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Innovation and Entrepreneurship Research

Procurement Institutions and Essential Drug Supply in Low and Middle-Income Countries

Wang, Lucy Xiaolu; Bin Zahur, Nahim (2025). Procurement Institutions and Essential Drug Supply in Low and Middle-Income CountriesMax Planck Institute for Innovation & Competition Research Paper No. 25-04.

International procurement institutions play an important role in drug supply. We study price, delivery, and procurement lead time of drug products for major infectious diseases (antiretrovirals, antimalarials, antituberculosis, and antibiotics) in 106 developing countries from 2007-2017 across procurement institution types. We find that pooled procurement lowers prices: pooling internationally is most effective for small buyers and concentrated markets, while pooling within-country is most effective for large buyers and unconcentrated markets. Pooling can reduce delays, but at the cost of longer anticipated procurement lead times. Finally, pooled procurement is more effective for older drugs, compared to patent pooling institutions that target newer drugs.

Available at SSRN