This study’s objective is to understand the industrial and technological context involved in the offset policy and technology transfer developed in Brazilian public healthcare. Initially, the acquisition of linear accelerators for oncology treatments seemed to be a solution for the problem of long waiting lines in the Brazilian Single Health System (SUS - Sistema Único de Saúde), but the reality was different. Through the methodological procedure of a case study at a hospital renowned for its oncology treatments in the south of the country, it was possible to elucidate its ability to manage the public investment in relation to the industrial and technological context. The relevant findings show that, even with the limitations of the commercial agreement, the hospital at hand was able to, through knowledge, mitigate the difficulties of the offset policy and carry out the technology transfer with ease, due to its familiarity with the new technology. Through this analysis, based on the empirical context, it was possible to summarize the main benefits and setbacks that arise from the strategic and operational levels of the commercial agreement, both at its initial and final stages. This study hopes to spark new investigations on the topic in order to comprehend and intervene in different contexts and situations.