In Summer 2025, Wise Angle, on behalf ofHealth Procurement Europe, explored the application of MEAT criteria and sustainable public procurement practices for human medicines. Published in October 2025, the report highlighted upstream weaknesses in the application of MEAT and sustainable procurement criteria, with significant implications for medicines supply chains, business sustainability, medicines availability and public health outcomes.
What’s the problem?
Medicines are crucial, necessary, goods bought by health service providers generally following rules defined by the EU’s Public Procurement Framework. The Framework makes clear that environmental and social considerations should be incorporated into public procurement procedures. In addition, the European Commission considers that public procurement is key for smart, sustainable, and inclusive growth, which can be achieved by awarding contracts to the Most Economically Advantageous Tender (MEAT). As such, according to the EU Public Procurement Directive, all public procurers should apply the MEAT criteria when selecting a winning bid.
However, a standardised approach to medicines procurement is wanting across the European Union. More often than not, economic considerations precede concerns about value and long-term social and environmental impact associated with medicines production. Sustained focus on public authorities’ medicines budgets impact access to medicines, and have long term effects for patient safety, business sustainability, research, development and innovation.
What we did
The objective of the study was to explore how tendering practices support or impede the supply, resilience and sustainability of medicines. Research questions included:
- What public procurement practices are used in medicines procurement;
- How is MEAT applied and what challenges exist for its implementation, and
- What, if any good practices exist promoting the sustainable procurement of medicines in Europe.
A rapid scoping literature review incorporated primary and secondary data sources. Good practices emerged from desk-based research and were further explored by sourcing publicly available information from institutional repositories and the websites of national medicines agencies.
The research team applied a sustainability framework guided by the OECDs and the UN’s Three Pillars of Sustainable development and procurement. This approach supported data collection, literature screening and the analysis of the good practices, presenting the extent to which the three pillars of economic, environmental and social sustainability are applied by public tenderers in practice.
What we found
- First, while MEAT theoretically means that procurers can go beyond price only considerations in procuring decisions, procurement bodies generally opt for the lowest price offer. This means that a cost-effective, best price quality approach that aligns with social and environmental objectives is not applied. While industry reports indicate that the importance of MEAT criteria is increasing in some European countries, use is not widespread.
- Second, competition and price are affected by the prevalence and preference of single winner contracts. Few procurers use multi-awardee framework contracts, meaning that lessons learned from the COVID-19 pandemic concerning resilience supply chains have yet to be implemented, even thoughresearch clearly shows a correlation between supplier numbers and tender savings.
- Third, at the European and national level, sustainability has become unequivocally equated with the green agenda. While 64% of OECD countries integrate GPP award criteria in procurement practices, GPP criteria is not consistently applied to medicines outside of the Scandinavian region. Furthermore, a significant gap appears to exist in the application of GPP in healthcare settings as while green public procurement is applied to almost all aspects of healthcare EXCEPT medicines.
- Next, social sustainability, which concerns human rights, labour standards, diversity, equity and inclusion, is lacking in procurement practices. Where it is applied, it is generally linked to immediate patient care (i.e., access to medicines), although some labour market practices are emerging in response to geopolitical pressures, including efforts to reshore medicines production to European countries.
- No good practices incorporating all three sustainability criteria in medicines procurement were identified. Where sustainable procurement practices are applied, only two of the three pillars (economic and environmental) are typically considered.
Suggested steps and follow-up actions
Evidence-based recommendations suggest tackling the contextual, operational and strategic factors limiting the application of MEAT criteria and the integration of the three pillars of sustainability in public procurement.
This included:
- At a minimum, develop and apply GPP criteria for medicines procurement.
- Develop standardised EU guidance for the sustainable procurement of medicines, incorporating SPP criteria encompassing the three sustainability factors.
- Invest in public procurers’ learning and development. CPD programmes should ensure practitioners can fulfil their legal and ethical responsibilities to build long-term, inclusive, sustainable, and healthy societies.
Read the full report here