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• Course Overview Note | 2013 (Revised from original 2013 version)

  The Entrepreneurial Manager: Course Overview, 2013 Winter Term

  Richard G. Hamermesh, Richard G. Hamermesh and Thomas Eisenmann

  Course overview of The Entrepreneurial Manager.

  Keywords: Entrepreneurship; Management; Business Education;

  Citation:

  Hamermesh, Richard G., and Thomas Eisenmann. "The Entrepreneurial Manager: Course Overview, 2013 Winter Term." Harvard Business School Course Overview Note 813-155, January 2013. (Revised from original January 2013 version.)

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• Case | HBS Case Collection | 2013 (Revised from original 2012 version)

  Companion Diagnostics: Uncertainties for Approval and Reimbursement

  Richard G. Hamermesh, Norman C. Selby and Phillip Andrews

  The FDA approvals of novel therapeutics were seen as signs in the personalized medicine community of real progress in the growth of personalized medicine. The FDA's approval of such drugs, along with companion diagnostics, suggested a shift in thinking and regulatory practices at the agency. Beyond the regulatory questions, many considered the reimbursement system archaic, dispersed, unpredictable, and unnecessarily time consuming. Many questioned whether the traditional models of reimbursement were relevant in the era of personalized medicine, and who should be covering the cost of tests needed to identify the sometimes small number of patients who could benefit from expensive targeted drugs. This case focuses on the array of possibilities and the ambiguity surrounding these regulatory and reimbursement issues.

  Keywords: models of reimbursement; personalized medicine; regulation; healthcare reform; Health Care and Treatment; Health Industry; United States;

  Citation:

  Hamermesh, Richard G., Norman C. Selby, and Phillip Andrews. "Companion Diagnostics: Uncertainties for Approval and Reimbursement." Harvard Business School Case 813-037, January 2013. (Revised from original November 2012 version.)

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• Article | Pediatrics | 2012

  Effects of Description of Options on Parental Perinatal Decision-Making

  Marlyse F. Haward, Leslie John, John M. Lorenz and Baruch Fischhoff

  Objective: To examine whether parents' delivery room management decisions for extremely preterm infants are influenced by (a) the degree of detail with which options-comfort care (CC) or intensive care (IC)-are presented or (b) their order of presentation. Methods: 309 volunteers, 18-55 years old, were each randomized to one of 4 groups: 1. detailed descriptions, CC presented first; 2. detailed descriptions, IC presented first; 3. brief descriptions, CC presented first; and 4. brief descriptions, IC presented first. Each received the description of a hypothetical delivery of a 23-week gestation infant and chose either IC or CC. Open-ended and structured questions elicited reasoning. Data were analyzed by chi-square and logistic regression analysis. Results: Neither degree of detail, comparing groups 1+2 with 3+4 (37% v 41%, OR=0.85, 95%CI=0.54-1.34, p=0.48), nor order, comparing groups 1+3 with 2+4 (40% v 37 %, OR=0.88, 95%CI=0.56-1.39; p=0.59), influenced the likelihood of choosing IC. Participants choosing IC were more likely to invoke sanctity of life and religiosity as personal values. Additional reasons for choosing IC were experiences with infants born at later gestational ages, giving the baby a chance, not watching their baby die, and equating CC with euthanasia. Some choosing CC wanted to avoid infant suffering. Conclusions: The degree of detail and order of presentation had no effect on treatment decisions, suggesting that individuals bring well-articulated preexisting preferences to such decisions. Understanding beliefs and attitudes motivating these preferences can assist physicians in helping parents make informed decisions consistent with their values.

  Keywords: Decision Making; Presentations; Mathematical Methods; Personal Characteristics; Attitudes; Motivation and Incentives; Family and Family Relationships; Value; Health Care and Treatment;

  Citation:

  Haward, Marlyse F., Leslie John, John M. Lorenz, and Baruch Fischhoff. "Effects of Description of Options on Parental Perinatal Decision-Making." Pediatrics 129, no. 5 (2012).

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