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Pharmaceutical companies have historically relied on their ability to research, develop, manufacture, and sell drug products. Developing a successful drug is a complex and lengthy process, with no guarantee of success, and the total cost of approving a new drug is estimated at $2.5 billion, and rising. This technical note offers an overview of changes in the biotechnology industry related to drug development, focusing on M&A, the milestone model, and venture capital.

This case set is about the unfolding uncertainty associated with a supply chain issue involving Cardinal Health (Cardinal), the primary supplier of surgical packs to Garfield Health System (GHS). John Jenkins, MD, the newly appointed chief medical officer (CMO) at a medium-size university hospital at GHS, must assess the issue and respond as Cardinal notifies GHS of potential contamination in the manufacture of surgical gowns. Cardinal initially notifies customers of a potential problem, and then over the next several days, releases more information, culminating in the recall of virtually all of its surgical supply packs. Many institutions, including GHS, are thus forced into a dire situation, resulting in some cases in cancelation of surgical procedures. In this D case, the contamination crisis has been resolved, but a new and potentially much more serious crisis looms: COVID-19. This case set could be utilized in health care courses or courses in business decision-making.

"This case set is about the unfolding uncertainty associated with a supply chain issue involving Cardinal Health (Cardinal), the primary supplier of surgical packs to Garfield Health System (GHS). John Jenkins, MD, the newly appointed chief medical officer (CMO) at a medium-size university hospital at GHS, must assess the issue and respond as Cardinal notifies GHS of potential contamination in the manufacture of surgical gowns. Cardinal initially notifies customers of a potential problem, and then over the next several days, releases more information, culminating in the recall of virtually all of its surgical supply packs. Many institutions, including GHS, are thus forced into a dire situation, resulting in some cases in cancelation of surgical procedures. In the A case, Cardinal issues its first warning of a potential contamination problem. In the B case, Cardinal warns that only a specific set of surgical gowns has been affected. In this C case, Jenkins learns that all the elements in Cardinal's surgical packs have been compromised. This case set could be utilized in health care courses or courses in business decision-making."

Case Supplement for Case UV8665

This case set is about the unfolding uncertainty associated with a supply chain issue involving Cardinal Health (Cardinal), the primary supplier of surgical packs to Garfield Health System (GHS). John Jenkins, MD, the newly appointed chief medical officer (CMO) at a medium-size university hospital at GHS, must assess the issue and respond as Cardinal notifies GHS of potential contamination in the manufacture of surgical gowns. Cardinal initially notifies customers of a potential problem, and then over the next several days, releases more information, culminating in the recall of virtually all of its surgical supply packs. Many institutions, including GHS, are thus forced into a dire situation, resulting in some cases in cancelation of surgical procedures. In this A case, Cardinal issues its first warning of a potential contamination problem. In the B and C cases, the crisis unfolds, and in the D case, a new crisis appears. This case set could be utilized in health care courses or courses in business decision-making.

Handout for Exercise UV8446

In this exercise, students read a brief medical history of fictional patient Mr. Jones, who has chronic low back pain (LBP). They are also given an overview of LBP and its treatment options in the United States. Their task is to develop a value-based payment system that defines outcome measures (patient success) over time and indicates how to compensate clinicians based on those outcome measures, then to create a short presentation to pitch their idea to the Centers for Medicare and Medicaid Services management team. This exercise is taught at Darden in the ""Solutions and Innovations in Health Care"" course and would also suitable in a module covering reimbursement in the health system.

This case set focuses on a health system undergoing transformation and change. In 2015, Mary Washington Healthcare (Mary Washington) is the latest health care organization to plan to upgrade its electronic health record system. The new CEO, Mike McDermott, MD, is considering which vendor to choose: Cerner Corporation or Epic Systems Corporation. In this B case, students discover which vendor Mary Washington chose. Now, the challenge is to decide how to implement the transition, aiming to make it a positive and seamless experience for all.

This case set focuses on a health system undergoing transformation and change. In 2015, Mary Washington Healthcare is the latest health care organization to plan to upgrade its electronic health record (EHR) system. The new CEO, Mike McDermott, MD, is considering which vendor to choose: Cerner Corporation or Epic Systems Corporation. This A case includes a brief history of EHR systems, including new regulations, their impact on demand, the state of the market, and the myriad benefits and challenges associated with implementing EHR systems. Students have the opportunity to evaluate the business case for two different EHR systems, as well as to consider the decision's effect on different stakeholders, such as the board, practitioners, and patients.

In this A case, it's December 2019, and Dr. Carol Evans is preparing for a meeting with the leaders of Garfield Health Sciences (GHS) Center. She aims to persuade them to launch a full-fledged direct-to-consumer (DTC) telemedicine offering. Evans needs to articulate a value proposition that secures support and funding for the initiative and pushes GHS to take on a leadership role in telemedicine. She considers ways GHS could expand its telemedicine offerings, including a program around e-consult for primary care providers, which she would like to expand to specialists. She also is aware of competition among programs for DTC virtual care. The case set provides students with a deep look into telemedicine. It offers a brief history of telemedicine initiatives since the 1990s, demonstrating how telemedicine can improve care and extend reach for both patients and medical professionals, while also addressing the myriad challenges associated with implementation. These challenges include integrating EMRs, billing virtual consults, and securing grants. This case set is taught in Darden's elective, ""Solutions and Innovations in Health Care.""

In the A case, Dr. Carol Evans is preparing for a December 2019 meeting with the leaders of Garfield Health Sciences (GHS) Center, about launching a full-fledged direct-to-consumer (DTC) telemedicine offering. This B case picks up a few months later, in March 2020. Now, in light of the looming COVID-19 pandemic, GHS leaders must make an urgent decision: Should they select a single EMR platform to expand GHS's virtual offerings or should they democratize the process and use systems like Zoom? The case set provides students with a deep look into telemedicine. It offers a brief history of telemedicine initiatives since the 1990s, demonstrating how telemedicine can improve care and extend reach for both patients and medical professionals, while also addressing the myriad challenges associated with implementation. These challenges include integrating EMRs, billing virtual consults, and securing grants. This case set is taught in Darden's elective, ""Solutions and Innovations in Health Care.""

In March 2020, the COVID-19 pandemic is looming. Gordon Chen, MD, the chief medical officer of ChenMed, a family-owned company committed to delivering primary care to the oldest and most vulnerable patients in the United States, has a number of decisions to make. How can he continue the strong doctor-patient relationship that his company is known for during a pandemic? How can he keep his staff employed while adhering to the precautions set in place for the pandemic? Finally, should ChenMed pause its plans for expansion until the pandemic passes? ChenMed turned the traditional model of primary health care on its head, opting for a value-based model rather than a traditional fee-for-service one. ChenMed's new model has had exemplary results, and the company plans to expand. But the pandemic poses unique challenges for ChenMed and the vulnerable population it serves. The case provides students with a deep look into many of the challenges of providing health care to older Americans. Students have the opportunity to learn how the United States pays for health care for older Americans, discuss the pros and cons of different models of health care, and finally, consider the very real-world implications of a pandemic for health care companies and their stakeholders.

In March 2020, the COVID-19 pandemic is looming. Gordon Chen, MD, the chief medical officer of ChenMed, a family-owned company committed to delivering primary care to the oldest and most vulnerable patients in the United States, has a number of decisions to make. How can he continue the strong doctor-patient relationship that his company is known for during a pandemic? How can he keep his staff employed while adhering to the precautions set in place for the pandemic? Finally, should ChenMed pause its plans for expansion until the pandemic passes? ChenMed turned the traditional model of primary health care on its head, opting for a value-based model rather than a traditional fee-for-service one. ChenMed's new model has had exemplary results, and the company plans to expand. But the pandemic poses unique challenges for ChenMed and the vulnerable population it serves. The case provides students with a deep look into many of the challenges of providing health care to older Americans. Students have the opportunity to learn how the United States pays for health care for older Americans, discuss the pros and cons of different models of health care, and finally, consider the very real-world implications of a pandemic for health care companies and their stakeholders.

In 2020, Jennifer and Corey Feist started the Dr. Lorna Breen Heroes' Fund in memory of Jennifer's sister. As the head of the emergency department at a Manhattan hospital, Lorna Breen had treated patients at hospitals overwhelmed by the COVID-19 pandemic, contracted the disease herself, and then tragically taken her own life. The Feists hoped the fund would bring new attention to the desperate need for improved support for health care workers' mental well-being. Now in late summer, it is garnering significant, and increasing, support. The Feists plan to turn the fund into a foundation, but they face decisions about how to accept donations, follow up with donors, and avoid duplicating the efforts of other organizations. Their challenge is to crystallize a long-term mission while maintaining the current fundraising momentum stemming from the media attention surrounding Breen's death. Through this case, students will grapple with difficult issues, including mental health challenges, burnout among health care providers, and suicide. Students also will learn about the challenges of starting a nonprofit and its lifecycle. Finally, they will be able to put practice into action and flesh out the mission for a nonprofit.

This case set follows Eric and Holly Nelson, founders of Special Hope Network, a nonprofit organization providing holistic therapy services for children with intellectual disabilities and their families in Lusaka, Zambia. Eric, a pastor, and Holly, a special needs teacher, had previously adopted three children with Down syndrome and moved to Zambia to form this enterprise. They worked hard to overcome systemic obstacles to their mission, including a cultural bias against bringing children with intellectual disabilities out in public; a feeling that the family was to blame for the child's disabilities; a scarcity of qualified therapists; and a variety of economic and regulatory factors. Having originally relied on donations from US-based friends and family, they needed to finance their therapy centers, which were targeted to low-income Zambian families, and were highly subsidized. Options they explored included fundraising with local businesses, "child sponsoring" on their website, grant writing, teaching other educators and nonprofits, and tourism fundraising. In the B and C cases, which take place between 2018 and 2019, it is revealed that while the for-profit resource center did provide a number of valuable intangible benefits, it was ultimately not profitable. This case is suitable for an undergraduate, graduate, or executive education class on nonprofit management or strategy. The focus is the alignment of a firm's activities, and whether they support its core mission-which can sometimes have a different answer depending on whether the firm is for profit or nonprofit.

This case set follows Eric and Holly Nelson, founders of Special Hope Network, a nonprofit organization providing holistic therapy services for children with intellectual disabilities and their families in Lusaka, Zambia. Eric, a pastor, and Holly, a special needs teacher, had previously adopted three children with Down syndrome and moved to Zambia to form this enterprise. They worked hard to overcome systemic obstacles to their mission, including a cultural bias against bringing children with intellectual disabilities out in public; a feeling that the family was to blame for the child's disabilities; a scarcity of qualified therapists; and a variety of economic and regulatory factors. Having originally relied on donations from US-based friends and family, they needed to finance their therapy centers, which were targeted to low-income Zambian families, and were highly subsidized. Options they explored included fundraising with local businesses, "child sponsoring" on their website, grant writing, teaching other educators and nonprofits, and tourism fundraising. In the B and C cases, which take place between 2018 and 2019, it is revealed that while the for-profit resource center did provide a number of valuable intangible benefits, it was ultimately not profitable. This case is suitable for an undergraduate, graduate, or executive education class on nonprofit management or strategy. The focus is the alignment of a firm's activities, and whether they support its core mission-which can sometimes have a different answer depending on whether the firm is for profit or nonprofit.

This case set follows Eric and Holly Nelson, founders of Special Hope Network, a nonprofit organization providing holistic therapy services for children with intellectual disabilities and their families in Lusaka, Zambia. Eric, a pastor, and Holly, a special needs teacher, had previously adopted three children with Down syndrome and moved to Zambia to form this enterprise. They worked hard to overcome systemic obstacles to their mission, including a cultural bias against bringing children with intellectual disabilities out in public; a feeling that the family was to blame for the child's disabilities; a scarcity of qualified therapists; and a variety of economic and regulatory factors. Having originally relied on donations from US-based friends and family, they needed to finance their therapy centers, which were targeted to low-income Zambian families, and were highly subsidized. Options they explored included fundraising with local businesses, "child sponsoring" on their website, grant writing, teaching other educators and nonprofits, and tourism fundraising. This A case takes place in 2012, when the Nelsons are considering opening a for-profit resource center, marketed to middle- and upper-class Zambians. It explores the viability of this option, and asks, "Does a for-profit resource center fit with our mission to serve the neediest children?" This case is suitable for an undergraduate, graduate, or executive education class on nonprofit management or strategy. The focus is the alignment of a firm's activities, and whether they support its core mission-which can sometimes have a different answer depending on whether the firm is for profit or nonprofit.

Mark Seidman at the Federal Trade Commission is evaluating a proposed merger between two health care entities and competing market leaders in southwest Virginia. The rural region is characterized by poverty, unemployment, and poor population health indicators relative to the rest of the state. The merger would form a virtual monopoly, normally prohibited by federal consumer protection laws, but the two companies assert that it would allow them to remain profitable and to continue to offer health care services in the region. In the B case, Marissa Levine, the Virginia Commissioner of Health, considers reports for and against the merger as she decides whether to issue a waiver to allow it. The optional C case describes the consequences of these decisions. The case set includes excerpts from public filings, which provide rich insight into the reasoning behind each entity's opinion. This case set explores the differences in and conflicts among the interests of for-profit health care systems, of rural, low-income residents, and of federal, state, and local governments. It allows students to engage in an in-depth discussion of the sometimes emotional issue of rural healthcare. It is suitable for students in a classes spanning health care management, nonprofit management, public policy, governance, ethics, and the social sector.

This optional C case follows UV7854 and UV7856, and describes the results of decisions on whether to allow a merger of two health care entities in rural Virginia. This case set explores the differences in and conflicts among the interests of for-profit health care systems, of rural, low-income residents, and of federal, state, and local governments. It allows students to engage in an in-depth discussion of the sometimes emotional issue of rural healthcare. It is suitable for students in a classes spanning health care management, nonprofit management, public policy, governance, ethics, and the social sector.

In this B case, the follow-up to UV7854, Marissa Levine, the Virginia Commissioner of Health, considers reports for and against the merger of two health care entities in rural Virginia, as she decides whether to issue a waiver to allow it. This case set explores the differences in and conflicts among the interests of for-profit health care systems, of rural, low-income residents, and of federal, state, and local governments. It allows students to engage in an in-depth discussion of the sometimes emotional issue of rural healthcare. It is suitable for students in a classes spanning health care management, nonprofit management, public policy, governance, ethics, and the social sector.