Procurement Data Research Articles

Revolutionizing Procurement: How AI & Data Analytics Driving Cost Effective Solutions in EPC

This paper, therefore, discusses the revolution brought by AI and Data Analytics in the procurement processes of EPC (Engineering, Procurement and Construction) and how each of the challenges, including cost control, enhanced efficiency and procurement downtime, could be solved using the two technologies. When the use of the procurement models is applied, the following benefits will be realized: supplier selection is facilitated using artificial intelligence, thereby automating the entire process; there is increased accuracy of costs compared to manual estimation, therefore reducing bias. The use of AI will allow better historical and real-time data analysis for procurement needs forecast, supplier evaluation and material cost prediction. Furthermore, machine learning algorithms can automate adjustments depending on real-time market variability, such for instance, a change in the price of the materials or a disruption in the supply chain, as well as execution flexibility regarding the project needs. Data Analytics also adds more weightage to procurement efficiency because it gives detailed analysis of the past and present procurement data. By utilizing state-of-the-art analytical frameworks, top managements are allowed to make powerful supplier analyses in relation to reliability, lead time, and cost of contracts prior to negotiations on contract supplier contracts and before contracting risks. What this study aims to do is to highlight real-life implementations of these technologies and how EPC firms can capitalize on these technologies to drive procurement efficiency, cost reduction, project delivery, and supplier relationship all for efficient project delivery. This paper thus provides a detailed discussion on the MI and TI of implementing AI and DA within procurement in the EPC sector via case studies and examples.

Research on the Relationship Between Average Cigarette Price per Box and Government Procurement in City A Based on a Regression Model

This study aims to analyze and predict the relationship between the average price per box in the cigarette market of City A and government procurement, providing a scientific basis and support for decision-making. By reviewing relevant theories and literature, qualitative prediction methods, regression prediction models, and other related theories were explored. Through the analysis of annual cigarette sales data and government procurement data in City A, a comprehensive understanding of the development of the tobacco industry and the economic trends of tobacco companies in the county was obtained. By predicting and analyzing the average price per box of cigarette sales across different years, corresponding prediction results were derived and compared with actual sales data. The prediction results indicate that the correlation coefficient between the average price per box of cigarette sales and government procurement is 0.982, implying that government procurement accounts for 96.4% of the changes in the average price per box of cigarettes. These findings offer an in-depth exploration of the relationship between the average price per box of cigarettes in City A and government procurement, providing a scientific foundation for corporate decision-making and market operations.

Uptake of biosimilars in China: a retrospective analysis of the case of trastuzumab from 2018 to 2023

BackgroundThe Chinese biosimilar industry has demonstrated rapid growth in recent years. Limited evidence is available about biosimilar uptake at the national level. This study aimed to assess biosimilar uptake in the case of trastuzumab and to explore potential factors influencing the biosimilar penetration at national and provincial levels.MethodsThis study employed an interrupted time series analysis to assess the level and trend changes of national trastuzumab originator consumption and the overall trastuzumab consumption after the price reduction of the originator and the introduction of the first biosimilar using the China Hospital Pharmacy Audit procurement data from March 2018 to February 2023. A latent class trajectory model (LCTM) was also adopted to estimate the biosimilar penetration across 30 provincial-level administrative divisions (PLADs). Based on the LCTM grouping results, provincial characteristics were analyzed.ResultsAfter rapid growth, the penetration of biosimilars demonstrated a moderate ascending trend at the national level, reaching 27% in February 2023. Following the introduction of the first biosimilar in July 2021, the consumption of the originator decreased by 0.5% per month (P = 0.008), and the growth rate of overall trastuzumab consumption decreased by 1.1% per month (P = 0.014). LCTM fit the best when the number of trajectory classes was two, dividing 30 PLADs into a group demonstrating a faster increase in biosimilar penetration and the other with a slower increase. The PLADs in the fast-increasing group had a higher proportion of the population covered by the national basic health insurance, a lower proportion of the urban population, a lower proportion of the population covered by the urban employee health insurance program, a lower gross domestic product per capita, a lower total health expenditure per capita, and a lower out-of-pocket expenditure.ConclusionsThe uptake of trastuzumab biosimilars in China was lower compared with major European countries. The introduction of trastuzumab biosimilars presented a substitutional effect. Perceptions of physicians and patients, the medicines procurement model, competition from other biologics, and health insurance payment methods may influence biosimilar uptake. Enhancing a comprehensive understanding of biosimilars among physicians and patients, including biologics with biosimilars in the national pooled procurement, and implementing provider payment reforms could foster biosimilar penetration.

S1713 Disparity between waitlist and recipient status for Liver Transplantation on the basis of Insurance Status and Race Using Organ Procurement and Transplantation Network Data

S1713 Disparity between waitlist and recipient status for Liver Transplantation on the basis of Insurance Status and Race Using Organ Procurement and Transplantation Network Data

Bid evaluation with distortionary scaling in multidimensional procurement auctions

ABSTRACT Construction projects are often procured through multidimensional auctions, in which suppliers bid on both price and non-price attributes such as quality. In Korea, a unique scaling method is employed to differentiate bids, adjusting scores to ensure a sufficient point difference between adjacent quality bids. This scaling method aims to enhance the discriminating power of the scoring system and attract more sophisticated project designs. However, it may distort overall bid rankings and lead to inefficient contract allocation. The added uncertainty may incentivize suppliers to inflate their prices, as the effect of price on winning probability decreases with the scaling factor. Using Korean procurement data, I analyse cases of rank reversal, and I reveal a tendency among suppliers to bid less aggressively on price when quality differences are magnified, with the effect varying with the level of uncertainty in bid evaluation. This highlights the preference of buyers for a less distortionary scoring system to enhance the value of procurement.

The application of continuous audit and monitoring methodology: A government medication procurement case

In the government procurement process, waste and abuses are hard to avoid, and there are usually latencies between the event occurrence and detection works. The continuous audit methodology has been adopted by many public and private firms to actively monitor transactions and detect possible anomalies. Compared to the adoptions in the private sector, implementations of continuous audit and monitoring of government procurement analyses are limited. This study applies the continuous monitoring and audit methodology to the medication procurement data of a Brazilian city government, and it aims to help internal auditors identify exceptions and anomalies in procurements for further investigation. By introducing the comparison of exogenous data, this study further provides cost management opportunities.

Variations of nitrous oxide procurement per public hospital bed between Australian states and territories: A cross-sectional analysis.

We aimed to identify variations in nitrous oxide (N2O) procurement between Australian states and territories per public hospital bed by undertaking a cross-sectional analysis of N2O procurement data for all Australian public hospitals from 1 January 2017 to 30 June 2022. Data were obtained from state and territory departments of health. All Australian public hospitals across six states and two territories were included. We obtained N2O procurement data from Department of Health representatives from all states and territories, accounting for all 697 Australian public hospitals and four public dental hospitals. The main outcome measured in this study was N2O procurement per public hospital bed by state or territory. Across the 5 years (1 January 2017 to 30 June 2022) an average of 242,054 (standard deviation (SD) 16,222) kg of N2O, equivalent to 64,144 (4299) tonnes of carbon dioxide emissions (CO2e), were procured per annum. CO2e emissions from N2O purchase varied more than threefold per public hospital bed between different states/territories (0.47-1.48 CO2e tonnes per hospital bed). There were significant variations in N2O procurement between Australian states and territories when adjusted for public hospital bed numbers. Further analysis of this variation to determine cause and to guide mitigation interventions is therefore warranted.

Individual-level social determinants of health and disparities in access to kidney transplant and waitlist mortality.

Comprehensive, individual-level social determinants of health (SDOH) are not collected in national transplant registries, limiting research aimed at understanding the relationship between SDOH and waitlist outcomes among kidney transplant candidates. We merged Organ Procurement and Transplantation Network data with individual-level SDOH data from LexisNexis, a commercial data vendor, and conducted a competing risk analysis to determine the association between individual-level SDOH and the cumulative incidence of living donor kidney transplant (LDKT), deceased donor kidney transplant (DDKT), and waitlist mortality. We included adult kidney transplant candidates placed on the waiting list in 2020, followed through December 2023. In multivariable analysis, having public insurance (Medicare or Medicaid), less than a college degree, and any type of derogatory record (liens, history of eviction, bankruptcy and/ felonies) were associated with lower likelihood of LDKT. Compared with patients with estimated individual annual incomes ≤ $30,000, patients with incomes ≥ $120,000 were more likely to receive a LDKT (sub distribution hazard ratio (sHR), 2.52; 95% confidence interval (CI), 2.03-3.12). Being on Medicare (sHR, 1.49; 95% CI, 1.42-1.57), having some college or technical school, or at most a high school diploma were associated with a higher likelihood of DDKT. Compared with patients with incomes ≤ $30,000, patients with incomes ≥ $120,000 were less likely to receive a DDKT (sHR, 0.60; 95% CI, 0.51-0.71). Lower individual annual income, having public insurance, at most a high school diploma, and a record of liens or eviction were associated with higher waitlist mortality. Patients with adverse individual-level SDOH were less likely to receive LDKT, more likely to receive DDKT, and had higher risk of waitlist mortality. Differential relationships between SDOH, access to LDKT, DDKT, and waitlist mortality suggest the need for targeted interventions aimed at decreasing waitlist mortality and increasing access to LDKT among patients with adverse SDOH.

Irregular surface temperature monitoring in liver procurement via time-vertex signal processing

The liver viability monitoring during its procurement is critical to guarantee the safe liver transportation. Traditionally, the viability is assessed by taking invasive biopsy on the liver surface. Recently, the noninvasive thermal images of liver surface have been used as an alternative assessment way. Researchers have proposed monitoring and classification approaches based on the thermal images. Existing works have demonstrated the importance of the temporal variation or the spatial variation of the thermal images to the viability monitoring. However, there is no prior work to leverage the graph structure of the spatio-temporal processes for the viability monitoring. In this paper, we propose a time-vertex signal processing framework for the irregular thermal data of the pure liver region monitoring. In particular, we extract features of irregular thermal data based on the joint Fourier transform (JFT), which is an integration of graph Fourier transform (GFT) and discrete Fourier transform (DFT). The extracted JFT features can accurately reconstruct the thermal images with a limited number of features. Then, we use a non-parametric online change-point estimation method, based on online scan B statistics, to monitor the JFT features without a parametric distribution. Our proposed framework is applied to both simulation and the liver procurement data, and achieves good monitoring performance.

Enhancing transparency in public procurement: A data-driven analytics approach

Open data is a strategy used by governments to promote transparency and accountability in public procurement processes. To reap the benefits of open data, exploring and analyzing the data is necessary to gain meaningful insights into procurement practices. However, accessing, processing, and analyzing open data can be challenging for non-data-savvy users with domain expertise, creating a barrier to leveraging open procurement data. To address this issue, we present the design, development, and implementation of a visual analytics tool. This tool automates data extraction from multiple sources, performs data cleansing, standardization, and database processing, and generates meaningful visualizations to streamline public procurement analysis. In addition, the tool estimates and visualizes corruption risk indicators at different levels (e.g., regions or public entities), providing valuable insights into the integrity of the procurement process. Key contributions of this work include: (1) providing a comprehensive guide to the development of an open procurement data visualization tool; (2) proposing a data pipeline to support processing, corruption risk estimator and data visualization; (3) demonstrating through a case study how visual analytics can effectively use open data to generate insights that promote and enhance transparency.

The vacated space of volume/price of the drugs centralized procurement with quantity in secondary and above public hospitals of China

BackgroundIn 2018, the National Centralized Drug Procurement (NCDP) policy has been implemented in 11 provinces, and promoted across the country in 2019. The main feature of the policy is “volume for price”, therefore, it is necessary to measure the price relationship, not only to reduce the price of drugs, reduce the burden of patients' medical costs, but also facilitate pharmaceutical companies to access enough innovation incentives. The aim of this study was to assess the vacated space effect of the drug centralized procurement by national organizations in exchange of price for quantity.MethodsA difference-in-differences (DID) model was employed to analyze the effect of the 4 + 7 pilot drugs centralized purchasing policy on drug sales volume and selected versus clinically substitutable unselected varieties, using observational data from 2018 to 2019. We compared drug procurement data between secondary and above public hospitals in pilot and non-pilot cities throughout China.ResultsThe study showed that the average treatment effect (ATE) of sales in the in-hospital market for the selected supply varieties in centralized purchasing is -0.42, and with a sales volume of 0.49. This indicates a volume-price vacated space of 1.16 ~ 1.17 DDD (defined daily dose)/Yuan, implying that for every 1 defined daily dose (DDD) increase in reported volume, the standardized price decreased by 1.16–1.17 Yuan. The ATE of in-hospital market sales for drugs not selected in centralized procurement shows a decrease of 0.13. This finding highlights the presence of the price linkage effect. The ATE of sales volume is 0.57, indicating a volume-price space of 4.38 ~ 4.39 DDD/Yuan for unselected drugs, approximately 3.75 higher relative to that of the selected ones.ConclusionsThe ratio of the volume-price space of clinically substitutable unselected and selected drugs may serve as direct evidence for evaluating the shift from centralized purchasing of drug varieties to clinically substitutable other ones. To strengthen the volume-based negotiation approach and maximize the effectiveness of centralized purchasing policies, we recommend the strategic implementation of a three-tiered centralized purchasing system, the expansion of drug coverage, and the introduction of relevant constraints and incentives.

Trends and patterns of antibiotic using from 2014 to 2018 in stomatology hospitals of China.

To analyze trends of antibiotic consumption and expenditure in Chinese stomatology hospitals between 2014 and 2018 with a longitudinal study design, and show the impacts of the comprehensive policy on dental antibiotic use in China. Consumption was quantified as the number of daily defined doses (DDDs) and expenditure as the procurement costs, using medical institutions' drug procurement data from the Chinese Monitoring Network for Rational Use of Drugs. Descriptive statistics was employed and the compound annual growth rate (CAGR) was calculated to show the average annual growth rate. Between 2014 and 2018, overall antibiotic consumption increased from 842.6 thousand DDDs to 1376.7 thousand DDDs (p < 0.001) and expenditure increased from 11.6 million RMB to 20.9 million RMB (p < 0.001), where other β-lactam antibacterials accounted for the largest proportion of total consumption (37.1%-50.1%) and expenditure (52.9%-66.6%), and also increase the largest (CAGR = 18.4%, p < 0.001). The proportion of oral antibiotics was nearly 9 times of parenteral antibiotics in consumption (CAGR = 0.3%, p = 0.023) and only 2 times in expenditure (CAGR = -1.7%, p = 0.112). The non-restricted group accounted for more than 90% of consumption (CAGR = 0.6%, p < 0.001). In 2018, oral first-generation cephalosporins (22.8%), oral imidazole derivatives (22.3%), and oral second-generation cephalosporins (19.2%) were the most frequently used antibiotic classification, while parenteral second-generation cephalosporins were top one (19.8%) for expenditure. At chemical substance levels, the consumption of oral cefradine ranked top one (21.4%) and parenteral cefuroxime accounted for the largest proportion of expenditure (14.5%) in 2018. Oral cefradine, oral metronidazole, and oral cefaclor were the top three frequently consumed antibiotics throughout the five years. Despite the potential antibiotic overuse, the comprehensive antibiotic stewardship regulations of China got a satisfactory and better performance in dental practices. More effort is needed to establish more explicit guidelines to improve antibiotic stewardship, such as priority recommending amoxicillin and its derivatives for endodontic infections.

Kidney Transplantation in ≤15 kg Children: Outcomes and Prognostic Indicators—A Review of the Organ Procurement and Transplantation Database

ABSTRACTBackgroundApproximately 2500 pediatric patients are awaiting kidney transplantation in the United States, with &lt;5% comprising those ≤15 kg. Transplant in this cohort is often delayed by center‐based growth parameters, often necessitating transplantation after the initiation of dialysis. Furthermore, prognostication remains somewhat ambiguous. In this report, we scrutinize the Organ Procurement and Transplantation Network (OPTN) data from 2001 to 2021 to help better understand specific variables impacting graft and patient outcomes in these children.MethodsThe OPTN kidney transplant dataset from 2001 to 2021 was analyzed. Inclusion criteria included age &lt;18 years, weight ≤15 kg, and recipient of primary living donor kidney transplantation (LDKT) or deceased donor kidney transplantation (DDKT). Patient and graft survival probabilities were calculated using the Kaplan–Meier method. The Cox proportional hazards model was used to calculate hazard ratio (HR) and identify variables significantly associated with patient and graft survival.ResultsTwo thousand one hundred sixty‐eight pediatric transplant recipients met inclusion criteria. Patient survival at 1 and 3 years was 98% and 97%, respectively. Graft survival at 1 and 3 years was 95% and 92%, respectively. Dialysis was the sole significant variable impacting both patient and graft survival. Graft survival was further impacted by transplant era, recipient gender and ethnicity, and donor type. Infants transplanted at Age 1 had better graft survival compared with older children, and nephrotic syndrome was likewise associated with a better prognosis.ConclusionPediatric kidney transplantation is highly successful. The balance between preemptive transplantation, medical optimization, and satisfactory technical parameters seems to suggest a “Goldilocks zone” for many children, favoring transplantation between 1 and 2 years of age.

Public procurement and bank lending

This article unveils that government is intertwined with banking through a hitherto underexplored channel—through public procurement. On a comprehensive firm-level dataset that combines public procurement and accounting data, we apply the difference-in-differences method to show that treated firms that secure a public procurement contract can strengthen their bank borrowing terms. Treated firms obtain a greater amount of bank funding and a higher share of long-term funding at lower interest rates compared to the control firms. The impact on bank lending exceeds the positive impact due to higher revenues and suggests a positive non-revenue channel of public procurement.

Impact of national drug price negotiation policy on the accessibility and utilization of PCSK9 inhibitors in China: an interrupted time series analysis

BackgroundPCSK9 inhibitors are a novel class of lipid-lowering drugs that have demonstrated favorable efficacy and safety. Evolocumab and alirocumab have been added to China’s National Reimbursement Drug List through the National Drug Price Negotiation (NDPN) policy. This study aims to evaluate the impact of the NDPN policy on the utilization and accessibility of these two PCSK9 inhibitors.MethodsThe procurement data of evolocumab and alirocumab were collected from 1,519 hospitals between January 2021 and December 2022. We determined the monthly availability, utilization, cost per daily defined dose (DDDc), and affordability of the two medicines. Single-group interrupted time series (ITS) analysis was performed to assess the impact of the NDPN policy on each drug, and multiple-group ITS analysis was performed to compare the differences between them.ResultsThe NDPN policy led to a significant and sudden increase in the availability and utilization of PCSK9 inhibitors, along with a decrease in their DDDc. In the year following the policy implementation, there was an increase in the availability, utilization, and spending, and the DDDc remained stable. The affordability of PCSK9 inhibitors in China have been significantly improved, with a 92.97% reduction in out-of-pocket costs. The availability of both PCSK9 inhibitors was similar, and the DDDc of alirocumab was only $0.23 higher after the intervention. The market share of evolocumab consistently exceeded that of alirocumab. Regional disparities in utilization were observed, with higher utilization in the eastern region and a correlation with per capita disposable income.ConclusionsThe NDPN policy has successfully improved the accessibility and utilization of PCSK9 inhibitors in China. However, regional disparities in utilization indicate the need for further interventions to ensure equitable medicine access.

The impact of Chinese volume-based procurement on pharmaceutical market concentration.

Optimizing the pharmaceutical industrial structure is the key mission of China's healthcare reform. From the industrial structure perspective, this study empirically evaluated the impact of China's national volume-based procurement (NVBP) policy on market concentration in the hospital-end drug market. This study used drug procurement data of China's public medical institutions which obtained from the national database. A quasi-natural experiment was designed involving eleven pairs of matched treatment-control region combinations, with NVBP policy as the intervention measure. The market was defined by drug name (molecular boundary) and city/province (geographical boundary). Market changes were measured from three dimensions: the number of enterprises and products, market share, and Herfindahl-Hirschman index (HHI). Dual comparison approach and difference-in-difference (DID) method with fixed effect model were applied to quantify policy impacts. The number of enterprises and products decreased by 18 and 83 in pilot regions after NVBP policy, far more than the decreases in control regions (6 and 21). The accumulative market share of 15 bid-winning enterprises increased by 53.67% in volume and 18.79% in value, among which the increment of enterprises with low baseline market share was more prominent (66.64% and 36.40%). Among three enterprise types, the market share of generic consistency evaluation (GCE) certificated generics significantly increased, GCE uncertificated generics significantly decreased, and originators slightly decreased. DID models indicated significantly positive impact of NVBP policy on market concentration, with HHI-volume and HHI-value increasing by 49.33% (β = 0.401, p < 0.01) and 21.05% (β = 0.191, p < 0.01). The implementation of NVBP promoted the intensive drug circulation and supply of Chinese public hospitals, intensifying the exit of GCE uncertificated generics from the hospital-end market. NVBP combined with GCE standards significantly improved market concentration, which brought a positive signal of pharmaceutical industrial structure optimization in China. In the future context of normalized and institutionalized NVBP, the balance should be further sought between low drug prices and reliable hospital drug supply, sustainable industry development.

How to choose between single-use and reusable medical materials for sustainable nursing: Methodological lessons learned from a national study.

To demonstrate and reflect upon the methodological lessons by which healthcare organizations can address questions of environmental sustainability related to single-use healthcare materials. A cross-sectional multi-centre study in hospitals was performed, followed by an exploratory analysis of the sustainability of commonly used healthcare materials. A hospital survey was conducted to collect the procurement data for single-use medical materials. Based on consumption and cost, five single-use medical materials with sustainable alternatives were selected using different reuse strategies. Single-use and reusable materials were assessed through an exploratory literature review and document study based on four parameters: environmental sustainability, safety, cost and efficiency. A pragmatic method emerged from this study, providing healthcare facilities with tools to select environmentally sustainable alternatives to replace single-use options. First, an inventory of single-use medical materials consumed was collected. Next, single-use materials were prioritized for further study based on criteria such as cost, volume of the material, feasibility and input of stakeholders. We then analysed the prioritized single-use materials and their alternatives based on life cycle assessments or available information on their different life stages. Finally, we assessed safety, costs and efficiency related to the process following the use of the medical material. This pragmatic method can guide healthcare institutions in making the most sustainable choices of medical materials and achieving sustainability goals within their institutions and nationwide. Patient care involves a large consumption of single-use medical materials with considerable environmental impact. A pragmatic method was developed to guide healthcare institutions in making the most sustainable choices regarding the use of single-use healthcare materials. Healthcare institutions, ideally represented by a green team including nurses and other relevant professionals, can use this method to reduce the use of single-use medical materials, thereby yielding positive outcomes for the entire population. No patient or public contribution.

Transforming Indigenous Procurement: Empowerment, Challenges, and the Road Ahead

The path toward economic reconciliation between Indigenous and non-Indigenous populations in Canada is a complex and vital journey that requires careful consideration of historical injustices and contemporary challenges. This paper focuses on the role of public procurement in addressing economic disparities and strengthening the nation-to-nation relationship between the Government of Canada and Indigenous communities. It provides an overview of public procurement's strategic importance, analyzes Indigenous federal procurement data from 2009 to May 2023 to identify trends and areas for improvement, and presents insights from a 2023 Indigenous procurement survey. Key findings emphasize the need to align Indigenous business capacities with procurement activities, promote inclusivity, and establish effective communication and mentorship programs. Implementing these recommendations can advance economic reconciliation and promote fairness within Canadian society.

Time trends and regional variations in prices of anticancer medicines in China.

High prices, as a main factor, contributed to the lack of adequate access to essential anticancer medicines, especially for patients in developing countries. The Chinese Government has introduced a series of policies to control the prices of medicines during the last decade, but the effect on anticancer medicine is not yet clear. To evaluate the time trends and regional variation in the price of essential anticancer medicines in China, we used the procurement data of anticancer medicines from 2015 to 2022. We selected 29 anticancer medicines from the 2018 Chinese National Essential Medicines List. To measure the cost of a medicine, we used defined daily dose cost -the cost per defined daily doses. At national level, we focused on the price changes over time and compared the price between medicine categories. At provincial level, we assessed price variation among provinces over time. For prices at the national level, all 6 targeted medicines exhibited a continuous decrease trend in price. Out of 23 non-targeted medicines, 4 (17·39%) experienced continuous increases in prices, and 9 (39·13%) showed price decreases from 2015 to 2019 and then an upward trend during 2019-2022; Of the remaining non-targeted medicines, 7 (30·43%) had continuous price decreases and 3 (13.04%) had price increases followed by decreases. For prices at the provincial level, provincial price variation became smaller for almost all targeted medicines, except rituximab; for 11 out of 23 non-targeted medicines, provincial price variations became larger. During the study period, the proportion of price-increased medicines in each province was geographically correlated, and no significant relationship between prices and GDP per capita was observed for both targeted and non-targeted anticancer medicines. The prices and regional disparity of most targeted anticancer medicines were decreasing, while for nearly half of the non-targeted anticancer medicines, the prices were increasing and the regional disparity became wider, which may lead to compromised access to these essential anticancer medicines and raise inequity health outcome among regions.

Health system lessons from the global fund-supported procurement and supply chain investments in Zimbabwe: a mixed methods study.

The Global Fund partnered with the Zimbabwean government to provide end-to-end support to strengthen the procurement and supply chain within the health system. This was accomplished through a series of strategic investments that included infrastructure and fleet improvement, training of personnel, modern equipment acquisition and warehouse optimisation. This assessment sought to determine the effects of the project on the health system. This study employed a mixed methods design combining quantitative and qualitative research methods. The quantitative part entailed a descriptive analysis of procurement and supply chain data from the Zimbabwe healthcare system covering 2018 - 2021. The qualitative part comprised key informant interviews using a structured interview guide. Informants included health system stakeholders privy to the Global Fund-supported initiatives in Zimbabwe. The data collected through the interviews were transcribed in full and subjected to thematic content analysis. Approximately 90% of public health facilities were covered by the procurement and distribution system. Timeliness of order fulfillment (within 90 days) at the facility level improved from an average of 42% to over 90% within the 4-year implementation period. Stockout rates for HIV drugs and test kits declined by 14% and 49% respectively. Population coverage for HIV treatment for both adults and children remained consistently high despite the increasing prevalence of people living with HIV. The value of expired commodities was reduced by 93% over the 4-year period. Majority of the system stakeholders interviewed agreed that support from Global Fund was instrumental in improving the country's procurement and supply chain capacity. Key areas include improved infrastructure and equipment, data and information systems, health workforce and financing. Many of the participants also cited the Global Fund-supported warehouse optimization as critical to improving inventory management practices. It is imperative for governments and donors keen to strengthen health systems to pay close attention to the procurement and distribution of medicines and health commodities. There is need to collaborate through joint planning and implementation to optimize the available resources. Organizational autonomy and sharing of best practices in management while strengthening accountability systems are fundamentally important in the efforts to build institutional capacity.