The relevance of the work is determined by the need to optimize the procurement process in state medical institutions to improve the quality and efficiency of medical services provided. The subject of the study is the socio-economic interactions between participants in the procurement process, including preparation, implementation, and monitoring of procurement agreements. The purpose of the study is to identify and systematize the main problems in the field of procurement activities of public medical institutions and develop proposals for solving them based on the principles of cost-effectiveness, transparency and fairness. Materials and methods. The study includes a comprehensive analysis of current regulations governing procurement activities, as well as a study of the experience of implementing procurement procedures in medical institutions. Methods of comparative analysis, systematization and synthesis of the obtained data are used to identify key problems and challenges. Results. The work identified the main problems associated with the procurement process in medical institutions, including shortcomings in the regulatory framework, lack of a clear distribution of responsibilities between participants in the process and ineffective management decisions. Proposals were developed to optimize the procurement process, including adapting procurement models to the size and specificity of the activities of institutions, improving the documentation of the distribution of responsibilities and using digital technologies to improve the monitoring and management of procurement. Conclusions. Optimization of the procurement process in state medical institutions requires a comprehensive approach, including improving the legislative framework, enhancing interaction between structural units, and applying modern technologies to increase transparency and efficiency of procurement activities. These measures will not only help eliminate existing problems but also ensure higher quality and availability of medical services. Application of results. The results of the work can be applied in the healthcare system at the level of state medical institutions for the development and implementation of effective procurement models. They can also be used in the development of regulatory documents regulating procurement in the healthcare sector, as well as in the educational process for training specialists in procurement and logistics management in medical institutions.