There are situations in medicine where administrative procedures can weigh on someone's health - or even life. An example is the organization of the purchase of a drug for children with spinal muscular atrophy. When the diagnosis is made early, and the appropriate therapy is implemented immediately - the progression of the disease can be stopped.
MPC on organization of tender for health or life-saving drug
Published April 8, 2025 08:56
Medical advances give children with SMA a real chance to live without symptoms of the disease - provided the drug is administered as soon as possible.
"According to current medical knowledge, it is extremely beneficial to combine early diagnosis for spinal muscular atrophy (SMA) with early treatment. Clinical studies confirm that drugs are most effective if they are administered to a patient before the first symptoms of the disease appear (...) every effort should be made to administer therapy as soon as possible."
The drug containing the active ingredient onasemnogen abeparwowek is effective - but very expensive. It must be given before the child is 6 months old. The earlier - the better.
Where did the problem arise?
The Patient Ombudsman investigated the case of one hospital that provides SMA treatment. It turned out that the hospital's documentation stipulated open tender as the only mode of procuring the drug. And this - while formally correct - in practice can sometimes be too slow when it comes to saving lives.
"The procurement procedure provides only for open tender, which, due to statutory deadlines, is a decidedly prolonged procedure when there is an urgent need to award a contract."
Meanwhile, the regulations allow a "negotiated" mode, intended precisely for such urgent, exceptional situations.
What should the hospital do?
- Identify situations where time is a critical factor - like SMA treatment.
- Adjust internal procedures to accommodate the possibility of using the "at-will" mode if necessary.
- Work with doctors and national consultants to know and apply the latest medical guidelines.
What did the Patient Ombudsman say?
The ombudsman found that limiting the mode of awarding the contract in an urgent situation violated patients' collective rights.
"In the case of SMA therapy, any delay in treatment not only results in a worsening of the child's baseline condition, but is also associated with significantly lower treatment efficacy."
It also stressed that:
"The need to purchase a drug that is essential to protect health and save human life, if the drug must be administered in the shortest possible time (...) is a circumstance justifying the selection of the negotiated procedure."
