Every year, public health facilities spend 7 billion euros on hospital medicines.
Pharmaceutical products, in fact, are a product category characterized by the number of active ingredients and suppliers on the market; for this reason, the tenders are structured on a considerable number of lots, one for each active ingredient and are therefore very complex especially from a procedural point of view, requiring long times for the evaluation of the offers. For this reason, they lend themselves well to online negotiation, allowing significant process and economic savings for contracting authorities and companies; the use of the Consip telematic platform, in fact, allows a considerable reduction of the procedural burdens, the simplification of the methods of participation for companies and of the evaluation of the offers by the selection commission, allowing shorter times for the award (a few hours instead of months).
By virtue of the success achieved with the tenders for the Regions and with a view to the evolution of the offer, in 2011 Consip launched a new purchasing tool, which was inaugurated precisely with a tender relating to the drug category worth 12 billions of euros in three years: this is the Public Administration's Dynamic Purchasing System (Sdapa), which allows all the Public Administrations to negotiate tenders above and below the EU threshold for the acquisition of medicines, in a fully electronic manner, inviting all qualified economic operators admitted by Consip to the System itself. In this way, a list of suppliers is made available to the Public Administrations who demonstrate that they possess the technical and economic requirements set out in the tender specifications and it is then the individual administrations that carry out the tender procedure using the telematic platform and inviting the accredited companies.
Since the launch of the System, the administrations have already carried out tenders for a value of over 4 billion euros on Sdapa and have managed to obtain significant economic benefits. And it is precisely the nature of the economic benefits linked to greater purchasing efficiency that deserves further study. In fact, it is important to underline that obtaining price reductions certainly has its relevance, but it is only the first step. The efficiency of the purchasing process in terms of unit price reduction – entrusted directly to a qualified entity such as a central purchasing body or, as in the case just described, using telematic tools supplied by Consip – cannot be the priority especially in the health sector, where the beneficiaries of supplies are sick people and where therefore attention to the quality of what you buy is essential.
Much more important and relevant also from an economic point of view are, on the other hand, the benefits that can be obtained with an incisive modification of the purchasing processes themselves and with their integration. Consip has launched a process to offer public health structures support towards the evolution and modernization of these processes and towards the introduction of new procurement logics, which are not limited to the reduction of the unit cost but which intervene on efficiency managerial. The dynamic purchasing system constitutes the first step, because it represents above all a benefit from the point of view of streamlining procedures which also has an economic value, but further ones can and must be implemented.
For example, also comparing itself with the realities of other countries, Consip has studied the possibility of implementing projects for the innovation of management processes linked to the supply of goods and services, such as the creation of single-dose packages and drug logistics. In fact, the objective is to promote actions that allow better control of the entire supply chain and therefore a more rational use of resources, so as to reduce their use and allow efficiency recoveries within the system. Only in this way will our public system be able to maintain sustainability, efficiency, and above all the high levels of service for Italian citizens.
20 – 09 – 2014 – Domenico Casalino – formiche.it
Dominic Casalino, managing director of Consip Spa
Article published in the August/September issue of Formiche magazine
Healthcare, now you save. 246 million less on gauze, needles and meals
The Region strengthens the Single Purchasing Center and sets reference prices for over 500 products. Tenders for medicines and laundry services.
by MAURO FAVALE – 21 September 2014 – R.it Rome
Una razionalizzazione della spesa (“Da questo punto di vista non si tratta di tagli”, assicurano in via Cristoforo Colombo) ottenuta grazie al potenziamento della Centrale unica degli acquisti. La direzione, guidata dal maggio 2013 da Elisabetta Longo, ha fatto di necessità virtù. Così, in una Regione con la sanità commissariata da 8 anni, con un disavanzo che a fine anno (salvo sorprese) dovrebbe assestarsi ancora sui 200 milioni di euro, il primo accorgimento è stato operare una stretta sugli acquisti.
“Siamo stati tra i precursori a livello nazionale – spiega la Longo – nel fissare i prezzi di riferimento per i dispositivi medici”. Un provvedimento che ha riguardato oltre 500 prodotti ai quali è stato assegnato un range da cui nessuna Asl ha potuto discostarsi. E così, per esempio, gli aghi ipodermici per siringa sono passati da 0,0013 di euro a 0,008. Lo stesso per le garze, da 0,33 centesimi di euro a 0,27. O le provette sterili per i prelievi: da 0,0124 a 0,058. Tutti prodotti di larghissimo consumo nella sanità, ordinati in quantità enormi, le cui riduzioni incidono in maniera significativa sui bilanci finali.
Effetto delle gare centralizzate, l’altra grande leva a disposizione della Centrale unica degli acquisti. Grazie a questo strumento oggi una “giornata alimentare” per ogni paziente (dalla colazione alla cena passando per il pranzo e la merenda) costa circa 11 euro. Quattro in meno rispetto alla media del 2012. Allora, prima della gara centralizzata, un pasto giornaliero in alcune Asl arrivava a costare anche 25 euro. “Ma con il risparmio non ne risente la qualità – spiega la direttrice della centrale – perché per i capitolati sulla ristorazione che abbiamo preparato hanno partecipato anche alcuni nutrizionisti”. Lo stesso vale per le operazioni di lavaggio e pulizia della biancheria, delle lenzuola, dei materassi: prima, per una giornata di degenza, il costo medio era di 5,5 euro. Oggi è sceso a 3. Per non parlare dei drugs o di apparecchiature mediche più delicate, come i pacemaker: per acquistarne uno cosiddetto “tricamerale” prima la Regione Lazio pagava fino a 3589 euro. Oggi, invece ne paga 2.200 euro, con un risparmio di quasi il 40%.
Carlo Cottarelli: "I earn 11,900 euros per month". Plus the IMF pension (€18,300)
But how much does he earn exactly the man of government cuts Renzi? In addition to the salary of public expenditure review commissioner, 258 thousand euros gross per year, Cottarelli receives a pension from International Monetary Fund, where he worked until last October. Others 220 thousand euros, which in total they do 478 thousand euros gross per year. But specify:
“I resigned from the International Monetary Fund the day before I was appointed spending commissioner.”
And, let us add, to receive the pension from the IMF. Cottarelli also inserts the net values in the declaration: 118,500 for retirement And 140,000 as commissioner of government. His effective paycheck is therefore of 21,500 euros per month for twelve months.
“If I had retired and remained in the United States – he specifies – my pension would have been taxed at the rate of 10%. Instead, I regularly pay for everything in Italy”.
His real estate assets include two houses: an apartment worth $850,000 in washington, jointly owned with his wife, and one in Cremona worth 250,000 euros. He has a stake in the Azimut investment fund worth 1.8 million.