How three firms captured the market for purchasing tomographs during the war — names of the medical mafiosi

How three firms captured the market for purchasing tomographs during the war — names of the medical mafiosi

For Ukrainian cancer dispensaries, tomographs are being purchased with taxpayers’ money for 44-45 million UAH, while abroad the same equipment can cost an order of magnitude less.

In the spring of 2023, the media noticed the purchase of a tomograph for 44,5 million UAH for the regional oncological dispensary of the Kyiv region from the company LLC "UMT+" of the Haievskyi group, which had already appeared in criminal cases. The story later caused considerable public outcry, and law enforcement opened proceedings on possible embezzlement of budget funds. Who is behind the scandalous purchase, whether tomographs are indeed being bought at inflated prices, and whether a cheaper tomograph could have been purchased with taxpayers’ money — more in the analytical article by StopCor.

Purchase of a tomograph for the regional oncology dispensary

In April 2023 the communal institution of the Kyiv Regional Council "Base of Special Medical Supply" intended to buy a tomograph for the oncology center for 44,5 million hryvnias, of which 20 million was allocated from the regional budget.

The auction was held successfully, the procurement procedure was completed, and on 11 April the customer announced the intention to purchase a single-photon emission computed tomography system from LLC "UMT+."

However, soon investigative journalists noticed the purchase and found that the price of the tomograph may have been inflated by one and a half times.

It turned out that two years earlier the same supplier, LLC "UMT+", had sold the same AnyScan S tomograph manufactured by Mediso Medical Imaging System Ltd for almost twice less — for 23,89 million hryvnias.

Perhaps over two years the price of the same tomograph legitimately changed due to inflation and the depreciation of the hryvnia against foreign currency. And the equipment configuration was probably different.

The regional oncology center itself wanted to buy it from the same LLC "UMT+" back in 2017 for as little as 66,4 million, but ultimately did not find the funds. The head of the Kyiv region oncological dispensary is Alla Areshkovych. She also ran for the Regional Council and was deputy to the head of the regional state administration.

Reaction of oversight and law enforcement agencies

During monitoring, the State Audit Service (auditing service) found a lack of justification for the correspondence between the size of the budget appropriations and the expected cost of the procurement subject. They also revealed another violation: the tender winner LLC "UMT+" did not provide consent to process the company’s personal data, so under the law the tender proposals should have been rejected.

The Antimonopoly Committee checked the procurement but did not find violations.

After the publicity, law enforcement took up the case. According to the Kyiv Regional State Administration, the Bureau of Economic Security of Ukraine is investigating possible embezzlement of funds in this tender. Regarding verification of all facts, the Kyiv Regional State Administration also contacted the SBU.

“We have taken appropriate measures and sent requests for explanations to the municipal enterprises: the CT customer and the one who carried out the procurement. Currently, the Kyiv Regional State Administration has not allocated funds for financing the purchase and will not do so until we have answers to all the questions raised by law enforcement,” Ruslan Kravchenko, head of the Kyiv Regional State Administration, told StopCor.

Main market players

The customer (the communal "Base of Special Medical Supply," hereinafter "the Base"), organizing the purchase of a tomograph for the Kyiv region oncological dispensary, gave businesses less than a week to gather documents and prepare proposals. The tender was held under the procedure — open bidding with specifics.

Only two suppliers managed to enter the tender: LLC "PROTEK SOLUTIONS UKRAINE" and LLC "UMT+", which in recent years have been dividing similar tenders among themselves without much competition.

The tomograph could likely have cost Kyiv region taxpayers less if other participants had entered the auction. This happened, for example, during an auction held a month earlier by the Poltava Regional Oncological Dispensary.

Even then the procurement was not transparent: the winning bidder’s proposal — the now-familiar LLC "PROTEK SOLUTIONS UKRAINE" — did not meet the tender documentation requirements (the file "Technical requirements+tech description (elimination of discrepancies).pdf" was provided after the deadline for submission of proposals). Then the Antimonopoly Committee obliged the Poltava Regional Oncological Dispensary to cancel the decision to name "PROTEK SOLUTIONS UKRAINE" the winner, but the obligation was not fulfilled.

The already mentioned LLC "PROTEK SOLUTIONS UKRAINE" and LLC "UMT+" are major players in the pharmaceutical market. In particular, LLC "PROTEK SOLUTIONS UKRAINE" is favored by the state enterprise "Medical Procurements of Ukraine", which has transferred to the company for goods and services in total over 1 billion 183 million hryvnias. The main actors of "Protek Solutions Ukraine" are Natalia Tuhay and Oleksandr Yezerskyi, who, together with a group of people, manage the company. Meanwhile, the director and official signatory is Andrii Skrypko.

"UMT+" does not lag behind, winning the most expensive tenders. Incidentally, the company "UMT+", which was to deliver a tomograph for over 44 million to the Kyiv region oncological dispensary, is part of businessman Kostiantyn Haievskyi’s group and has already figured in criminal cases regarding price inflation, but continues to operate successfully. The company is led by Yurii Tereshchuk.

In 2022-2023 several other Ukrainian hospitals paid 45 million each for the purchase of the same tomograph, but these procurements went unnoticed.

Are there cheaper tomographs?

Worldwide there are a few popular manufacturers of such tomographs that can be counted on one hand. They are similar in functions but differ in technical specifications. The tender of the Kyiv regional oncology center, journalists believe, was written for two global brands (the very ones supplied by the aforementioned regular tender winners).

There is also a third option from the well-known tomograph manufacturer Siemens, which among popular devices is the cheapest.

Such a model was bought in Dnipro in 2021 for 16,4 million hryvnias. They are supplied to state institutions by LLC "ARTEK MEDICAL GROUP".

Although this company also likely operates not very transparently on Prozorro. In that same cheapest tender from Dnipro Clinical Hospital No. 4, a possible trace of tailoring the documentation for LLC "ARTEK MEDICAL GROUP", which deals with Siemens tomographs, is evident. This is indicated by a complaint to the Antimonopoly Committee from the already-known LLC "UMT+": the company complained about discriminatory requirements in the tender, and the Antimonopoly Committee agreed there were violations.

By the way, LLC "Artek Medical Group" is owned by director Natalya Kurashko and Ruslan Stretovych. According to our colleagues, this company once used the phone number +380504416615, which was also used by the firm "Bureau of National Developments" from businessman Mykola Kuzma’s group. Kuzma once served as an assistant to Serhii Pashynskyi and Raisa Bohatyryova. Suspended from his duties as Minister of Health, Oleh Musii said in 2014 that Mykola Kuzma was part of the Ministry of Health’s tender mafia, and that a group including Mykola Kuzma, Borys Lytovskyi, Petro Bahrii, and Mykhailo Kuchyrko have for decades participated in tenders and divided the medical procurement market among themselves. Lacking special experience in defense, Kuzma, known in the pharma business, also appeared in a scandalous case regarding the purchase of a hundred armored vehicles for half a billion hryvnias for the Ministry of Internal Affairs; NABU conducted searches in his case on embezzlement of budget money for poor-quality equipment at inflated prices. Kuzma himself called himself the ideologist of creating the armored vehicle "Varta."

In any case, a cheaper tomograph exists. So why, given a popular equivalent, do oncology centers buy the more expensive one? Why do such price gaps in medical equipment occur in practice? As the StopCor medical expert explained, it is impossible to assert which tomograph is better without an expert evaluation (which, by the way, law enforcement should now conduct in the course of the opened case) because tomographs can have different technical characteristics:

"You need to look at the technical characteristics, why the tomograph is cheaper. Maybe it lacks navigation, lacks the latest instruments required for modern examinations. You also need to look at how many slices the cheaper tomograph has, how powerful it is, what its throughput is (there are devices that can examine five people per hour, and there are those that can examine only two). And only if the technical characteristics are the same can we ask why buy the same tomograph three times more expensive." — StopCor medical expert

Procurement officers often justify the desire to purchase specific equipment by citing doctors’ requirements, and they can be understood, a StopCor source in medicine explains and gives an example.

"There are surgical scissors by Aesculap. They cost about 500$. They are considered among the best, self-sharpening, fit well in the hand. The company Golf makes similar scissors; such scissors can be bought for 200 euros. They are also good, also titanium, also self-sharpening, but they are different: they make a larger incision, not of the same expert-class quality. And there are third scissors manufactured by our Medtekhnika. They are not worse than the first or second, but a good surgeon will feel the difference. When you are a master, of course you want something better. The same goes for equipment."

The doctor also said that an expensive tomograph cannot, a priori, be bad. The question is different: why does it cost much more in Ukraine? According to our source, unlike new cars, whose prices in Europe and Ukraine are almost the same, the cost of medical equipment differs by two times.

According to journalist Artem Polikovskyi, who has repeatedly investigated patterns of procurement in the medical field, those responsible for allocating funds overpay for medical equipment because they act in their own interests rather than the state’s.

"All procurements in the medical field have been distinguished by their brazenness. Those responsible for procurements believe that if they buy equipment that will benefit patients, people should not interfere with checks. Thus, officials at the highest levels try to enrich themselves on everything they have access to. They pad the procurement price so they can themselves be treated in expensive premium hospitals or vacation abroad." — Artem Polikovskyi, investigative journalist

Who manages the distribution of medical funds?

Since 23 December 2022, the distribution of medical funds in the region has been handled by the communal enterprise of the Kyiv Regional Council "Base of Special Medical Supply" (hereinafter – "the Base"). It organizes all procurements for 18 hospitals of the Kyiv region (except for repairs and small purchases). Initial tender documents are prepared by the hospital, and the Base enters them into the procurement plan and can "recommend" corrections to the tender or unilaterally adjust conditions if the documents contain restrictions on competition or discrimination of participants.

Since 2022, the director of the Base has been Volodymyr Tymofiichuk. Before going into politics he worked as a journalist; in 2019 he became an aide to Oleksandr Kunytskyi. In 2020 Tymofiichuk was elected to the Kyiv Regional Council, where he was part of the construction commission. Six months after Tymofiichuk’s appointment, his enterprise transformed from an ordinary warehouse into one of the most influential in the field. On 23 December the regional council made the "Base of Special Medical Supply" a centralized purchasing organization.

It is through the Base that significant budget funds for procurements with likely inflated prices and nontransparent procedures, according to journalists, pass.

In a comment to StopCor, Kyiv Regional State Administration head Ruslan Kravchenko noted that the regional administration monitors procurements, but not all of them.

"Yes, the internal audit department has the appropriate specialists. However, there are many procurements and a small staff with very low pay."

We intend to obtain comments from the Kyiv region oncological dispensary, the customer — the "Base of Special Medical Supply", the tomograph supplier LLC "UMT+" for 44 and a half million hryvnias, the Bureau of Economic Security of Ukraine, and the State Audit Service.

stopcor.org