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Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

Case Study SWOT Analysis Solution

Case Study Description of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids


This case is based on highly publicized events surrounding lethal medication manufactured and sold by a small pharmaceutical company outside Boston, Massachusetts called New England Compounding Center (NECC). Formed in 1998, NECC was owned and operated by husband and wife Barry Cadden and Lisa Conigliaro Cadden, along with other family members. In conjunction with its sister company, Ameridose, the businesses focused on preparing prefilled syringes and large vats of medication into smaller intravenous bags, ready for individual use. It also compounded medication for individual patients' specific needs. But as the business grew aggressively, taking larger and larger orders, fast production was prioritized over safety and sanitation. A fungal meningitis outbreak in the fall of 2012 was linked to steroids fabricated by NECC. Despite an immediate recall, the allegedly contaminated product had been distributed to more than 14,000 patients in 23 states. In total, the Centers for Disease Control and Prevention reported 751 cases of fungal infection that could be linked to tainted steroid injections compounded by NECC. Of these, 64 were fatal. How should the legal system respond?

Authors :: Cheryl Kirschner

Topics :: Leadership & Managing People

Tags :: Ethics, Negotiations, Public relations, Risk management, SWOT Analysis, SWOT Matrix, TOWS, Weighted SWOT Analysis

Swot Analysis of "Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids" written by Cheryl Kirschner includes – strengths weakness that are internal strategic factors of the organization, and opportunities and threats that Necc Medication facing as an external strategic factors. Some of the topics covered in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study are - Strategic Management Strategies, Ethics, Negotiations, Public relations, Risk management and Leadership & Managing People.


Some of the macro environment factors that can be used to understand the Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids casestudy better are - – increasing government debt because of Covid-19 spendings, talent flight as more people leaving formal jobs, increasing household debt because of falling income levels, increasing inequality as vast percentage of new income is going to the top 1%, cloud computing is disrupting traditional business models, there is backlash against globalization, there is increasing trade war between United States & China, increasing commodity prices, banking and financial system is disrupted by Bitcoin and other crypto currencies, etc



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Introduction to SWOT Analysis of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids


SWOT stands for an organization’s Strengths, Weaknesses, Opportunities and Threats . At Oak Spring University , we believe that protagonist in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study can use SWOT analysis as a strategic management tool to assess the current internal strengths and weaknesses of the Necc Medication, and to figure out the opportunities and threats in the macro environment – technological, environmental, political, economic, social, demographic, etc in which Necc Medication operates in.

According to Harvard Business Review, 75% of the managers use SWOT analysis for various purposes such as – evaluating current scenario, strategic planning, new venture feasibility, personal growth goals, new market entry, Go To market strategies, portfolio management and strategic trade-off assessment, organizational restructuring, etc.




SWOT Objectives / Importance of SWOT Analysis and SWOT Matrix


SWOT analysis of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids can be done for the following purposes –
1. Strategic planning using facts provided in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study
2. Improving business portfolio management of Necc Medication
3. Assessing feasibility of the new initiative in Leadership & Managing People field.
4. Making a Leadership & Managing People topic specific business decision
5. Set goals for the organization
6. Organizational restructuring of Necc Medication




Strengths Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids | Internal Strategic Factors
What are Strengths in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The strengths of Necc Medication in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids Harvard Business Review case study are -

High brand equity

– Necc Medication has strong brand awareness and brand recognition among both - the exiting customers and potential new customers. Strong brand equity has enabled Necc Medication to keep acquiring new customers and building profitable relationship with both the new and loyal customers.

Ability to lead change in Leadership & Managing People field

– Necc Medication is one of the leading players in its industry. Over the years it has not only transformed the business landscape in its segment but also across the whole industry. The ability to lead change has enabled Necc Medication in – penetrating new markets, reaching out to new customers, and providing different value propositions to different customers in the international markets.

Digital Transformation in Leadership & Managing People segment

- digital transformation varies from industry to industry. For Necc Medication digital transformation journey comprises differing goals based on market maturity, customer technology acceptance, and organizational culture. Necc Medication has successfully integrated the four key components of digital transformation – digital integration in processes, digital integration in marketing and customer relationship management, digital integration into the value chain, and using technology to explore new products and market opportunities.

Learning organization

- Necc Medication is a learning organization. It has inculcated three key characters of learning organization in its processes and operations – exploration, creativity, and expansiveness. The work place at Necc Medication is open place that encourages instructiveness, ideation, open minded discussions, and creativity. Employees and leaders in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids Harvard Business Review case study emphasize – knowledge, initiative, and innovation.

Diverse revenue streams

– Necc Medication is present in almost all the verticals within the industry. This has provided firm in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study a diverse revenue stream that has helped it to survive disruptions such as global pandemic in Covid-19, financial disruption of 2008, and supply chain disruption of 2021.

Strong track record of project management

– Necc Medication is known for sticking to its project targets. This enables the firm to manage – time, project costs, and have sustainable margins on the projects.

Sustainable margins compare to other players in Leadership & Managing People industry

– Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids firm has clearly differentiated products in the market place. This has enabled Necc Medication to fetch slight price premium compare to the competitors in the Leadership & Managing People industry. The sustainable margins have also helped Necc Medication to invest into research and development (R&D) and innovation.

Successful track record of launching new products

– Necc Medication has launched numerous new products in last few years, keeping in mind evolving customer preferences and competitive pressures. Necc Medication has effective processes in place that helps in exploring new product needs, doing quick pilot testing, and then launching the products quickly using its extensive distribution network.

Analytics focus

– Necc Medication is putting a lot of focus on utilizing the power of analytics in business decision making. This has put it among the leading players in the industry. The technology infrastructure suggested by Cheryl Kirschner can also help it to harness the power of analytics for – marketing optimization, demand forecasting, customer relationship management, inventory management, information sharing across the value chain etc.

Innovation driven organization

– Necc Medication is one of the most innovative firm in sector. Manager in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids Harvard Business Review case study can use Clayton Christensen Disruptive Innovation strategies to further increase the scale of innovtions in the organization.

Highly skilled collaborators

– Necc Medication has highly efficient outsourcing and offshoring strategy. It has resulted in greater operational flexibility and bringing down the costs in highly price sensitive segment. Secondly the value chain collaborators of the firm in Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids HBR case study have helped the firm to develop new products and bring them quickly to the marketplace.

Cross disciplinary teams

– Horizontal connected teams at the Necc Medication are driving operational speed, building greater agility, and keeping the organization nimble to compete with new competitors. It helps are organization to ideate new ideas, and execute them swiftly in the marketplace.






Weaknesses Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids | Internal Strategic Factors
What are Weaknesses in SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis

The weaknesses of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids are -

High bargaining power of channel partners

– Because of the regulatory requirements, Cheryl Kirschner suggests that, Necc Medication is facing high bargaining power of the channel partners. So far it has not able to streamline the operations to reduce the bargaining power of the value chain partners in the industry.

No frontier risks strategy

– After analyzing the HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids, it seems that company is thinking about the frontier risks that can impact Leadership & Managing People strategy. But it has very little resources allocation to manage the risks emerging from events such as natural disasters, climate change, melting of permafrost, tacking the rise of artificial intelligence, opportunities and threats emerging from commercialization of space etc.

Need for greater diversity

– Necc Medication has taken concrete steps on diversity, equity, and inclusion. But the efforts so far has resulted in limited success. It needs to expand the recruitment and selection process to hire more people from the minorities and underprivileged background.

Workers concerns about automation

– As automation is fast increasing in the segment, Necc Medication needs to come up with a strategy to reduce the workers concern regarding automation. Without a clear strategy, it could lead to disruption and uncertainty within the organization.

Ability to respond to the competition

– As the decision making is very deliberative, highlighted in the case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids, in the dynamic environment Necc Medication has struggled to respond to the nimble upstart competition. Necc Medication has reasonably good record with similar level competitors but it has struggled with new entrants taking away niches of its business.

Products dominated business model

– Even though Necc Medication has some of the most successful products in the industry, this business model has made each new product launch extremely critical for continuous financial growth of the organization. firm in the HBR case study - Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids should strive to include more intangible value offerings along with its core products and services.

Compensation and incentives

– The revenue per employee as mentioned in the HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids, is just above the industry average. Necc Medication needs to redesign the compensation structure and incentives to increase the revenue per employees. Some of the steps that it can take are – hiring more specialists on project basis, etc.

High operating costs

– Compare to the competitors, firm in the HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids has high operating costs in the. This can be harder to sustain given the new emerging competition from nimble players who are using technology to attract Necc Medication 's lucrative customers.

Interest costs

– Compare to the competition, Necc Medication has borrowed money from the capital market at higher rates. It needs to restructure the interest payment and costs so that it can compete better and improve profitability.

High cash cycle compare to competitors

Necc Medication has a high cash cycle compare to other players in the industry. It needs to shorten the cash cycle by 12% to be more competitive in the marketplace, reduce inventory costs, and be more profitable.

High dependence on star products

– The top 2 products and services of the firm as mentioned in the Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids HBR case study still accounts for major business revenue. This dependence on star products in has resulted into insufficient focus on developing new products, even though Necc Medication has relatively successful track record of launching new products.




Opportunities Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids | External Strategic Factors
What are Opportunities in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The opportunities highlighted in the Harvard Business Review case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids are -

Buying journey improvements

– Necc Medication can improve the customer journey of consumers in the industry by using analytics and artificial intelligence. Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids suggest that firm can provide automated chats to help consumers solve their own problems, provide online suggestions to get maximum out of the products and services, and help consumers to build a community where they can interact with each other to develop new features and uses.

Better consumer reach

– The expansion of the 5G network will help Necc Medication to increase its market reach. Necc Medication will be able to reach out to new customers. Secondly 5G will also provide technology framework to build new tools and products that can help more immersive consumer experience and faster consumer journey.

Building a culture of innovation

– managers at Necc Medication can make experimentation a productive activity and build a culture of innovation using approaches such as – mining transaction data, A/B testing of websites and selling platforms, engaging potential customers over various needs, and building on small ideas in the Leadership & Managing People segment.

Creating value in data economy

– The success of analytics program of Necc Medication has opened avenues for new revenue streams for the organization in the industry. This can help Necc Medication to build a more holistic ecosystem as suggested in the Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study. Necc Medication can build new products and services such as - data insight services, data privacy related products, data based consulting services, etc.

Loyalty marketing

– Necc Medication has focused on building a highly responsive customer relationship management platform. This platform is built on in-house data and driven by analytics and artificial intelligence. The customer analytics can help the organization to fine tune its loyalty marketing efforts, increase the wallet share of the organization, reduce wastage on mainstream advertising spending, build better pricing strategies using personalization, etc.

Using analytics as competitive advantage

– Necc Medication has spent a significant amount of money and effort to integrate analytics and machine learning into its operations in the sector. This continuous investment in analytics has enabled, as illustrated in the Harvard case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids - to build a competitive advantage using analytics. The analytics driven competitive advantage can help Necc Medication to build faster Go To Market strategies, better consumer insights, developing relevant product features, and building a highly efficient supply chain.

Use of Bitcoin and other crypto currencies for transactions

– The popularity of Bitcoin and other crypto currencies as asset class and medium of transaction has opened new opportunities for Necc Medication in the consumer business. Now Necc Medication can target international markets with far fewer capital restrictions requirements than the existing system.

Redefining models of collaboration and team work

– As explained in the weaknesses section, Necc Medication is facing challenges because of the dominance of functional experts in the organization. Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids case study suggests that firm can utilize new technology to build more coordinated teams and streamline operations and communications using tools such as CAD, Zoom, etc.

Reconfiguring business model

– The expansion of digital payment system, the bringing down of international transactions costs using Bitcoin and other blockchain based currencies, etc can help Necc Medication to reconfigure its entire business model. For example it can used blockchain based technologies to reduce piracy of its products in the big markets such as China. Secondly it can use the popularity of e-commerce in various developing markets to build a Direct to Customer business model rather than the current Channel Heavy distribution network.

Learning at scale

– Online learning technologies has now opened space for Necc Medication to conduct training and development for its employees across the world. This will result in not only reducing the cost of training but also help employees in different part of the world to integrate with the headquarter work culture, ethos, and standards.

Manufacturing automation

– Necc Medication can use the latest technology developments to improve its manufacturing and designing process in Leadership & Managing People segment. It can use CAD and 3D printing to build a quick prototype and pilot testing products. It can leverage automation using machine learning and artificial intelligence to do faster production at lowers costs, and it can leverage the growth in satellite and tracking technologies to improve inventory management, transportation, and shipping.

Reforming the budgeting process

- By establishing new metrics that will be used to evaluate both existing and potential projects Necc Medication can not only reduce the costs of the project but also help it in integrating the projects with other processes within the organization.

Identify volunteer opportunities

– Covid-19 has impacted working population in two ways – it has led to people soul searching about their professional choices, resulting in mass resignation. Secondly it has encouraged people to do things that they are passionate about. This has opened opportunities for businesses to build volunteer oriented socially driven projects. Necc Medication can explore opportunities that can attract volunteers and are consistent with its mission and vision.




Threats Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids External Strategic Factors
What are Threats in the SWOT Analysis / TOWS Matrix / Weighted SWOT Analysis


The threats mentioned in the HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids are -

Stagnating economy with rate increase

– Necc Medication can face lack of demand in the market place because of Fed actions to reduce inflation. This can lead to sluggish growth in the economy, lower demands, lower investments, higher borrowing costs, and consolidation in the field.

Increasing international competition and downward pressure on margins

– Apart from technology driven competitive advantage dilution, Necc Medication can face downward pressure on margins from increasing competition from international players. The international players have stable revenue in their home market and can use those resources to penetrate prominent markets illustrated in HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids .

Learning curve for new practices

– As the technology based on artificial intelligence and machine learning platform is getting complex, as highlighted in case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids, Necc Medication may face longer learning curve for training and development of existing employees. This can open space for more nimble competitors in the field of Leadership & Managing People .

Regulatory challenges

– Necc Medication needs to prepare for regulatory challenges as consumer protection groups and other pressure groups are vigorously advocating for more regulations on big business - to reduce inequality, to create a level playing field, to product data privacy and consumer privacy, to reduce the influence of big money on democratic institutions, etc. This can lead to significant changes in the Leadership & Managing People industry regulations.

New competition

– After the dotcom bust of 2001, financial crisis of 2008-09, the business formation in US economy had declined. But in 2020 alone, there are more than 1.5 million new business applications in United States. This can lead to greater competition for Necc Medication in the Leadership & Managing People sector and impact the bottomline of the organization.

Instability in the European markets

– European Union markets are facing three big challenges post Covid – expanded balance sheets, Brexit related business disruption, and aggressive Russia looking to distract the existing security mechanism. Necc Medication will face different problems in different parts of Europe. For example it will face inflationary pressures in UK, France, and Germany, balance sheet expansion and demand challenges in Southern European countries, and geopolitical instability in the Eastern Europe.

Backlash against dominant players

– US Congress and other legislative arms of the government are getting tough on big business especially technology companies. The digital arm of Necc Medication business can come under increasing regulations regarding data privacy, data security, etc.

Barriers of entry lowering

– As technology is more democratized, the barriers to entry in the industry are lowering. It can presents Necc Medication with greater competitive threats in the near to medium future. Secondly it will also put downward pressure on pricing throughout the sector.

Capital market disruption

– During the Covid-19, Dow Jones has touched record high. The valuations of a number of companies are way beyond their existing business model potential. This can lead to capital market correction which can put a number of suppliers, collaborators, value chain partners in great financial difficulty. It will directly impact the business of Necc Medication.

Technology acceleration in Forth Industrial Revolution

– Necc Medication has witnessed rapid integration of technology during Covid-19 in the Leadership & Managing People industry. As one of the leading players in the industry, Necc Medication needs to keep up with the evolution of technology in the Leadership & Managing People sector. According to Mckinsey study top managers believe that the adoption of technology in operations, communications is 20-25 times faster than what they planned in the beginning of 2019.

Increasing wage structure of Necc Medication

– Post Covid-19 there is a sharp increase in the wages especially in the jobs that require interaction with people. The increasing wages can put downward pressure on the margins of Necc Medication.

High dependence on third party suppliers

– Necc Medication high dependence on third party suppliers can disrupt its processes and delivery mechanism. For example -the current troubles of car makers because of chip shortage is because the chip companies started producing chips for electronic companies rather than car manufacturers.

Technology disruption because of hacks, piracy etc

– The colonial pipeline illustrated, how vulnerable modern organization are to international hackers, miscreants, and disruptors. The cyber security interruption, data leaks, etc can seriously jeopardize the future growth of the organization.




Weighted SWOT Analysis of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids Template, Example


Not all factors mentioned under the Strengths, Weakness, Opportunities, and Threats quadrants in the SWOT Analysis are equal. Managers in the HBR case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids needs to zero down on the relative importance of each factor mentioned in the Strengths, Weakness, Opportunities, and Threats quadrants. We can provide the relative importance to each factor by assigning relative weights. Weighted SWOT analysis process is a three stage process –

First stage for doing weighted SWOT analysis of the case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids is to rank the strengths and weaknesses of the organization. This will help you to assess the most important strengths and weaknesses of the firm and which one of the strengths and weaknesses mentioned in the initial lists are marginal and can be left out.

Second stage for conducting weighted SWOT analysis of the Harvard case study Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids is to give probabilities to the external strategic factors thus better understanding the opportunities and threats arising out of macro environment changes and developments.

Third stage of constructing weighted SWOT analysis of Double, Double, Toil and Trouble: One Compounding Pharmacy's Recipe for Steroids is to provide strategic recommendations includes – joining likelihood of external strategic factors such as opportunities and threats to the internal strategic factors – strengths and weaknesses. You should start with external factors as they will provide the direction of the overall industry. Secondly by joining probabilities with internal strategic factors can help the company not only strategic fit but also the most probably strategic trade-off that Necc Medication needs to make to build a sustainable competitive advantage.



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