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Canada’s healthcare procurement system faced an unprecedented stress test during the COVID-19 pandemic – and it exposed the fragility of our supply chain. When global supply chains collapsed in early 2020, hospitals across Canada found themselves scrambling for critical supplies like masks and ventilators. Pre-pandemic, almost all of our personal protective equipment (PPE) was imported; when the pandemic struck, emergency stockpiles proved inadequate and frontline workers were left unprotected (Waddell, 2024). Though Canadian manufacturers re-tooled to fill the gap – making Canada essentially self-sufficient in key PPE within a year – our outdated procurement processes struggled to adapt (Canadian Association of PPE Manufacturers [CAPPEM], 2021). Even life-saving innovations, such as new diagnostic tools and digital health platforms, encountered barriers to adoption at the very moment they were needed most. In short, COVID-19 was a wake-up call: Canada needs a smarter, faster, and more innovative approach to procuring medical technologies.
The pandemic underscored that Canada’s traditional procurement habits are too slow and inflexible in a crisis. Before COVID-19, timelines for change in healthcare were often discussed in terms of years, not weeks – Canada has historically lagged in adopting innovations like virtual care or value-based care models (Britnell, 2021). Yet during the pandemic, necessity forced rapid transformation: virtual care became the new normal practically overnight. Hospitals stood up new workflows and technologies within days. This contrast revealed that the capacity for quick adoption exists, but our systems typically hold it back.
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The pandemic also spotlighted how siloed and “just-in-time” our supply chains had become. Many Canadian healthcare facilities operated with lean inventories and complex global suppliers – a recipe for disaster when borders closed. The "just-in-time" procurement approach left facilities dangerously vulnerable to disruption (Waddell, 2024). In the scramble for PPE, Canada learned the hard way that relying on lowest-cost foreign suppliers can backfire. A federal review noted that Canada experienced delays in vaccine procurement and depleted reserves of critical equipment in 2020, leading to heavy reliance on other countries for essential medical goods. (Waddell, 2024).
This vulnerability is now compounded by rising geopolitical uncertainty and the potential impact of U.S. tariffs on medical supplies and components. As trade tensions continue, any new tariffs or export restrictions imposed by the United States could threaten Canada's access to key technologies and raw materials. The U.S. remains Canada's largest supplier of medical devices, accounting for over 42% of imports in 2022 – valued at more than US$3.2 billion (U.S. Department of Commerce, 2023). Disruptions to this flow, whether from tariffs or export controls, could significantly affect availability and affordability in Canada. For example, a 25% U.S. tariff on Canadian pharmaceutical exports was projected to cost $750 million in added expenses, a dynamic that could easily extend to other medical goods (Ontario Drug Policy Research Network, 2023). These risks further underscore the need to bolster domestic production and diversify procurement strategies (BLG, 2025).
Smaller companies and startups are often seen as risky choices in public healthcare procurement—but the real risk may lie in sticking with the status quo. According to the Council of Canadian Innovators, large government software projects with budgets over $10 million have a success rate of just 8%, while smaller projects under $1 million succeed 70% of the time (Council of Canadian Innovators, 2024). In other words, leaning on “safe,” big-ticket vendors can backfire—particulartly when flexibility, speed, and innovation are needed most.
Under the current system, adopting a new medical technology in Canada’s health system can be agonizingly slow. A big reason is an ingrained culture of risk aversion and red tape. Health technology assessments and approval protocols in Canada are notoriously lengthy. Even in a best-case scenario, getting a new device from lab to bedside takes over a year, and in practice many devices languish for several years before receiving approval (Wyman, 2022). In one survey of Ontario’s academic hospitals, 76% of respondents said procurement regulations were a “major hurdle” to adopting innovations (Wyman, 2022).
The federal Competition Bureau echoed this concern, warning that drawn-out procurement cycles in a fast-moving tech environment often result in products “becoming outdated before the procurement process is complete” (Competition Bureau, 2022). The prevailing mindset has been to avoid risk at all costs – but in healthcare, avoiding controlled risk can itself be dangerous. Canadian entrepreneurs have noted they sometimes skip Health Canada approval and launch in the U.S. first, obtaining FDA approval as the “gold standard” to ease acceptance elsewhere (Bharti, 2024).
Canada’s health procurement is hampered by layers of complexity – a patchwork of rules and jurisdictions. Healthcare in Canada is decentralized: while funding and standards have federal components, the actual purchasing of equipment and services largely happens at the provincial and hospital levels. This means a company with a great new medical device must navigate multiple provincial systems, each with its own regulations, priorities, and paperwork (Competition Bureau, 2022). As one healthtech founder put it,
"Canadian healthcare can feel federally procured but distributed provincially” (Bharti, 2024).
Procurement rules can also be overly prescriptive. Requests for Proposals (RFPs) often come with strict, unclear requirements that inadvertently box out potential bidders. A small Canadian medtech firm might be discouraged from bidding if the tender is written in a way that favors large, established vendors. Furthermore, government and hospital tenders still tend to reward the lowest upfront price, despite widespread adoption of value based procurement frameworks. While cost-consciousness is understandable in a taxpayer-funded system, an excessive focus on lowest bid ignores long-term value and outcomes (Competition Bureau, 2022). For instance, buying cheaper consumables like patient diapers can increase total costs due to higher replacement rates and staff time (Healthy Debate, 2016).
Another glaring issue is the insufficient involvement of frontline clinicians in purchasing decisions. Procurement staff often make decisions without adequately consulting the physicians and nurses who will be using the equipment. This can lead to choices that don’t align with clinical realities. Clinicians bring a critical perspective on what “quality” means in practice, including usability, integration into workflows, and outcome improvement. Without their input, purchasing defaults to technical specs and price alone (Shiau et al., 2016). During COVID-19, some rapidly procured devices proved unusable or unsuitable, requiring workarounds from clinical staff. To fix this, procurement processes should include clinician input at every stage – from setting requirements to final selection. Their expertise can ensure that technology decisions actually improve care and gain frontline buy-in.
Canada is home to world-class researchers and budding medtech companies, yet our healthcare system has a poor track record of adopting Canadian-made technologies. Public funds often support research and startups, but when it comes time to purchase, homegrown products struggle to compete with large international firms.
" In 2021 alone, Canada spent over $20 billion on imported medical devices" (Waddell, 2024). Meanwhile, local startups struggle to get noticed.
Canadian firms report it is easier to launch in the U.S. than at home, due to fewer procurement hurdles and clearer pathways. During the pandemic, government support helped local companies scale up PPE and ventilator production. However, outdated procurement criteria often continued to favor offshore suppliers, undermining domestic capacity (CAPPEM, 2021).
Some efforts are changing this. The CAN Health Network was created to connect healthcare institutions with Canadian tech companies and help them validate and procure local innovations (CAN Health Network, 2023). Ontario’s 2024 budget also introduced a $12 million Health Technology Accelerator Fund to speed up adoption of new tools from Ontario-based firms (Scott, 2024).
The need to rethink healthcare procurement in Canada is no longer a niche issue – it’s essential for improving care and building a more resilient system. Outdated procurement practices lead to slow innovation uptake, critical supply shortages, and missed opportunities. But each challenge is also a chance to build better.
Faster adoption of innovations, clinician-led purchasing, and partnerships with Canadian tech companies can all help deliver smarter, more responsive healthcare. Policymakers are beginning to respond, but real transformation will require collaboration between hospitals, clinicians, innovators, and governments. Canadians deserve a health system that is as innovative and forward-thinking as they are. Rethinking procurement is a vital step toward that.
Bharti, B. (2024). The procurement problem in Canadian healthtech. BetaKit. https://betakit.com
Britnell, M. (2021). Canada has opportunity to capitalize on virtual healthcare innovation. Business in Vancouver. https://biv.com
BLG. (2025, February). The evolving tariff threat: Impact on medtech and life science industries. https://blg.com
Canadian Association of PPE Manufacturers. (2021, December 14). CAPPEM press release. https://cappem.ca
CAN Health Network. (2023). Bringing Canadian innovation to the health system. https://canhealthnetwork.ca
Competition Bureau of Canada. (2022). Improving health care through pro-competitive procurement policy. https://competitionbureau.gc.ca
Council of Canadian Innovators. (2024). Buying ideas: Procuring public sector innovation in Canada.https://www.canadianinnovators.org/content/buying-ideas-procuring-public-sector-innovation-in-canada
Healthy Debate. (2016, February). Health systems should buy better: the case for value-based procurement. https://healthydebate.ca
Ontario Drug Policy Research Network. (2023). Trade tariffs on Canadian pharmaceuticals. https://odprn.ca
Scott, J. (2024, March). Ontario budget 2024: Funding to healthtech procurement. BetaKit. https://betakit.com
Shiau, G., et al. (2016). Physician involvement in procurement is essential. Canadian Association of Radiologists Journal, 67(2), 85-93.
U.S. Department of Commerce. (2023). Canada - Medical Devices Country Commercial Guide. https://www.trade.gov
Waddell, C. (2024). Exposed: How Canada can close its health security gaps, Public Policy Forum. https://ppforum.ca
Wyman, O. (2022). Medtech and the future: Canada as a global leader in advancing health care and innovation, Balsillie School of International Affairs.
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