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Every year, hospitals and public health services across Europe issue tens of thousands of procurement notices for pharmaceutical products.

Tenderlake actively track the public procurement of over ten thousand individual drugs and their active ingredients, including the native language variations and alternative names and synonyms.

In this article we take a closer look at how those procurements have developed over the years.

Table 1 shows the top 35 active ingredients ranked according to how frequently they appeared in public procurement notices across the EEA, from 2012 to 2019 (22-Nov).

Notice, that Antibiotics not only feature very prominently, but their prominence is increasing. Apart from meropenem, all other antibiotics on the list have increased their ranking over the years.

Table 1: Top 35 active ingredients ranked according to how frequently they appear in European public procurement notices

Active ingredient	Type or usage	2012	2013	2014	2015	2016	2017	2018	2019
paracetamol	Pain relief	3	2	4	2	2	1	1	1
ciprofloxacin	Antibiotic	4	3	3	7	1	2	2	2
metronidazole	Antibiotic	10	9	32	23	5	5	3	3
amoxicillin	Antibiotic	11	12	21	9	3	3	4	4
tramadol	Pain relief	54	35	68	36	9	7	5	5
furosemide	Blod pressure	43	27	86	86	6	17	8	6
diclofenac	Nonsteroidal anti-inflammatory	54	74	110	86	20	33	11	7
lidocaine	Numbing tissue	43	136	138	141	40	9	13	8
dexamethasone	Corticosteroid	54	116	138	36	18	6	18	9
diazepam	Calming (Valium and other)	80	62	110	53	40	32	13	10
fentanyl	Pain relief	80	18	86	77	8	17	16	10
cefuroxime	Antibiotic	15	15	32	36	6	10	7	12
omeprazole	Proton-pump inhibitor	6	9	45	47	24	30	18	13
salbutamol	Asthma treatment	43	116	110	47	47	36	25	14
clindamycin	Antibiotic	17	49	55	53	18	26	36	15
levofloxacin	Antibiotic	43	62	138	53	28	30	33	16
ibuprofen	Nonsteroidal anti-inflammatory	54	74	55	77	65	45	33	17
ampicillin	Antibiotic	30	35	45	53	81	63	27	18
fluconazole	Antifungal	43	42	55	141	28	12	6	18
propofol	Anaesthetic	36	49	38	47	52	16	25	20
hydrocortisone	Hormone cortisol	54	49	138	242	28	13	9	21
meropenem	Antibiotic	1	16	10	13	4	4	33	22
pantoprazole	Stomach ulcer	54	23	38	36	14	36	30	23
vancomycin	Antibiotic	30	27	86	53	12	11	51	24
ketoprofen	nonsteroidal anti-inflammatory	70	89	110	141	89	59	39	25
methylprednisolone	Corticosteroid	70	74	180	86	24	23	21	26
aciclovir	Antiviral	43	62	238	47	40	22	17	27
metoprolol	Blod pressure	54	89	110	86	24	38	20	27
midazolam	Anaesthetic	43	49	63	110	28	26	12	29
sevoflurane	Anaesthetic	9	12	10	9	14	14	22	29
digoxin	Heart medication	92	136	238	375	89	103	42	31
amiodarone	Heart medication	153	266	238	204	73	76	44	32
ceftazidime	Antibiotic	30	23	68	36	20	43	39	33
clavulanic acid	Antibiotic effectiveness	70	35	86	110	52	56	46	34
ceftriaxone	Antibiotic	92	116	68	110	58	53	80	35

Table 2 shows the top 35 active ingredients ranked according to how much mindshare they receive. When buyers procure very common drugs such as those listed in Table 1, they usually bundle many drugs, sometimes thousands, into one single procurement notice.

But when they buy important and expensive drugs, they often buy a very small number of drugs in one procurement exercise. 

When calculating a drug’s mindshare (in a procurement context) we split the attribution of the procurement notice among the number of drugs mentioned in said notice. 

So, if a procurement notice only mentions one drug, the whole notice is attributed to said drug. If five drugs are mentioned in a notice, each drug receives one fifth of the attribution and so forth.

This way we can rank the drugs according the focus they get in the procurement process – a measure of their importance to the buyer.

Therefore Table 2 contains more expensive drugs exclusive to one manufacturer than Table 1.

When Table 2 has a blank entry, it is because there were no procurement notices issued for the drug that year or it can be because it was not available in the EU in the years in question. This can be because it was lower ranked or because, like for example in the case of Pembrolizumab, which received its marketing approval in the EU (under the name Keytruda) in the second half of 2015.

Table 2: Top 35 active ingredients ranked according to their mindshare

Active Ingredient	2012	2013	2014	2015	2016	2017	2018	2019
everolimus	20	16	32	15	10	9	12	1
sirolimus	4	2	3	3	2	2	4	2
chlorhexidine	90	79	80	636	57	31	11	3
adalimumab	2	7	12	23	14	19	3	4
trastuzumab	41	5	38	11	18	16	1	5
sevoflurane	3	3	4	4	7	20	14	6
nusinersen							174	7
mercaptopurine	21	8	43	55	48	14	5	8
rituximab	5	4	10	7	28	3	2	9
infliximab	18	26	2	1	1	1	9	10
paclitaxel	45	44	27	28	32	6	7	11
bortezomib	10	19	49	12	79	78	73	12
interferon beta	1	1	1	2	4	4	8	13
paracetamol	6	6	7	6	12	5	18	14
liraglutide					1107	390	6	15
valsartan	604	527	584		282	35	182	16
aflibercept	308	252	111	25	17	12	15	17
darunavir	147	157	126	387	68	189	42	18
voglibose	26	10	21	46	19	22	13	19
etanercept	12	21	28	5	6	15	10	20
gefitinib	240	48	46	60	42	113	158	21
pegfilgrastim	91	234	44	451	11	36	16	22
natalizumab	55	12	18	56	62	134	83	23
palivizumab	80	35	9	19	39	65	117	24
meropenem	7	53	25	74	15	24	45	25
fulvestrant	203	59	245	39	135	21	63	26
atazanavir	65	427	74	387	46	210	47	27
formoterol	287	72	15	37	30	25	24	28
methotrexate	30	17	101	58	53	41	32	29
dimethyl sulfoxide	42	196	67	250	44	11	17	30
aprepitant	272	150	236	170	359	149	220	31
pembrolizumab					85	58	21	32
nivolumab					147	68	22	33
vancomycin	229	139	143	130	72	37	50	34
propofol	110	38	17	36	78	52	52	35

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