CONTENTS

5 EXECUTIVE SUMMARY
5 Partnerships with payers facilitate access in emerging markets
5 Partnerships with payers take many forms, depending on funding source
5 Customization is key for successful partnerships in self-pay markets
6 Even in reimbursed emerging markets, paying for outcomes is rare
6 The most successful partnerships are driven at the local level

7 THE PHARMA-PAYER PARTNERSHIPS LANDSCAPE
7 Payer partnerships are unlocking emerging-market opportunities
7 The market structure shapes the partnership
11 Bibliography

12 PARTNERSHIPS IN SELF-PAY EMERGING MARKETS
12 Self-pay markets: summary of partnership options
15 Donation partnerships
20 Tiered pricing
25 Continuous treatment programs
33 Complementary health insurance
35 Bibliography

41 PARTNERSHIPS IN REIMBURSED EMERGING MARKETS
41 Service support can boost access in reimbursed markets
42 Real-world evidence is gaining traction in emerging markets
45 Risk sharing in reimbursed emerging markets
52 Technology transfer in emerging markets
61 Bibliography

65 CRITICAL SUCCESS FACTORS FOR PARTNERSHIPS IN EMERGING MARKETS
65 Aligning partnerships with local goals and capabilities is key
67 Assessing risk-reward in partnering options

70 APPENDIX
70 About the author
70 Methodology

LIST OF FIGURES
8 Figure 1: Payer partnership options in emerging markets
16 Figure 2: Donation/tiered pricing archetype
19 Figure 3: Novartis access differentiated strategy
26 Figure 4: Continuous treatment program archetype
30 Figure 5: Discount card archetype (variant of CTP model)
34 Figure 6: Complementary insurance partnership archetype
45 Figure 7: Stakeholder map of Turkey
46 Figure 8: Outcomes-based risk sharing archetype
47 Figure 9: Stakeholder map of Mexico
54 Figure 10: Technology transfer archetype (Brazilian Partnerships for Productive Development model)
68 Figure 11: Requirements for emerging-market payer partnerships

LIST OF TABLES
13 Table 1: Risk-benefit matrix: partnerships in self-pay markets
18 Table 2: Case study 1: The Max Foundation
23 Table 3: Case study 2: Novartis Philippines and Roche Egypt
28 Table 4: Case study 3: Sanofi’s emerging-market partnerships
32 Table 5: Case study 4: PAPs in Argentina
35 Table 6: Case study 5: Complementary insurance programs in China
42 Table 7: Case study 6: Payer support programs in Latin America
49 Table 8: Case study 7: Risk sharing in three Latin American markets
55 Table 9: Case study 8: Technology transfer programs in Brazil
66 Table 10: Options for payer partnerships by market archetype