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How Procurement Judges The Value of Medical Technologies: A Review of Healthcare Tenders

Published online by Cambridge University Press:  08 February 2019

Fiona A. Miller*
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
Pascale Lehoux
Affiliation:
Department of Health Management, Evaluation and Policy, University of Montreal, Institute of Public Health Research of University of Montreal (IRSPUM)
Stuart Peacock
Affiliation:
Canadian Centre for Applied Research in Cancer Control (ARCC) and Faculty of Health Sciences, Simon Fraser University
Valeria E. Rac
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto Ted Rogers Centre for Heart Research, Peter Munk Cardiac Centre
Jeff Neukomm
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
Carolyn Barg
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
Jessica P. Bytautas
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto
Murray Krahn
Affiliation:
Institute of Health Policy, Management and Evaluation, University of Toronto Toronto Health Economics and Technology Assessment Collaborative (THETA)
*
Author for correspondence: Fiona A. Miller, E-mail: fiona.miller@utoronto.ca

Abstract

Objectives

Procurement's important role in healthcare decision making has encouraged criticism and calls for greater collaboration with health technology assessment (HTA), and necessitates detailed analysis of how procurement approaches the decision task.

Methods

We reviewed tender documents that solicit medical technologies for patient care in Canada, focusing on request for proposal (RFP) tenders that assess quality and cost, supplemented by a census of all tender types. We extracted data to assess (i) use of group purchasing organizations (GPOs) as buyers, (ii) evaluation criteria and rubrics, and (iii) contract terms, as indicators of supplier type and market conditions.

Results

GPOs were dominant buyers for RFPs (54/97) and all tender types (120/226), and RFPs were the most common tender (92/226), with few price-only tenders (11/226). Evaluation criteria for quality were technical, including clinical or material specifications, as well as vendor experience and qualifications; “total cost” was frequently referenced (83/97), but inconsistently used. The most common (47/97) evaluative rubric was summed scores, or summed scores after excluding those below a mandatory minimum (22/97), with majority weight (64.1 percent, 62.9 percent) assigned to quality criteria. Where specified, expected contract lengths with successful suppliers were high (mean, 3.93 years; average renewal, 2.14 years), and most buyers (37/42) expected to award to a single supplier.

Conclusions

Procurement's evaluative approach is distinctive. While aiming to go beyond price in the acquisition of most medical technologies, it adopts a narrow approach to assessing quality and costs, but also attends to factors little considered by HTA, suggesting opportunities for mutual lesson learning.

Type
Policy
Copyright
Copyright © Cambridge University Press 2019 

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References

1.Graves, K (2011) Global best practices in medical device procurement--A road map to system success. J Med Market 11, 101108.Google Scholar
2.Montgomery, K (2007) Schneller E. Hospitals' strategies for orchestrating selection of physician preference items. Millbank Q 85, 307335.Google Scholar
3.Arshoff, L, Henshall, C, Juzwishin, D, et al. (2012) Procurement change in Canada: An opportunity for improving system performance. Healthc Manage Forum 25, 6669.Google Scholar
4.Kastanioti, C, Kontodimopoulos, N, Stasinopoulos, D, et al. (2013) Public procurement of health technologies in Greece in an era of economic crisis. Health Policy 109, 713.Google Scholar
5.Meehan, J, Menzies, L, Michaelides, R (2017) The long shadow of public policy: Barriers to a value-based approach in healthcare procurement. J Purch Supply Manage. 23, 229241.Google Scholar
6.Callea, G, Armeni, P, Marsilio, M, et al. (2017) The impact of HTA and procurement practices on the selection and prices of medical devices. Soc Sci Med 174, 8995.Google Scholar
7.Sorenson, C, Kanavos, P (2011) Medical technology procurement in Europe: A cross-country comparison of current practice and policy. Health Policy 100, 4350.Google Scholar
8.Robinson, J (2008) Value-based purchasing for medical devices. Health Affairs (Millwood) 27, 15231531.Google Scholar
9.Poder, TG (2017) Using the health technology assessment toolbox to facilitate procurement: The case of smart pumps in a Canadian hospital. Int J Technol Assess Health Care 33, 5462.Google Scholar
10.Trippoli, S, Caccese, E, Marinai, C, et al. (2018) Value-based procurement of medical devices: Application to devices for mechanical thrombectomy in ischemic stroke. Clin Neurol Neurosurg 166, 6165.10.1016/j.clineuro.2018.01.028Google Scholar
11.Arrowsmith, S, Linarelli, J, Wallace, D (2000) Regulation public procurement--National and international perspectives. Kluwer Law International.Google Scholar
12.Lian, P, Laing, A (2004) Public sector purchasing of health services: A comparison with private sector purchasing. J Purch Supply Manage 10, 247256.Google Scholar
13.Healthcare Supply Chain Network (2012) RFP Health Goods. Common Tendering and Contracting Templates.Google Scholar
14.Nollet, J, Beaulieu, M (2003) The development of group purchasing: An empirical study in the healthcare sector. J Purch Supply Manage 9, 310.Google Scholar
15.Leather, R, Gardner, M, Green, M, et al. (2013) Charting a course for cardiac electrophysiology training in Canada: The vital role of fellows in advanced cardiovascular care. Can j Cardiol. 29, 15271530.Google Scholar
16.Karjalainen, K, Kemppainen, K (2008) The involvement of small- and medium-sized enterprises in public procurement: Impact of resource perceptions, electronic systems and enterprise size. J Purch Supply Manage. 14, 230240.Google Scholar
17.Garfield, S, Zack, L (2015) User experience a novel, but critical element in payer and purchaser value analysis of medical Technologies. Value Health 18, A48.Google Scholar
18.Lingg, M, Merida-Herrera, E, Wyss, K, et al. (2017) Attitudes of orthopedic specialists toward effects of medical device purchasing. Int J Technol Assess Health Care 33, 4653.Google Scholar
19.Bröchner, J, Camén, C, Eriksson, H, et al. (2016) Quality and legal aspects in public care procurement. TQM J. 28, 648663.Google Scholar
20.Thokala, P, Devlin, N, Marsh, K, et al. (2016) Multiple criteria decision analysis for healthcare decision making--an introduction: Report 1 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 19, 13.Google Scholar
21.Marsh, K, Ijzerman, M, Thokala, P, et al. (2016) Multiple criteria decision analysis for healthcare decision making--emerging good practices: Report 2 of the ISPOR MCDA Emerging Good Practices Task Force. Value Health. 19, 125137.Google Scholar
22.Lehoux, P, Williams-Jones, B (2007) Mapping the integration of social and ethical issues in health technology assessment. Int J Technol Assess Health Care 23, 916.Google Scholar
23.Marsh, K, Ganz, M, Hsu, J, et al. (2016) Expanding health technology assessments to include effects on the environment. Value Health 19, 249254.Google Scholar
24.Bryan, S, Mitton, C, Donaldson, C (2014) Breaking the addiction to technology adoption. Health Econ 23, 379383.Google Scholar