Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan Net Present Value (NPV) / MBA Resources

Introduction to Net Present Value (NPV) - What is Net Present Value (NPV) ? How it impacts financial decisions regarding project management?

NPV solution for Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan case study

At Oak Spring University, we provide corporate level professional Net Present Value (NPV) case study solution. Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan case study is a Harvard Business School (HBR) case study written by Margaret L. Eaton, Madhi Roy, Marko Curavic. The Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan (referred as “Crixivan Drug” from here on) case study provides evaluation & decision scenario in field of Technology & Operations. It also touches upon business topics such as - Value proposition, Marketing, Policy, Supply chain.

The net present value (NPV) of an investment proposal is the present value of the proposal’s net cash flows less the proposal’s initial cash outflow. If a project’s NPV is greater than or equal to zero, the project should be accepted.

NPV = Present Value of Future Cash Flows LESS Project’s Initial Investment

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Case Description of Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan Case Study

Pharmaceutical company Merck had created the U.S. Managed Distribution Team to handle a unique problem. In March, 1996, the U.S. Food and Drug Administration (FDA) had approved Merck's new drug application for Crixivan, a novel antiviral drug to fight acquired immunodeficiency syndrome (AIDS). Driven by positive early data from the clinical studies, a tremendous medical need for new human immunodeficiency virus (HIV) treatments, and the demands of AIDS activists to make new medicines available as quickly as possible, the FDA had approved Merck's application in a record-setting 42 days from submission. Since Merck's manufacturing facilities would not be ready to produce the drug at capacity for at least six months, a small pilot plant facility would immediately supply Crixivan for an estimated 25,000 to 30,000 patients. Propelled by the need to make Crixivan quickly available, but concerned about ensuring a continuous supply to individual patients so that immune resistance to the drug would not develop as a result of insufficient dosage, the team had grappled with the issue of how to distribute a drug in limited supply. The worst situation would be to start patients on therapy only to discontinue treatment because Merck could not continue to supply the drug. Such a situation was a setup for the emergence of viral resistance, which would markedly exacerbate the AIDS epidemic. After much consideration, the U.S. Managed Distribution Team decided to: (1) abandon traditional distribution channels; (2) manage distribution from one source; and (3) track all patients starting on therapy with Crixivan. The team had gathered to review the progress and success of its plan.

Case Authors : Margaret L. Eaton, Madhi Roy, Marko Curavic

Topic : Technology & Operations

Related Areas : Marketing, Policy, Supply chain

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Calculating Net Present Value (NPV) at 6% for Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan Case Study

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 6 %	Discounted Cash Flows
Year 0	(10019048)	-10019048	-	-
Year 1	3447866	-6571182	3447866	0.9434	3252704
Year 2	3960387	-2610795	7408253	0.89	3524730
Year 3	3955742	1344947	11363995	0.8396	3321317
Year 4	3236188	4581135	14600183	0.7921	2563364
TOTAL			14600183		12662115

The Net Present Value at 6% discount rate is 2643067

In isolation the NPV number doesn't mean much but put in right context then it is one of the best method to evaluate project returns. In this article we will cover -

Different methods of capital budgeting

What is NPV & Formula of NPV,
How it is calculated,
How to use NPV number for project evaluation, and
Scenario Planning given risks and management priorities.

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Capital Budgeting Approaches

Methods of Capital Budgeting

There are four types of capital budgeting techniques that are widely used in the corporate world –

1. Payback Period
2. Internal Rate of Return
3. Net Present Value
4. Profitability Index

Apart from the Payback period method which is an additive method, rest of the methods are based on Discounted Cash Flow technique. Even though cash flow can be calculated based on the nature of the project, for the simplicity of the article we are assuming that all the expected cash flows are realized at the end of the year.

Discounted Cash Flow approaches provide a more objective basis for evaluating and selecting investment projects. They take into consideration both –

1. Magnitude of both incoming and outgoing cash flows – Projects can be capital intensive, time intensive, or both. Crixivan Drug shareholders have preference for diversified projects investment rather than prospective high income from a single capital intensive project.
2. Timing of the expected cash flows – stockholders of Crixivan Drug have higher preference for cash returns over 4-5 years rather than 10-15 years given the nature of the volatility in the industry.

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Formula and Steps to Calculate Net Present Value (NPV) of Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan

NPV = Net Cash In Flowt1 / (1+r)t1 + Net Cash In Flowt2 / (1+r)t2 + … Net Cash In Flowtn / (1+r)tn
Less Net Cash Out Flowt0 / (1+r)t0

Where t = time period, in this case year 1, year 2 and so on.
r = discount rate or return that could be earned using other safe proposition such as fixed deposit or treasury bond rate. Net Cash In Flow – What the firm will get each year.
Net Cash Out Flow – What the firm needs to invest initially in the project.

Step 1 – Understand the nature of the project and calculate cash flow for each year.
Step 2 – Discount those cash flow based on the discount rate.
Step 3 – Add all the discounted cash flow.
Step 4 – Selection of the project

Why Technology & Operations Managers need to know Financial Tools such as Net Present Value (NPV)?

In our daily workplace we often come across people and colleagues who are just focused on their core competency and targets they have to deliver. For example marketing managers at Crixivan Drug often design programs whose objective is to drive brand awareness and customer reach. But how that 30 point increase in brand awareness or 10 point increase in customer touch points will result into shareholders’ value is not specified.

To overcome such scenarios managers at Crixivan Drug needs to not only know the financial aspect of project management but also needs to have tools to integrate them into part of the project development and monitoring plan.

Calculating Net Present Value (NPV) at 15%

After working through various assumptions we reached a conclusion that risk is far higher than 6%. In a reasonably stable industry with weak competition - 15% discount rate can be a good benchmark.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 15 %	Discounted Cash Flows
Year 0	(10019048)	-10019048	-	-
Year 1	3447866	-6571182	3447866	0.8696	2998144
Year 2	3960387	-2610795	7408253	0.7561	2994622
Year 3	3955742	1344947	11363995	0.6575	2600965
Year 4	3236188	4581135	14600183	0.5718	1850301
TOTAL					10444031

The Net NPV after 4 years is 424983

(10444031 - 10019048 )

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Calculating Net Present Value (NPV) at 20%

If the risk component is high in the industry then we should go for a higher hurdle rate / discount rate of 20%.

Years	Cash Flow	Net Cash Flow	Cumulative     Cash Flow	Discount Rate @ 20 %	Discounted Cash Flows
Year 0	(10019048)	-10019048	-	-
Year 1	3447866	-6571182	3447866	0.8333	2873222
Year 2	3960387	-2610795	7408253	0.6944	2750269
Year 3	3955742	1344947	11363995	0.5787	2289203
Year 4	3236188	4581135	14600183	0.4823	1560662
TOTAL					9473355

The Net NPV after 4 years is -545693

At 20% discount rate the NPV is negative (9473355 - 10019048 ) so ideally we can't select the project if macro and micro factors don't allow financial managers of Crixivan Drug to discount cash flow at lower discount rates such as 15%.

Acceptance Criteria of a Project based on NPV

Simplest Approach – If the investment project of Crixivan Drug has a NPV value higher than Zero then finance managers at Crixivan Drug can ACCEPT the project, otherwise they can reject the project. This means that project will deliver higher returns over the period of time than any alternate investment strategy.

In theory if the required rate of return or discount rate is chosen correctly by finance managers at Crixivan Drug, then the stock price of the Crixivan Drug should change by same amount of the NPV. In real world we know that share price also reflects various other factors that can be related to both macro and micro environment.

In the same vein – accepting the project with zero NPV should result in stagnant share price. Finance managers use discount rates as a measure of risk components in the project execution process.

Sensitivity Analysis

Project selection is often a far more complex decision than just choosing it based on the NPV number. Finance managers at Crixivan Drug should conduct a sensitivity analysis to better understand not only the inherent risk of the projects but also how those risks can be either factored in or mitigated during the project execution. Sensitivity analysis helps in –

What can impact the cash flow of the project.

Understanding of risks involved in the project.

What are the key aspects of the projects that need to be monitored, refined, and retuned for continuous delivery of projected cash flows.

What are the uncertainties surrounding the project Initial Cash Outlay (ICO’s). ICO’s often have several different components such as land, machinery, building, and other equipment.

What will be a multi year spillover effect of various taxation regulations.

Some of the assumptions while using the Discounted Cash Flow Methods –

Projects are assumed to be Mutually Exclusive – This is seldom the came in modern day giant organizations where projects are often inter-related and rejecting a project solely based on NPV can result in sunk cost from a related project.

Independent projects have independent cash flows – As explained in the marketing project – though the project may look independent but in reality it is not as the brand awareness project can be closely associated with the spending on sales promotions and product specific advertising.

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Negotiation Strategy of Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan

References & Further Readings

Margaret L. Eaton, Madhi Roy, Marko Curavic (2018), "Merck's U.S. Managed Distribution Program for the HIV Drug Crixivan Harvard Business Review Case Study. Published by HBR Publications.