FINANCIAL IMPACT OF BUNDLED CONTRACTS IN HEMODIALYSIS: A TOTAL COST OF OWNERSHIP (TCO) CASE STUDY OF A REGION IN SWEDEN
Author(s)
Aleksandra Kozlova, MSc1, Ellen Busink, MSc1, Jovana Petrovic, MPH1, Carsten Hornig, Dr1, Karin Johansson, RN2, Johan Sundholm, BCs2, Sophie Boeger, MSc1.
1Fresenius Medical Care, Bad Homburg, Germany, 2Fresenius Medical Care, Stockholm, Sweden.
1Fresenius Medical Care, Bad Homburg, Germany, 2Fresenius Medical Care, Stockholm, Sweden.
OBJECTIVES: Hemodialysis involves multiple cost components, e.g. consumables, equipment, maintenance. Managing these costs under separate contracts is complex, time-consuming and unpredictable. The objective of this study was to assess the financial and non-clinical value for a region in Sweden who switched from itemized to bundled tendering by using a Total Cost of Ownership (TCO) methodology.
METHODS: TCO provides a structured framework to capture direct and indirect costs, enabling decision-makers to assess the financial impact of contracting models. A TCO analysis was conducted comparing for the region in Sweden the switch from itemized (individual product category tendering, 2017-2022) to a bundled (single fee per treatment, 2022-now) financial model. Due to the data availability challenges the following assumptions were made 1) average of 55,000 treatments annually and 2) when pricing for certain items was unavailable for some suppliers an average of others were taken.
RESULTS: The TCO analysis demonstrated that the bundled financial model reduced annual costs by approximately 3 million SEK, resulting in projected savings of around 15 million SEK over five years. In addition to direct cost reduction, the bundle model simplifies procurement, improves cost predictability, increases efficiency and builds partnership with one supplier. The analysis showed cost drivers and annual treatment costs, and how switching to a bundled financial model could be a solution for the customer’s budget. It demonstrated that savings on the total treatment cost can be made by switching to the bundle model.
CONCLUSIONS: The TCO assessment demonstrates the financial value of a bundled model, creating a win-win situation for the supplier and region. Bundled financial models lower expenditure while enhancing transparency and administrative efficiency, supporting sustainable dialysis care. This example shows how a Value-Based Procurement approach, starting with a bundled model and TCO assessment, creates partnership and added value.
METHODS: TCO provides a structured framework to capture direct and indirect costs, enabling decision-makers to assess the financial impact of contracting models. A TCO analysis was conducted comparing for the region in Sweden the switch from itemized (individual product category tendering, 2017-2022) to a bundled (single fee per treatment, 2022-now) financial model. Due to the data availability challenges the following assumptions were made 1) average of 55,000 treatments annually and 2) when pricing for certain items was unavailable for some suppliers an average of others were taken.
RESULTS: The TCO analysis demonstrated that the bundled financial model reduced annual costs by approximately 3 million SEK, resulting in projected savings of around 15 million SEK over five years. In addition to direct cost reduction, the bundle model simplifies procurement, improves cost predictability, increases efficiency and builds partnership with one supplier. The analysis showed cost drivers and annual treatment costs, and how switching to a bundled financial model could be a solution for the customer’s budget. It demonstrated that savings on the total treatment cost can be made by switching to the bundle model.
CONCLUSIONS: The TCO assessment demonstrates the financial value of a bundled model, creating a win-win situation for the supplier and region. Bundled financial models lower expenditure while enhancing transparency and administrative efficiency, supporting sustainable dialysis care. This example shows how a Value-Based Procurement approach, starting with a bundled model and TCO assessment, creates partnership and added value.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE132
Topic
Economic Evaluation, Medical Technologies, Organizational Practices
Topic Subcategory
Budget Impact Analysis
Disease
Urinary/Kidney Disorders