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Background: Fraud in pharmaceutical tenders is a severe form of corruption that poses a significant threat to public health, patients, and the community. Due to the substantial financial volume in the pharmaceutical sector, vulnerable points in decision-making for market entry and purchase are at risk. As a result, the objective of this study was to measure the level of transparency and risk of corruption in pharmaceuticals' procurement practices in South Wollo, North-East Ethiopia. Methodology: From October 1 to December 15, 2023, a multi-facility, cross-sectional study was conducted. The participants were pharmaceutical procurement committee (PPC) members. The World Health Organization's (WHO's) standardised interviewer-administered questionnaire was used to collect the data. The collected data was entered, cleaned, processed, and analyzed using Statistical Package for Social Sciences (SPSS) version 27. Both descriptive and inferential statistics (univariate and linear regression analyses) were computed. The relationship between the independent (health facility level) and dependent (level of transparency) variables was determined using beta with a p-value of less than 0.05 and a 95% CI. Results: One hundred eighty-seven respondents, from 47 health centres (low, medium, and high volume) and 14 hospitals (primary, secondary, and tertiary), participated. The aggregate result showed that pharmaceutical procurement practice was very vulnerable to corruption, with a transparency level of only 33.0% (3.3 out of 10). The univariate analysis demonstrated a significant disparity in the mean transparency scores between health centres and hospitals. The linear regression also showed that for every one standard deviation increase in the facility level, there was an associated 0.39 increase in the transparency level of pharmaceutical procurement (β = 0.39, 95% CI: 0.02-0.04). Conclusion: The pharmaceutical procurement practice at the health facilities was generally found to be very vulnerable to corruption, which slightly increased with a decrease in facility levels and vice versa. [ABSTRACT FROM AUTHOR]

IntroductionThe urgent need to acquire medical supplies amidst the COVID-19 pandemic has led to bypassing of controls that govern the global pharmaceutical supply chain, increasing the risk of corruption. Hence, promoting anti-corruption, transparency, and accountability (ACTA) in supply chain and procurement has never been more important. The adoption of digital tools, if designed and implemented appropriately, can reduce the risks of corruption.Areas coveredFollowing PRISMA guidelines, we conducted an interdisciplinary systematic review of health/medicine, humanities/social sciences, engineering, and computer science literature, with the aims of identifying technologies used for pharmaceutical supply chain and procurement optimization and reviewing whether they address ACTA mechanisms to strengthen pharmaceutical governance. Our review identified four distinct categories of digital solutions: e-procurement and open contracting; track-and-trace technology; anti-counterfeiting technology; and blockchain technology.Expert opinionFindings demonstrate an increase in research of technologies to improve pharmaceutical supply chain and procurement functions; however, most technologies are not being leveraged to directly address ACTA or global health outcomes. Some blockchain and RFID technologies incorporated ACTA mechanisms and mentioned specific policy/governance frameworks, but more purposeful linkage is needed. Findings point to the need for targeted policy development and governance to activate these innovative technologies to improve global health .

A centralized electronic bidding (e-bidding) system has recently become a key government strategy in developing mechanisms for public drug purchasing systems in Thailand. From the previous literature, e-bidding can be an effective tool for controlling the purchase price of a product in various industries. However, this system is still uncommon in pharmaceutical procurement. Thus, this study aims to determine the impact of the e-bidding system on the pricing of generic medicines. Drug procurement data from Thailand for all generic products of omeprazole injection from 2018 to 2019 were used to analyze drug price changes before and after the adoption of the e-bidding system. The results showed that the effect of the e-bidding system was consistent with a 17.35% drop in the mean prices. In addition, the distribution of purchase prices was greatly reduced compared to the traditional system.

This study explores the challenges and benefits of adopting electronic procurement (e-procurement) technologies to facilitate anti-corruption mechanisms, accountability and transparency in the procurement of pharmaceuticals at the National Pharmaceutical (NatPharm) Company in Zimbabwe. Pharmaceutical corruption is a serious threat to the attainment of Universal Health Coverage. It is imperative for the Government of Zimbabwe to adopt Information Communication Technologies (ICTs) to detect and prevent corruption and fraud, thereby, addressing leakages, mismanagement and theft of medicines, thereby, improving population health outcomes. The study used a qualitative exploratory case study approach and data was gathered through documentary review. The study findings reveal that, pharmaceutical procurement is highly vulnerable to corruption at NatPharm. Bid rigging, procurement-related corruption, bribery and nepotism characterise pharmaceutical procurement at NatPharm. The study recommends the adoption of a transparent e-procurement system with open contracting and integrity pacts to reduce corruption, increase transparency and accountability at NatPharm.

Background: In line with global trends, cancer incidence and mortality may have decreased for specific types of cancer in Qatar. However, the cancer-related burden on patients, healthcare systems, and the economy is expected to expand; thus, cancer remains a significant public healthcare issue in Qatar. Qatar's free access to cancer care represents a considerable economic burden. Ensuring the best utilization of financial resources in the healthcare sector is important to provide unified and fair access to cancer care for all patients. Experts from the Qatar Oncology Health Economics Expert Panel (Q-OHEP) aimed to establish a consistent and robust base for evaluating oncology/hematology medications; involve patients' insights to accelerate access to cutting-edge medications; increase the value of cancer care; and reach a consensus for using cost-effective strategies and efficient methodologies in cancer treatment. Methods: The Q-OHEP convened on 30 November 2021 for a 3-hour meeting to discuss cancer management, therapeutics, and health economics in Qatar, focusing on four domains: (1) regulatory, (2) procurement, (3) treatment, and (4) patients. Discussions, guided by a moderator, focused on a list of suggested open-ended questions. Results: Some of the salient recommendations included the development of a formal, fast-track, preliminary approval pathway for drugs needed by patients with severe disease or in critical condition; and encouraging and promoting the conduct of local clinical trials and real-world observational studies using existing registry data. The Q-OHEP also recommended implementing a forecast system using treatment center data based on the supply/demand of formulary oncology drugs to detect treatment patterns, estimate needs, expedite procurement, and prevent shortages/delays. Furthermore, the panel discussed the needs to define value concerning cancer treatment in Qatar, implement value-based models for reimbursement decision-making such as health technology assessment and multiple-criteria decision analysis, and promote patient education and involvement/feedback in developing and implementing cancer management guidelines. Conclusion: Herein, we summarize the first Q-OHEP consensus recommendations, which aim to provide a solid basis for evaluating, registering, and approving new cancer medications to accelerate patient access to novel cancer treatments in Qatar; promote/facilitate the adoption and collection of patient-reported outcomes; and implement value-based cancer care in Qatar. [ABSTRACT FROM AUTHOR]

This study explores the challenges and benefits of adopting electronic procurement (eprocurement) technologies to facilitate anti-corruption mechanisms, accountability and transparency in the procurement of pharmaceuticals at the National Pharmaceutical (NatPharm) Company in Zimbabwe. Pharmaceutical corruption is a serious threat to the attainment of Universal Health Coverage. It is imperative for the Government of Zimbabwe to adopt Information Communication Technologies (ICTs) to detect and prevent corruption and fraud, thereby, addressing leakages, mismanagement and theft of medicines, thereby, improving population health outcomes. The study used a qualitative exploratory case study approach and data was gathered through documentary review. The study findings reveal that, pharmaceutical procurement is highly vulnerable to corruption at NatPharm. Bid rigging, procurement-related corruption, bribery and nepotism characterise pharmaceutical procurement at NatPharm. The study recommends the adoption of a transparent e-procurement system with open contracting and integrity pacts to reduce corruption, increase transparency and accountability at NatPharm. [ABSTRACT FROM AUTHOR]

Background: In Tanzania, the Medical Stores Department is the principal pharmaceutical provider to public health facilities throughout the country. However, growing demand from health facilities has proved difficult to satisfy and stock-outs at health facilities are frequent. The aim of the current study was to conduct a situation analysis of the procedures and practices of procuring medicines and medical supplies from private suppliers in the Dar es Salaam region when those commodities are unavailable at the Medical Stores Department. Methods: A mixed-method approach including qualitative and quantitative methods was applied to understand procurement procedures and practices and private suppliers' performance at district level. Qualitative interviews with suppliers and district authorities, and a review of inventory documents at store level was conducted between February and March 2018. The quantitative approach included a review and analyses of relevant procurement documents from the 2016/2017 financial year to explore the funds used to procure health commodities from the private sector. The ten most frequently mandated private suppliers were assessed in more detail focusing on cost, quality and availability of medicines and lead times and delivery. Results: A lack of consistency and written guidelines for procuring medicines and medical supplies from the private sector was observed. The procurement process was bureaucratic and lengthy requiring multiple steps between health facilities, suppliers and district authorities. A significant number of people were involved requiring a minimum of 13 signatures and 16 steps from order preparation to approval. Only 17 of 77 prequalified private suppliers received orders from public health facilities. The criteria for choosing which supplier to use were unclear. Completed orders amounted to USD 663,491. The bureaucratic process drove councils and healthcare facilities towards alternative ways to procure health commodities when Medical Stores Department stock-outs occurred. Conclusion: The procurement procedure outside the Medical Stores Department is inefficient and cumbersome, often circumventing government regulations. General lack of accountability renders the process susceptible to leakage of funds and medicines. Increasing the transparency and efficiency of procurement procedures from the private sector with a prime vendor system would help to better manage Medical Stores Department stock-outs and help improve health care services overall. [ABSTRACT FROM AUTHOR]

An electronic bidding system promises to save resources in procurement procedures for many industries. While the results of previous studies in several countries sounded promising, it is concerning that more evidence would be needed to support changes in practice for the pharmaceutical sector. The objective of this study was to determine the prevalence of price saving in bidding-based electronic procurement setting and to clarify the main factors contributing to drug price changes. A comprehensive literature search was retrieved from five databases (Scopus, PubMed, ProQuest, Web of Science, Medline) to identify articles that studied the prices of medicines as a case study before and after the implementation of the electronic bidding system. Articles that were published in English from January 2012 to December 2021 were eligible for inclusion. The result showed that a total of 3214 records articles were identified in the electronic databases after the exclusion of duplicate articles. After the initial review, we found 13 studies that fulfilled our inclusion criteria. The review presented the important information suggesting that the use of the electronic bidding system likely results in a reduction in procurement prices of medicines. The prevalence of price saving for pharmaceutical procurement ranged from 7.24 % to 40 %. Additionally, the following factors were indirectly associated with drug price changes; bid volume, procurement location, contract characteristics, level of competitiveness and procurement organization. Further research may need to examine the functioning of e-bidding policies to address problems like supply disruptions to preserve the integrity of bidding-based pharmaceutical systems. [ABSTRACT FROM AUTHOR]

Purpose – This paper aims to explore effective supply chain principles, through the theory of transaction cost economics, as measures to improve current contingency pharmaceutical item shortfalls in the Air Force Medical Service (AFMS) Contingency Pharmaceutical Programme. Design/methodology/approach – In this research, AFMS contingency pharmaceutical data was collected from various databases, including the Joint Medical Asset Repository, Medical Contingency Requirements Workflow and the Medical Requirements List. Through the methodology of cost-benefit analysis, alternative sourcing and fulfilment practices are evaluated. Findings – The findings of this research indicate that the application of centralized purchasing principles, in an effort to leverage prime vendor contract fill rates for shortage items, can lead to 12%–17% increases in pharmaceutical material availability across the programme. Originality/value – This research clearly shows that consolidating demand for shortage items across Active Duty War Reserve Material assemblages, though applications of centralized purchasing principles that leverage prime vendor contract fill rates, can lead to substantial increases in material availability at costs that justify the calculated benefits.

Internal barriers in the procurement process and pharmaceutical supply planning are barriers that can be controlled through interventions. The research focuses on proposing changes to the pharmaceutical supply management system, particularly in the aspects of planning and procurement within the internal team of the RSPG Cisarua Bogor. The intervention in this research applying lean six sigma extends only up to the “improve” phase. Data collection involves in-depth interviews with informants involved in the pharmaceutical supply planning and procurement process, as well as observation and document analysis. The research ends in group discussions to reach an agreement. The research findings reveal that a lack of established procedures in the pharmaceutical supply procurement process contributes to prolonged procedures and the absence of efficiency benchmarks within the system. Moreover, an unavailability of tools to facilitate the pharmaceutical supply procurement process causes low internal team communication. The “improve” phase of lean six sigma leads to proposed changes to the standards of operational procedures for routine pharmaceutical procurement, indicator applications of procurement efficiency and the utilization of the ABC VEN functioning as a tool within the pharmaceutical supply procurement process. The proposed improvement to tackle the matter includes the utilization of ABC VEN and efficiency indicators to overcome waste overproduction identified during the pharmaceutical supply planning process. In addition, it also involves the establishment of a new standard of operating procedure covering timelines, tools for pharmaceutical supply categorization based on ABC VEN and procurement efficiency indicator to handle waste waiting during the pharmaceutical supply procurement process.

• This paper studies bidder behavior in auctions with an uncertain quality threshold. • A high-quality index results in a higher bid. • High-quality bidders are more likely to withdraw from an auction. • Bidding strategies in auctions with an uncertain quality threshold are inefficient. Procuring high-quality goods at reasonable prices is a critical public sector concern. Yet, procurers often do not advertise clear weighting rules for price and quality but set a flexible quality threshold upon participation. This paper studies endogenous entry and bidding behavior in such procurement auctions. Using unique data on pharmaceutical procurement in Guangdong, China, we find that a high-quality index acts as a signal of high production costs. We also observe that high-quality bidders are more likely to withdraw from bidding because of their prior commitment to quality. The procurers who use quality indicators in price auctions need a carefully considered quality threshold. Our results have important implications for price-quality trade-offs in procurements that have uncertain quality thresholds. [ABSTRACT FROM AUTHOR]

Background The availability of medicines in public health facilities in Tanzania is problematic. Medicines shortages are often caused by unavailability at Medical Stores Department, the national supplier for public health facilities. During such stock-outs, districts may purchase from private suppliers. However, this procedure is intransparent, bureaucratic and uneconomic. Objectives To complement the national supply chain in case of stock-outs with a simplified, transparent and efficient procurement procedure based on a public-private partnership approach with a prime vendor at the regional level. To develop a successful pilot of a Prime Vendor system with the potential for national scale-up. Methods A public-private partnership was established engaging one private sector pharmaceutical supplier as the Prime Vendor to provide the complementary medicines needed by public health facilities in Tanzania. The Dodoma pilot region endorsed the concept involving the private sector, and procedures to procure complementary supplies from a single vendor in a pooled regional contract were developed. A supplier was tendered and contracted based on Good Procurement Practice. Pilot implementation was guided by Standard Operating Procedures, and closely monitored with performance indicators. A 12-step approach for national implementation was applied including cascade training from national to facility level. Each selected vendor signed a contract with the respective regional authority. Results In the pilot region, tracer medicines availability increased from 69% in 2014 to 94% in 2018. Prime vendor supplies are of assured quality and average prices are comparable to prices of Medical Stores Department. Procurement procedures are simplified, shortened, standardized, transparent and well-governed. Procurement capacity was enhanced at all levels of the health system. Proven successful, the Prime Vendor system pilot was rolled-out nationally, on government request, to all 26 regions of mainland Tanzania, covering 185 councils and 5381 health facilities. Conclusion The Prime Vendor system complements regular government supply through a regional contract approach. It is anchored in the structures of the regional health administration and in the decentralisation policy of the country. This partnership with the private sector facilitates procurement of additional supplies within a culture of transparency and accountability. Regional leadership, convincing pilot results and policy dialogue have led to national roll-out. Transferring this smaller-scale supply chain intervention to other regions requires country ownership and support for sustainable operations.

Procurement of raw materials, key intermediates and excipients for the preparation of finished pharmaceutical preparation is considered to be complex process which involve multiple channels and require skilled personnel and proper validation. This review attempts, in relatively brief compass to provide an account of the problems that arise while procurement of active pharmaceutical ingredient (API) and excipients in pharmaceutical industry. This review has been structured with specified as well as generalized problems raised up during procurement of API and other material in pharmaceutical industry. Lack of proper regulatory requirements and unbiased market information with the absence of a comprehensive procurement policy is the major factor which creates complications while procurement. Besides these, lack of properly designed user requirement specifications (URS) which ultimately affect quality and delivery of quoted material. An 8-Question-based approach has been proposed to design URS, other approaches for material procurement and supplier qualification have been discussed, and a vendor certification procedure is presented. [ABSTRACT FROM AUTHOR]

Using a sample from the pharmaceutical procurement in Guangdong, China, over the period from 2007-2009 and a data set of comprehensive potential bidders, this article analyzes the determinants of bidding behaviors in the presence of sample selection. Bidding patterns between highly competitive and less competitive groups are also examined. Price differentials are further decomposed to explain factors that account for the gap. We find that a high level of competitiveness and more winning experiences induce manufacturers to behave aggressively and make lower bids. Moreover, bidders in a less competitive group are less sensitive to the number of potential bidders and the experience of past wins. The decomposition results indicate that the characteristics of bidders are not the main driver for the large price differentials between those groups. [ABSTRACT FROM AUTHOR]

Background: We review procurement and pricing transparency practices for pharmaceutical products. We specifically focus on Brazil and examine its approach to increasing pricing transparency, with the aim of determining the level of effectiveness in lower prices using a tool (Banco de Preços em Saúde, BPS) that only reveals purchase prices as compared to other tools (in other countries) that establish a greater degree of price transparency. Methods: A general report of Preços em Saúde (BPS) and Sistema Integrado de Administração de Serviços Gerais (SIASG) pricing data was created for 25 drugs that met specific criteria. To explore the linear time trend of each of the drugs, separate regression models were fitted for each drug, resulting in a total of 19 models. Each model controlled for the state variable and the interaction between state and time, in order to accommodate expected heterogeneity in the data. Additionally, the models controlled for procurement quantities and the effect they have on the unit price. Secondary analysis using mixed effects models was also carried out to account for the impact that institutions and suppliers may have upon the unit price. Adjusting for these predictor variables (procurement quantities, supplier, purchasing institution) was important to determine the sole effect that time has had on unit prices. A total of 2 × 19 = 38 models were estimated to explore the overall effect of time on changes in unit price. All statistical analyses were performed using the R statistical software, while the linear mixed effects models were fitted using the lme4 R package. Results: The findings from our analysis suggest that there is no pattern of consistent price decreases within the two Brazilian states during the five-year period for which the prices were analyzed. Conclusions: While the BPS does allow for an increase in transparency and information on drug purchase prices in Brazil, it has not shown to lead to consistent reductions in drug purchase prices for some of the most widely used medicines. This is indicative of a limited model for addressing the challenges in pharmaceutical procurement and puts into question the value of tools used globally to improve transparency in pharmaceutical pricing. [ABSTRACT FROM AUTHOR]

Background: The availability of medicines in public health facilities in Tanzania is problematic. Medicines shortages are often caused by unavailability at Medical Stores Department, the national supplier for public health facilities. During such stock-outs, districts may purchase from private suppliers. However, this procedure is intransparent, bureaucratic and uneconomic. Objectives: To complement the national supply chain in case of stock-outs with a simplified, transparent and efficient procurement procedure based on a public-private partnership approach with a prime vendor at the regional level. To develop a successful pilot of a Prime Vendor system with the potential for national scale-up. Methods: A public-private partnership was established engaging one private sector pharmaceutical supplier as the Prime Vendor to provide the complementary medicines needed by public health facilities in Tanzania. The Dodoma pilot region endorsed the concept involving the private sector, and procedures to procure complementary supplies from a single vendor in a pooled regional contract were developed. A supplier was tendered and contracted based on Good Procurement Practice. Pilot implementation was guided by Standard Operating Procedures, and closely monitored with performance indicators. A 12-step approach for national implementation was applied including cascade training from national to facility level. Each selected vendor signed a contract with the respective regional authority. Results: In the pilot region, tracer medicines availability increased from 69% in 2014 to 94% in 2018. Prime vendor supplies are of assured quality and average prices are comparable to prices of Medical Stores Department. Procurement procedures are simplified, shortened, standardized, transparent and well-governed. Procurement capacity was enhanced at all levels of the health system. Proven successful, the Prime Vendor system pilot was rolled-out nationally, on government request, to all 26 regions of mainland Tanzania, covering 185 councils and 5381 health facilities. Conclusion: The Prime Vendor system complements regular government supply through a regional contract approach. It is anchored in the structures of the regional health administration and in the decentralisation policy of the country. This partnership with the private sector facilitates procurement of additional supplies within a culture of transparency and accountability. Regional leadership, convincing pilot results and policy dialogue have led to national roll-out. Transferring this smaller-scale supply chain intervention to other regions requires country ownership and support for sustainable operations. [ABSTRACT FROM AUTHOR]