THE ITALIAN HEALTH CARE SYSTEM
Health care in Italy is provided mainly by the State and is regulated by the Ministry of Health. The system works through local health offices that administer and deliver health care services in ambulatory care facilities and hospital centers.
By Italian law the local health offices must pay their suppliers within 90 days of delivery, but due to huge administrative delays payment usually take up to over one year.
Almost all acquisitions are done through public tenders announced annually for the following year’s supply. During the second half of every year, hospital divisions are required to submit their estimates for the supplies they will need the following year. These estimates are then reviewed by the local health offices whose job it is to try and fit the supply requests within foreseen budget allocations.
Price is of fundamental importance in the bidding process. To win a tender not only must suppliers offer a better quality product but first and foremost they have to have very competitive prices. The prices quoted in the tender must also be kept valid during the entire year ahead and for the duration of supply.
THE DECISION MAKER
In the Italian health care system, the role of the decision maker in approving the purchase of supplies is still undefined. The adoption of a product is proposed by the surgeon, but it is the purchasing department that decides on the basis of price whether a certain product can be ordered. Convincing the surgeon of a product’s superiority is only one step in obtaining a sales agreement; the next step is the purchasing office whose administrators are strongly conditioned by the lack of adequate funds.
This situation makes it necessary that a supplier works with a highly qualified sales force armed with a sound scientific background that enables them to convincingly present the product to the surgeon. Likewise, they must have a business attitude and talent for communicating, so that together with the surgeon the team can promote sales efforts more successfully to the purchasing department. What leads to results is persistence and continuity in pursuing these goals.