Value-based procurement and tenders for medical devices with application to wound care: international perspectives and practical opportunities

BACKGROUND: Chronic wounds impose a substantial and growing burden on healthcare systems worldwide, consuming significant resources while often delivering suboptimal patient outcomes. In parallel, value-based procurement (VBP) has gained increasing policy attention in medical devices as a multidisciplinary approach that links purchasing decisions to outcomes, service quality, and total cost of care rather than unit price alone. OBJECTIVE: To examine how value-based procurement for medical devices is conceptualized, enabled, and implemented internationally, and to assess its relevance to wound care. METHODS: We conducted an integrative review combining database searches with structured searching of authoritative policy and grey literature relevant to VBP for medical devices and wound care across 15 countries. RESULTS: Across jurisdictions, VBP in medical-device procurement moves beyond lowest-price purchasing towards multidimensional evaluation that may include clinical outcomes, patient-relevant outcomes, service and training, sustainability, and total or life-cycle cost. Legal frameworks enabling value-based award criteria were identified in all 15 countries examined, but operational maturity, institutional capacity, and documented implementation varied substantially. In wound care specifically, the evidence consistently indicates that major cost drivers are clinical time, healing duration, and complications rather than product acquisition cost alone. CONCLUSIONS: VBP appears to be an increasingly policy-enabled and selectively implemented procurement approach with clear relevance to wound care. However, operational maturity and empirical evaluation remain uneven across settings. Realizing its full potential will require better designed and reported wound-care studies, more standardized outcome measures, stronger real-world data infrastructure, and procurement processes capable of evaluating value across the full care pathway.