Driven by changing demographics and increasing medical costs, both mature and emerging markets are adopting novel strategies to manage their domestic healthcare systems. A range of methods are being adopted across the globe in an effort to optimize healthcare and manage the increasing costs associated with aging populations (in the mature markets) and with growing expectations (in emerging markets). Examples include market-entry agreements, risk-sharing, and value-based pricing in many European markets, government-driven efforts to encourage knowledge transfer that will allow the creation of a biologics manufacturing industry in Latin America, and relaxing requirements for local clinical trials in Asia without risking patient safety. Separately, decisions that occur outside of government can still influence the national experience with healthcare such as in the United States, where consolidation of PBMs and their willingness to exert their power have led to increasing power to negotiate on price in a market largely untouched by the type of cost pressures experienced in other developed markets. For any healthcare system seeking to improve, examples such as these (and others) provide opportunities to leverage prior experience and avoid prior mistakes.