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PubMed1992

Developing a pharmaceutical purchasing strategy.

The process commonly used by group purchasing organizations to contract for multisource pharmaceuticals and a strategic approach for the director of pharmacy in working with the purchasing group and the P & T Committee is described. The pharmacist should be knowledgeable concerning the group's contract commitment requirements, product specifications, terms and conditions and procedures for vendor selection, product award, contract implementation, and performance monitoring. To ensure results that meet the needs of the medical staff, it is important that the P & T Committee actively participate. The P & T Committee should understand the reasons for selecting a particular purchasing group, understand the necessary steps in obtaining the most favorable economic advantage, review products with potential brand interchange concerns, recommend product specifications, and reaffirm formulary procedures regarding the principle of current consent.

Competitive Bidding↗
PubMed1994

Buying groups seek compliance.

Purchasing groups are trying harder than ever to entice hospitals into buying a greater percentage of products through group contracts, and to tackle the old obstacle of contract compliance, according to Modern Healthcare's 1994 purchasing survey.

Data Collection↗
PubMed1994

A community quality initiative for health care reform.

In 1989, the Madison Area Employers Health Care Coalition conducted a feasibility study for the purpose of finding solutions to common health care concerns. The study revealed three conclusions: (1) there was little or no price competition among providers; (2) employers lacked useful data and information regarding health care costs and outcomes; and (3) employers and employees lacked basic health care consumerism. These conclusions led to the development of a health care purchasing group in the spring of 1990 with the formation of the Employers Health Care Alliance Cooperative (The Alliance). The conclusions outlined above became the cornerstone of the services offered by The Alliance, which include provider contracting, data collection, and consumer education and advocacy. The Alliance also developed the community quality initiative, a partnership of employers, health care consumers, and providers committed to using continuous quality improvement methods.

Community Health Services↗
PubMedDate not supplied

HealthMarts, HIPCs (health insurance purchasing cooperatives), MEWAs (multiple employee welfare arrangements), and AHPs (association health plans): a guide for the perplexed.

This paper considers how pending proposals to authorize new forms of group purchasing arrangements for health insurance would fit and function within the existing, highly complex market and regulatory landscape and whether these proposals are likely to meet their stated objectives and avoid unintended consequences. Cost savings are more likely to result from increased risk segmentation than through true market efficiencies. Thus, these proposals could erode previous market reforms whose goal is increased risk pooling. On the other hand, these proposals contain important enhancements, clarifications, and simplification of state and federal regulatory oversight of group purchasing vehicles. Also, they address some of the problems that have hampered the performance of purchasing cooperatives. On balance, although these proposals should receive cautious and careful consideration, they are not likely to produce a significant overall reduction in premiums or increase in coverage.

Cost Savings↗
PubMed1999

Hospitals leave national GPOs to create their own competitive contracts.

Hospitals cut better medical/surgical supply deals in smaller, innovative group purchasing networks. Meridian Health System in New Jersey posted an annual $1.5 million savings by renegotiating about a dozen of its supply contracts over the past year. By ditching memberships with the big GPOs and creating its own group purchasing cooperative, administrators there are cutting competitive deals. Find out how they're doing it.

Contract Services↗
PubMed1976

National survey of selected hospital pharmacy practices.

The incidence of 10 selected hospital pharmacy programs in short-term hospitals which contained a pharmacy was surveyed. A short questionnaire was mailed to a national sample of 738 hospitals. The 10 programs surveyed were: unit dose drug distribution; pharmacy-prepared i.v. admixtures; pharmacy-controlled drug administration; radiopharmaceutical dispensing; drug usage review; use of computers in the dispensing process; 24-hour pharmacy service; participation in group purchasing; pharmacy operation of central supply; and pharmacists' authority to select the brand or supplier of drugs. In addition, the volume of drug and supply purchases was determined. A large number of pharmacies (41%) belonged to a group purchasing plan, and a high percentage (67%) reported that pharmacists had authority to select the source of supply for all drug orders unless noted otherwise by the prescriber. Less than 10% of the hospitals had both complete unit dose drug distribution and intravenous admixture programs; an additional 10% had implemented such programs partially. Only 17% of the pharmacies in large hospitals were open 24 hours a day. Computer-assisted medication dispensing was used by 13% of the large hospitals and 5% of the small hospitals. Total pharmacy purchases for all short-term hospitals in 1974 was estimated to be 1.5 billion dollars.

Computers↗
PubMed1998

Determining when integrated delivery systems should belong to GPOs.

Membership in national group purchasing organizations (GPOs) is a proven way for healthcare organizations to access supply price discounts through collectively negotiated contracts. Yet, for various reasons, both suppliers and healthcare materials managers have expressed dissatisfaction with GPOs. Integrated delivery systems (IDSs), in particular, may find that negotiating with suppliers independently is a more cost-effective alternative. Whether an IDS should participate in group purchasing or negotiate with suppliers on its own depends on the following factors: whether the IDS would find it relatively simple to get its clinicians to standardize on certain key supplies; whether the IDS has sufficient staff to devote to contracting; whether the benefits offered by the GPO do not outweight the costs of membership; and whether all of the supplier products and services the GPO makes available also are available through second-tier suppliers eager to negotiate directly with the IDS.

Consumer Behavior↗
PubMed1992

Shifting no solution to problem of increasing costs.

Rising healthcare costs are being allocated unevenly because some stakeholders are better than others at insulating themselves from paying their share of the burden. Those with significant or group purchasing power are paying less than actual cost, forcing providers to shift a disproportionate share of the costs to small businesses and non-group purchasers. The magnitude of this cost shifting is large and growing. Its primary impact is a destabilization of insurance markets. Stability can only be restored with well thought-out proposals that deal with causes of the cost increases.

Cost Allocation↗
PubMed1984

Evaluation of drug-procurement alternatives.

Methods of drug procurement used by hospital pharmacies are discussed. Pharmaceuticals may be purchased directly from the manufacturer or from one or more local wholesalers. Factors influencing the extent to which each of these procurement sources is used are described, and the advantages and disadvantages of group purchasing and the prime-vendor concept are discussed. Finally, factors to be considered when evaluating proposed modifications of a hospital purchasing program are discussed. Prime-vendor relationships and pharmaceutical purchasing groups offer some potential advantages to hospital pharmacists in terms of cost and efficiency. The applicability of these methods must be carefully analyzed in each individual hospital setting.

Costs and Cost Analysis↗
PubMed1995

Could changes in the wheelchair delivery system improve safety?

Despite emerging evidence about the high incidence and severity of wheelchair-related injuries, regulations governing wheelchair safety are almost nonexistent in Canada. The authors believe that, to improve wheelchair safety, a concerted effort by government, manufacturers, purchasing groups, users and clinicians is needed. Health Canada's Health Protection Branch should treat wheelchairs as medical devices (as defined in the Food and Drugs Act 1985) and improve its injury-reporting network. Manufacturers should give a higher priority to safety in wheelchair design, improve their educational materials and formalize postmarketing surveillance. Purchasing groups should try to ensure that they do not stifle innovation in wheelchair design by setting unrealistic reimbursement ceilings and should use their market power more effectively. Users should obtain their wheelchairs in specialized settings, heed safety warnings and make more effective use of litigation when such action is warranted. Clinicians should ensure that patients are equipped with the most appropriate wheelchair for their needs, that they are given adequate training in safe wheelchair use and that they understand the dangers involved. Rapid changes in wheelchair technology and emerging evidence about the high incidence and severity of injuries related to wheelchair use suggest that such changes are needed in the wheelchair delivery system.

Canada↗