中低收入国家公平获取新模式：从倡议到整合生态系统

How pharmaceutical leaders aresuccessfully embedding equitableaccess into strategy, structure,and scale across LMICs Contents Executive summary3 Chapter overview4 1.Rethinking “emerging markets” and the new mandatefor equitable access6 2.The execution gap14 3.Navigating complexities and exploring blueprints for success Outlook: Building future-ready equitable access platforms36 Authors40 Executive summary For years, access efforts in low- and middle-income countries (LMICs) focused largelyon infectious diseases like HIV, tuberculosis, and malaria, supported by donor funding,one-off programs, or fragmented public-private partnerships. These models broughtprogress, but they were not built for sustainability nor scale. As non-communicablediseases (NCDs) have become more prevalent, this has prompted a shift toward moreintegrated, long-term access models. With over 80% of the world’s population residing in LMICs, it is no longer surprising thatthese geographies are rising to the top of corporate agendas. Their scale alone makesthem central to the future of global healthcare access and innovation. LMICs are beginning to occupy a more central place in pharmaexecutives’ discussions, not just as growth markets, but asstrategic priorities. As healthcare systems in these regionsevolve, pharma and biotech companies companies are rethinkinghow they define relevance, access, and long-term impact. With rising populations, increased life expectancy, expanded health investment, andincreasing disease burden, these markets are essential for the pharmaceutical industry’slong-term growth. For many companies, access in LMICs is no longer just a moralimperative, but a strategic necessity to diversify future revenue streams and align withrising expectations on social responsibility. Those investing now, operationally, financially,and culturally, are positioning themselves for resilience, growth, and leadership in thenext era of healthcare. Rather than offering a retrospective, this industry study highlights how the accesslandscape is shifting and what forward-looking companies are doing now to lead thatchange. It explores how leaders are moving beyond short-term access programs orone-off pricing strategies, and instead building lasting approaches through stronggovernance, long-term planning, and well-aligned incentives. This study draws oninterviews with 25 leaders across pharmaceutical companies, including both commercialand access functions who have been working on driving the access agenda globally andin LMICs, as well as global health organizations and advocacy bodies. It captures howthose closest to the work are redefining access to care. Chapter overview CHAPTER 1 Rethinking “emerging markets” and the newmandate for equitable access Our first chapter frames LMICs as complex, diverse markets requiring more thangeneric access models. While some companies continue using terms like “LMICs” inline with World Bank classification, others are rethinking how they define “emergingmarkets,” using broader frameworks that account for inequality, system maturity,and policy environment, even in higher-income settings. Emerging market accessconsiderations are now appearing in portfolio governance, pipeline planning, andeven board-level strategy. We discuss how the most forward-looking organizations are investingearly by identifying access modalities that can support positive marginsover time. While these are not traditionally high-return markets, somecompanies have begun to unlock commercially viable approaches forthe future. This shift is further driven by external forces, with investorsand global benchmarks increasingly calling on companies to showmeaningful, measurable commitments to access in these markets. CHAPTER 2 The execution gap This next chapter examines the internal and external frictions that hinder progress.From regulatory complexity to misaligned KPIs, companies face real barriers, but thosemaking progress are building partnerships, aligning incentives early, and treating riskmitigation as a long-term investment. The difference lies in how companies learn, adapt, and stay committedover time. Those that integrate access into decision-making andperformance structures are beginning to close the gap betweenstrategy and scale. Several of these markets are reaching levels ofmaturity comparable to where some high-income countries were justa few years ago. Companies that invest now will be better positionedto lead as demand rises and systems evolve. CHAPTER 3 Navigating complexities and exploringblueprints for success Our final chapter highlights six strategic levers shaping access models that are scalable,sustainable, and compatible with LMIC healthcare systems. These include more holisticsolutions encompassing key learnings also for vulnerable populations in high-incomecountries. We describe how, together, they offer a blueprint for what effectiveaccess looks like when it evolves from one-off pilots to lo