Aligning Business and Public Health Needs: Assessing the Customer Value Proposition of an HIV Pre-Exposure Prophylaxis Adherence Startup

Abstract

Entrepreneurship plays a major role in developing innovative medical technologies that contribute to better public health; however, most entrepreneurs fail to scale their innovations. One of the most commonly cited reasons for startup failure is the lack of customer need. Therefore, during the early stages of the startup lifecycle, entrepreneurs must focus on achieving product-market fit by developing robust value propositions that will enable early market success. The goal of this Doctor of Public Health (DrPH) thesis is to assess the challenges and opportunities associated with a host organization’s value proposition for its product offering. The host organization for this project, UrSure, Inc., is an early-stage startup established at the Harvard Innovation Labs seeking to improve adherence to HIV pre-exposure prophylaxis (PrEP) medications through the use of a novel diagnostic test. As part of this doctoral project, I took a full-time position as Director of Business Development at UrSure from June 2018 to March 2019. This experiential learning, combined with an interdisciplinary review of entrepreneurship and public health literature, informed the development of a qualitative research protocol to understand the needs, opportunities, and purchasing behaviors of customers in a key market segment, 340B clinics. I interviewed thirteen health care providers at 340B clinics that offer PrEP services and used thematic analysis to uncover three global themes that provide insight on UrSure’s customer value proposition. From the global themes, I distilled implications for practice in the form of three strategic recommendations to help UrSure improve its chances of achieving entrepreneurial success. The first recommendation is to conduct ongoing customer discovery research. The second recommendation is to consider reframing the value proposition to more aptly meet the unmet needs of potential customers. The third recommendation is to continue generating evidence on the efficacy and utility of PrEP adherence testing. This thesis also presents important lessons learned that can inform customer development strategies at other health care startups to increase the likelihood of successfully commercializing impactful public health interventions.