Public Procurement during COVID-19: Balancing Emergency and Efficiency in the Medical Devices Sector

This thesis examines how the COVID-19 crisis affected public procurement in Italy, with a specific focus on medical devices contracts. Using contract-level data from ANAC combined with firm-level financial information from AIDA, the analysis covers the period 2018–2023 and compares procurement patterns before, during, and after the pandemic. The study focuses on procedure choice, competition, contract values, discount rates, and the revenue profile of winning firms. The descriptive evidence shows that procurement activity increased sharply during the COVID period, especially in 2020. The results also indicate that negotiated procedures and direct awards dominated the procurement process throughout the whole period, while open and restricted procedures played a limited role. Competition appears weak across the sample, with low average numbers of admitted bids and bidding firms, and high single-bidder rates. In terms of cost efficiency, open procedures are associated with higher rebate values, while direct awards show much lower discount levels. Firm-level evidence suggests that non-competitive procedures are associated with higher-revenue winning firms. Overall, the findings point to a procurement environment in which flexibility and speed were central, but where competition remained limited. The thesis contributes to the discussion on crisis procurement by showing how emergency conditions affected competition and firm selection in Italian medical devices procurement.