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The effectiveness of pharmaceutical tenders as a cost containment mechanism

Analysis through the Synthetic Control Method. The case of Andalusia (Spain)

Bibliographic Data

ID21467485
AuthorsPedro Atienza Montero (0000-0002-5347-511X, Universidad de Sevilla), Luis Ángel Hierro Recio (0000-0002-5868-5589, Universidad de Sevilla), Antonio J Garzón (0000-0003-4075-4926, Universidad de Cádiz), Antonio José Garzón Gordón
Year2026
Volume163
Pages105481
Publication date2026-01-01
Open AccessYes
TypeARTICLE
VenueHealth Policy (JOURNAL)
Journal identifiersISSN: 0168-8510 • E-ISSN: 1872-6054
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2025.105481
PMID41177036
OpenAlexW4415687820
LanguageEN
References cited18

Outpatient pharmaceutical tenders: not a widespread measure for reducing expenditure • Region of Andalusia is the only Spanish health administration to have applied them. • In Andalusia these public tenders failed to lead to a reduction in expenditure • A novel methodology is applied in this field of research: the Synthetic Control Method Outpatient pharmaceutical tenders are not a widespread measure. In Spain, the sub-central government of the Andalusian region is the only Spanish health administration to have applied them. This work aims to evaluate the effectiveness of this measure in reducing public pharmaceutical expenditure during the period it was in force –from June 2012 to December 2020. We use the Synthetic Control Method (SCM), which estimates a counterfactual (synthetic) value for our variable of interest (outpatient pharmaceutical expenditure per capita) based on a set of predictor variables from a combination of units from the potential control group (in this case, the rest of the regions in Spain). The results of the SCM show no evidence that the pharmaceutical tender implemented in Andalusia reduced pharmaceutical spending. Statistical tests show that the null hypothesis of no differential effect of the measure on pharmaceutical spending during the period in which it was in force cannot be rejected. These results are robust to various robustness tests. Public tenders for outpatient pharmaceuticals in Andalusia did not prove effective as a mechanism for controlling public expenditure during the period it was in force and failed to lead to a reduction in expenditure when compared to the rest of the regions in Spain, which did not apply it

Call for bids · Cost control · Public expenditure · Public hospital · Health Systems, Economic Evaluations, Quality of Life · Healthcare Systems and Reforms · Pharmaceutical Economics and Policy

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