Volume Guarantees and the High-Price, Low-Volume Trap with Hema Srinivasan

Show notes

Hema Srinivasan, formerly the Chief Access Officer of MedAccess, a leader of CHAI’s market shaping work, and a former country director for a major pharma company, joins host Inder Singh to discuss how market shaping in global health has evolved to use more formal tools like volume guarantees. They discuss when and how volume guarantees should and should not be used, how they can help address the high-price, low-volume trap to dramatically lower prices and expand access to critical health products, and other use cases including ensuring supply security or incentivizing supply expansion. The Market Shapers Podcast is a production of Inder Singh and is produced by University FM. This interview was recorded in July 2026. Episode Quotes: Escaping the high-price, low-volume trap 09:48: It's core to the way any manufacturing organization runs its business. If you reduce uncertainty around how much you're going to produce, if you maximize the scale at which you're producing, you will save costs, and you can pass those on to the customer. And in the case of global health, that often becomes self-fulfilling. So, reducing that high-price, low-volume trap can become quite catalytic, where we would often see this issue where the price is really high, the volumes are low. We know if the price came down, the volumes would be quite a bit higher, and everyone would win. But the supplier doesn't see enough in the market to say, ‘Let me reduce the price and hope for the best.’ The credibility test every market shaper has to pass 35:19: You can't build a market-shaping success story just based on credibility with the public health community or credibility with the buy side of the market. You really need credibility with the suppliers and we tried to do a lot without that. That didn't work so well. How do you know a volume guarantee is the right tool? 10:33: If we see the enabling environment is there for uptake and there are just these few critical market-related barriers that we can solve for that unlock that equation, then, we can implement a volume guarantee, and it can have massive impact. But the trick is really spending the time to understand is the market-related barrier what's really holding back access, and not something like developing a whole new product that isn't available today or doing a ton of health worker training work for many, many years. I think those other barriers to access always exist, but if they are much more important than the price or the supply, a volume guarantee won't be successful. Show Links: Hema’s Bio | MedAccess Connect with Hema on LinkedIn Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.