The study of problems and priority areas for improving procurement in health care

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Public procurement in the healthcare system (HCS) is a key factor in ensuring the viability of medical institutions and the quality of medical and pharmaceutical care they provide. The problem of improving the public procurement system has not lost its relevance in recent years, but it is considered mainly in the theoretical and applied aspect. Sociological research (questionnaire) as an effective tool for collecting information allows to explore the opinion of professionals who directly procure essential medicines, medical devices (MDs) and other equipment on the problems that are associated with the procurement planning and conducting processes. It will also help to identify possible ways to improve the efficiency of procurement in the healthcare system, in particular under martial law. The purpose of the study is to investigate the state and problems of organizing centralized and decentralized public procurement of medicines and medical devices, as well as to identify priority areas for their improvement. The survey made it possible to determine the current state and key problems in the sector of medical procurement at different levels of healthcare provision. The survey showed that the most commonly procured medicines, medical devices, reagents, test systems, and medical equipment are the most frequently used. When forming a need, the majority of respondents (84.4%) operate flexibly, depending on the situation, 9.4% use the consumption method, and 6.2% use the incidence method. At the same time, 56.3% of respondents are based on available financial resources, 25% rely on the list of medicines. The survey made it possible to identify the problems that arise in public procurement. These are, first of all, restrictions on procurement according to the National List (56.3%), non-fulfillment/violation of contract terms (18.8%), and creation of artificial obstacles (12.5%). If necessary, procurement of medicines not included in the National List is guided by protocols, state or local formularies. According to the survey, 50% of respondents emphasize the creation of a single list, while 6.3% of respondents are strongly against it. The areas of improvement of the public procurement system proposed by the respondents relate primarily to the regulatory framework (simplification and systematization, stability of the regulatory framework, in particular, regulatory lists; raising thresholds and expanding procurement through the e-catalog; expanding the use of non-price criteria; improving the procedures for procurement of high-value equipment and innovative medical technologies.