NEW APPROACHES for procuring Effective Healthcare Solutions

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Procurement of medical technology, done properly, and with an eye toward factors other than short-term price, can greatly enhance value and efficiency in the health care system. Procurement should thus emerge as a partner to innovation and value in ensuring sustainability, access and quality in the Irish health care system.

This report demonstrates how best practices are put to work at various stages of the innovative procurement process: from pre-procurement processes that are essential to maximize fairness and useful input to allow for the most up-to-date technologies and concepts of value to be utilized, to capturing adequately these concepts in technical specifications written by committees of end-users, to award and post-award processes that help to ensure flexibility and fairness. They also present a robust palette of policy choices to enable greater utilization of innovation procurement, to enhance outcomes and value and to identify where there are opportunities to procure for solutions rather than products. To achieve these objectives, we would encourage the adoption of the best practices outlined in this paper by all stakeholders.

Procurement can be a powerful tool that, when utilized properly, enhances value and innovation in the Irish Health care system. The goal of innovative procurement is to maximize public purchasing power to enable patients to receive the best, most cost-effective, life-saving and innovative treatments across all phases of health care. If utilized judiciously, procurement can be a tool to create efficiency and quality rather than just cut costs.

IMSTA view this paper as a further step in our commitment to support health care system performance, access, quality and sustainability and greater social and economic development. We continue to believe that the continued meaningful engagement between industry, policy makers and stakeholders holds the most promise for improving the Irish Health Care procurement processes and
to further enhance the value within the health care system.

Recommendations

Appoint Procurement Committees

Procurement Committees to oversee needs assessment, market engagement, specification generation and the most appropriate procurement processes are essential to maximize public purchasing power to enable patients to receive the best life-saving, most cost-effective and innovative treatments across all phases of health care. In most, if not all, cases a suitable key opinion leader (KOL) with clinical experience of using relevant technology should be appointed to chair a procurement committee.

Procurement committees should comprise multi-disciplinary teams which, in the vast majority of cases involving medical devices, will mean physicians, often including consultants and surgeons, biomedical / clinical engineering, medical scientists and other applied healthcare professional. In some cases other stakeholders and patient representatives should be consulted.

Standardise Medical Technology Evaluation
The broad diversity, rapid innovation cycle and unique nature of medical devices presents a challenge for gathering comparative clinical and health-economic data for all medical devices. While Health Technology Assessments (HTAs) are used by procuring authorities when sourcing medical technology, they may not always provide the data required at hospital, local or regional level.

Studies which examine costs and benefits only at hospital level may be commercially useful to the hospital but will necessarily address the impact on the broader healthcare system. Therefore, we recommend a multi-disciplinary Professional Evaluation Group be established, reporting to the Procurement Committee.

Facilitate and Adopt InnovationHarnessing innovation has the potential to improve the health, well-being and economic productivity of the population and slow the growth in the cost of care. Funding innovation through pre-commercial procurement is a tried and tested process which challenges industry to come up with solutions for identified healthcare problems. Developing a guide to commissioning for innovation of medical devices, linked to unmet health needs identified by the National Clinical

Programmes should be considered as a priority for the health service.