Date: 09/05/2017

Roundtable on the Quality in Public Procurement in Health Care

On May 9th, AmCham organized a Roundtable on the quality assessment in public procurement of medical devices and supplies, that gathered representatives of relevant state institutions, as well as contracting authorities and suppliers.

The roundtable was an opportunity to hear comparative experiences in applying the most economically advantageous tender (MEAT) criteria in EU countries. Namely, Mr. Damir Detić in front of AmCham Croatia Health Care Committee shared their valuable views on the importance of MEAT usage in public procurement in health care, as well as conclusions on the potential impact of the lowest price (LP) public procurement on clinical outcomes. He presented results of analysis which showed significant rise in hip and knee surgery revisions in cases when orthopedic implants where procured by using only the lowest price as only criterion. He noted that the lowest price public procurement impacts revision surgery rate, complications (bleeding, infection etc.) rate, mortality rate, length of stay in hospital, surgical site infection rate, hospital acquired infection rate, rate of administration of blood/blood derivates, rate of embolic incidents – deep venous thrombosis, pulmonary embolism, days out of work/inability to live normal life. Mr. Detić concluded: “We should not afford ourselves a luxury to do any public procurement in health care without thorough consideration on how goods and services procured may impact clinical outcomes and overall costs of care”.

In the second part of the Roundtable, Mr. Boris Žulj of Clinical Centre Osijek presented some of the negative effects of centralized public procurement procedure based on the lowest price criteria, that was conducted in 2013 in Clinical Centre Lovran, Croatia. On the other hand, Mr. Žulj spoke about the public procurement of orthopedic supplies based on MEAT that is currently under procedure in Clinical Centre Osijek and presented necessary elements of MEAT calculation that have been used in this case to ensure quality.

A very vibrant discussion that followed included representatives of the following institutions:

  • Ministry of Health
  • Ministry of Finance & Budgetary Inspection
  • NHIF
  • Clinical Centre of Serbia
  • Clinical Centre of Vojvodina
  • Military Medical Academy
  • The Institute for Orthopedic Surgery "Banjica"
  • Institute of Cardiovascular Diseases "Dedinje"
  • World Bank
The conclusions from this Roundtable will serve to identify what are the next steps to ensure that the lowest price isn't the only decision driver in the public procurement of medical devices and supplies.

Full conclusions from the meeting can be found here.

To download the presentation of Mr. Detić please follow this link, while for the presentation of Mr. Žulj, please click here.