Today, December 23, 2025, the Center for Civic Communications published the research Key players and competition in healthcare public procurement in the period from 2015 to 2024. The research showed that:
- In the last decade, the value of healthcare public procurement contracts has increased by more than double, while the number of economic operators awarded such contracts was increased by only 12%, which indicates a concentration of funds among a limited number of suppliers.
- With the growth in the value of tenders, the share of the ten largest holders of public procurement contracts has decreased from 62% in 2015 to 49% in 2024, which indicates a moderate decrease in concentration.
- Two companies, Alkaloid Kons and D-r Panovski strengthened their dominant position on the healthcare public procurement market and nowadays control one quarter of the total value of tender procedures in this sector. When analysed at the level of public procurements organized for medicines, medical supplies and medical equipment their combined share increases to one third.
- Over the last ten years, public procurement contracts awarded to only 10 companies account for a cumulative amount of more than 1 billion EUR, i.e. more than half of the total value of healthcare public procurement (53%).
- The value of public procurements performed by the biggest suppliers in the healthcare sector awarded under tender procedures where they appeared as the only bidder and without any competition has increased in the course of analysed years. On average, while the value share of contracts awarded to the biggest pharmaceutical companies in absence of any competition 10 years ago accounted for one third of the total value of healthcare public procurement (33%), today they account for more than half of the total value of contracts awarded (55%).
- The absence of competition concentrates wealth and influence among a small group of dominant players and leads to increased prices, reduced quality of healthcare services for patients and reduced variety of medicines.
- Viewed by programs, the company “Phoenix Pharma” dominates in the procurement of medicines and consumables for the treatment of diabetes, “Alkaloid Cons” in the program for immunization of the population, and “Alkaloid Cons” and “Dr. Panovski” in the program for rare diseases. In the tenders for the procurement of reagents and tests, “Avicena” and “Biotek” dominate.
This research is conducted as part of the project “Combating Corruption in Healthcare Public Procurement”, implemented by the Centre for Civil Communications with financial support from the National Endowment for Democracy (NED).
For more information, please contact the Center for Civic Communications at (02) 3213-513 or at center@ccc.org.mk.