In October 2013, Colgate-Palmolive Company, the world's leading oral care company, was about to launch its new Colgate® Maximum Cavity Protection™ plus Sugar Acid Neutralizer™ toothpaste in Brazil. Oral care category accounted for 46 percent of Colgate's $17.4 billion sales worldwide in 2013. The new toothpaste was clinically proven to reduce and prevent cavities more effectively than toothpaste with the same level of fluoride alone. All major industry players, including Procter & Gamble, GlaxoSmithKline and Colgate itself, had long ago launched products with the maximum amount of fluoride allowed by Health authorities. Yet cavities remained a significant threat to public health in many countries, both developing and developed. As Suzan Harrison, Colgate's president of Oral Care, prepared to launch CMCP+SAN in Brazil, the world's third largest oral care market, her executive team was divided over the product's positioning and pricing. Should it be positioned as a basic product to maximize reach for its health benefits or as a premium product for consumers who sought superior cavity protection?
In 2014, Dr. Michael Dulin, chief clinical officer for analytics and outcomes research and head of the Dickson Advanced Analytics (DA2) group at Carolinas HealthCare System (CHS), successfully unified all analytics talent and resources into one group over a three year period. Rapid increases in computing power and decreases in data storage costs had enabled DA2's data architects to build predictive models incorporating complex clinical, financial, demographic, and claims data that would have been impossible to create only a few years before. However, in 2014, both Apple and Google announced features in their new mobile operating systems that collected and displayed output from various health-wearables (like heart-rate monitors or step-counters), as well as electronic medical record (EMR) data. Their expertise in analytics, access to demographic and location data, as well as large consumer bases, led Dulin to consider which players consumers would trust to integrate their healthcare data in the future and what role DA2 could play.
In March 2015, the U.S. television industry received a major wake-up call. HBO, a premium cable channel with over 30 million subscribers, had announced it would begin offering a standalone streaming service. This new service would allow customers to bypass the cable companies and get direct access to HBO's programming online. The announcement was followed closely by Brian Roberts, chief executive of the Comcast Corporation. Comcast was America's largest cable and internet service provider, having built a profitable business bundling television content and delivering it via cable networks to more than 20 million households. Broadcast and cable television was a $173 billion industry in the U.S., but the rise of on-demand and streaming services meant viewers had more options than ever before. What did developments such as HBO's new service mean for the future of Comcast, and for the industry overall?
In 2014, Social Impact Bonds (SIBs) were quickly gaining popularity as an investment vehicle which joined together private investors and nonprofits to tackle social issues. Although numerous SIB projects and proposals had cropped up across the U.S. following the launch of the first SIB in the UK in 2010, none were explicitly focused on healthcare. Fresno, California announced the first healthcare SIB in 2013 to fund home-based programs to reduce asthma attacks. If successful, the Fresno SIB model would help solve the challenge of delivering preventative care efficiently in at-risk communities.
In February 2014, Michael Schrader, chief executive of Vaxess Technologies, Inc., was assessing the startup health care company's 2014 marketing plan. On December 31st, 2013, Vaxess had obtained an exclusive license to a series of patents for a silk protein technology that, when added to vaccines, reduced or removed the need for refrigeration between manufacturing and delivery to the end patient. Schrader and his colleagues had to decide on which vaccines to focus and whether and how to target the drug companies that manufactured the vaccines or the quasi-government organizations (such as UNICEF and PAHO) and nongovernment organizations (such as GAVI) that purchased large quantities of vaccines for the developing world.
Delivering health care to the global population was a challenge. Health care costs accounted for ten percent of world GDP by 2013. In the U.S., health care costs were expected to top $3.1 trillion in 2014. New technologies, shortages of trained personnel and lengthening life expectancies were accelerating the growth of health care costs. Physicians often failed to engage patients in preventative care, which many believed would help combat the rising costs of treating chronic conditions. Diabetes and hypertension, in particular, afflicted many developed nations and were a growing threat in the developing world. Mobile health (mHealth) used networked devices to distribute or collect medical information from patients and/or medical personnel. Given its low cost and broad reach, many wondered if and how mHealth could help solve the global health care crisis.
In 2014, Yasuchika Hasegawa was orchestrating the transformation of Takeda from a Japanese pharmaceutical company with a global footprint into a global company with a Japanese heritage. A 33-year veteran of Takeda, Hasegawa-san was appointed president of Takeda in 2003 and chief executive in 2009. By 2013, Takeda was in the midst of implementing its new Vision 2020 plan, a strategic plan for the evolving global corporation, which included developing a global vaccine business.
In January 2014, Gary Bald, senior vice president of Safety, Environment and Health at Royal Caribbean Cruise Lines (RCL), prepared for a review meeting with the company's chief executive, Adam Goldstein, and chairman, Richard Fain. Prior to joining RCL in 2006, Bald had spent 28 years with the Federal Bureau of Investigation. After seven years of upgrading security for the cruise line, Bald stated, "We've come a long way, but what keeps me up at night is what I don't know." As he prepared for his meeting with Fain and Goldstein, Bald considered whether his department's current initiatives would be sufficient to maintain RCL's position at the cutting edge of cruise industry best practice, and whether RCL could and should differentiate itself in marketing from its competitors in the areas of safety, environment and health.
Since founding CancerScan in 2008, Jun Fukuyoshi and Yoshiki Ishikawa had helped to improve cancer screening rates in Japan. Between 2005 and 2007, awareness of breast cancer in Japan rose from 55% to 70%, but the incidence of breast cancer screenings remained constant. Jun and Yoshiki applied marketing research techniques to increase the screening rate for breast cancer, a disease which killed over 12,000 Japanese women in 2011. Cancer screening initiatives accounted for 60% of the company's 2013 sales of $2.5 million.
On November 22, 2013, the direct-to-consumer genetic testing provider, 23andMe, received a letter from the U.S. Food and Drug Administration (FDA) ordering the company to halt the sale and promotion of its genetic testing kit. The FDA stated that the product was marketed as a diagnostic and preventative tool and that it was subject to the agency's regulations for medical devices. Company co-founder Anne Wojcicki and chairman Andy Page carefully considered the potential impact of the FDA's letter on 23andMe's position in the industry and the sustainability of its operations.
Following the FDA's letter in November 2013, which ordered 23andMe to cease sales of its DNA test kits, observers wondered how co-founder and CEO, Anne Wojcicki, would guide the company in the presence of uncertainty.
Electronic cigarettes (e-cigarettes) were heralded by some as a healthcare game changer, enabling smokers to switch to a new product which carried lower risk of cancer. However, there were concerns about the public health risk of e-cigarettes, particularly the chance that teens would easily develop nicotine addictions from smoking the fruit-flavored products. Manufacturers argued that current smokers, not teens were the target market, but laws regulating e-cigarettes were far less stringent than those governing tobacco products.
In 2013, Chinese investigators detained four GSK employees for allegedly bribing health care staff to sell GSK pharmaceuticals. A month later, GSK's Asia Pacific regional president, Abbas Hussain, said the company would help identify corrupt practices. Two days later, GSK's CEO, Andrew Witty, called the allegations "shameful" and said the company would use the opportunity to "make changes."
Four GlaxoSmithKline employees were accused of bribing Chinese health care workers to prescribe the company's drugs. The accusations brought to light the questionable incentive structures of the Chinese health care system and the pressure on companies to adhere to local customs while still observing local laws.
In 2013, New York City Mayor Michael Bloomberg tried and failed to institute a ban on serving sizes of large sugary beverages. Obesity posed a large public health risk to the city. Mayor Bloomberg's proposed ban was one of many attempts to combat the rising threat of obesity. The case discusses the efficacy of the proposed ban on large soda serving sizes in the context of the other anti-obesity initiatives crafted by Bloomberg's administration.
In 2012, over 750 million people around the globe lacked access to safe drinking water. Dean Kamen, inventor of the Segway, sought to bring fresh water to poor and rural areas with the Slingshot, a water purification device. Kamen's challenge was to identify ways to distribute the Slingshot to areas where it was most needed. A partnership with the Coca-Cola Company helped Kamen to pilot distribution of the Slingshot in low-access regions.
In the aftermath of the Rana Plaza building collapse, a group of international retailers and labor unions partnered to create a proposal for more stringent inspections and enforcement of safety standards in Bangladesh garment factories. The proposal was met by opposition from several U.S. firms, which claimed the proposal carried too a high a risk of litigation for them to sign. Neither proposal relied on legislation, but options for government involvement are also discussed in the case.
On April 24, 2013 the Rana Plaza factory building collapsed in Dhaka, the capital of Bangladesh. Over 1,100 people were killed in the worst industrial accident since the Union Carbide plant gas leak in Bhopal, India. Most of the victims worked for garment factories, whose primary clients were European, US and Canadian firms. Export contracts to such firms had helped Bangladesh become the world's second largest clothing exporter. Rana Plaza was not the first tragedy to occur in Bangladesh's garment industry, and without intervention, more might follow. International brand owners, domestic and foreign governments, labor unions and non-governmental organizations (NGOs), stepped up to discuss their responsibilities for improving conditions for Bangladeshi garment workers.