Strategic Access Models for Multinational Pharmaceutical Companies to Expand Access to Innovative Medicine in Emerging Markets: An Equity-Based Approach

Multinational pharmaceutical companies in emerging markets often face strategic failures due to rigid global governance and pricing models that force them into either premium pricing or cost leadership, with no viable middle-ground strategy. These challenges are worsened by delayed product launches and over-reliance on government tenders for patient access. In Indonesia, JKN policies prioritizing cost containment over clinical innovation further intensify these difficulties. This research aims to analyze the strategic challenges faced by pharmaceutical MNCs in emerging markets, formulate adaptable business-level strategies, and assess the feasibility of innovative financing solutions, particularly equity-based pricing, to promote equitable access to medicines. Using a qualitative exploratory design guided by Design Thinking, the research employed strategic management frameworks including Porter's Five Forces, Resource-Based View (RBV), and Strategic Entrepreneurship. Data were collected through semi-structured interviews with industry stakeholders and triangulated with secondary sources. Thematic analysis was conducted using NVivo software. Strategic ideation explored innovative access models such as equity-based pricing. Prototypes were evaluated through scenario modeling and stakeholder feedback, demonstrating strong feasibility as a scalable solution. Findings emphasize that success in emerging markets requires MNCs to abandon strategic arrogance and rigid global playbooks in favor of localized, collaborative, and adaptable strategies.