Generally accepted principles of procurement and order placement
are formulated in a number of international documents, such as, for example, the EU Directives, the Multilateral Agreement on Public Procurement under the WTO, documents of the Asia-Pacific Economic Cooperation Organization. International organizations are developing mechanisms for centralized procurement of goods and services for the needs of their divisions, as well as to assist participating countries in their fight against the COVID-19 pandemic. In order to carry out the procurement of goods and services, the United Nations Organization, back in 1990, formed a special platform – the UN Global Market (UNDG).
The UN market consists of many specialized agencies, affiliate programs, foundations and various subsidiary bodies. In 1999, the Inter-Agency Pharmaceutical Coordination Group (IPC), with the participation of UNICEF, the United Nations Population Fund (UNFPA), WHO and the World Bank, developed and implemented four strategic goals and twelve principles for good drug procurement practice. One of them is to achieve the lowest possible total costs. A collaboration plan has been launched by the governments of 24 EU member states to jointly procure pandemic vaccines. Also supported was the Healthy Aging – Public Procurement Innovation (HAPPI) project, which aims to bring together the efforts of European public health procurement authorities for their joint activities.
In April-July 2015, Belgium, the Netherlands and Luxembourg signed a Memorandum of Understanding to jointly discuss prices for drugs for the treatment of orphan diseases, and Bulgaria and Romania announced their intention to jointly purchase high-cost drugs. The joint Benelux-Austria initiative (BeNeLuxA Initiative, which Ireland joined in 2018) on drug policy, launched in 2015, has a number of achievements to its credit, including the negotiation of the price of nusinersen with Biogen in 2018 g. Also in 2015, the Nordisk Lægemiddel Forum began operating, bringing together Denmark, Iceland, Norway and Sweden. Cooperation between Bulgaria and Romania on the procurement of high-value medicines also dates back to 2015, and in June 2016, another 9 countries joined them by signing the Sofia Declaration – Croatia, Estonia, Hungary, Latvia, Macedonia, Poland, Serbia, Slovakia and Slovenia.
In 2015, the Scandinavian Pharmaceutical Forum was also established to cooperate in the procurement of medicines. In July 2016, the Council of the European Union issued a series of recommendations that contribute to the affordability of medicines and drug supply. These include a recommendation on voluntary cooperation between the relevant public authorities of each of its member countries. In September 2016, the WHO Office for Europe indicated that procurement practices that can guarantee more competitive prices and improve drug supply to patients include: – consolidation of volumes into a single pool at different levels (Brazil, Bulgaria, Cyprus, Croatia, Denmark, Finland, Georgia, Greece, Hungary, Iceland, Italy, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Malta, Republic of Moldova, Poland, Portugal, Romania , Scotland, Serbia, Slovenia, Republika Srpska, Tajikistan, Ukraine, Great Britain); – use of framework agreements (Belgium, Bulgaria, Croatia, Denmark, Finland, France, Greece, Hungary, Iceland, Italy, Norway, Portugal, Romania, Scotland, Slovenia, Republika Srpska, Great Britain, USA) – procurement through international procurement agencies (global drug supply mechanism, UNDP, UNICEF, UNRWA). In May 2017, Cyprus, Greece, Italy, Malta, Portugal and Spain signed the Valletta Declaration on the Evaluation and Procurement of New Medicines.
Later they were joined by Croatia, Ireland, Romania and Slovenia. In June 2018, representatives of the national health technology assessment agencies of Finland, Norway and Sweden signed a memorandum to establish a FINOSE collaboration to jointly evaluate clinical and cost-effectiveness. In 2019, China embarked on a pilot program for centralized procurement and use of medicines to significantly reduce public spending on medicines. To date, the fifth round of group procurement of medicines has already taken place. The drugs selected in the fifth round of the Chinese government’s new centralized drug procurement program will, on average, be 56% cheaper than usual for those government health facilities that procure them, according to the PRC’s National Health Security Administration.
During the COVID-19 pandemic, the United Nations Children’s Fund (UNICEF) announced a tender for the supply of personal protective equipment (PPE) to meet the needs of such organizations.