Risks in the procurement of medicines and medical supplies in the Peruvian health sector:a scoping revie

Abstract

Introduction: The procurement of medicines and medical supplies is one of the processes most exposed to regulatory, operational, corruption-related, technological, and financial
risks within public health systems. Objective: To map the risks documented in the literature regarding the procurement of medicines and medical supplies in Peru’s health sector, their
manifestations, and the reported mitigation strategies. Materials and methods: A scoping review was conducted following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) and
the Arksey and O’Malley framework. Searches were performed in PubMed, Scopus, SciELO, Google Scholar, and the institutional repository of OECE/SEACE for the 2015–2025 period,
with the inclusion of selected earlier seminal sources. Results: Of 312 records identified, 36 documents—including scientific articles, technical and institutional reports, and regulatory
documents—met the eligibility criteria and were included. Risks were classified into five categories: budgetary and financial, regulatory, logistical and operational, integrity and corruptionrelated, and technological risks. These categories were compared with the COSO 2013 framework and ISO 31000:2018. Conclusions: Regulatory ambiguity, imminent stock-outs, collusion, procurement splitting, irregular bid steering, and lack of traceability were among the most frequently reported risks in the reviewed documentation. Procurement centralization, market
assessment, and the implementation of internal reporting mechanisms within public institutions were among the most commonly reported mitigation strategies. Risk management
in public-sector procurement requires a comprehensive approach that integrates Peruvian regulations with international risk-management standards. Important gaps in quantitative
evidence were also identified, highlighting the need for independent primary research.