From promise to practice: a guide to developing pooled procurement mechanisms for medicines and vaccines

Abstract

Introduction

Buyers of medicines and vaccines are increasingly interested in pooling their procurement to improve access to affordable and quality-assured health commodities. However, the academic literature has provided no detailed description of how pooled procurement mechanisms are set up and develop over time. These insights are valuable as it increases our understanding of implementing and operating pooled procurement mechanisms successfully. Therefore, the aim of this paper is twofold. First, to explore how such mechanisms evolve over time. Second, to clarify the work that is needed to set up and sustain a pooled procurement mechanism. These findings have been translated into our Pooled Procurement Guidance document.

Methods

This qualitative study draws upon theoretical insights from organizational life cycles, collaborative and network governance, semi-structured interviews with procurement experts and academic and grey literature documents on pooled procurement of medicines and vaccines.

Results

We identified four general developmental stages of pooled procurement mechanisms: promise, creation, early operational and mature. The promise stage is characterized by initiating engagement between participating actors, while they try to convert their perceived problem(s) or opportunities into a shared vision. The creation stage is where the participating actors formalize and design the mechanism through consensus-building, articulation of a shared plan, and mobilize resources to put the shared plan into action. The early operational stage is where the shared plan is being executed. The newly established or appointed procurement organization is required to learn fast from experience while showing flexibility to the changing needs of buyers and suppliers. Once operations are routinized, the mechanism enters the mature stage. During this stage, the pooled procurement organization develops into a trusted player that provides sufficient incentives for all actors involved. Importantly, pooled procurement mechanisms can stagnate or turn inactive at any time during the developmental process when alignment between actors is threatened.

Conclusions

Pooled procurement mechanisms evolve over time. Setting up such mechanisms is a collaborative process that relies on intentional efforts by key actors involved. To increase the lifespan of pooled procurement mechanisms, key actors need to sustain a relative alignment of goals, needs, motivations and purpose of the mechanism throughout its entire life cycle.

Keywords:

• Pooled procurement
• Joint procurement
• Bulk purchasing
• Group procurement
• Centralized procurement
• Developmental stages
• Organizational life cycle
• Pharmaceuticals
• Medicines
• Vaccines

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s40545-023-00574-9.

Supplementary Information

The online version contains supplementary material available at https://doi.org/10.1186/s40545-023-00574-9.

Acknowledgements

We are grateful to all respondents in this study for their participation and expertise. We also thank the funders for financial support; and the reviewers of the manuscript for their helpful suggestions in improving the paper.

Author contributions

All authors made valuable contributions to the conceptualisation and review of the manuscript. KP conceptualised and drafted the study design, collected the data, analysed the data, and wrote the draft of the manuscript. RB refined the study design, analysed the data, reviewed and edited the draft manuscript. HvdB analysed the data, reviewed and edited the draft manuscript. MK refined the study design, analysed the data, reviewed the draft manuscript.

Funding

This work was supported by the D.P. Hoijer Fonds, Erasmus Trustfonds, Erasmus University Rotterdam, The Netherlands and the U.S. Pharmacopeia (USP) Quality Institute. KP was a recipient of a 2-year research fellowship by the USP Quality Institute. The funders had no role in writing the manuscript or in decision to submit for publication.

Availability of data and materials

The interview data generated and/or analyzed during the current research are not publicly available as individual privacy could be compromised. All other data is available in the public domain.

Declarations

Ethics approval and consent to participate

Ethics approval was obtained from ESHPM Review Board (IRB 20-01 Parmaksiz).

Consent for publication

Written and/or oral informed consent was obtained from the respondents at the start of the interview.

Competing interests

The authors declare that they have no competing interests.

Supplementary Information

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