Through recent years, numerous innovative and exiting drug treatments have become available for treatment at hospitals to the benefit of patients. However, health budgets throughout Europe are challenged by the high costs of these drugs, and hospital pharmacies have a key role by buying medications for hospitals. In order to address the increasing medication costs, procurement and tendering should be considered as topics related to managing medication costs.

Procurement can be performed at national, regional as well as at local hospital level. Pros and cons for the hospital pharmacies exist for performing procurement at the various levels including effects on drug cost reduction, continuity of drug supply, competition etc.

Tenders are made when procuring drugs at hospital pharmacies, and various pros and cons exist for doing tenders as well. The traditional of doing tenders based on price only is widely accepted, however, value-based tenders including other aspects of the drugs than the price itself (e.g. patient safety issues, environmental aspects, quality-based factors and innovative characteristics) is becoming increasingly popular. The hospital pharmacist has a role for the future in ensuring relevance of the included factors of these value-based procurements.

In some European countries pay-per-performance and other models are used as a part of the tenders. These models may allow for the possibility of a greater price reduction, but they also lead to increased administration costs of monitoring of the tender and ensuring reimbursement.

Finally, procurement is regulated by EU-legislation, and all of the above should comply with these rules.