How to address affordability in low and middle-income countries through tiered pricing and access innovation

As pharmaceutical innovation continues to accelerate, millions in low- and middle-income countries (LMICs) still lack access to essential therapies due to cost barriers. For Ifeloluwa Adefolaju, a pharmacist and access strategist, the solution lies not in charity but in rethinking commercial models. This includes tiered pricing and access innovation tailored to local realities.

“Affordability is only one part of the equation,” Adefolaju said. “For any access strategy to work in LMICs, especially in countries like Nigeria, it must be backed by infrastructure, strategic partnerships, and trust.”

Tiered pricing allows pharmaceutical companies to offer differentiated prices across markets or population segments based on economic capacity. However, Adefolaju is quick to note that without complementary systems such as regulatory coordination, anti-diversion mechanisms, and structured distribution, such pricing can remain theoretical.

Nigeria: A Case in Point

Adefolaju highlights Nigeria as a prime example of both challenge and potential. Although it is Africa’s largest economy, a significant portion of health spending is out-of-pocket. This financial structure, he explained, forces companies to reimagine how to make products affordable while maintaining commercial viability.

One project Adefolaju led introduced key account partnerships with major pharmacy chains, created decentralised hubs for patient access, and deployed flexible purchasing options. At the same time, training and engagement with healthcare professionals helped build awareness and trust, particularly for high-impact, underutilised therapies. The result was expanded access, increased inventory turnover, and improved outcomes.

Global Parallels, Local Adaptation

While access innovations such as subscription models in Southeast Asia and value-based agreements in Latin America are gaining momentum, Adefolaju stresses the importance of context-specific models. He noted that a framework that works in Peru will not automatically translate to Port Harcourt. Local insights, data, and segmentation are essential.

By using digital tools, CRM systems, and community feedback, companies can tailor their pricing and distribution strategies to accommodate differences in geography, income, and insurance coverage.

No Solo Solutions

Adefolaju also emphasises that no single player can bridge the affordability gap alone. Collaboration, he said, is non-negotiable. Government agencies, NGOs, local distributors, and digital health innovators must work together to build ecosystems that support sustainable access.

Strategic and Moral Value

Ultimately, Adefolaju frames access innovation not just as a moral imperative but as a competitive advantage. He believes the companies that will succeed in the next decade are those that embed equity into their commercial strategies. This, he said, is not just about doing good. It is about doing smart business in the world’s fastest-growing markets.

For a sector grappling with how to expand reach without compromising value, Adefolaju offers a roadmap that sees equity not as a trade-off but as a foundation for shared prosperity.

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