Innovation procurement in health includes several complex processes including, but not limited to, needs identification and assessment, market maturity assessment, supply value chain rearrangement, digital transformation and reorganisation, demand business case definition and suppliers business models alignment, new roles for value chain actors as suppliers, users, consumers, co-creation of solutions regulated by contracts complying with the EU Treaty principles (transparency, open competition, non-discrimination and equal treatment, proportionality and mutual recognition), value generation along the innovation pathway, investors support and risks distribution between the demand and the suppliers. Such issues should be understood and addressed by all participants in the ecosystem to effectively execute innovation while also mitigating inherent risks throughout the innovation pathway. The project addresses the critical needs of public procurers (hospitals, health system and insurers) and the innovation providers (Small and Medium-sized Enterprises (SMEs) and industry) within the healthcare sector through the creation and activation of a sustainable and scalable platform of specialist advisory services on public procurement of innovation. The solution takes as a starting point the individual expertise and know how built up by each of the consortium partners in their work within the healthcare sector, dating back to 2012, which covers distinct perspectives including providing SME support, incubation and acceleration; providing consulting services on the sides of public procurers and innovation SMEs; providing legal expertise on public procurement exercises; providing access to market, access to finance, and fast tracking innovation support services. Based on the diverse set of experiences the consortium partners have garnered in their own spaces, they are uniquely well positioned to join forces and address the existing challenges in bridging fragmentation gaps.

There is a clear gap in the adoption of paediatric healthcare innovations which continues to hinder the access to such innovations. Demand-driven policy instruments offer the possibility to overcome market failures and allow risk sharing between co-owners and investors. These include Public Procurement of Innovation (PPI) and Pre-Commercial Procurement (PCP), Value-Based Procurement (VBP), and Social Impact Bonds (SIBs). Such demand-driven funding instruments have the potential to reduce the adoption gap in paediatric healthcare. However, these innovative funding tools are rarely used to support paediatric innovation adoption. This limited adoption of demand-driven funding tools can be attributed to several barriers which are specific to paediatric healthcare, such as the perceived high-risk and complex nature of bringing paediatric innovations to market, fragmented regulatory pathways and market access, limited market demand (low numbers of patients) and perceived small impact. Additionally, there is poor awareness, knowledge and understanding of demand-driven tools, which results in their underutilisation. The i4KIDS-LEGACY project will create a holistic innovation action plan in paediatrics to ensure optimal implementation and utilisation of demand-driven innovation financing instruments to support the adoption of paediatric innovation in a coordinated manner across Europe. The project will: 1) Identify demand-driven financing instruments and mechanisms for paediatric health. 2) Collect data on the needs and challenges in the adoption of paediatric innovation. 3) Develop working groups to ideate solutions that address the needs and challenges identified. 4) Collaboratively build a European action plan to catalyse the use of demand-driven tools for the adoption of paediatric innovation solutions. 5)Promote cross-border adoption of paediatric innovations using financial instruments.