Understanding public procurement within the health sector: a priority in a post-COVID-19 world

Abstract

Every year, over 250,000 public authorities in the European Union (EU) spend about 14% of GDP on the purchase of services, works and supplies. Many are in the health sector, a sector in which public authorities are the main buyers in many countries. When these purchases exceed threshold values, EU public procurement rules apply. Public procurement is increasingly being promoted as a tool for improving efficiency and contributing to better health outcomes, and as a policy lever for achieving other government goals, such as innovation, the development of small and medium-sized enterprises, sustainable green growth and social objectives like public health and greater inclusiveness. In this paper, we describe the challenges that arise within health care systems with public procurement and identify potential solutions to them. We examined the tendering of pharmaceuticals, health technology, and e-health. In each case we identify a series of challenges relating to the complexity of the procurement process, imbalances in power on either side of transactions and the role of procurement in promoting broader public policy objectives. Finally, we recommend several actions that could stimulate better procurement, and suggest a few areas where further EU cooperation can be pursued.

Health Care Professionals’ Experiences and Views of eHealth in Pediatric Care: Qualitative Interview Study Applying a Theoretical Framework for Implementation

“…Challenges related to procurement and delays in large IT projects within the regional health care organization appeared to create an atmosphere of uncertainty and, in some cases, cynicism among health care providers. Effective public procurement of eHealth requires specialized skills regarding, for example, interoperability and life-cycle costing [ 26 ].…”

Prioritizing Patient Safety: Analysis of the Procurement Process of Infusion Pumps in Spain

“…Currently, public procurement in Europe is an essential vehicle for implementing government policies and meeting national strategic objectives, as well-functioning pub-lic procurement markets contribute to improving the competitiveness of quality service strategies [32]. New strategies are needed to ensure that public procurement addresses existing social challenges such as environmental protection and sustainable consumption and production [33].…”

A concept for multi-winner tenders for medicinal products with balancing between efficient prices, long-term competition and sustainability of supply

“…The concept does not deal with the optimisation of the length of the sales period. Several factors may influence the optimal length of the sales period, like the number of pharmaceutical companies, characteristics of the therapy, transaction costs ( 35 ), etc.…”

“…This is rarely the case: there are differences in the excipients, the dosage forms, or even in the active substances. Though these differences may not result in different treatment outcomes for most of the patients, some patients may be intolerant (34) or allergic to certain excipients (e.g. lactose); the same dosage form may not be suitable for certain patients for the administration of the medicine (e.g., too large tablet for patients with difficulties in swallowing instead of an oral liquid form), some patients may have special clinical conditions which significantly influence the bioavailability or elimination of active substances (e.g., renal failure).…”