Background and Context
For the past eight years, Mexico has grappled with chronic drug shortages. Under President Claudia Sheinbaum’s administration, a megacompra initiative for 2027-2028 has been proposed as a potential solution. This ambitious plan aims to increase the volume of key items and components purchased, integrating modern innovations and therapies to better serve an aging population with a higher prevalence of degenerative diseases.
Who is Claudia Sheinbaum?
Claudia Sheinbaum is the current Head of Government of Mexico City, serving since 2018. As a prominent figure in Mexican politics, she has been instrumental in addressing various challenges faced by the capital city and its residents. Her administration’s focus on healthcare, including this megacompra initiative, underscores her commitment to improving public welfare.
Current Situation and Challenges
Since the cancellation of a planned megacompra for 2025-2026, the current administration has completed over 200 procurement processes for healthcare supplies, primarily through direct adjudications. Only two major tenders have been adjusted to meet actual demand, resulting in unfilled key items and continuous direct adjudications at inflated prices. This proliferation of processes complicates management for both the government and laboratories, which must handle multiple contracts for the same medication or medical device.
In terms of volume, 2025 saw approximately 1.39 billion pieces acquired, a 10% decrease from the nearly 1.5 billion pieces in 2024. This decline is partly attributed to the cancellation of the initial megacompra plan in April of the administration’s first year. During López Obrador’s six-year term, the annual average was around 1.2 billion pieces; currently, there has been improvement, but it remains below the 1.7 billion pieces average of 2017-2018 purchases.
Addressing the Growing Needs
With a population surpassing 130 million and an increase in chronic diseases, Mexico’s healthcare system faces immense pressure. The Consejo de Salubridad General (CSG) has been working to refine the Compendio de Insumos para la Salud (CIS) by excluding outdated keys, totaling around 600 in the last three years (2023-2025). This process is positive for updating the catalog, eliminating unutilized or non-manufactured items. However, hospitals like IMSS, ISSSTE, and IMSS Bienestar continue to request keys that have already been excluded, indicating ongoing descoordination.
The Proposed Megacompra for 2027-2028
According to the Instituto Farmacéutico INEFAM, the proposed 2027-2028 megacompra introduces encouraging novelties. It includes numerous new keys, not always strictly innovative but rather existing molecules now entering the public sector with updated formulations or concentrations. This fosters innovation, though not at the desired pace. Key examples include:
- Dolutegravir with Lamivudina (Key 7026): An HIV antiretroviral with projected purchases of 3.5 million pieces and a value exceeding 10,000 million pesos.
- Dapagliflozin (Key 6007): A high-specialty, high-cost therapy that aids in improving glucose index in type 2 diabetes. Securing this purchase would help the government better manage patient care.
The estimated total budget for the 2027-2028 megacompra surpasses 480,000 million pesos ($410,000 for medications and the rest for devices), equivalent to over $200,000 million annually, excluding vaccines. For 2026, the projected budget for these purchases is approximately $150,000 million for medications and $61,000 for devices, totaling nearly $211,000 million.
Overcoming Hurdles
Securing the necessary funds and negotiating aggressive prices will be crucial for success. With a growing population and increasing demands, this megacompra could be a turning point, but only if communication and logistical issues are resolved to finally address the drug shortages affecting Mexico’s public health for nearly eight years.
Key Questions and Answers
- What is the megacompra initiative? It’s a large-scale procurement plan by President Claudia Sheinbaum’s administration to tackle chronic drug shortages in Mexico by increasing the volume of essential items and incorporating modern therapies.
- Why is this initiative important? It aims to better serve an aging population with a higher prevalence of degenerative diseases and foster innovation in healthcare.
- What challenges does the initiative face? The plan must overcome chronic inefficiencies in coordination and execution, ensuring that funds and logistics effectively resolve the ongoing drug shortages affecting millions of Mexicans.
- What are the projected costs and volumes for the 2027-2028 megacompra? The estimated total budget is over 480,000 million pesos ($410,000 for medications and the rest for devices), equivalent to more than $200,000 million annually, excluding vaccines. The target volume is around 1.8 billion pieces per year, recovering historical maximum levels with a greater emphasis on innovation.
