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Purchasing medical devices: The role of buyer competence and discretion


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


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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    References listed on IDEAS

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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


    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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