BACKGROUND: Research has signaled the need for reformed biosimilar policy frameworks that adopt a behavioral approach, are informed by consensus-generating strategies and thus better align with the requirements of local healthcare communities. RESEARCH DESIGN AND METHODS: Through a series of co-creation workshops, the current study explores the feasibility of applying learnings from Collective Action Theory to formulate evidence-based multistakeholder-supported policy recommendations. RESULTS: Insights from the conducted workshops indicate that future policy frameworks would benefit from: 1) a working system of incentives and rewards aligned with stakeholder needs
2) evaluating the cost-benefit balance for stakeholders prior to policy implementation
3) involving multistakeholder panels in policy co-design
4) adopting a long-term vision
5) fostering coordination at the interface between levels of governance
6) defining shared goals and efficient systems to monitor policy compliance
and 7) using policy outcome data to adapt current policy frameworks based on evolving needs. The incorporation of these elements to policies is expected to help prioritize long-term sustainable solutions, and balance short-term gains and long-term objectives in biosimilar markets. CONCLUSIONS: This study constitutes a first approach to developing multistakeholder-supported principles for sustainable biosimilar markets. This is a necessary step toward generating stakeholders' consensus on biosimilar policies.