Keywords: Public Procurement; Centralization; Decentralization; Pharmaceutical Spending.
This paper deals with the open issue about the choice between centralized or decentralized public procurement policy. This is not an easy task since many factors have to be taken into account. We discuss them systematically underling how they act on the two procurement organizational structures of interest. We try to give our contribution to solve this issue, testing which procurement system performs better using tender prices of selected drugs for hospital usage awarded by a sample of 52 Italian public procurers between 2009 and 2012. Controlling for several covariates, we always find that centralized and hybrid systems perform better than decentralized systems.