Role of supply chain intermediaries in steering hospital product choice: Group Purchasing Organizations and biosimilars.

Autor:	Dean EB; Miami Herbert Business School, Coral Gables, FL 33146, United States., Pierre R; Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, United States., Carter S; Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, United States., Bond AM; Department of Population Health Sciences, Weill Cornell Medical College, New York, NY 10065, United States.
Jazyk:	angličtina
Zdroj:	Health affairs scholar [Health Aff Sch] 2024 May 15; Vol. 2 (6), pp. qxae067. Date of Electronic Publication: 2024 May 15 (Print Publication: 2024).
DOI:	10.1093/haschl/qxae067
Abstrakt:	Over 95% of hospitals in the United States use pooling alliances, known as Group Purchasing Organizations (GPOs), to purchase medications, devices, and supplies. While GPOs create savings for hospitals through lowered prices and reduced administrative burden, critics allege that these supply chain intermediaries reduce competition, particularly if GPOs concentrate purchasing from larger, dominant manufacturers. Using a mixed-methods design, we studied whether GPOs influence hospital purchasing behavior and explored the contracting mechanisms used by GPOs. Focusing on 4 high-cost biologic molecules that face competition from generic-like biosimilars between 2015 and 2019, we found that biosimilar uptake was 16%-23% higher among Traditional Medicare patients in hospitals associated with 2 of the 3 top GPOs as compared with smaller GPOs. The increase in biosimilar use was driven by single biosimilar brands that varied by GPO. Based on qualitative interviews, these 2 GPOs used more aggressive contracting strategies to steer member hospitals to specific biosimilar brands. To date, the use of GPOs and these aggressive contracting strategies appear to have increased biosimilar use, suggesting savings for payers and patients. However, single-source GPO contracting could inhibit competition or create shortages in the long term. Transparency on GPO practices and pricing strategies is needed for further GPO evaluations. Competing Interests: Conflicts of interest Please see ICMJE form(s) for author conflicts of interest. These have been provided as supplementary materials. (© The Author(s) 2024. Published by Oxford University Press on behalf of Project HOPE - The People-To-People Health Foundation, Inc.)
Databáze:	MEDLINE
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