher Ody, and Matt Schmitt. "Undermining Value-Based Purchasing — Lessons from the Pharmaceutical Industry." New England Journal of Medicine 375, no. 21 (November 24, 2016): 2013–2015.
      • March 2016 (Revised March 2022)
      • Teaching Note

      Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)

      By: John Beshears
      The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. The case associated with this teaching note follows Bob Nease, chief scientist at Express Scripts, as he... View Details
      Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Consumer Behavior; Distribution Channels; Health Care and Treatment; Service Industry; Pharmaceutical Industry
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      Beshears, John. "Express Scripts: Promoting Prescription Drug Home Delivery (A) and (B)." Harvard Business School Teaching Note 916-047, March 2016. (Revised March 2022.)
      • February 2016
      • Case

      Express Scripts: Promoting Prescription Drug Home Delivery (A)

      By: John Beshears, Patrick Rooney and Jenny Sanford
      The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details
      Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Service Delivery; Decision Choices and Conditions; Health Care and Treatment; Order Taking and Fulfillment; Compensation and Benefits; Pharmaceutical Industry
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      Beshears, John, Patrick Rooney, and Jenny Sanford. "Express Scripts: Promoting Prescription Drug Home Delivery (A)." Harvard Business School Case 916-026, February 2016.
      • February 2016 (Revised March 2022)
      • Case

      Express Scripts: Promoting Prescription Drug Home Delivery (B)

      By: John Beshears, Patrick Rooney and Jenny Sanford
      The pharmacy benefit manager (PBM) sector processes prescription drug claims on behalf of companies that offer a prescription drug benefit to their employees. This case follows Bob Nease, Chief Scientist at Express Scripts, as he considers methods to promote home... View Details
      Keywords: Pharmaceuticals; Prescription Drugs; Pharmacy Benefit Manager; PBM; Healthcare; Behavioral Economics; Choice Architecture; Active Choice; Health Care and Treatment; Service Delivery; Decision Choices and Conditions; Order Taking and Fulfillment; Compensation and Benefits
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      Beshears, John, Patrick Rooney, and Jenny Sanford. "Express Scripts: Promoting Prescription Drug Home Delivery (B)." Harvard Business School Case 916-040, February 2016. (Revised March 2022.)
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