POSB253 Development of a Multi Criteria Decision Analysis (MCDA) Tool for Medical Devices National Procurement in Egypt

Abstract

The lack of effective and good quality medical devices impairs health service delivery, leading to poor patient outcomes and inefficient health system. Our aim is to develop a Multi-Criteria Decision Analysis (MCDA) tool that can support the multidimensional scope of procuring medical devices for the Unified Procurement Authority (UPA) in Egypt. Initially, a systematic literature review was conducted searching Medline and EMBASE databases as well as other grey literature sources. The search term was constructed on the domains “criteria”, “medical devices” and “procurement” or “tendering” (and related synonyms), to identify relevant publications. Two independent researchers screened the titles and abstracts. A preliminary list of potentially relevant criteria was identified based on the literature review. A hierarchal structure was developed, which included 9 main domains. Within each domain, criteria were broken down into a total of 25 sub-domains. A 2-days workshop was conducted, involving local experts representing different stakeholders to select the final criteria. Participants voted for ranks, scoring functions and weight of each criterion. Of the identified records, data was extracted from 46 papers to create the initial list of criteria. Based on the workshop, nine criteria were included in the MCDA tool. The top three criteria according to weight were “technical characteristics of the medical device” (33.0%), “use in reference countries” (17.8%), and “supply reliability” (11.3%). Other included criteria in order were “country of origin”; “previous use in tenders”; “pharmacovigilance system”; “instant replacement within product variety”; “training” and lastly “Refund/Replacement within product variety”, which had a weight of 4.2%. Policymakers focused mainly on technical aspects and quality of the devices followed by supply reliability for medical device purchases. This creates incentives for manufacturers to invest into improving their manufacturing standards and product quality, as well as maintaining an efficient supply chain.