To the Editor: Most US and European-based drug manufacturers producing biosimilar products use manufacturing processes that are decades old. Although there is no commercial incentive for Western manufacturers to innovate downstream, the situation is very different in emerging economies. Here, we highlight two Indian companies, Biocon and Enzene Biosciences (of Alkem Laboratories), that have increased their competitiveness in local markets by investing in process innovation in manufacturing, enabling cost reduction without compromising safety and reliability. product quality. We propose that their approach could be adopted on a larger scale by other companies in emerging economies, especially where there are multiple market participants seeking competitive advantage. Furthermore, as emerging economies continue to grow, we believe that investment in process-side innovation can provide companies in emerging economies with a competitive advantage over their larger counterparts in developed economies.