Modernize Public Procurement Policies Public procurement can have an enormous impact on patient access to medical technology, particularly in emerging markets that may rely exclusively on direct procurement models. A number of global markets are increasingly focused on reducing reimburse- ment as a means to address budgetary issues. Such mechanisms appear to be more frequently utilized in markets where access to care is increasing the most rapidly. In many instances, an exces- sive focus on up-front costs has led to imposition of price controls, which fail to consider the full value medical technology brings to patients, the health care system and the economy over time. For example, advancements in medical technology often yield savings across the health care system by replacing more invasive procedures, reducing hospital stays, and allowing people to return to work more quickly. AdvaMed has convened several international forums over the last few years to develop consensus best practic- es for value-based procurement. These principles were formulated through collaborative efforts with thought leaders including physi- cians, hospitals, government entities as well as industry. Related White Papers can be viewed on AdvaMed’s website.11 Ensure that Health Technology Assessments (HTAs) are transparent and fair, to promote access to quality care AdvaMed has formulated principles on health technology assessment that help to define its appropriate role and utilization. AdvaMed works with local association partners to address unfairness in HTA processes. Not infrequently, HTAs are used as a barrier to market entry or as a mechanism to control costs, rather than as an attempt to assess value. AdvaMed has been on the forefront in many markets of holding HTA agencies accountable to ensure transparency and fairness, and to ensure appropriate data are accepted. 15 In some cases, AdvaMed has worked to ensure broader adoption of beneficial technologies with positive assessments. AdvaMed did this in the UK with insulin pumps. In Korea, AdvaMed has been successful in obtaining improvements in reviews that allow for greater reimbursement levels for innovative technology. In Germany, AdvaMed worked with a BVMed coalition to defeat a proposal that would have required benefit assessment studies for all Class IIB and III devices coming onto the market. In every market around the world, AdvaMed works to ensure that HTAs are transparent, fair and reflect the latest scientific knowledge. AdvaMed has also played a key role in working with the World Bank to develop a value-based procurement framework for medical technology. While the Bank’s initial emphasis is primarily on capital equipment, AdvaMed’s work with the Bank has resulted in adoption of broad value-based concepts that are applicable to situations in which governments want to obtain better value. The initiative is anticipated to conclude in 2017. 11