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• Article | Journal of Invasive Cardiology | January 2020

  The Market Reacts Quickly: Changes in Paclitaxel Vascular Device Purchasing Within the Ascension Healthcare System

  Peter P. Monteleone, Subhash Banerjee, Priya Kothapalli, Ariel Dora Stern, Daniel Fehder, Ron Ginor, Dominic Vollmar, Edward T. A. Fry and Mark J. Pirwitz

  Background. A meta-analysis of trials in endovascular therapy suggested an increased mortality associated with treatment exposure to paclitaxel. Multiple publications and corrections of prior data were performed, and the United States Food and Drug Administration has issued multiple advisories regarding paclitaxel use. We analyzed how this controversy impacted device purchasing and related utilization patterns in the period immediately following publication of the meta-analysis. Methods and Results. Ascension Healthcare System purchase data over a 14-month period were synthesized across centers for both paclitaxel and non-paclitaxel devices. A fixed-effects regression model and a binary regression model with facility-level controls were used to compare purchasing patterns before and after the meta-analysis. Purchase volumes of each paclitaxel device fell. Pooled purchase volumes of all paclitaxel devices decreased from a 14-month peak of 631 devices in October 2018 to a 14-month nadir of 359 devices in February 2019. An F-test comparing the pooled-month specific fixed effects for the months before vs. after the publication of the meta-analysis has an F-statistic of 11.64, suggesting that average purchasing levels in the two periods are statistically different (P<.001). Utilization of non-paclitaxel devices did not decline. Conclusions. Purchase volumes of paclitaxel devices decreased immediately during the months following publication of the related meta-analysis. Total Ascension-wide paclitaxel device purchase volume in February 2019 demonstrated a 43.1% reduction from peak monthly purchase volume during the assessed period and a 32.5% reduction compared with November 2019, the last month preceding publication of the meta-analysis.

  Citation:

  Monteleone, Peter P., Subhash Banerjee, Priya Kothapalli, Ariel Dora Stern, Daniel Fehder, Ron Ginor, Dominic Vollmar, Edward T. A. Fry, and Mark J. Pirwitz. "The Market Reacts Quickly: Changes in Paclitaxel Vascular Device Purchasing Within the Ascension Healthcare System." Journal of Invasive Cardiology 32, no. 1 (January 2020).  View Details

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• Technical Note | HBS Case Collection | December 2019

  Technical Note on Bayesian Statistics and Frequentist Power Calculations

  Amitabh Chandra and Ariel Dora Stern

  This Technical Note provides an introduction to Bayes’ Rule and the statistical intuition that stems from it. In this note, we review the concepts that underlie Bayesian statistics, and we offer several simple mathematical examples to illustrate applications of Bayes’ Rule. Instructors can assign this note either as a standalone reading to familiarize students with Bayesian statistics or as a supplement to accompany “Adaptive Platform Trials: The Clinical Trial of the Future?” (HBS Case No. 618-025). This case introduces the concept of an adaptive platform clinical trial, in which Bayesian statistical methods are used to expedite the investigation and regulatory approval of promising new therapies, such as cancer treatments.

  Keywords: Bayesian statistics; Mathematical Methods;

  Citation:

  Chandra, Amitabh, and Ariel Dora Stern. "Technical Note on Bayesian Statistics and Frequentist Power Calculations." Harvard Business School Technical Note 620-032, December 2019.  View Details

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• Case | HBS Case Collection | December 2019

  JUUL and the Vaping Revolution

  Michael W. Toffel, John Masko and Sarah Mehta

  In late 2019, San Francisco-based electronic cigarette (e-cigarette) maker JUUL Labs (pronounced “jewel”) faced intense pressure. Sales of JUUL products exceeded $1 billion in 2018, dominating the e-cigarette category. While JUUL Labs’ stated goal was to help current smokers switch from traditional cigarettes to e-cigarettes, the company’s products had become popular with high school and even middle school students, among whom “vaping”—the use of e-cigarettes—was rapidly spreading. Some advocacy groups and policymakers speculated that JUUL Labs had purposefully marketed its products to minors, an allegation the company strongly denied. The debate over JUUL Labs’ marketing and products had made 2019 a difficult year for the company, with a number of states and municipalities imposing bans on the sale of flavored e-liquids, and in some cases, on all e-cigarette products. Given that the company was ostensibly founded to reduce the harm of smoking, what more could JUUL Labs do to prevent misuse of its products, restore its reputation, and grow its business more successfully?

  Keywords: electronic cigarettes; E-Cigarettes; vaping; Nicotine Replacement; JUUL; Juuling; Advertising; Online Advertising; Customers; Innovation and Invention; Marketing; Ethics; Brands and Branding; Marketing Communications; Marketing Strategy; Product Marketing; Corporate Social Responsibility and Impact; Social Issues; Technology; Technology Industry;

  Citation:

  Toffel, Michael W., John Masko, and Sarah Mehta. "JUUL and the Vaping Revolution." Harvard Business School Case 620-069, December 2019.  View Details

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