European buyers are becoming more organized. Hospital groups are banding together to achieve better pricing and value-for-money on high-volume equipment, health technology assessors have expanded their focus to devices, and several European countries use tender systems to select lower-cost providers. All of this impacts medical device firms.
In May 2019, four manufacturers of external fixations bid for a two-year tender offered by the Vestre Viken Hospital Trust in Norway. The bidders included Stryker Corp., Smith & Nephew PLC, and Texas-based Orthofix Medical Inc. The winners, though, were two Istanbul, Turkey-based manufacturers, Response Ortho (acquired in 2018 by Indiana-based orthopediatrics firm WishboneMedical Inc.) and TST Medical Devices.