Precision medicine relies on two technologies jointly working together to deliver benefit to patients, a medicine on the one hand and a diagnostic on the other. The diagnostic's purpose is to identify the right patient population for the medicine, and could be considered complementary to the use of the medicine. In recent years the market access of these complementary diagnostics has been scrutinized as being inadequate to ensure time access for patients. This thesis has delved into this issue and, as indicated in Chapters 1 and 2, sought to gain insights in these market access hurdles and gain a better understanding of the value derived from complementary diagnostics for our healthcare system. Chapter 3 delves into the reimbursement policies of complementary diagnostics (such as companion diagnostics). It identifies the reasons why the reimbursement issues of complementary diagnostics, and specifically companion diagnostics have emerged across European countries. In this study several issues with the standard in vitro diagnostic reimbursement pathways were identified across eight European countries, that consequently have risen to prominence when precision medicine was gradually introduced into healthcare systems. Several alternative reimbursement approaches were identified, specifically for companion diagnostics in Germany and Belgium and more broadly for complementary diagnostics in France. Chapter 4 examines the Belgian healthcare payer's health technology assessment of precision medicines with companion diagnostics. This research formulated several recommendations that could enhance the assessment practice under the novel reimbursement pathway for precision medicines with companion diagnostics in Belgium, as identified and discussed in chapter 3. Specifically, the introduction of the linked-evidence approach was recommended to be introduced in the assessment practice as many companion diagnostics lack the necessary direct evidence to establish their clinical utility. In Chapter 5, a study on the interaction between the biomarker that is identified by the diagnostic test, and the precision medicine is discussed. This interaction can also be referred to as the 'precision mechanism'. In this chapter we introduce the use of a novel performance parameter that examines directly what is at the heart of precision medicine; The ability of the diagnostic test to identify patients who are more likely to respond to treatment. These novel parameters convey the probability that a patient belonging to a specific subgroup will benefit from precision therapy or not. We applied these novel parameters to European medicine agency's approved precision medicines. The result of this analysis shows that not every companion diagnostics, or therefore precision mechanism, provides the same clinical utility, and that this differentiation could inform reimbursement decision making. Chapter 6 covers a systematic review on the use and adoption of assessment frameworks for complementary diagnostics such as omics technologies, by health technology assessment agencies. Many of these frameworks have been published, however none have seen their wide scale adoption by health technology assessment agencies. When looking at the health technology assessment reports on these technologies, the most recurrent elements under assessment were the clinical utility and the cost-effectiveness of these types of tests. Concepts such as ethical, social, and organisational aspect were often not considered. Specifically for organisational aspects, this could be of concern, as the specific context in which a test is implemented determines its clinical utility and therefore its cost-effectiveness. In Chapter 7 this issue is further illustrated. The working hypothesis of the study is that specific contextual factors influencing the clinical utility of a test (e.g., level of training by the treating physician, local clinical guidelines, experience level, etc) will therefore influence the cost-effectiveness, and hence the value perception of the test, which is expressed through the value-based price at a certain willingness to pay threshold. The study collected a range of published clinical utility scenarios across countries and healthcare systems. These scenarios were consequently inputted into a cost-effectiveness model with all other variables kept the same. The results showed that there is a range of outcomes where either the test can be seen as extremely valuable to the current clinical practice and others where the test adds not much additional benefit tot the current practice. This finding has its implications if one is to consider value-based pricing mechanisms as a pricing methodology for complementary diagnostics. In summary, this work took a closer look at the policies forming the market access of complementary diagnostics together with a specific focus on their clinical utility, how it is established, how it can be interpretated through probabilistic performance parameters, how its interpretation has implications for reimbursement policies and finally how contextual factors determining the clinical utility influence the value perception of these tests.

Several organisations have introduced a new leadership role, the Chief Digital Officer (CDO), as a centralised role in their top management team (TMT), tasked with accelerating and coordinating their digital transformation. While previous research proposes a complementary, tight alignment between the CDO and the Chief Information Officer (CIO), role redundancies and the fight for recognition and resources also suggest an inherent tension. We provide insights into the CIO-CDO collaboration quality based on role, TMT cooperation, conflict theory, and a dyadic design approach of 11 CIO-CDO relationships with 33 expert interviews in two waves. Our findings indicate that the CIO-CDO relationship may not always be as complementary as proposed in the literature; instead, in the vast majority of our dyads, there is too much role conflict to achieve tight alignment, leading to separation behaviour between the roles. We identify the involvement in the introduction of the other role, the CIO demand-side orientation, and the CDO supply-side orientation as important contingency factors determining the quality of the CIO-CDO relationship. Finally, unless the CIO-CDO relationship resembles a perfect match, a unified Chief Digital and Information Officer (CDIO) role may better resolve the challenges we identify in our sample’s dyads. Our insights extend the understanding of the CIO-CDO relationship.

In January 2021, the chief data and analytics officer (CDAO) at Allianz Benelux SA (Allianz) spotted a possible opportunity to optimize cash flow with direct debit. Direct debit was a pre-authorized financial transaction between two parties where the amount due was directly and automatically collected from the payer’s bank account. Direct debit would allow Allianz to shorten payment processes, reduce risks by anticipating payments, and improve customer loyalty. Despite the clear advantages of direct debit for both clients and insurers, only a few of Allianz’s clients were currently making use of direct debit. It was not clear what drove Allianz’s customers or brokers to implement direct debit. This was where the CDAO and his data office team came in. The data office possessed a large amount of data on Allianz’s property and casualty insurance contracts and customers. Now the team needed to investigate how this data could be leveraged to determine the value drivers and develop a strategy to convert more clients to direct debit payments.

In October 2019, the regional chief data and analytics officer at Allianz AG, Belgium, attended a two-hour strategy meeting with the Allianz Benelux chief executive officer, who had expressed concerns about the company’s digitalization strategy. A few days earlier, the marketing department had found that online sales channel results had fallen unexpectedly. The chief executive officer was worried that the company could lose market share if it did not react accordingly, which would damage the company’s competitive position in the market. Therefore, the regional chief data and analytics officer was asked to gather a team to investigate why online sales were low and to design an effective customer acquisition strategy. In addition to his data office staff, the regional chief data and analytics officer asked for the business transformation unit to provide assistance. He had to consider how best to approach this challenging task.

This paper reviews a set of ten existing metaheuristic solution procedures for the resource-constrained multi-project scheduling problem. Algorithmic implementations are constructed based on the description of the original procedures in literature. Equivalence is verified on the original test instances for the original objective and parameters through a comparison with the reported results. An extensive benchmark analysis is performed on a novel, publicly available dataset for a variety of optimisation criteria and due date settings for which the original algorithms have not been tested earlier. The impact of the different objectives, due dates and test instance parameters is analysed and an overall ranking of the metaheuristic solution methods for different situations is discussed. Key insights into the structure of competitive solutions for disparate objectives and due date settings are presented and effective algorithmic components are revealed.

Climate change is a major challenge facing society. Given its intricate links with business, governance scholars have shown an increasing interest in understanding how corporate governance (CG) actors can improve corporate environmental sustainability (CES). In this article, we review the literature focusing on CG and CES. We assess the importance of the motivations, expertise, and power of CG actors at different levels (individual, team, firm, and supra‐firm) for CES. Using this as a guiding framework, we build a multilevel synthesis highlighting the theoretical mechanisms around motivations, expertise, and power suggested in the literature. Based on this synthesis, we present critical reflections on the extant knowledge. Finally, we develop a future research agenda that calls for research at single levels, but also for integrative research examining how CG actors at multiple levels collectively shape CES.

In the context of intense global stakeholder pressures to improve female representation in the executive suite, we examine the speed of advancement and exit of first time executive directors around the world. We make two inter-related arguments. First, we argue that while normative pressures from global stakeholders have created a gender premium for women in the form of lower age at the time of appointment vis-à-vis male executive directors, appointed women are also penalized in the form of quicker exits from these positions because of their lower age. Second, we contend that this gender premium and penalty is contingent on the local gender norms in a society such that lower gender parity leads to a higher premium and penalty for these women. Results based on a sample of 15,202 first time executive directors from 6,452 firms in 33 countries largely support our theoretical predictions.

An extensive body of research in international business (IB) theoretically and empirically examines factors that determine international location decisions of multinational companies (MNCs). However, not much attention has been paid to the heterogeneity in these decisions across firms. In this paper, we ask: why do some firms make more novel location choices vis-à-vis others? We seek to answer this question by exploring the role of top management team's (TMT) task-related experiences and characteristics in shaping these strategic choices. Combining insights from upper echelons (UE) and faultlines models, we develop a framework to explore how TMT level task-related faultlines impact the novelty of international location decisions of MNCs. Moreover, we also examine how shared experiences and power dynamics across subgroups influence the relationship between faultline strength and novelty of locations. In doing so, we identify contextual conditions under which TMT level characteristics are especially important for novelty of location choices. Implications for UE, faultlines and location choice theories are discussed.

An extensive body of research in international business (IB) theoretically and empirically examines factors that determine international location decisions of multinational companies (MNCs). Most of this research, however, does not address the heterogeneity observed in the locations choices of MNCs. Specifically, why do some firms make more novel location choices vis-à-vis others? This conceptual paper seeks to answer this question by examining the role of top management team's (TMT) task-related experiences and characteristics in shaping these strategic decisions. Combining insights from upper echelons (UE) and faultlines theories, we develop a framework to explore how TMT level task-related faultlines impact the novelty of international location decisions of MNCs. Moreover, we also examine how power dynamics across subgroups arising from these faultlines influence the relationship between faultline strength and novelty of locations. In doing so, we identify contextual conditions under which TMT level characteristics are especially important for novelty of location choices. Implications for UE, faultlines and location choice theories are discussed.