Medical technology procurement must focus on quality if it is to deliver value
Tenders for medical devices across Europe are increasingly focused on price only. This is one of the key findings of a recent analysis “Tendering Medical Devices in Europe – Strategy & Implications for Pricing” that we conducted on tenders from 2016 to 2019 to understand where the procurement environment is moving to.
In other words, quality criteria are included less and less in tenders, despite the proposed MEAT criterion (Most Economically Advantageous Tender) from the EU Public Procurement Directive 2014/24. We should really expect to see the opposite trending taking hold, where quality criteria were becoming increasingly important.
One may think that this was only happening in a handful of countries. But, in fact, it’s a trend we have observed in almost all countries of the European Economic Area. The number of tenders including quality criteria is decreasing at a high pace – falling from more than 90% to less than 80% in just three years
Essentially, a more price-only tender environment leaves only two choices for manufacturers to remain in the game. The first alternative is to try to fight back against the trend and to include more quality criteria. The second option is to cope with the situation and to focus on reducing costs. While both strategies would require significant investments from manufacturers, the outcome will be different.
A shift to MEAT tenders will require more time as the criteria cannot be changed overnight. Tender authorities are composed of multiple members, and the introduction of MEAT tenders require careful understanding and cooperation. In this scenario, it would take even more time to achieve a change in the specifications, while this shift is in the benefit of all stakeholders.
On the other hand, price reductions could impact the availability of life-saving innovation to patients since manufacturers usually reinvest revenues in enhanced treatments and solutions. Therefore, reducing resources dedicated to innovation could remove those incremental innovations and commoditize the market very quickly. Furthermore, in the longer term, we believe this could create problems for the healthcare system as it would become more and more difficult to compete if innovation is not rewarded.
Regardless of the strategy chosen by individual manufacturers, there is a strong connection between manufacturing standards and costs.While being part of the solution, adding manufacturing standards into tender specifications would only limit the change in standards to a certain extent.
Our concern is that manufacturers may not be able to invest in or bear more of the risk for developing new treatment solutions, if innovation will not be rewarded appropriately anymore. Therefore, it would be great to see the European healthcare systems actually leveraging the MEAT criterion established by the EU PPD in future to ensure a continuous high-quality standard of products as well as fostering the access to new innovation for patients and society even more than today.