HOSPITAL PROCUREMENT FRENCH EXPERIENCE Patrick BROUDIC Bratislava June 2016 HOSPITAL PROCUREMENT FRENCH EXPERIENCE PROGRAM « PHARE »

context The program PHARE was initiated to carry the dynamics necessary for the development and for the structuring of the purchasing function within hospitals. Launched by the French Ministry of Health in the beginning of October, 2011.

RAISING THE PERFORMANCE The program « PHARE” aims not only to the realization of economic benefits for hospitals. It also aims to raise their performance level: by the access of all the hospitals to group purchases; by the identification of a person in charge of purchases for each hospital or group of hospitals for the smallest of them; by the institution of a real dialogue between the person in charge of purchases and the prescribers within hospitals. By his knowledge of the market, the person in charge can help the prescribers to tranlate their needs into the best economic offer.

The levers of a "successful" purchase The negotiation of the prices, to obtain moderate and justified prices; The standardization, which avoids generally additional costs connected to too specific or too sharp products; The reasoning in complete cost, favouring the anticipation on the life cycle of the bought products, on their precise conditions of use or installation and on their maintenance; The good knowledge of products available on the market for more competition between suppliers and to detect the innovations …

Program management The program PHARE associates all the stakeholders and decision makers. The driving of the program is made by specialists experienced both in the private and public sectors. It associates purchasing managers of big private companies, hospital directors, hospital practitioners ... These specialists are involved in a national committee of hospital purchases. They meet every month to share and promote best practices.

12 best practice For a successful purchase (1) N°1: Organize systematically with the prescribers a common reflection to define the real need N°2: Identify all the costs beyond the only acquisition costs: implementation, use, associated costs, costs of the end of life, etc. N°3: Define a target price N°4: Annual measuring of the impact of what was improved N°5: Define a level of allotment adapted for most competition and assure a first level of standardization N°6: Join clauses of promotional price

12 best practice For a successful purchase (2) N°8: Anticipate the various times of a market: study of the offer, evaluation of the staff necessary for managing the market N°9: Negotiate every time the regulation permits it N°10: Include in the markets a clause of cooperation with the supplier during the execution of the market N°11- Have a dynamic management of markets N°12 - Facilitate the change management inside hospitals

Workgroups on 10 themes Computer servers Energy Food Equipment of endoscopy Solutions of impression Medicines Cleaning and household Small not sterile medical surgical devices Office supplies Waste management

achievements Amount of hospital purchase: 18 Billion € Annual economies: target of 900 Million € (5%), estimate of materialized gains = 500 Million € at this stage