First Look

Abstract—Objective: Assess whether a commitment contract informed by behavioral economics leads to persistent virologic suppression among HIV-positive patients with poor antiretroviral therapy (ART) adherence. Design: Single-center pilot randomized clinical trial and a nonrandomized control group. Setting: Publicly funded HIV clinic in Atlanta, Georgia, USA. Intervention: The study involved three arms. First, participants in the provider visit incentive (PVI) arm received $30 after attending each scheduled provider visit. Second, participants in the incentive choice arm were given a choice between the above arrangement and a commitment contract that made the $30 payment conditional on both attending the provider visit and meeting an ART adherence threshold. Third, the passive control arm received routine care and no incentives. Participants: A total of 110 HIV-infected adults with a recent plasma HIV-1 viral load more than 200 copies/ml despite ART. The sample sizes of the three groups were as follows: PVI, n=21; incentive choice, n=19; and passive control, n=70. Main outcome measure: Virologic suppression (plasma HIV-1 viral load<=200 copies/ml) at the end of the incentive period and at an unanticipated postincentive study visit approximately three months later. Results: The odds of suppression were higher in the incentive choice arm than in the passive control arm at the postincentive visit (adjusted odds ratio 3.93, 95% confidence interval 1.19–13.04, P=0.025). The differences relative to the passive control arm at the end of the incentive period and relative to the PVI arm at both points in time were not statistically significant. Conclusion: Commitment contracts can improve ART adherence and virologic suppression.

Publisher's link: http://www.hbs.edu/faculty/Pages/item.aspx?num=52745

Abstract—No abstract available.

Publisher's link: http://www.hbs.edu/faculty/Pages/item.aspx?num=52992

Abstract—We document the existence and consequences of brand flirting: a short-lived experience in which a consumer engages with and/or indulges in the alluring qualities of a brand without committing to it. We propose that brand flirting is exciting and that when consumers flirt with a brand other than their typically preferred brand in the same product category, they can transfer this excitement to their preferred brand—resulting in even greater love and desire for it. Consistent with this conceptual account, we demonstrate that this brand flirting effect is mediated by excitement. Moreover, the brand flirting effect is most likely to emerge under conditions that facilitate arousal transfer: when consumers are highly committed to their preferred brand as well as when the brand with which consumers flirt is similar to their preferred brand.

Publisher's link: http://www.hbs.edu/faculty/Pages/item.aspx?num=53001

Abstract—In this address, I outline a back-to-basics approach to specifying the responsibilities and role of business in relation to society. Three “basics” comprise the approach. The first is arguing that basic principles of ordinary morality, such as a duty not to harm, provide an adequate basis for specifying the responsibilities of business managers. The second is framing the role of business in society by looking to the values realized by the basic building blocks of contemporary economic activity, i.e., markets and firms. The third is making explicit the basic institutions that structure the background against which business operates. The aim is to develop a plausible framework for managerial decision-making that respects the fact of value pluralism in a global economy and that fosters meaningful criticism of current business practices while remaining sufficiently grounded in contemporary circumstances so as to be relevant for managers.

Publisher's link: http://www.hbs.edu/faculty/Pages/item.aspx?num=52977

Abstract—In recent decades, advances in information and communication technology and falling trade barriers have led firms to retain within their boundaries and in their domestic economies only a subset of their production stages. A key decision facing firms worldwide is the extent of control to exert over the different segments of their production processes. We describe a property-rights model of firm boundary choices along the value chain that generalizes Antràs and Chor (2013). To assess the evidence, we construct firm-level measures of the upstreamness of integrated and nonintegrated inputs by combining information on the production activities of firms operating in more than 100 countries with input-output tables. In line with the model's predictions, we find that whether a firm integrates upstream or downstream suppliers depends crucially on the elasticity of demand for its final product. Moreover, a firm's propensity to integrate a given stage of the value chain is shaped by the relative contractibility of the stages located upstream versus downstream from that stage, as well as by the firm's productivity. Our results suggest that contractual frictions play an important role in shaping the integration choices of firms around the world.

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Abstract—Do private equity firms contribute to financial fragility during economic crises? We find that during the 2008 financial crisis, PE-backed companies increased investments relative to their peers, while also experiencing greater equity and debt inflows. The effects are stronger among financially constrained companies and those whose private equity investors had more resources at the onset of the crisis. PE-backed companies consequentially experienced higher asset growth and increased market share during the crisis.

Abstract—This working paper provides a business history perspective on debates about the Great Divergence, the rise of the income gap between the West and the Rest, and the more recent Great Convergence, which has seen a narrowing of that gap. The literature on the timing and causes of the Great Divergence has focused on macro analysis. This working paper identifies the potential for more engagement at the micro level of business enterprises. While recognizing that the context of institutions, education, and culture plays a role in explanations of wealth and poverty, the paper calls for a closer engagement with the processes of how these factors translated into generating productive firms and entrepreneurs. The challenges of catching up were sufficiently great in the Rest that initially, minorities held significant advantages in raising capital and trust levels, which enabled them to flourish as entrepreneurs. Yet by the interwar years, there is evidence of a more general emergence of modern business enterprise in Asia, Latin America, and Africa. Many governmental policies after 1945 designed to facilitate catch-up ended up crippling such emergent business enterprises without putting effective alternatives in place. The second wave of globalization from the 1980s provided more opportunities for catch-up from the Rest. Firms from emerging markets had the opportunity to access the global networks that replaced large integrated firms. There were also new ways to access knowledge and capital, including through management consultancies and hiring graduates from business schools. The upshot was the rise to global prominence of firms based in the Rest, including Foxcomm, Huawei, HNA, Cemex, and TCS.

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Abstract—We investigate the relation between the growth in corporate profits and the overall U.S. economy, focusing on the impact of the U.S. corporate tax regime on this relation. We document that the growth of corporate profits, on average, has outpaced the growth of the economy, and this disconnect increases as the difference between the corporate income tax rate of the U.S. and the other OECD countries increases. The underlying mechanism is fewer corporate profits being channeled into subsequent domestic investments when the U.S. tax rate is relatively higher, leading to lower economic growth. Our findings have implications for policy setters.

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Abstract—I develop measures of firm-level pay disparity and examine their relation to firm accounting performance. Using comprehensive compensation data for a large sample of firms, I find no statistically significant relation between the ratio of CEO-to-mean employee compensation and performance. I next create empirical models that allow me to separate the components of CEO and employee compensation explained by economic factors from those that are not and use these models to estimate explained and unexplained pay disparity. After validating my estimate of unexplained pay disparity as a proxy for pay fairness, I find robust evidence of a negative (positive) relation between unexplained (explained) pay disparity and future firm performance. Additional tests show that the negative relation between unexplained disparity and firm performance is driven by firms where both the CEO is overpaid and employees are underpaid and is more pronounced for firms with weak corporate governance and high employee turnover.

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Abstract—This paper offers guidance and shares collective wisdom for accounting Ph.D. students who will be entering the academic job market. It is divided into two sections. The first offers subjective advice on the dissertation process—from choosing a topic to surviving the inevitable self-doubt—from my personal experience and the experiences of other former job candidates. The second section focuses mainly on factual components of the job market, providing details that will be useful to candidates before they begin the search. It concludes with subjective advice on how to make the job hunt more enjoyable. Both sections are organized chronologically and attempt to be comprehensive, beginning with choosing a dissertation topic and adviser, and concluding with the decision to accept an offer.

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Abstract—Biologic drugs (therapeutic proteins or “large-molecule drugs”) represent a substantial and growing share of the U.S. drug market, accounting for less than 1% of prescriptions filled but more than 25% of dollars spent. Whereas traditional drugs (chemically-synthesized, “small-molecule” drugs) face price competition from generic drugs after patent expiration, biosimilars—biologic drugs that have been shown to be therapeutically equivalent to an already approved original biologic drug—do not yet play the same role, having been approved in the United States only since 2015. Europe, however, has had biosimilar entry since 2006; we consider how competition from biosimilars might impact the U.S. biosimilar market by examining data from the first eight years of biosimilar competition in 23 European countries. We develop a detailed survey that allows us to precisely characterize European biologic drug procurement institutions over time. Using data from three classes of biosimilar drugs, we analyze how market features and public policies predict entry, market prices, and penetration of biosimilars. We find significant heterogeneity across countries and drug classes among all outcomes. While traditional predictors of entry, such as market size, are significant, we also observe that effective buyer institutions (in particular, committed tenders) are associated with increased biosimilar penetration. Price patterns are more difficult to glean from the available data. Our estimates can inform ongoing policy discussions on both sides of the Atlantic about the economic implications of biosimilar policies.

No abstract available.

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Brazil has just won a case action against the U.S. cotton agriculture program at the World Trade Organization. What does this mean for future agricultural programs in the United States? For future trade policies of the United States, Brazil, and others in the global agribusiness system? The future role of the WTO? Negotiation through litigation? Developed versus developing country trade policies?

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To transform IBM for the next technology wave, Ginni Rometty, who became CEO in 2012, led divestment of declining businesses, made acquisitions in digital innovation and cloud computing, formed partnerships with former competitors such as Apple and tech startups, and invested in internally developed cognitive computing/AI platform Watson, a big bet directed at applications for healthcare, education, and cybersecurity. Revenues declined, criticism grew, and challenges of change remained. Watson businesses were new, unproven, and required change in nearly every aspect of legacy operations and culture. To increase speed and agility, Rometty used methods such as online Think Academy, design thinking, and startup contests. In mid-2016, questions remained about the pace and magnitude of change, the scale-up and profitability of Watson, and Rometty’s leadership of change. What was left to do?

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Faced with the imminent loss of 40% of its revenues due to patent expirations, pharma giant Eli Lilly sets out on a dramatic transformation process in 2009. The case considers how Lilly restructured the organization into business areas to aid better decision-making, faster innovation, and clearer customer insight; the forward guidance and minimum performance guarantees that Lilly provided to the market during the transformation; the difficult HR adjustments that were required; and how the top leadership encountered and overcame market skepticism towards the innovation-focused plan.

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Supplements the (A) case.

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Supplements the (A) case.

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TalentCorp Malaysia runs the "Returning Expert Programme" (REP), a government program designed to encourage Malaysian professionals abroad to return home through use of various incentives. The REP is intended to combat the "brain drain," caused by highly educated professionals moving away to take advantage of better career opportunities by offering returnees benefits such as tax breaks and permanent residency for family members. In 2011, TalentCorp took over administration of the REP, and through adjustments to incentives and application requirements was able to dramatically increase the number of REP applicants and approvals. Now they are considering another set of changes and must demonstrate that their changes will increase "bang for the taxpayer buck," raising the number of applicants while maintaining the same level of quality.

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Vicki Fuller traveled from a four-room tenement bordering Chicago’s infamous Cabrini-Green housing projects to speaking at conferences around the world and typically holding court wherever she went. As a teenager, she helped raise her siblings. As a Wall Street executive, she navigated the investment management world to generate attractive investment results for clients. And as the Chief Investment Officer of New York State’s Employees’ Common Retirement Fund (CRF), she helped manage the third-largest state pension fund in the United States. Fuller’s 5’2” height understated her reputational stature, as audiences where she was featured anxiously awaited hearing her market outlook, innovative investment allocations, and industry insights for effective state pension fund strategies.

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