E-procurement in the Brazilian healthcare system: the impact of joint drug purchases by a hospital network.

OBJECTIVE To evaluate the use of e-procurement to obtain supplies for a network of seven university hospitals with a joint purchase system. METHODS The study was carried out between October 2003 and October 2005. We analyzed nine joint purchases of 37 pharmaceutical items. All the items were purchased in at least two-thirds of the nine occasions and/or were among the 10 items with the highest expenditure. The following aspects were recorded: price, number of suppliers providing quotes, type of supplier (distributor or manufacturer), reference value (lowest price paid per item by each hospital prior to the establishment of the joint purchase system), unit price for first purchase, and unit price for last purchase. The percent variation in price was compared in relation to the reference value, first and last purchases, and average unit price for the nine purchases. RESULTS A decrease in price > 10% was observed in 47% of the medications analyzed. A decrease > 20% was recorded in 32% of the 37 items. Five items (midazolam 5 mg 3 mL, tramadol 100 mg 2 mL, vancocin 500 mg vial, ceftazidime 1 g vial and cefepime 1 g vial) had a decrease >or= 50% in unit cost in the first purchase compared to the last purchase value. The unit price for 26 items (70%) had an average reduction of 23%. CONCLUSIONS E-procurement was successful in achieving real savings. The results show that the incorporation of new management technologies such as e-procurement in the healthcare setting may help overcome the management gap in the healthcare sector.