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This case examines the strategic choices and evolving business model of Imprimis Pharmaceuticals from the perspective of CEO Mark Baum. The A case provides a brief history of the company and of the compounding business, outlining the challenges faced by Imprimis in 2013. At the time, Imprimis was in the process of seeking FDA approval for a branded drug called Impracor. This process, already difficult, was further complicated by recent manufacturing issues. Meanwhile, the opportunity arose for Imprimis to purchase a technology related to compounded ocular injections. Because of the different competencies and business models required for the traditional pharmaceutical business vs. pharmaceutical compounding, Imprimis did not have the resources to pursue both of these options at once. Instead, Baum had to decide whether or not to abandon the company's previous focus on Impracor and to delve headlong into the compounding business. The two paths would require vastly different approaches to marketing, R&D, and manufacturing, so that either decision would shape the future of the company for years to come.

This case is a supplement to Imprimis (Case A). It describes the company's decision to enter into the pharmaceutical compounding business in 2013-14. Imprimis purchased a compounded ophthalmological medication called Dropless Therapy, which was injected into patients' eyes post-cataract surgery, with the aim of replacing a complex regimen of prescription eye drops. After a successful launch of the compounded medication, Imprimis ran into complications when Medicare changed its policy regarding payment for the drug. Under the new policy, not only would Medicare not cover the medication, but patients could no longer pay for it out of pocket. Instead, the cost had to be absorbed by the physician or surgery center. Imprimis now had to figure out a way to deal with the effects of this policy, whether that be by lobbying for a policy change, creating a compounded eye drop treatment of their own, or moving out of the cataract treatment business entirely.

This case is a supplement to Imprimis (Case A) and Imprimis (Case B). Set in 2015, it first describes Imprimis's decision to introduce its own line of compounded eye drop medication called LessDrops. The case then examines the moral dilemma faced by CEO Mark Baum, who was struck by the problem of high drug prices in the United States. Recent, drastic price hikes on pharmaceutical drugs, such as those initiated by Turing Pharmaceuticals under CEO Martin Shkreli, had recently brought media attention to this issue. Baum believed it would be relatively easy for Imprimis to create compounded versions of many of the affected drugs, which could increase competition in the pharmaceutical industry and lessen the strain both on patients and the healthcare system as a whole. However, doing so would require the company to raise capital, strengthen its sales force, and increase its manufacturing capabilities. The decision was further complicated by the relatively low barrier to entry, and by the ubiquitous nature of the drug pricing problem. Baum had to decide whether Imprimis should stick with its already-successful ophthalmology business, or begin the endeavor of combatting high drug prices, going up against powerful competitors in the drug industry.

This case is a supplement to Imprimis (Case A), Imprimis (Case B), and Imprimis (Case C). It describes Imprimis's 2015 decision to develop a $1 per pill compounded alternative to Daraprim, the branded drug that had recently undergone an extreme price hike, raising its price to $750/pill. Imprimis also created compounded alternatives to several other branded drugs, and made investments to increase its manufacturing capabilities. The company now had to decide where to focus its efforts in the future. In developing innovative compounded formulations, should it base its decisions on market size, either by population or dollar size? Should it concentrate instead on the level of exploitation by the branded drug manufacturers--how much they had raised prices by, in what amount of time? Or should it decide instead based on the life-threatening nature of the disease, regardless of how many people were afflicted? The company had to balance these choices with the expansion of its core ophthalmology business while continuing to raise funds from investors.