Promoting Circular Economy Concerns in Medical Device Procurement Through Structured Collaborative Processes

Abstract

ABSTRACT Healthcare systems face rising expenditure and growing scrutiny over their environmental impact, to which single‐use medical devices contribute substantially. Because procurement determines which devices enter clinical use, it is a key lever for addressing both pressures. Yet healthcare procurement remains cost‐driven, with limited guidance on incorporating environmental aspects and reprocessing considerations. Developed through and applied in Portugal's National Health Service, this study develops a novel, generic, case‐driven multimethodology embedding Problem Structuring Methods (specifically cognitive mapping) within a Delphi process to support multiple stakeholders in identifying value aspects beyond unit price. Findings highlight life cycle cost evaluation, waste management costs, reprocessing feasibility, environmental impact and multiple‐use alternatives as central yet underused aspects for implementing circular medical device procurement. This study contributes methodologically by operationalising cognitive mapping within Delphi, empirically by identifying stakeholder‐supported circular procurement aspects, and practically by proposing a Portuguese roadmap for sustainability‐oriented medical device procurement.