PubMed · 2744175
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K A Lopatin. 1989. [The work contract (its features and scope)].. https://pubmed.ncbi.nlm.nih.gov/2744175/
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In November 1994, the Department of Pharmacy at Madigan Army Medical Center and the 62nd Medical Group Logistics (Fort Lewis, Washington) examined the feasibility of prime vendor support for the 18th Mobile Army Surgical Hospital in a Table of Organization and Equipment (TOE) unit rapid deployment. The TOE medication list was deemed to be out of date and a state-of-the-art formulary was developed. By identifying three National Drug Code bioequivalent substitutes for each National Stock Number, a 94% prime vendor match was achieved for pharmaceuticals form the new formulary serving as our template. The 6% of medications that were not able to be matched consisted of items deemed as military-unique or items not covered by the prime vendor government contracts with wholesalers. On August 7, 1995, a trial was conducted to determine whether the local prime vendor had the capacity to support a deployment under its present contract with Madigan Army Medical Center. Two hundred eighty-six line items were ordered, mocking the deployment of two medical units. More than 95% of the line items were filled within 5 days from the local prime vendor. Under the local contract, the prime vendor was under no obligation to have out-of-stock medications provided by overnight shipment from other national distribution sites. This advantage, which is standard in national pharmaceutical prime vendor contracts negotiated by large civilian group purchasing organizations, would have substantially decreased the period of time to attain a > 95% fill. The results of this trial have provided strong support for prime vendor utilization in future deployments.
Contracting to provide technological information (TI) is a significant challenge. TI is an unusual commodity in five ways. (i) TI is difficult to count and value; conventional indicators, such as patients and citations, hardly indicate value. TI is often sold at different prices to different parties. (ii) To value TI, it may be necessary to "give away the secret." This danger, despite nondisclosure agreements, inhibits efforts to market TI. (iii) To prove its value, TI is often bundled into complete products, such as a computer chip or pharmaceutical product. Efficient exchange, by contrast, would involve merely the raw information. (iv) Sellers' superior knowledge about TI's value make buyers wary of overpaying. (v) Inefficient contracts are often designed to secure rents from TI. For example, licensing agreements charge more than marginal cost. These contracting difficulties affect the way TI is produced, encouraging self-reliance. This should be an advantage to large firms. However, small research and development firms spend more per employee than large firms, and nonprofit universities are major producers. Networks of organizational relationships, particularly between universities and industry, are critical in transmitting TI. Implicit barter-money for guidance-is common. Property rights for TI are hard to establish. Patents, quite suitable for better mousetraps, are inadequate for an era when we design better mice. Much TI is not patented, and what is patented sets fuzzy demarcations. New organizational forms are a promising approach to contracting difficulties for TI. Webs of relationships, formal and informal, involving universities, start-up firms, corporate giants, and venture capitalists play a major role in facilitating the production and spread of TI.