In Germany all vaccines go through the standard pricing and reimbursement process since a 2017 law banned the use of tenders for vaccines. The law came after tenders for flu vaccines were introduced in 2011. Bidding suppliers were required to fulfill certain criteria to win tenders, which followed a single winner model. However, in 2014, the model was changed so that two suppliers could win the bid.

In Italy vaccine schedules are set and then tenders are organized by regional health authorities. The regions use similar processes, although there are some differences between them, for example in the number of winners per tender or length of contract.

In Romania, setting the vaccination schedule and procurement in done at a national level through the ministry of health. Decisions are based on price and a pre-qualification of the bidder’s financial standing. Contracts now last for between two and four years.

In Spain autonomous communities can use two mechanisms to select their preferred supplier. Both allow for other differentials beyond price. There is a national level centralized process and a regional level decentralized process, with the former establishing a maximum price for every vaccine. Under the latter system, the autonomous communities set their own frameworks for tendering and there are a range of success criteria combinations beyond price.

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