Table 2.

Organizing multi-winner tenders—considerations.

Advantages	Conditions
Stimulating market presence of multiple suppliers over the longer term	Volume at purchaser level needs to be sufficiently large to be divided among different suppliers. Alternatively, multiple single-winner opportunities can be organized in a given market to ensure supplier plurality (i.e., the approach and number of winners should be adjusted to market purchasing characteristics.)
Offering commercial opportunity to multiple suppliers	The purchaser’s capacity needs to be sufficiently consolidated to accommodate the increased complexity and workload
Lowering immediate steep price pressure (avoid one winner takes all), which may lead to more sustainable price dynamics over the longer term	The allocation of volume between suppliers needs to be clear and guaranteed
Providing price reductions on all tendered products
Possibly increasing physician’s product choice
The availability of multiple commercial products on the market may help to mitigate supply issues in case shortages would occur