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Purchasing medical devices: The role of buyer competence and discretion

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  • Bucciol, Alessandro
  • Camboni, Riccardo
  • Valbonesi, Paola

Abstract

This paper investigates the price variability of standardized medical devices purchased by Italian Public Buyers (PBs). A semiparametric approach is used to recover the marginal cost of each device. Average prices vary substantially between PBs; we show that most of the difference between the purchase prices and estimated costs is associated with a PB fixed effect, which, in turn, is related to the institutional characteristics and size of the PB. Repeating the main estimation using device fixed effects yields similar results. Finally, an exogenous policy change, i.e. the termination of the mandatory reference price regime, is used to assess how discretion affects medical device procurement given the skills of each PB. Our results show that less PB discretion — i.e. when mandatory reference prices apply — determines efficiency gains and losses for low- and high-skilled PBs, respectively.

Suggested Citation

  • Bucciol, Alessandro & Camboni, Riccardo & Valbonesi, Paola, 2020. "Purchasing medical devices: The role of buyer competence and discretion," Journal of Health Economics, Elsevier, vol. 74(C).
  • Handle: RePEc:eee:jhecon:v:74:y:2020:i:c:s0167629620302381
    DOI: 10.1016/j.jhealeco.2020.102370
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    1. Emmanuel Guerre & Isabelle Perrigne & Quang Vuong, 2000. "Optimal Nonparametric Estimation of First-Price Auctions," Econometrica, Econometric Society, vol. 68(3), pages 525-574, May.
    2. Audinga Baltrunaite & Cristina Giorgiantonio & Sauro Mocetti & Tommaso Orlando, 2021. "Discretion and Supplier Selection in Public Procurement [Formal and Real Authority in Organizations]," The Journal of Law, Economics, and Organization, Oxford University Press, vol. 37(1), pages 134-166.
    3. Elodie Guerre & I. Perrigne & Q.H. Vuong, 2000. "Optimal nonparametric estimation of first-price auctions [[Estimation nonparamétrique optimale des enchères au premier prix]]," Post-Print hal-02697497, HAL.
    4. Philip A. Haile & Han Hong & Matthew Shum, 2003. "Nonparametric Tests for Common Values in First-Price Sealed-Bid Auctions," Cowles Foundation Discussion Papers 1445, Cowles Foundation for Research in Economics, Yale University.
    5. Ján Palguta & Filip Pertold, 2017. "Manipulation of Procurement Contracts: Evidence from the Introduction of Discretionary Thresholds," American Economic Journal: Economic Policy, American Economic Association, vol. 9(2), pages 293-315, May.
    6. Steve Kelman, 1990. "Procurement and Public Management," Books, American Enterprise Institute, number 53122, September.
    7. Federico, Giovanni & Vasta, Michelangelo & Nuvolari, Alessandro, 2017. "The Origins Of The Italian Regional Divide: Evidence From Real Wages, 1861-1913," CEPR Discussion Papers 12358, C.E.P.R. Discussion Papers.
    8. Nicola Lacetera & Bradley J. Larsen & Devin G. Pope & Justin R. Sydnor, 2016. "Bid Takers or Market Makers? The Effect of Auctioneers on Auction Outcome," American Economic Journal: Microeconomics, American Economic Association, vol. 8(4), pages 195-229, November.
    9. Decio Coviello & Luigi Moretti & Giancarlo Spagnolo & Paola Valbonesi, 2018. "Court Efficiency and Procurement Performance," Scandinavian Journal of Economics, Wiley Blackwell, vol. 120(3), pages 826-858, July.
    10. Francesco Decarolis, 2018. "Comparing Public Procurement Auctions," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 59(2), pages 391-419, May.
    11. Gary S. Becker & George J. Stigler, 1974. "Law Enforcement, Malfeasance, and Compensation of Enforcers," The Journal of Legal Studies, University of Chicago Press, vol. 3(1), pages 1-18, January.
    12. Bergman, Mats A. & Johansson, Per & Lundberg, Sofia & Spagnolo, Giancarlo, 2016. "Privatization and quality: Evidence from elderly care in Sweden," Journal of Health Economics, Elsevier, vol. 49(C), pages 109-119.
    13. Di Tella, Rafael & Schargrodsky, Ernesto, 2003. "The Role of Wages and Auditing during a Crackdown on Corruption in the City of Buenos Aires," Journal of Law and Economics, University of Chicago Press, vol. 46(1), pages 269-292, April.
    14. Sorenson, Corinna & Kanavos, Panos, 2011. "Medical technology procurement in Europe: A cross-country comparison of current practice and policy," Health Policy, Elsevier, vol. 100(1), pages 43-50, April.
    15. Susan Athey & Philip A. Haile, 2002. "Identification of Standard Auction Models," Econometrica, Econometric Society, vol. 70(6), pages 2107-2140, November.
    16. Matthew Grennan & Robert J. Town, 2020. "Regulating Innovation with Uncertain Quality: Information, Risk, and Access in Medical Devices," American Economic Review, American Economic Association, vol. 110(1), pages 120-161, January.
    17. Kastanioti, Catherine & Kontodimopoulos, Nick & Stasinopoulos, Dionysis & Kapetaneas, Nikolaos & Polyzos, Nikolaos, 2013. "Public procurement of health technologies in Greece in an era of economic crisis," Health Policy, Elsevier, vol. 109(1), pages 7-13.
    18. Spagnolo, Giancarlo, 2012. "Reputation, competition, and entry in procurement," International Journal of Industrial Organization, Elsevier, vol. 30(3), pages 291-296.
    19. Decio Coviello & Andrea Guglielmo & Giancarlo Spagnolo, 2018. "The Effect of Discretion on Procurement Performance," Management Science, INFORMS, vol. 64(2), pages 715-738, February.
    20. Michael Carlos Best & Jonas Hjort & David Szakonyi, 2023. "Individuals and Organizations as Sources of State Effectiveness," American Economic Review, American Economic Association, vol. 113(8), pages 2121-2167, August.
    21. Patrick Bajari & Stephanie Houghton & Steven Tadelis, 2014. "Bidding for Incomplete Contracts: An Empirical Analysis of Adaptation Costs," American Economic Review, American Economic Association, vol. 104(4), pages 1288-1319, April.
    22. Matthew Grennan, 2014. "Bargaining Ability and Competitive Advantage: Empirical Evidence from Medical Devices," Management Science, INFORMS, vol. 60(12), pages 3011-3025, December.
    23. Matt Shum & Phil Haile & Han Hong, 2003. "Nonparametric Tests for Common Values in First-Price Auctions," Economics Working Paper Archive 501, The Johns Hopkins University,Department of Economics.
    24. Matthew Grennan, 2013. "Price Discrimination and Bargaining: Empirical Evidence from Medical Devices," American Economic Review, American Economic Association, vol. 103(1), pages 145-177, February.
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    Cited by:

    1. Claudia Allende & Juan Pablo Atal & Rodrigo Carril & José Ignacio Cuesta & Andres Gonzalez-Lira, 2023. "Drivers of Public Procurement Prices: Evidence from Pharmaceutical Markets," Working Papers 1413, Barcelona School of Economics.
    2. Martinez-Carrasco, José & ConceiçaÞo, Otavio & Dezolt, Ana Lúcia, 2023. "More Information, Lower Price? Access Market-based Reference Prices and Gains in Public Procurement Efficiency," IDB Publications (Working Papers) 12754, Inter-American Development Bank.
    3. Francesco Decarolis & Gaétan de Rassenfosse & Leonardo M. Giuffrida & Elisabetta Iossa & Vincenzo Mollisi & Emilio Raiteri & Giancarlo Spagnolo, 2021. "Buyers' role in innovation procurement: Evidence from US military R&D contracts," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 30(4), pages 697-720, November.
    4. Clark, Robert & Coviello, Decio & de Leverano, Adriano, 2021. "Centralized procurement and delivery times: Evidence from a natural experiment in Italy," ZEW Discussion Papers 21-063, ZEW - Leibniz Centre for European Economic Research.
    5. De Leverano, Adriano & Coviello, Decio & Clark, Robert, 2023. "Centralized Procurement and Delivery Times: Evidence from a Natural Experiment in Italy," VfS Annual Conference 2023 (Regensburg): Growth and the "sociale Frage" 277589, Verein für Socialpolitik / German Economic Association.
    6. Andrea Bafundi & Riccardo Camboni & Edoardo Grillo & Paola Valbonesi, 2023. "Public Procurement and the Risk of Severe Weather Events," "Marco Fanno" Working Papers 0303, Dipartimento di Scienze Economiche "Marco Fanno".
    7. Visa Pitkänen, 2022. "Competition and efficiency in repeated procurements: Lessons from the Finnish rehabilitation markets," Health Economics, John Wiley & Sons, Ltd., vol. 31(5), pages 820-835, May.
    8. Chiappinelli, Olga & Giuffrida, Leonardo M. & Spagnolo, Giancarlo, 2023. "Public procurement as an innovation policy: Where do we stand?," ZEW Discussion Papers 23-002, ZEW - Leibniz Centre for European Economic Research.
    9. Clarissa Lotti & Giancarlo Spagnolo, 2022. "Indirect Savings from Public Procurement Centralization," CEIS Research Paper 532, Tor Vergata University, CEIS, revised 01 Feb 2022.
    10. Bru, Lluís & Cardona, Daniel & Sákovics, József, 2023. "Block sourcing plus," European Journal of Operational Research, Elsevier, vol. 305(3), pages 1130-1140.
    11. Drake, Samielle & Xu, Fei, 2023. "Regulation and Competition in Public Procurement," Umeå Economic Studies 1013, Umeå University, Department of Economics.
    12. Giuffrida, Leonardo M. & Raiteri, Emilio, 2021. "Buyers' workload and R&D procurement outcomes: Evidence from the US Air Force Research Lab," ZEW Discussion Papers 21-059, ZEW - Leibniz Centre for European Economic Research.

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    More about this item

    Keywords

    Medical devices; Procurement; Reference price; Discretion;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • H11 - Public Economics - - Structure and Scope of Government - - - Structure and Scope of Government
    • H57 - Public Economics - - National Government Expenditures and Related Policies - - - Procurement

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