European collaborations on medicine and vaccine procurement

Abstract

To ensure equitable access to medicines and vaccines, organizational efforts and purchase volumes have been pooled in joint procurements and negotiations for decades in some regions of the world, as well as globally through supranational procurement mechanisms. In Europe, countries started to collaborate on procurement and negotiations recently when it became increasingly difficult to ensure access to high-priced medicines, even in high-income countries. Two European country collaborations (the Nordic Pharmaceutical Forum and the Baltic Procurement Initiative) have successfully concluded at least one joint tender process for medicines and vaccines and the Beneluxa Initiative has concluded its first successful joint price negotiation. This article describes the experiences of these country collaborations. Challenges observed included: legal barriers; institutional and organizational differences between health-care systems in member countries; and the risk that suppliers will be reluctant to cooperate with country collaborations. Although these collaborations helped improve access to medicines and vaccines for the countries involved, in situations such as a global health crisis, larger-scale, more-inclusive initiatives are needed. In the current coronavirus disease 2019 (COVID-19) pandemic, COVID-19 Vaccines Global Access (COVAX) initiative established a global procurement mechanism to ensure the equitable distribution of COVID-19 vaccines globally. Despite differences in organization and scale, the European country collaborations and COVAX have some similarities: (i) their success depends on the increased purchasing power associated with pooled order volumes; (ii) expert knowledge and previous procurement experience is pooled; (iii) they perform other collaborative activities that go beyond procurement alone; and (iv) they actively involve external partners and stakeholders.

Purchasing medicines for the public sector: Evaluation of the performance of centralised procurement in Portugal

“…Empirical evidence on pooled procurement for medicines (or medical devices) in different organisational set‐ups confirmed the expected positive impacts 15 , 16 , 20 , 24 , 28 , 30–39 : First of all, it helped to achieve lower purchase prices and thus savings for the public sector. The operational costs and the administrative burden for the individual purchasers were found to have been reduced.…”

“…28 European countries involved in the cross-country collaborative networks of the Nordic Pharmaceutical Forum and the Baltic Procurement Initiative successfully procured medicines and vaccines. 29 Empirical evidence on pooled procurement for medicines (or medical devices) in different organisational set-ups confirmed the expected positive impacts 15 , 16 , 20 , 24 , 28 , 30-39 : First of all, it helped to achieve lower purchase prices and thus savings for the public sector. The operational costs and the administrative burden for the individual purchasers were found to have been reduced.…”

“…Spain 27 ). In addition, public procurers of different countries may also collaborate (cross‐country procurement) 28 . European countries involved in the cross‐country collaborative networks of the Nordic Pharmaceutical Forum and the Baltic Procurement Initiative successfully procured medicines and vaccines 29 …”

How to balance valuable innovation with affordable access to medicines in Belgium?

“…advanced therapies). To date, the success of BeNeLuxA has been hampered by the need to invest resources in setting up an operational structure and supporting legal framework, the need to align pricing and reimbursement procedures, a lack of transparency and clarity on how the BeNeLuxA procedures work, and the limited willingness of pharmaceutical companies to submit applications (Vogler et al, 2021), since advantages of market access via BeNeLuxA remain unclear for companies.…”

“…Initiatives such as the proposed African Medicines Agency with respect to the former and the collaboration between the European Medicines Agency and EUnetHTA with respect to the latter are to be welcomed. Furthermore, countries can augment their buying power by collaborating through regional medicine procurement schemes (Vogler et al, 2021) such as the Strategic Fund of the Pan American Health Organization (Pan American Health Organization, 2022).…”