Background
Country level comparative studies on the performance and experiences of medical device procurement systems, in terms of both quality and efficiency, particularly during COVID-19 are lacking.
Objective
To evaluate the impact on healthcare cost and efficiency of four national models of medical device procurement. Further, to propose procurement system "best practices" using the response to COVID-19 as a reference.
Methods
A review of qualitative data drawn from public and private sources was conducted, as well as various studies related to national procurement systems in four G20 countries, to (1) identify differences, strengths and weaknesses; (2) evaluate how each system responded to the COVID-19 crisis; and, (3) identify best practices for policy-makers.
Results
While some governments have centralized the procurement of medical devices, developing a national scheme for tendering and purchase, other countries have deployed a decentralized approach where regions or even individual hospitals are responsible for all or some aspects of procurement. This dichotomy has led to a variety of efficiency and quality of service outcomes, with models implementing national uniformity achieving greater cost-savings. Furthermore centralized systems of procurement performed better during times of health crisis. It remains unclear whether these short-term savings lead to long-term efficiencies achieved through improved patient outcomes as data is lacking.
Conclusion
The available data indicates that countries that have adopted a centralized approach to the procurement of medical devices tend to have an advantage during times of crisis, as well as in the normal provision of healthcare services.