Advanced therapies such as cell and gene therapy (CGT) and biologics are reshaping healthcare by offering transformative outcomes for complex diseases. Yet in low- and middle-income countries (LMICs), where healthcare systems face structural and economic constraints, the journey from therapy approval to widespread patient access remains challenging.
At SouthBridge Advisory, we recognize that success in LMICs depends on a pragmatic approach—one that combines affordable pricing, effective reimbursement, and patient-centric programs.
1. Designing Affordable and Sustainable Pricing Models
High therapy costs remain the single biggest barrier to access in LMICs. Unlike high-income countries with robust insurance systems, many LMICs depend on out-of-pocket expenditure. This makes one-size-fits-all pricing models impractical.
Effective strategies include:
- Tiered pricing models based on country income levels.
- Outcome-based payments where costs align with patient results.
- Value-based pricing frameworks adapted to local payer systems.
These approaches ensure affordability for patients while protecting long-term commercial viability.
2. Building Localized Reimbursement Strategies
Even in LMICs with partial public funding, reimbursement pathways are often underdeveloped. To expand coverage, companies must proactively engage with regulators, payers, and health ministries to co-create solutions.
Key elements include:
- Early health technology assessments (HTAs) to demonstrate cost-effectiveness.
- Pilot reimbursement programs to generate local real-world evidence.
- Partnerships with payers for shared-risk models that lower upfront costs.
When carefully designed, reimbursement frameworks can transform access, shifting therapies from elite to mainstream.
3. Expanding Access Through Patient Support Programs (PSPs)
Beyond pricing and reimbursement, patient-centric programs are critical in LMICs, where patients often struggle with affordability, awareness, and adherence.
Successful PSPs typically include:
- Financial assistance schemes to reduce treatment burden.
- Education initiatives for patients and caregivers.
- Adherence tracking and outcome monitoring to ensure long-term benefits.
These programs not only improve access but also enhance patient trust and therapy adoption.
4. Leveraging Partnerships and Hospital Networks
Access does not stop at pricing—it requires infrastructure readiness. Collaborating with hospital networks to build treatment capacity, train physicians, and establish distribution channels ensures therapies can be delivered effectively.
Partnerships with local healthcare providers, NGOs, and governments help bridge systemic gaps, making advanced therapies more widely available.
The Path Ahead
For biopharma companies, LMICs represent both a challenge and an opportunity. By adopting localized strategies for pricing, reimbursement, and patient engagement, companies can unlock access to millions of patients who would otherwise be left behind.
At SouthBridge Advisory, we bring 25+ years of commercialization experience in emerging markets—designing strategies that make therapies both accessible and commercially sustainable. From pricing frameworks to patient support ecosystems, our focus is on execution that delivers real-world impact.
Conclusion
Advanced therapies can only fulfill their promise if patients in LMICs can access them. The key lies in moving beyond traditional pricing models and embracing innovative, patient-centric strategies. By combining affordability, reimbursement, and support programs, we can turn breakthrough science into sustainable healthcare solutions for the world’s most underserved markets.
