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Proteus is a healthcare start-up that has developed technology to embed electronics for computing and sensing in existing medical devices and drugs. The technology could potentially change the basis of competition in the pharmaceutical industry. The company is currently considering a number of licensing and business development deals and must choose which one(s) to pursue.

CEO Jim Billings wants to attract energetic, entrepreneurial talent to Stone Finch, Inc., which comprises an older division that fabricates products like piping and tanks for water and wastewater processing plants, and a much newer division that develops biochemical solutions associated with water purification. To accelerate the company's growth, Billings sets up subsidiaries to create cutting-edge technologies that can be brought to market by the biochemical solutions division. After a few years the subsidiaries have indeed produced innovative products and driven growth; however, problems are surfacing. Much of the investment in the subsidiaries has come from the old manufacturing-based "cash cow" division, which is now suffering from turnover, loss of morale, and loss of competitive position. Moreover, the solutions division -- which has absorbed numerous employees who became wealthy by developing successful subsidiaries -- is plagued by increasing polarization between the "haves" and the "have-nots."

This interactive spreadsheet accompanies the ProfitLogic case (#802-110) to enable analysis of the cash flow implications of three business models that the company is considering. Students are able to change key assumptions and see the impact on cash flow.

This case chronicles the role that Harvard Business School alumni play in the healthcare industry. Overall data on alumni is given, and the industry is broken into seven areas in which the careers of twenty-five alumni are highlighted.

Scientific advances have begun to give doctors the power to customize therapy for individuals. However, adoption of this approach has progressed slowly and unevenly because the trial-and-error treatment model still governs how the health care system develops, regulates, pays for, and delivers therapies. Aspinall, the president of Genzyme Genetics, and Hamermesh, chair of a Harvard Business School initiative to improve leadership in health care organizations, discuss the barriers to personalized medicine and suggest ways to overcome them. The blockbuster model for developing drugs, the authors point out, is still what most major pharmaceutical companies follow, even though its days are numbered. What the industry must embrace in its place is a business model based on a larger portfolio of targeted--and therefore more effective and profitable--treatments, not a limited palette of one-size-fits-all drugs. The current regulatory environment overemphasizes large-scale clinical trials of broad-based therapies. Instead, the focus should be on enrolling subpopulations, based on diagnostic testing, in trials of targeted drug treatments and on monitoring and assessing effectiveness after drugs are approved. A dysfunctional payment system complicates matters by rewarding providers for performance of procedures rather than for accurate diagnosis and effective prevention. Aspinall and Hamermesh call for coordinating regulation and reimbursement so that incentives are provided for the right outcomes. Finally, the authors urge changing physicians' habits through education about genomics, diagnostic testing, and targeted therapies. They say that medical schools and physician organizations must become committed advocates of personalized medicine so that patients and the medical industry can get all the benefits it offers.

DermaCare has developed an innovative new product for the treatment of acne that they hope to sell to consumers via direct-response television. The unconventional nature of the product and its distribution has led the company to seek angel financing. The Silicon Valley Band of Angels has agreed to finance the company and has submitted a proposed term sheet. Recently, however, a venture capital (VC) group has submitted a competing term sheet. The company must decide whether to accept financing from the Angels or the VC group.

Spreadsheet Supplement for case 808064

Gokhan Hotamisligil is a star researcher at Harvard School of Public Health who has made groundbreaking discoveries linking fat cells, inflammation, and diabetes. He now wants to form a company to commercialize these discoveries. At the same time, Isaac Kohlberg, the head of Harvard's Office of Technology Development (OTD) is eager to improve Harvard's record in commercializing science. Describes the negotiations between Hotamisligil, OTD, the new company, and the School of Public Health to establish appropriate licensing and sponsored research agreements.

Describes the U.S. FDA with particular emphasis on its role in the development of new drugs, biologic products, and medical devices today. Provides context for the drug approval process by describing the FDA's history and organizational structure.

Describes the business development process in biotechnology companies. Topics covered include: participants in the licensing process and their interests, the major steps in the licensing process, the terms that are part of most agreements, and the most contentious issues that arise in the implementation of licensing agreements.

Technology transfer from U.S. universities to industry has increased dramatically in the last 25 years. Reviews the history of technology transfer with particular emphasis on the Bayh-Dole Act of 1980. It then examines how universities responded to Bayh-Dole, the growth of technology transfer offices, and compares how three different universities (MIT, Stanford, and Harvard) approach technology transfer. Provides an overview of the technology transfer process and issues around current practices.

Describes the formation and rapid growth of a drug testing company. The company needs to decide whether to enter the painkiller testing market, in addition to growing its drug treatment center business.

Reviews the role of corporate venture capital and its history at Eli Lilly. Also presents a challenging venture investment opportunity.

Endo Pharmaceuticals was formed in 1997 as a leveraged buyout spin-off from DuPont Merck. In 1999, it must decide whether to do an IPO or merge with a smaller company.

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Describes the start up of Viacord, a Boston-based medical services firm founded by Cynthia Fisher (HBS MBA) in 1993. Told from Fisher's perspective, the entrepreneur details the conceptualization and launch of the business and the many obstacles and expenses faced in the company's first seven years. Fisher describes the venture capital negotiations and a merger with a biotech company that led to the creation of ViaCell in 2000. Fisher explains how her role changed from founder and CEO of Viacord to president and then board member of ViaCell, and carries the firm's story to the successful 2005 IPO.