Developed market multinational enterprises (DMNEs) and emerging market multinational enterprises (EMNEs) can serve developed and emerging markets via a strategic alliance, encouraging reverse innovation. The objective of this study is to identify an alliance strategy and alliance dynamics that encourage innovation of low-cost medical devices which have the potential to become reverse innovations. The main research question is therefore as follows: ‘What kind of collaboration framework can ensure collaboration between a DMNE and an EMNE in the context of reverse innovation of medical devices?’ The study found that a joint venture is an appropriate type of alliance strategy and that the alliance dynamics that can be used by managers to stimulate collaboration are: strategic positioning, value alignment, balanced loyalty and bilateral learning. Symmetry is considered as a context dependent alliance dynamic as it is considered important in the scientific literature but was less important in the two analyzed cases. A key means of continuously aligning the values and strategic positioning of the enterprises is the relationships at the senior level of the enterprises and the joint venture. A key means of balancing the loyalty to the joint venture and to the parent companies is to hire people from the enterprise whose organizational culture is in minority in the joint venture or hire people with no history at one of the enterprises.